Assessment system for short-term lower cranial nerve dysfunction following medulla oblongata glioma surgery: risk stratification and optimal surgical strategy

延髓胶质瘤手术后短期下组脑神经功能障碍评估系统：风险分层与最佳手术策略

Medullary gliomas pose significant surgical risks, particularly the risk of postoperative lower cranial nerve (LCN) dysfunction, which profoundly affects quality of life. The lack of standardized risk assessment hinders optimal surgical planning. The aim of this study was to develop and validate an individualized predictive model for short-term postoperative LCN impairment integrating clinical and imaging data and to estimate individual risk across a range of resection extent to optimize surgical planning. Medullary gliomas pose significant surgical risks, particularly the risk of postoperative lower cranial nerve (LCN) dysfunction, which profoundly affects quality of life. The lack of standardized risk assessment hinders optimal surgical planning. The aim of this study was to develop and validate an individualized predictive model for short-term postoperative LCN impairment integrating clinical and imaging data and to estimate individual risk across a range of resection extent to optimize surgical planning.

髓质胶质瘤存在显著的手术风险，尤其是术后下颅神经（LCN）功能障碍的风险，这会严重影响患者的生活质量。缺乏标准化的风险评估阻碍了最佳手术规划的制定。本研究的目的是开发并验证一个整合临床和影像数据的术后短期LCN损伤个体化预测模型，并评估不同切除范围下的个体风险，以优化手术规划。髓质胶质瘤存在显著的手术风险，尤其是术后下颅神经（LCN）功能障碍的风险，这会严重影响患者的生活质量。缺乏标准化的风险评估阻碍了最佳手术规划的制定。本研究的目的是开发并验证一个整合临床和影像数据的术后短期LCN损伤个体化预测模型，并评估不同切除范围下的个体风险，以优化手术规划。

REF: Zhang M, Xiao X, Jia H, et al. Assessment system for short-term lower cranial nerve dysfunction following medulla oblongata glioma surgery: risk stratification and optimal surgical strategy. J Neurosurg. Published online May 29, 2026. doi:10.3171/2025.12.JNS251593 PMID: 42214095

Effect of VEGF coating and intra-arterial injection of mesenchymal stem cells on neointima formation after endovascular stenting in a rabbit model

血管内皮生长因子涂层及间充质干细胞动脉内注射对兔血管内支架置入术后新生内膜形成的影响

The rates of thromboembolic events are highest within the first few days of intracranial stent placement and before complete endothelialization has occurred. Accelerating the rate of neointima formation may be a strategy to reduce thromboembolic events. This study was performed to evaluate the efficacy of vascular endothelial growth factor (VEGF) embedded in a poly(lactic-co-glycolic acid) (PLGA) coating in conjunction with mesenchymal stem cells (MSCs) to improve neointima formation after stent placement. This short-term study demonstrates that coating stents with VEGF embedded in PLGA, along with an intra-arterial injection of MSCs, improves neointimal coverage and may reduce thrombus formation. Follow-up studies are required to assess the long-term consequences of VEGF and MSC administration, as well as to elucidate the potential mechanism of their effect.

颅内支架置入后的最初几天内，且在完全内皮化发生之前，血栓栓塞事件的发生率最高。加速新生内膜形成速度可能是减少血栓栓塞事件的一种策略。本研究旨在评估聚乳酸 - 乙醇酸共聚物（PLGA）涂层中包埋的血管内皮生长因子（VEGF）联合间充质干细胞（MSCs）在支架置入后促进新生内膜形成的效果。这项短期研究表明，用包埋有VEGF的PLGA对支架进行涂层处理，同时动脉内注射MSCs，可改善新生内膜覆盖情况，并可能减少血栓形成。需要进行后续研究来评估VEGF和MSCs应用的长期影响，并阐明其作用的潜在机制。

REF: Panchendrabose K, Ladak RJ, Muram S, et al. Effect of VEGF coating and intra-arterial injection of mesenchymal stem cells on neointima formation after endovascular stenting in a rabbit model. J Neurosurg. Published online May 29, 2026. doi:10.3171/2025.12.JNS251651 PMID: 42214099

Impact on pulmonary function from phrenic nerve transfer: a systematic review and meta-analysis

膈神经移位对肺功能的影响：系统评价与荟萃分析

The aim of this study was to evaluate the respiratory consequences of phrenic nerve transfer (PNT) by analyzing clinical and paraclinical data across published studies. The aim of this study was to evaluate the respiratory consequences of phrenic nerve transfer (PNT) by analyzing clinical and paraclinical data across published studies.

本研究的目的是通过分析已发表研究中的临床和辅助检查数据，评估膈神经移位术（PNT）对呼吸的影响。本研究的目的是通过分析已发表研究中的临床和辅助检查数据，评估膈神经移位术（PNT）对呼吸的影响。

REF: Emamhadi M, Shoubash L, Haghani Dogahe M, Zarei R, Bashiri Aliabadi S, Mahan MA. Impact on pulmonary function from phrenic nerve transfer: a systematic review and meta-analysis. J Neurosurg. Published online May 29, 2026. doi:10.3171/2025.11.JNS251462 PMID: 42214098

Rediscovering the origins of Kocher's point

重新探寻科赫尔点的起源

Kocher's point serves as the most common entry site for accessing the ventricles of the brain. Named after Nobel laureate Theodor Kocher, a prominent Swiss surgeon of the late 19th and early 20th centuries, the discovery of the anatomical landmark highlights the power of progressive refinement and collaboration across generations. Utilizing his well-acclaimed craniometer, Kocher described a safe trajectory to the lateral ventricle, navigating around eloquent regions of the brain and resolving the issue of ventricular collapse, a concern during his time with the use of Keen's point. To perform ventricular drainage, Theodor Kocher employed an approach resembling the modern craniotomy with bone flap replacement, which he deemed provided greater visibility of the target region anterior to the precentral gyrus. Despite achieving excellent ventricular drainage through his point, the open approach failed to address the risk of blood loss and infection and the requirement for high levels of anesthesia. Were it not for the forgotten contributions of Theodor's son, Albert Kocher, the present method of external ventricular drainage would have remained far more complicated. Albert simplified the approach, using cocaine for local anesthesia and directly drilling through the skin and bone at Kocher's point followed by insertion of a syringe.

科赫尔点是进入脑室最常用的入路点。该点以19世纪末20世纪初著名的瑞士外科医生、诺贝尔奖获得者西奥多·科赫尔的名字命名，这一解剖标志的发现彰显了历代不断改进和合作的力量。西奥多·科赫尔利用他广受赞誉的颅骨测量仪，描述了一条通向侧脑室的安全路径，避开了大脑的重要功能区，并解决了当时使用基恩点时出现的脑室塌陷问题。为进行脑室引流，西奥多·科赫尔采用了一种类似现代骨瓣复位开颅术的方法，他认为这种方法能更好地显露中央前回前方的目标区域。尽管通过他所提出的科赫尔点能实现良好的脑室引流，但这种开放入路无法解决失血、感染风险以及高麻醉水平需求的问题。若不是西奥多的儿子阿尔伯特·科赫尔做出了被人遗忘的贡献，如今的外部脑室引流方法会复杂得多。阿尔伯特简化了操作方法，使用可卡因进行局部麻醉，直接在科赫尔点处钻透皮肤和颅骨，然后插入注射器。

REF: Kanter M, D'Amico A, Patel J, Heilman CB, Kryzanski J, Riesenburger R. Rediscovering the origins of Kocher's point. J Neurosurg. Published online May 29, 2026. doi:10.3171/2026.1.JNS252300 PMID: 42214096

The risk of cerebrospinal fluid rhinorrhea from early resumption of positive pressure ventilation after transsphenoidal surgery with autologous fat graft repair

经蝶窦手术并自体脂肪移植修复后早期恢复正压通气导致脑脊液鼻漏的风险

Multiple closure techniques may prevent CSF leak after transsphenoidal surgery for sellar lesions. In patients with obstructive sleep apnea requiring positive pressure ventilation (PPV), the optimal closure technique remains unclear. The authors assessed the efficacy of autologous abdominal fat graft repair for preventing CSF leaks in patients reinitiating PPV early after transsphenoidal surgery. Early initiation of PPV after transsphenoidal surgery with autologous abdominal fat (with or without fascia) grafting did not increase the risk of CSF leak, suggesting that it reasonably prevents leaks in patients with sleep apnea after transsphenoidal surgery.

经蝶窦手术治疗鞍区病变后，多种封闭技术可预防脑脊液漏。对于需要正压通气（PPV）的阻塞性睡眠呼吸暂停患者，最佳的封闭技术仍不明确。作者评估了自体腹部脂肪移植修复在经蝶窦手术后早期重新开始PPV的患者中预防脑脊液漏的效果。经蝶窦手术后采用自体腹部脂肪（伴或不伴筋膜）移植并早期启动PPV不会增加脑脊液漏的风险，这表明该方法能有效预防经蝶窦手术后睡眠呼吸暂停患者出现脑脊液漏。

REF: Kim LJ, Rennert RC, Couldwell WT. The risk of cerebrospinal fluid rhinorrhea from early resumption of positive pressure ventilation after transsphenoidal surgery with autologous fat graft repair. J Neurosurg. Published online May 29, 2026. doi:10.3171/2026.1.JNS251476 PMID: 42214100

Impact of intracranial pressure monitoring on 30-day mortality in severe traumatic brain injury: a retrospective cohort study in Kenya

颅内压监测对严重创伤性脑损伤患者30天死亡率的影响：肯尼亚的一项回顾性队列研究

The objective of this study was to evaluate 15-year trends in epidemiology, baseline severity, management, and outcomes of severe traumatic brain injury (sTBI) at a Kenyan tertiary center, and to determine the impact of invasive intracranial pressure (ICP) monitoring on 30-day mortality in a low- and middle-income country (LMIC) context. Over the 15-year period, sTBI admissions rose while early mortality declined following the adoption of ICP monitoring and protocol-based care. In this LMIC setting, ICP monitoring was independently associated with lower 30-day mortality, supporting the use of guideline-concordant neuromonitoring and scalable multimodality bundles.

本研究的目的是评估肯尼亚一家三级医疗中心严重创伤性脑损伤（sTBI）在流行病学、基线严重程度、治疗及预后方面的15年趋势，并确定在中低收入国家（LMIC）背景下，有创颅内压（ICP）监测对30天死亡率的影响。在这15年期间，随着采用ICP监测和基于方案的治疗，sTBI入院人数增加，而早期死亡率下降。在这个中低收入国家的环境中，ICP监测与30天死亡率降低独立相关，这支持使用符合指南的神经监测和可扩展的多模式治疗方案。

REF: Ongas T, Chikophe I, Mavuti J, et al. Impact of intracranial pressure monitoring on 30-day mortality in severe traumatic brain injury: a retrospective cohort study in Kenya. J Neurosurg. Published online May 22, 2026. doi:10.3171/2025.12.JNS251974 PMID: 42172674

Temporal relationship between hematoma resolution and functional recovery after middle meningeal artery embolization for chronic subdural hematoma

慢性硬膜下血肿行脑膜中动脉栓塞术后血肿吸收与功能恢复的时间关系

The objective was to evaluate the trajectories of hematoma resolution and functional improvement after middle meningeal artery embolization (MMAE) for chronic subdural hematoma (cSDH), model the temporal pattern of cSDH resolution, and identify factors associated with favorable outcomes. After MMAE for cSDH, reduction in hematoma thickness follows a predictable exponential decay pattern. Greater extent (≥ 80%) and faster timing (within 90 days) of resolution are valuable prognostic indicators. Functional outcomes improve progressively through 6-12 months after the procedure. The relationship between resolution extent and functional outcomes provides quantitative benchmarks for evaluating treatment response.

研究目的是评估脑膜中动脉栓塞术（MMAE）治疗慢性硬膜下血肿（cSDH）后血肿吸收和功能改善的轨迹，建立cSDH吸收的时间模式，并确定与良好预后相关的因素。采用MMAE治疗cSDH后，血肿厚度的减小遵循可预测的指数衰减模式。吸收程度更大（≥80%）且吸收时间更快（90天内）是有价值的预后指标。术后6 - 12个月，功能预后逐渐改善。吸收程度与功能预后之间的关系为评估治疗反应提供了量化标准。

REF: DeMessie B, Essibayi MA, Salim HA, et al. Temporal relationship between hematoma resolution and functional recovery after middle meningeal artery embolization for chronic subdural hematoma. J Neurosurg. Published online May 22, 2026. doi:10.3171/2025.12.JNS251884 PMID: 42172679

Active surveillance versus stereotactic radiosurgery for Koos grade I and II vestibular schwannoma in patients aged 60 years or older

60岁及以上患者的Koos I级和II级前庭神经鞘瘤：主动监测与立体定向放射外科治疗的比较

The aim of this study was to evaluate freedom from tumor progression and clinical outcomes in older adults with small- to medium-sized vestibular schwannoma (VS) managed by observation versus stereotactic radiosurgery (SRS) to better inform optimal management in this patient population. SRS in older patients for management of Koos grade I or II VS resulted in significantly superior rates of freedom from tumor progression, comparable hearing preservation rates, and significantly higher rates of favorable overall radiographic and neurological outcomes than observation alone. Compared with observation, SRS might be the preferred management option in this patient population.

本研究的目的是评估观察与立体定向放射外科手术（SRS）治疗中小规模前庭神经鞘瘤（VS）的老年患者的肿瘤无进展情况和临床结局，以便为该患者群体的最佳治疗提供更充分的依据。对于Koos I级或II级VS的老年患者，采用SRS治疗的肿瘤无进展率显著更高，听力保留率相当，且总体影像学和神经学良好结局的比率显著高于单纯观察。与观察相比，SRS可能是该患者群体的首选治疗方案。

REF: Ishaque M, Mantziaris G, Tos SM, et al. Active surveillance versus stereotactic radiosurgery for Koos grade I and II vestibular schwannoma in patients aged 60 years or older. J Neurosurg. Published online May 15, 2026. doi:10.3171/2026.1.JNS242756 PMID: 42139729

Comparative outcomes of syringopleural, syringosubarachnoid, and syringoperitoneal shunts for syringomyelia: a single-center retrospective cohort study

脊髓空洞症行脊髓空洞 - 胸膜腔分流术、脊髓空洞 - 蛛网膜下腔分流术和脊髓空洞 - 腹腔分流术的对比结局：一项单中心回顾性队列研究

Syringomyelia is a progressive neurological disorder characterized by intramedullary fluid-filled cavities. Shunt placement remains a key treatment option when decompression fails, yet comparative outcomes across shunt types remain poorly defined. The aim of this study was to compare revision rates, time to failure, and neurological outcomes among patients treated with syringopleural, syringosubarachnoid, and syringoperitoneal shunts. Syrinx shunting provided modest early neurological benefit, but long-term durability remained limited. Syringopleural shunts demonstrated greater early clinical improvement but carried greater revision risk. Syringosubarachnoid shunts had lower mechanical failure rates but limited clinical efficacy. Optimizing patient selection and vigilant postoperative monitoring are crucial. Further research is needed to refine surgical strategies and improve durable outcomes.

脊髓空洞症是一种进行性神经系统疾病，其特征是脊髓内出现充满液体的空洞。当减压手术失败时，分流术仍然是关键的治疗选择，但不同类型分流术的对比结果仍不明确。本研究的目的是比较接受脊髓空洞-胸膜腔分流术、脊髓空洞-蛛网膜下腔分流术和脊髓空洞-腹腔分流术患者的翻修率、失效时间和神经功能结局。脊髓空洞分流术在早期能带来一定的神经功能改善，但长期效果有限。脊髓空洞-胸膜腔分流术在早期显示出更大的临床改善，但翻修风险更高。脊髓空洞-蛛网膜下腔分流术的机械故障率较低，但临床疗效有限。优化患者选择和术后密切监测至关重要。需要进一步研究以完善手术策略并改善长期疗效。

REF: Khalafallah AM, Dusseau NB 2nd, Narayanan D, Dower A, Levi AD. Comparative outcomes of syringopleural, syringosubarachnoid, and syringoperitoneal shunts for syringomyelia: a single-center retrospective cohort study. J Neurosurg. Published online May 15, 2026. doi:10.3171/2025.12.JNS252016 PMID: 42139731