【期刊速览】Journal of Neurosurgery | Online 2024年10月速览（二）

1. Microsurgical anatomy and the inner architecture of the retrocommissural portion of the hippocampal formation demonstrated through fiber microdissection

通过纤维显微解剖证实的海马结构后合缝部分的显微外科解剖和内部结构

The purpose of this article was to clarify the terminology related to the nomenclature of anatomical structures of the mediobasal-temporal region (MTR), with special emphasis on that of the retrocommissural hippocampal formation (RHF). It also describes the 3D anatomical relationships of the RHF and MTR through a white matter dissection study. In doing so, this study provides the reader with a tool for a systematic understanding of the anatomy of this complex region.

The natural history of ruptured high Spetzler-Martin grade IV and V brain arteriovenous malformations (bAVMs) is underreported given the scarcity of this pathology, and decision-making for patients with bAVMs remains unclarified. In this study, the authors sought to shed light on this topic. The natural history of cortical ruptured high-grade bAVMs bears a risk similar to that of incidental bAVMs, whereas deep-seated ruptured high-grade bAVMs have an increased risk of hemorrhage. With extremely prudent patient selection, surgery might be a viable option for cortical bAVMs to obliterate the bAVM and reduce hemorrhagic risk, while preserving functional status. Radiosurgery might be beneficial to lower hemorrhagic risk in deep-seated bAVMs. Embolization as a single modality should be avoided as it provides no benefit to reduce hemorrhagic risk.

REF: Sattari SA, Yang W, Feghali J, et al. Natural history and management outcomes of patients with ruptured Spetzler-Martin grade IV and V brain arteriovenous malformations. J Neurosurg. Published online October 18, 2024. doi:10.3171/2024.6.JNS241075 PMID: 39423432

The objective of this study was to evaluate the effects of a condylar fossa osteotomy on long-term oral health and general health quality of life in patients with skull base tumors. The authors found low absolute scores for jaw dysfunction in patients after a condylar osteotomy, and lower relative scores compared with a similar surgical control group without the osteotomy. The findings of this study provide supporting evidence on the safety and preservation of patient quality of life of this surgical technique.

REF: Taniguchi S, Kam J, Castle-Kirszbaum M, Akagami R. Oral and general health quality of life following a subtemporal preauricular infratemporal approach with condylar fossa osteotomy in surgical skull base tumor resection. J Neurosurg. Published online October 18, 2024. doi:10.3171/2024.6.JNS232959 PMID: 39423441

This study examined rates and predictors of follow-up loss for patients who underwent initial "wait-and-scan" management of sporadic vestibular schwannomas. In this single-center study, the follow-up loss rate was 27% with a median follow-up duration of 13 months. Additionally, 22.2% of patients demonstrated inconsistent imaging adherence during the follow-up period. Patients with smaller tumors and those living farther away from the treating facility were at the highest risk of follow-up loss.

REF: Morshed RA, Bauman MM, Alexander M, et al. Rates and predictors of loss to follow-up for sporadic vestibular schwannomas undergoing imaging surveillance. J Neurosurg. Published online October 18, 2024. doi:10.3171/2024.6.JNS232904 PMID: 39423436

The aim of this study was to highlight the authors' experience treating wartime penetrating traumatic brain injury (pTBI) involving the paranasal sinuses at a frontline Ukrainian hospital during the Russian-Ukrainian war. There was an association between high admission Glasgow Coma Scale score, low Injury Severity Score, favorable injury lateralization, and no midline shift on favorable short-term outcome and survival. This was the largest 1-year study on neurosurgical treatment of wartime pTBI involving the paranasal sinuses. Implementation of primary neurosurgical intervention at the time of presentation demonstrated promising early results.

REF: Sirko A, Berlin C, Tsang S, Naik BI, Armonda R. Wartime penetrating traumatic brain injury of the anterior skull base involving the paranasal sinuses: a single-center, first-year experience from Dnipro, Ukraine. J Neurosurg. Published online October 18, 2024. doi:10.3171/2024.6.JNS24852 PMID: 39423435

Researchers investigated the cognitive profile of patients with long-standing overt ventriculomegaly in adults (LOVA) hydrocephalus and the immediate and longer-term effects of endoscopic third ventriculostomy (ETV). LOVA hydrocephalus was associated with selective deficits in long-term memory and visuospatial skills and not global cognitive deterioration. ETV immediately and durably improved memory and spatial skills. However, improvement was significant only for patients with higher premorbid IQ, thus highlighting the effectiveness of ETV surgery but also the role of cognitive reserve in promoting cognitive plasticity.

The objective of this study was to train and validate a predictive rule-out tool for neurosurgical intervention in patients with mild traumatic brain injury (mTBI) and isolated subdural hematoma (SDH). The tool identified 100% of patients having neurosurgical intervention within 48 hours and correctly identified 55% of those who did not. This tool could improve treatment efficiency and provide prognostic information, reducing unnecessary neurosurgical consultations and interhospital transfers in patients with mTBI and isolated SDH.

This study aimed to identify ideal middle cerebral artery bifurcation aneurysm sizes for treatment using the Woven EndoBridge device. It found that aneurysms with a width of ≤ 6.1 mm and a neck size of ≤ 4.6 mm had higher occlusion rates and lower retreatment rates. The study provides valuable size thresholds for better patient selection, improving outcomes and reducing retreatments.