Prognostic Value of the Goutallier Scale for Paravertebral Muscle Atrophy in Predicting Disability and Pain Outcomes in Degenerative Lumbar Spinal Stenosis: A Longitudinal Cohort Study of 100 Patients.

Degenerative lumbar spinal stenosis (LSS) is a prevalent cause of disability in elderly populations, often treated with decompressive surgery. However, postoperative functional outcomes are variable and influenced by factors beyond neural compression alone. This study aimed to investigate the prognostic significance of the Goutallier Classification System (GS), a radiological index of paravertebral muscle fatty degeneration, in predicting long-term postoperative disability and pain in elderly patients undergoing decompression for LSS.

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.

Risk factors and surgical maneuvers to decrease recurrences of olfactory groove meningiomas: institutional case series and systematic literature review.

Background: Recurrences of olfactory groove meningiomas (OGMs) sometimes occur even after gross total resection. The present study discusses the risk factors of recurrences and the most important surgical steps at initial surgery to reduce the recurrence rate.

Methods: A monoinstitutional series of 60 patients with OGMs operated through microsurgical transcranial approaches and a comprehensive systematic literature review on recurrent OGMs operated via transcranial approaches (TCAs) (Group A) or endoscopic endonasal approach (EEA) (Group B) were retrospectively and separately analyzed.

Neuroradiological Evaluation of Anatomo-Morphometric Arcuate Fascicle Modifications According to Different Brain Tumor Histotypes: An Italian Multicentric Study.

The arcuate fasciculus (AF) is a critical white matter (WM) tract that connects key cortical language-processing regions, including the so-called Broca's and Wernicke's areas. The aim of the present study was to quantitatively assess its radiological-anatomical-morphometric modifications according to different brain tumor histotypes. A retrospective multicentric Italian study was conducted.

Evaluating the predictive value of multimodal intraoperative neuromonitoring in anterior cervical discectomy and fusion: a retrospective cohort study on 442 patients.

Background And Objectives: Anterior cervical discectomy and fusion (ACDF) is a widely regarded surgical technique for the management of cervical disc herniation (CDH) and myelopathy, offering significant therapeutic efficacy. However, the potential for neurological complications persists, underscoring the need for strategies to enhance procedural safety. Multimodal intraoperative neuromonitoring (IONM) has emerged as a promising adjunct, providing real-time assessment of neural integrity to identify and address intraoperative compromise.

Full-Endoscopic Minimally-Invasive Trans-Magendie Approach to the Fourth Ventricle: An Anatomical Feasibility Study.

Background: The telovelar approach provides access to the caudal two-thirds of the fourth ventricle without requiring vermian splitting. Indeed, the traditional microsurgical approach is often limited by a restricted cranial angle of attack and visualization, making it challenging to evaluate the patency of the aqueduct. To address this limitation, resection of the posterior arch of C1 is frequently performed.

Management of Anticoagulant and Antiplatelet Therapy in Elective Degenerative Lumbosacral Spine Surgery: A Clinical Study on 578 Elderly Patients.

Background And Objectives: Managing anticoagulant and antiplatelet therapy in elderly patients with high cardiovascular risk undergoing degenerative lumbosacral spine surgery is a complex challenge. Balancing the reduction of thromboembolic events and minimizing bleeding risks requires tailored perioperative strategies. This study evaluates the outcomes of a standardized management approach for such therapies in this vulnerable population.

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.

Naso-Ethmoidal Schwannoma: From Pathology to Surgical Strategies.

Naso-ethmoidal schwannoma is a rare slow-growing tumor arising from the Schwann cells of the sinonasal tract. This study discusses the evolution of surgical approaches to naso-ethmoidal schwannomas with respect to tumor growth and recent advances in minimally invasive techniques. A comprehensive literature review on Embase online electronic database on benign naso-ethmoidal schwannoma was performed.

Quantitative evaluation of neuroradiological and morphometric alteration of inferior Fronto-Occipital Fascicle across different brain tumor histotype: an Italian multicentric study.

Background: Inferior Fronto-Occipital Fascicle (IFOF) is a multitasking connection bundle essential for communication and high level mentalization. The aim of the present study was to quantitatively assess its radiological-anatomical-morphometric modifications according to different brain tumor histotype.

Methods: A retrospective multicentric Italian study was conducted.

Surgical risk of CSF leakage following endoscopic transorbital approach for anterior and middle skull base pathologies: a systematic review and meta-analysis.

The endoscopic superior eyelid transorbital approach (SETOA) has demonstrated considerable versatility and effectiveness in managing various paramedian anterior and middle skull base pathologies. However, as with any relatively new technique, potential complications remain. We conducted an extensive literature search in MEDLINE and Embase in accordance with PRISMA guidelines including case reports and surgical series reporting cerebrospinal fluid (CSF) leak rate following SETOA for intracranial pathologies.

Contact Endoscopy in Neurosurgery: A Feasibility Anatomical Study on Advantages, Limitations, and Clinical Applications.

Background: Contact endoscopy (CE) is a visualization technique with high magnification power, facilitating the in vivo examination of biological tissue morphology during different endoscopic-assisted procedures. Although its widespread implementation remains limited in neurosurgery, CE has emerged as a novel visualization tool, with several reports in the literature documenting its adoption.

Methods: The functionality and limitations of CE were investigated using 6 formalin-fixed heads (12 sides) and in 2 patients with both intra- and extra-axial lesions to comprehensively evaluate the effectiveness and potential limitations of CE in real-world clinical scenarios.

Topographic Patterns of Recurrence of Olfactory Groove Meningiomas After Transcranial Approach.

Background: Olfactory groove meningiomas may recur up to 30% of cases. This study focused on the topographic patterns and location of the recurrences and their surgical management.

Methods: Data on topography of recurrences from a single-center surgical series of olfactory groove meningiomas were retrospectively reviewed and analyzed along with data from pertinent literature.

How I do it: surgical resection of micro-arteriovenous malformations.

Background: Micro-arteriovenous malformations (AVMs) are a subgroup of AVMs with a nidus smaller than 1- cm. As such, intraoperative localization of micro-AVMs can be challenging. Once identified intraoperatively, however, treatment of the micro-AVM is often straightforward.

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.

Pleomorphic dermal sarcoma of the scalp with intracranial space involvement: management of a rare entity. Illustrative case.

Background: Exophytic tumors of the calvaria (ETCs) remain a challenging pathology because of their complex management. The authors discuss the case of a woman with a large exophytic mass of the right frontotemporal region and underline their decision-making process on the management of this unique case and possible similar ones.

Observations: Neuroradiological findings showed a calvarial tumor with both epicranial and intracranial extension involving the frontotemporal bone with a mixed component (lytic and sclerotic) and dural infiltration with a pseudonodular pattern.

Quantitative Neuroanatomical Measurement on Photogrammetric Model: Validation Study.

Objective: To examine and compare the accuracy of measurements obtained from photogrammetric models versus direct measurements taken on dry skulls, with the aim to verify the feasibility of photogrammetry for quantitative analysis in microsurgical neuroanatomy.

Methods: Two dry human skulls were used. Each was scanned using the dual camera system of a smartphone The selected photos were separately processed using 2 different softwares to create three-dimensional models.

Complex Management of Brain Metastases in Head and Neck Squamous Cell Carcinoma: A Case Report and Literature Review.

Head and neck squamous cell carcinoma (HNSCC) can, in rare instances, metastasize to the CNS, which is often associated with a poor prognosis. We present the case of a 65-year-old male with a history of HNSCC who developed two enhancing brain lesions: one in the right parietal region and another in the right insular region. Initially, the patient was managed with CyberKnife radiosurgery targeting both lesions.

Biphenotypic Sinonasal Sarcoma: Literature Review of a Peculiar Pathological Entity-The Neurosurgical Point of View.

Background: Biphenotypic sinonasal sarcoma (BSNS) is a low-grade tumor of the sinonasal tract with frequent extension to the orbit and skull base. Due to its rare incidence and recent histopathological and molecular characterization, little data are available in regard to its natural history, treatment and surveillance protocol.

Methods: A comprehensive literature review in Embase online electronic databases on BSNS was made.

Clinical Implication of Brain Metastases En-Bloc Resection: Surgical Technique Description and Literature Review.

The role of brain metastases (BM) surgery is of paramount importance for patients' progression-free and overall survival. "En-bloc" and "piecemeal" resection represent the main surgical techniques. Although en-bloc resection remains the best surgical option, it is not widely adopted or feasible as the first choice.