Neurochirurgie最新文献

英文中文

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 : 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 : 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

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 : 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。

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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 : 2025-11-22 DOI: 10.1016/j.neuchi.2025.101750

Riza Amalia

引用次数: 0

The Neurosurgical Exodus — A Loss for Latin American Science and Public Health 神经外科的外流——拉丁美洲科学和公共卫生的损失

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2025-11-21 DOI: 10.1016/j.neuchi.2025.101749

Jack Váscones-Román , Fritz Fidel Váscones-Román

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 : 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

Awake surgery and music: Two illustrative cases of frontal resection in pianists 清醒手术与音乐：钢琴家额叶切除术两例。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2025-11-19 DOI: 10.1016/j.neuchi.2025.101753

Francesca Di Nardo , Florence Le Vourc’h , Justine Bleunven , Marine Pedreni , Romuald Seizeur , Vanessa Saliou

Functional anatomy underlyng music perception and production has been quite abundantly described in literature, together with some examples of musical tasks adopted during awake surgery. We have used a keyboard-playing test for per-operative monitoring of two patients affected by a glial lesion.

Our two cases differ in age, lateralization and hemispheric localization of the lesion. One of them, who presented a left middle frontal gyrus lesion, showed a decrease in his ability to play piano, together with other neurological abnormalities, from which he completely recovered within a year. The other patient, whose lesion was instead right and prefrontal, didn’t show any music-related anomalies.

Our patients’ outcomes are consistent with previous literature concerning lateralization and localization of music-related functions in musicians.

In our left-sided case, the emerging of a slowdown in piano playing, without other relevant language, sensitive or motor abnormalities, confirmed by mistakes in picture naming (DO80 N-1) performed simultaneously with a motor task, led us to interrupt our resection, allowing the patient to fully recover within a year, suggesting, with the limitations that we will further discuss, a certain sensibility of the action of playing for early detection of cognitive abnormalities, usually determined with a task-switching test strategy.

在文献中，已经对音乐感知和产生的功能解剖学进行了大量的描述，并提供了一些在清醒手术中采用的音乐任务的例子。我们使用键盘演奏测试术中监测两例神经胶质病变患者。我们的两例不同的年龄，侧边和半球定位病变。其中一人表现为左额叶中回损伤，钢琴演奏能力下降，并伴有其他神经系统异常，但他在一年内完全康复。另一名患者的病变位于右侧和前额叶，没有显示出任何与音乐相关的异常。我们患者的结果与先前关于音乐家音乐相关功能偏侧和定位的文献一致。在我们的左脑病例中，钢琴演奏出现了减速，没有其他相关的语言、敏感或运动异常，并被与运动任务同时进行的图片命名错误（DO80 N-1）所证实，导致我们中断了手术切除，让患者在一年内完全康复，这表明，尽管我们将进一步讨论的局限性，演奏动作的某种敏感性可以早期发现认知异常。通常通过任务切换测试策略来确定。

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引用次数: 0

Postoperative Management Following Degenerative Lumbar Spine Surgery: Results From a Survey Conducted by the French Society of Spine Surgery and Literature Review 腰椎退行性手术后的术后处理：来自（盲法回顾）和文献回顾的调查结果。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2025-11-19 DOI: 10.1016/j.neuchi.2025.101751

Mathieu Lozouet , Mourad Ould-Slimane , Marc Szadkowski , Henri-Arthur Leroy , Jérôme Delambre , Thais Dutra Vieira , François Lucas , Xavier Castel , Martin Dupuy , Henri d’Astorg , the French Spine Society (SFCR)

Background

Postoperative instructions influence lumbar surgery outcomes, but lack of consensus and differing expertise lead to varied practices.

Methods

An online, practice-based questionnaire was distributed in 2021 to all members of the (blinded for review). This survey investigated postoperative care following degenerative lumbar surgery, focusing on follow-up procedures, postoperative imaging practices, recommendations for immobilization and timelines for returning to work and sports activities.

Results

The survey involved 239 surgeons, with neurosurgeons (66%) and orthopaedic surgeons (34%), achieving a response rate of 68.2%. The diversity of opinions varies by item. Notably, routine postoperative imaging was not advocated in 62.7% of non-instrumented procedures. In contrast, it was recommended in 91.9% of cases after instrumented surgeries. Less than 16% of surgeons preconized a postoperative immobilization. Physiotherapy was generally recommended after the first follow-up visit by more than 80% of surgeons. Recommendations for return to work varied, with 62.7% suggesting a 6-week medical leave for non-instrumented surgery and 61.9% recommending over 2 months for instrumented procedures. Most surgeons (94.8%) advised avoiding sports for at least three months post-surgery. Differences between orthopaedic and neurosurgeons were noted, particularly regarding immobilization practices (p < 0.0001) and postoperative imaging for non-instrumented surgeries (p < 0.0001).

Conclusion

A variety of postoperative care practices for lumbar spine surgery exists in France. This mainly relates to recommendations for imaging and return to work following non-instrumented surgery. Finally, there were few differences between the practices of neurosurgeons and orthopaedic surgeons, aligning with contemporary literature on the subject.

背景：术后指导影响腰椎手术的结果，但缺乏共识和不同的专业知识导致不同的做法。方法：一份基于实践的在线问卷于2021年分发给所有成员（盲法审查）。本研究调查了退行性腰椎手术的术后护理，重点是随访程序、术后影像学实践、固定的建议以及重返工作和体育活动的时间表。结果：239名外科医生参与调查，其中神经外科医生占66%，骨科医生占34%，有效率为68.2%。意见的多样性因项目而异。值得注意的是，62.7%的非器械手术不提倡常规的术后影像学。相比之下，91.9%的病例在器械手术后被推荐使用。不到16%的外科医生在手术后预固定。超过80%的外科医生在第一次随访后普遍推荐物理治疗。对于重返工作岗位的建议各不相同，62.7%的人建议进行无器械手术的患者请6周病假，61.9%的人建议进行有器械手术的患者休2个多月病假。大多数外科医生（94.8%）建议术后至少三个月内避免运动。注意到骨科和神经外科医生之间的差异，特别是在固定做法方面(p结论：法国存在各种腰椎手术术后护理做法。这主要涉及无器械手术后影像学和重返工作岗位的建议。最后，神经外科医生和骨科医生的实践之间几乎没有什么不同，与当代关于该主题的文献一致。

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引用次数: 0

Letter to the Editor regarding “Laser Interstitial Thermal Therapy (LITT) in pediatric neurosurgery: Single center retrospective analysis of 41 consecutive procedures” 致编辑关于“激光间质热疗法（LITT）在儿科神经外科中的应用：41例连续手术的单中心回顾性分析”

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2025-11-08 DOI: 10.1016/j.neuchi.2025.101745

Parth Aphale , Himanshu Shekhar , Shashank Dokania

引用次数: 0

Introducing the « J » shaped dural tack-up suture technique when you’re missing the right handpiece for the drill bit during craniotomy: technical note 当你在开颅手术中缺少合适的钻头机头时，介绍“J”形硬脑膜缝合技术：技术说明。

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2025-11-04 DOI: 10.1016/j.neuchi.2025.101740

Nathan Beucler

Placing dural tack-up sutures is part of the surgical treatment of cranial epidural hematoma, but it is also very useful to stop untimely epidural bleeding during any craniotomy procedure. Hence, dural tack-up sutures stand among the essential technical skills that should be taught to every neurosurgery resident. Traditional tack-up sutures involve passing a thread suture between the thickness of dura mater and a small hole drilled at the bone edge of the craniotomy flap. Alternative dural tack-up sutures can also be tied up between the dura mater and the galea or pericranium when the proper drill handpiece is missing, for example in surgical teams deployed overseas. With this in mind, we present a new technical tip for dural tack-up sutures, which involves making a « J » shaped cut at the edge of the craniotomy. Passing the thread suture down to the bottom of the « J » provides the bone anchor for the dural tack-up suture. This helpful technique only requires the same drill handpiece that is used to cut the craniotomy bone flap.

硬膜缝合是颅硬膜外血肿的外科治疗的一部分，但在任何开颅手术中，它也非常有用，以防止过早的硬膜外出血。因此，硬脑膜缝合是每个神经外科住院医师都应该学习的基本技术技能之一。传统的缝合方法是在硬脑膜厚度和开颅皮瓣骨边缘钻一个小孔之间通过线缝合线。当缺少合适的钻头时，也可以在硬脑膜和胼胝体或颅包皮之间进行替代硬脑膜缝合，例如在海外部署的外科团队中。考虑到这一点，我们提出了硬脑膜缝合的新技术技巧，包括在开颅边缘做一个“J”形切口。将线缝线向下至“J”形底部，为硬脑膜缝合提供骨锚。这种有用的技术只需要与切割开颅骨瓣相同的钻头。

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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