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IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01

引用次数: 0

Influence of epilepsy and antiepileptic drug intake in patients suffering from aneurysmal subarachnoid hemorrhage on outcome 动脉瘤性蛛网膜下腔出血患者癫痫及抗癫痫药物摄入对预后的影响

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2025.105924

Tim Lampmann , Harun Asoglu , Haitham Alenezi , Mohammed Jaber , Bettina Otto , Mohammed Banat , Erdem Güresir , Hartmut Vatter , Motaz Hamed

Objective

Many patients suffering from aneurysmal subarachnoid hemorrhage (SAH) develop epileptic seizures. The recent guidelines do not recommend routine administration of antiepileptic drugs (AED).

Research question

We performed a retrospective single-center study to analyze the effect of AEDs on the outcome in patients suffering from epilepsy after SAH.

Methods

752 patients with SAH treated between 01/2006 and 12/2020 were analyzed. Patients were divided into good-grade (WFNS grades I-II) versus poor-grade (WFNS grades III-V) on admission. Data of patients’ history as well as clinical course were collected. Outcome according to the modified Rankin scale (mRS) score was assessed at 6 months after ictus. Outcome was dichotomized into favorable (mRS 0–2) and unfavorable (mRS 3–6). Univariate and multivariate analyses were performed.

Results

346 (46.0 %) patients suffered from poor-grade SAH and 366 (48.7 %) patients achieved unfavorable outcome. 202 (26.9 %) patients suffered from seizures after SAH and 136 (18.1 %) had to be treated with antiepileptic drugs (AEDs) for more than a week. Epilepsy and AED intake after 3 months was more often in patients with unfavorable outcome (18.9 % vs. 8.3 %; p < 0.001 and 21.9 % vs. 11.9 %; p < 0.001, respectively).

In multivariate analysis, ‘poor-grade SAH’ (p < 0.001, OR 10.5, 95 % CI 6.0–18.2), ‘age >50 years’ (p = 0.001, OR 2.7, 95 % CI 1.5–4.8, ‘aneurysm size >10 mm’ (p = 0.018, OR 2.2, 95 % CI 1.1–4.1), ‘hydrocephalus’ (p = 0.002, OR 2.6, 95 % CI 1.4–4.7), ‘delayed cerebral ischemia’ (p = 0.002, OR 5.0, 95 % CI 2.3–10.9) and ‘epilepsy within 3 months’ (p = 0.002, OR 5.9, 95 % CI 1.9–18.3) were predictors for unfavorable outcome, whereas ‘AED intake after 6 months’ (p = 0.037, OR 0.35, 95 % CI 0.13–0.94) was predictor for favorable outcome.

Conclusions

Manifestation of epilepsy in patients suffering from SAH deteriorates outcome. Continued AED intake in SAH patients who developed epileptic seizures should be advised.

目的动脉瘤性蛛网膜下腔出血（SAH）患者多并发癫痫发作。最近的指南不建议常规使用抗癫痫药物（AED）。研究问题：我们进行了一项回顾性单中心研究，分析AEDs对SAH后癫痫患者预后的影响。方法对2006年1月~ 2020年12月收治的752例SAH患者进行分析。入院时将患者分为良好（WFNS分级I-II）和不良（WFNS分级III-V）。收集患者病史及临床病程资料。根据改良Rankin量表（mRS）评分于狂击后6个月评估结果。结果分为有利（mRS 0-2）和不利（mRS 3-6）。进行单因素和多因素分析。结果346例（46.0%）患者出现低度SAH， 366例（48.7%）患者出现不良预后。202例（26.9%）患者在SAH后出现癫痫发作，136例（18.1%）患者使用抗癫痫药物治疗超过一周。3个月后服用癫痫和AED的患者更常出现不良结果（分别为18.9%对8.3%;p <； 0.001和21.9%对11.9%;p < 0.001）。在多变量分析中,“低分SAH”(p & lt; 0.001或10.5,95% CI 6.0 - -18.2),年龄在50年(p = 0.001, 2.7, 95% CI 1.5 - -4.8的动脉瘤大小在10毫米(p = 0.018, 2.2, 95%可信区间1.1 - -4.1),“脑积水”(p = 0.002, 2.6, 95%可信区间1.4 - -4.7),“延迟脑缺血”(p = 0.002, 5.0, 95%可信区间2.3 - -10.9)和“癫痫在3个月内”(p = 0.002, 5.9, 95%可信区间1.9 - -18.3)预测了不利的结果,而“AED摄入后6个月”(p = 0.037、0.35,95% CI 0.13-0.94)是预后良好的预测因子。结论SAH患者的癫痫表现恶化了预后。建议发生癫痫发作的SAH患者继续服用AED。

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引用次数: 0

Does adding an interbody cage in L4–L5 posterolateral fusion for degenerative spondylolisthesis and stenosis improve clinical outcome? 在L4-L5后外侧融合术中加入椎间笼治疗退行性腰椎滑脱和椎管狭窄是否能改善临床结果？

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105926

Enrico Aimar , Lucrezia Di Stefano , Federico Longhitano , Alberto Bona , Marco Meloni , Tommaso Alfiero , Federica Valente , Roberta Bonomo , Giulio Bonomo , Flavio Tancioni , Guglielmo Iess

Introduction

As the population ages, L4–L5 degenerative spondylolisthesis is increasingly common. Posterolateral fusion was long standard; interbody cages are widely used for perceived higher fusion rates.

Research question

Does adding an interbody cage to posterolateral fusion improve outcomes or reduce complications in elderly patients with grade I spondylolisthesis and severe stenosis?

Materials and methods

We retrospectively studied 319 adults aged 60–85 who underwent single-level L4–L5 fusion (2011–2018) after failed conservative care. Patients received posterior lumbar fusion (PLIF, n = 155) or posterolateral lumbar fusion (PLF, n = 164). Primary outcomes were Oswestry Disability Index (ODI) change and complications over a median five-year follow-up; secondary outcomes were operative time, hospital stay, and transfusions. Multivariable analyses adjusted for age, sex, BMI, year of surgery, and sagittal alignment.

Results

Functional improvement was similar (median ODI reduction ≈22 points; p = 0.97), and implant-related revision and revision-free survival did not differ. Cage use increased overall complications (24.5 % vs 7.9 %), prolonged surgery (125 vs 95 min) and hospital stay (4 vs 3 days), and raised transfusions (9.7 % vs 1.8 %), dural tears (11.6 % vs 2.4 %), and radicular deficits (6.5 % vs 1.2 %). The association between cage use and complications persisted after adjustment.

Conclusion

In this elderly, low-grade L4–L5 degenerative spondylolisthesis cohort, adding a posterior interbody cage to instrumented posterolateral fusion did not improve 5-year disability but was associated with higher peri-operative morbidity and greater resource use.

随着人口老龄化，L4-L5退行性椎体滑脱越来越常见。后外侧融合长标准；椎体间固定器被广泛用于更高的融合率。研究问题：对于患有I级椎体滑脱和严重椎管狭窄的老年患者，在后外侧融合中加入椎间笼是否能改善预后或减少并发症？材料和方法我们回顾性研究了319例年龄在60-85岁之间的成年人，他们在保守治疗失败后接受了单节段L4-L5融合（2011-2018）。患者接受后路腰椎融合术（PLIF, n = 155）或后外侧腰椎融合术（PLF, n = 164）。主要结局是Oswestry残疾指数（ODI）变化和中位5年随访期间的并发症；次要结局为手术时间、住院时间和输血量。多变量分析调整了年龄、性别、BMI、手术年份和矢状排列。结果功能改善相似（ODI中位数降低≈22点；p = 0.97），种植体相关翻修和无翻修生存期无差异。笼的使用增加了总并发症（24.5% vs 7.9%），延长了手术时间（125 vs 95分钟）和住院时间（4 vs 3天），增加了输血量（9.7% vs 1.8%），硬脑膜撕裂（11.6% vs 2.4%）和神经根缺损（6.5% vs 1.2%）。调整后，笼的使用与并发症之间的关系仍然存在。结论：在老年低级别L4-L5退行性椎体滑脱队列中，在固定后外侧融合中加入后路椎体间固定器并不能改善5年残疾，但会导致更高的围手术期发病率和更多的资源使用。

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引用次数: 0

Re: Intracranial primary collision tumours: A comprehensive systematic review on preoperative radiological accuracy and neuro-oncological insights. Brain Spine 2026: 105943 颅内原发性碰撞瘤：术前放射学准确性和神经肿瘤学见解的综合系统综述。脑脊骨杂志2026:105943

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105950

Tayfun Hakan

引用次数: 0

Validation of simulator-based neuroangiographical training 基于模拟器的神经血管造影训练的验证

IF 2.5 Q3 CLINICAL NEUROLOGY

Brain & spine

Pub Date : 2026-01-01 DOI: 10.1016/j.bas.2026.105931

Elle Vermeulen , Ramon Torné , Ebba Katsler , Nuri Alioski , Mihail Petrov , Teodora Sakelarova , Leire Pedrosa , Torstein Ragnar Meling , Nikolay Velinov , Hieronymus Damianus Boogaarts

Background

Angiography is a diagnostic and interventional technique in (endo)vascular neurosurgery that demands a high level of precision and technical expertise. Traditionally, mastery of angiographic techniques has relied on hands-on training, often limited by patient availability and procedural complexity. This study aims to investigate the effectiveness of simulator-based training for angiography, determining its role in enhancing procedural proficiency and its potential integration into a neuroendovascular training curriculum.

Research question

Is a simulator-based training for neuroangiography effective ?

Materials and methods

Participants (22 trainees and 10 experts) were recruited in neurosurgical departments from four international university hospitals. After a familiarization session, each participant performed 6 attempts of diagnostic angiography and 3 attempts of coiling on an Angio mentor endovascular simulator. Data gathered were procedure time, fluoroscopy time, amount of contrast injected, number of roadmap sequences and number of errors. The learning curve was studied and contrasting group assessment was performed.

Results

There was a clear steep improvement for all parameters in the learning curve which flattens out as the trainees master angiography and coiling. Trainees had a notable reduction in procedure time, approaching the experts' levels after sixth and seventh attempt of diagnostic angiography. The contrasting group assessment demonstrated discriminating results of experts compared to trainees and a distinctly increasing overlap between trainees and experts with increasing number of attempts.

Discussion and conclusions

Endovascular simulators enable skill acquisition in a controlled environment, enhancing technical proficiency in neuroendovascular coiling and angiography, and should play a role in neuroendovascular training.

背景：血管造影是血管神经外科的一种诊断和介入技术，需要高水平的精确度和专业技术。传统上，血管造影技术的掌握依赖于实践培训，往往受到患者可用性和程序复杂性的限制。本研究旨在探讨基于模拟器的血管造影训练的有效性，确定其在提高程序熟练程度方面的作用，以及将其整合到神经血管内训练课程中的潜力。基于模拟器的神经血管造影训练有效吗？材料与方法从四所国际大学附属医院神经外科招募22名学员和10名专家。在熟悉课程后，每位参与者在血管内模拟器上进行了6次诊断性血管造影和3次卷曲。收集的数据包括操作时间、透视时间、注射造影剂量、路线图序列数和错误数。研究学习曲线，并进行对比组评价。结果在掌握血管造影术和卷绕术后，各参数的学习曲线均有明显的提高，并逐渐趋于平缓。受训者的手术时间明显减少，在第六次和第七次尝试诊断性血管造影后接近专家水平。对比小组评估表明，与受训人员相比，专家的结果是有区别的，并且随着尝试次数的增加，受训人员和专家之间的重叠明显增加。讨论与结论血管模拟器可以在受控环境下获得技能，提高神经血管内盘绕和血管造影的技术熟练程度，应该在神经血管内训练中发挥作用。

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