【期刊速览】Journal of Neurosurgery | Online 2024年9月速览（二）

1. Stereotactic radiosurgery for anterior cranial fossa dural arteriovenous fistulas

立体定向放射外科治疗前颅窝硬脑膜动静脉瘘

The authors presented their treatment results for stereotactic radiosurgery (SRS) on anterior cranial fossa dural arteriovenous fistula (ACF DAVF). In their series, ACF DAVF obliteration was achieved in 7 of the 11 patients after SRS treatment. No post-SRS intracranial hemorrhage occurred, and most patients presented improved clinical symptoms. From the authors' experience, SRS is a viable alternative treatment for ACF DAVF.

This paper aimed to analyze the clinical characteristics of elderly patients with craniopharyngioma and evaluate surgical outcomes after endoscopic endonasal surgery. Endoscopic endonasal surgery represents a viable treatment option for older craniopharyngioma patients. With appropriate perioperative management, this approach does not significantly increase mortality and is well tolerated by selected patient populations. Insights into the clinical characteristics and surgical outcomes of elderly craniopharyngioma patients can inform treatment decisions and enhance postoperative management strategies.

REF: Bao YY, Pan LS, Cao Y, et al. Clinical characteristics and therapeutic outcomes after endoscopic endonasal surgery for craniopharyngioma in the elderly. J Neurosurg. Published online September 20, 2024. doi:10.3171/2024.5.JNS232533 PMID: 39303301

This study compared factors associated with bypass occlusion between moyamoya disease (MMD) and atherosclerotic disease (AD). Occlusion rates at last follow-up did not vary between groups, although short-term follow-up results suggested earlier bypass failure in AD and extended follow-up trended toward higher occlusion rates in MMD. Patients with AD were more likely to have further stroke by last follow-up. Importantly, the bypass flow and cut flow index at the time of surgery predicted occlusion in both AD and MMD.

REF: McGuire LS, Abou-Mrad T, Atwal G, Amin-Hanjani S, Charbel FT. Does disease etiology matter in long-term patency in extracranial-intracranial bypass?. J Neurosurg. Published online September 20, 2024. doi:10.3171/2024.6.JNS2414IF: 3.5 Q1 PMID: 39303307

The authors conducted a review on cardiac migration of ventriculoperitoneal shunt and a Weibull analysis on the diagnosis latency to investigate the time-course of the occurrence rate. They showed that the migration was not diagnosed at a constant rate but dominated by an initial factor, pointing out the feasibility of early diagnosis on the basis of statistics. This study exemplified a different way to analyze a compilation of qualitative data such as case reports.

REF: Nakae T, Hojo M, Arakawa Y. Early diagnosis to avoid invasive treatment in cardiac migration of a ventriculoperitoneal catheter: a qualitative systematic review and Weibull analysis of case reports. J Neurosurg. Published online September 20, 2024. doi:10.3171/2024.5.JNS232830 PMID: 39303306

The aim of this study was to evaluate the frequency and severity of venous air embolism (VAE) in 1000 patients after surgery in the lounging position. The study found that clinically relevant VAE was rare (grade 3–4 in <5%, grade 5 in 0% of cases). No fatal adverse events or permanent sequelae attributable to VAE occurred, even in patients with a patent foramen ovale (n = 172). The incidence of acute respiratory distress syndrome was low (0.3%). The results show that experienced interdisciplinary teams can safely use the lounging position for neurosurgical procedures.

REF: Hurth H, Ebner FH, Clement E, et al. The risk of intraoperative venous air embolism from neurosurgical procedures performed in the lounging position: an in-depth analysis of detection, management, and outcomes of 1000 consecutive cases. J Neurosurg. Published online September 20, 2024. doi:10.3171/2024.5.JNS232449 PMID: 39303312

Researchers used logistic regression and restricted cubic splines to explore the relationship between stent selection and aneurysm outcome, and they reported a linear correlation between Dd and aneurysm outcome. As Dd increased, the probability of aneurysm occlusion decreased. Furthermore, they found PED plus coiling and smoking history were predictors of aneurysm occlusion. This article may furnish empirical evidence to inform stent selection in clinical practice.