Spontaneous Intracranial Hemorrhage in Brazil: Trends, Seasonality, Pandemic Disruption, and Cost Burden

巴西自发性颅内出血：趋势、季节性特征、疫情影响及成本负担

Spontaneous intracranial hemorrhage (sICH) is a severe stroke subtype with high morbidity, mortality, and health care costs. This study evaluated national trends in sICH hospitalizations in Brazil from 2017 to 2022, focusing on seasonal variation, neurosurgical access, financial burden, and the impact of the COVID-19 pandemic. The rising incidence, costs, and seasonal nature of sICH highlight a growing burden on the Brazilian public system. Current trends suggest demographic aging is outpacing prevention efforts, while the heavy reliance on decompressive techniques reveals a critical gap in the adoption of minimally invasive surgical options.

自发性颅内出血（sICH）是一种严重的卒中亚型，具有高发病率、高死亡率和高昂的医疗费用。本研究评估了2017年至2022年巴西sICH住院治疗的全国趋势，重点关注季节变化、神经外科治疗可及性、经济负担以及COVID - 19大流行的影响。sICH发病率上升、费用增加以及其季节性特点凸显了巴西公共医疗系统日益加重的负担。当前趋势表明人口老龄化速度超过了预防工作的推进速度，而对减压技术的高度依赖则显示出在采用微创外科手术方案方面存在重大差距。

REF: Goulart TO, Marazzi TBM, Monteiro RA, Camilo MR, Pontes-Neto OM. Spontaneous Intracranial Hemorrhage in Brazil: Trends, Seasonality, Pandemic Disruption, and Cost Burden. World Neurosurg. 2026;207:124793. doi:10.1016/j.wneu.2026.124793 PMID: 41520782

Toxic metal Burden in Intracranial Thrombi Retrieved During Mechanical Thrombectomy: An Observational Study

机械取栓术中取出的颅内血栓中的有毒金属负荷：一项观察性研究

Acute ischemic stroke caused by intracranial large vessel occlusion is associated with significant morbidity and mortality. Emerging evidence suggests that environmental exposures, including toxic metals, may be associated with cerebrovascular disease. However, the presence of toxic metals within intracranial thrombi and their relationship with clinical features of acute ischemic stroke remain largely unexplored. This study identifies significant associations between thrombus toxic metal concentrations and clinical outcomes, suggesting that thrombus metal composition may be relevant to acute ischemic stroke characteristics.

颅内大血管闭塞所致的急性缺血性卒中与较高的发病率和死亡率相关。越来越多的证据表明，包括有毒金属在内的环境暴露可能与脑血管疾病有关。然而，颅内血栓中有毒金属的存在及其与急性缺血性卒中临床特征的关系在很大程度上仍未得到研究。本研究发现血栓中有毒金属浓度与临床结局之间存在显著关联，这表明血栓的金属成分可能与急性缺血性卒中的特征相关。

REF: Scimeca M, Mauriello A, Nguyen TN, et al. Toxic metal Burden in Intracranial Thrombi Retrieved During Mechanical Thrombectomy: An Observational Study. World Neurosurg. 2026;207:124803. doi:10.1016/j.wneu.2026.124803 PMID: 41544973

Predictors of Postoperative Delirium in Non-Intensive Care Unit Elderly Spinal Surgery Patients: The Impact of Diabetes and Early Postoperative Pain

非重症监护病房老年脊柱手术患者术后谵妄的预测因素：糖尿病和术后早期疼痛的影响

To explore the risk factors for postoperative delirium (POD) in elderly patients after spinal surgery. Advanced age, emergency surgery, diabetes, preoperative cognitive dysfunction, long operation time, intraoperative hypotension (SBP<80 mmHg), and a PACU-VAS score ≥4 were independent risk factors for POD in elderly patients after spinal surgery. In the perioperative period, reasonable and effective measures should be taken according to risk factors to reduce the incidence of POD in elderly patients after spinal surgery.

探讨老年脊柱手术后患者发生术后谵妄（POD）的危险因素。高龄、急诊手术、糖尿病、术前认知功能障碍、手术时间长、术中低血压（收缩压<80 mmHg）以及麻醉后监护室视觉模拟评分（PACU - VAS）≥4分是老年脊柱手术后患者发生POD的独立危险因素。围手术期应根据危险因素采取合理有效的措施，以降低老年脊柱手术后患者POD的发生率。

REF: Liu DK, Wang ZW, Chen YP, Zhao C, Yang DL. Predictors of Postoperative Delirium in Non-Intensive Care Unit Elderly Spinal Surgery Patients: The Impact of Diabetes and Early Postoperative Pain. World Neurosurg. 2026;207:124805. doi:10.1016/j.wneu.2026.124805 PMID: 41565200

A Novel Radiation-Free Navigation Method for Robotic Pedicle Screw Placement Using Three-Dimensional Printed Guide Templates: A Cadaveric Study

一种使用三维打印导向模板的无辐射机器人椎弓根螺钉置入新型导航方法：一项尸体研究

Robot-assisted spinal surgery has advanced surgical accuracy but increased radiation exposure for both staff and patients, raising safety concerns. The purpose of this study was to evaluate the clinical accuracy of thoracic pedicle screw placement performed with a three-dimensional (3D)-printed navigation guide plate for robotic registration and to determine whether equivalent precision can be achieved without intraoperative imaging. 3D-printed navigation guide plates enable accurate, radiation-free robot-assisted thoracic pedicle screw placement. Surgical efficiency improved markedly with experience, supporting the technique as a safe alternative to conventional image-guided methods. This study involves no ionizing radiation in its methodology and transforms the traditional registration process for robots, making it safe and efficient.

机器人辅助脊柱手术提高了手术精度，但增加了医护人员和患者的辐射暴露，引发了安全担忧。本研究的目的是评估使用三维（3D）打印导航导板进行机器人配准的胸椎椎弓根螺钉置入的临床准确性，并确定在不进行术中成像的情况下是否能达到同等的精度。3D打印导航导板可实现无辐射的精确机器人辅助胸椎椎弓根螺钉置入。随着经验的积累，手术效率显著提高，这表明该技术是传统影像引导方法的一种安全替代方案。本研究在方法学上不涉及电离辐射，改变了机器人的传统配准过程，使其既安全又高效。

REF: Bao Y, Bian C, Luo HT, Yang XG, Lu S. A Novel Radiation-Free Navigation Method for Robotic Pedicle Screw Placement Using Three-Dimensional Printed Guide Templates: A Cadaveric Study. World Neurosurg. 2026;207:124790. doi:10.1016/j.wneu.2026.124790 PMID: 41519467

Quantitative and Comparative Analysis of Dream Content in Parkinson's Disease Patients Undergoing Deep Brain Stimulation: A Pilot Study

接受深部脑刺激治疗的帕金森病患者梦境内容的定量与比较分析：一项探索性研究

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra, resulting in motor and nonmotor symptoms including diminished sleep quality and altered dream content. The neurocircuitry underlying the latter remain poorly understood. The goal of this study is to assess the influence of deep brain stimulation (DBS) on sleep quality and, for the first time, dream characteristics. This pilot study provides novel insights into the effects of DBS on dream content in PD patients. DBS may influence and even reverse PD-altered dream content potentially through modulation of brain networks involved in dream generation.

帕金森病（PD）是一种神经退行性疾病，其特征是黑质中多巴胺能神经元丧失，导致运动和非运动症状，包括睡眠质量下降和梦境内容改变。后者背后的神经回路仍知之甚少。本研究的目的是评估脑深部电刺激（DBS）对睡眠质量的影响，并首次评估其对梦境特征的影响。这项初步研究为DBS对PD患者梦境内容的影响提供了新的见解。DBS可能通过调节参与梦境产生的大脑网络来影响甚至逆转PD导致的梦境内容改变。

REF: Joswig H, Oreizi-Esfahani S, Medack S, Träger U, Staudt MD. Quantitative and Comparative Analysis of Dream Content in Parkinson's Disease Patients Undergoing Deep Brain Stimulation: A Pilot Study. World Neurosurg. 2026;207:124816. doi:10.1016/j.wneu.2026.124816 PMID: 41554339

Stent Angioplasty in Acute-Phase ICAD-LVO: A Retrospective Cohort Study on Long-Term Recurrence and Safety Outcomes

急性期颅内动脉粥样硬化性大血管闭塞的支架血管成形术：一项关于长期复发和安全性结局的回顾性队列研究

The optimal treatment strategy of Intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) remains undetermined. Current evaluation criteria focus on 90-day functional independence for acute-phase management, yet this timeframe does not represent the therapeutic endpoint given the persistent risk of recurrent stroke in this patient population. This study aims to examine whether stent angioplasty in patients with ICAD-LVO reduces long-term stroke recurrence risk while achieving successful vascular recanalization. In this retrospective cohort study, emergency stent angioplasty was associated with a lower risk of 30-day to 1-year stroke recurrence in intracranial atherosclerotic occlusions and was not associated with an increased risk of procedural complications.

颅内动脉粥样硬化疾病相关的大血管闭塞（ICAD - LVO）的最佳治疗策略仍未确定。目前的评估标准侧重于急性期管理的90天功能独立性，但鉴于该患者群体存在持续的复发性卒中风险，这一时间框架并不代表治疗终点。本研究旨在探讨ICAD - LVO患者行支架血管成形术在实现成功血管再通的同时是否能降低长期卒中复发风险。在这项回顾性队列研究中，急诊支架血管成形术与颅内动脉粥样硬化性闭塞患者30天至1年的卒中复发风险降低相关，且与手术并发症风险增加无关。

REF: Chen L, Mi S, He Y, et al. Stent Angioplasty in Acute-Phase ICAD-LVO: A Retrospective Cohort Study on Long-Term Recurrence and Safety Outcomes. World Neurosurg. 2026;207:124819. doi:10.1016/j.wneu.2026.124819 PMID: 41554337

Comprehensive Learning Curve, Clinical Outcomes, and Radiological Evaluation of Modified Trans-Kambin Endoscopic Lumbar Interbody Fusion at over 1-Year Follow-Up

改良经坎宾三角内镜下腰椎椎间融合术超过1年随访的综合学习曲线、临床结局及影像学评估

To evaluate the learning curve, clinical outcomes, and radiological results of modified trans-Kambin endoscopic lumbar interbody fusion. Modified trans-Kambin endoscopic lumbar interbody fusion is effective and safe, with high fusion rates and significant pain relief. Greater graft volume improved fusion grades. VO was linked to high BMI, male sex, and osteoporosis treatment. A 40-case threshold was associated with improved outcomes, underscoring the importance of surgical experience.

评估改良经坎宾三角内镜下腰椎椎间融合术的学习曲线、临床疗效和影像学结果。改良经坎宾三角内镜下腰椎椎间融合术有效且安全，融合率高，疼痛缓解显著。更大的植骨量可改善融合等级。椎间隙撑开不足与高体重指数、男性和骨质疏松治疗有关。完成40例手术是一个节点，此后手术效果有所改善，这凸显了手术经验的重要性。

REF: Chien KT, Liao KH, Li JY, et al. Comprehensive Learning Curve, Clinical Outcomes, and Radiological Evaluation of Modified Trans-Kambin Endoscopic Lumbar Interbody Fusion at over 1-Year Follow-Up. World Neurosurg. 2026;207:124818. doi:10.1016/j.wneu.2026.124818 PMID: 41565201

Body Mass Index as a Risk Factor for Recurrence and Frequency of Re-surgery after Lumbar Spine Surgery

身体质量指数作为腰椎手术后复发及再次手术频率的危险因素

Obesity is linked to degenerative spinal disorders, but its effect on recurrence and re-surgery after lumbar spine surgery remains unclear. Elevated body mass index (BMI) may influence outcomes through biomechanical stress and metabolic inflammation. Elevated BMI is significantly associated with increased recurrence and reoperation after lumbar discectomy. Preoperative BMI optimization may reduce the risk of re-surgery and improve postoperative outcomes.

肥胖与脊柱退行性疾病相关，但它对腰椎手术后复发和再次手术的影响仍不清楚。身体质量指数（BMI）升高可能通过生物力学应力和代谢性炎症影响手术结果。BMI升高与腰椎间盘切除术后复发和再次手术增加显著相关。术前优化BMI可能降低再次手术的风险并改善术后结果。

REF: Soliman MA, Kandil EA, El-Badawy MK, Salama AI, Abaza HA. Body Mass Index as a Risk Factor for Recurrence and Frequency of Re-surgery after Lumbar Spine Surgery. World Neurosurg. 2026;207:124824. doi:10.1016/j.wneu.2026.124824 PMID: 41577128

Pseudarthrosis After Anterior Cervical Discectomy and Fusion: An Infectious Source Might be Suspected

颈椎前路椎间盘切除融合术后假关节形成：可能需怀疑存在感染源

The involvement of infectious agents has been demonstrated in some cases of lumbar pseudarthrosis, but remains poorly documented and discussed for anterior cervical discectomy and fusion (ACDF) pseudarthrosis. The purpose of our work was to determine whether an infectious source should be suspected in cervical pseudarthrosis following ACDF. In cervical pseudarthrosis, an infection should be considered as a potential cause. Surgical revision must include bacteriological sampling and antibiotic prophylaxis. Patients reoperated for infectious pseudarthrosis often suffered from residual neck pain.

在一些腰椎假关节病例中已证实有感染因子参与，但关于前路颈椎间盘切除融合术（ACDF）假关节的相关情况，记录和讨论仍较少。我们这项研究的目的是确定ACDF术后颈椎假关节是否应怀疑存在感染源。对于颈椎假关节，应将感染视为一个潜在病因。手术翻修必须包括细菌学采样和抗生素预防。因感染性假关节再次手术的患者常遗留颈部疼痛。

REF: Amelot A, Loret JE, Le Brun C, et al. Pseudarthrosis After Anterior Cervical Discectomy and Fusion: An Infectious Source Might be Suspected. World Neurosurg. 2026;207:124828. doi:10.1016/j.wneu.2026.124828 PMID: 41579948