Placing dural tack-up sutures is part of the surgical treatment of cranial epidural hematoma, but it is also very useful to stop untimely epidural bleeding during any craniotomy procedure. Hence, dural tack-up sutures stand among the essential technical skills that should be taught to every neurosurgery resident. Traditional tack-up sutures involve passing a thread suture between the thickness of dura mater and a small hole drilled at the bone edge of the craniotomy flap. Alternative dural tack-up sutures can also be tied up between the dura mater and the galea or pericranium when the proper drill handpiece is missing, for example in surgical teams deployed overseas. With this in mind, we present a new technical tip for dural tack-up sutures, which involves making a « J » shaped cut at the edge of the craniotomy. Passing the thread suture down to the bottom of the « J » provides the bone anchor for the dural tack-up suture. This helpful technique only requires the same drill handpiece that is used to cut the craniotomy bone flap.

Neurogenic symptoms in craniofacial fibrous dysplasia (FD) are typically caused by direct compression due to the lesion's expansile nature. However, in rare cases, atypical symptoms unrelated to direct compression and associated dural contrast enhancement have been reported. The aim of this study was to investigate the relationship between FD and adjacent dural contrast enhancement.

Minimally invasive techniques for lumbar spinal stenosis (LSS) aim to reduce soft-tissue injury while achieving adequate neural decompression. Traditional open decompression remains effective but is associated with extensive muscle dissection and prolonged recovery. Although the Quadrant retractor system is commonly used in transforaminal lumbar interbody fusion (TLIF), its application for non-fusion decompression has been seldom reported [1].

Surgical robotics represent a significant advancement in healthcare, enhancing precision and safety in operative procedures. While widely used in neurosurgery, visceral surgery, and urology, its adoption in spinal surgery remains in development. This study reports the implementation of robotic-assisted spine surgery within a neurosurgical department, focusing on the learning curve, workflow integration, complications, and prospects. Successful integration requires a dedicated technical infrastructure and thorough training-both theoretical and practical-for the entire surgical team. Collaboration among surgeons, paramedical staff, and biomedical engineers is essential to optimize outcomes. We used a table-mounted robotic system (Mazor X Stealth Edition, Medtronic), with surgical planning based on preoperative, sub-millimetric bone-density CT scans to ensure personalized care. From November 2022 to May 2023, we included 32 patients with an average age of 58 y/o (SD 15 (19; 87)) for a total of 204 inserted screws. Degenerative spine represented the main indication followed by tumoral spine. Optimal accuracy for pedicle screw placement was 97 % corresponding to grade A (90.1%) and grade B (6.9%) from GRS. The operating time was of 186.7 min (SD 89.7 (45; 386)) and the average fluoroscopy time per screw was of 3.0 s (1.8-5.5). Installation is a time-consuming step. We observed a trend towards shorter operating times as more cases are operated on. No revision surgery was needed during the study period. Only 2 superficial skin infections were reported, with no other complication. Robotic spine surgery improves standardization, enhances accuracy, and promotes personalized medicine, with potential for further workflow optimization.

Postoperative instructions influence lumbar surgery outcomes, but lack of consensus and differing expertise lead to varied practices.

Analysis along the Perivascular Space (ALPS) index has been proposed as a quantitative magnetic resonance imaging (MRI) marker for evaluating the function of the brain's glia-dependent waste clearance pathway, known as the glymphatic system. We hypothesized that the ALPS index on the contralateral side of the brain lesion may relate to postoperative memory disturbance. This study aimed to evaluate the relationship among the preoperative and intraoperative contralateral ALPS indexes and postoperative mini-mental state examination (MMSE) scores in patients with newly diagnosed glioblastoma (GBM).

Functional anatomy underlyng music perception and production has been quite abundantly described in literature, together with some examples of musical tasks adopted during awake surgery. We have used a keyboard-playing test for per-operative monitoring of two patients affected by a glial lesion. Our two cases differ in age, lateralization and hemispheric localization of the lesion. One of them, who presented a left middle frontal gyrus lesion, showed a decrease in his ability to play piano, together with other neurological abnormalities, from which he completely recovered within a year. The other patient, whose lesion was instead right and prefrontal, didn't show any music-related anomalies. Our patients' outcomes are consistent with previous literature concerning lateralization and localization of music-related functions in musicians. In our left-sided case, the emerging of a slowdown in piano playing, without other relevant language, sensitive or motor abnormalities, confirmed by mistakes in picture naming (DO80 N-1) performed simultaneously with a motor task, led us to interrupt our resection, allowing the patient to fully recover within a year, suggesting, with the limitations that we will further discuss, a certain sensibility of the action of playing for early detection of cognitive abnormalities, usually determined with a task-switching test strategy.

Aneurysmal subarachnoid hemorrhage (SAH) is a severe condition associated with high mortality and morbidity. Acute hydrocephalus is a common complication that often necessitates external ventricular drainage (EVD) and, in some cases, permanent shunt placement. Determining the optimal timing for EVD weaning remains challenging, as it requires balancing the need for permanent shunting against the risk of meningitis.

idiopathic chronic hydrocephalus (iCH) is underdiagnosed in older adults. The diagnosis of iCH is important because effective surgical treatment is available. Indeed, iCH is the only curable dementia. The disproportionately enlarged subarachnoid space hydrocephalus (DESH) score was recently developed on the basis of morphologic MRI data, as a guide to the diagnosis of iCH in adults.

Meningiomas are common primary intracranial tumors with varying biological behavior. Accurate preoperative grading is essential for surgical planning and patient management.

Epidermoid cysts of the cerebellopontine angle (CPA) are rare benign congenital lesions derived from ectodermal inclusions during early embryogenesis. Despite their slow growth, they may become giant and cause progressive cranial nerve dysfunction due to their close relationship with critical neurovascular structures.

Idiopathic intracranial hypertension (IIH) is severe condition affecting patients' vision and quality of life. When medical treatment is insufficient, an invasive approach may be proposed, consisting of either performing a ventricular shunt or stenting a stenosed venous sinus. The aim of this study is to compare these two techniques.

This study assessed the long-term risk of acquired hydrocephalus in individuals with head trauma to identify time-specific risk patterns and to evaluate high-risk subgroups using a nationwide cohort in South Korea.

Retrospective cohort study.