Global Hotspots and Research Frontiers of Moyamoya Disease and Radiological Features: A Bibliometric Analysis

烟雾病及其影像学特征的全球研究热点与前沿：一项文献计量学分析

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by the progressive stenosis of the intracranial internal carotid artery and the development of a collateral network in the brain. As medical imaging technology and artificial intelligence have advanced, various imaging methods have been widely used in the clinical diagnosis of MMD. In this study, we conducted bibliometric visualization of research papers about MMD and radiological features between 2000 and 2024, intending to explore the development status quo, hotspots, and future developments and contributing to studies on imaging in diagnosis of cerebrovascular diseases. This article provides a scientific perspective from which researchers, especially doctors in neurosurgery and radiodiagnosis departments can visually find out about important trends and new areas of research directions in the field of MMD and radiological features.

烟雾病（MMD）是一种脑血管疾病，其特征为颅内颈内动脉进行性狭窄以及脑部侧支循环网络的形成。随着医学影像技术和人工智能的发展，多种影像检查方法已广泛应用于烟雾病的临床诊断。在本研究中，我们对2000年至2024年间关于烟雾病和影像学特征的研究论文进行了文献计量可视化分析，旨在探索其发展现状、研究热点和未来发展方向，为脑血管疾病的影像学诊断研究提供参考。本文为研究人员，尤其是神经外科和放射诊断科的医生提供了一个科学视角，使他们能够直观地了解烟雾病和影像学特征领域的重要趋势和研究方向的新领域。

REF: Li B, Lu M, Zhao Z, et al. Global Hotspots and Research Frontiers of Moyamoya Disease and Radiological Features: A Bibliometric Analysis. World Neurosurg. 2025;197:123817. doi:10.1016/j.wneu.2025.123817 PMID: 39987973

Dermatological Adverse Effects of Ventriculoperitoneal Shunt: A Systematic Review

脑室腹腔分流术的皮肤不良反应：系统评价

Ventriculoperitoneal (VPS) implantation provides immediate improvement in hydrocephalus management but is associated with complications such as infection, malfunction, and dermatological issues. We conducted a systematic review of studies examining adverse skin reactions related to VPS placement in patients of all ages. Databases searched included PubMed, Scopus, Google Scholar, and Web of Science from inception to April 2023 using Medical Subject Headings such as "ventriculoperitoneal shunt" and "skin diseases." Twenty-nine articles, including 35 cases, were included. Common skin-related complications were infections, allergic reactions, skin breakdown, and metastases, sometimes occurring decades after the initial shunt placement. Factors contributing to these complications ranged from underlying malignancies to device failure, while the severity varied from mild irritation to life-threatening infections. Prompt identification and interdisciplinary collaboration among healthcare professionals can help mitigate these adverse outcomes. Recognizing potential dermatological manifestations of VPSs is critical for early intervention and improved patient care.

脑室腹腔分流术（VPS）植入可立即改善脑积水的治疗情况，但会引发感染、功能障碍和皮肤问题等并发症。我们对所有年龄段患者中与VPS置入相关的皮肤不良反应的研究进行了系统综述。检索的数据库包括PubMed、Scopus、谷歌学术和科学网，检索时间从建库至2023年4月，使用了如“脑室腹腔分流术”和“皮肤病”等医学主题词。共纳入29篇文章，包含35个病例。常见的皮肤相关并发症有感染、过敏反应、皮肤破损和转移，有时在首次分流术置入数十年后仍会出现。导致这些并发症的因素从潜在恶性肿瘤到装置故障不等，严重程度从轻度刺激到危及生命的感染各异。医疗保健专业人员迅速识别并开展跨学科合作有助于减轻这些不良后果。认识到VPS潜在的皮肤表现对于早期干预和改善患者护理至关重要。

REF: Sami N, Baghani M, Shayan M, Baghani M. Dermatological Adverse Effects of Ventriculoperitoneal Shunt: A Systematic Review. World Neurosurg. 2025;197:123828. doi:10.1016/j.wneu.2025.123828 PMID: 40020996

Perceived Barriers to a Neurosurgical Career for Medical Students and Unspecialized Residents Worldwide: A Systematic Literature Review

全球医学生和非神经外科专科住院医师从事神经外科职业的感知障碍：一项系统文献综述

Globally, a large deficit of neurosurgeons exists along with a growing burden of disease requiring neurosurgical care. Also, considerable geographical disparities remain in the neurosurgical workforce distribution. Augmenting and diversifying the neurosurgical workforce requires addressing barriers which deter medical students and unspecialized residents from pursuing a neurosurgical career. Current studies have largely investigated these challenges on a national scale. Investigation into barriers to a neurosurgical career from a global perspective has been limited. Identifying these barriers across high- and low/middle-income countries is critical to recruiting a more robust neurosurgical workforce and reducing global disparities in access to neurosurgical care. We conducted a systematic review to identify perceived barriers encountered by medical students and unspecialized residents to pursuing a neurosurgical career worldwide. We compared studies performed in high- versus low/middle-income countries and identified shared challenges related to gender stereotypes, work-life balance, academic rigor, and financial compensation. Our findings form a basis for formulating global solutions to augment the neurosurgical workforce.

在全球范围内，神经外科医生存在大量短缺，同时需要神经外科治疗的疾病负担也在不断加重。此外，神经外科人力资源分布仍存在显著的地域差异。扩充和多元化神经外科人力资源，需要解决那些阻碍医学生和非专科住院医师从事神经外科职业的障碍。目前的研究大多是在国家层面上对这些挑战进行调查。从全球视角对从事神经外科职业的障碍进行的研究十分有限。确定高收入国家和中低收入国家面临的这些障碍，对于招募更强大的神经外科人力资源以及减少全球在获得神经外科治疗方面的差异至关重要。我们进行了一项系统综述，以确定全球范围内医学生和非专科住院医师在从事神经外科职业时所遇到的、他们所认为的障碍。我们比较了在高收入国家和中低收入国家开展的研究，并确定了与性别刻板印象、工作与生活平衡、学术要求严格程度以及经济报酬相关的共同挑战。我们的研究结果为制定增加神经外科人力资源的全球解决方案奠定了基础。

REF: Ran KR, Das O, Kankam SB, et al. Perceived Barriers to a Neurosurgical Career for Medical Students and Unspecialized Residents Worldwide: A Systematic Literature Review. World Neurosurg. 2025;197:123886. doi:10.1016/j.wneu.2025.123886 PMID: 40081490

A Bibliometric Analysis of Sitting Position and Air Embolism in Neurosurgery: Top 100 Most Cited Articles

神经外科坐姿与空气栓塞的文献计量分析：引用次数排名前100的文章

The selection of a neurosurgical sitting position (SP) regarding complication avoidance is a much-debated topic in neurosurgery and anesthesiology. In this bibliometric analysis, we examined the 100 most cited neurosurgical and anesthesiology SP articles focused on posterior fossa surgery. The use of an SP is often debated in neurosurgery and anesthesiology. This bibliometric analysis summarizes the most cited reports to provide a guide for neurosurgeons and anesthesiologists for diagnostic evaluation, complication avoidance, and surgical management.

在神经外科和麻醉学领域，为避免并发症而选择神经外科坐位（SP）是一个备受争议的话题。在这项文献计量分析中，我们研究了100篇被引用次数最多的、聚焦于后颅窝手术的神经外科和麻醉学坐位相关文章。在神经外科和麻醉学领域，坐位的使用常常引发争论。这项文献计量分析总结了被引用次数最多的报告，旨在为神经外科医生和麻醉医生在诊断评估、并发症预防和手术管理方面提供指导。

REF: Hatipoglu Majernik G, Baskaya MK. A Bibliometric Analysis of Sitting Position and Air Embolism in Neurosurgery: Top 100 Most Cited Articles. World Neurosurg. 2025;197:123884. doi:10.1016/j.wneu.2025.123884 PMID: 40058630

Brain Tissue Oxygen Combined with Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury: An Updated Systematic Review and Pooled Analysis Following the OXY-TC Trial

严重创伤性脑损伤患者脑组织氧联合颅内压监测：OXY - TC 试验后的最新系统评价与汇总分析

Severe traumatic brain injury (TBI) is associated with high mortality and long-term disability. Effective TBI management, aimed at minimizing secondary brain damage, requires constant monitoring of intracranial pressure (ICP) with or without brain tissue oxygen pressure (PbtO2). The recent OXY-TC trial suggested that combined ICP + PbtO2 monitoring does not improve the 6-month neurological outcomes, prompting a meta-analysis to reassess the clinical role of PbtO2 monitoring. Our research findings partially align with the OXY-TC trial regarding the primary endpoint, demonstrating that brain tissue oxygen-guided therapy does not significantly reduce mortality rates in TBI patients 6 months postinjury. However, in contrast to the OXY-TC trial, we observed that the PbtO2 monitoring group showed a significantly higher proportion of favorable outcomes.

严重创伤性脑损伤（TBI）与高死亡率和长期残疾相关。有效的TBI管理旨在将继发性脑损伤降至最低，需要持续监测颅内压（ICP），可同时监测或不监测脑组织氧分压（PbtO2）。近期的OXY - TC试验表明，联合监测ICP + PbtO2并不能改善6个月时的神经功能结局，这促使我们进行一项荟萃分析，以重新评估PbtO2监测的临床作用。我们的研究结果在主要终点方面与OXY - TC试验部分一致，表明脑组织氧引导治疗并不能显著降低TBI患者伤后6个月的死亡率。然而，与OXY - TC试验不同的是，我们观察到PbtO2监测组的良好结局比例显著更高。

REF: Chang Y, Wong CE, Hsu HH, et al. Brain Tissue Oxygen Combined with Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury: An Updated Systematic Review and Pooled Analysis Following the OXY-TC Trial. World Neurosurg. 2025;197:123926. doi:10.1016/j.wneu.2025.123926 PMID: 40122236

Effects of Multimodal Interventions on Patients with Neck Pain: A Systematic Review and Meta-Analysis

多模式干预对颈痛患者的影响：一项系统评价与荟萃分析

To evaluate the impact of multimodal therapy on patients with neck pain. Multimodal therapy can effectively reduce pain severity, improve kinesiophobia and pain thresholds in patients with neck pain, and significantly improve neck function when the intervention duration exceeds 4 weeks. Future studies with larger sample sizes and higher quality are needed for further exploration.

评估多模式疗法对颈痛患者的影响。多模式疗法可有效降低颈痛患者的疼痛严重程度，改善其运动恐惧和痛阈，且当干预时长超过4周时，可显著改善颈部功能。未来需要开展样本量更大、质量更高的研究作进一步探索。

REF: Chen L, Hu X, Zhou W, et al. Effects of Multimodal Interventions on Patients with Neck Pain: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;197:123927. doi:10.1016/j.wneu.2025.123927 PMID: 40139494

Incidence and Risk Factors of Delayed Facial Paralysis After Vestibular Schwannoma Resection: A Systematic Review and Meta-Analysis

前庭神经鞘瘤切除术后迟发性面瘫的发生率及危险因素：系统评价与 Meta 分析

Delayed facial nerve paralysis (DFNP) is a common complication after vestibular schwannoma surgery. Previous studies have focused on immediate facial nerve paralysis, and the risk factors for developing DFNP remain largely unclear. This study aimed to determine the incidence and risk factors of DFNP in patients after vestibular schwannoma resection. DFNP is a complication after vestibular schwannoma surgery that cannot be ignored. The risk factors (age and tumor size) of DFNP in patients after vestibular schwannoma surgery still need to be considered, and clinical management of high-risk groups should be strengthened in clinical practice.

迟发性面神经麻痹（DFNP）是前庭神经鞘瘤手术后常见的并发症。以往的研究主要集中在即刻面神经麻痹方面，而发生迟发性面神经麻痹的危险因素在很大程度上仍不清楚。本研究旨在确定前庭神经鞘瘤切除术后患者迟发性面神经麻痹的发生率及危险因素。迟发性面神经麻痹是前庭神经鞘瘤手术后不可忽视的一种并发症。前庭神经鞘瘤手术后患者发生迟发性面神经麻痹的危险因素（年龄和肿瘤大小）仍需加以考虑，在临床实践中应加强对高危人群的临床管理。

REF: Zhang X, Wen H, Chen G. Incidence and Risk Factors of Delayed Facial Paralysis After Vestibular Schwannoma Resection: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;197:123938. doi:10.1016/j.wneu.2025.123938 PMID: 40127861

Efficacy and Safety of Endovascular Thrombectomy for Large Vessel Occlusion Stroke Beyond 24 Hours From Time Last Known Well: A Systematic Review and Meta-Analysis

最后正常时间超过24小时的大血管闭塞性卒中血管内血栓切除术的有效性和安全性：系统评价与荟萃分析

Endovascular thrombectomy (EVT) has become the standard of care for selected patients with acute ischemic stroke within 24 hours of symptom onset. However, the efficacy and safety of EVT for stroke presenting beyond 24 hours are undetermined. Our study found that the EVT time window did not significantly affect Thrombolysis In Cerebral Infarction 2b-3 and sICH, and EVT showed better therapeutic effects than BMT for stroke patients beyond 24 hours. Specifically, patients who underwent EVT beyond 24 hours had a higher proportion of functional independence at 90 days and a lower risk of sICH. Therefore, EVT remains an effective treatment option for patients with large vessel ischemic stroke beyond the traditional 24-hour time window.

血管内血栓切除术（EVT）已成为症状发作24小时内部分急性缺血性卒中患者的标准治疗方法。然而，对于发病超过24小时的卒中患者，EVT的有效性和安全性尚未确定。我们的研究发现，EVT时间窗对脑梗死溶栓分级2b - 3级和症状性颅内出血（sICH）无显著影响，且对于发病超过24小时的卒中患者，EVT的治疗效果优于最佳药物治疗（BMT）。具体而言，发病超过24小时接受EVT的患者在90天时功能独立的比例更高，发生sICH的风险更低。因此，对于超过传统24小时时间窗的大血管缺血性卒中患者，EVT仍是一种有效的治疗选择。

REF: Wu J, Gao WY, Liang MG, Yan FL, Liu B, Yang MF. Efficacy and Safety of Endovascular Thrombectomy for Large Vessel Occlusion Stroke Beyond 24 Hours From Time Last Known Well: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;197:123943. doi:10.1016/j.wneu.2025.123943 PMID: 40157452

Pedicle Screw Fixation Plus Cement Augmentation or Cement augmentation Only for Osteoporotic Vertebral Compression Fracture: A Systematic Review and Meta-Analysis

椎弓根螺钉固定联合骨水泥强化或单纯骨水泥强化治疗骨质疏松性椎体压缩骨折的系统评价与Meta分析

Osteoporotic vertebral compression fractures (OVCFs) are common fractures and pedicle screw system gains dissatisfactory results since bone mass loss. Cement augmentation (CA) is the most applied surgery modality for OVCFs but with shortcomings. Pedicle screw fixation plus CA (PSF + CA) has been reported superior to CA. This study aims to investigate the impact of PSF + CA on OVCFs. PSF + CA and CA-only procedures achieved efficient clinical outcomes in OVCFs. PSF + CA showed better strength in deformity correction and long-term maintenance, less strength in incidence of secondary fracture, and more pain relief at the cost of length of hospital stay, blood loss, and operative time.

骨质疏松性椎体压缩骨折（OVCFs）是常见的骨折类型，由于骨量丢失，椎弓根螺钉系统的治疗效果不尽如人意。骨水泥强化（CA）是治疗OVCFs最常用的手术方式，但存在缺点。有报道称，椎弓根螺钉固定联合骨水泥强化（PSF + CA）优于单纯骨水泥强化。本研究旨在探讨PSF + CA对OVCFs的治疗影响。PSF + CA和单纯CA手术在治疗OVCFs方面均取得了有效的临床效果。PSF + CA在畸形矫正和长期维持方面表现更好，二次骨折发生率更低，止痛效果更明显，但代价是住院时间更长、失血量更多、手术时间更长。

REF: Wang C, Chu YW, Lv CT. Pedicle Screw Fixation Plus Cement Augmentation or Cement augmentation Only for Osteoporotic Vertebral Compression Fracture: A Systematic Review and Meta-Analysis. World Neurosurg. 2025;197:123952. doi:10.1016/j.wneu.2025.123952 PMID: 40180035