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 - October 17, 2021 Category: Neurosurgery Source Type: research

Radiofrequency thermocoagulation of the sulcus bottom in type II focal cortical dysplasia-related epilepsy with tapered implantation of electrodes: a case report
We report a 15-year-old male patient with recurrent epileptic seizures for 12  years. Oral multiple drugs do not work well to his condition. MRI FLAIR scans revealed focal cortical dysplasia type II in the right parietal lobe. The diagnosis of the patient was drug-refractory epilepsy, FCD-related secondary epilepsy. According to the shape of the FCD lesion, electrodes were i mplanted in a tapered pattern along the bottom of the sulcus to completely destroy the focus. Magnetic resonance imaging at 6 months after surgery revealed that the FCD at the sulcus bottom was completely destroyed. After 26 months of fo...
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Multiple anterior choroidal arteries and perioperative ischemic complications in unruptured anterior choroidal artery aneurysms treated with microsurgical clipping
ConclusionsMultiple-type AchoA aneurysms and multilobulated shape are significantly correlated with perioperative ischemic complications. Postoperative ischemic complications can be minimized by recognizing these variations and using multimodal approach with MEP monitoring. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Posterior cranial fossa and cervical spine morphometric abnormalities in symptomatic Chiari type 0 and Chiari type 1 malformation patients with and without syringomyelia
ConclusionsPatients withSPCF-TH0 with and without syringomyelia developed Chiari 1 symptoms and signs. Patients withSPCF-TH0-syr (Chiari 0) had more constriction of their CSF pathways in and around the foramen magnum than patients withSPCF-TH0-only. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Impact of subcallosal artery origin and A1 asymmetry on surgical outcomes of anterior communicating artery aneurysms
ConclusionCombination of A1 asymmetry and larger aneurysmal size was significantly associated with SubCA aneurysmal neck origin and poor functional outcomes in ACoA aneurysm surgery. Interhemispheric approach may be proposed to provide a wider and unobstructed view of SubCA for ACoA aneurysms with this high-risk anatomical variant. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Lateral one-third gland resection in Cushing patients with failed adenoma identification leads to low remission rates: long-term observations from a small, single-center cohort
ConclusionsIn CD patients with failed intraoperative adenoma visualization, lateral one-third gland resection resulted in low morbidity and long-term remission in 31% of patients without the need for additional therapies. Bearing in mind the sample size of this audit, the indication for lateral one-third-gland resection has to be critically appraised and discussed with the patients before surgery. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Clinical characteristics and long-term surgical outcomes of spinal pilocytic astrocytoma: a report of twenty cases
ConclusionPrimary spinal PA is a rare entity with acceptable progression-free survival if treated appropriately. Surgical resection may provide reasonable prolongation of survival, and GTR should be achieved if possible. A close follow-up is recommended especially for residual lesions, and a further in-depth investigation of molecular biomarkers is needed to stratify risk and prognostic factors. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Robotic-assisted percutaneous iliac screw fixation for destructive lumbosacral metastatic lesions: an early single-institution experience
ConclusionRobotic-assisted percutaneous iliac screw fixation is a safe and feasible technique to improve operative and clinical outcomes in complex spinal instrumentation surgeries. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Pituitary surgery for Cushing ’s disease
ConclusionA rigorous and planned surgical strategy avoids the pitfalls of Cushing ’s disease surgery and leads to a high rate of endocrine remission. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Biportal endoscopic debridement and percutaneous screw fixation technique for spinal tuberculosis: how I do it
ConclusionMinimally invasive endoscopic and percutaneous screw technique can aid the diagnosis and treatment of spinal tuberculosis. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Complication avoidance: resection of the insular glioma complicated by iatrogenic injury to the lenticulostriate artery
ConclusionProximal dissection of the Sylvian fissure up to the most lateral LSA, the emergence of the beige putamen, and the lenticulostriate veins are anatomic landmarks that allow reducing the risk of damaging the intraparenchymatous segment of the LSAs. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

How I do it? Posterior inferior cerebellar artery-intracranial vertebral artery reimplantation bypass and trapping of dissecting aneurysm involving the proximal posterior inferior cerebellar artery
ConclusionThis case demonstrates the feasibility and safety of PICA-V4 reimplantation bypass, especially if the origin of the PICA is highly seated and the intracranial VA, or V4 segment, is long enough and well-exposed supra or under hypoglossal nerves. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Author response to: Complications in stereoelectroencephalography: are we too severe?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Complications in stereoelectroencephalography: are we too severe?
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Reply to the Letter: Failed back surgery syndrome, a term overdue for replacement
(Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 17, 2021 Category: Neurosurgery Source Type: research

Distribution of electric field in patients with obsessive compulsive disorder treated with deep brain stimulation of the bed nucleus of stria terminalis
AbstractBackgroundDeep brain stimulation (DBS) is being investigated as a treatment for therapy-refractory obsessive compulsive disorder (OCD). Many different brain targets are being trialled. Several of these targets such as the ventral striatum (including the nucleus accumbens (NAc)), the ventral capsule, the inferior thalamic peduncle, and the bed nucleus of stria terminalis (BNST)) belong to the same network, are anatomically very close to one another, or even overlap. Data is still missing on how various stimulation parameters in a given target will affect surrounding anatomical areas and impact the clinical outcome o...
Source: Acta Neurochirurgica - October 15, 2021 Category: Neurosurgery Source Type: research

Twist drill craniostomy vs burr hole drainage of chronic subdural hematoma: a systematic review and meta-analysis
ConclusionA systematic review and meta-analysis of available literature directly comparing TDC and BHD for primary evacuation of cSDH did not demonstrate clear superiority of either technique, although reoperations may be higher following TDC. Use of negative suction drainage with TDC may lead to similar rates of reoperation as BHD. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 14, 2021 Category: Neurosurgery Source Type: research

The utility of plasma circulating cell-free messenger RNA as a biomarker of glioma: a pilot study
The objective of this study was to determine whether significant differences exist in the plasma transcriptomic profile of glioma patients relative to differences in their tumour characteristics, and also whether any observed differences were representative of synchronously obtained glioma samples and TCGA glioma-derived RNA.MethodsBlood samples were collected from twenty glioma patients prior to tumour resection. Plasma ccfmRNAs and glioma-derived RNA were extracted and profiled.ResultsBCL2L1, GZMB, HLA-A, IRF1, MYD88, TLR2, and TP53 genes were significantly over-expressed in glioma patients (p 
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma
ConclusionThe level of psychological distress in asymptomatic meningiomas and postoperative meningiomas with excellent outcome is high. Further investigations are needed to identify and counsel the patients at risk. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Detection of impending perfusion deficits by intraoperative computed tomography (iCT) in aneurysm surgery of the anterior circulation
ConclusionsEspecially iCTP can reveal signs of impending ischemia in selected cases and enable the surgeon to promptly initiate therapeutic measures such as clip repositioning or intraoperative onset of maximum conservative treatment, while established tools might fail to detect those intraoperative pathologic changes. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Hydroxyapatite cement cranioplasty for reconstruction of translabyrinthine approach: aesthetic results, long-term satisfaction, quality of life, and complications
ConclusionThe use of hydroxyapatite for cranial reconstruction after translabyrinthine approaches has improved patient satisfaction and decreased cranial defects in our small series. Postoperative complications are consistent with other described methods, but with shorter hospital stay, decreased risk of superficial wound dehiscence/infection, and a perceived superiority in preventing percutaneous post-op CSF leaks. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

How I do it: horizontal fissure approach to the middle cerebellar peduncle
ConclusionSplitting the horizontal (petrosal) fissure of the cerebellum brings the middle cerebellar peduncle into view behind the root entry zone of the trigeminal nerve, providing an expanded, safe corridor to the central and dorsolateral pons. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

The utility of plasma circulating cell-free messenger RNA as a biomarker of glioma: a pilot study
The objective of this study was to determine whether significant differences exist in the plasma transcriptomic profile of glioma patients relative to differences in their tumour characteristics, and also whether any observed differences were representative of synchronously obtained glioma samples and TCGA glioma-derived RNA.MethodsBlood samples were collected from twenty glioma patients prior to tumour resection. Plasma ccfmRNAs and glioma-derived RNA were extracted and profiled.ResultsBCL2L1, GZMB, HLA-A, IRF1, MYD88, TLR2, and TP53 genes were significantly over-expressed in glioma patients (p 
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma
ConclusionThe level of psychological distress in asymptomatic meningiomas and postoperative meningiomas with excellent outcome is high. Further investigations are needed to identify and counsel the patients at risk. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Detection of impending perfusion deficits by intraoperative computed tomography (iCT) in aneurysm surgery of the anterior circulation
ConclusionsEspecially iCTP can reveal signs of impending ischemia in selected cases and enable the surgeon to promptly initiate therapeutic measures such as clip repositioning or intraoperative onset of maximum conservative treatment, while established tools might fail to detect those intraoperative pathologic changes. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

How I do it: horizontal fissure approach to the middle cerebellar peduncle
ConclusionSplitting the horizontal (petrosal) fissure of the cerebellum brings the middle cerebellar peduncle into view behind the root entry zone of the trigeminal nerve, providing an expanded, safe corridor to the central and dorsolateral pons. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Hydroxyapatite cement cranioplasty for reconstruction of translabyrinthine approach: aesthetic results, long-term satisfaction, quality of life, and complications
ConclusionThe use of hydroxyapatite for cranial reconstruction after translabyrinthine approaches has improved patient satisfaction and decreased cranial defects in our small series. Postoperative complications are consistent with other described methods, but with shorter hospital stay, decreased risk of superficial wound dehiscence/infection, and a perceived superiority in preventing percutaneous post-op CSF leaks. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 13, 2021 Category: Neurosurgery Source Type: research

Combined use of multimodal techniques for the resection of glioblastoma involving corpus callosum
ConclusionCombined use of multimodal techniques can optimize the safe removal of ccGBM. Aggressive resection of EOR  >  92% using multimodal techniques combined with postoperative radiochemotherapy should be suggested for ccGBM. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 12, 2021 Category: Neurosurgery Source Type: research

Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study
AbstractBackgroundSpontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH.MethodsA retrospective study including all patients that underwent surgery due to SSEDH at the University Hospital of St. Poelten between 1/7/2005 and 30/6/2020 was conducted. The percentage of spinal canal obliteration at the level where th...
Source: Acta Neurochirurgica - October 11, 2021 Category: Neurosurgery Source Type: research

Combined biportal unilateral endoscopic endonasal and endoscopic anterior transmaxillary approach for resection of lesions involving the infratemporal fossa
ConclusionThe EEA-ATMa is technically feasible and offers excellent surgical exposure to the anterior and lateral aspect of ITF, without the need of transecting the Vidian nerve or performing a wide septectomy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 11, 2021 Category: Neurosurgery Source Type: research

Extent of spinal canal obliteration as prognostic factor for functional outcome in patients with spontaneous spinal epidural hematoma: a retrospective study
AbstractBackgroundSpontaneous spinal epidural hematoma (SSEDH) is a rare condition with potentially devastating consequences. Known prognostic factors are short time to surgery, preoperative neurologic condition, and age. The aim of this study was to investigate the impact of the transversal hematoma extent with its subsequent spinal canal obliteration on outcome in patients with SSEDH.MethodsA retrospective study including all patients that underwent surgery due to SSEDH at the University Hospital of St. Poelten between 1/7/2005 and 30/6/2020 was conducted. The percentage of spinal canal obliteration at the level where th...
Source: Acta Neurochirurgica - October 11, 2021 Category: Neurosurgery Source Type: research

Combined biportal unilateral endoscopic endonasal and endoscopic anterior transmaxillary approach for resection of lesions involving the infratemporal fossa
ConclusionThe EEA-ATMa is technically feasible and offers excellent surgical exposure to the anterior and lateral aspect of ITF, without the need of transecting the Vidian nerve or performing a wide septectomy. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 11, 2021 Category: Neurosurgery Source Type: research

Intraoperative findings of abnormal muscle response for hemifacial spasm following botulinum neurotoxin treatment
ConclusionsPreoperative BTX injections should be less than 4 times to ensure effective AMR monitoring. MVD using AMR monitoring is useful for patients with HFS who were previously treated by BTX as well as those who were not treated. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 9, 2021 Category: Neurosurgery Source Type: research

Factors which influence the complications of external ventricular cerebrospinal fluid drainage
ConclusionGeneralized brain edema has a significant influence on misplacements in both groups. Midline shift lost its significance when considering only the patients in group 2. Patients under oral anticoagulation and antiplatelet therapy have increased odds of EVD-associated hemorrhage. Metal needles and polyurethane catheters are equivalent in terms of patient safety when there are no midline shift and generalized brain edema. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 9, 2021 Category: Neurosurgery Source Type: research

Intraoperative findings of abnormal muscle response for hemifacial spasm following botulinum neurotoxin treatment
ConclusionsPreoperative BTX injections should be less than 4 times to ensure effective AMR monitoring. MVD using AMR monitoring is useful for patients with HFS who were previously treated by BTX as well as those who were not treated. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 9, 2021 Category: Neurosurgery Source Type: research

Factors which influence the complications of external ventricular cerebrospinal fluid drainage
ConclusionGeneralized brain edema has a significant influence on misplacements in both groups. Midline shift lost its significance when considering only the patients in group 2. Patients under oral anticoagulation and antiplatelet therapy have increased odds of EVD-associated hemorrhage. Metal needles and polyurethane catheters are equivalent in terms of patient safety when there are no midline shift and generalized brain edema. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 9, 2021 Category: Neurosurgery Source Type: research

How I do it: surgical resection of a subcallosal gyrus cavernous malformation by a contralateral anterior interhemispheric approach
ConclusionWe hope this case provides new insights into anatomical knowledge and surgical approach techniques for subcallosal lesions. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 8, 2021 Category: Neurosurgery Source Type: research

Prognostic value of magnetic resonance imaging in spinal dural arteriovenous fistulas
ConclusionIn patients with SDAVFs, the extent of spinal edema on preoperative MRI may predict the severity of preoperative spinal neurological dysfunction. There was a significant correlation between the degree of reduction in spinal edema at 3  months after operation and patients’ clinical outcomes 1 year after surgery. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Bridge technique for hemifacial spasm with vertebral artery involvement
ConclusionsThe bridge technique is a safe and effective decompression method for VA-involved HFS. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Atypical evolution of meningiomatosis after discontinuation of cyproterone acetate: clinical cases and histomolecular characterization
ConclusionTo our knowledge, this is the first report describing an atypical tumor evolution of CPA-associated meningiomas after CPA discontinuation. The underlying biological mechanisms explaining this observation and especially the close relationship between mutational landscapes and embryologic origins of the meninges in CPA-related meningiomas as well as their clonal origin require further research. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Prognostic value of magnetic resonance imaging in spinal dural arteriovenous fistulas
ConclusionIn patients with SDAVFs, the extent of spinal edema on preoperative MRI may predict the severity of preoperative spinal neurological dysfunction. There was a significant correlation between the degree of reduction in spinal edema at 3  months after operation and patients’ clinical outcomes 1 year after surgery. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Bridge technique for hemifacial spasm with vertebral artery involvement
ConclusionsThe bridge technique is a safe and effective decompression method for VA-involved HFS. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Atypical evolution of meningiomatosis after discontinuation of cyproterone acetate: clinical cases and histomolecular characterization
ConclusionTo our knowledge, this is the first report describing an atypical tumor evolution of CPA-associated meningiomas after CPA discontinuation. The underlying biological mechanisms explaining this observation and especially the close relationship between mutational landscapes and embryologic origins of the meninges in CPA-related meningiomas as well as their clonal origin require further research. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 6, 2021 Category: Neurosurgery Source Type: research

Impact of awake mapping on overall survival and extent of resection in patients with adult diffuse gliomas within or near eloquent areas: a retrospective propensity score-matched analysis of awake craniotomy vs. general anesthesia
ConclusionEven if the glioma was within or close to the eloquent area, AC was comparable with GA in terms of EOR and OS. In case of difficulties in randomizing patients with eloquent or near eloquent glioma, our propensity score-matched analysis provides retrospective evidence that AC can obtain EOR and OS equivalent to removing glioma under GA. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - October 4, 2021 Category: Neurosurgery Source Type: research

How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5/S1 Bertolotti ’s syndrome under intraoperative computer tomographic guidance in an ambulatory setting
ConclusionThe uniportal full endoscopic pseudoarthrosis release is a good alternative to open surgery to release pseudoarthrosis in L5/S1 Bertolotti ’s syndrome in an ambulatory setting (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 16, 2021 Category: Neurosurgery Source Type: research

Upper limb dysfunction and activities in daily living in idiopathic normal pressure hydrocephalus
ConclusionsA 3-month follow-up period after shunt surgery is adequate to show improvement in motor tasks, and a positive outcome will last for at least 12  months. A shunt-responsive dysfunction of upper limb motor performance plays a major role in ADL of iNPH patients. Therefore, we suggest an evaluation of upper limb motor performance to be included in routine evaluation of iNPH patients. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 16, 2021 Category: Neurosurgery Source Type: research

Psychotropic medication use among patients with a traumatic brain injury treated in the intensive care unit: a multi-centre observational study
ConclusionsPsychotropic medication use is common in TBI survivors. Higher TBI severity is associated with increased odds of psychotropic medication use. New use of psychotropic medications after TBI was associated with increased odds of late mortality. Our results highlight the need for early identification of potential psychiatric sequelae and psychiatric evaluation in TBI survivors. (Source: Acta Neurochirurgica)
Source: Acta Neurochirurgica - September 16, 2021 Category: Neurosurgery Source Type: research