Study Design: This is an observational study. Objectives: In general practice, it is noted that some people can deal more easily with a prominent belly than others. Recent use of spinopelvic parameters in the analysis of the spine might explain this observation. This study aimed to determine the correlation between pelvic incidence (PI), waist circumference (WC), and body mass index (BMI) in patients with non-specific chronic low back pain. We hypothesized that people with a low PI (non-pronounced lumbar lordosis) have significantly lower WC values than those with a high PI (pronounced lumbar lordosis). Methods: Adult patients presenting to the outpatient neurosurgery clinic with non-specific chronic low back pain who had undergone full spine radiography were included. The PI, BMI, and WC were measured in all cases. Results: We included 272 patients (male–female ratio, 1.08) with a mean age of 54 years. There was a statistically significant difference (p < 0.05) in the mean PI according to BMI group. The mean PI in our population was 57.8° (range 28.4–97.2°, SD 12.1°). A significant correlation coefficient of 0.271 (p < 0.001; 95%CI 0.157–0.377) was found between BMI and PI and 0.410 (p-value < 0.001; 95%CI 0.262–0.539). Conclusions: We found a significant correlation between PI, BMI, and WC. This finding is the first step in confirming our hypothesis that a patient with a high PI might be able to tolerate being overweight and a high WC better than patients with a low PI, possibly because of their ability to retrovert the pelvis to a greater extent. Further research is warranted to investigate whether people with a high pelvic PI can better cope with obesity, especially those with a higher waist circumference and abdominal weight.

BACKGROUND: Acute subdural hematoma (ASDH) is a worrisome condition. The majority of traumatic ASDHs are secondary to the rupture of bridging veins. In cases of life-threatening rise of intracranial pressure, surgery can be indicated to alleviate intracranial pressure through a craniotomy with or without bone flap replacement. OBSERVATIONS: Here, the authors report the case of a 76-year-old male with a traumatic ASDH secondary to a skull base fracture causing laceration of the middle meningeal artery (MMA) at the foramen spinosum (FS). To the best of the authors’ knowledge, ASDH secondary to laceration of the MMA has not been reported. They discuss relevant radiological and surgical anatomy as well as surgical implications. LESSONS: Balloon-shaped anteroinferior hematoma is a hint of proximal laceration of the MMA. The FS must be carefully checked on imaging when dealing with ASDH. In such cases, the surgical approach should allow easy access to the middle fossa. https://thejns.org/doi/10.3171/CASE25331

The recent emergence of hybrid operating rooms (H-OR) broadens treatment options for complex intracranial aneurysms. Combining endovascular options enabled by the H-OR with refined microsurgical techniques could provide less arduous treatment alternatives for large, distal, and fusiform MCA aneurysms. To describe the technical nuances of a hybrid treatment consisting of microcatheter-guided flash fluorescence to enable revascularization bypass and endovascular parent vessel occlusion (PVO) in three different cases of large, distal and fusiform MCA aneurysms. A technical report of three cases is provided. At a H-OR, after STA harvest and side-appropriate craniotomy, femoral artery access was obtained and a microcatheter was guided in the corresponding aneurysm. Indocyanine green (ICG) was injected throughout the microcatheter while running a videoangiography on the surgical microscope, allowing straight-forward identification of the appropriate vessel recipient for the revascularization bypass. The described hybrid flash-fluorescence technique allowed straight-forward identification of the appropriate vessel recipient for the revascularization bypass in all three cases. After completion of the bypass and verification of its patency by intraoperative angiography, the aneurysms and their parent vessels were occluded endovascularly. This hybrid treatment using modern endovascular and microsurgical techniques obviates the need for a large craniotomy, Sylvian fissure dissection and aneurysm manipulation, while reducing surgical risks and operative time in the treatment of complex fusiform MCA aneurysms. The H-OR room can result in new proficient, creative and safe treatment options of different neurovascular pathologies.