Microsurgical removal of a C1-C5 laterally located intramedullary subependymoma through a postero-lateral sulcus approach: case report, surgical video and critical review of diagnostic and surgical challenges.

Introduction: Spinal subependymomas are rare, benign, and slow-growing intramedullary tumors, often misdiagnosed preoperatively due to their radiological resemblance to more common spinal cord neoplasms such as ependymomas and astrocytomas. Given their rarity, the optimal surgical approach and oncological strategy remains debated. While these tumors are histologically benign, obtaining a definitive diagnosis is crucial due to the diagnostic overlap with more aggressive lesions.

Evaluating the role of gross total resection in primary spinal cord glioblastoma: evidence from a multicenter cohort and meta-analysis.

Background: Primary spinal cord glioblastoma (PscGB) is a rare, aggressive tumor that accounts for about 7.5% of spinal cord gliomas. Its infiltrative growth and proximity to critical neural structures make diagnosis and management challenging, and data on prognostic factors and optimal treatment remain limited.

Assessing Surgical Approaches and Postoperative Complications for Thoracic Schwannomas: A Multicenter Retrospective Observational Analysis of 106 Cases.

Thoracic schwannomas are benign nerve sheath tumors that can cause neurological and respiratory symptoms depending on their location and extension. The optimal surgical approach remains debated, particularly regarding resection extent, complication rates, and postoperative morbidity. This retrospective multicenter study analyzed 106 patients treated between 2011 and 2024, classifying tumors according to the Eden system and comparing surgical strategies.

The Role of Simpson Grading System in Spinal Meningioma Surgery: Institutional Case Series, Systematic Review and Meta-Analysis.

Background: Although its validity has recently been questioned since its introduction, the Simpson grade has remained one of the most relevant factors in estimating the recurrence risk of intracranial meningiomas. This study aims to assess its role in spinal meningiomas through a retrospective analysis of a mono-institutional surgical series and literature meta-analysis.

Methods: We conducted a systematic review and meta-analysis of the literature from 1980 to 2023, complemented by a mono-institutional series of 74 patients treated at "Santa Maria delle Grazie" hospital.

Paediatric meningiomas: a multi-centre case series of 27 patients.

Purpose: This study presents a series of paediatric meningiomas and discusses aetiology, risk factors and outcomes with comparison to current literature.

Methods: This is a retrospective review of surgically treated paediatric meningiomas from three UK centres: the University Hospital of Wales, Alder Hey Children's Hospital and Royal Manchester Children's Hospital. Twenty-seven patients aged 16 and under at the time of their first procedure were identified over a 15-year period (1 January 2007 and 1 March 2023).

Low-grade epilepsy-associated tumors: Epilepsy outcome and antiseizure medication discontinuation after lesionectomies as first-line surgical approach in pediatric population.

Objective: This study aimed to evaluate epilepsy outcome and antiseizure medication (ASM) discontinuation after lesionectomies as first surgical approach in pediatric population diagnosed with low-grade epilepsy-associated neuroepithelial tumors (LEATs).

Methods: We conducted a retrospective study. Thirty-six consecutive patients with histological diagnoses of LEATs who underwent surgery between 2018 and 2021 at our institution were included.

Gender gap in deep brain stimulation for Parkinson's disease: preliminary results of a retrospective study.

Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment of PD for both women and men. However, discussions have been reported about the impact of STN-DBS surgery in PD. The aim of our study is to identify differences between men and women in terms of pre- and post-DBS symptoms and try to explain the possible causes.

Endoscopic Ultrasonic Aspiration of Brain Abscess.

Brain abscess is a focal infection occurring within the brain parenchyma consisting of a pus collection surrounded by a vascularized capsule and a fibrinous-caseous layer between the pus and capsule. Surgery is indicated for lesions with a diameter >25 mm. Different surgical approaches have been described, including puncturing of the abscess (under neuronavigation, stereotactic or echographic guidance) with aspiration of the purulent fluid through a catheter and craniotomy with microsurgical removal of the purulent material and surrounding capsule.

Review of the targeting accuracy of frameless and frame-based robot-assisted deep brain stimulation electrode implantation in pediatric patients using the Neurolocate module.

Objective: The Neurolocate module is a 3D frameless patient registration module that is designed for use with the Neuromate stereotactic robot. Long-term electrical stimulation of the globus pallidus internus (GPi) and subthalamic nucleus (STN) via deep brain electrode implantation is particularly successful in a select group of movement disorders in pediatric patients. This study aimed to review the targeting accuracy of deep brain stimulation (DBS) electrode implantation in a single center, comparing standard frame-based techniques to the frameless Neurolocate module.

Dry Field Technique and Ultrasonic Aspirator in Endoscopic Removal of a Hemorrhagic Intraventricular Tumor in a 2-Year-Old Girl.

Neuroendoscopic procedures inside the ventricular system always bear the risk for an unexpected intraoperative hemorrhage. Most hemorrhages can be managed by constant irrigation with low- and high-pressure washes. In the other rare cases, the dry field technique may be necessary.

Endoscopic ultrasonic aspiration of posterior fossa abscess in Dandy-Walker malformation: case report.

Background: Dandy-Walker malformation (DWM) is a posterior fossa malformation characterized by a huge posterior fossa cyst in communication with the fourth ventricle. Hydrocephalus is associated with more than 80% of cases and is usually treated by shunting. Despite infection being a common complication of the shunt, abscess formation within the cyst was reported only once.

Psychiatric Symptoms in Parkinson's Disease Patients before and One Year after Subthalamic Nucleus Deep Brain Stimulation Therapy: Role of Lead Positioning and Not of Total Electrical Energy Delivered.

Parkinson’s disease (PD) patients may experience neuropsychiatric symptoms, including depression, anxiety, sleep disturbances, psychosis, as well as behavioral and cognitive symptoms during all the different stages of the illness. Deep Brain Stimulation (DBS) therapy has proven to be successful in controlling the motor symptoms of PD and its possible correlation with the occurrence or worsening of neuropsychiatric symptoms has been reported. We aimed to assess the neuropsychiatric symptoms of 14 PD patients before and after one year of Subthalamic Nucleus (STN)-DBS and to correlate the possible changes to the lead placement and to the total electrical energy delivered.

Removal of Koos IV acoustic neuroma and auditory brainstem implant in NF2 patient.

The authors present the case of removal of a Koos grade IV right acoustic neuroma in a neurofibromatosis type 2 (NF2) patient, already operated on for left cerebellopontine angle meningioma at 7 years of age and a left acoustic neuroma at 16 years of age. A transpetrosal approach allowed cochlear sensor implantation to detect residual hearing. An enlarged retrosigmoid approach then allowed subtotal microsurgical removal of the lesion; consequently, the authors illustrate the technical nuances of an auditory brainstem implant (ABI).

Evolution in endoscopic endonasal approach for the management of hypothalamic-pituitary region metastasis: A single-institution experience.

Introduction: Endonasal endoscopic surgery has changed the treatment perspectives for different lesions of the hypothalamic-pituitary region. The metastases of the hypothalamic-pituitary region represent 0.4% of all intracranial metastatic tumors and account for only 1.

Acute ischemic stroke secondary to ventriculoperitoneal shunt dysfunction in a child with Moyamoya syndrome.

Background: Patients with brain vascular disease and hydrocephalus may be predisposed to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pression. Patients with brain tumor may develop hydrocephalus as a consequence of obstruction of cerebrospinal fluid pathways and radiation-induced moyamoya syndrome secondary (RIMS) to radiotherapy (RT).

Case Description: A 15-year-old male patient, affected by hydrocephalus and RIMS, presented acute cerebral ischemia after an episode of shunt malfunction.

Endoscopic ultrasonic aspiration as alternative to more invasive surgery in initial management of optic pathway gliomas in children.

Introduction: Optic pathway gliomas (OPGs) presenting with acute hydrocephalus represent a true neurosurgical and neurooncological challenge. Two main strategies are currently used: microsurgical removal of the tumor, restoring CSF pathways, and endoscopic biopsy associated with ventriculo-peritoneal shunt implantation. Since the availability of an ultrasonic aspirator handpiece, that can be used inside the working channel of a neuroendoscope, a different less invasive surgical strategy can be used.

Prenatal diagnosis and postnatal management of congenital unilateral hydrocephalus for stenosis of the foramen of Monro.

Congenital hydrocephalus and ventriculomegaly can be diagnosed reliably with prenatal ultrasound and Magnetic Resonance Imaging (MRI). Unilateral hydrocephalus is uncommon, and the prognosis depends on etiology and postnatal management. Here, we present a case of a 32-years-old woman with prenatal diagnosis of unilateral hydrocephalus associated with stenosis of the foramen of Monro.

Interhemispheric transcallosal transchoroidal approach to a pineal teratoma in a 15-year-old boy.

In this video, the authors present an interhemispheric transcallosal transchoroidal approach to a pineal mass in a 15-year-old boy. He received emergency endoscopic third ventriculostomy (ETV), then an endoscopic biopsy that revealed an immature teratoma. Surgical removal was selected.

Malignant cerebral infarction associated with COVID-19 in a child.

Neurological manifestations, such as encephalitis, meningitis, ischemic, and hemorrhagic strokes, are reported with increasing frequency in patients affected by Coronavirus disease 2019 (COVID-19). In children, acute ischemic stroke is usually multifactorial: viral infection is an important precipitating factor for stroke. We present a case of a child with serological evidence of SARS-CoV-2 infection whose onset was a massive right cerebral artery ischemia that led to a malignant cerebral infarction.

Fat and Fibrin Glue: Quo Vadis?

Aim: To analyze the effectiveness of fat and fibrin glue to prevent postoperative cerebrospinal fluid (CSF) leak in pituitary surgery.

Material And Methods: Two hundred and eleven patients affected by pituitary adenoma entered this study. Patients that underwent a microscopic transsphenoidal approach between January 2013 and April 2019 were included.

Early vascular modifications after endoscopic endonasal pituitary surgery: The role of OCT-angiography.

Purpose: The aim of the present study is to analyze the changes in retinal vessel density (VD), using Optical Coherence Tomography Angiography (OCT-A), in patients that received endoscopic endonasal approach for the removal of an intra-suprasellar pituitary adenoma compressing optic chiasm.

Methods: We evaluated the VD in Superficial Capillary Plexus (SCP), Deep Capillary Plexus (DCP), Radial Peripapillary Capillary (RPC) and the Foveal Avascular Zone (FAZ) area in a series of fourteen patients (7 males, 7 females, mean age 56 ± 13 years), as compared to healthy controls. We also detected the structural Spectral Domain (SD)-OCT parameters: Ganglion Cell Complex (GCC), Retinal Nerve Fiber Layer (RNFL), visual field parameters (Mean Deviation, Pattern Standard Deviation) and Best Corrected Visual Acuity (BCVA).