World Neurosurgery: X最新文献

{"title":"Delivery management and related complications in pregnant women with brain arteriovenous malformation: A systematic review","authors":"Mahdi Arjipour ,&nbsp;Mohammadamin Rezaei ,&nbsp;Soheil Abdollahi Yeganeh ,&nbsp;Mohammadmahdi Sabahi ,&nbsp;Amin Doosti Irani ,&nbsp;Scott Y. Rahimi","doi":"10.1016/j.wnsx.2025.100551","DOIUrl":"10.1016/j.wnsx.2025.100551","url":null,"abstract":"<div><h3>Objective</h3><div>Brain arteriovenous malformation (BAVM) is a rare condition. Regarding considerable risk of hemorrhage and subsequent complications, pregnant women with BAVMs are classified as high-risk patients. The aim of this review is to evaluate different aspects of BAVM during pregnancy leading to an appropriate comparison of delivery methods in those patients.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria, reviewing 784 articles between 1974 and 2024. Articles were selected by searching the MEDLINE, Embase, Scopus, Web of Science, and Cochrane electronic bibliographic databases. 18 papers were included for systematic review. Outcome results were discussed via Glasgow Outcome Scale and Apgar score.</div></div><div><h3>Results</h3><div>Out of 171 patients with age reference of 27–31 (25th-75th percentile) and median of 28, cesarean section (CS), normal vaginal delivery (NVD) and abortion were reported in 75, 55, and 26 patients, respectively. The status of delivery in three patients was not reported. Most patients had headaches while nausea, vomiting, and dizziness were also reported as other symptoms. Newborns had similar stable condition after birth in both groups. Maternal postpartum and postprocedural status was good except for 6 maternal deaths.</div></div><div><h3>Conclusion</h3><div>Based on available data there is no demonstration of a clear difference between CS or NVD in clinically stable patients. While, in cases of instability, CS is preferred to minimize the complications. Conclusively, delivery plan should be individualized for each patient, considering both neurosurgical and obstetric conditions for optimal outcome.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"29 ","pages":"Article 100551"},"PeriodicalIF":2.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervertebral disc degeneration and stroke: A bidirectional two-sample Mendelian randomization study","authors":"Yifan Wang ,&nbsp;Rong Zhou ,&nbsp;Shaoting Nan ,&nbsp;Yanlong Duan ,&nbsp;Lei Cao ,&nbsp;Shenglong Guo","doi":"10.1016/j.wnsx.2025.100535","DOIUrl":"10.1016/j.wnsx.2025.100535","url":null,"abstract":"<div><h3>Background</h3><div>Although previous studies suggest a possible association between intervertebral disc degeneration (IVDD) and stroke, the causal relationship between them remains unclear.</div></div><div><h3>Methods</h3><div>Genetic instrumental variables for IVDD were obtained from the FinnGen database; data for stroke, ischemic stroke (IS), and Intracerebral hemorrhage (ICH) were sourced from the MEGASTROKE consortium. All genome-wide association study (GWAS) datasets were accessed through the IEU online database. The inverse-variance weighted (IVW) method was used as the primary analysis approach, incorporating a rigorous framework, including bidirectional Mendelian randomization and various sensitivity analyses to avoid potential confounding biases.</div></div><div><h3>Results</h3><div>The MR analysis revealed a positive causal relationship between IVDD and stroke(OR = 1.168, 95 %CI: [1.033, 1.320], <em>p</em> = 0.01). Additionally, IVDD was found to increase the risk of IS (IVW: OR = 1.171, 95 %CI: [1.025, 1.337], <em>p</em> = 0.02). Reverse analysis showed no causal relationship between stroke and IVDD risk. Heterogeneity, pleiotropy, and statistical power analyses confirmed the robustness of these findings.</div></div><div><h3>Conclusion</h3><div>There is a causal relationship between IVDD and stroke. These findings suggest that IVDD may be a risk factor for stroke. Therefore, interventions and treatments targeting IVDD could potentially reduce the incidence and mortality rates of stroke.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100535"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrodiagnostic signatures of lower-limb nerve dysfunction in children with spina bifida: A retrospective case-control study","authors":"Ting-Jie I ,&nbsp;Yu-Cheng Chou ,&nbsp;Chia-Man Chou ,&nbsp;Jimmy, Chun-Ming Fu","doi":"10.1016/j.wnsx.2025.100547","DOIUrl":"10.1016/j.wnsx.2025.100547","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral‐nerve abnormalities contribute to lower-limb disability in children diagnosed with spina bifida, yet paediatric, norm-referenced electrodiagnostic data are scarce. This study characterized lower-limb nerve-conduction deviations in this population.</div></div><div><h3>Methods</h3><div>We performed a single-centre retrospective case–control review of lower-limb nerve-conduction studies (NCS) performed between January 2019 and January 2024. Sixteen children with clinically or image-confirmed spina bifida met the inclusion criteria. Distal latency, conduction velocity and amplitude of the common peroneal, tibial and sural nerves were all recorded using the American Clinical Neurophysiology Society guidelines. Values were compared with age-matched paediatric norms via Wilcoxon signed-rank testing (<em>α</em> = 0.05).</div></div><div><h3>Results</h3><div>A total of 16 patients were included. Peroneal compound muscle-action-potential (CMAP) amplitudes were significantly reduced bilaterally versus norms (median difference right − 1.9 mV, <em>p</em> = 0.003; left − 1.7 mV, <em>p</em> = 0.001), whereas distal latency and velocity were preserved. Sural nerves exhibited prolonged distal latency on both sides (right −1.0 ms, <em>p</em> = 0.001; left −1.01 ms, <em>p</em> = 0.01) without any amplitude or velocity change. No significant differences were observed in any tibial nerve parameters. All subjects generated recordable motor and sensory responses.</div></div><div><h3>Conclusions</h3><div>Children diagnosed with spina bifida demonstrate a characteristic electrodiagnostic profile—attenuated peroneal CMAP combined with isolated sural latency prolongation—suggesting distal axonal loss and focal demyelination of selected lower-extremity nerves. However, the cross-sectional design and lack of functional assessment limit the prognostic value of the characteristics. Future research focused on the correlation of longitudinal NCS parameters and functional outcomes should be warranted.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100547"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grading the damage: Prognostic significance of diffuse axonal injury severity and hemorrhagic lesions in traumatic brain injury outcomes","authors":"Nanci Estefanía Bayas-Almeida ,&nbsp;Fabricio González-Andrade","doi":"10.1016/j.wnsx.2025.100539","DOIUrl":"10.1016/j.wnsx.2025.100539","url":null,"abstract":"<div><h3>Background</h3><div>Diffuse axonal injury (DAI) is a key determinant of prognosis in traumatic brain injury (TBI), yet the interaction between DAI severity and associated hemorrhagic lesions is not well defined, especially in low- and middle-income countries (LMICs).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 283 adults with moderate-to-severe TBI admitted to a tertiary hospital in Ecuador (2019–2023). DAI severity was graded anatomically using CT or MRI, and patients were stratified by the presence of hemorrhagic lesions. Demographic, clinical, metabolic, and radiological variables were collected. Outcomes were evaluated at 6 months with the Glasgow Outcome Scale–Extended (GOS-E). Logistic and ordinal regression models identified predictors of mortality and disability.</div></div><div><h3>Results</h3><div>Of 283 patients, 141 had isolated DAI and 142 had DAI with hemorrhage. Baseline demographics were similar. Patients with hemorrhagic lesions had lower median Glasgow Coma Scale scores (6 vs 9, <em>p</em> &lt; 0.001), more frequent hyperglycemia (15.5 % vs 7.1 %, <em>p</em> = 0.045), and greater surgical needs (77.5 % vs 16.3 %, <em>p</em> &lt; 0.001). Complications, including pneumonia and central nervous system infections, were more frequent in the hemorrhagic group (63.9 % vs 45.7 %, <em>p</em> &lt; 0.001). At 6 months, functional outcomes were significantly worse with hemorrhage (median GOS-E 7 vs 8, <em>p</em> &lt; 0.001). Multivariable regression identified Grade III DAI as the strongest predictor of mortality (OR 20.02, 95 % CI 7.99–50.15) and disability (OR 71.59, 95 % CI 23.11–221.77). Hemorrhagic lesions predicted poor functional recovery (OR 2.08, 95 % CI 1.24–3.48) but not mortality.</div></div><div><h3>Conclusions</h3><div>DAI grading is the most powerful prognostic factor in severe TBI, while hemorrhagic lesions primarily worsen disability. In LMICs, CT-based assessment remains essential for prognostic stratification and guiding rehabilitation strategies.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100539"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of pre-stroke physical activity on the initial volume and growth of the brain infarct and the rate of recanalization: A post-hoc analysis of the rescue brain trial","authors":"B. Douma ,&nbsp;M. Ferrigno ,&nbsp;E. Drumez ,&nbsp;B. Lapergue ,&nbsp;C. Rosso ,&nbsp;E. Meseguer ,&nbsp;M.L. Chadenat ,&nbsp;M. Obadia ,&nbsp;C. Hirel ,&nbsp;D.L. Duong ,&nbsp;C. Cordonnier ,&nbsp;P. Amarenco ,&nbsp;F. Pico","doi":"10.1016/j.wnsx.2025.100534","DOIUrl":"10.1016/j.wnsx.2025.100534","url":null,"abstract":"<div><h3>Background</h3><div>– Pre-stroke physical activity is known to influence stroke severity and long-term outcomes. However, its effects on infarct volume and vascular recanalization remain unclear. Using data from the RESCUE BRAIN trial, we aimed to determine whether the beneficial effects of physical activity before stroke are associated with smaller infarct volumes at presentation, reduced infarct growth over 24 h, and/or increased rates of arterial recanalization.</div></div><div><h3>Methods</h3><div><em>–</em> This study is a post-hoc analysis of the RESCUE BRAIN trial, a multicenter, randomized, open-label, controlled trial. Patients for whom information on activity habits was available at the time of randomization were included in this analysis. Hierarchical ascendant clustering was used to define physical activity clusters based on intensity (none, walking, walking and sports), frequency (0, 1, 1–3, &gt;3 times per week), and duration (0, &lt;30, 30–60, &gt;60 min). We examined the associations between physical activity clusters and baseline infarct volume and change in infarct volume over 24 h, site of arterial occlusion, and successful recanalization (including intravenous thrombolysis and mechanical thrombectomy).</div></div><div><h3>Results</h3><div><em>–</em> A total of 151 patients (mean ± standard deviation age 66.3 ± 15.9 years; 47.0 % male) were included. Patients with high levels of pre-stroke physical activity were younger and had a lower prevalence of hypertension (<em>p</em> = 0.02) and atrial fibrillation (<em>p</em> = 0.03). At baseline, infarct volume was unexpectedly larger in the walking and sports cluster (<em>p</em> = 0.01), but there was no significant difference between the three physical activity groups regarding the change in infarct volume at 24 h. We also found no evidence of a difference in baseline cerebral artery occlusion or recanalization rates.</div></div><div><h3>Conclusion</h3><div><em>–</em> This study suggests that pre-stroke physical activity does not affect the change in infarct volume or recanalization rates, despite its impact on the initial infarct size. These findings may suggest that the effects of physical activity may not operate through reducing infarcts volume or improving reperfusion, but rather through other mechanisms.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100534"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145320241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additive manufacturing for neurosurgical training: Development of patient-specific intracranial aneurysm flexible biomodels","authors":"Lorena Maria Dering ,&nbsp;Eduardo Burkot Hungria ,&nbsp;Jorge Luis Novak Filho ,&nbsp;Matheus Kahakura Franco Pedro ,&nbsp;André Giacomelli Leal ,&nbsp;Mauren Abreu de Souza","doi":"10.1016/j.wnsx.2025.100538","DOIUrl":"10.1016/j.wnsx.2025.100538","url":null,"abstract":"<div><h3>Background</h3><div>Additive manufacturing (AM) technologies have revolutionized the fabrication of three-dimensional objects by sequentially adding material layers based on digital representations. In addition to the production of medical equipment and implants, AM can reproduce precise anatomical models for the visualization of organs and structures, called 3D biomodels. The use of biomodels has the advantages of reducing costs, facilitating communication between doctor and patient, and is also a useful tool for simulation and surgical training.</div></div><div><h3>Methods</h3><div>Five rotational angiography exams of patients with aneurysms were selected. Based on these images, the modeling and 3D printing of biomodels of flexible aneurysms were customized, each model was evaluated based on manufacturing methodology, morphological fidelity compared to digital models, and usability in surgical training.</div></div><div><h3>Results</h3><div>Five IA biomodels, malleable and hollow, were obtained. On average, the production time was 176 min, with an average material cost of US$0.60. In their morphometric analysis, conducted using Geomagic Wrap® software, the biomodels did not demonstrate significant differences in relation to the three-dimensional image of the exam. In the software metrics, the differences between the printed aneurysms and their digital model did not exceed 0.57 mm. The surgical simulation with the biomodels performed by neurosurgeons still in-training and experienced neurosurgeons were positive, validating their use for resident training.</div></div><div><h3>Conclusions</h3><div>The 3D intracranial aneurysm biomodels, produced with flexible resin by 3D printing, demonstrate potential as valuable educational tools for training new professionals in clinical settings.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100538"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgery outcomes for intradural extramedullary tumors: a systematic review and meta-analysis","authors":"Ahmer Nasir Baig ,&nbsp;Tabinda Tahir ,&nbsp;Mohammad Hamza Bajwa ,&nbsp;Faiza Urooj ,&nbsp;Aimen Tameezuddin ,&nbsp;Saqib Kamran Bakhshi ,&nbsp;Muhammad Shahzad Shamim","doi":"10.1016/j.wnsx.2025.100544","DOIUrl":"10.1016/j.wnsx.2025.100544","url":null,"abstract":"<div><h3>Introduction</h3><div>Traditionally, spinal intradural-extramedullary (ID-EM) tumors have been accessed via open surgery which involves significant tissue dissection, prolonged time of surgery and painful recovery. Advanced techniques of minimally invasive surgery (MIS) aim to reduce these risks and complications while achieving similar goals of surgery.</div></div><div><h3>Objectives</h3><div>To evaluate and compare surgical, functional, and complication-related outcomes in patients with ID-EM spine tumors receiving surgery through open approaches and MIS.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines and registered under PROSPERO (#CRD42022302574), a systematic literature search was conducted across PubMed, EBSCO, and the Cochrane Library. Eligible studies included retrospective cohorts and case series that provided comparative data on MIS and open surgical approaches for IDEM tumor excision. Meta-analysis utilized the Mantel-Haenszel random-effects model for pooled data.</div></div><div><h3>Results</h3><div>We reviewed 426 articles and included 16 for qualitative and quantitative analysis. On meta-analysis, a total of 804 patients (372 MIS and 432 open surgery) were included. MIS showed a significant reduction in operative time, intraoperative blood loss, and length of hospital stay. Gross total resection rates were comparable between the two approaches. MIS also resulted in fewer postoperative complications, including cerebrospinal fluid leaks and the need for spinal fusion.</div></div><div><h3>Conclusion</h3><div>MIS for IDEM tumors provides surgical and recovery benefits compared to traditional open surgery, including shorter operative times, reduced blood loss, and fewer postoperative complications. Although both methods achieve similar tumor resection rates, MIS is linked to enhanced patient outcomes and shorter hospital stays, underscoring its role as a viable alternative in managing IDEM tumors. Future research should aim to optimize MIS techniques to improve patient safety and outcomes further.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100544"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular management of arterial-encasing meningiomas: A case report and review of treatment strategies","authors":"Mario Benvenutti-Regato ,&nbsp;Hannia M. Macias-Cruz ,&nbsp;Hector R. Martínez ,&nbsp;Carlos D. Acevedo-Castillo ,&nbsp;Omar R. Ortega-Ruiz ,&nbsp;Uriel A. Bautista-Coronado ,&nbsp;Jose A. Moran-Guerrero ,&nbsp;Rogelio E. Flores-Salcido ,&nbsp;Misael Salazar-Alejo ,&nbsp;Jose A. Figueroa-Sanchez","doi":"10.1016/j.wnsx.2025.100533","DOIUrl":"10.1016/j.wnsx.2025.100533","url":null,"abstract":"<div><h3>Introduction</h3><div>Skull base meningiomas pose significant surgical challenges due to their proximity to and encasement of critical neurovascular structures, particularly the internal carotid artery (ICA). While surgical resection remains the standard of care, complete excision may be limited by the risk of vascular injury. Endovascular approaches such as stenting and angioplasty have emerged as potential adjuncts to mitigate ischemic complications.</div></div><div><h3>Methods</h3><div>A review using Scopus, Medline, and Web of Science was conducted according to PRISMA guidelines to evaluate the use of endovascular stenting and angioplasty in patients with intracranial meningiomas encasing arteries. Inclusion criteria targeted cases with symptomatic encasement treated with endovascular procedures.</div></div><div><h3>Results</h3><div>Among 114 studies, three patients presented with skull base meningiomas involving the ICA, with symptoms including hemiparesis, aphasia, proptosis, and visual deficits. Endovascular strategies included: (1) ICA stenting for high-grade stenosis with favorable long-term patency; (2) preoperative angioplasty to reduce perioperative ischemic risk; and (3) postoperative stenting for vasospasm due to vessel kinking. Additionally, we report the case of a 71-year-old woman with a meningioma encasing the ICA, managed with endovascular stenting and radiotherapy. No ischemic events or tumor progression were observed at 12-month follow-up.</div></div><div><h3>Discussion</h3><div>The reviewed cases highlight the potential of endovascular strategies to maintain vascular integrity and prevent ischemia in tumors with arterial encasement. This strategy may reduce intraoperative complications and expand resection options. Current evidence is limited to isolated reports, underscoring the need for prospective studies to validate efficacy and safety.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100533"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum pentraxin-3 and plaque burden predict unexplained early neurological deterioration in branch atheromatous disease","authors":"Zhiyong Cao ,&nbsp;Xiaoming Guo ,&nbsp;Mei Ding ,&nbsp;Zhuo Chen ,&nbsp;Lei Wang ,&nbsp;Qi Fang","doi":"10.1016/j.wnsx.2025.100530","DOIUrl":"10.1016/j.wnsx.2025.100530","url":null,"abstract":"<div><h3>Objective</h3><div>Pentraxin-3 (PTX-3), an inflammatory biomarker, is associated with atherosclerosis-related cerebral infarction. Plaque burden is a known predictor of poor prognosis in cerebral infarction. This study aimed to determine whether serum PTX-3 levels and plaque burden are independent risk factors for unexplained early neurological deterioration (END) in patients with branch atheromatous disease (BAD).</div></div><div><h3>Methods</h3><div>This prospective observational cohort study included 289 consecutive BAD patients. END was evaluated within 72 h after acute ischemic stroke onset. Univariate and multivariate regression analyses were used to assess the relationships between PTX-3, plaque burden, and END. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive performance of PTX-3, plaque burden, and their combination for unexplained END.</div></div><div><h3>Results</h3><div>Among the 289 patients, 82 (28.4 %) developed END. END was associated with higher PTX-3, oxLDL, and LDL levels; older age; hypertension; higher NIHSS scores after END; and greater plaque burden. After adjusting for confounders, both the highest PTX-3 quartile (OR = 1.256, 95 % CI: 1.032–29.930) and plaque burden (OR = 1.568, 95 % CI: 0.918–2.926) were independent predictors of END. The ROC analysis demonstrated that the combination of PTX-3(AUC = 0.742, 95 % CI: 0.680–0.804) and plaque burden (AUC = 0.758, 95 % CI: 0.697–0.818) yielded the highest predictive value (AUC = 0.785, 95 % CI: 0.727–0.844, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Elevated serum PTX-3 levels and increased plaque burden were independently associated with unexplained END in BAD patients. Their combination showed superior predictive performance, indicating potential clinical utility for risk stratification.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100530"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure control after surgical resection of low-grade Gliomas: A Regional retrospective analysis","authors":"Saqib Kamran Bakhshi ,&nbsp;Rabeet Tariq ,&nbsp;Faiza Urooj ,&nbsp;Safwan Masood ,&nbsp;Farhan Arshad Mirza ,&nbsp;Syed Ather Enam","doi":"10.1016/j.wnsx.2025.100548","DOIUrl":"10.1016/j.wnsx.2025.100548","url":null,"abstract":"<div><h3>Introduction</h3><div>Seizures occur in 60–75 % of patients with low-grade gliomas (LGGs). 60–90 % of patients attain seizure freedom after resection. Seizure control varies with histopathology, the extent of resection (EOR), and the type of seizures. There is an inconsistency in the literature regarding the utility of anti-epileptic drugs (AED) after tumor resection. We aimed to determine factors associated with seizure control in patients after LGG resection.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the medical records of all patients who underwent LGG resection at our center from 2018 to 2021. 77 patients fulfilled the selection criteria and were contacted via phone calls to collect information about their seizure control as per Engel Classification. The data was analyzed using SPSSv21.</div></div><div><h3>Results</h3><div>The mean age was 34.9 ± 11.3 years, and there was male predominance (62; 80.5 %). Generalized seizures were the most common type (54; 70 %), and Levetiracetam was the most commonly prescribed AED (60; 77.9 %). The median duration of pre-operative AED use was 4 (IQR: 1–24) months. The frontal lobe was the most common location of tumor (36; 46.8 %). Most of the patients had their surgery under general anesthesia (51; 61.4 %), while 29 (37.7 %) underwent awake craniotomy. Nearly half of the patients had a gross total resection (31; 40.3 %), and another 15 (19.5 %) had near-total resection. Sixteen patients (20.8 %) had their AEDs stopped within the first 6 months post-operatively (at variable intervals), and all of them had Engel Class IA to ID control at the time of follow-up (<em>p</em> = 0.008). The 12 patients with Grade I glioma also had optimum seizure control (<em>p</em> = 0.032).</div></div><div><h3>Conclusion</h3><div>Pilocytic Astrocytomas have better seizure control as compared to Grade II Astrocytomas and Oligodendrogliomas. Further studies are required with larger samples to establish guidelines on achieving adequate postoperative seizure control in LGG patients.</div></div>","PeriodicalId":37134,"journal":{"name":"World Neurosurgery: X","volume":"28 ","pages":"Article 100548"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}