Pub Date : 2026-02-11DOI: 10.1007/s10143-025-04109-5
Tedy Apriawan, Alivery Raihanada Armando, Indri Lakhsmi Putri, Gunna Hutomo Putra, Citrawati Dyah Kencono Wungu, Surya Pratama Brilliantika, Muhammad Fadhil Kamaruddin, Muhammad Tidar Abiyu Amiruddin, Muhammad Hasan Al Banna
{"title":"Emerging microsurgical techniques for facial nerve reconstruction in traumatic skull base fractures: a systematic review and comprehensive evidence analysis.","authors":"Tedy Apriawan, Alivery Raihanada Armando, Indri Lakhsmi Putri, Gunna Hutomo Putra, Citrawati Dyah Kencono Wungu, Surya Pratama Brilliantika, Muhammad Fadhil Kamaruddin, Muhammad Tidar Abiyu Amiruddin, Muhammad Hasan Al Banna","doi":"10.1007/s10143-025-04109-5","DOIUrl":"https://doi.org/10.1007/s10143-025-04109-5","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"218"},"PeriodicalIF":2.5,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-10DOI: 10.1007/s10143-026-04158-4
Md Sohanur Rahman, Muhammad Mohsin Khan, Cathal John Hannan, Bipin Chaurasia, Noman Shah, Airton Leonardo de Oliveira Manoel, Ghaya Al Rumaihi, Ghanem Al Sulaiti, Shona Pederson, Micheal Lawton, Nazmin Ahmed, Muhammad E H Chowdhury, Jawad Yousaf
{"title":"Interpretable machine learning model for predicting rupture risk in anterior communicating artery aneurysms.","authors":"Md Sohanur Rahman, Muhammad Mohsin Khan, Cathal John Hannan, Bipin Chaurasia, Noman Shah, Airton Leonardo de Oliveira Manoel, Ghaya Al Rumaihi, Ghanem Al Sulaiti, Shona Pederson, Micheal Lawton, Nazmin Ahmed, Muhammad E H Chowdhury, Jawad Yousaf","doi":"10.1007/s10143-026-04158-4","DOIUrl":"https://doi.org/10.1007/s10143-026-04158-4","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"216"},"PeriodicalIF":2.5,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical practices in decompressive hemicraniectomy for malignant middle cerebral artery infarction with hemorrhagic transformation: results from an international survey.","authors":"Beate Kranawetter, Tammam Abboud, Veit Rohde, Silvia Hernández-Durán","doi":"10.1007/s10143-026-04157-5","DOIUrl":"https://doi.org/10.1007/s10143-026-04157-5","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"215"},"PeriodicalIF":2.5,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-09DOI: 10.1007/s10143-025-04031-w
Albert Gabriel Turpo-Peqqueña, Lucia Fernanda Del Carpio-Velásquez, Francisco Martins Lamas, Victoria Elena Quispe-Pastor, Karen Veronica Quintanilla-Apaza, Diego Fernando Muñoz-Cervantes, Mayra Alejandra Quispe-Díaz, Pierina Valeria Bermejo-Rosado, Ariana Solange Rodriguez-Valenzuela, Josue Rodrigo Turpo-Peqqueña, Évrard Pérès, Juan Pedro Murillo Gutierrez, Julian Alejandro Rivillas, Richard Hernández Mayori
<p><p>Moyamoya disease is a rare progressive cerebral vasculopathy characterized by narrowing or occlusion of the internal carotid arteries, leading to the formation of fragile collateral vessels and a high risk of ischemic events, especially in pediatric patients. Although direct revascularization techniques are commonly used, they are technically challenging in children due to vascular fragility and anatomy. Indirect revascularization techniques favor the formation of new blood vessels through alternative flow routes. Their efficacy is usually assessed using the Matsushima scale, which measures the degree of revascularization achieved. This study aims to describe postoperative angiographic outcomes of indirect revascularization techniques in pediatric patients with Moyamoya disease. A systematic review and meta-analysis was performed following PRISMA guidelines, searching six databases (PubMed, Embase, Scopus, Web of Science, CENTRAL and Google Scholar) for observational studies that evaluated indirect revascularization techniques in pediatric patients with Moyamoya disease. Seventeen studies comprising 1360 hemispheres were included. Primary outcomes were the proportions of angiographic revascularization according to grades A, B, and C of the Matsushima scale. Secondary outcomes included postoperative clinical complications such as stroke, transient ischemic attacks (TIAs), seizures, bleeding, mortality, and functional status assessed using the modified Rankin scale (mRS ≤2). Meta-analyses were performed with random-effects models in R (version 4.2.3) and risk of bias was assessed with the MINORS tool. Meta-regression was applied to explore possible predictors of outcomes. The certainty of evidence was assessed with the GRADE approach. The combined proportions of hemispheres achieving Matsushima grades A, B and C were 47.1% (95% CI: 38.4-55.9; I<sup>2</sup> = 84.4%), 38.2% (95% CI: 32.0-44.9; I<sup>2</sup> = 84.4%) and 12.3% (95% CI: 9.3-16.0; I<sup>2</sup> = 47.0%), respectively. Postoperative complications were low: stroke 8.3%, TIA 7.2%, seizures 2.5%, bleeding 2.7% and mortality 0.8%. Good functional status (mRS ≤2) was achieved in 82.1% of patients. Meta-regression revealed that unilateral vs. bilateral procedures significantly predicted Matsushima grade B outcomes (p = 0.002). The risk of bias was low to moderate. The certainty of evidence was generally low to moderate, except for mortality which showed high certainty. Indirect revascularization techniques in pediatric Moyamoya show favorable angiographic and clinical results, with low complications and high functional independence. According to the Matsushima scale, about 47% of the hemispheres achieved grade A, 38% grade B and 12% grade C. Pial synangiosis and EDAMS were more effective in grade A, whereas EDAS showed a lower proportion in grade A and slightly more in grade C. Postoperative complications were low and most patients achieved good functional status (mRS ≤2). These findings
{"title":"Angiographic outcomes after indirect revascularization in pediatric Moyamoya disease: a systematic review and Meta-analysis.","authors":"Albert Gabriel Turpo-Peqqueña, Lucia Fernanda Del Carpio-Velásquez, Francisco Martins Lamas, Victoria Elena Quispe-Pastor, Karen Veronica Quintanilla-Apaza, Diego Fernando Muñoz-Cervantes, Mayra Alejandra Quispe-Díaz, Pierina Valeria Bermejo-Rosado, Ariana Solange Rodriguez-Valenzuela, Josue Rodrigo Turpo-Peqqueña, Évrard Pérès, Juan Pedro Murillo Gutierrez, Julian Alejandro Rivillas, Richard Hernández Mayori","doi":"10.1007/s10143-025-04031-w","DOIUrl":"https://doi.org/10.1007/s10143-025-04031-w","url":null,"abstract":"<p><p>Moyamoya disease is a rare progressive cerebral vasculopathy characterized by narrowing or occlusion of the internal carotid arteries, leading to the formation of fragile collateral vessels and a high risk of ischemic events, especially in pediatric patients. Although direct revascularization techniques are commonly used, they are technically challenging in children due to vascular fragility and anatomy. Indirect revascularization techniques favor the formation of new blood vessels through alternative flow routes. Their efficacy is usually assessed using the Matsushima scale, which measures the degree of revascularization achieved. This study aims to describe postoperative angiographic outcomes of indirect revascularization techniques in pediatric patients with Moyamoya disease. A systematic review and meta-analysis was performed following PRISMA guidelines, searching six databases (PubMed, Embase, Scopus, Web of Science, CENTRAL and Google Scholar) for observational studies that evaluated indirect revascularization techniques in pediatric patients with Moyamoya disease. Seventeen studies comprising 1360 hemispheres were included. Primary outcomes were the proportions of angiographic revascularization according to grades A, B, and C of the Matsushima scale. Secondary outcomes included postoperative clinical complications such as stroke, transient ischemic attacks (TIAs), seizures, bleeding, mortality, and functional status assessed using the modified Rankin scale (mRS ≤2). Meta-analyses were performed with random-effects models in R (version 4.2.3) and risk of bias was assessed with the MINORS tool. Meta-regression was applied to explore possible predictors of outcomes. The certainty of evidence was assessed with the GRADE approach. The combined proportions of hemispheres achieving Matsushima grades A, B and C were 47.1% (95% CI: 38.4-55.9; I<sup>2</sup> = 84.4%), 38.2% (95% CI: 32.0-44.9; I<sup>2</sup> = 84.4%) and 12.3% (95% CI: 9.3-16.0; I<sup>2</sup> = 47.0%), respectively. Postoperative complications were low: stroke 8.3%, TIA 7.2%, seizures 2.5%, bleeding 2.7% and mortality 0.8%. Good functional status (mRS ≤2) was achieved in 82.1% of patients. Meta-regression revealed that unilateral vs. bilateral procedures significantly predicted Matsushima grade B outcomes (p = 0.002). The risk of bias was low to moderate. The certainty of evidence was generally low to moderate, except for mortality which showed high certainty. Indirect revascularization techniques in pediatric Moyamoya show favorable angiographic and clinical results, with low complications and high functional independence. According to the Matsushima scale, about 47% of the hemispheres achieved grade A, 38% grade B and 12% grade C. Pial synangiosis and EDAMS were more effective in grade A, whereas EDAS showed a lower proportion in grade A and slightly more in grade C. Postoperative complications were low and most patients achieved good functional status (mRS ≤2). These findings","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"211"},"PeriodicalIF":2.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-09DOI: 10.1007/s10143-025-04111-x
Jiamin Mou, Xiaoshu Wang, Qin Yin, Yi Liu, Hongfan Lu, Xiaochuan Sun, Gang Yang
{"title":"In-situ bone flap combined with a nasoseptal flap or a free mucosa flap for skull base reconstruction after endoscopic resection of craniopharyngiomas: A series of 115 cases.","authors":"Jiamin Mou, Xiaoshu Wang, Qin Yin, Yi Liu, Hongfan Lu, Xiaochuan Sun, Gang Yang","doi":"10.1007/s10143-025-04111-x","DOIUrl":"10.1007/s10143-025-04111-x","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"212"},"PeriodicalIF":2.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-09DOI: 10.1007/s10143-025-04096-7
Paolo Ferroli, Edoardo Maria Barbieri, Francesco Restelli, Morgan Broggi, Leonardo Maresca, Luca Mattioli, Riccardo Ciocca, Erica Boccardi, Michela Moretti, Isabella Canavero, Valentina Caldiera, Giuseppe Ganci, Elisa Ciceri, Francesco Acerbi, Marco Schiariti
{"title":"Unruptured anterior communicating artery aneurysms surgery: preservation of an old-fashioned, but ever-precious craft.","authors":"Paolo Ferroli, Edoardo Maria Barbieri, Francesco Restelli, Morgan Broggi, Leonardo Maresca, Luca Mattioli, Riccardo Ciocca, Erica Boccardi, Michela Moretti, Isabella Canavero, Valentina Caldiera, Giuseppe Ganci, Elisa Ciceri, Francesco Acerbi, Marco Schiariti","doi":"10.1007/s10143-025-04096-7","DOIUrl":"https://doi.org/10.1007/s10143-025-04096-7","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"209"},"PeriodicalIF":2.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-09DOI: 10.1007/s10143-026-04156-6
Yufang Wang, Yan Li, Lei Shi, Jingchao Li, Mingli Yao, Bin Ouyang
Cerebral cavernous malformations (CCMs) are vascular lesions in the brain, presenting risks of intracerebral hemorrhage (ICH) and non-hemorrhagic focal neurological deficit (NH-FND). Currently, no effective medical therapy exists for CCMs, and treatment options limited to surgical resection and stereotactic radiosurgery. Beta-blockers, particularly propranolol, have shown promise in treating similar vascular conditions and may have therapeutic potential for CCMs. We conducted a systematic search of PubMed, Web of Science, EMBASE, Cochrane Central, and ClinicalTrials.gov (March 2024) for randomized clinical trials (RCTs) and cohort studies comparing neurological outcomes in adult patients with CCMs treated with beta-blockers versus controls. Meta-analysis was performed using Review Manager 5.4. The primary outcomes were the incidence of new-onset ICH and NH-FND attributable to CCMs. Five studies (1 RCT and 4 cohort studies; n = 1,553 participants) met the inclusion criteria. Beta-blocker exposure was associated with significantly lower odds of new-onset ICH or NH-FND attributable to CCMs (OR 0.52; 95% CI 0.35-0.77; p = 0.001), with low heterogeneity (I² = 35%). Subgroup analysis showed a reduced incidence of new ICH alone (OR 0.60; 95% CI 0.39-0.91; p = 0.02). In propranolol-specific analyses, the reduction in the primary outcome was not statistically significant (OR 0.33; 95% CI 0.08-1.38; p = 0.13). Beta-blocker therapy was associated with improved neurological outcomes in patients with CCMs, with a significant reduction in the risk of new-onset ICH and NH-FND. However, propranolol alone did not demonstrate a statistically significant benefit, potentially due to subtherapeutic dosing and adverse effects. The evidence suggests other beta-blockers may also be beneficial, but further research is needed to clarify their roles and optimal regimen.
脑海绵状血管瘤（CCMs）是大脑中的血管病变，具有脑出血（ICH）和非出血性局灶性神经功能缺损（NH-FND）的风险。目前，没有有效的药物治疗CCMs，治疗选择仅限于手术切除和立体定向放射手术。-受体阻滞剂，特别是心得安，已显示出治疗类似血管疾病的希望，并可能对CCMs有治疗潜力。我们对PubMed、Web of Science、EMBASE、Cochrane Central和ClinicalTrials.gov（2024年3月）进行了系统检索，以比较接受β受体阻滞剂治疗的成年CCMs患者与对照组的神经系统预后的随机临床试验（rct）和队列研究。meta分析使用Review Manager 5.4进行。主要结局是由CCMs引起的新发ICH和NH-FND的发生率。5项研究（1项RCT和4项队列研究，n = 1553名受试者）符合纳入标准。β受体阻滞剂暴露与CCMs导致的新发ICH或NH-FND的发生率显著降低相关（or 0.52; 95% CI 0.35-0.77; p = 0.001），异质性低（I²= 35%）。亚组分析显示单独新发脑出血发生率降低（OR 0.60; 95% CI 0.39-0.91; p = 0.02）。在普萘洛尔特异性分析中，主要结局的降低无统计学意义（OR 0.33; 95% CI 0.08-1.38; p = 0.13）。受体阻滞剂治疗可改善CCMs患者的神经预后，显著降低新发ICH和NH-FND的风险。然而，单独使用心得安并没有显示出统计学上显著的益处，这可能是由于亚治疗剂量和不良反应。有证据表明，其他β受体阻滞剂也可能是有益的，但需要进一步的研究来阐明它们的作用和最佳方案。
{"title":"Beta-blockers improve neurological outcomes of cerebral cavernous malformations: a systematic review.","authors":"Yufang Wang, Yan Li, Lei Shi, Jingchao Li, Mingli Yao, Bin Ouyang","doi":"10.1007/s10143-026-04156-6","DOIUrl":"https://doi.org/10.1007/s10143-026-04156-6","url":null,"abstract":"<p><p>Cerebral cavernous malformations (CCMs) are vascular lesions in the brain, presenting risks of intracerebral hemorrhage (ICH) and non-hemorrhagic focal neurological deficit (NH-FND). Currently, no effective medical therapy exists for CCMs, and treatment options limited to surgical resection and stereotactic radiosurgery. Beta-blockers, particularly propranolol, have shown promise in treating similar vascular conditions and may have therapeutic potential for CCMs. We conducted a systematic search of PubMed, Web of Science, EMBASE, Cochrane Central, and ClinicalTrials.gov (March 2024) for randomized clinical trials (RCTs) and cohort studies comparing neurological outcomes in adult patients with CCMs treated with beta-blockers versus controls. Meta-analysis was performed using Review Manager 5.4. The primary outcomes were the incidence of new-onset ICH and NH-FND attributable to CCMs. Five studies (1 RCT and 4 cohort studies; n = 1,553 participants) met the inclusion criteria. Beta-blocker exposure was associated with significantly lower odds of new-onset ICH or NH-FND attributable to CCMs (OR 0.52; 95% CI 0.35-0.77; p = 0.001), with low heterogeneity (I² = 35%). Subgroup analysis showed a reduced incidence of new ICH alone (OR 0.60; 95% CI 0.39-0.91; p = 0.02). In propranolol-specific analyses, the reduction in the primary outcome was not statistically significant (OR 0.33; 95% CI 0.08-1.38; p = 0.13). Beta-blocker therapy was associated with improved neurological outcomes in patients with CCMs, with a significant reduction in the risk of new-onset ICH and NH-FND. However, propranolol alone did not demonstrate a statistically significant benefit, potentially due to subtherapeutic dosing and adverse effects. The evidence suggests other beta-blockers may also be beneficial, but further research is needed to clarify their roles and optimal regimen.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"49 1","pages":"214"},"PeriodicalIF":2.5,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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