NEUROSURGICAL REVIEW 的目标是为神经外科当前问题的全面审查提供一个论坛。每期最多包含三篇评论，反映一个主题（疾病或手术方法）的所有重要方面。专家小组在同一问题中的评论完善了该主题。通过每期提供一个主题的全面报道，NEUROSURGICAL REVIEW 将专业期刊的话题性与专着的深入处理相结合。也欢迎高质量的原创论文。

The goal of Neurosurgical Review is to provide a forum for a comprehensive review of current issues in neurosurgery. Each issue contains up to three reviews that cover all important aspects of a specific topic (such as a disease or surgical method). The comments from a panel of experts further enhance the discussion on the topic. By providing a thorough report on a single theme in each issue, Neurosurgical Review combines the topicality of a professional journal with the in-depth treatment of a monograph. High-quality original papers are also welcome.

《Neurosurgical Review》的目标是为神经外科领域的当前问题提供一个全面审查的论坛。每期最多包含三篇评论，涵盖一个特定主题（如疾病或手术方法）的所有重要方面。专家小组的评论将进一步完善该主题。通过每期提供一个主题的全面报道，《Neurosurgical Review》将专业期刊的广泛性与专著的深入分析相结合。同时，我们也欢迎高质量的原创论文。

Neurosurgical Review

Neuronavigation has become an essential neurosurgical tool in pursuing minimal invasiveness and maximal safety, even though it has several technical limitations. Augmented reality (AR) neuronavigation is a significant advance, providing a real-time updated 3D virtual model of anatomical details, overlaid on the real surgical field. Currently, only a few AR systems have been tested in a clinical setting. The aim is to review such devices. We performed a PubMed search of reports restricted to human studies of in vivo applications of AR in any neurosurgical procedure using the search terms "Augmented reality" and "Neurosurgery." Eligibility assessment was performed independently by two reviewers in an unblinded standardized manner. The systems were qualitatively evaluated on the basis of the following: neurosurgical subspecialty of application, pathology of treated lesions and lesion locations, real data source, virtual data source, tracking modality, registration technique, visualization processing, display type, and perception location. Eighteen studies were included during the period 1996 to September 30, 2015. The AR systems were grouped by the real data source: microscope (8), hand- or head-held cameras (4), direct patient view (2), endoscope (1), and X-ray fluoroscopy (1) head-mounted display (1). A total of 195 lesions were treated: 75 (38.46 %) were neoplastic, 77 (39.48 %) neurovascular, and 1 (0.51 %) hydrocephalus, and 42 (21.53 %) were undetermined. Current literature confirms that AR is a reliable and versatile tool when performing minimally invasive approaches in a wide range of neurosurgical diseases, although prospective randomized studies are not yet available and technical improvements are needed.

Antonio Meola

Fabrizio Cutolo

Marina Carbone

Federico Cagnazzo

Mauro Ferrari

Vincenzo Ferrari

Neurosurgical review

Neurosurg Rev

Augmented reality in neurosurgery: a systematic review.

The article comprises three main parts: a historical review on navigation, the mathematical basics for calculation and the clinical applications of navigation devices. Main historical steps are described from the first idea till the realisation of the frame-based and frameless navigation devices including robots. In particular the idea of robots can be traced back to the Iliad of Homer, the first testimony of European literature over 2500 years ago. In the second part the mathematical calculation of the mapping between the navigation and the image space is demonstrated, including different registration modalities and error estimations. The error of the navigation has to be divided into the technical error of the device calculating its own position in space, the registration error due to inaccuracies in the calculation of the transformation matrix between the navigation and the image space, and the application error caused additionally by anatomical shift of the brain structures during operation. In the third part the main clinical fields of application in modern neurosurgery are demonstrated, such as localisation of small intracranial lesions, skull-base surgery, intracerebral biopsies, intracranial endoscopy, functional neurosurgery and spinal navigation. At the end of the article some possible objections to navigation-aided surgery are discussed.

P Grunert

K Darabi

J Espinosa

R Filippi

Computer-aided navigation in neurosurgery.

神经外科中的计算机辅助导航。

Spontaneous intracerebral hemorrhage (ICH) is a prevalent hemorrhagic stroke characterized by a significant fatality rate and severe neurological impairments. Stress hyperglycemia has been confirmed to have a significant prognostic role in a range of diseases. However, studies on the association between stress hyperglycemia and the outcome of ICH have not currently been reported. Critically ill patients diagnosed with ICH in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were included in our study. Logistic regression and Cox regression were used to analyze the correlation between stress hyperglycemia and the outcome of ICH. The predictive ability of different glucose metrics was demonstrated by the receiver-operating characteristic (ROC) curve and was further compared by the integrated discrimination improvement (IDI) index. A total of 880 ICH patients in the MIMIC-IV database were included in this study. In logistic regression and Cox regression, blood glucose level (BGL), glycemic gap (GG), and stress hyperglycemia ratio (SHR) were independent predictors of unfavorable outcomes in ICH after adjustment for other confounders. The IDI results indicated that the 5-day maximum stress hyperglycemia ratio had better predictive performance than glycemic gap and blood glucose level in-hospital mortality and 1-year mortality, and the predictive performance of the 5-day maximum stress hyperglycemia ratio was better than that of stress hyperglycemia ratio measured at admission. In the age-stratified subgroup analysis, the 5-day maximum stress hyperglycemia ratio was more sensitive in predicting long-term outcomes in the young subgroup than in the elderly subgroup. The 5-day maximum stress hyperglycemia ratio is strongly correlated with an elevated risk of mortality in ICH patients and displays a better predictive ability than glycemic gap and blood glucose level in the short/long-term prognosis of ICH.

Guo-Guo Zhang

Xiao-Dan Zhang

Hong-Zhi Gao

Yuan-Xiang Lin

Zong-Qing Zheng

Exploration and comparison of stress hyperglycemia-related indicators to predict clinical outcomes in patients with spontaneous intracerebral hemorrhage.

探索和比较应激性高血糖相关指标以预测自发性脑出血患者的临床结局。

Microvascular decompression (MVD) is an effective and safe treatment option that offers the prospect of definitive cure for hemifacial spasm (HFS). However, there are potential risks of complications for MVD associated with retromastoid suboccipital craniectomy (RmSOC) and cranial nerves in particular. The purpose of this study was to identify clinical characteristics of possible complications after MVD for HFS and to establish appropriate management concept of these complications. We retrospectively reviewed medical records of 2040 patients who underwent RmSOC with MVD for HFS at Samsung medical center between January 1998 and March 2013. Of 2040 patients, 2027 were followed (99.4%). Of the 2027 patients, 1841 (90.8%) exhibited complete relief or minimal symptoms, and 113 (5.6%) reported improved spasm but had mild remnant symptoms. After operation, the most frequently developed complications were facial nerve palsy (8.19%), followed by middle ear effusion (4.90%) and hearing loss (3.63%). There were two cases of supratentorial subdural hemorrhage, three cases of infarction. MVD was found to be safe and effective treatment for HFS, in consistent with previous reports. Some of the complications such as facial nerve palsy, middle ear effusion, and hearing loss are relatively common. However, they have mild clinical courses that are usually transient.

Min Ho Lee

Tae Keun Jee

Jeong Ah Lee

Kwan Park

Postoperative complications of microvascular decompression for hemifacial spasm: lessons from experience of 2040 cases.

微血管减压治疗半面痉挛术后并发症：2040例经验教训。

The lateral spread response (LSR) on preoperative facial electromyogram (EMG) is a useful tool in evaluating patients with hemifacial spasm (HFS). There may be some instances where the LSR does not appear on the preoperative EMG, thus disrupting the diagnosis and treatment of HFS. In this study, we evaluated the patients who did not exhibit LSR on preoperative EMG but underwent microvascular decompression (MVD) for hemifacial spasm. We searched for patients who underwent MVD for HFS but had an absence of LSR on preoperative EMG between January 2016 and June 2018. Surgical outcomes were evaluated at 1, 3, and 6 months after surgery. Follow-up facial EMG was performed 3 months after surgery. Results were divided into two categories: (1) spasm relief within 24 h of surgery and (2) spasm was observed immediately post-operation. The following parameters were analyzed when comparing between the two groups: age, sex, affected side, duration of symptoms, and offending vessel(s). A total of 306 patients underwent MVD for HFS during the study period. Among them, 13 (4.2%) patients had no LSR on preoperative EMG. Eight patients (61.5%) were female and five patients were male. The 13 patients had a mean age of 51 years. All patients exhibited probable offending vessels in the root exit zone (REZ) of the facial nerve on preoperative magnetic resonance (MR) imaging that was confirmed during surgery. Seven patients were free of HFS immediately after surgery, though six patients were not. Only one (7.7%) patient had persisted symptom 6 months after surgery. No patients experienced recurrence of spasm, nor exhibited abnormal waves on follow-up facial EMG. LSR on facial EMG is a valuable tool for evaluating hemifacial spasm. However, although LSR did not appear on preoperative EMG, if the patient presents with typical symptoms and the offending vessels are identified on MRI, we expect good results after MVD for HFS.

Chang Kyu Park

Seung Hoon Lim

Seung Hwan Lee

Bong Jin Park

Is the pre-operative lateral spread response on facial electromyography a valid diagnostic tool for hemifacial spasm?

面部肌电图术前侧向扩散反应是否为半面痉挛的有效诊断工具？

Anterior choroidal artery (AChA) aneurysms represent 2-5% of intracranial aneurysms. The proximity of the origin of the AChA to the aneurysm neck poses a risk of thromboembolic complications following treatment. AChA occlusion can result in significant neurological deficits. We present a case-series of patients with AChA aneurysms and their treatment outcomes. We describe how treatment was chosen based on aneurysm and patient-specific factors to minimize risks, enhance efficacy of treatment, and improve patient outcomes. We retrospectively reviewed 27 patients who underwent treatment for AChA aneurysms at a single institution from 2015-2024. Clinical presentation, aneurysm characteristics, procedural details, and follow-up data were collected. Twenty-seven AChA aneurysms (median diameter 2.94 mm), were treated in 29 procedures. Treatments included clipping (11 aneurysms), flow diversion (13), or coiling (5). The five coiled aneurysms were ruptured at presentation. Three patients experienced permanent infarction (10.3%), two in the setting of vasospasm after coiling and one after flow diversion in a patient who proved to have resistance to clopidogrel. At a median follow-up of 4.73 months (IQR = 1.23-14.03), 25 patients (93%) had favorable functional recovery (mRS 0-2). Patients treated for AChA aneurysms experienced favorable functional outcomes by utilizing surgical and endovascular techniques carefully chosen based on aneurysm and patient-specific factors. Two patients did not achieve independence post-coiling due to disability from their initial subarachnoid hemorrhage. There were no treatment related causes of unfavorable functional outcomes.

Patrick S. Barhouse

Felipe Ramirez-Velandia

Michael Young

Philipp Taussky

Christopher S. Ogilvy

Anterior choroidal artery aneurysm case series: a clinical decision algorithm for endovascular and surgical treatment using a novel classification system

前交通动脉瘤病例系列：使用新型分类系统的血管内和手术治疗临床决策算法

The burr-hole technique is a minimally invasive transcranial approach designed to minimize the surgical incision size and reduce disruption to brain tissue. We aimed to share our experience with the burr-hole technique for removing brain lesions and to evaluate its effectiveness in treating appropriately sized intra-axial brain lesions.

Jun-Feng Huo

Jia-Jia Zheng

Mohamed Helmy

Min-Di Liu

Xue-Jun Zhang

Dong-Lei Song

Wei Sun

Minimally invasive neurosurgery: application of burr-hole technique across a spectrum of brain lesions

微创神经外科手术：钻孔技术在多种脑部病变中的应用

Abstract Recent advancements in endovascular treatment (EVT) and different views on optimal management for posterior communicating artery (PComA) aneurysms with oculomotor nerve palsy (ONP) highlight a need to compare recovery timelines between microsurgery and EVT; heterogeneous outcomes and influencing factors may also affect results. A comprehensive systematic review and meta-analysis were conducted by searching PubMed, Embase, Scopus, and Web of Science databases. The extracted data encompassed patient demographics, details on treatment modalities and timing, and characteristics of PComA aneurysms ONP caused by either unruptured or ruptured aneurysms. The primary outcome was ONP favorable recovery, defined as the resolution of admission symptoms, except for subtle ptosis and mild pupillary asymmetry. We used random effect models to calculate odds ratios (OR) and pool prevalence with their corresponding 95% confidence intervals (CI). A total of 40 studies met the inclusion criteria. Overall, microsurgical clipping of PComA aneurysms demonstrated a significantly higher likelihood of ONP recovery compared to EVT at 1,3,6, and 12 months follow-up. However, recovery rates were comparable in long-term follow-up [18 months: (0.87 vs. 0.64, P-value = 0.36); ≥24 months: (0.86 vs. 0.72 P-Value = 0.26)]. The recovery outcomes for early treatment were similar when assessed during the 6-month follow-up (0.75 vs. 0.56, P-value = 0.07). Our findings suggest microsurgery leads to prompt ONP recovery from PComA aneurysms, while EVT shows potential for delayed favorable recovery; both treatments yield short-term recovery when administered early. A case-by-case approach is recommended, emphasizing a comprehensive understanding of patient factors in relation to the immediate and sustained effects of each treatment.

Rahim Abo Kasem

Conor Cunningham

Sameh Samir Elawady

Mohammad Mahdi Sowlat

Sofia Babool

Saad Hulou

Zachary Hubbard

Atakan Orscelik

Basel Musmar

Alejandro M. Spiotta

Oculomotor nerve palsy recovery following microsurgery vs. endovascular treatment of posterior communicating artery aneurysms: a comparative meta-analysis of short- and long-term outcomes

后交通动脉瘤的显微手术与血管内治疗后的动眼神经麻痹恢复：短期和长期结果的比较性meta分析

Spinal metastases are a significant concern for patients with advanced cancer, leading to pain, neurological deficits, and reduced quality of life. They occur in up to 70% of cancer patients, with the vertebral column being the most common osseous site for metastatic disease1-3. An approximate 10% of patients with vertebral body metastases eventually develop spinal cord compression, which can potentially cause severe and permanent disability4-6. This article aims to summarize the consensus statements developed by the World Federation of Neurosurgical Societies (WFNS) Spine Committee on the clinical evaluation, diagnosis, and decision-making for metastatic spine tumors.

Sandeep Vaishya

Vibha Gaonkar

Manbachan Singh Bedi

Onur Yaman

Mehmet Zileli

Salman Sharif

Clinical evaluation, diagnosis, and decision-making for metastatic spine tumors: WFNS spine committee recommendations

转移性脊柱肿瘤的临床评估、诊断及决策：WFNS脊柱委员会建议

To investigate the clinical efficacy and safety of microsurgical surgery in patients with proximal vertebral artery stenosis unsuitable for endovascular treatment. A retrospective analysis was conducted on the clinical data of 34 patients with proximal vertebral artery stenosis who underwent microsurgical surgery at the Department of Cerebrovascular Surgery, Shengli Oilfield Central Hospital, Dongying, Shandong, from March 2020 to April 2023. Preoperative imaging confirmation of proximal vertebral artery stenosis or occlusion was obtained using cervical CT angiography (CTA), CT perfusion imaging (CTP), and magnetic resonance angiography (MRA). Postoperative imaging examinations were utilized to evaluate blood flow patency, and clinical symptoms and complications during hospitalization and follow-up were documented. Postoperative imaging examinations in the 34 patients (Males: 79.4%; Mean age: 66.7 ± 9.6 years) revealed patent vertebral and supplying arteries. No new instances of transient ischemic attacks (TIAs) or other cerebrovascular events were observed during hospitalization, and clinical symptoms were improved. The mean follow-up duration was 10 months (range: 6–39 months). One patient died from septic shock due to abdominal infection, and one patient exhibited moderate ipsilateral vertebral artery stenosis on a follow-up CTA at 6 months postoperatively. The Modified Rankin Scale (mRS) scores decreased for 30 patients after surgery compared to preoperative scores, with all postoperative mRS scores being less than 1. The difference between preoperative and postoperative mRS scores was statistically significant (P < 0.01). Six patients experienced temporary postoperative complications, which resolved after active treatment, and one patient developed permanent Horner's syndrome without affecting the quality of life. Microsurgical surgery for patients with proximal vertebral artery stenosis, when endovascular treatment is unsuitable, demonstrates good clinical efficacy and a low incidence of complications, offering a viable surgical treatment option. Further multicenter studies with larger sample sizes will be instrumental in validating its clinical application value.

Mingyuan Liu

Peiguang Yan

Mingxin Wang

Jia Guo

Wei Liu

Ganchun Wu

Lufei Wang

Jingjing Liu

Li Li

Application of microsurgical surgery in patients with proximal vertebral artery stenosis unsuited for endovascular treatment: a single-center retrospective study

近端椎动脉狭窄不适合血管内治疗的患者的显微外科手术应用：一项单中心回顾性研究

Abbreviation	Neurosurg Rev
Journal Impact	2.49
Quartiles(Global)	SURGERY(Q1)

ISSN	0344-5607, 1437-2320
h-index	74

Publication Information	Publisher: Springer Science and Business Media Deutschland GmbH，Publishing cycle: Quarterly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1978，Proportion of original research papers: 59.49%，Self Citation Rate:4.00%， Gold OA Rate: 25.91%
Average review cycle	网友分享经验：较慢,6-12周
Average recruitment ratio	网友分享经验：较易

Neurosurgical Review

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