Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.123581
Lukas Andereggen , Angelo Tortora
An unusual case of a patient with bilateral carotid artery dissection caused by compression from elongated styloid processes is presented. The diagnosis was overlooked 8 years earlier. Eagle syndrome, marked by an elongated styloid process, can result in cervical artery dissection, highlighting the significance of recognizing this correlation in recurrent cases, which occur more frequently than idiopathic internal carotid artery dissections.
{"title":"Recurrent Internal Carotid Artery Dissection Due to Missed Diagnosis of Eagle Syndrome","authors":"Lukas Andereggen , Angelo Tortora","doi":"10.1016/j.wneu.2024.123581","DOIUrl":"10.1016/j.wneu.2024.123581","url":null,"abstract":"<div><div>An unusual case of a patient with bilateral carotid artery dissection caused by compression from elongated styloid processes is presented. The diagnosis was overlooked 8 years earlier. Eagle syndrome, marked by an elongated styloid process, can result in cervical artery dissection, highlighting the significance of recognizing this correlation in recurrent cases, which occur more frequently than idiopathic internal carotid artery dissections.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123581"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.123582
Yohannes Ghenbot , Joshua Golubovsky , Hasan S. Ahmad , John D. Arena , Gabrielle Santangelo , Connor Wathen , Rahwa Ghenbot , Mert Marcel Dagli , Daksh Chauhan , Emily Ling-Lin Pai , Jang W. Yoon
Bony metastases frequently involve the spinal column, most commonly the thoracic spine.1 Surgical interventions in spinal metastatic disease are palliative and effective in providing diagnoses, reducing pain, and maintaining ambulatory function through neural element decompression and improving axial pain and posture through spinal column stabilization. Surgeons must weigh the benefits of surgery against fragility and limited life expectancy in patients with cancer.2,3 Minimally invasive techniques such as tubular and endoscopic approaches modulate preoperative risk profiles by disrupting less tissue, which may hasten time for postoperative recovery and time to radiation and systemic therapy for disease control.4,5 Advancements in surgical technique and technology have expanded endoscopic indications in spinal oncology. Indications have evolved from biopsy and hybrid open minimally invasive surgery approaches to fully endoscopic separation surgery and gross total resection of nonmetastatic tumors.6, 7, 8, 9, 10 In the case presented in Video 1, we used a biportal endoscopic technique to separate an unstable T12 retropulsed burst fracture from the ventral thoracic spinal cord. The biportal endoscopic technique allowed use of standard instruments for partial corpectomy such as osteotomes, rongeurs, and drills assisted by endoscopic visualization. Minimally invasive surgery percutaneous instrumentation was performed to stabilize the spinal column. Postoperative imaging showed improved spinal alignment and adequate spinal canal decompression, which allowed the patient to be discharged on postoperative day 4 without wound complications and undergo stereotactic body radiation therapy. The patient consented to this procedure, and identifiable individuals consented to publication of their image.
{"title":"Technical Feasibility and Safety of Transpedicular Thoracic Partial Corpectomy Using Biportal Endoscopic Technique: A Novel Approach for Separation Surgery in Spinal Metastatic Disease","authors":"Yohannes Ghenbot , Joshua Golubovsky , Hasan S. Ahmad , John D. Arena , Gabrielle Santangelo , Connor Wathen , Rahwa Ghenbot , Mert Marcel Dagli , Daksh Chauhan , Emily Ling-Lin Pai , Jang W. Yoon","doi":"10.1016/j.wneu.2024.123582","DOIUrl":"10.1016/j.wneu.2024.123582","url":null,"abstract":"<div><div>Bony metastases frequently involve the spinal column, most commonly the thoracic spine.<span><span><sup>1</sup></span></span> Surgical interventions in spinal metastatic disease are palliative and effective in providing diagnoses, reducing pain, and maintaining ambulatory function through neural element decompression and improving axial pain and posture through spinal column stabilization. Surgeons must weigh the benefits of surgery against fragility and limited life expectancy in patients with cancer.<span><span><sup>2</sup></span></span><sup>,</sup><span><span><sup>3</sup></span></span> Minimally invasive techniques such as tubular and endoscopic approaches modulate preoperative risk profiles by disrupting less tissue, which may hasten time for postoperative recovery and time to radiation and systemic therapy for disease control.<span><span><sup>4</sup></span></span><sup>,</sup><span><span><sup>5</sup></span></span> Advancements in surgical technique and technology have expanded endoscopic indications in spinal oncology. Indications have evolved from biopsy and hybrid open minimally invasive surgery approaches to fully endoscopic separation surgery and gross total resection of nonmetastatic tumors.<span><span>6</span></span>, <span><span>7</span></span>, <span><span>8</span></span>, <span><span>9</span></span>, <span><span>10</span></span> In the case presented in <span><span>Video 1</span></span>, we used a biportal endoscopic technique to separate an unstable T12 retropulsed burst fracture from the ventral thoracic spinal cord. The biportal endoscopic technique allowed use of standard instruments for partial corpectomy such as osteotomes, rongeurs, and drills assisted by endoscopic visualization. Minimally invasive surgery percutaneous instrumentation was performed to stabilize the spinal column. Postoperative imaging showed improved spinal alignment and adequate spinal canal decompression, which allowed the patient to be discharged on postoperative day 4 without wound complications and undergo stereotactic body radiation therapy. The patient consented to this procedure, and identifiable individuals consented to publication of their image.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123582"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.123597
Jie Liu , Ge Huang , Jing Zhang , Tian-Kang Yi , Shen-Yu Li , Guang-Sheng Zhu , Xin-Hua Tian , Qing-Chun Mu , Zhong Liu
Objective
This study aims to elucidate the anatomical principles governing the surrounding venous structures (VS) of the horizontal part of the third segment of the vertebral artery (V3h) and develop a safe and bloodless surgical technique for exposing V3h.
Methods
This study used 10 formalin-infused cadaveric head specimens. The dissections were performed stepwise to simulate the far lateral approach process, exposing the V3h with a novel technique. Additionally, we applied this technique to 10 patients undergoing far or extreme lateral approaches.
Results
The VS surrounding V3h is divided into 3 components: the vertebral venous plexus, suboccipital cavernous sinus, and the anastomotic vein. The posterior atlanto-occipital membrane (PAOM), a resilient fascial layer in the craniovertebral junction, extends from the periosteum of the occipital squama to the posterior arch of the atlas. It adheres ventrally to the VS within the suboccipital triangle (SOT), forming a tent-like structure that maintains tension and ensures fullness of the VS around V3h. We discovered that by releasing tension in this membrane and reducing strain on this tent-like structure, the collapse of the venous sinus within the SOT can be achieved, resulting in reduced intraoperative bleeding and improved surgical efficiency. Additionally, we successfully managed 10 clinical cases employing the PAOM tension release technique in clinical cases, with no reported incidents of intraoperative vertebral artery injury.
Conclusions
The application of the PAOM tension release technique effectively collapses the tent-like structure within the SOT, significantly reducing bleeding during V3h exposure in craniovertebral junction.
{"title":"The Application of the Posterior Atlanto-Occipital Membrane Tension Release Technique for Surgical Exposure of the Horizontal Part of the Vertebral Artery's Third Segment: An Anatomical and Clinical Investigation","authors":"Jie Liu , Ge Huang , Jing Zhang , Tian-Kang Yi , Shen-Yu Li , Guang-Sheng Zhu , Xin-Hua Tian , Qing-Chun Mu , Zhong Liu","doi":"10.1016/j.wneu.2024.123597","DOIUrl":"10.1016/j.wneu.2024.123597","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to elucidate the anatomical principles governing the surrounding venous structures (VS) of the horizontal part of the third segment of the vertebral artery (V3h) and develop a safe and bloodless surgical technique for exposing V3h.</div></div><div><h3>Methods</h3><div>This study used 10 formalin-infused cadaveric head specimens. The dissections were performed stepwise to simulate the far lateral approach process, exposing the V3h with a novel technique. Additionally, we applied this technique to 10 patients undergoing far or extreme lateral approaches.</div></div><div><h3>Results</h3><div>The VS surrounding V3h is divided into 3 components: the vertebral venous plexus, suboccipital cavernous sinus, and the anastomotic vein. The posterior atlanto-occipital membrane (PAOM), a resilient fascial layer in the craniovertebral junction, extends from the periosteum of the occipital squama to the posterior arch of the atlas. It adheres ventrally to the VS within the suboccipital triangle (SOT), forming a tent-like structure that maintains tension and ensures fullness of the VS around V3h. We discovered that by releasing tension in this membrane and reducing strain on this tent-like structure, the collapse of the venous sinus within the SOT can be achieved, resulting in reduced intraoperative bleeding and improved surgical efficiency. Additionally, we successfully managed 10 clinical cases employing the PAOM tension release technique in clinical cases, with no reported incidents of intraoperative vertebral artery injury.</div></div><div><h3>Conclusions</h3><div>The application of the PAOM tension release technique effectively collapses the tent-like structure within the SOT, significantly reducing bleeding during V3h exposure in craniovertebral junction.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123597"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.123628
Aref Nassar , Joy Naba , Joe Demian
Background
Burr holes can lead to cranial defects that result in cosmetic and functional issues. Effective reconstruction of these burr holes is crucial for improving patient outcomes, yet there is no consensus on the optimal techniques and materials. This systematic review critically evaluates the efficacy and safety of various materials used in neurosurgical practice for burr hole reconstruction.
Methods
A comprehensive literature search was performed across PubMed, Medline (via Ovid), Embase, and the Cochrane Library, targeting studies published from January 2000 onwards. The quality of the included studies was systematically assessed, and data pertaining to the types of reconstruction materials, clinical outcomes, and complication rates was extracted.
Results
Seventeen studies met the inclusion criteria. The materials employed in burr hole reconstruction were categorized into biological and synthetic groups. Biological materials, such as autologous bone grafts and bone dust, demonstrated varying degrees of integration and resorption, with cortical bone grafts showing superior results. Synthetic materials were assessed for their safety, complication profiles, and esthetic outcomes. Titanium covers were associated with the lowest rates of skin depression. However, the overall quality of evidence was constrained by the heterogeneity in study designs, the brief follow-up periods, and a reliance on subjective outcome measures.
Conclusions
Burr hole reconstruction is essential for enhancing esthetic outcomes and patient satisfaction post-trephination. Autologous bone grafts, particularly cortical grafts, demonstrate superior integration, while synthetic materials offer viable alternatives with low complication rates. Future research should focus on long-term outcomes and the implementation of standardized, objective evaluation methods.
{"title":"Burr Hole Reconstruction Techniques: A Systematic Review of Materials and Outcomes","authors":"Aref Nassar , Joy Naba , Joe Demian","doi":"10.1016/j.wneu.2024.123628","DOIUrl":"10.1016/j.wneu.2024.123628","url":null,"abstract":"<div><h3>Background</h3><div>Burr holes can lead to cranial defects that result in cosmetic and functional issues. Effective reconstruction of these burr holes is crucial for improving patient outcomes, yet there is no consensus on the optimal techniques and materials. This systematic review critically evaluates the efficacy and safety of various materials used in neurosurgical practice for burr hole reconstruction.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across PubMed, Medline (via Ovid), Embase, and the Cochrane Library, targeting studies published from January 2000 onwards. The quality of the included studies was systematically assessed, and data pertaining to the types of reconstruction materials, clinical outcomes, and complication rates was extracted.</div></div><div><h3>Results</h3><div>Seventeen studies met the inclusion criteria. The materials employed in burr hole reconstruction were categorized into biological and synthetic groups. Biological materials, such as autologous bone grafts and bone dust, demonstrated varying degrees of integration and resorption, with cortical bone grafts showing superior results. Synthetic materials were assessed for their safety, complication profiles, and esthetic outcomes. Titanium covers were associated with the lowest rates of skin depression. However, the overall quality of evidence was constrained by the heterogeneity in study designs, the brief follow-up periods, and a reliance on subjective outcome measures.</div></div><div><h3>Conclusions</h3><div>Burr hole reconstruction is essential for enhancing esthetic outcomes and patient satisfaction post-trephination. Autologous bone grafts, particularly cortical grafts, demonstrate superior integration, while synthetic materials offer viable alternatives with low complication rates. Future research should focus on long-term outcomes and the implementation of standardized, objective evaluation methods.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123628"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.11.118
Erica Antunes Effgen , Luis Ángel Canache Jiménez , Érico Samuel Gomes Galvão da Trindade , Mariano Teyssandier , Sebastian Juan Maria Giovannini , Francisco José Luis de Sousa , Talita Helena Martins Sarti , Feres Chaddad-Neto
Arteriovenous malformations (AVMs) consist of multiple connections between arteries and veins without a capillary bed and are characterized by an early draining vein.1,2 This pathology affects mainly young adults, and the morbimortality is caused mostly by rupture and hemorrhage.3, 4, 5, 6 In this Video 1, we present a case of a 29-year-old female patient presenting with a sudden severe headache. Magnetic resonance imaging demonstrated the presence of a left AVM located at the fusiform gyrus, above the tentorium cerebelli, and angiography depicted those temporal branches of the left middle cerebral artery and posterior lateral choroidal arteries irrigated the AVM. In contrast, the main venous drainage was to the transverse sinus. The patient was submitted for microsurgical treatment, and the technique involved the resection of the inferior temporal gyrus to reach the fusiform gyrus and, hence, the AVM. The inferior temporal gyrus is part of both the lateral surface and the basal surface of the brain.7,8 Since the inferior temporal gyrus does not contain the main white matter tracts,7,8 such as the sagittal stratum, its resection represents a surgical strategy to reach the fusiform and the lateral occipitotemporal gyri and their pathologies. The patient consented to the procedure and to the publication of their image. In addition, the study was accepted by the ethics committee. The patient evolved without complications or deficits.
{"title":"Application of the Technique of Inferior Temporal Gyrus Resection for Microsurgical Treatment of Arteriovenous Malformation of the Fusiform Gyrus","authors":"Erica Antunes Effgen , Luis Ángel Canache Jiménez , Érico Samuel Gomes Galvão da Trindade , Mariano Teyssandier , Sebastian Juan Maria Giovannini , Francisco José Luis de Sousa , Talita Helena Martins Sarti , Feres Chaddad-Neto","doi":"10.1016/j.wneu.2024.11.118","DOIUrl":"10.1016/j.wneu.2024.11.118","url":null,"abstract":"<div><div>Arteriovenous malformations (AVMs) consist of multiple connections between arteries and veins without a capillary bed and are characterized by an early draining vein.<span><span><sup>1</sup></span></span><sup>,</sup><span><span><sup>2</sup></span></span> This pathology affects mainly young adults, and the morbimortality is caused mostly by rupture and hemorrhage.<span><span>3</span></span>, <span><span>4</span></span>, <span><span>5</span></span>, <span><span>6</span></span> In this <span><span>Video 1</span></span>, we present a case of a 29-year-old female patient presenting with a sudden severe headache. Magnetic resonance imaging demonstrated the presence of a left AVM located at the fusiform gyrus, above the tentorium cerebelli, and angiography depicted those temporal branches of the left middle cerebral artery and posterior lateral choroidal arteries irrigated the AVM. In contrast, the main venous drainage was to the transverse sinus. The patient was submitted for microsurgical treatment, and the technique involved the resection of the inferior temporal gyrus to reach the fusiform gyrus and, hence, the AVM. The inferior temporal gyrus is part of both the lateral surface and the basal surface of the brain.<span><span><sup>7</sup></span></span><sup>,</sup><span><span><sup>8</sup></span></span> Since the inferior temporal gyrus does not contain the main white matter tracts,<span><span><sup>7</sup></span></span><sup>,</sup><span><span><sup>8</sup></span></span> such as the sagittal stratum, its resection represents a surgical strategy to reach the fusiform and the lateral occipitotemporal gyri and their pathologies. The patient consented to the procedure and to the publication of their image. In addition, the study was accepted by the ethics committee. The patient evolved without complications or deficits.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123535"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.11.050
Jose A. Moran-Guerrero , Hector R. Martínez , David G. Gonzalez-Sanchez , Luis E. Perez-Martinez , Rogelio E. Flores-Salcido , Ana S. Ferrigno , Enrique Caro-Osorio , Misael Salazar-Alejo , Pablo J. Avalos-Montes , Jose A. Figueroa-Sanchez
{"title":"In Reply to the Letter to the Editor Regarding “Backup Frontal Drainage System for Urgent Tension Pneumocephalus Management After Chronic Subdural Hematoma Surgery: A Retrospective Cohort Study”","authors":"Jose A. Moran-Guerrero , Hector R. Martínez , David G. Gonzalez-Sanchez , Luis E. Perez-Martinez , Rogelio E. Flores-Salcido , Ana S. Ferrigno , Enrique Caro-Osorio , Misael Salazar-Alejo , Pablo J. Avalos-Montes , Jose A. Figueroa-Sanchez","doi":"10.1016/j.wneu.2024.11.050","DOIUrl":"10.1016/j.wneu.2024.11.050","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123467"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.11.110
Angel Bueno-Alvarez , Ankush Chandra , Manish K. Aghi
{"title":"In Reply to the Letter to the Editor Regarding: “The Path to U.S. Neurosurgical Residency for Foreign Medical Graduates: Trends from a Decade 2007-2017”","authors":"Angel Bueno-Alvarez , Ankush Chandra , Manish K. Aghi","doi":"10.1016/j.wneu.2024.11.110","DOIUrl":"10.1016/j.wneu.2024.11.110","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123527"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.123566
Hiba Mushtaq, Jaweria Musharraf
{"title":"Letter to the Editor Regarding: \"Effectiveness of a Sellar Reconstruction Algorithm in Transsphenoidal Pituitary Surgery: Insights from 490 Cases\"","authors":"Hiba Mushtaq, Jaweria Musharraf","doi":"10.1016/j.wneu.2024.123566","DOIUrl":"10.1016/j.wneu.2024.123566","url":null,"abstract":"","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123566"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.10.095
Tuan Anh Pham , Cuong Minh Luong , Phuong Duy Dao , Nghia Thanh Vo , Tai Ngoc Tran , Thuy Anh Diem Nguyen
Objective
This study investigates the correlation among craniometric measurements, skull morphology, and subthalamic nucleus (STN) target coordinates in DBS surgery.
Methods
We conducted a retrospective study of 77 Parkinson disease patients who underwent bilateral STN-DBS surgery at Nguyen Tri Phuong Hospital and University Medical Center in Ho Chi Minh City, Vietnam. Craniometric measurements and STN target coordinates were analyzed using Pearson correlation and multivariate linear regression. The coordinates of the STN were compared between 2 hemispheres in the same patient, based on skull morphology indices, including the Cephalic Index and the Cranial Vault Asymmetry Index.
Results
Significant gender-based differences were observed in craniometric measurements, with males exhibiting larger dimensions. STN coordinates demonstrated correlations with various cranial measurements, notably with X-coordinates correlating most strongly with horizontal arc and third ventricle width (r = 0.4 and r = 0.42, respectively). The linear regression equation: X (mm) = 0.967 + 0.202∗ Third ventricle width (mm) + 0.024∗Horizontal arc (mm) with R2 = 0.32. Skull morphology revealed potential asymmetries affecting STN coordinates.
Conclusions
Craniometric measurements and third ventricle width correlate significantly with STN coordinates, particularly the X-coordinates. Our study highlights the importance of individualized craniometric considerations in DBS surgery planning to optimize electrode placement and therapeutic outcomes.
{"title":"How Do Craniometric Measurements and Skull Morphology Influence Subthalamic Nucleus Target Coordinations in Deep Brain Stimulation Surgery for Parkinson Disease?","authors":"Tuan Anh Pham , Cuong Minh Luong , Phuong Duy Dao , Nghia Thanh Vo , Tai Ngoc Tran , Thuy Anh Diem Nguyen","doi":"10.1016/j.wneu.2024.10.095","DOIUrl":"10.1016/j.wneu.2024.10.095","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigates the correlation among craniometric measurements, skull morphology, and subthalamic nucleus (STN) target coordinates in DBS surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 77 Parkinson disease patients who underwent bilateral STN-DBS surgery at Nguyen Tri Phuong Hospital and University Medical Center in Ho Chi Minh City, Vietnam. Craniometric measurements and STN target coordinates were analyzed using Pearson correlation and multivariate linear regression. The coordinates of the STN were compared between 2 hemispheres in the same patient, based on skull morphology indices, including the Cephalic Index and the Cranial Vault Asymmetry Index.</div></div><div><h3>Results</h3><div>Significant gender-based differences were observed in craniometric measurements, with males exhibiting larger dimensions. STN coordinates demonstrated correlations with various cranial measurements, notably with X-coordinates correlating most strongly with horizontal arc and third ventricle width (r = 0.4 and r = 0.42, respectively). The linear regression equation: X (mm) = 0.967 + 0.202∗ Third ventricle width (mm) + 0.024∗Horizontal arc (mm) with R2 = 0.32. Skull morphology revealed potential asymmetries affecting STN coordinates.</div></div><div><h3>Conclusions</h3><div>Craniometric measurements and third ventricle width correlate significantly with STN coordinates, particularly the X-coordinates. Our study highlights the importance of individualized craniometric considerations in DBS surgery planning to optimize electrode placement and therapeutic outcomes.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123366"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.wneu.2024.10.096
Justin N. Passman , Nathaniel A. Cleri , Jermaine Robertson , Jordan R. Saadon , Claire Polizu , Xuwen Zheng , Vaibhav Vagal , Sima Mofakham , Charles B. Mikell
Objective
Individuals with psychiatric illnesses (PIs) have increased rates of traumatic brain injury (TBI). Nonetheless, the influence of underlying PI on TBI outcomes is poorly understood.
Methods
We analyzed the medical records of 633 adult-severe TBI patients admitted to our institution between 2010 and 2021. We identified patients with premorbid PI (Psych (+) group, n = 129) and a subset with only a substance use disorder (SUD (+) group, n = 60) and compared them to patients without PI (Psych (−) group, n = 480). Outcome measures included discharge Glasgow Coma Scale (GCS), length of stay, in-hospital survival, and Glasgow Outcome Scale-Extended (GOS-E).
Results
The Psych (+) group had increased in-hospital survival (69.8% vs. 55.0%, P = 0.003) and fewer patients with severe (3–8) discharge-GCS (28.7% vs. 46.0%, P < 0.001). The SUD (+) group had increased in-hospital survival (70.0% vs. 55.0%, P = 0.028) and fewer patients with severe discharge-GCS (28.3% vs. 46.0%, P = 0.009). However, the Psych (+) (21.0 vs. 10.0 days, P < 0.001) and SUD (+) (16.0 v. 10.0 days, P = 0.011) groups had longer length of stay. The Psych (+) group had a higher mean GOS-E at discharge (2.7 vs. 2.4, P = 0.004), 6-months (3.8 vs. 3.0, P = 0.006) and 1-year (3.4 vs. 2.3, P = 0.027). The SUD (+) group also had a higher mean GOS-E at discharge (2.8 vs. 2.4, P = 0.034), six months (3.8 vs. 3.0, P = 0.035), and one year (3.5 vs. 2.3, P = 0.008). Additionally, there were no significant differences in injury severity or computed tomography scan findings.
Conclusions
Individuals with PI and SUD appeared to have better outcomes but more complicated hospital stays following severe TBI. Future studies should investigate the mechanisms underlying these outcomes.
目的：患有精神疾病（PI）的人发生创伤性脑损伤（TBI）的几率更高。然而，人们对潜在精神疾病对创伤性脑损伤结果的影响知之甚少：我们分析了本院在 2010-2021 年间收治的 633 名成年重度 TBI（sTBI）患者的病历。我们确定了有病前 PI 的患者（Psych(+)组，n=129）和仅有药物使用障碍的患者（SUD(+)组，n=60），并将他们与无 PI 的患者（Psych(-)组，n=480）进行了比较。结果测量包括出院时的格拉斯哥昏迷量表（GCS）、住院时间（LOS）、院内存活率和格拉斯哥结果量表扩展版（GOS-E）：结果：Psych(+)组的院内存活率更高（69.8% 对 55.0%，P=0.003），出院 GCS 重度（3-8）患者更少（28.7% 对 46.0%，P=0.003）：有 PI 和 SUD 的患者在 sTBI 后似乎有更好的预后，但住院时间更长。未来的研究应调查这些结果的内在机制。
{"title":"Severe Traumatic Brain Injury Outcomes in Patients with Premorbid Psychiatric Illness","authors":"Justin N. Passman , Nathaniel A. Cleri , Jermaine Robertson , Jordan R. Saadon , Claire Polizu , Xuwen Zheng , Vaibhav Vagal , Sima Mofakham , Charles B. Mikell","doi":"10.1016/j.wneu.2024.10.096","DOIUrl":"10.1016/j.wneu.2024.10.096","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals with psychiatric illnesses (PIs) have increased rates of traumatic brain injury (TBI). Nonetheless, the influence of underlying PI on TBI outcomes is poorly understood.</div></div><div><h3>Methods</h3><div>We analyzed the medical records of 633 adult-severe TBI patients admitted to our institution between 2010 and 2021. We identified patients with premorbid PI (Psych (+) group, n = 129) and a subset with only a substance use disorder (SUD (+) group, n = 60) and compared them to patients without PI (Psych (−) group, n = 480). Outcome measures included discharge Glasgow Coma Scale (GCS), length of stay, in-hospital survival, and Glasgow Outcome Scale-Extended (GOS-E).</div></div><div><h3>Results</h3><div>The Psych (+) group had increased in-hospital survival (69.8% vs. 55.0%, <em>P</em> = 0.003) and fewer patients with severe (3–8) discharge-GCS (28.7% vs. 46.0%, <em>P</em> < 0.001). The SUD (+) group had increased in-hospital survival (70.0% vs. 55.0%, <em>P</em> = 0.028) and fewer patients with severe discharge-GCS (28.3% vs. 46.0%, <em>P</em> = 0.009). However, the Psych (+) (21.0 vs. 10.0 days, <em>P</em> < 0.001) and SUD (+) (16.0 v. 10.0 days, <em>P</em> = 0.011) groups had longer length of stay. The Psych (+) group had a higher mean GOS-E at discharge (2.7 vs. 2.4, <em>P</em> = 0.004), 6-months (3.8 vs. 3.0, <em>P</em> = 0.006) and 1-year (3.4 vs. 2.3, <em>P</em> = 0.027). The SUD (+) group also had a higher mean GOS-E at discharge (2.8 vs. 2.4, <em>P</em> = 0.034), six months (3.8 vs. 3.0, <em>P</em> = 0.035), and one year (3.5 vs. 2.3, <em>P</em> = 0.008). Additionally, there were no significant differences in injury severity or computed tomography scan findings.</div></div><div><h3>Conclusions</h3><div>Individuals with PI and SUD appeared to have better outcomes but more complicated hospital stays following severe TBI. Future studies should investigate the mechanisms underlying these outcomes.</div></div>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":"194 ","pages":"Article 123367"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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