Neurocirugia最新文献

{"title":"Histiocitosis de células de Langerhans con invasión al parénquima cerebral: una entidad rara","authors":"Claudio Sebastián Iglesias Vargas ,&nbsp;Tomas Quinzacara Aravena ,&nbsp;Ingrid Trujillo Ramos ,&nbsp;Sebastián Vigueras Alvares","doi":"10.1016/j.neucir.2025.500676","DOIUrl":"10.1016/j.neucir.2025.500676","url":null,"abstract":"<div><div>This case presents an unusual case of Langerhans cell histiocytosis with invasion into the brain parenchyma, a rare phenomenon documented in few cases worldwide. The relevance of this case lies in the contribution to the knowledge of this pathology in the pediatric neuro-oncologic context.</div><div>An 11-year-old boy presented with increased volume in the left frontal region, without neurological deficit or systemic symptoms. CT and MRI revealed an aggressive osteolytic lesion with perilesional edema and intracranial extension.</div><div>Complete excision of the lesion was performed, confirming Langerhans cell histiocytosis by immunohistochemistry. Chemotherapy was started with good tolerance and no complications so far.</div><div>This case highlights the need for timely diagnosis and treatment in cases of Langerhans cell histiocytosis with brain involvement, given its potential impact on prognosis and the scarcity of specific guidelines for this type of manifestations.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500676"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425472","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}

{"title":"Embolización por punción directa de tumor fibroso solitario intracraneal con SQUID","authors":"Dixit Varma,&nbsp;Avinash A. Gutte,&nbsp;Snehal Kose,&nbsp;Abin Jose","doi":"10.1016/j.neucir.2025.500700","DOIUrl":"10.1016/j.neucir.2025.500700","url":null,"abstract":"<div><div>Solitary fibrous tumors (SFTs) are rare intracranial neoplasms that are highly vascular, making surgical resection challenging due to significant intraoperative blood loss. Preoperative embolization is commonly performed via the transarterial route; however, this approach has limitations, including difficulty in accessing multiple feeders, prolonged procedural time, and the risk of embolic material reflux into the intracranial circulation.</div><div>Here, we report the case of a 19-year-old male with a large intracranial SFT, initially treated with transarterial embolization using polyvinyl alcohol (PVA) particles, which failed to achieve proper devascularization of the tumor. Consequently, direct puncture embolization using the SQUID 12 agent was performed. Following successful embolization, complete tumor resection was achieved with significantly reduced intraoperative blood loss and no postoperative neurological deficits.</div><div>This case highlights the effectiveness of direct puncture embolization as a viable alternative to traditional transarterial approaches for managing highly vascular intracranial tumors.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500700"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425469","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}

{"title":"Derrame subdural contralateral tras craneotomía descompresiva flotante: reporte de caso y revisión narrativa","authors":"Artem Kuptsov ,&nbsp;Alessandra Rocca ,&nbsp;Cristina Gómez-Revuelta ,&nbsp;Ana Flores-Justa ,&nbsp;Jaime Fernández-Villa ,&nbsp;Juan Antonio Nieto-Navarro","doi":"10.1016/j.neucir.2025.500660","DOIUrl":"10.1016/j.neucir.2025.500660","url":null,"abstract":"<div><div>Hinged craniotomy is an alternative surgical technique that can be used in place of decompressive craniectomy to treat refractory intracranial hypertension. This procedure has the advantage of avoiding the need for a second surgery to replace the bone, while giving a good control of intracranial pressure. However, there is no consistent literature about complications of hinged craniotomy. In particular, there are no reported cases of contralateral subdural effusion after hinged craniotomy. In this article we present a case of a 55-years-old man who developed contralateral subdural effusion after a hinged craniotomy for intracranial hypertension, and how we handled it. Therefore, we explored literature to better understand the pathogenesis of contralateral subdural effusion, treatments and possible prevention strategies.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500660"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425473","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}

{"title":"Cirugía de epilepsia en niños: resultados de pacientes con epilepsia farmacorresistente en un hospital pediátrico de Bogotá, Colombia, durante 10 años de seguimiento","authors":"Kevin José Navarro Jaime ,&nbsp;Bryan Gómez Cristancho ,&nbsp;David C. Gómez Cristancho ,&nbsp;Nelson Andres Cuevas Morales ,&nbsp;Armando Rojas Calderon ,&nbsp;Oscar Fernando Zorro Guio","doi":"10.1016/j.neucir.2025.500701","DOIUrl":"10.1016/j.neucir.2025.500701","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug-resistant epilepsy is defined as the lack of response to two appropriately selected antiepileptic drugs that the patient has tolerated properly. Epilepsy is a common neurological disorder in the pediatric population, with an estimated prevalence ranging from 4.3 to 9.3 cases per 1,000 children, affecting 1.2% of the global population. Despite pharmacological treatment, between 30% and 40% of patients fail to achieve adequate seizure control, and approximately half of these become candidates for epilepsy surgery.</div></div><div><h3>Objective</h3><div>To determine the incidence of seizure freedom, considering the Engel classification, in pediatric patients undergoing epilepsy surgery at a level IV pediatric hospital in Bogotá, Colombia.</div></div><div><h3>Methodology</h3><div>A retrospective observational cohort study was conducted with pediatric patients treated at a level IV pediatric hospital by the epilepsy surgery team between January 1, 2013, and July 31, 2024.</div></div><div><h3>Results</h3><div>Between 2013 and 2024, a total of 326 patients were evaluated through the epilepsy surgery program. Of these, 154 underwent surgery. The median postoperative follow-up was 40<!--> <!-->months. The type of surgery was significantly associated with a higher likelihood of achieving favorable outcomes at 6<!--> <!-->months (RR<!--> <!-->=<!--> <!-->3.54; 95%<!--> <!-->CI: 1.86-6.77; <em>P</em> <!-->&lt;<!--> <!-->.001) and 12<!--> <!-->months of follow-up (RR<!--> <!-->=<!--> <!-->4; 95%<!--> <!-->CI: 1.96-8.08; <em>P</em> <!-->&lt;<!--> <!-->.001). The presence of daily seizures and the need for treatment with more than three medications were associated with a lower likelihood of achieving favorable outcomes during the follow-up period.</div></div><div><h3>Conclusions</h3><div>The loss of years of healthy life since the diagnosis of epilepsy and the type of surgery performed (palliative or curative) were identified as independent factors strongly associated with favorable outcomes in the treatment of drug-resistant epilepsy.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500701"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425558","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}

{"title":"Control mediante imagen después del clipaje de un aneurisma: ¿es suficiente la angiotomografía 3D?","authors":"Sebastián Menéndez-Girón,&nbsp;Antonio González-Crespo,&nbsp;Alberto Blanco Ibáñez de Opacua,&nbsp;Roser García-Armengol,&nbsp;Carlos J. Dominguez,&nbsp;Ana Rodríguez-Hernández","doi":"10.1016/j.neucir.2025.500677","DOIUrl":"10.1016/j.neucir.2025.500677","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral digital subtraction angiography (DSA) remains the gold standard for the control of aneurysmal remnants after surgical clipping. Despite being associated with minimal risks, it is an invasive procedure far from being iatrogenia free. Furthermore, it has limited availability which may prolong patient's postoperative stay. On the other hand, the image quality of computed tomography angiography (CTA) has improved significantly over the past decades providing a valuable alternative to DSA. The objective of this study was to compare the capacity of CTA and DSA to detect clinically significant aneurysmal remnants.</div></div><div><h3>Methods</h3><div>From a prospective series of surgically treated aneurysms, those with postoperative CTA and DSA were retrospectively included in the study. A three-dimensional reconstruction of the CTA was performed using the Brainlab Elements software and the results were compared with those of the DSA. In addition, variables that could affect the three-dimensional reconstruction were collected, such as the number of clips per aneurysm and previous clipping or embolization. In case of an aneurysm remnant, its size was also recorded.</div></div><div><h3>Results</h3><div>Between January 2020 and January 2022, a total of 42 patients in whom 52 aneurysms were clipped (8 of them ruptured) were included. CTA presented a sensitivity of 50% and a specificity of 97% in the detection of aneurysmal remnants. The cases in which CTA did not detect the aneurysmal remnant were previously embolized aneurysms or complex aneurysms that required neck reconstruction with 3 or more clips. None of the remnants undetected by CTA were significant enough to warrant retreatment of the aneurysm.</div></div><div><h3>Conclusions</h3><div>Excluding complex aneurysms (previously embolized or requiring surgical reconstruction with 3 or more clips), three-dimensional reconstructions of CTA images showed excellent results in detecting clinically significant postoperative aneurysm remnants and may obviate the need for a the more invasive and less available DSA.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500677"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425471","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}

{"title":"Microcirugía transcraneal como estrategia de rescate en adenomas hipofisarios gigantes: experiencia unicéntrica y resultados del seguimiento a largo plazo","authors":"Oguz Altunyuva,&nbsp;Ali Imran Ozmarasali,&nbsp;Nur Balcin,&nbsp;Hanside Setenay Unal,&nbsp;Selcuk Yilmazlar","doi":"10.1016/j.neucir.2025.500699","DOIUrl":"10.1016/j.neucir.2025.500699","url":null,"abstract":"<div><h3>Introduction</h3><div>Endoscopic transsphenoidal surgery (ETSS) is the preferred approach for most pituitary adenomas. However, transcranial microsurgery remains relevant for giant adenomas with complex features. This study presents long-term outcomes and complications in a single-surgeon series of patients with giant pituitary adenomas who underwent transcranial resection.</div></div><div><h3>Material and methods</h3><div>This retrospective study analyzed 29 patients with giant pituitary adenomas (≥ 4<!--> <!-->cm) who underwent transcranial surgery between 2009 and 2018 at Bursa Uludağ University Faculty of Medicine. Inclusion criteria were: a minimum tumor diameter of 4<!--> <!-->cm, histologically confirmed pituitary adenoma, tumor resection via a transcranial approach, regular postoperative follow-up, and a minimum follow-up of 60 months. Data collected included patient demographics, clinical presentation, tumor characteristics, surgical details, extent of resection, and long-term outcomes (minimum 60 months follow-up).</div></div><div><h3>Results</h3><div>The mean patient age was 48.17<!--> <!-->±<!--> <!-->12.92 years. Vision loss was the most common presenting symptom (n<!--> <!-->=<!--> <!-->20). Gross total resection (GTR) was achieved in 51.7% (n<!--> <!-->=<!--> <!-->15) and subtotal resection (STR) in 48.3% (n<!--> <!-->=<!--> <!-->14). Postoperative improvement in visual function was observed in 48.3% (n<!--> <!-->=<!--> <!-->14), while 20.7% (n<!--> <!-->=<!--> <!-->6) experienced deterioration. Endocrinological remission occurred in 20.7% (n<!--> <!-->=<!--> <!-->6). Complications included diabetes insipidus (24.13%, n<!--> <!-->=<!--> <!-->7), cerebrovascular events (10.34%, n<!--> <!-->=<!--> <!-->3), and mortality (17.24%, n<!--> <!-->=<!--> <!-->5).</div></div><div><h3>Conclusions</h3><div>Transcranial surgery for giant pituitary adenomas can achieve favorable outcomes in terms of tumor control and visual function improvement. However, it is associated with a risk of complications, including endocrinological and cerebrovascular events. Careful patient selection, meticulous surgical technique, and close postoperative monitoring are essential for optimizing outcomes. Transcranial microsurgery remains an important tool in the armamentarium of neurosurgeons managing complex giant pituitary adenomas.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500699"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425557","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}

{"title":"¿Existe la enfermedad del disco negro?","authors":"Giancarlo Mattos Piaggio,&nbsp;Esteban Quevedo Orrego,&nbsp;Emilio González Martínez,&nbsp;Javier Ibañez Plágaro,&nbsp;José García-Cosamalón","doi":"10.1016/j.neucir.2025.500673","DOIUrl":"10.1016/j.neucir.2025.500673","url":null,"abstract":"<div><div>The study of degenerative pathology of the intervertebral disc (IVD) with magnetic resonance imaging (MRI) has generated such an extensive and ambiguous terminology that it causes confusion. The loss of the nucleus pulposus signal intensity (ISNP) in the T2 sequence of MRI, secondary to the early decrease in water content, is generally described as «black disc», a term spread as a synonym for degenerative disc disease. On the other hand, to designate a supposedly symptomatic dehydrated disc, the following names have been introduced: «painful black disc», «black disc syndrome» and «black disc disease». In this way, the physiological dehydration of the NP present in the entire population from the third decade on, is arbitrarily considered a presumed radiological marker of discogenic back pain, with the consequent risk of being the target of unnecessary interventions. Dehydrated discs suspected of being a source of pain present, in addition to the decrease in ISNP, other radiological signs such as a high intensity zone (HIZ) in the posterior part of the annulus fibrosus (AF), protrusion, loss of height or Modic changes.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500673"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425468","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}

{"title":"Influencia de la magnitud y orientación de las fuerzas en la fractura de odontoides: análisis de un modelo de elementos finitos","authors":"Pedro Miguel González-Vargas ,&nbsp;Jorge Caramés ,&nbsp;Antonio Riveiro ,&nbsp;José Luis Thenier-Villa ,&nbsp;Cesáreo Conde ,&nbsp;Juan Pou","doi":"10.1016/j.neucir.2025.500675","DOIUrl":"10.1016/j.neucir.2025.500675","url":null,"abstract":"<div><h3>Background</h3><div>Fractures of the odontoid, prevalent among the elderly but affecting diverse demographics, pose significant risks ranging from mild discomfort to severe disability or fatality. These fractures, often stemming from trauma, are particularly frequent in the cervical spine. While commonly attributed to high-impact events like traffic accidents in adults, even low-energy incidents such as falls can precipitate these fractures in the elderly.</div><div>Previous studies have explored loading conditions and treatment effects; however, a comprehensive investigation into the influence of the magnitude and direction of the force involved in the trauma, and the influence of the sex and age of the patient remains scarce so we want to delve deeper into this topic.</div></div><div><h3>Methods</h3><div>This study uses a finite element (FE) model to analyze the response of 3<!--> <!-->D models of the second cervical vertebra (extracted from computed tomography images) exposed to different loads of magnitude and force. 52 patients were analyzed in this study.</div><div>The patients were divided into 4 groups: male &lt;<!--> <!-->70, female &lt;<!--> <!-->70, male &gt;<!--> <!-->70, female &gt;<!--> <!-->70) under different force conditions.</div><div>von Mises stress values were obtained when loads of 200<!--> <!-->N and 1500<!--> <!-->N were applied to the anterior surface of the odontoid with different angles of incidence in the sagittal and axial plane.</div></div><div><h3>Results</h3><div>Odontoid fractures in subjects over 70 years of age are more frequent in female, the maximum stresses produced in the odontoid are 181<!--> <!-->MPa and are considerably higher compared to male, which is 131<!--> <!-->MPa. In young subjects (&lt;<!--> <!-->70 years), the differences between sex are less marked, 113<!--> <!-->MPa for female and 114<!--> <!-->MPa for male.</div></div><div><h3>Conclusions</h3><div>Load direction is one of the main factors affecting odontoid fracture, especially in subjects &gt;<!--> <!-->70 years of age; by understanding this, the mechanisms that cause different types of fractures can be understood and better strategies can be proposed to apply different treatment approaches to them, both from a medical and surgical point of view.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 6","pages":"Article 500675"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425470","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}

{"title":"Continuous sitting position during the postoperative period as an intervention to reduce risk of cerebrospinal fluid leak after endoscopic endonasal surgery","authors":"José de Jesús Martínez-Manrique ,&nbsp;Ricardo A. Palacios-Rodríguez ,&nbsp;Luis A. Rodríguez-Hernández ,&nbsp;Jorge F. Aragón-Arreola ,&nbsp;Marcos V. Sangrador-Deitos ,&nbsp;Juan Luis Gómez-Amador","doi":"10.1016/j.neucir.2025.500658","DOIUrl":"10.1016/j.neucir.2025.500658","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>In recent decades, endoscopic endonasal surgery for skull base tumours has modified the way in which this region is approached. One of the most feared complications is the cerebrospinal fluid leak. It has been shown in different publications about CSF physiology that changes in the position modify the pressure of the CSF (pCSF). With this background, it is proposed as a viable, noninvasive, and very low-risk option, the continuous sitting position in patients during their hospital stay after endoscopic endonasal surgery as an adjuvant intervention to reduce the risk of CSF leak in patients considered to be at high risk. The objective is to demonstrate that the continuous sitting position in the postoperative period is a useful adjuvant intervention for the prevention of CSF leak in endoscopic endonasal surgery.</div></div><div><h3>Methods</h3><div>This is a retrospective, observational, cross-sectional, comparative study. It included patients over 18 years of either sex, intervened by endoscopic endonasal surgery with intraoperative CSF leak observed and with advanced reconstruction technique realized. A continuous sitting position (between 70 ° and 90 °) was considered when the patient remained in this position from the immediate postoperative period until the hospital discharge.</div></div><div><h3>Results</h3><div>A total of 60 patients were included. No statistically significant difference was found on all the variables studied, except when patients were stratified into sitting and non-sitting patients (p = 0.045). OR of 0.12 (95% CI 0.002–1.03) was observed. In the sitting group, only 1 patient (6.67%) had CSF leak, which was resolved with non-surgical treatment. The average length of hospital stay was 18 days (7–38) for sitting patients and 14 days (5–80) for non-sitting patients, with statistical significance stablished by the dispersion of the data (p = 0.023).</div></div><div><h3>Conclusions</h3><div>The continuous sitting position during the immediate postoperative period is an intervention that shows a decrease in the risk of CSF leak in patients intervened by endoscopic endonasal approach, included extended routes.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 5","pages":"Article 500658"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926852","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}

{"title":"La génesis de la Neurocirugía Académica. Parte II: La contribución de los líderes de la escuela de Medicina del Johns Hopkins","authors":"Ramiro D. Lobato ,&nbsp;Alfonso Lagares ,&nbsp;Igor Paredes ,&nbsp;Ana M. Castaño-Leon ,&nbsp;Pablo M. Munarriz ,&nbsp;Irene Panero","doi":"10.1016/j.neucir.2025.500672","DOIUrl":"10.1016/j.neucir.2025.500672","url":null,"abstract":"<div><div>This paper describes the influence of the Jonhs Hopkins School of Medicine on the origin of academic neurosurgery in America. The impact, arising from two of the founders, W Osler and W Halsted, was vehiculated by their direct pupils Harvey Cushing and Walter Dandy. The relationships between all these pioneers (sometimes stormy) are analized along with the development of the primitive residency program and the efforts to create the first neurosurgical society (the Society of Neurological Surgeons).</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"36 5","pages":"Article 500672"},"PeriodicalIF":0.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926858","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}