Feasibility of occipital condyle screw placement in patients with Chiari malformation type I: a computed tomography-based morphometric study
ConclusionsThe OC screw is feasible in approximately half of OCs in CMI patients. Careful morphometric analyses and personalized surgical plans are necessary for the success of this operation in CMI patients. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 18, 2021 Category: Neurosurgery Source Type: research

Validation of 3D fluoroscopy for image-guidance registration in depth electrode implantation for medically refractory epilepsy
AbstractBackgroundFrame registration is a critical step to ensure accurate electrode placement in stereotactic procedures such as stereoelectroencephalography (SEEG) and is routinely done by merging a computed tomography (CT) scan with the preoperative magnetic resonance (MR) examination. Three-dimensional fluoroscopy (XT) has emerged as a method for intraoperative electrode verification following electrode implantation and more recently has been proposed as a registration method with several advantages.MethodsWe compared the accuracy of SEEG electrode placement by frame registration with CT and XT imaging by analyzing the...
Source: Acta Neurochirurgica - January 14, 2021 Category: Neurosurgery Source Type: research

Letter to the Editor: Endoscopic surgical strategy of pineal cyst-associated aqueductal stenosis
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 13, 2021 Category: Neurosurgery Source Type: research

Anterior callosal angle correlates with gait impairment and fall risk in iNPH patients
ConclusionsThe baseline ACA is a useful neuroradiological marker to differentiate patients by fall risk and has significant correlation with the improvement in gait and balance impairment following surgery. This study demonstrated that the ACA may be a complementary tool to the CA in predicting shunt responsiveness in iNPH. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2021 Category: Neurosurgery Source Type: research

Predatory journals: temporary inconvenience or permanent disruption?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2021 Category: Neurosurgery Source Type: research

Patterns of axono-cortical evoked potentials: an electrophysiological signature unique to each white matter functional site?
ConclusionsWe found that the patterns of ACEPs provided unique electrophysiological signatures for each of the five white matter functional sites. Our results could ultimately provide neurosurgeons with a new tool of intraoperative electrophysiologically based functional guidance. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 12, 2021 Category: Neurosurgery Source Type: research

Comparison of clinical and histopathological characteristics of short-term progressive and non-progressive blood blister-like aneurysms
AbstractBackgroundMany blood blister aneurysms (BBAs) have been documented with a rapid progression history in repeated angiography. The underlying mechanism and clinical significance remained elusive. This current study aims to clarify the clinical and histopathological differences between short-term progressive BBA and non-progressive BBAs.Methods and materialsEighty-one patients with BBAs were consecutively included for this single-center retrospective analysis. Clinical and radiological data on these patients were retrieved from 2017 to 2019. BBAs were defined as either progressive or non-progressive based on observed ...
Source: Acta Neurochirurgica - January 11, 2021 Category: Neurosurgery Source Type: research

Early clinical predictors of functional recovery following traumatic spinal cord injury: a population-based study of 143 patients
AbstractBackgroundTraumatic spinal cord injuries (TSCI) are associated with uncertainty regarding the prognosis of functional recovery. The aim of the present study was to evaluate the potential of early clinical variables to predict the degree of functional independence assessed by Spinal Cord Independence Measure III (SCIM-III) up to 1  year after injury.MethodsProspectively collected data from 143 SCI patients treated in Western Denmark during 2012 –2019 were retrospectively analysed. Data analysis involved univariate methods and multivariable linear regression modelling total SCIM-III scores against age, gen...
Source: Acta Neurochirurgica - January 11, 2021 Category: Neurosurgery Source Type: research

Effect of a bundle approach on external ventricular drain-related infection
AbstractBackgroundEmergency placement of an external ventricular drain (EVD) is one of the most frequently performed neurosurgical procedures. EVD-related infection continues to be a major challenge causing significant morbidity and costs. Bundle approaches have been shown to reduce infection rates; however, they are still not widely used, and observation periods often were rather short.MethodsThe present study evaluated the effect of a multi-item bundle approach for EVD placement and care on the occurrence of EVD-related infection. A before/after approach was used to compare groups of consecutive patients over 5-year epoc...
Source: Acta Neurochirurgica - January 11, 2021 Category: Neurosurgery Source Type: research

How I do it: Management of venous bleeding from the superior petrosal vein during endoscopic microvascular decompression
ConclusionThis oxycellulose ball technique offers simple, reliable control of venous bleeding from the SPV. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 8, 2021 Category: Neurosurgery Source Type: research

Telemetric monitoring in idiopathic intracranial hypertension demonstrates intracranial pressure in a case with sight-threatening disease
AbstractThe understanding of raised intracranial pressure (ICP) is increasing with the directed use of intracranial telemetric ICP monitors. This case uniquely observed ICP changes by telemetric monitoring in a patient with idiopathic intracranial hypertension (IIH), who developed rapid sight-threatening disease. A lumbar drain was inserted, as a temporising measure, and was clamped prior to surgery. This resulted in a rapid rise in ICP, which normalised after insertion of a ventriculoperitoneal shunt. This case highlighted the utility of the ICP monitor and the lumbar drain as a temporising measure to control ICP prior to...
Source: Acta Neurochirurgica - January 7, 2021 Category: Neurosurgery Source Type: research

Determinants of accuracy of freehand external ventricular drain placement by neurosurgical trainees
AbstractBackgroundThe external ventricular drain (EVD) placement is one of the most common neurosurgical procedures. This operation is performed by freehand technique in the majority of cases; therefore, the operator ’s experience plays an important role in success and possible morbidity of this procedure.ObjectiveTo evaluate the accuracy and safety of EVD placement by junior neurosurgery residents and factors predicting accuracy of EVD placement.MethodsThis is a prospective cohort study conducted at our academic medical center, between September 2017 and August 2018. All patients 18  years or older who required...
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Color Doppler ultrasonography for predicting the patency of anastomosis after superficial temporal to middle cerebral artery bypass surgery
ConclusionCDUS can be utilized for predicting the patency after STA-MCA bypass surgery; if the postoperative (compensated and compared) CDUS parameters increased by more than 47.5% in the MFR or 15% in the CSD, the patency of the anastomosis on DSA would be good. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Clinical features of middle cluneal nerve entrapment neuropathy
ConclusionsWe confirmed MCN-EN in 50 of 105 patients admitted for intractable LBP. Repeat MCN blocks were effective in 22 patients; 19 required additional conservative treatment, and 9 underwent surgery. Buttock pain radiating to the posterior thigh was an MCN-EN symptom that has been diagnosed as pseudo-sciatica. Before subjecting patients with intractable LBP to surgery, the presence of MCN-EN must be ruled out. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Modifications in lumbar facet joint are associated with spondylolisthesis in the degenerative spine diseases: a comparative analysis
AbstractBackgroundMagnetic resonance imaging (MRI) is important in the assessment of degenerative spine disease. However, its role is limited in the identification of spinal instability; therefore, weight-bearing and dynamic studies like X-rays are required. The supine position eliminates the gravitational pull, corrects the vertebral slippage, and opens the facet joints leading to the collection of the synovial fluid into the joint space, which is detected on the MRI and can serve as a marker for instability. We aim to compare the facet fluid, facet hypertrophy, facet angle, and disc degenerative changes among the patient...
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Timelines and rebleeds in patients admitted into neurosurgical care for aneurysmal subarachnoid haemorrhage
ConclusionsThe risk of rebleed is imminent throughout the entire timeline of aSAH management even with ultra-early aneurysm repair. Several modifiable factors can be linked to the occurrence of rebleeds and they should be identified and optimised within neurosurgical departments. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Blood-brain barrier permeability imaging as a predictor for delayed cerebral ischaemia following subarachnoid haemorrhage. A narrative review
ConclusionRadiological biomarkers offer a potential non-invasive prognostication tool and may also allow early identifications of patients who may be at risk of DCI. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Effects of aspirin and heparin treatment on perioperative outcomes in patients with Moyamoya disease
ConclusionsIn MMD patients who received combined revascularization surgery, aspirin medication lowered the occurrence of white thrombus. Heparin injections help to treat white thrombus but can enhance the risk of hemorrhagic complications. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Current patterns of practice in spinal fusion for chronic low back pain —results from a survey at the German Spine Societies’ Annual Congress 2018
AbstractBackgroundThere is debate regarding criteria to select patients for lumbar fusion surgery who have chronic low back pain (CLBP) and corresponding degenerative changes, but without nerve root compression or neurogenic claudication. The aim of this study was to compare patterns in current practice.MethodA total of 143 printed questionnaires containing 51 questions were distributed at the German Spine Societies' (DWG) annual congress, 6 –8 December 2018.ResultsWe received 127 (89%) surveys (64 orthopedic surgeons and 63 neurosurgeons). Excluding the 22% who do not perform lumbar fusion for CLBP, 41.4% reported p...
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

How I do it: anterior interhemispheric approach to tuberculum sellae meningiomas
ConclusionThis approach has the advantage of providing full control over all the vasculo-nervous structures involved and of allowing access to the medial aspect of both optic canals tangentially to the dorsum sellae. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Sedation and cerebrovascular reactivity in traumatic brain injury: another potential avenue for personalized approaches in neurocritical care?
ConclusionsThis small series highlights the potential impact of depth of sedation on cerebrovascular reactivity in TBI. It suggests that there may be an individual optimal depth of sedation, so as to optimize cerebrovascular reactivity. Further study of objective depth of sedation and its impact on cerebrovascular physiology in TBI is required. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Radiographic predictors of clinical outcome in traumatic brain injury after decompressive craniectomy
ConclusionsHemispheric hypodensity and effacement of the crural and ambient cisterns on postoperative CT after primary DC seems to associate with poor outcome in patients with TBI. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Editorial: Radiosurgical induced malignancy associated with stereotactic radiosurgery
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

From patient-centred ethics to the ethics of a pandemic
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

How neurosurgical departments in Lombardy are getting ready to face the second wave of the COVID-19 pandemic: update from the most hit region in Italy
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 6, 2021 Category: Neurosurgery Source Type: research

Utility of intraoperative ultrasonography for resection of pituitary adenomas: a comparative retrospective study
AbstractBackgroundThe evolution of pituitary surgery has made it a safe and effective form of treatment; however, risks of inadequate tumor resection, cerebrospinal fluid (CSF) leak, pituitary dysfunction, and vascular injury still exist. The use of intraoperative ultrasonography (IOUS) in pituitary surgery has been well described. Recent advancements in ultrasound technology have allowed for expanded utility as described here.MethodsA retrospective review was performed between January 2016 and December 2019. One hundred thirty-eight patients (mean age 53.7 years, 47% females) were identified undergoing transsphenoidal sur...
Source: Acta Neurochirurgica - January 5, 2021 Category: Neurosurgery Source Type: research

Impact of the weekend effect on outcome after microsurgical clipping of ruptured intracranial aneurysms
ConclusionsAdmission out of regular working hours and clipping at nighttime were not independently associated with poor outcome. The adherence to standardized treatment protocols might mitigate the “weekend effect.” (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 5, 2021 Category: Neurosurgery Source Type: research

Clinical evaluation of a real-time inverse planning for Gamma Knife radiosurgery by convex optimization: a prospective comparative trial in a series of vestibular schwannoma patients
ConclusionThese preliminary results showed that this new IP method based on « efficient convex optimization algorithms », called IntuitivePlan®, provided high-quality dose plans in real time with excellent coverage, selectivity, and gradient indexes with optimized beam-on time. If the new IP evaluated here is able to compete in real time with the quality of the treatment plans of an expert with extensive radiosurgical experience, this could allow new planners/radiosurgeons with limited or no experience to immediately provide patients with high-quality GKRS for benign and malignant lesions. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 5, 2021 Category: Neurosurgery Source Type: research

Safety and efficacy of upfront stereotactic radiosurgery for brain metastases with high cumulative intracranial tumor volume ( & gt;  7 ml): analysis of 233 consecutive patients
AbstractBackgroundThe cumulative intracranial tumor volume (CITV) has recently been suggested to be a more relevant predictive factor for patients with brain metastases (BM) treated with stereotactic radiosurgery (SRS). We aimed to investigate the feasibility of upfront SRS for patients with BM having a high CITV, i.e., exceeding 7  ml.MethodsTwo hundred thirty-three consecutive patients with BM having a CITV>  7 ml who underwent SRS as first-line treatment from 2011 to 2019 were retrospectively identified. The overall survival (OS) and intracranial disease control rates were analyzed. Multivariate prop...
Source: Acta Neurochirurgica - January 4, 2021 Category: Neurosurgery Source Type: research

Clinical applications of the endoscopic transorbital approach for various lesions
ConclusionsThe endoscopic transorbital approach could be considered to be feasible for various lesions with different characteristics. After carefully considering the lesion anatomy, consistency, and vascular relationships, using this approach, we could achieve a satisfactory extent of resection without severe complications. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 4, 2021 Category: Neurosurgery Source Type: research

Validation of shunt dependency prediction scores after aneurysmal spontaneous subarachnoid hemorrhage
AbstractBackgroundCurrently available scores for predicting shunt dependency after aneurysmal spontaneous subarachnoid hemorrhage (aSAH) are limited and not widely accepted. The key purpose of this study was to validate a recently created score for shunt dependency in aSAH (SDASH) in an independent population of aSAH patients. We compared this new SDASH score based on a combination of the Hunt and Hess grade, Barrow Neurological Institute (BNI) score, and the presence or not of acute hydrocephalus with other published predictive scores.MethodsThe SDASH score, Hijdra score, BNI grading system, chronic hydrocephalus ensuing ...
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Craniocervical fractures management in case of craniocervical pneumatization: case report and review of the literature
ConclusionsThis review suggests that fractures secondary to CCP are extremely rare and are associated to a good clinical and radiological outcome with conservative treatment. Ear, nose, and throat (ENT) evaluation is recommended to detect cases who need treatment for a subjacent middle ear disease. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

The role of pulsatile and static intracranial pressure measurements in the management of children with craniosynostosis –an institutional experience from 49 patients
ConclusionsIn this cohort of pediatric patients with CSS presenting with various diagnostic challenges, we found the diagnostic measurement of static and pulsatile ICP useful in selecting the optimal treatment modality and timing of surgery. Papilledema was associated with elevated pulsatile ICP, a parameter that in previous studies has been shown to correlate with impaired intracranial compliance. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Metastases to meningioma —review and meta-analysis
ConclusionTTMM should be suspected in cases of meningioma in a patient with background cancer, regardless of meningioma parameters or cancer status. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Impact of vestibular nerve preservation on facial and hearing outcomes in small vestibular schwannoma surgery: a technical feasibility study
ConclusionImprovement of facial nerve and hearing outcomes is feasible through the intentional preservation of the vestibular nerves in the resection of small VSs. Longer follow-up is required to rule out tumor recurrence. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

The “weekend effect” and outcomes after clipping of ruptured intracranial aneurysms—general healthcare metrics and trained vascular neurosurgeons
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Long-term telemetric intracerebral pressure monitoring as a tool in intracranial hypotension
We present a 42-year-old male with IH treated with computed tomography-guided epidural blood patch. The diagnosis and treatment assessment included continual intracerebral pressure (ICP) monitoring. We found ICP monitoring helpful in IH diagnosis and long-term assessment of treatment and propose this modality as a supplement in difficult IH cases. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Predatory publishing and journals: how to address a profitable and ubiquitous business
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Letter to the Editor regarding “Chiari I malformation and pregnancy: a comprehensive review of the literature to address common questions and to guide management.”
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 3, 2021 Category: Neurosurgery Source Type: research

Past, present and future, the experience of time during examination for malignant brain tumor: a qualitative observational study
ConclusionsThe findings contribute to a better understanding of the perception of time among seriously ill patients and may further healthcare professionals ’ awareness of how to support patients in achieving a more meaningful use of their remaining lifetime. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 2, 2021 Category: Neurosurgery Source Type: research

Complications of external cerebrospinal fluid drainage in aneurysmal subarachnoid haemorrhage
ConclusionComplications are common in patients with aneurysmal subarachnoid haemorrhage of which 32% are drain-related. A correlation is present between drainage period and the number of complications. Therefore, reducing drainage period could be a target for further improvement of care. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 2, 2021 Category: Neurosurgery Source Type: research

Dural arteriovenous fistula formation following bilateral middle meningeal artery embolization for the treatment of a chronic subdural hematoma: a case report
AbstractHere is reported a case of dural arteriovenous fistula (DAVF) formation following middle meningeal artery (MMA) embolization. A 64-year-old male patient was operated for a bilateral CSDH by burr-hole craniostomy. Prophylactic post-operative MMA embolization was performed with 300 –500-μm calibrated microparticles. The patient was admitted 3 months later for a left CSDH recurrence. Digital subtraction angiography demonstrated formation of a superior sagittal sinus DAVF fed by both superficial temporal arteries. This case highlights the possible role of local tissue hypoxia as a significant component of DAVF...
Source: Acta Neurochirurgica - January 2, 2021 Category: Neurosurgery Source Type: research

Posterior fossa decompression with duraplasty in Chiari malformation type 1: a systematic review and meta-analysis
ConclusionsIn the absence of hydrocephalus and craniocervical region instability, PFDD provides better clinical outcomes but with higher risk. The use of PFD may be justified in some cases in children, and in the absence of a syrinx. To help with future outcome assessments in patients with a CM-I, standardization of clinical and radiological grading systems are required.Trial registration: not required (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Globus pallidus internus activity during simultaneous bilateral microelectrode recordings in status dystonicus
We report simultaneous microelectrode recordings (MERs) from the globus pallidus internus (GPi) of a patient with SD who was treated with bilateral deep brain stimulation (DBS). Mean neuronal discharge rate was of 30.1  ± 10.9 Hz and 38.5 Hz ± 11.1 Hz for the right and left GPi, respectively. On the right side, neuronal electrical activity was completely abolished at the target point, whereas the mean burst index values showed a predominance of bursting and irregular activity along trajectories on bot h sides. Our data are in line with previous findings of pallidal i...
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Frequency and risk factors for postoperative aneurysm residual after microsurgical clipping
ConclusionsA middle cerebral artery location seems to lower the risk for the incomplete clip occlusion of an aneurysm. Greater aneurysm size (11 –25 mm) is associated with a postoperative aneurysm remnant. The majority of “dog-ear” remnants appear to remain stable during follow-up. In these cases, unnecessarily frequent angiographic checks could be avoided. By contrast, broad-based residuals show a higher risk of regrowth that requires close imaging controls if retreatment cannot be performed immediately. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

An analysis of retractions in neurosurgery and allied clinical and basic science specialties
ConclusionsThe retraction notice needs to be freely available on all search engines. Plagiarism checks and reference checks prior to publication of papers (to ensure no retracted papers have been cited) must be mandatory. Mandatory data deposition would help overcome issues with data and results. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Arachnoiditis and Chiari I malformation
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Predatory publishing and journals: it ’s ubiquitous!
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Surgery for diaphragma sellae meningioma: how I do it
ConclusionsThe transcranial approach allows a safe tumor excision with an early and adequate control of the neurovascular structures, while minimizing postoperative CSF rhinorrhea. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research

Annular closure device breakage due to recurrent lumbar disc herniation: a case report
AbstractDetailed surgical management, magnetic resonance imaging (MRI), and computer tomography (CT) images of a broken annular closure device (ACD) have not been reported yet. In this case, a 28-year-old male presented with a new onset of radiculopathy three years after lumbar discectomy and placement of an ACD. The CT-myelography and MRI revealed a recurrent disc herniation (RDH) and dislocation of a broken ACD. ACD removal was performed and confirmed breakage due to RDH with scarring around the RDH and displaced ACD. Implant-associated complications and management should be reported in detail in order to enhance knowled...
Source: Acta Neurochirurgica - January 1, 2021 Category: Neurosurgery Source Type: research