Anton de Haen (1704–1776) and his extraordinary "portentosum infundibulum" case: the futile skull cauterization of a blind patient with a craniopharyngioma

Anton de Haen(1704-1776)和他的非凡的“漏斗门”案例：一个患有颅咽管瘤的盲人患者徒劳的头骨烧灼

Authors analyzed and interpreted, from a contemporary perspective, the astounding clinicopathological record of a large tumor of the pituitary infundibulum, which caused amaurosis and amenorrhea in a young patient and was documented by the Viennese physician Anton de Haen in 1761. This report represents the first historical account of amenorrhea of hypothalamic origin caused by a craniopharyngioma. It highlights the historical importance and impact of de Haen's work Rationis Medendi in Nosocomio Practico on the fields of neuroendocrinology and neurosurgery.

作者从当代的角度分析和解释了一个令人震惊的脑垂体漏斗大肿瘤的临床病理记录，它导致了一名年轻患者的无月经和闭经，并由维也纳内科医生Anton de Haen于1761年记录。本报告首次报道了颅咽管瘤引起的下丘脑性闭经。它突出了德海恩的著作《现实生活》中的Rationis Medendi在神经内分泌学和神经外科领域的历史重要性和影响。

REF: Pascual JM, Prieto R, Rosdolsky M, Hofecker V. Anton de Haen (1704-1776) and his extraordinary "portentosum infundibulum" case: the futile skull cauterization of a blind patient with a craniopharyngioma [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-10. doi:10.3171/2023.3.JNS2381 PMID: 37119109

Cytodifferentiation of pituitary tumors influences pathogenesis and cavernous sinus invasion

垂体瘤的细胞分化影响发病机制和海绵窦侵袭

Researchers studied the influence of pituitary cytodifferentiation on cavernous sinus invasion. Pituitary transcription factor-1 tumors, which are responsible for the differentiation of somatotroph, somatolactotroph, and lactotroph tumors, behave in a more invasive manner compared with other pituitary tumor subtypes. These findings suggest that tumors causing acromegaly and prolactinoma are more likely to invade the cavernous sinus than other tumor subtypes.

研究人员研究了垂体细胞分化对海绵窦侵袭的影响。与其他类型的垂体肿瘤相比，垂体转录因子-1肿瘤具有更强的侵袭性，是生长激素、催乳素和催乳素肿瘤的主要分化因子。这些发现表明，导致肢端肥大症和催乳素瘤的肿瘤比其他肿瘤亚型更容易侵犯海绵窦。

REF: Asmaro K, Zhang M, Rodrigues AJ, et al. Cytodifferentiation of pituitary tumors influences pathogenesis and cavernous sinus invasion [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-9. doi:10.3171/2023.3.JNS221949 PMID: 37119095

Early stellate ganglion block for improvement of postoperative cerebral blood flow velocity after aneurysmal subarachnoid hemorrhage: results of a pilot randomized controlled trial

早期星状神经节阻滞改善动脉瘤性蛛网膜下腔出血术后脑血流速度：一项先导随机对照试验的结果

In this pilot study, the authors aimed to explore the feasibility and potential efficacy of the early application of stellate ganglion block (SGB) for preventing cerebral vasospasm (CVS) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Early SGB was found to significantly improve postoperative cerebral blood flow velocity following aSAH and decrease the incidence of both transcranial Doppler-detected CVS during hospitalization and 3-month total new infarctions. These results indicated that SGB is a potentially effective treatment for aSAH and provided the necessary feasible basis for subsequent research.

本研究旨在探讨早期应用星状神经节阻滞(SGB)预防动脉瘤性蛛网膜下腔出血(ASAH)患者脑血管痉挛(CVS)的可行性和潜在疗效。早期SGB可显著改善ASAH术后脑血流速度，降低住院期间经颅多普勒检测CVS的发生率和3个月后新发脑梗塞的发生率。这些结果表明，SGB是治疗ASAH的一种潜在有效方法，并为后续研究提供了必要的可行性基础。

REF: Wu Y, Lin F, Bai Y, et al. Early stellate ganglion block for improvement of postoperative cerebral blood flow velocity after aneurysmal subarachnoid hemorrhage: results of a pilot randomized controlled trial [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-9. doi:10.3171/2023.3.JNS222567 PMID: 37119094

Flow diversion: a disruptive technology coming of age. Lessons learned and challenges for the future

分流：一项即将成熟的颠覆性技术。吸取的经验教训和未来的挑战

Flow diversion as a concept and a technology has unique features allowing for reconstructive remodeling of dysplastic vessel segments allowing for aneurysm occlusion over time with overall inclusion rates increasing over time, which is unique in endovascular technologies. Here, the authors provide an overview of flow diversion as a disruptive technology in endovascular aneurysm treatment, highlighting early challenges, current knowledge, and future directions. This study presents a complete overview of flow diversion technology summarizing early trials to modern-day indications such as in the use in ruptured blister aneurysms.

血流分流作为一种概念和技术，具有独特的功能，允许重建发育不良的血管节段，允许随着时间的推移闭塞动脉瘤，总包含率随着时间的推移而增加，这在血管内技术中是独一无二的。在这里，作者提供了作为血管内动脉瘤治疗的颠覆性技术的血流分流的概述，强调了早期的挑战、当前的知识和未来的方向。本研究对分流技术作了一个完整的概述，总结了早期试验到现代适应症，例如在破裂的水泡性动脉瘤中的应用。

REF: Enriquez-Marulanda A, Young MM, Taussky P. Flow diversion: a disruptive technology coming of age. Lessons learned and challenges for the future [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-11. doi:10.3171/2023.3.JNS221795 PMID: 37119093

Implications and future directions of ChatGPT utilization in neurosurgery

ChatGPT在神经外科中应用的意义和未来方向

Artificial intelligence (AI) is a rapidly developing tool that is quickly becoming adopted in healthcare and neurosurgery. 1 The subfield of natural language processing (NLP), which is aimed at having computers understand the content and context of documents, has major potential in medicine from data analysis and clinical decision support to medical education and administrative assistance. Chat generative pre-trained transformer (ChatGPT) is a recently launched open-access AI model that interacts with user inputs in a conversational manner. It has created a buzz within the medical community because of its future potential, reliability...

人工智能(AI)是一种快速发展的工具，正迅速被医疗保健和神经外科采用。1自然语言处理(NLP)子领域旨在使计算机理解文件的内容和上下文，在医学方面具有重大潜力，从数据分析和临床决策支持到医学教育和行政辅助。Chat生成性预训练转换器(ChatGPT)是最近推出的一个开放访问的AI模型，它以对话的方式与用户输入交互。它在医学界引起了轰动，因为它未来的潜力，可靠性...

REF: Singh R, Reardon T, Srinivasan VM, Gottfried O, Bydon M, Lawton MT. Implications and future directions of ChatGPT utilization in neurosurgery [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-3. doi:10.3171/2023.3.JNS23555 PMID: 37119117

The influence of tumor topography on the surgical outcome of craniopharyngiomas

肿瘤形态对颅咽管瘤手术疗效的影响

This study aimed to evaluate the surgical outcomes of craniopharyngioma based on its topographic relation to optic chiasm and third ventricular floor. Retrochiasmatic craniopharyngiomas (RCPs) are associated with significant postoperative hypopituitarism and hypothalamic morbidities when compared with non-RCPs. RCPs with intra- and extraventricular components tend to have higher tumor recurrence. This study supports the fact that the site of origin and axis of growth determine the tumor's relation to the hypothalamus and, subsequently, the surgical complications.

本研究旨在根据颅咽管瘤与视交叉和第三脑室底的解剖关系来评估其手术效果。与非交叉后颅咽管瘤相比，视交叉后颅咽管瘤(RCP)与术后明显的垂体功能低下和下丘脑病变相关。具有室内外成分的RCP往往有更高的肿瘤复发率。这项研究支持这样一个事实，即肿瘤的起源和生长轴决定了肿瘤与下丘脑的关系，并随后决定了手术并发症。

REF: Sadhasivam S, Menon G, Abraham M, Arora RK, Nair SN. The influence of tumor topography on the surgical outcome of craniopharyngiomas [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-11. doi:10.3171/2023.3.JNS222302 PMID: 37119112

Link between both infratentorial and supratentorial intracranial pressure burdens and final outcome in patients with infratentorial brain injury

幕下脑损伤患者幕下和幕上颅内压负荷与最终结局的关系

Infratentorial intracranial pressure (ICPinf) monitoring can be clinically valuable in selected patients, detecting pertinent complications and giving a detailed insight into pathophysiological interactions within the posterior fossa (PF). ICPinf but not supratentorial ICP (ICPsup) burden is associated with worse neurological outcome, and ICPsup measurement insufficiently captures ICP in the infratentorial region. The fundamental perspective on ICP distribution within the cranium as well as the therapeutic approach in patients with PF lesions should be reappraised.

幕下颅内压(ICPinf)监测在选定的患者中具有临床价值，可以检测相关的并发症，并详细了解后颅窝(PF)内的病理生理相互作用。ICPinf而不是幕上颅内压(ICPsup)负担与较差的神经预后相关，并且ICPsup测量不能充分捕捉幕下区域的颅内压。应重新评估颅内压在颅骨内分布的基本观点以及PF病变患者的治疗方法。

REF: Petr O, Ho WM, Petutschnigg T, et al. Link between both infratentorial and supratentorial intracranial pressure burdens and final outcome in patients with infratentorial brain injury [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-9. doi:10.3171/2023.1.JNS221806 PMID: 37119097

Microsurgical and fiber tract anatomy of the interthalamic adhesion

丘脑间粘连的显微外科和纤维束解剖

The interthalamic adhesion (ITA) is an anatomical structure located in the middle of both cerebral hemispheres between both thalami. This structure, which has been neglected as a remnant structure for many years, has been examined anatomically, radiologically, and histologically. There are fibers connecting important regions of the brain through this structure. In this study, for the first time, the ITA was divided into 4 main types according to the radiological and anatomical features.

丘脑间粘连(ITA)是位于双侧丘脑之间的大脑半球中部的一种解剖结构。这个多年来一直被忽视的残存结构，经过了解剖学、放射学和组织学的检查。有纤维通过这个结构连接大脑的重要区域。在本研究中，首次根据影像和解剖学特征将ITA分为4种主要类型。

REF: Şahin MH, Güngör A, Demirtaş OK, et al. Microsurgical and fiber tract anatomy of the interthalamic adhesion [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-10. doi:10.3171/2023.3.JNS221669 PMID: 37119096

Predictors of extent of resection and recurrence following endoscopic endonasal resection of craniopharyngioma

鼻内窥镜下颅咽管瘤切除术后切除范围和复发的预测因素

Researchers evaluated predictors of recurrence and gross-total resection (GTR) in a large series of craniopharyngiomas. GTR with stalk sacrifice led to the best long-term control rates, as compared to subtotal resection plus radiation. Preserving the stalk moderately reduced postoperative hypopituitarism and diabetes insipidus rates but increased the risk of recurrence, even if GTR had been achieved. The study offers a large series of craniopharyngiomas treated via the endoscopic endonasal approach with long-term follow-up, guiding surgical decision-making and improving outcomes for both pediatric and adult patients.

研究人员评估了一大系列颅咽管瘤复发和大体全切除(GTR)的预测因素。与次全切除加放射治疗相比，切除根茎的GTR可获得最好的长期控制率。保留柄适度减少了术后垂体功能减退和尿崩症的发生率，但增加了复发的风险，即使已经达到GTR。这项研究提供了一系列通过内窥镜鼻内入路治疗的颅咽管瘤，并进行了长期随访，指导手术决策，改善儿童和成人患者的预后。

REF: Bobeff EJ, Mathios D, Mistry AA, et al. Predictors of extent of resection and recurrence following endoscopic endonasal resection of craniopharyngioma [published online ahead of print, 2023 Apr 28]. J Neurosurg. 2023;1-12. doi:10.3171/2023.3.JNS222607 PMID: 37119110