Interdisciplinary Neurosurgery: Advanced Techniques and Case Management最新文献_第10页

Qualitative meta-synthesis comparing non-Newtonian, non-Kolmogorov, and modified Krieger computational fluid dynamics models exploring the intracranial aneurysm dynamics: state of the art 定性综合比较非牛顿、非kolmogorov和改进的Krieger计算流体动力学模型，探索颅内动脉瘤动力学：最新进展

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-09-01 DOI: 10.1016/j.inat.2025.102119

Yao Christian Hugues Dokponou, Abdessamad El Ouahabi, Mahjouba Boutarbouch

Background

Computational fluid dynamics (CFD) models are crucial for examining blood flow and the morphology of brain aneurysms. These models are used to enhance the understanding of the formation, rupture, and post-treatment behavior of aneurysms. The three principal models are non-Newtonian, non-Kolmogorov, and modified Krieger. However, the extent to which these models differ in their ability to predict changes in blood flow within aneurysms remains unclear. This study aimed to compare these models to identify their differences and similarities and to determine which model is most effective for intracranial aneurysm geometry appraisal.

Methods

We conducted a qualitative systematic review according to the ENTREQ guidelines. Our search encompassed the MEDLINE/PubMed and American Mathematical Society/MathSciNet databases, from their inception until January 2025. We utilized terms such as “intracranial aneurysm” and “cerebral aneurysm,” along with keywords like non-Newtonian, non-Kolmogorov, modified Krieger CFD models, and IA dynamics.

Results

Seventy-four articles were included in this study.

Conclusion

CFD simulation accuracy depends on blood vessel mapping, boundary conditions, and fluid model assumptions. Non-Newtonian models, which consider blood shear-thinning behavior, provide better flow depictions compared to Newtonian models. Advanced models, such as non-Kolmogorov and modified Krieger, enhance understanding by capturing turbulence and predicting wall shear stress. Despite these advances, debate continues regarding optimal aneurysm blood flow modeling. The field requires standardized protocols, validation procedures, and uncertainty quantification methods for effective treatment planning.

计算流体动力学（CFD）模型对于检查脑动脉瘤的血流和形态至关重要。这些模型用于增强对动脉瘤形成、破裂和治疗后行为的理解。三个主要模型是非牛顿模型、非柯尔莫哥洛夫模型和改进的克里格模型。然而，这些模型在预测动脉瘤内血流变化的能力上的差异程度仍不清楚。本研究旨在比较这些模型，以确定它们的异同，并确定哪种模型对颅内动脉瘤几何评估最有效。方法根据ENTREQ指南进行定性系统评价。我们的搜索包括MEDLINE/PubMed和美国数学学会/MathSciNet数据库，从它们成立到2025年1月。我们使用了“颅内动脉瘤”和“脑动脉瘤”等术语，以及非牛顿、非kolmogorov、修正Krieger CFD模型和IA动力学等关键词。结果共纳入74篇文献。结论cfd模拟的准确性取决于血管映射、边界条件和流体模型假设。与牛顿模型相比，考虑血液剪切变薄行为的非牛顿模型提供了更好的血流描述。先进的模型，如非kolmogorov模型和改进的Krieger模型，通过捕捉湍流和预测壁面剪切应力来增强理解。尽管取得了这些进展，但关于最佳动脉瘤血流模型的争论仍在继续。该领域需要标准化的方案、验证程序和不确定度量化方法来进行有效的治疗计划。

{"title":"Qualitative meta-synthesis comparing non-Newtonian, non-Kolmogorov, and modified Krieger computational fluid dynamics models exploring the intracranial aneurysm dynamics: state of the art","authors":"Yao Christian Hugues Dokponou, Abdessamad El Ouahabi, Mahjouba Boutarbouch","doi":"10.1016/j.inat.2025.102119","DOIUrl":"10.1016/j.inat.2025.102119","url":null,"abstract":"<div><h3>Background</h3><div>Computational fluid dynamics (CFD) models are crucial for examining blood flow and the morphology of brain aneurysms. These models are used to enhance the understanding of the formation, rupture, and post-treatment behavior of aneurysms. The three principal models are non-Newtonian, non-Kolmogorov, and modified Krieger. However, the extent to which these models differ in their ability to predict changes in blood flow within aneurysms remains unclear. This study aimed to compare these models to identify their differences and similarities and to determine which model is most effective for intracranial aneurysm geometry appraisal.</div></div><div><h3>Methods</h3><div>We conducted a qualitative systematic review according to the ENTREQ guidelines. Our search encompassed the MEDLINE/PubMed and American Mathematical Society/MathSciNet databases, from their inception until January 2025. We utilized terms such as “intracranial aneurysm” and “cerebral aneurysm,” along with keywords like non-Newtonian, non-Kolmogorov, modified Krieger CFD models, and IA dynamics.</div></div><div><h3>Results</h3><div>Seventy-four articles were included in this study.</div></div><div><h3>Conclusion</h3><div>CFD simulation accuracy depends on blood vessel mapping, boundary conditions, and fluid model assumptions. Non-Newtonian models, which consider blood shear-thinning behavior, provide better flow depictions compared to Newtonian models. Advanced models, such as non-Kolmogorov and modified Krieger, enhance understanding by capturing turbulence and predicting wall shear stress. Despite these advances, debate continues regarding optimal aneurysm blood flow modeling. The field requires standardized protocols, validation procedures, and uncertainty quantification methods for effective treatment planning.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102119"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003727","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}

引用次数: 0

Needle-landing arteriotomy for microvascular anastomosis in patients with moyamoya disease: A technical note 针刺动脉切开术在烟雾病患者微血管吻合中的应用：技术说明

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-09-01 DOI: 10.1016/j.inat.2025.102117

Makoto Isozaki, Yoshifumi Higashino, Ayumi Akazawa, Hidetaka Arishima, Ken-ichiro Kikuta

Background

Microvascular anastomosis is vital in cerebrovascular surgery, particularly in bypass procedures for moyamoya disease. Conventional arteriotomy methods, such as a linear incision or fishmouth techniques, can prolong clamping time, increasing ischemic risk. To address this, the authors developed the “needle-landing arteriotomy” technique to reduce clamping time and improve arteriotomy efficiency.

Methods

We evaluated the efficacy of needle-landing arteriotomy through in vivo and in vitro investigations. Six patients with moyamoya disease underwent bypass surgery. Each of the three patients was treated with the conventional arteriotomy and needle-landing methods. Clamping time, patency, and complications were assessed intraoperatively and at a six-month follow-up. In the in vitro study, neurosurgeons and residents performed simulated arteriotomies to compare both techniques.

Results

The needle-landing technique significantly reduced clamping time in vivo by 55 % (176 ± 20.8 s vs. 97.3 ± 30.8 s, P < 0.02). All surgeries were successful with no complications. Follow-up angiography confirmed patent bypass grafts. The technique also shortened the clamping time in vitro.

Conclusion

The needle-landing technique simplifies recipient vessel preparation by improving visibility and reducing procedural complexity. This minimizes the risk of inadvertent suturing and shortens clamping time, which is crucial for preventing ischemic complications, while also reducing performance variability, making it especially helpful for less-experienced surgeons. It is particularly valuable in cerebrovascular bypass procedures for patients with moyamoya disease.

背景：微血管吻合在脑血管手术中是至关重要的，特别是在烟雾病的搭桥手术中。传统的动脉切开术，如线性切口或鱼口技术，可以延长夹紧时间，增加缺血性风险。为了解决这个问题，作者开发了“针落动脉切开术”技术，以减少夹紧时间，提高动脉切开术效率。方法通过体内和体外观察，评价针刺动脉切开术的疗效。6名烟雾病患者接受了搭桥手术。3例患者均采用常规动脉切开术和针刺法治疗。术中和6个月随访时评估夹紧时间、通畅度和并发症。在体外研究中，神经外科医生和住院医生进行了模拟动脉切开术来比较这两种技术。结果针着地技术可显著缩短体内夹持时间55%（176±20.8 s vs. 97.3±30.8 s, P < 0.02）。所有手术均成功，无并发症。随访血管造影证实血管搭桥通畅。该技术还缩短了体外夹紧时间。结论针入技术通过提高可视性和降低程序复杂性，简化了受体血管制备。这最大限度地减少了无意缝合的风险，缩短了夹紧时间，这对于预防缺血性并发症至关重要，同时也减少了性能变化，对经验不足的外科医生特别有帮助。它在烟雾病患者的脑血管搭桥手术中特别有价值。

{"title":"Needle-landing arteriotomy for microvascular anastomosis in patients with moyamoya disease: A technical note","authors":"Makoto Isozaki, Yoshifumi Higashino, Ayumi Akazawa, Hidetaka Arishima, Ken-ichiro Kikuta","doi":"10.1016/j.inat.2025.102117","DOIUrl":"10.1016/j.inat.2025.102117","url":null,"abstract":"<div><h3>Background</h3><div>Microvascular anastomosis is vital in cerebrovascular surgery, particularly in bypass procedures for moyamoya disease. Conventional arteriotomy methods, such as a linear incision or fishmouth techniques, can prolong clamping time, increasing ischemic risk. To address this, the authors developed the “needle-landing arteriotomy” technique to reduce clamping time and improve arteriotomy efficiency.</div></div><div><h3>Methods</h3><div>We evaluated the efficacy of needle-landing arteriotomy through <em>in vivo</em> and <em>in vitro</em> investigations. Six patients with moyamoya disease underwent bypass surgery. Each of the three patients was treated with the conventional arteriotomy and needle-landing methods. Clamping time, patency, and complications were assessed intraoperatively and at a six-month follow-up. In the <em>in vitro</em> study, neurosurgeons and residents performed simulated arteriotomies to compare both techniques.</div></div><div><h3>Results</h3><div>The needle-landing technique significantly reduced clamping time <em>in vivo</em> by 55 % (176 ± 20.8 s vs. 97.3 ± 30.8 s, P < 0.02). All surgeries were successful with no complications. Follow-up angiography confirmed patent bypass grafts. The technique also shortened the clamping time <em>in vitro</em>.</div></div><div><h3>Conclusion</h3><div>The needle-landing technique simplifies recipient vessel preparation by improving visibility and reducing procedural complexity. This minimizes the risk of inadvertent suturing and shortens clamping time, which is crucial for preventing ischemic complications, while also reducing performance variability, making it especially helpful for less-experienced surgeons. It is particularly valuable in cerebrovascular bypass procedures for patients with moyamoya disease.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102117"},"PeriodicalIF":0.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996653","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}

引用次数: 0

Management of benign primary vertebral tumors: WFNS spine committee recommendations 良性原发性椎体肿瘤的治疗：WFNS脊柱委员会的建议

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-18 DOI: 10.1016/j.inat.2025.102114

Francesco Costa , Francesco Restelli , Niccolò Innocenti , Corinna Zygourakis , Zan Chen , Mirza Pojskic , Onur Yaman , Artem Gushcha , Salman Sharif , Mehmet Zileli

Background

Benign primary vertebral tumors (PVTs) represent a diverse group of spinal lesions that, despite their non-malignant nature, can significantly impact patients’ quality of life. This review aimed to formulate the most current, evidence-based recommendations regarding the management strategies for benign PVTs.

Methods

To this aim, comprehensive search was conducted in PubMed/EMBASE/MEDLINE databases. Inclusion criteria included English-language publications between January 2012 and December 2023. The screening process involved reviewing abstracts, assessing full-text articles, and reviewing reference lists for additional studies. Eligibility criteria were applied to ensure the selection of relevant studies. Data extraction involved recording various variables. A total of 160 abstracts were screened, resulting in 99 articles being selected for further review. 57 articles met the inclusion criteria and were included in the study. The results were discussed and voted in two consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee, reaching a positive or negative consensus using the Delphi method.

Results

Imaging with MRI/CT is essential for diagnosis and treatment planning, with classification systems guiding surgical strategies; general condition, tumor histology, and life expectancy must be considered. En-bloc resection is the gold standard for malignant tumors, while vertebroplasty, radiotherapy, or minimally invasive ablation may be appropriate depending on lesion type. Specific management recommendations were confirmed for osteoid osteoma, osteoblastoma, ABCs, giant cell tumors, and hemangiomas, including the role of embolization, biopsy, and emerging percutaneous procedures.

Conclusions

The WFNS Spine Committee finalized multiple recommendation guidelines on the management of benign primary vertebral tumors. Further higher-quality studies are recommended to establish more substantial evidence and recommendations.

背景：良性原发性椎体肿瘤（pvt）代表了一组不同的脊柱病变，尽管它们是非恶性的，但可以显著影响患者的生活质量。本综述旨在就良性室性早搏的治疗策略提出最新的循证建议。方法在PubMed/EMBASE/MEDLINE数据库中进行综合检索。纳入标准包括2012年1月至2023年12月之间的英文出版物。筛选过程包括审查摘要，评估全文文章，以及审查额外研究的参考文献列表。采用入选标准以确保入选相关研究。数据提取涉及记录各种变量。共筛选了160篇摘要，最终选出99篇文章进行进一步审查。57篇符合纳入标准的文章被纳入本研究。结果在WFNS（世界神经外科学会联合会）脊柱委员会的两次共识会议上进行了讨论和投票，使用德尔菲法达成了肯定或否定的共识。结果MRI/CT成像对诊断和治疗方案至关重要，分类系统指导手术策略；一般情况、肿瘤组织学和预期寿命必须考虑在内。整体切除是恶性肿瘤的金标准，而根据病变类型，椎体成形术、放疗或微创消融可能是合适的。对于类骨骨瘤、成骨细胞瘤、abc、巨细胞瘤和血管瘤，我们提出了具体的治疗建议，包括栓塞、活检和新出现的经皮手术。结论WFNS脊柱委员会最终确定了多个关于良性原发性椎体肿瘤治疗的推荐指南。建议进一步进行高质量的研究，以建立更实质性的证据和建议。

{"title":"Management of benign primary vertebral tumors: WFNS spine committee recommendations","authors":"Francesco Costa , Francesco Restelli , Niccolò Innocenti , Corinna Zygourakis , Zan Chen , Mirza Pojskic , Onur Yaman , Artem Gushcha , Salman Sharif , Mehmet Zileli","doi":"10.1016/j.inat.2025.102114","DOIUrl":"10.1016/j.inat.2025.102114","url":null,"abstract":"<div><h3>Background</h3><div>Benign primary vertebral tumors (PVTs) represent a diverse group of spinal lesions that, despite their non-malignant nature, can significantly impact patients’ quality of life. This review aimed to formulate the most current, evidence-based recommendations regarding the management strategies for benign PVTs.</div></div><div><h3>Methods</h3><div>To this aim, comprehensive search was conducted in PubMed/EMBASE/MEDLINE databases. Inclusion criteria included English-language publications between January 2012 and December 2023. The screening process involved reviewing abstracts, assessing full-text articles, and reviewing reference lists for additional studies. Eligibility criteria were applied to ensure the selection of relevant studies. Data extraction involved recording various variables. A total of 160 abstracts were screened, resulting in 99 articles being selected for further review. 57 articles met the inclusion criteria and were included in the study. The results were discussed and voted in two consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee, reaching a positive or negative consensus using the Delphi method.</div></div><div><h3>Results</h3><div>Imaging with MRI/CT is essential for diagnosis and treatment planning, with classification systems guiding surgical strategies; general condition, tumor histology, and life expectancy must be considered. En-bloc resection is the gold standard for malignant tumors, while vertebroplasty, radiotherapy, or minimally invasive ablation may be appropriate depending on lesion type. Specific management recommendations were confirmed for osteoid osteoma, osteoblastoma, ABCs, giant cell tumors, and hemangiomas, including the role of embolization, biopsy, and emerging percutaneous procedures<strong>.</strong></div></div><div><h3>Conclusions</h3><div>The WFNS Spine Committee finalized multiple recommendation guidelines on the management of benign primary vertebral tumors. Further higher-quality studies are recommended to establish more substantial evidence and recommendations.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102114"},"PeriodicalIF":0.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866120","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}

引用次数: 0

Understanding tanycytic ependymoma: A rare subtype of ependymoma 了解伸长细胞室管膜瘤：一种罕见的室管膜瘤亚型

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102111

Mitrajit Sharma, Aanchal Datta, Chhitij Srivastava

Spinal intramedullary tanycytic ependymoma (TE) is a rare variant of ependymoma with only about 60 cases reported till date. Radiological diagnosis is tedious and identification of its unique histopathology is required for definitive diagnosis. It is often misdiagnosed solely on radiology as well as intra-operative findings. Because of its exceedingly low incidence (1% of all spinal cord neoplasms), only a small number of cases of intramedullary TE have been recorded so far. We report an adult female who presented with dorsal intramedullary TE and underwent gross total resection under intraoperative nerve monitoring. Additionally, we have also reviewed the literature already published on this entity. Subtle radiological differentiations may assist in considering TE as a differential diagnosis. Long term survival in these cases is extremely favorable. Our case depicts one of the few cases of spinal intramedullary TE known in literature and one of the very few in Southern Asian region. We highlight the challenges involved in making an accurate diagnosis of this entity radiologically and intra-operatively.

摘要脊髓髓内伸长细胞型室管膜瘤（TE）是一种罕见的室管膜瘤，至今仅报告约60例。放射学诊断是繁琐的，其独特的组织病理学鉴定是明确诊断所必需的。仅凭放射学和术中发现常被误诊。由于其发病率极低（占所有脊髓肿瘤的1%），迄今为止仅记录了少量髓内TE病例。我们报告一位成年女性，她表现为背侧髓内TE，并在术中神经监测下接受了全切除术。此外，我们还回顾了已经发表的关于该实体的文献。细微的放射鉴别可能有助于考虑TE作为鉴别诊断。这些病例的长期存活是非常有利的。我们的病例描述了文献中已知的少数脊髓髓内TE病例之一，也是南亚地区极少数病例之一。我们强调在放射学和术中对这种实体进行准确诊断所涉及的挑战。

{"title":"Understanding tanycytic ependymoma: A rare subtype of ependymoma","authors":"Mitrajit Sharma, Aanchal Datta, Chhitij Srivastava","doi":"10.1016/j.inat.2025.102111","DOIUrl":"10.1016/j.inat.2025.102111","url":null,"abstract":"<div><div>Spinal intramedullary tanycytic ependymoma (TE) is a rare variant of ependymoma with only about 60 cases reported till date. Radiological diagnosis is tedious and identification of its unique histopathology is required for definitive diagnosis. It is often misdiagnosed solely on radiology as well as intra-operative findings. Because of its exceedingly low incidence (1% of all spinal cord neoplasms), only a small number of cases of intramedullary TE have been recorded so far. We report an adult female who presented with dorsal intramedullary TE and underwent gross total resection under intraoperative nerve monitoring. Additionally, we have also reviewed the literature already published on this entity. Subtle radiological differentiations may assist in considering TE as a differential diagnosis. Long term survival in these cases is extremely favorable. Our case depicts one of the few cases of spinal intramedullary TE known in literature and one of the very few in Southern Asian region. We highlight the challenges involved in making an accurate diagnosis of this entity radiologically and intra-operatively.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102111"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780680","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}

引用次数: 0

Advantages and limitations of radiofrequency treatment for intervertebral disc herniation 椎间盘突出症射频治疗的优点与局限性

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102112

Junfeng Wang, Xiaoxia Li, Yuenong Zhang

Radiofrequency therapy for intervertebral discs is a minimally invasive technique that acts on the nucleus pulposus tissue of the intervertebral disc to achieve thermal coagulation, thereby treating pain. Compared to traditional surgery, its operation is more straightforward. It involves puncturing the intervertebral disc with a needle, causing minimal damage. After surgical treatment, pain can be quickly relieved, and it is completed under the guidance of fluoroscopy or CT without damaging the stable structure of the spine. This also improves the accuracy and safety of treatment. If the pain recurs, the patient can receive repeated radiofrequency therapy.

However, radiofrequency treatment for intervertebral discs also has some limitations and potential risks. Multiple radiofrequency treatments may be required for some patients to achieve the desired pain relief effect. Currently, there is no unified standard for radiofrequency treatment, which needs to be determined based on the specific situation of the patient and the experience of the doctor. Some complications may include intervertebral disc infection and vascular and nerve damage. Although the incidence of these complications is not high, once they occur, they may seriously impact the patients.

Overall, intervertebral disc radiofrequency therapy is an effective pain treatment method. However, it must be carried out under the guidance of a professional doctor and consider the patient’s specific situation and potential risks.

椎间盘射频治疗是一种微创技术，通过作用于椎间盘髓核组织实现热凝，从而治疗疼痛。与传统外科手术相比，其操作更为直接。它包括用针刺穿椎间盘，造成最小的损伤。手术治疗后疼痛可迅速缓解，在透视或CT指导下完成，不破坏脊柱的稳定结构。这也提高了治疗的准确性和安全性。如果疼痛复发，病人可以接受反复的射频治疗。然而，椎间盘的射频治疗也有一些局限性和潜在的风险。一些患者可能需要多次射频治疗才能达到预期的止痛效果。目前，射频治疗没有统一的标准，需要根据患者的具体情况和医生的经验来确定。一些并发症可能包括椎间盘感染、血管和神经损伤。虽然这些并发症的发生率不高，但一旦发生，可能对患者造成严重影响。综上所述，椎间盘射频治疗是一种有效的疼痛治疗方法。但是，必须在专业医生的指导下进行，并考虑患者的具体情况和潜在风险。

{"title":"Advantages and limitations of radiofrequency treatment for intervertebral disc herniation","authors":"Junfeng Wang, Xiaoxia Li, Yuenong Zhang","doi":"10.1016/j.inat.2025.102112","DOIUrl":"10.1016/j.inat.2025.102112","url":null,"abstract":"<div><div>Radiofrequency therapy for intervertebral discs is a minimally invasive technique that acts on the nucleus pulposus tissue of the intervertebral disc to achieve thermal coagulation, thereby treating pain. Compared to traditional surgery, its operation is more straightforward. It involves puncturing the intervertebral disc with a needle, causing minimal damage. After surgical treatment, pain can be quickly relieved, and it is completed under the guidance of fluoroscopy or CT without damaging the stable structure of the spine. This also improves the accuracy and safety of treatment. If the pain recurs, the patient can receive repeated radiofrequency therapy.</div><div>However, radiofrequency treatment for intervertebral discs also has some limitations and potential risks. Multiple radiofrequency treatments may be required for some patients to achieve the desired pain relief effect. Currently, there is no unified standard for radiofrequency treatment, which needs to be determined based on the specific situation of the patient and the experience of the doctor. Some complications may include intervertebral disc infection and vascular and nerve damage. Although the incidence of these complications is not high, once they occur, they may seriously impact the patients.</div><div>Overall, intervertebral disc radiofrequency therapy is an effective pain treatment method. However, it must be carried out under the guidance of a professional doctor and consider the patient’s specific situation and potential risks.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102112"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780596","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}

引用次数: 0

Lumbar spine infection caused by candida albicans: A case report 白色念珠菌所致腰椎感染1例

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102110

Jian Wang , Jianbiao Huang , Jie Chen , Dongping Wang , Qunwei Dong , Hui Zhu , Jianxin Zhang , Jianxian Luo

Introduction

Lumbar spine infection caused by Candida albicans is a rare condition in clinical practice that often presents as chronic lower back pain. The combination of imaging and laboratory tests can aid in the accurate diagnosis of this disease.

Case report

A 75-year-old female patient reported to a physician with complaints of low back pain, numbness, and weakness in both lower extremities for one month. Despite receiving anti-inflammatory analgesia and nerve nutrition treatment, there was no improvement and the patient occasionally developed high fever and chills. After the surgical intervention and anti-infection treatment, the symptoms disappeared and the outcome was satisfactory.

Conclusion

Chronic low back pain is a characteristic symptom of lumbar spine infection caused by Candida albicans. Pathological biopsy remains the gold standard for its diagnosis. Conservative treatment using azoles is effective, while surgical management remains controversial.

由白色念珠菌引起的腰椎感染在临床上是一种罕见的疾病，通常表现为慢性腰痛。影像学检查和实验室检查相结合有助于准确诊断这种疾病。病例报告：一名75岁女性患者向医生报告，主诉腰痛、麻木和双下肢无力一个月。尽管接受了抗炎镇痛和神经营养治疗，但没有改善，患者偶尔出现高热和寒战。经手术干预及抗感染治疗后症状消失，效果满意。结论慢性腰痛是白色念珠菌引起的腰椎感染的特征性症状。病理活检仍然是其诊断的金标准。使用唑类药物保守治疗是有效的，而手术治疗仍有争议。

{"title":"Lumbar spine infection caused by candida albicans: A case report","authors":"Jian Wang , Jianbiao Huang , Jie Chen , Dongping Wang , Qunwei Dong , Hui Zhu , Jianxin Zhang , Jianxian Luo","doi":"10.1016/j.inat.2025.102110","DOIUrl":"10.1016/j.inat.2025.102110","url":null,"abstract":"<div><h3>Introduction</h3><div>Lumbar spine infection caused by Candida albicans is a rare condition in clinical practice that often presents as chronic lower back pain. The combination of imaging and laboratory tests can aid in the accurate diagnosis of this disease.</div></div><div><h3>Case report</h3><div>A 75-year-old female patient reported to a physician with complaints of low back pain, numbness, and weakness in both lower extremities for one month. Despite receiving anti-inflammatory analgesia and nerve nutrition treatment, there was no improvement and the patient occasionally developed high fever and chills. After the surgical intervention and anti-infection treatment, the symptoms disappeared and the outcome was satisfactory.</div></div><div><h3>Conclusion</h3><div>Chronic low back pain is a characteristic symptom of lumbar spine infection caused by Candida albicans. Pathological biopsy remains the gold standard for its diagnosis. Conservative treatment using azoles is effective, while surgical management remains controversial.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102110"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772572","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}

引用次数: 0

Optimizing high-frequency and low-frequency deep brain stimulation parameters for drug-resistant epilepsy: Mechanisms, clinical outcomes, and future directions 优化抗药癫痫的高频和低频深部脑刺激参数：机制、临床结果和未来方向

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102109

Faeze Sadat Ahmadi Tabatabaei , Mohammad Taghi Joghataei , Kiana Askarian , Leila Riahi Pour , Bita Kouhnavard Pour , Nooshin Ahmadirad

Objective

This review evaluates the therapeutic potential of high-frequency stimulation (HFS) and low-frequency stimulation (LFS) in deep brain stimulation (DBS) for drug-resistant epilepsy (DRE), focusing on mechanisms, target selection, and parameter optimization.

Methods

A synthesis of preclinical and clinical studies was conducted, analyzing electrode placement, stimulation parameters (frequency, pulse width, intensity), and outcomes across key DBS targets, including the centromedian thalamus, anterior thalamus, and hippocampus. Emerging non-invasive neuromodulation strategies, such as repetitive transcranial magnetic stimulation (rTMS), were contextualized within the broader therapeutic landscape.

Results

HFS (100–130 Hz) demonstrates robust antiepileptic effects by disrupting cortical synchronization and enhancing GABAergic inhibition, achieving sustained seizure reduction in 40–60 % of DRE patients. LFS 1–10 Hz shows variable efficacy, with risks of exacerbating seizures via cortical synchronization. Optimal pulse widths (60–240 μs) and amplitude (150–300 μA) require patient-specific calibration. rTMS (0.3–1 Hz) exhibits adjunctive potential for non-invasive modulation of epileptogenic networks, particularly when combined with neuroimaging.

Conclusion

While DBS remains a cornerstone for DRE, parameter optimization is critical to balancing efficacy and safety. Future research should prioritize closed-loop systems, biomarker-driven protocols, and synergies between invasive (DBS) and non-invasive (rTMS) neuromodulation.

目的探讨深部脑刺激（DBS）中高频刺激（HFS）和低频刺激（LFS）治疗耐药癫痫（DRE）的作用机制、靶点选择和参数优化。方法综合临床前和临床研究，分析电极放置、刺激参数（频率、脉宽、强度）和DBS关键靶点（包括丘脑中央区、丘脑前侧和海马）的结果。新兴的非侵入性神经调节策略，如重复性经颅磁刺激（rTMS），在更广泛的治疗领域中得到了广泛的应用。结果shfs （100-130 Hz）通过破坏皮质同步和增强gaba能抑制，显示出强大的抗癫痫作用，在40 - 60%的DRE患者中实现持续的癫痫发作减少。LFS 1 - 10hz表现出不同的疗效，有通过皮质同步加剧癫痫发作的风险。最佳脉冲宽度（60-240 μs）和幅度（150-300 μA）需要根据具体患者进行校准。rTMS （0.3-1 Hz）显示出非侵入性调制致痫网络的辅助潜力，特别是当与神经成像相结合时。结论DBS是DRE的基础，但参数优化是平衡疗效和安全性的关键。未来的研究应优先考虑闭环系统，生物标志物驱动的方案，以及侵入性（DBS）和非侵入性（rTMS）神经调节之间的协同作用。

{"title":"Optimizing high-frequency and low-frequency deep brain stimulation parameters for drug-resistant epilepsy: Mechanisms, clinical outcomes, and future directions","authors":"Faeze Sadat Ahmadi Tabatabaei , Mohammad Taghi Joghataei , Kiana Askarian , Leila Riahi Pour , Bita Kouhnavard Pour , Nooshin Ahmadirad","doi":"10.1016/j.inat.2025.102109","DOIUrl":"10.1016/j.inat.2025.102109","url":null,"abstract":"<div><h3>Objective</h3><div>This review evaluates the therapeutic potential of high-frequency stimulation (HFS) and low-frequency stimulation (LFS) in deep brain stimulation (DBS) for drug-resistant epilepsy (DRE), focusing on mechanisms, target selection, and parameter optimization.</div></div><div><h3>Methods</h3><div>A synthesis of preclinical and clinical studies was conducted, analyzing electrode placement, stimulation parameters (frequency, pulse width, intensity), and outcomes across key DBS targets, including the centromedian thalamus, anterior thalamus, and hippocampus. Emerging non-invasive neuromodulation strategies, such as repetitive transcranial magnetic stimulation (rTMS), were contextualized within the broader therapeutic landscape.</div></div><div><h3>Results</h3><div>HFS (100–130 Hz) demonstrates robust antiepileptic effects by disrupting cortical synchronization and enhancing GABAergic inhibition, achieving sustained seizure reduction in 40–60 % of DRE patients. LFS 1–10 Hz shows variable efficacy, with risks of exacerbating seizures via cortical synchronization. Optimal pulse widths (60–240 μs) and amplitude (150–300 μA) require patient-specific calibration. rTMS (0.3–1 Hz) exhibits adjunctive potential for non-invasive modulation of epileptogenic networks, particularly when combined with neuroimaging.</div></div><div><h3>Conclusion</h3><div>While DBS remains a cornerstone for DRE, parameter optimization is critical to balancing efficacy and safety. Future research should prioritize closed-loop systems, biomarker-driven protocols, and synergies between invasive (DBS) and non-invasive (rTMS) neuromodulation.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102109"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772571","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}

引用次数: 0

Slit ventricle could be a neurosurgical emergency? Case Report 脑室裂可能是神经外科急诊？病例报告

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102104

Daniela S Massa, A.Carolina Olea, Carina O. Maineri, Santiago A Portillo Medina

Symptomatic slit ventricle is one of complications of hydrocephalus shunting surgery in children. It is characterized by the clinical triad of headache, slow refilling of the valve and narrow ventricles on imaging. We report the case of a boy with a ventriculoperitoneal shunt due to preterm intraventricular hemorrhage, at 22 days of life. At age of 33 months, he started with symptoms of Slit Ventricles Syndrome. His parents did not consent to performing invasive diagnostic methods, so the boy only received symptomatic medication. At 40-month-old he had acute seizures without loss of consciousness and at that time computed tomography (CT) scan showed massive brain edema. At that time, an emergency frontal biparietal decompressive craniectomy was performed as an emergency procedure and an intracranial pressure catheter was placed, which demonstrated an intracranial pressure of 40 mmHg. The ICP continued to increase up to 100 mmHg without response to intensive medical treatment and after 24 hs, a boy developed brain death. Increased intracranial pressure (ICP) can lead to death in patients who previously undergone shunt treatment even in the absence of ventricular enlargement.

症状性狭缝脑室是小儿脑积水分流术的并发症之一。临床表现为头痛、瓣膜充盈缓慢、影像上心室狭窄。我们报告的情况下，一个男孩与脑室腹腔分流由于早产儿脑室内出血，在22天的生活。在33个月大时，他开始出现狭缝心室综合征的症状。他的父母不同意进行侵入性诊断方法，因此男孩只接受对症治疗。在40个月大时，他有急性癫痫发作，但没有意识丧失，当时计算机断层扫描（CT）显示大面积脑水肿。当时急诊行额双顶骨减压术，置入颅内压导管，颅内压为40mmhg。颅内压继续升高至100毫米汞柱，经强化治疗无效，24小时后，一名男孩发生脑死亡。颅内压升高（ICP）可导致患者死亡，以前接受分流治疗，即使没有心室增大。

{"title":"Slit ventricle could be a neurosurgical emergency? Case Report","authors":"Daniela S Massa, A.Carolina Olea, Carina O. Maineri, Santiago A Portillo Medina","doi":"10.1016/j.inat.2025.102104","DOIUrl":"10.1016/j.inat.2025.102104","url":null,"abstract":"<div><div>Symptomatic slit ventricle is one of complications of hydrocephalus shunting surgery in children. It is characterized by the clinical triad of headache, slow refilling of the valve and narrow ventricles on imaging. We report the case of a boy with a ventriculoperitoneal shunt due to preterm intraventricular hemorrhage, at 22 days of life. At age of 33 months, he started with symptoms of Slit Ventricles Syndrome. His parents did not consent to performing invasive diagnostic methods, so the boy only received symptomatic medication. At 40-month-old he had acute seizures without loss of consciousness and at that time computed tomography (CT) scan showed massive brain edema. At that time, an emergency frontal biparietal decompressive craniectomy was performed as an emergency procedure and an intracranial pressure catheter was placed, which demonstrated an intracranial pressure of 40 mmHg. The ICP continued to increase up to 100 mmHg without response to intensive medical treatment and after 24 hs, a boy developed brain death. Increased intracranial pressure (ICP) can lead to death in patients who previously undergone shunt treatment even in the absence of ventricular enlargement.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102104"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841867","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}

引用次数: 0

Effects of steroids on vasogenic edema due to brain tumors, a narrative review 类固醇对脑肿瘤引起的血管源性水肿的影响

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102106

Marzieh Shahrabi , Azin Abdollahi , Mohammad Niakan Lahiji , Tahereh Sorbi , Mohammad Solduzian

Background and objectives

Tumor-associated edema is a serious condition that can lead to severe complications. Corticosteroids in the treatment of edema can be administered postoperatively or preoperatively. Each method has its benefits and drawbacks, and there still isn’t a consensus on choosing the best approach. In this review, the effects of different types of corticosteroids will be discussed in the management of tumor-associated edema, also it provides basis for further investigation due to the lack of data in this regard.

Method

PubMed, Google Scholar, and Scopus were used for search from inception to February 13, 2025. The Scale for the Assessment of Narrative Review Article was used for evaluation and it received the score of 10.

Result

Conducted search resulted in 965 relevant articles. In total, 19 of them matched to our purpose of the study.

Conclusion

There are more studies focused on dexamethasone than on the other agents. Due to its lower mineralocorticoid effects, dexamethasone is usually the corticosteroid of choice, except in cases where the patient has a history of an allergic reaction to it. Preoperative administration of these medications can provide benefits, such as decreasing complications and improving the patient’s clinical status. Postoperative use of corticosteroids may also reduce the length of hospitalization.

背景和目的肿瘤相关性水肿是一种严重的疾病，可导致严重的并发症。皮质类固醇治疗水肿可在术后或术前使用。每种方法都有其优点和缺点，在选择最佳方法方面仍然没有达成共识。本文将讨论不同类型的皮质类固醇在肿瘤相关性水肿治疗中的作用，也为这方面缺乏资料的进一步研究提供依据。方法采用pubmed、谷歌Scholar、Scopus检索，检索时间为成立至2025年2月13日。采用《叙述性评论文章评价量表》进行评价，得分为10分。结果检索到相关文献965篇。总共有19个符合我们的研究目的。结论对地塞米松的研究较多，对其他药物的研究较少。由于地塞米松的矿化皮质激素作用较低，所以通常选择地塞米松作为皮质类固醇，除非患者有过敏反应史。术前给予这些药物可以提供益处，如减少并发症和改善患者的临床状况。术后使用皮质类固醇也可缩短住院时间。

{"title":"Effects of steroids on vasogenic edema due to brain tumors, a narrative review","authors":"Marzieh Shahrabi , Azin Abdollahi , Mohammad Niakan Lahiji , Tahereh Sorbi , Mohammad Solduzian","doi":"10.1016/j.inat.2025.102106","DOIUrl":"10.1016/j.inat.2025.102106","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Tumor-associated edema is a serious condition that can lead to severe complications. Corticosteroids in the treatment of edema can be administered postoperatively or preoperatively. Each method has its benefits and drawbacks, and there still isn’t a consensus on choosing the best approach. In this review, the effects of different types of corticosteroids will be discussed in the management of tumor-associated edema, also it provides basis for further investigation due to the lack of data in this regard.</div></div><div><h3>Method</h3><div>PubMed, Google Scholar, and Scopus were used for search from inception to February 13, 2025<strong>.</strong> The Scale for the Assessment of Narrative Review Article was used for evaluation and it received the score of 10.</div></div><div><h3>Result</h3><div>Conducted search resulted in 965 relevant articles. In total, 19 of them matched to our purpose of the study.</div></div><div><h3>Conclusion</h3><div>There are more studies focused on dexamethasone than on the other agents. Due to its lower mineralocorticoid effects, dexamethasone is usually the corticosteroid of choice, except in cases where the patient has a history of an allergic reaction to it. Preoperative administration of these medications can provide benefits, such as decreasing complications and improving the patient’s clinical status. Postoperative use of corticosteroids may also reduce the length of hospitalization.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102106"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772995","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}

引用次数: 0

A complicated intrathecal baclofen pump implantation in a child with spastic Diplegia: Should a genetic mimic of cerebral palsy be Considered? 痉挛性双瘫患儿的复杂鞘内巴氯芬泵植入：是否应考虑脑瘫的遗传模拟？

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

Pub Date : 2025-08-05 DOI: 10.1016/j.inat.2025.102113

Mohamed Ashraf , Peter Emad Khalil , Omnia Fathy ElRashidi , Jacob Edwar Ibrahem , Hedayat Khaled Mansour , Ahmed Wael Ibrahim , Mohamed Ismael Ali , Hesham Nafea , Mostafa G. Mahran , Abdelwahab Marzouk , Walid Abdel Ghany

Background

Management of hypertonia in children with cerebral palsy was challenged over decades including physical rehabilitation, splinting, orthopedic procedures, Botulinum toxin injection, ablative neurosurgical techniques and neuromodulation procedures including intrathecal baclofen infusion. Neurological decline is not a common fate of the classic cerebral palsy (perinatal insult). Observations: We report a 14-year-old boy child with spastic cerebral palsy diplegia showing rapid decline of neurological status following intrathecal baclofen pump implantation. The whole exome genetic sequencing of the child showed an ultra-rare bi-allelic mutation in the NFU1 gene. This gene mutation has a wide spectrum of symptoms including fatal leukoencephalopathy, muscular hypotonia, psychomotor regression, swallowing difficulties and pulmonary hypertension. Lessons: Genetic mimics of cerebral palsy may be overlooked and must be put into consideration before making surgical decisions.

Previous presentations:: An abstract was accepted for oral presentation in the Ain shams Neurosurgery Congress (ASNS) in Cairo, Egypt in May 2023. There are no other presentations or submissions of publications for this case.

几十年来，脑瘫儿童高渗症的治疗一直面临挑战，包括物理康复、夹板、骨科手术、肉毒杆菌毒素注射、消融神经外科技术和神经调节手术，包括鞘内输注巴氯芬。神经功能衰退不是典型脑瘫的常见结局（围产期侮辱）。观察：我们报告了一名14岁的痉挛性脑瘫男孩，在鞘内植入巴氯芬泵后，神经系统状态迅速下降。该儿童的全外显子组基因测序显示，NFU1基因存在超罕见的双等位基因突变。这种基因突变具有广泛的症状，包括致命性脑白质病、肌肉张力低下、精神运动减退、吞咽困难和肺动脉高压。经验教训：脑瘫的基因模拟可能被忽视，必须在做出手术决定之前加以考虑。以前的报告：2023年5月，在埃及开罗举行的艾因沙姆斯神经外科大会（ASNS）上，一篇摘要被接受口头报告。本案例没有其他报告或出版物提交。

{"title":"A complicated intrathecal baclofen pump implantation in a child with spastic Diplegia: Should a genetic mimic of cerebral palsy be Considered?","authors":"Mohamed Ashraf , Peter Emad Khalil , Omnia Fathy ElRashidi , Jacob Edwar Ibrahem , Hedayat Khaled Mansour , Ahmed Wael Ibrahim , Mohamed Ismael Ali , Hesham Nafea , Mostafa G. Mahran , Abdelwahab Marzouk , Walid Abdel Ghany","doi":"10.1016/j.inat.2025.102113","DOIUrl":"10.1016/j.inat.2025.102113","url":null,"abstract":"<div><h3>Background</h3><div>Management of hypertonia in children with cerebral palsy was challenged over decades including physical rehabilitation, splinting, orthopedic procedures, Botulinum toxin injection, ablative neurosurgical techniques and neuromodulation procedures including intrathecal baclofen infusion. Neurological decline is not a common fate of the classic cerebral palsy (perinatal insult). <strong>Observations:</strong> We report a 14-year-old boy child with spastic cerebral palsy diplegia showing rapid decline of neurological status following intrathecal baclofen pump implantation. The whole exome genetic sequencing of the child showed an ultra-rare bi-allelic mutation in the NFU1 gene. This gene mutation has a wide spectrum of symptoms including fatal leukoencephalopathy, muscular hypotonia, psychomotor regression, swallowing difficulties and pulmonary hypertension. <strong>Lessons:</strong> Genetic mimics of cerebral palsy may be overlooked and must be put into consideration before making surgical decisions.</div><div><strong>Previous presentations::</strong> An abstract was accepted for oral presentation in the Ain shams Neurosurgery Congress (ASNS) in Cairo, Egypt in May 2023. There are no other presentations or submissions of publications for this case.</div></div>","PeriodicalId":38138,"journal":{"name":"Interdisciplinary Neurosurgery: Advanced Techniques and Case Management","volume":"41 ","pages":"Article 102113"},"PeriodicalIF":0.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858268","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}

引用次数: 0