Curative Treatment of Brain Arteriovenous Malformations Combining Endovascular and Surgical Approaches Consecutively

连续联合血管内治疗和手术方法对脑动静脉畸形的治愈性治疗

Brain arteriovenous malformations (AVMs) pose a significant treatment challenge, with options including microsurgical resection, endovascular embolization, radiosurgery, or combinations thereof. We present our experience with a curative strategy combining complete endovascular treatment followed by microsurgical resection under the same anesthesia session, without relying on a hybrid operating room. Combining maximal endovascular embolization and complete surgical resection in a single session in patients with AVM yielded a high cure rate and low morbidity, especially for low-grade lesions. This technique may make it possible to treat high-grade AVMs previously considered ineligible for surgery and reduce periprocedural morbidity.

脑动静脉畸形（AVMs）是一项重大的治疗挑战，治疗方案包括显微外科切除术、血管内栓塞术、放射外科治疗或其联合应用。我们分享在同一麻醉周期内先进行完全血管内治疗，随后实施显微外科切除术的治愈策略经验，且无需依赖复合手术室。对于动静脉畸形患者，在单一疗程中联合进行最大限度的血管内栓塞和完全手术切除，可实现较高的治愈率和较低的发病率，尤其适用于低级别病变。该技术或许能使既往被认为不适合手术的高级别动静脉畸形得到治疗，并降低围手术期发病率。

REF: Brauner R, Smajda S, Chauvet D, et al. Curative Treatment of Brain Arteriovenous Malformations Combining Endovascular and Surgical Approaches Consecutively. World Neurosurg. 2025;197:123896. doi:10.1016/j.wneu.2025.123896 PMID: 40090406

The Characteristics of Intracerebral Hemorrhages in Dialysis Patients

透析患者脑出血的特点

Chronic kidney failure is a global public health challenge and is associated with a higher risk of intracerebral hemorrhage (ICH). ICH is known to result in a poorer prognosis in hemodialysis (HD) patients than in non-HD patients. The study concludes that HD patients with ICH exhibit a higher risk of hematoma enlargement and poorer clinical outcomes. Dialysis and anticoagulant use emerged as significant risk factors for hematoma enlargement. Larger prospective studies are essential for validating these findings.

慢性肾衰竭是一项全球性的公共卫生挑战，且与较高的脑出血（ICH）风险相关。众所周知，与非血液透析（HD）患者相比，血液透析患者发生脑出血后的预后更差。该研究得出结论，发生脑出血的血液透析患者出现血肿扩大的风险更高，临床结局更差。透析和使用抗凝剂是血肿扩大的重要危险因素。开展更大规模的前瞻性研究对于验证这些研究结果至关重要。

REF: Karita H, Inaba T, Sekine T, Nakamura K, Yamazaki T, Komatsu Y. The Characteristics of Intracerebral Hemorrhages in Dialysis Patients. World Neurosurg. 2025;197:123909. doi:10.1016/j.wneu.2025.123909 PMID: 40118379

Nomogram Prediction of Prognosis After Surgical Operation for Cerebral Hemorrhage

脑出血手术预后的列线图预测

This study aimed to investigate the risk factors for intensive care unit (ICU) mortality in patients with intracerebral hemorrhage after surgery and to construct a clinical nomogram. For patients with severe cerebral hemorrhage after craniotomy, we developed a distinctive nomogram model to forecast all-cause mortality in the critical care unit. It can simply and intuitively display the risk of poor prognosis for patients, providing clinicians with an important treatment tool for individualized treatment and outcome forecasting.

本研究旨在探讨脑出血患者术后重症监护病房（ICU）死亡的危险因素，并构建临床列线图。对于开颅术后的重症脑出血患者，我们开发了一种独特的列线图模型，用于预测重症监护病房的全因死亡率。它可以简单直观地展示患者预后不良的风险，为临床医生提供一个重要的个体化治疗和结局预测工具。

REF: Xie Z, Lv X, Dai S, Ma Y, Wang J. Nomogram Prediction of Prognosis After Surgical Operation for Cerebral Hemorrhage. World Neurosurg. 2025;197:123936. doi:10.1016/j.wneu.2025.123936 PMID: 40139496

Malignant Peripheral Nerve Sheath Tumors in Children and Adolescents: A Population-Based Study

儿童和青少年恶性外周神经鞘膜瘤：一项基于人群的研究

This study aims to analyze the prognosis of malignant peripheral nerve sheath tumors (MPNSTs) in children using the Surveillance, Epidemiology, and End Results (SEER) database to identify significant prognostic factors affecting survival. Pediatric MPNSTs presents with a challenging prognosis, significantly influenced by the SEER stage at diagnosis. Surgery is crucial as first-line treatment for MPNSTs, especially if the tumor is localized at diagnosis.

本研究旨在利用监测、流行病学和最终结果（SEER）数据库分析儿童恶性外周神经鞘膜瘤（MPNST）的预后，以确定影响生存的重要预后因素。儿童MPNST预后不佳，其预后显著受诊断时SEER分期的影响。手术作为MPNST的一线治疗方法至关重要，尤其是当肿瘤在诊断时处于局限性阶段时。

REF: Wu H, Liao Z, Wu Y, Li L. Malignant Peripheral Nerve Sheath Tumors in Children and Adolescents: A Population-Based Study. World Neurosurg. 2025;197:123934. doi:10.1016/j.wneu.2025.123934 PMID: 40139495

Explainable Machine Learning Models for Prediction of Surgical Site Infection After Posterior Lumbar Fusion Surgery Based on Shapley Additive Explanations

基于夏普利加性解释的可解释机器学习模型用于预测后路腰椎融合手术后手术部位感染

This study aims to develop machine learning (ML) models combined with an explainable method for the prediction of surgical site infection (SSI) after posterior lumbar fusion surgery. ML-based prediction tools can accurately assess the risk of SSI after posterior lumbar fusion surgery. Additionally, ML combined with SHAP could provide a clear interpretation of individualized risk prediction and give physicians an intuitive comprehension of the effects of the model's essential features.

本研究旨在开发结合可解释方法的机器学习（ML）模型，用于预测后路腰椎融合手术后手术部位感染（SSI）的发生情况。基于机器学习的预测工具能够准确评估后路腰椎融合手术后发生手术部位感染的风险。此外，将机器学习与SHAP方法相结合可以对个体化风险预测进行清晰的解释，并使医生直观地理解模型关键特征的影响。

REF: Wang P, Liu L, Xie Z, et al. Explainable Machine Learning Models for Prediction of Surgical Site Infection After Posterior Lumbar Fusion Surgery Based on Shapley Additive Explanations. World Neurosurg. 2025;197:123942. doi:10.1016/j.wneu.2025.123942 PMID: 40154601

Efficacy and Safety of Adjunctive Coiling in Pipeline Embolization Device Implantation for Small- and Medium-Sized Unruptured Cerebral Aneurysms: A Retrospective Cohort Study and Literature Review

Pipeline血流导向装置植入联合弹簧圈栓塞治疗中小型未破裂脑动脉瘤的有效性和安全性：一项回顾性队列研究及文献综述

The pipeline embolization device with adjunctive coiling (PAC) for small- and medium-sized unruptured cerebral aneurysms (UCAs) has not yet been fully evaluated for promoting aneurysm occlusion and preventing delayed rupture. The present study investigated the efficacy and safety of the PAC for UCAs ≤10 mm in diameter. PAC for UCAs ≤10 mm in diameter may enhance the rate of complete occlusion without increasing the risk of complications.

对于中小型未破裂脑动脉瘤（UCA），采用管道栓塞装置联合辅助弹簧圈栓塞（PAC）在促进动脉瘤闭塞和预防延迟破裂方面尚未得到充分评估。本研究探讨了PAC治疗直径≤10 mm的UCA的有效性和安全性。对于直径≤10 mm的UCA，PAC可能提高完全闭塞率，且不增加并发症风险。

REF: Fuga M, Ishibashi T, Kan I, et al. Efficacy and Safety of Adjunctive Coiling in Pipeline Embolization Device Implantation for Small- and Medium-Sized Unruptured Cerebral Aneurysms: A Retrospective Cohort Study and Literature Review. World Neurosurg. 2025;197:123933. doi:10.1016/j.wneu.2025.123933 PMID: 40139493

Should Proximal Fixation be at C2 or C3-C4? An Application of the Operative Value Index for Elective Posterior Cervical Decompression and Fusion

近端固定应选在C2还是C3 - C4？选择性颈椎后路减压融合术手术价值指数的应用

There is clinical equipoise regarding the ideal upper instrumented vertebrae (UIV) for elective posterior cervical decompression and fusion (PCDF). Instrumentation may be performed at the axial C2 level, or at the subaxial C3/C4 vertebrae. To our knowledge, a true "value" (outcomes per dollar spent) comparison axial versus subaxial UIV for PCDF has never been performed. Although the C2 UIV construct incurred significantly higher intraoperative costs compared with C3/C4 UIV, there was no significant difference in "value" between axial and subaxial UIV.

对于选择性后路颈椎减压融合术（PCDF）的理想上固定椎体（UIV），临床上尚无定论。固定可在枢椎（C2）节段进行，也可在亚轴位的C3/C4椎体进行。据我们所知，从未有人对PCDF采用轴位与亚轴位UIV进行过真正的“价值”（每花费一美元所获得的治疗效果）比较。尽管与C3/C4 UIV相比，C2 UIV结构的术中成本显著更高，但轴位和亚轴位UIV在“价值”方面并无显著差异。

REF: Sarikonda A, Self DM, Quraishi D, et al. Should Proximal Fixation be at C2 or C3-C4? An Application of the Operative Value Index for Elective Posterior Cervical Decompression and Fusion. World Neurosurg. 2025;197:123898. doi:10.1016/j.wneu.2025.123898 PMID: 40090409

Kinematic Analysis of the Hindbrain via Dynamic Neck Motion in Adult Patients with Chiari Malformation Type I: A Radiological Study with Clinical Implications

成人Ⅰ型 Chiari 畸形患者通过动态颈部运动进行后脑的运动学分析：一项具有临床意义的放射学研究

The influence of cervical motion on the hindbrain in patients with Chiari malformation type I (CMI) remains under investigation. In this study, the kinematic effects of cervical extension and flexion on cerebellar tonsillar herniation were evaluated. The mobility of the ectopic tonsils and the degree of cervical motion were verified in adult CMI patients. The herniated tonsils largely ascended with extension and descended with flexion, without obvious tonsillar tissue strain, whereas the brain stem remained stable. Tonsillar motion may be a potential marker of CMI and may therefore help surgeons confirm CMI as well as tailor surgical procedures for such patients.

I型Chiari畸形（CMI）患者颈部活动对后脑的影响仍在研究中。本研究评估了颈部伸展和屈曲对小脑扁桃体下疝的运动学影响。在成年CMI患者中验证了异位扁桃体的活动度和颈部活动程度。下疝的扁桃体在颈部伸展时大多上移，在颈部屈曲时下移，且无明显的扁桃体组织张力变化，而脑干保持稳定。扁桃体的运动可能是CMI的一个潜在标志物，因此可能有助于外科医生确诊CMI并为这类患者制定个性化的手术方案。

REF: Deng H, Chen T, Chen G, et al. Kinematic Analysis of the Hindbrain via Dynamic Neck Motion in Adult Patients with Chiari Malformation Type I: A Radiological Study with Clinical Implications. World Neurosurg. 2025;197:123925. doi:10.1016/j.wneu.2025.123925 PMID: 40122235

Preliminary Results of Paraclinoid Aneurysm Clipping With Indocyanine Green-Video Angiography: A Single-Center Experience in Vietnam

吲哚菁绿血管造影辅助床突旁动脉瘤夹闭术的初步结果：越南单中心经验

There are 2 main treatments for unruptured paraclinoid aneurysms: endovascular procedures and surgical clipping. Recent advancements such as intraoperative indocyanine green video angiography (ICG-VA) are improving the safety of clipping procedure in the surgical center without intraoperative imaging. This study is a single-center experience in Vietnam to evaluate the preliminary result of a surgical series in paraclinoid aneurysms with ICG-VA. Surgical clipping of unruptured paraclinoid aneurysms is a safe and feasible treatment, and good neurological outcomes can be achieved. Applying ICG-VA has provided intraoperative real-time visualization and the potential to decrease complications. The incomplete clipping rate of aneurysms in this position is still a challenge to overcome and several factors can predict this important issue.

未破裂的床突旁动脉瘤主要有两种治疗方法：血管内介入手术和外科夹闭术。诸如术中吲哚菁绿视频血管造影（ICG - VA）等近期技术进展正在提高无术中影像设备的外科中心进行夹闭手术的安全性。本研究是越南一家单中心的经验，旨在评估采用ICG - VA进行床突旁动脉瘤外科手术系列的初步结果。对未破裂的床突旁动脉瘤进行外科夹闭是一种安全可行的治疗方法，并且可以取得良好的神经功能预后。应用ICG - VA可实现术中实时可视化，并有可能减少并发症。该部位动脉瘤的不完全夹闭率仍是有待克服的挑战，有几个因素可预测这一重要问题。

REF: Nguyen AM, Do HH, Trung NH, Bui DHT. Preliminary Results of Paraclinoid Aneurysm Clipping With Indocyanine Green-Video Angiography: A Single-Center Experience in Vietnam. World Neurosurg. 2025;197:123928. doi:10.1016/j.wneu.2025.123928 PMID: 40139489