Surgical Management and Prognostic Factors for Endolymphatic Sac Tumor: A Single-Institute Experience with a Systematic Review

内淋巴囊肿瘤的外科治疗和预后因素: 系统综述的单研究所经验

To evaluate the clinical features, surgical outcomes, and predictors of progression-free survival (PFS) in patients with endolymphatic sac tumors (ELSTs). GTR is crucial for improving PFS in patients with ELST, emphasizing the need for advanced surgical techniques and long-term follow-up because of potential recurrences.

评估内淋巴囊肿瘤 (ELSTs) 患者的临床特征，手术结局和无进展生存期 (PFS) 的预测因素。GTR对于改善ELST患者的PFS至关重要，强调由于潜在的复发，需要先进的手术技术和长期随访。

REF: Weng J, Wen X, Li D, Li H, Li H. Surgical Management and Prognostic Factors for Endolymphatic Sac Tumor: A Single-Institute Experience with a Systematic Review. World Neurosurg. 2025;194:123384. doi:10.1016/j.wneu.2024.10.113 PMID: 39491618

DTI Analysis of the Peritumoral Zone of Diffuse Low-grade Gliomas in Progressing Patients

进展期患者弥漫性低级别胶质瘤瘤周区的DTI分析

Diffuse low-grade gliomas are rare brain tumors transforming to higher grade even with surgery, chemotherapy, and radiotherapy. Their preferential infiltration of white matter tracts, beyond tumor boundaries on fluid-attenuated inversion recovery (FLAIR), make difficult to plan focal treatment such as surgery or radiotherapy and monitor response to chemotherapy. Diffusion tensor imaging (DTI) might reflect this infiltration of white matter tracts. The aim of our study is to assess how DTI signal in the peritumoral zone might be modified before FLAIR tumor progression appears at 1-year follow-up. This study shows pre-existing DTI signal abnormalities in regions with tumor progression at 1 year. Such abnormalities could correspond to a tumor infiltration not yet visible on FLAIR. This might be helpful to predict tumor progression and allow to adapt the therapeutic strategy.

弥漫性低度神经胶质瘤是罕见的脑肿瘤，即使经过手术，化学疗法和放射疗法也会转化为更高级别。它们优先浸润白质束，超出了液体衰减反转恢复 (FLAIR) 的肿瘤边界，使得难以计划局部治疗，例如手术或放疗，并监测对化疗的反应。扩散张量成像 (DTI) 可能反映了这种白质束的浸润。我们研究的目的是评估在1年随访时FLAIR肿瘤进展出现之前，肿瘤周围区域的DTI信号如何被修改。这项研究显示了1年时肿瘤进展区域中预先存在的DTI信号异常。这种异常可能对应于在FLAIR上还不可见的肿瘤浸润。这可能有助于预测肿瘤进展并允许调整治疗策略。

REF: Chiche D, Taillandier L, Blonski M, et al. DTI Analysis of the Peritumoral Zone of Diffuse Low-grade Gliomas in Progressing Patients. World Neurosurg. 2025;194:123382. doi:10.1016/j.wneu.2024.10.111 PMID: 39489335

Meningioma En Plaque Associated with Cerebrospinal Fluid Rhinorrhea: A Systematic Review of the Literature with Case Presentation

脑膜瘤与脑脊液流涕相关的斑块: 文献系统综述与病例介绍

Meningiomas are the most frequently diagnosed benign intracranial tumors. However, meningioma en plaque (MEP) is a rare subset accounting for 2.5% of all meningiomas and is characterized by flat, carpetlike proliferation along the dura, typically arising in the spheno-orbital region, and, therefore, causes proptosis, decreased visual acuity, and orbital pain. We present a unique case of a patient with MEP presenting with cerebrospinal fluid (CSF) rhinorrhea and conduct a systematic review of the literature. MEP associated with spontaneous CSF rhinorrhea is extremely rare and poses diagnostic and therapeutic challenges. Conservative management for select cases of MEP can be a good choice, sparing the patient from surgical complications, especially for skull base areas that are difficult to access.

脑膜瘤是最常被诊断的颅内良性肿瘤。然而，脑膜瘤斑块 (MEP) 是一种罕见的子集，占所有脑膜瘤的2.5%，其特征是沿硬脑膜平坦，地毯状增生，通常发生在蝶骨眶区域，因此导致眼球突出，视力下降和眼眶疼痛。我们介绍了一例MEP患者出现脑脊液 (CSF) 流涕的独特病例，并进行了文献系统综述。与自发性CSF流涕相关的MEP极为罕见，并带来诊断和治疗挑战。对于MEP的某些病例，保守治疗可能是一个不错的选择，可以使患者免于手术并发症，尤其是对于难以进入的颅底区域。

REF: Abouammo MD, Alsavaf MB, Biswas C, et al. Meningioma En Plaque Associated with Cerebrospinal Fluid Rhinorrhea: A Systematic Review of the Literature with Case Presentation. World Neurosurg. 2025;194:123371. doi:10.1016/j.wneu.2024.10.100 PMID: 39486580

Surgical Strategy and Decision-Making in Recurrent Atlanto-Axial Dislocations: The Role of Traction

复发性寰枢椎脱位的手术策略和决策: 牵引的作用

To analyse patients with recurrent atlanto-axial dislocation and give a criterion of an ideal patient who can benefit from redo surgery. The best candidates who can benefit after redo surgery are the ones who exhibit either clinical and/or radiological improvement on the trial of traction, as the pathological C1-C2 joints are either not fused or have undergone pseudoarthrosis. Those patients who do not exhibit significant clinical or radiological improvement post-trial of traction should not be offered subsequent surgical intervention.

分析复发性寰枢椎脱位的患者，并给出可以从重做手术中受益的理想患者的标准。重做手术后可以受益的最佳候选人是在牵引试验中表现出临床和/或放射学改善的候选人，因为病理性C1-C2关节没有融合或经历了假关节。那些在牵引试验后未表现出明显临床或放射学改善的患者不应接受后续手术干预。

REF: Devani KK, Singha S, Purohit P, Pruthi N. Surgical Strategy and Decision-Making in Recurrent Atlanto-Axial Dislocations: The Role of Traction. World Neurosurg. 2025;194:123370. doi:10.1016/j.wneu.2024.10.099 PMID: 39486581

Burnout in Neurosurgery in the Postpandemic Era

大流行后时代神经外科的倦怠

Burnout syndrome impacts 1 of 2 neurosurgeons and negatively impacts both the individual and institution. The impact of burnout on neurosurgeons may have increased due to the SARS-CoV-2 pandemic. Characteristics of burnout may differ among neurosurgeons and non-neurosurgeon physicians, and this may better target wellness initiatives designed to alleviate burnout. We show that although the rate of burnout does not differ for neurosurgeons, the characteristics of burnout may. This may represent the key to providing specialty-specific targeted interventions to alleviate burnout. Furthermore, there is a significant proportion of neurosurgeons at risk for subsequent burnout for which additional importance must be placed to prevent progression to burnout.

倦怠综合征影响2名神经外科医生中的1名，并对个人和机构产生负面影响。由于SARS-CoV-2大流行，倦怠对神经外科医生的影响可能会增加。神经外科医生和非神经外科医生的倦怠特征可能有所不同，这可能会更好地针对旨在减轻倦怠的健康计划。我们表明，尽管神经外科医生的倦怠率没有差异，但倦怠的特征可能。这可能是提供针对特定专业的针对性干预措施以减轻倦怠的关键。此外，有很大比例的神经外科医生有随后倦怠的风险，为此必须给予额外的重视，以防止进展为倦怠。

REF: Schneider D, Mishra A, Shao M, Larry Lo SF, Sciubba DM; Northwell Wellness Consortium. Burnout in Neurosurgery in the Postpandemic Era. World Neurosurg. 2025;194:123369. doi:10.1016/j.wneu.2024.10.098 PMID: 39481847

The Correlation of Vessel Wall Macrophage Infiltration With Hemosiderin in Arteriovenous Malformations

动静脉畸形血管壁巨噬细胞浸润与含铁血黄素的相关性

Endothelial dysfunction, induced by high shear stress from increased nidal blood flow, may promote a cycle of inflammation, possibly leading to instability and cerebral arteriovenous malformations (AVMs) rupture. Macrophages, identified with Cluster of Differentiation 68, are key inflammatory components in AVM pathology. We aim to evaluate the relationship of inflammation with AVM flow and hemosiderin. These findings suggest a relationship among AVM vessel wall inflammation, hemosiderin, and hemorrhage presentation. Further investigations with larger sample sizes are warranted to understand the role of altered hemodynamics, hemosiderin deposition, and inflammation in AVM vessel walls.

由nidal血流增加引起的高剪切应力引起的内皮功能障碍可能会促进炎症循环，可能导致不稳定和脑动静脉畸形 (avm) 破裂。用分化簇68鉴定的巨噬细胞是AVM病理学中的关键炎性组分。我们旨在评估炎症与AVM流量和含铁血黄素的关系。这些发现表明AVM血管壁炎症，含铁血黄素和出血表现之间存在关系。有必要进行更大样本量的进一步研究，以了解血液动力学改变，含铁血黄素沉积和AVM血管壁炎症的作用。

REF: Hossa J, McGuire LS, Valyi-Nagy T, et al. The Correlation of Vessel Wall Macrophage Infiltration With Hemosiderin in Arteriovenous Malformations. World Neurosurg. 2025;194:123368. doi:10.1016/j.wneu.2024.10.097 PMID: 39505300

Severe Traumatic Brain Injury Outcomes in Patients with Premorbid Psychiatric Illness

病前精神疾病患者的严重颅脑损伤结局

Individuals with psychiatric illnesses (PIs) have increased rates of traumatic brain injury (TBI). Nonetheless, the influence of underlying PI on TBI outcomes is poorly understood. Individuals with PI and SUD appeared to have better outcomes but more complicated hospital stays following severe TBI. Future studies should investigate the mechanisms underlying these outcomes.

患有精神疾病 (pi) 的人的创伤性脑损伤 (TBI) 发生率增加。尽管如此，潜在的PI对TBI结果的影响知之甚少。患有PI和SUD的人似乎有更好的结果，但在严重的TBI后住院时间更复杂。未来的研究应该调查这些结果背后的机制。

REF: Passman JN, Cleri NA, Robertson J, et al. Severe Traumatic Brain Injury Outcomes in Patients with Premorbid Psychiatric Illness. World Neurosurg. 2025;194:123367. doi:10.1016/j.wneu.2024.10.096 PMID: 39486578

How Do Craniometric Measurements and Skull Morphology Influence Subthalamic Nucleus Target Coordinations in Deep Brain Stimulation Surgery for Parkinson Disease?

在帕金森病脑深部电刺激手术中，颅骨测量和颅骨形态如何影响丘脑底核目标的协调？

This study investigates the correlation among craniometric measurements, skull morphology, and subthalamic nucleus (STN) target coordinates in DBS surgery. Craniometric measurements and third ventricle width correlate significantly with STN coordinates, particularly the X-coordinates. Our study highlights the importance of individualized craniometric considerations in DBS surgery planning to optimize electrode placement and therapeutic outcomes.

这项研究调查了DBS手术中颅骨测量，颅骨形态和丘脑底核 (STN) 目标坐标之间的相关性。颅骨测量和第三脑室宽度与STN坐标，尤其是X坐标显着相关。我们的研究强调了在DBS手术计划中个性化颅骨测量考虑的重要性，以优化电极放置和治疗结果。

REF: Pham TA, Luong CM, Dao PD, Vo NT, Tran TN, Diem Nguyen TA. How Do Craniometric Measurements and Skull Morphology Influence Subthalamic Nucleus Target Coordinations in Deep Brain Stimulation Surgery for Parkinson Disease?. World Neurosurg. 2025;194:123366. doi:10.1016/j.wneu.2024.10.095 PMID: 39481841

Electromagnetic Navigation Improves Accuracy and Reduces Complications of Ventriculoperitoneal Shunts in Patients with Idiopathic Normal Pressure Hydrocephalus: A Single-Center Clinical Experience

电磁导航可提高特发性正常压力脑积水患者的准确性并减少脑室-腹腔分流术的并发症: 单中心临床经验

Ventriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compared the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in patients with iNPH, focusing on catheter accuracy and postoperative complication rates. The use of EM navigation in VP shunt placement for patients with iNPH improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.

脑室腹膜 (VP) 分流手术是特发性正常压力脑积水 (iNPH) 患者的主要治疗方法。这项研究比较了iNPH患者使用电磁 (EM) 导航与标准方法放置VP分流器的结果，重点是导管准确性和术后并发症发生率。在iNPH患者的VP分流器放置中使用EM导航可提高导管放置的准确性，减少术后并发症和分流器故障率，并提供精确和个性化的手术治疗。

REF: Ma X, Fan X, Yang W, et al. Electromagnetic Navigation Improves Accuracy and Reduces Complications of Ventriculoperitoneal Shunts in Patients with Idiopathic Normal Pressure Hydrocephalus: A Single-Center Clinical Experience. World Neurosurg. 2025;194:123428. doi:10.1016/j.wneu.2024.11.011 PMID: 39577631