Journal of Neurosurgery
本篇文献由机器智能翻译
Hearing preservation outcomes using direct cranial nerve eight and auditory brainstem response neuromonitoring in the resection of vestibular schwannomas
在前庭神经鞘瘤切除术中使用直接颅神经八和听觉脑干反应神经监测的听力保护结果
Researchers compared hearing preservation rates following vestibular schwannoma resections when utilizing auditory brainstem response (ABR) neuromonitoring alone versus ABR plus direct cranial nerve eight monitoring (ABR+DCNEM). Their model suggests that patients with ABR+DCNEM trend toward an increased chance of serviceable hearing preservation for smaller tumors compared to ABR only, whereas this relationship becomes indistinguishable and, eventually, inverses as tumor size increases. This study introduces a helpful model to clearly visualize the advantages and disadvantages of ABR+DCNEM.
研究人员比较了前庭神经鞘瘤切除术后单独使用听觉脑干反应 (ABR) 神经监测与ABR加直接脑神经八位监测 (ABR DCNEM) 的听力保存率。他们的模型表明,与仅ABR相比,ABR DCNEM患者倾向于较小肿瘤的有效听力保留机会增加,而这种关系变得难以区分,并最终随着肿瘤大小的增加而反转。这项研究引入了一个有用的模型,以清楚地可视化ABR DCNEM的优缺点。
REF: Sloane DC, Nuru M, Pecoraro NC, et al. Hearing preservation outcomes using direct cranial nerve eight and auditory brainstem response neuromonitoring in the resection of vestibular schwannomas. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.4.JNS221868 PMID: 38941638
Microsurgical management of recurrent intracranial aneurysm after endovascular treatment: a series of 60 consecutive patients
血管内治疗后复发性颅内动脉瘤的显微外科治疗: 连续60例患者
The aim of this study was to evaluate the morbidity associated with microsurgical treatment in patients with a recurrent aneurysm to improve their surgical management. Microsurgery remains an effective therapeutic option for recurrent intracranial aneurysms. However, in the authors’ experience, postoperative morbidity is higher than in patients with nonrecurrent aneurysms. Therefore, a pretherapeutic multidisciplinary evaluation is mandatory to reduce the potential morbidity associated with the retreatment as much as possible. When endovascular occlusion of the aneurysm requires both stenting and coiling, alternative microsurgical treatment should be carefully evaluated, as microsurgical clipping will become much more challenging in cases of aneurysm recurrence.
这项研究的目的是评估复发性动脉瘤患者与显微手术治疗相关的发病率,以改善其手术管理。显微外科手术仍然是复发性颅内动脉瘤的有效治疗选择。然而,根据作者的经验,术后发病率高于非复发性动脉瘤患者。因此,必须进行治疗前多学科评估,以尽可能减少与再治疗相关的潜在发病率。当动脉瘤的血管内闭塞需要支架置入和盘绕时,应仔细评估替代的显微手术治疗,因为在动脉瘤复发的情况下,显微手术夹闭将变得更具挑战性。
REF: Lejeune JP, Karnoub MA, Devalckeneer A, Bretzner M, Bourgeois P, Aboukais R. Microsurgical management of recurrent intracranial aneurysm after endovascular treatment: a series of 60 consecutive patients. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.3.JNS24116 PMID: 38941640
The natural course, treatment outcomes, and long-term prognosis of cervical spinal cord arteriovenous shunts
颈部脊髓动静脉分流的自然病程,治疗结果和长期预后
This study presents a comprehensive analysis of the natural course, treatment, and clinical outcomes of cervical spinal cord arteriovenous shunts (SCAVSs). The results suggest that the outcomes of cervical SCAVSs were generally favorable, even in patients with partial obliteration of the lesions. However, patients who did not show a trend toward spontaneous recovery after onset had a significantly elevated risk of unfavorable prognosis, highlighting the need for prompt clinical intervention.
这项研究对颈部脊髓动静脉分流 (SCAVSs) 的自然病程,治疗和临床结果进行了全面分析。结果表明,即使在病变部分闭塞的患者中,颈部SCAVSs的结果通常也是有利的。然而,发病后未表现出自发恢复趋势的患者预后不良的风险显着升高,这凸显了及时进行临床干预的必要性。
REF: Lu HH, Li ZS, Li JW, et al. The natural course, treatment outcomes, and long-term prognosis of cervical spinal cord arteriovenous shunts. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.4.JNS232552 PMID: 38941649
A nomogram to predict long-term facial nerve function after vestibular schwannoma resection: a contemporary multi-institutional study
预测前庭神经鞘瘤切除术后长期面神经功能的列线图: 一项当代多机构研究
The objective of this study was to develop a nomogram to predict long-term facial nerve (FN) function after vestibular schwannoma (VS) resection. Better immediate postoperative HB grade, intraoperative FN EMG response ≥ 100 µV, and tumor size ≤ 25 mm strongly predicted good long-term FN function after VS resection. A point-of-care nomogram based on these variables could serve as a useful tool for postoperative counseling and prognosis of long-term FN recovery.
这项研究的目的是开发一种列线图来预测前庭神经鞘瘤 (VS) 切除术后的长期面神经 (FN) 功能。更好的术后即刻HB等级,术中FN EMG反应 ≥ 100 µ v,肿瘤大小 ≤ 25毫米,强烈预测VS切除术后良好的长期FN功能。基于这些变量的即时护理列线图可以作为术后咨询和长期FN恢复预后的有用工具。
REF: Harris MK, Macielak RJ, Kaul VF, et al. A nomogram to predict long-term facial nerve function after vestibular schwannoma resection: a contemporary multi-institutional study. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.4.JNS232208 PMID: 38941635
Subventricular zone–associated classification in isocitrate dehydrogenase–wildtype glioblastomas: improved prognostic value through integration of FLAIR with contrast-enhanced imaging
异柠檬酸脱氢酶-野生型胶质母细胞瘤的脑室下区相关分类: 通过FLAIR与对比增强成像的整合改善预后价值
The authors aimed to assess the potential of incorporating FLAIR imaging into contrast-enhanced T1-weighted (T1CE) imaging-;based subventricular zone (SVZ) classification to improve the prognostic value for glioblastoma (GBM) patients. They identified limitations of conventional T1CE imaging-based SVZ classification in GBM and demonstrated that incorporating T2-weighted/FLAIR imaging provides superior prognostic ability. The TERT promoter mutation may be crucial in infiltrating nonenhancing tumors into the SVZ. The study highlights the importance of nonenhancing components in GBM.
作者旨在评估将FLAIR成像纳入对比增强T1-weighted (T1CE) 成像的潜力; 基于脑室下区 (SVZ) 分类,以改善胶质母细胞瘤 (GBM) 患者的预后价值。他们确定了GBM中基于常规T1CE成像的SVZ分类的局限性,并证明了结合T2-weighted/FLAIR成像可提供出色的预后能力。TERT启动子突变可能在浸润非增强肿瘤进入SVZ中至关重要。这项研究强调了非增强成分在GBM中的重要性。
REF: Zhao X, Ren X, Li M, et al. Subventricular zone-associated classification in isocitrate dehydrogenase-wildtype glioblastomas: improved prognostic value through integration of FLAIR with contrast-enhanced imaging. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.4.JNS232658 PMID: 38941641
Surgical infarct volume reduction and functional outcomes in patients with ischemic cerebellar stroke: results from a multicentric retrospective study
缺血性小脑中风患者的手术梗死体积减少和功能预后: 多中心回顾性研究的结果
Recent work on ischemic cerebellar stroke has suggested that the resection of infarcted tissue may lead to improved functional outcomes compared with decompressive surgery alone. Nonetheless, no studies have assessed the extent to which necrotic tissue should be resected or if there are any volumetric thresholds capable of predicting functional outcomes in this patient population. In this study, the authors aimed to determine potential thresholds for volume reduction in ischemic cerebellar stroke in an effort to optimize the management of ischemic cerebellar stroke and, in so doing, improve functional outcomes. The reduction of necrotic tissue volumes by at least 50% and/or the reduction of the infarct volume by ≤ 17 cm3 appear to be associated with favorable outcomes in patients with surgically managed ischemic cerebellar strokes.
最近关于缺血性小脑中风的研究表明,与单纯减压手术相比,切除梗死组织可能会改善功能预后。尽管如此,尚无研究评估应切除坏死组织的程度,或者是否有任何体积阈值能够预测该患者人群的功能结局。在这项研究中,作者旨在确定缺血性小脑中风体积减少的潜在阈值,以优化缺血性小脑中风的管理,从而改善功能结局。坏死组织体积减少至少50% % 和/或梗死体积减少 ≤ 17立方厘米 % 似乎与手术治疗缺血性小脑中风患者的良好预后相关。
REF: Hernandez-Duran S, Walter J, Behmanesh B, et al. Surgical infarct volume reduction and functional outcomes in patients with ischemic cerebellar stroke: results from a multicentric retrospective study. J Neurosurg. Published online June 28, 2024. doi:10.3171/2024.3.JNS232883 PMID: 38941630
Brain tumor surgery guided by navigated transcranial magnetic stimulation mapping for arithmetic calculation
经颅磁刺激导航映射指导的脑肿瘤手术算术计算
Researchers used navigated transcranial magnetic stimulation (nTMS) mapping for arithmetic calculation to evaluate clinical outcome, identify subcortical circuits mainly involved in mathematical processing, and compare DCS and nTMS in a sample of 61 patients. Navigated TMS achieved a good clinical outcome: 92.8% had no impairment at 3 months of follow-up. The primary involved subcortical tracts were the arcuate fasciculus (56%) and frontal aslant tract (22%). The comparison between DCS and nTMS for calculation in awake surgery documented good reliability of nTMS.
研究人员使用导航经颅磁刺激 (nTMS) 映射进行算术计算,以评估临床结果,确定主要参与数学处理的皮质下回路,并比较61例患者的DCS和nTMS。导航TMS取得了良好的临床结果: 92.8% 在3个月的随访中没有损伤。主要累及的皮质下束是弓形束 (56%) 和额叶倾斜束 (22%)。DCS和nTMS在清醒手术中进行计算的比较证明了nTMS的良好可靠性。
REF: Bonaudo C, Pedone A, Capelli F, et al. Brain tumor surgery guided by navigated transcranial magnetic stimulation mapping for arithmetic calculation. J Neurosurg. Published online June 21, 2024. doi:10.3171/2024.4.JNS232968 PMID: 38905716
Predictors of unexplained early neurological deterioration after thrombectomy for posterior circulation infarction: a reanalysis of the BASILAR study
后循环梗死血栓切除术后不明原因早期神经功能恶化的预测因素: 对基底研究的再分析
The objective of this study was to assess the predictors of unexplained early neurological deterioration after endovascular thrombectomy with posterior circulation large-vessel occlusion. The authors found that stress hyperglycemic ratio, baseline National Institutes of Health Stroke Scale score, and asymptomatic intracranial hemorrhage were predictors of unexplained early neurological deterioration. These findings indicate that some modifiable factors may be targeted for improving the rate of a favorable outcome in patients after endovascular thrombectomy with posterior circulation large-vessel occlusion.
本研究的目的是评估后循环大血管闭塞的血管内血栓切除术后不明原因早期神经功能恶化的预测因素。作者发现应激性高血糖比率、基线美国国立卫生研究院卒中量表评分和无症状颅内出血是不明原因早期神经功能恶化的预测因子。这些发现表明,一些可改变的因素可能是提高后循环大血管闭塞的血管内血栓切除术后患者的良好结果率的目标。
REF: Dai Z, Cheng D, Peng D, et al. Predictors of unexplained early neurological deterioration after thrombectomy for posterior circulation infarction: a reanalysis of the BASILAR study. J Neurosurg. Published online June 21, 2024. doi:10.3171/2024.4.JNS232632IF: 3.5 Q1 PMID: 38905713
Adult craniopharyngioma concomitant with unruptured intracranial aneurysms: incidence, risk factors, and treatment strategies
成人颅咽管瘤合并未破裂颅内动脉瘤的发病率、危险因素及治疗策略
This study aimed to investigate the incidence and potential risk factors for the occurrence of unruptured intracranial aneurysms (UIAs) in patients with craniopharyngioma (CP), as well as to propose treatment strategies. The incidence rate of UIA in patients with CP was higher than that in the general population. Older age, hypertension, estrogen deficiency, and suprasellar tumor were independent risk factors for the occurrence of UIAs in CP patients. This study may provide a reference for the treatment of CP concomitant with UIA.
本研究旨在调查颅咽管瘤 (CP) 患者发生未破裂颅内动脉瘤 (UIAs) 的发生率和潜在危险因素,并提出治疗策略。CP患者UIA发病率高于普通人群。高龄、高血压、雌激素缺乏、鞍上肿瘤是CP患者UIAs发生的独立危险因素。本研究可为CP合并UIA的治疗提供参考。
REF: Cai K, Jia Y, Jin L, et al. Adult craniopharyngioma concomitant with unruptured intracranial aneurysms: incidence, risk factors, and treatment strategies. J Neurosurg. Published online June 14, 2024. doi:10.3171/2024.3.JNS232258 PMID: 38875730
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