Incidence and risk factors of hyponatremia after transsphenoidal surgery: a systematic meta-analysis.

The transsphenoidal approach to sellar lesions is a mainstay technique in modern neurosurgical treatment of pituitary adenomas. One prominent complication following transsphenoidal surgery is the development of postoperative hyponatremia, frequently necessitating additional medical management and hospital readmission. However, the precise incidence and risk factors of postoperative hyponatremia remain unclear in the current literature.

Pilot Program in Surgical Anatomy Education for Complex Cranial and Skull Base Procedures: Curriculum Overview and Initial 2-Year Experience at Mayo Clinic.

 Cadaveric dissection remains a preferred and irreplaceable learning modality among neurosurgery residents. We aimed to develop and describe a tiered, quantifiable, and practical curriculum for cranial neurosurgical anatomy education. We report the structure and evaluation of our 2-year pilot study to serve as a suggested guide for other neurosurgery programs.

A supervised machine learning approach for predicting the need for postsurgical intervention in acromegaly.

Objective: Patients with growth hormone (GH)-secreting pituitary adenomas (PAs) experience various symptoms and comorbidities, which can ultimately lead to increased mortality. This study aimed to develop and validate a machine learning (ML) model for predicting long-term outcomes in patients with GH-secreting PAs following endonasal transsphenoidal surgery (ETS).

Methods: The authors conducted a retrospective three-institution cohort study that included patients with GH-secreting PAs treated with ETS between 2013 and 2023.

The Importance of Impedance: A Case of Responsive Neurostimulation Failure Characterized by Concurrent Stereoelectroencephalography.

Epilepsy neuromodulation treatment failure is a significant challenge, with multiple possible causes. The responsive neurostimulation (RNS) system delivers stimulation from a single current source, and the relative flow of the electrical current through each stimulating contact is inversely proportional to the relative impedance of each contact. Current shunting through low-impedance contacts (i.

Use of calcium phosphate bone cement in retrosigmoid craniotomies to reduce rates of pseudomeningocele and craniotomy-site CSF leakage: a cohort study and meta-analysis.

Objective: Calcium phosphate cement (CPC) use has been previously described as a strategy to reduce the rates of pseudomeningocele and CSF leakage following skull base surgery. The authors aimed to present their institutional experience with CPC in retrosigmoid craniotomy and perform a systematic review of the literature to determine the effectiveness of CPC in reducing postoperative complications, including pseudomeningocele and craniotomy-site CSF leakage.

Methods: A retrospective single-institution cohort study of patients who underwent retrosigmoid craniotomy with and without CPC cranioplasty from January 2017 to April 2024 was performed.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Surgical Resection for the Treatment of Patients With Vestibular Schwannomas: Update.

Background: Surgical intervention remains an important option in the management of vestibular schwannoma (VSs). Development of a systematic approach to choose the most appropriate route for this intervention, based on existing published evidence, is an important goal.

Objective: To review the literature published since the 2018 Congress of Neurological Surgeons Guideline on surgical intervention for patients with sporadic VSs and use this information to update that set of recommendations.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Hearing Preservation Outcomes in Patients With Sporadic Vestibular Schwannoma: Update.

Background: Given the increasing prevalence and shifting disease demographic of vestibular schwannoma toward smaller tumors in people with less advanced symptoms, increasing emphasis has been placed on functional hearing preservation.

Objective: To provide an update to the 2018 CNS Guideline on hearing preservation outcomes in patients with sporadic vestibular schwannoma.

Methods: Systematic review and clinical practice guideline summarizing data pertaining to hearing preservation outcomes within the first 10 years after contemporary stereotactic radiation, microsurgery, or observation with serial imaging.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines Update for the Role of Imaging in the Management of Patients With Vestibular Schwannomas.

Background: Imaging is a critical aspect of vestibular schwannoma (VS) management, influencing essentially every aspect of care including diagnosis, surveillance, treatment decision making, and follow-up after either resection or stereotactic radiosurgery. Despite this, treatment protocols are heterogeneous, and frequently based on historical practices, or low-quality evidence.

Objective: To update evidence-based guidelines for the use of imaging in the clinical management of patients with VS published by the Congress of Neurological Surgeons in 2018.

Outcome metrics for primary endoscopic endonasal surgery for low-risk patients with Cushing's disease: an evidence-based position statement from the Registry of Adenomas of the Pituitary and Related Disorders consortium.

Objective: Reports of surgical outcomes for Cushing's disease are mostly limited to single-center experiences by expert surgeons. Therefore, no generalizable surgical outcome metrics for endoscopic endonasal Cushing's disease surgery are available for practitioners to guide quality-improvement efforts. This is potentially problematic, given the high morbidity and excess mortality observed in patients who do not achieve remission.

Exploring perspectives on skull base chordoma management: a modified Delphi approach to consensus.

Objective: Current treatment for skull base chordomas utilizes both surgical resection and adjuvant radiation, but recent studies have demonstrated evidence that has brought the use of adjuvant radiotherapy into question. Chordomas differ greatly in molecular makeup and proliferation. These factors have led to significant variation in management across providers.

Thalamocortical seizure onset patterns in drug resistant focal epilepsy.

Drug-resistant epilepsy affects tens of millions of people worldwide and is associated with considerable morbidity and mortality. Thalamic deep brain stimulation and cortical responsive neurostimulation are proven treatments for focal epilepsy. Both have been used to target a range of thalamic nuclei, yet the roles of these thalamic nuclei in focal seizure generation remain incompletely understood.

Impact of hydrocortisone vs prednisone therapy on postsurgical recovery in patients with endogenous hypercortisolism: a prospective cohort study.

Objective: Glucocorticoid withdrawal syndrome (GWS) may develop in patients following successful surgery for endogenous hypercortisolism. Effective strategies to minimize GWS and improve quality of life (QoL) are currently lacking. We aimed to determine the impact of hydrocortisone vs prednisone therapy on GWS and QoL during the first 12 weeks postsurgery.

Inner Ear Signal Abnormalities of Adjacent Intracranial Lipochoristoma.

Background And Purpose: Inner ear signal abnormalities commonly develop in cases of vestibular schwannoma and are associated with hearing loss. Whether such signal alterations occur in other masses of the internal auditory canal (IAC), however, remains unknown. Here, we assessed inner ear signal abnormalities of lipochoristomas, historically termed "lipomas," involving the IAC and cerebellopontine angle (CPA).

Intracranial stimulation for pediatric refractory epilepsy: A single institutional experience using evolving therapies.

Objective: Neuromodulation for pediatric refractory epilepsy (PRE) is preferred when the seizure onset zone is not amenable to surgical resection, due to multifocal onset or involvement of eloquent cortex. Given its rapidly evolving landscape, we describe our institutional experience with neurostimulation therapies including deep brain stimulation (DBS) of the anterior nucleus (DBS-ANT), the centromedian nucleus (DBS-CM), responsive neurostimulation (RNS), and chronic subthreshold stimulation (CSS) to treat PRE.

Methods: A retrospective chart review was conducted to identify pediatric patients (≤18 years of age) who presented to our institution with PRE.

Human pulvinar stimulation engages select cortical pathways in epilepsy.

The pulvinar has been proposed as an effective neuromodulation target for patients with posterior quadrant and temporal epilepsies. However, the pulvinar has a large tissue volume, multiple subnuclei, and widespread cortical connections. It remains unknown whether electrical stimulation of distinct pulvinar subregions affects the temporal, occipital, and parietal areas differently.

The association of hospital volume status with treatment and survival outcomes of intracranial meningioma patients: a multivariable analysis of the National Cancer Database.

Purpose: This study investigates the influence of treatment center volume on survival outcomes and treatment strategies for patients with intracranial meningioma.

Methods: This is a retrospective cohort study of patients from the National Cancer Database treated for intracranial meningioma from 2004 to 2019. High-volume facility was defined as performing > 45 meningioma procedures/year (top 15%).

Surgical Approaches to Resection of Olfactory Groove Meningiomas: Comparative Meta-analysis of the Endoscopic Endonasal versus Transcranial and Unilateral versus Bilateral Approaches.

 Here we systematically review the extant literature to highlight the advantages of bilateral versus unilateral approaches and endoscopic endonasal (midline) approaches versus transcranial approaches for olfactory groove meningiomas, focusing on complications, extent of resection, and local recurrence rates.  Three databases were queried to identify all primary prospective trials and retrospective series comparing outcomes following endoscopic endonasal versus transcranial approaches and unilateral versus bilateral craniotomy for surgical resection of olfactory groove meningiomas. All articles were screened by two independent authors and selected for formal analysis according to predefined inclusion/exclusion criteria.

Machine learning-based model to predict long-term tumor control and additional interventions following pituitary surgery for Cushing's disease.

Objective: In this study, the authors aimed to establish a supervised machine learning (ML) model based on multiple tree-based algorithms to predict long-term biochemical outcomes and intervention-free survival (IFS) after endonasal transsphenoidal surgery (ETS) in patients with Cushing's disease (CD).

Methods: The medical records of patients who underwent ETS for CD between 2013 and 2023 were reviewed. Data were collected on the patient's baseline characteristics, intervention details, histopathology, surgical outcomes, and postoperative endocrine functions.

Microsurgical Resection Versus Stereotactic Radiosurgery for Trigeminal Schwannoma: A Meta-Analysis of 949 Patient Treatment Outcomes.

Background And Objectives: Schwannomas are benign, slow-growing peripheral nerve sheath tumors. Approximately 8% of intracranial schwannomas originate from the trigeminal nerve. No consensus exists regarding superiority of outcomes after resection vs stereotactic radiosurgery (SRS) in the treatment of trigeminal schwannomas (TS).

A Rare Case of Osteoblastic Osteosarcoma of the Temporal Bone and Comprehensive Review of the Literature.

Introduction: Although osteosarcoma represents the most common primary malignant bone tumor in children, they comprise only 0.2% of all cancers. Osteosarcoma frequently involves long bones; however, 8% of osteosarcomas involve the skull or mandible.

Safe and efficacious therapeutic outcomes with salvage endonasal transsphenoidal surgery for pituitary adenoma progression following stereotactic radiosurgery.

Objective: Stereotactic radiosurgery (SRS) offers excellent tumor control for pituitary adenoma (PA); however, treatment failure occasionally necessitates salvage surgery. Comprehensive studies on salvage surgical outcomes for recurrent PA after SRS remain scarce. This study aimed to elucidate the outcomes of salvage endonasal transsphenoidal surgery (sETS) for progressive PA failing SRS.

Radiofrequency thermocoagulation in focal epilepsy: A retrospective cohort study.

Objective: Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RFTC) has been increasingly used as diagnostic and therapeutic approach for drug-resistant focal epilepsies (DREs). We aimed to describe seizure outcomes of RFTC before and after further neurosurgical intervention.

Methods: Retrospective single-institution case series of patients who underwent SEEG-RFTC.

Recurrent adamantinomatous craniopharyngioma stabilized with tocilizumab and bevacizumab: illustrative case.

Background: Adamantinomatous craniopharyngiomas (ACPs) are slow-growing, cystic, highly morbid central nervous system tumors located adjacent to vital structures including the pituitary, hypothalamus, and optic chiasm. Tumor recurrence is common. Treatment relies on resection with or without adjuvant radiation and is highly individualized.

A field resource for the glioma cerebrospinal fluid proteome: Impacts of resection and location on biomarker discovery.

Background: While serial sampling of glioma tissue is rarely performed prior to recurrence, cerebrospinal fluid (CSF) is an underutilized longitudinal source of candidate glioma biomarkers for understanding therapeutic impacts. However, the impact of key variables to consider in longitudinal CSF samples for monitoring biomarker discovery, including anatomical location and post-surgical changes, remains unknown.

Methods: Aptamer-based proteomics was performed on 147 CSF samples from 74 patients; 71 of whom had grade 2-4 astrocytomas or grade 2-3 oligodendrogliomas.