Neurochirurgie最新文献

英文中文

Corrigendum to “Robotic hydrocephalus surgery: A systematic review of the effectiveness in neurosurgical interventions” [Neurochirurgie (2025) 101677] “机器人脑积水手术：神经外科干预有效性的系统回顾”的勘误表[Neurochirurgie(2025) 101677]。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-03-01 Epub Date: 2026-03-06 DOI: 10.1016/j.neuchi.2026.101789

Paweł Łajczak, Anna Łajczak, Stanisław Buczkowski, Kamil Jóźwik, Przemysław Nowakowski

引用次数: 0

Educational quality and reliability of neurosurgical content on YouTube: a systematic review and meta-analysis YouTube上神经外科内容的教育质量和可靠性：系统回顾和荟萃分析。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-03-01 Epub Date: 2026-03-06 DOI: 10.1016/j.neuchi.2026.101795

Fritz Fidel Váscones-Román , Martin Alonso Hemeryth-Rengifo , Jack Váscones-Román , Martha Isabel Vilca-Salas , Nuria Arlette Rodriguez-Aguilar , Renzo Ugaz , Diego Alonso Quiroz-Marcelo , Nagheli Borjas , Niels Pacheco-Barrios

Introduction

YouTube is increasingly used for neurosurgical learning; however, the educational quality, transparency, and reliability of neurosurgery-related content—and whether these features differ by video source—remain unclear.

Objective

To synthesize published evaluations of neurosurgical YouTube videos and meta-analyze standardized quality/reliability scores, exploring source- and time-related differences and reporting gaps in validation and procedural completeness.

Methods

Following PRISMA, we searched PubMed, Scopus, Embase, and Web of Science (2017–2024) for studies assessing neurosurgical YouTube videos using standardized tools (DISCERN/mDISCERN, JAMA Benchmark, Global Quality Score [GQS]). Data were pooled using random-effects meta-analysis with Hartung–Knapp adjustment; scores were also transformed to the Proportion of Maximum Possible (POMP, 0–100).

Results

Sixteen studies (12–1,233 videos each) were included. On native scales, pooled means were: DISCERN per-item 3.06/5, DISCERN total 30.1/80, JAMA 2.41/4, and GQS 3.04/5. Harmonized POMP point estimates (0–100) were: DISCERN 39.8, JAMA 60.3, and GQS 51.0. Heterogeneity was substantial (I² > 95%) except for DISCERN total (I² = 0%). Subgroup analyses suggested higher scores for institutional versus non-institutional sources, although meta-regression did not confirm significance. Validation and procedural completeness were infrequently reported.

Conclusion

Neurosurgical YouTube content shows moderate-to-low educational quality with substantial inconsistency. Institutional sources may perform better, but gaps in transparency, validation, structure, and procedural completeness are common. Standardized production criteria and curated peer-reviewed repositories may improve safe integration into neurosurgical education.

Clinical trial number

Not applicable

简介：YouTube越来越多地用于神经外科学习；然而，神经外科相关内容的教育质量、透明度和可靠性——以及这些特征是否因视频来源而异——仍不清楚。目的：综合已发表的神经外科YouTube视频评价，并对标准化质量/可靠性评分进行meta分析，探索与来源和时间相关的差异，以及在验证和程序完整性方面的报告差距。方法：遵循PRISMA，我们检索PubMed， Scopus， Embase和Web of Science(2017-2024)，使用标准化工具（DISCERN/mDISCERN, JAMA Benchmark, Global Quality Score [GQS]）评估神经外科YouTube视频的研究。采用随机效应meta分析合并Hartung-Knapp调整；分数也被转换成最大可能的比例（POMP, 0-100）。结果：共纳入16项研究（每项12-1,233个视频）。在本地量表上，合并平均值为：每项识别率为3.06/5，总识别率为30.1/80，JAMA为2.41/4，GQS为3.04/5。统一POMP点估计值（0-100）为：DISCERN 39.8, JAMA 60.3, GQS 51.0。除了DISCERN total （I2 = 0%）外，异质性很大（I2 = 95%）。亚组分析表明，机构来源比非机构来源得分更高，尽管元回归并没有证实其重要性。验证和程序完整性很少被报道。结论：神经外科YouTube内容教学质量中低，存在较大的不一致性。制度来源可能表现得更好，但在透明度、有效性、结构和程序完整性方面的差距是常见的。标准化的生产标准和精心策划的同行评审库可能会改善神经外科教育的安全整合。临床试验号：不适用。

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引用次数: 0

Acknowledging our reviewers 感谢我们的审稿人

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-03-01 Epub Date: 2026-01-21 DOI: 10.1016/j.neuchi.2026.101776

引用次数: 0

Gender and leadership equity in neurosurgery: a systematic review of representation and authorship trends (2000–2025) 神经外科的性别和领导平等：代表性和作者趋势的系统回顾（2000-2025）

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-03-01 Epub Date: 2026-01-24 DOI: 10.1016/j.neuchi.2026.101778

Tomasz Tykocki , Mohamed Eltayeb

Background

Neurosurgery remains one of the least gender-diverse surgical specialties. We quantified gender representation across the neurosurgical pipeline and assessed authorship and mentorship patterns.

Methods

: PRISMA-compliant systematic review (2000–2025) of databases and neurosurgical society sources. Random-effects models were used to pool proportions; meta-regression estimated temporal trends; mentorship effect was analyzed as odds ratio for female first authorship when the senior author was female.

Results

Thirty-eight studies (27 workforce/leadership; 11 authorship/editorial) from 75 countries (>40,000 neurosurgeons) were included. Female residents: 20.2% (95% CI 18.0–22.5); female consultants: 18.9% (95% CI 16.1–21.8); female department chairs: 4.5% (95% CI 3.2–5.9). Female first authors: 16.9%; female senior authors: 8.9%; female–female pairs: 2.1%. Female senior authorship more than doubled the odds of a female first author (pooled OR 2.43; 95% CI 1.86–3.17).

Thirty-eight studies from 75 countries were included, representing >40,000 neurosurgeons. Women accounted for 20.2% (95% CI 18.0–22.5) of trainees, 18.9% (95% CI 16.1–21.8) of practicing neurosurgeons, and 4.5% (95% CI 3.2–5.9) of department leaders. Female first authorship was 16.9% and senior authorship 8.9%. Female senior authors more than doubled the odds of female first authorship (OR 2.43; 95% CI 1.86–3.17).

Conclusion

Entry into neurosurgery has improved for women, but leadership and senior authorship remain disproportionately male. Increasing the number of women in senior roles is likely to have a multiplicative effect on authorship and visibility.

背景神经外科仍然是性别差异最小的外科专业之一。我们量化了整个神经外科管道的性别代表性，并评估了作者身份和指导模式。方法：采用符合prisma标准的数据库和神经外科学会来源的系统评价（2000-2025）。随机效应模型用于汇总比例；元回归估计时间趋势；当资深作者为女性时，以女性第一作者的优势比分析师徒关系效应。结果纳入来自75个国家（>40,000名神经外科医生）的38项研究（27项劳动力/领导；11项作者/社论）。女性居民：20.2% (95% CI 18.0-22.5)；女性咨询师：18.9% (95% CI 16.1-21.8)；女系主任：4.5% （95% CI 3.2-5.9）。女性第一作者：16.9%；女性资深作者占8.9%；男女配对：2.1%。女性资深作者是女性第一作者的几率增加了一倍多（合并OR为2.43；95% CI为1.86-3.17）。该研究纳入了来自75个国家的38项研究，代表了4万名神经外科医生。女性占受训人员的20.2% (95% CI 18.0-22.5)，执业神经外科医生的18.9% (95% CI 16.1-21.8)，科室领导的4.5% （95% CI 3.2-5.9）。女性第一作者占16.9%，高级作者占8.9%。女性资深作者成为第一作者的几率增加了一倍多（OR 2.43; 95% CI 1.86-3.17）。结论进入神经外科的女性有所增加，但领导和高级作者仍然不成比例的男性。增加女性担任高级职位的人数可能会对作者身份和知名度产生倍增的影响。

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引用次数: 0

Globalizing Neurotrauma Prognostication: Integrating Cultural Context and Computational Intelligence in Pediatric TBI Research 全球化的神经创伤预测：在儿童脑外伤研究中整合文化背景和计算智能。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-22 DOI: 10.1016/j.neuchi.2025.101750

Riza Amalia

引用次数: 0

Relationship Among Preoperative and Intraoperative Contralateral Analysis along the Perivascular Space Indexes and Postoperative Mini-Mental State Examination Scores in Newly Diagnosed Glioblastoma 新诊断的胶质母细胞瘤术前、术中对侧分析血管周围间隙指数与术后精神状态检查评分的关系。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.neuchi.2025.101752

Ryohei Ono, Shunichiro Miki, Alexander Zaboronok, Eiichi Ishikawa

Objective

Analysis along the Perivascular Space (ALPS) index has been proposed as a quantitative magnetic resonance imaging (MRI) marker for evaluating the function of the brain’s glia-dependent waste clearance pathway, known as the glymphatic system. We hypothesized that the ALPS index on the contralateral side of the brain lesion may relate to postoperative memory disturbance. This study aimed to evaluate the relationship among the preoperative and intraoperative contralateral ALPS indexes and postoperative mini-mental state examination (MMSE) scores in patients with newly diagnosed glioblastoma (GBM).

Methods

Thirty-three patients with newly diagnosed, solitary GBMs who underwent intraoperative MRI and diffusion tensor imaging (DTI) were enrolled in this retrospective study. Patient data included tumor volume, peritumoral edema volume, preoperative and postoperative MMSE scores, and the preoperative and intraoperative contralateral ALPS index.

Results

A higher preoperative ALPS index was associated with older age, and a significant negative correlation was observed between the preoperative ALPS index and MMSE scores both before and after surgery, while the index was unrelated to the degree of improvement in the MMSE scores. Unexpectedly, the intraoperative ALPS index tended to show a negative correlation with the postoperative MMSE score and showed a strong correlation with the degree of improvement in the MMSE scores.

Conclusions

These findings suggest that the contralateral glymphatic pathway may associated with irreversible higher brain dysfunction in GBM patients. However, further studies are needed to confirm this speculation.

目的：沿血管周围间隙（ALPS）指数的分析已被提出作为定量磁共振成像（MRI）标记物，用于评估脑胶质细胞依赖的废物清除途径，即淋巴系统的功能。我们假设脑损伤对侧的ALPS指数可能与术后记忆障碍有关。本研究旨在探讨新诊断的胶质母细胞瘤（GBM）患者术前和术中对侧ALPS指数与术后最小精神状态检查（MMSE）评分的关系。方法：对33例新诊断的孤立性GBMs患者进行术中MRI和弥散张量成像（DTI）的回顾性研究。患者资料包括肿瘤体积、瘤周水肿体积、术前和术后MMSE评分、术前和术中对侧ALPS指数。结果：术前阿尔卑斯指数越高，年龄越大，术前阿尔卑斯指数与术前和术后MMSE评分呈显著负相关，而该指数与MMSE评分改善程度无关。出乎意料的是，术中ALPS指数与术后MMSE评分呈负相关，与MMSE评分的改善程度有很强的相关性。结论：这些发现提示对侧淋巴通路可能与GBM患者不可逆的高级脑功能障碍有关。然而，需要进一步的研究来证实这一推测。

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引用次数: 0

Comment on “Performance of magnetic resonance imaging in discriminating between intra- and extradural versus extradural-only nerve sheath tumor” 对“磁共振成像在鉴别硬膜内和硬膜外与仅硬膜外神经鞘肿瘤中的表现”的评论。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-30 DOI: 10.1016/j.neuchi.2025.101757

Ankur Sharma , Janvi Patel , Pankaj Nainwal , Hariharan Srinivasan

引用次数: 0

Can Microsurgery be Standardized? Quantifying Technique in Intracerebral Hemorrhage 显微外科手术能标准化吗？脑出血定量技术

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI: 10.1016/j.neuchi.2025.101756

Catherine Veilleux, Matthew Skarsgard, Garnette R. Sutherland, Andrew M. Demchuk, Michael D. Hill, Sanju Lama

引用次数: 0

Assessment of dural involvement in calvarial and skull base fibrous dysplasia 颅及颅底纤维性发育不良患者硬脑膜受累的评估。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-03 DOI: 10.1016/j.neuchi.2025.101744

Elif Gozgec , Hayri Ogul , Ahmet Tugrul Akkus , Muhammed Furkan Barutcugil

Objectives

Neurogenic symptoms in craniofacial fibrous dysplasia (FD) are typically caused by direct compression due to the lesion's expansile nature. However, in rare cases, atypical symptoms unrelated to direct compression and associated dural contrast enhancement have been reported. The aim of this study was to investigate the relationship between FD and adjacent dural contrast enhancement.

Material and Methods

This observational study included patients with FD localized to the skull base or calvarium. The location of the lesion, its axial dimensions, and the presence of destruction of the inner table were determined on CT images. On contrast enhanced cranial MR imaging, the presence of dural enhancement was evaluated. The relationship between dural enhancement and other parameters was statistically analyzed.

Results

Of the 27 patients included in the study, 15 were female. Dural contrast enhancement was detected in 16 cases. It was higher in skull base localization than in calvarial localization. Fibrous dysplasia was most commonly localized in the frontal bones, with the highest rate of concomitant dural contrast enhancement in the temporal bone (100%). There was a significant correlation between dural contrast enhancement and inner table destruction. There was no correlation between the size of the lesions and dural contrast enhancement.

Conclusions

MRI findings suggest that FD is frequently associated with dural contrast enhancement, particularly in cases with inner table destruction. This may contribute to neurogenic symptoms and influence treatment strategies. Understanding this association may aid in determining optimal management and avoiding unnecessary surgical interventions.

目的：颅面纤维发育不良（FD）的神经源性症状通常是由病变的扩张性直接压迫引起的。然而，在少数病例中，非典型症状与直接压迫和相关的硬脑膜对比增强无关。本研究的目的是探讨FD与相邻硬膜对比增强之间的关系。材料和方法：本观察性研究纳入了局限于颅底或颅骨的FD患者。在CT图像上确定病变的位置，其轴向尺寸和内表破坏的存在。在增强颅磁振造影上，评估硬脑膜增强的存在。统计分析硬脑膜增强与其他参数的关系。结果：纳入研究的27例患者中，15例为女性。硬膜造影增强16例。颅底定位高于颅骨定位。纤维性发育不良最常见于额骨，颞骨伴硬脑膜增强的比例最高（100%）。硬脑膜造影增强与内表破坏有显著相关性。病灶大小与硬脑膜造影增强无相关性。结论：MRI显示FD常与硬脑膜造影增强有关，特别是在内表破坏的情况下。这可能导致神经源性症状并影响治疗策略。了解这种关联可能有助于确定最佳管理和避免不必要的手术干预。

{"title":"Assessment of dural involvement in calvarial and skull base fibrous dysplasia","authors":"Elif Gozgec , Hayri Ogul , Ahmet Tugrul Akkus , Muhammed Furkan Barutcugil","doi":"10.1016/j.neuchi.2025.101744","DOIUrl":"10.1016/j.neuchi.2025.101744","url":null,"abstract":"<div><h3>Objectives</h3><div>Neurogenic symptoms in craniofacial fibrous dysplasia (FD) are typically caused by direct compression due to the lesion's expansile nature. However, in rare cases, atypical symptoms unrelated to direct compression and associated dural contrast enhancement have been reported. The aim of this study was to investigate the relationship between FD and adjacent dural contrast enhancement.</div></div><div><h3>Material and Methods</h3><div>This observational study included patients with FD localized to the skull base or calvarium. The location of the lesion, its axial dimensions, and the presence of destruction of the inner table were determined on CT images. On contrast enhanced cranial MR imaging, the presence of dural enhancement was evaluated. The relationship between dural enhancement and other parameters was statistically analyzed.</div></div><div><h3>Results</h3><div>Of the 27 patients included in the study, 15 were female. Dural contrast enhancement was detected in 16 cases. It was higher in skull base localization than in calvarial localization. Fibrous dysplasia was most commonly localized in the frontal bones, with the highest rate of concomitant dural contrast enhancement in the temporal bone (100%). There was a significant correlation between dural contrast enhancement and inner table destruction. There was no correlation between the size of the lesions and dural contrast enhancement.</div></div><div><h3>Conclusions</h3><div>MRI findings suggest that FD is frequently associated with dural contrast enhancement, particularly in cases with inner table destruction. This may contribute to neurogenic symptoms and influence treatment strategies. Understanding this association may aid in determining optimal management and avoiding unnecessary surgical interventions.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 1","pages":"Article 101744"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Permanent ventricular shunt and risk of meningitis: Challenges in weaning from external ventricular drain 永久性脑室分流和脑膜炎的风险：从外脑室引流中断奶的挑战。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2026-01-01 Epub Date: 2025-11-24 DOI: 10.1016/j.neuchi.2025.101748

Elisabeth Garrido , Mathieu Lozouet , Vianney Gilard , Pauline Garel , Jean Glenisson , Julien Burel , Stéphane Derrey

Background

Aneurysmal subarachnoid hemorrhage (SAH) is a severe condition associated with high mortality and morbidity. Acute hydrocephalus is a common complication that often necessitates external ventricular drainage (EVD) and, in some cases, permanent shunt placement. Determining the optimal timing for EVD weaning remains challenging, as it requires balancing the need for permanent shunting against the risk of meningitis.

Methods

This retrospective cohort study analysed aneurysmal SAH patients requiring EVD at Rouen University Hospital between January 2020 and December 2022. Predictive factors for successful weaning, the risk of meningitis, and the impact of weaning attempt timing on outcomes were assessed.

Results

A total of 63 patients were included. Successful weaning was achieved in 37 cases (58.7%), while 26 patients (41.3%) required a ventriculoperitoneal shunt (VPS). Younger age, minimal comorbidities, higher Glasgow Coma Scale (GCS) scores (≥10), and limited intraventricular haemorrhage were significantly associated with weaning success. Meningitis cases exhibited a bimodal distribution, with an early peak related to procedural factors, and a second peak which coincided with EVD failure attempt. Most weaning attempts performed within the first 14 days post-SAH resulted in false failure attempts, and repeated attempts were sometimes successful.

Conclusion

These findings underscore that EVD weaning remains a complex clinical challenge, characterized by multifaceted risks requiring careful management and highlighting the need for refined weaning strategies.

背景：动脉瘤性蛛网膜下腔出血（SAH）是一种死亡率和发病率高的严重疾病。急性脑积水是一种常见的并发症，通常需要外脑室引流术（EVD），在某些情况下，需要永久性分流术。确定埃博拉病毒病断奶的最佳时机仍然具有挑战性，因为它需要平衡永久性分流的需要和脑膜炎的风险。方法：这项回顾性队列研究分析了2020年1月至2022年12月在鲁昂大学医院接受EVD治疗的动脉瘤性SAH患者。评估了成功断奶的预测因素、脑膜炎的风险以及尝试断奶时间对结果的影响。结果：共纳入63例患者。37例（58.7%）患者成功脱机，26例（41.3%）患者需要脑室腹腔分流术（VPS）。年龄较小、合并症最少、格拉斯哥昏迷评分（GCS）评分较高（≥10）和有限的脑室内出血与断奶成功显著相关。脑膜炎病例呈双峰分布，早期高峰与程序因素有关，第二个高峰与EVD失败尝试相吻合。大多数在sah后的前14天内进行的断奶尝试导致错误的失败尝试，重复尝试有时会成功。结论：这些研究结果强调，EVD断奶仍然是一个复杂的临床挑战，其特点是多方面的风险需要仔细管理，并强调需要完善的断奶策略。

{"title":"Permanent ventricular shunt and risk of meningitis: Challenges in weaning from external ventricular drain","authors":"Elisabeth Garrido , Mathieu Lozouet , Vianney Gilard , Pauline Garel , Jean Glenisson , Julien Burel , Stéphane Derrey","doi":"10.1016/j.neuchi.2025.101748","DOIUrl":"10.1016/j.neuchi.2025.101748","url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (SAH) is a severe condition associated with high mortality and morbidity. Acute hydrocephalus is a common complication that often necessitates external ventricular drainage (EVD) and, in some cases, permanent shunt placement. Determining the optimal timing for EVD weaning remains challenging, as it requires balancing the need for permanent shunting against the risk of meningitis.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analysed aneurysmal SAH patients requiring EVD at Rouen University Hospital between January 2020 and December 2022. Predictive factors for successful weaning, the risk of meningitis, and the impact of weaning attempt timing on outcomes were assessed.</div></div><div><h3>Results</h3><div>A total of 63 patients were included. Successful weaning was achieved in 37 cases (58.7%), while 26 patients (41.3%) required a ventriculoperitoneal shunt (VPS). Younger age, minimal comorbidities, higher Glasgow Coma Scale (GCS) scores (≥10), and limited intraventricular haemorrhage were significantly associated with weaning success. Meningitis cases exhibited a bimodal distribution, with an early peak related to procedural factors, and a second peak which coincided with EVD failure attempt. Most weaning attempts performed within the first 14 days post-SAH resulted in false failure attempts, and repeated attempts were sometimes successful.</div></div><div><h3>Conclusion</h3><div>These findings underscore that EVD weaning remains a complex clinical challenge, characterized by multifaceted risks requiring careful management and highlighting the need for refined weaning strategies.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"72 1","pages":"Article 101748"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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