Background: Extent of resection (EOR) plays a major role in the prognosis on patients with gliomas, although the postoperative functionality of the patient is of great importance as well. It is why many surgeons advocate to not operate extensively on tumors that involve eloquent regions such as the central lobe. Recent series have demonstrated that it is possible to achieve extensive resections in this area without significantly affecting the functional outcome for these patients. We illustrate this issue with the experience obtained at the National Institute of Neurology and Neurosurgery in Mexico City. Methods: This is an observational and retrospective study that included patients that received surgical resection for intracranial gliomas that involved the central lobe at the National Institute of Neurology and Neurosurgery of Mexico, between January 2017 and May 2020. Demographic and clinical variables of the patients at the time of diagnosis were collected as well as tumor morphological variables, surgical adjuncts, and clinical outcomes. Statistical analysis was performed with SPSS software. Results: A total of 28 patients were included in the study with 43% of patients having a motor deficit before surgery. The average EOR was 88.6%. Patients presented with worsening of their motor status in the immediate postoperative period in 21% of the cases, although most of the patients recovered within the 1^st month of follow-up. After analyzing all variables, not having a presurgical motor deficit was a statistically significant risk factor for developing a new motor deficit in the immediate postoperative period (P: 0.02). Conclusion: A resective surgery for gliomas near or within the central lobe can be performed safely and a satisfactory motor outcome for patients can be achieved without sacrificing the EOR. An intact presurgical motor status is a risk factor for developing a new deficit after surgery.

Pericallosal artery aneurysms (PCAA) are relatively rare intracranial aneurysms that present unique challenges in diagnosis and management. This study provides a comprehensive review of the literature to assess demographic patterns, risk factors, treatment approaches, and complications associated with PCAA. Data from 23 studies were analyzed using Python with libraries such as Pandas and Matplotlib. Descriptive statistics and crosstabulations explored the relationships between treatment modalities (microsurgical, endovascular, combined) and complications, including hydrocephalus, vasospasms, and intraprocedural ruptures. Visualizations were employed to depict the prevalence and impact of various outcomes. Analysis revealed a notable gender disparity, with females constituting 70.47% of the study population. The average age was 49.93 years, and the average aneurysm size was 6.34 mm. A majority of aneurysms were ruptured (542 ruptured vs. 251 unruptured). Risk factors like smoking were prevalent, and radiological features such as subarachnoid hemorrhage (SAH) were commonly reported. Endovascular treatment was slightly more frequent (86.96%) than microsurgical treatment (73.91%). Vasospasm was the most reported complication (56.5%), followed by hydrocephalus and intraprocedural rupture. The analysis of the distribution of studies reporting complication for each treatment modality showed that endovascular treatment studies reported higher rates of vasospasms, hydrocephalus and intraprocedural rupture. The mortality rate was 6.52%, with a mean follow-up duration of 20.77 months. This review reveals that PCAAs predominantly affect females, with an average patient age of 49.93 years. Aneurysms averaged 6.34 mm and often caused SAH. Endovascular treatments were more common but had higher complication rates than microsurgical methods, which also carried risks. The mortality rate was 6.52%.

Interhemispheric subdural hematoma (ISH) poses significant challenges in neurosurgical practice owing to its deep localization within the cerebral hemispheres. Despite widespread adoption of advanced neurosurgical technologies, adverse patient outcomes hinder progress in enhancing overall prognosis. This review seeks to evaluate the etiology, clinical manifestations, treatment modalities, and outcomes associated with ISHs, thereby informing clinical decision-making and improving patient care. Databases such as PubMed, Scopus, and Google Scholar were systematically searched from 1964 to 2024. The search was limited to studies involving human subjects and published in English. Keywords such as “interhemispheric subdural hematoma” and “parafalcine subdural hematoma” were used in various combinations to identify relevant articles. Our search identified 167 individuals (87 females and 80 males) ranging in age from 6 weeks to 93 years. Trauma emerged as the leading risk factor, accounting for 86.8% of cases. Nausea and vomiting were the most frequent symptoms (14.7%), followed by headache (11.8%). Most patients (22.8%) had a Glasgow Coma Scale score of 13 to 16, indicating moderate severity. Radiological analysis showed that subdural hematomas were almost evenly distributed between hemispheres, with 51% located in the right hemisphere and 49% in the left. Quantitative analysis revealed that 65.1% of patients were managed conservatively, particularly those with minimal neurological impairment, while 34% underwent surgery, including burr hole drainage and craniotomy. Of the surgical cases, 18.4% experienced complications. Our findings reveal that the outcome of ISH management depends on several factors, the most important being the etiology and size of the hematoma, the clinical presentation and comorbidities of the patient, and the interval between presentation and treatment.

(1) Background: Our team has previously introduced the Single-Step Pedicle Screw System (SSPSS), which eliminates the need for K-wires, as a safe and effective method for percutaneous minimally invasive spine (MIS) pedicle screw placement. Despite this, there are ongoing concerns about the reliability and accuracy of screw placement in MIS procedures without traditional tools like K-wires and Jamshidi needles. To address these concerns, we evaluated the accuracy of the SSPSS workflow by comparing the planned intraoperative screw trajectories with the final screw positions. Traditionally, screw placement accuracy has been assessed by grading the final screw position using postoperative CT scans. (2) Methods: We conducted a retrospective review of patients who underwent lumbar interbody fusion, using intraoperative 3D navigation for screw placement. The planned screw trajectories were saved in the navigation system during each procedure, and postoperative CT scans were used to evaluate the implanted screws. Accuracy was assessed by comparing the Gertzbein and Robbins classification scores of the planned trajectories and the final screw positions. Accuracy was defined as a final screw position matching the classification of the planned trajectory. (3) Results: Out of 206 screws, 196 (95%) were accurately placed, with no recorded complications. (4) Conclusions: The SSPSS workflow, even without K-wires and other traditional instruments, facilitates accurate and reliable pedicle screw placement.