This study aimed to extend clinical documentation of cerebral calculi by reporting six cases of cerebral calculi with distinct etiologies and localizations. We evaluated the age, sex distribution, presenting symptoms, neurological examination findings, pathology results, and location of the calcifications of six patients with intracranial calcifications. Three of the six patients with brain stones were female (50%), and three were male (50%). The patient ages ranged from 12 to 46 years. A radiological examination of each patient’s cranium was performed with pre-operative cranial computed tomography and magnetic resonance imaging. All of the lesions were completely excised. The patients’ pathologies were determined to be distinct hyalinization, dystrophic calcification, hamartoma, ossification developing from widespread pituitary adenoma tissue, benign mesenchymal neoplasia, a mass consisting of sporadically ossified fibrous tissue, and angiomatous meningioma with distinct hyalinization and fibrosis. Intracranial calcifications are a common phenomenon in neurosurgical practice. However, brain stones, as well as solid calcifications also termed cerebral calculi, are rarely encountered. Brain stones can be classified on the basis of their etiology and localization. Additionally, we suggest that lesions smaller than 1 cm might be classified as calcifications and those greater than 1 cm as brain stones. We further suggest that the differentiation between calcification and brain stones might be based on size. These pathologies typically manifest as seizures and are occasionally identified during routine brain tomography. Meningiomas constitute an important portion of extra-axial calcifications, whereas tumorous and vascular causes are more prevalent among intra-axial calcifications.

Background/Objectives: Stellate ganglion block (SGB) is an interventional technique frequently applied to manage pain associated with sympathetic dysfunction. This study aimed to evaluate the short-term clinical outcomes and tolerability of SGB in patients with different pain phenotypes. Methods: From 1 January 2024 through 1 March 2025, 96 patients who underwent fluoroscopy-guided SGB at a single center were retrospectively analyzed. The Oswestry Disability Index (ODI) was used to assess functional status, the SF-36 was applied to evaluate health-related quality of life, and the Visual Analog Scale (VAS) was employed to measure pain intensity. This study included baseline measurements and follow-up evaluations at 1, 3, and 6 months after the procedure. Results: Statistically significant improvements were observed in VAS, ODI, and SF-36 scores across all pain groups (p < 0.001). The largest median VAS reductions were observed in the migraine (4.0 [3.5–5.0]) and complex regional pain syndrome (CRPS) (3.7 [3.0–4.5]) groups, both exceeding the minimal clinically important difference (MCID). Patients with neuropathic and nociceptive pain showed smaller median reductions (3.4 [2.8–4.0] and 3.0 [2.5–3.8], respectively). The highest proportion of responders (≥50% VAS reduction) was noted in the migraine group (64.3%), while the lowest occurred in the nociceptive group (37.5%). Multivariate analysis identified pain phenotype as the only independent predictor of favorable outcomes, particularly in migraine and CRPS. Minor transient complications occurred in 9.4% of patients, all resolving spontaneously. Conclusions: SGB was well tolerated and associated with significant pain reduction and functional improvement. The observed clinical benefits may reflect mechanisms involving both peripheral and central sympathetic modulation. Larger multicenter prospective studies with extended follow-up are warranted to confirm these findings.

Background/Objectives: Spinal hydatid disease frequently poses significant surgical challenges and leads to severe neurological complications. Despite the development of various surgical techniques, recurrence remains a common issue. The aim of this study was to evaluate the impacts of radical vertebrectomy on recurrence and long-term follow-up outcomes by comparing total en-bloc spondylectomy with conventional laminectomy, decompression, and posterior stabilisation in patients treated at our centre. Methods: This study included 21 patients who underwent surgery for spinal hydatid cysts at our centre between 2001 and 2021. Twelve patients had cystectomy, laminectomy, decompression, and stabilisation, and nine patients had total en-bloc spondylectomy. A single senior surgeon carried out each procedure, selecting the surgical approach based on the presence of vertebral body involvement. All patients received albendazole treatment for six months following surgery. The surgeon who performed the operations followed up all patients clinically and radiologically for at least three years. Results: Seven out of twelve patients (58.3%) who had conventional surgery experienced recurrences, while total en-bloc spondylectomy produced no recurrences (p = 0.004). The recurrent cases had a mean of 2.8 surgical procedures and manifested within 14 months. Although total en-bloc spondylectomy was associated with a longer operative time and greater blood loss, neurological recovery and overall clinical outcomes were comparable between the two groups. The difference in the recurrence rate was statistically significant. Conclusions: Although technically demanding, radical vertebrectomy is shown to provide complete protection against recurrence in appropriately selected patients with spinal hydatid disease in this study. Furthermore, as conservative approaches often require multiple procedures, total en-bloc spondylectomy can be considered an effective treatment for patients with vertebral body involvement.

Background/Objectives: Cranial gunshot injuries represent severe traumatic brain injuries associated with high mortality rates. This study investigated whether integrating clinical findings at admission, including GCS score and pupillary response, with a CT-derived anatomical burden score and midline shift improves the prediction of in-hospital mortality. Methods: Adult patients aged 18 years and older with penetrating cranial gunshot injuries (n = 143) treated at a tertiary referral centre between 1 January 2005 and 31 December 2025 were retrospectively analysed using a single-centre cohort design. All included patients completed in-hospital follow-up, defined as hospital discharge or in-hospital death. Clinical variables, the anatomical burden score, and midline shift were evaluated using a multivariable logistic regression model where the primary outcome was in-hospital mortality. Model performance was assessed using ROC analysis, calibration measures, and bootstrap internal validation. Results: The in-hospital mortality rate was 56.6%, with early mortality occurring in 33.6% of patients. In the multivariable analysis, a low admission GCS score (≤8), bilateral non-reactive pupils, an increased anatomical burden score, and midline shift were independently associated with a higher risk of mortality. The model demonstrated good discrimination (AUC = 0.87; 95% CI 0.81–0.93), and similar performance was maintained following internal validation (optimism-corrected AUC = 0.86). The addition of radiological parameters to clinical variables improved model discrimination (ΔAUC = 0.07; 95% CI 0.02–0.11). Conclusions: The combined evaluation of admission clinical findings and CT-based anatomical parameters may support a more structured early estimation of in-hospital mortality risk in adult patients with penetrating cranial gunshot injuries.

AIM: To evaluate the clinical processes of patients with cervical postlaminectomy kyphosis (PLK) who underwent standalone posterior pedicle screw fixation surgery.MATERIAL and METHODS: The results of 21 patients with cervical PLK treated using the pedicle screw method between 2015 and 2018 were retrospectively examined. Patient data included demographic information and indications for surgery. Furthermore, the following criteria were calculated for each patient: cervical sagittal vertical axis (cSVA), C2-7 cervical lordosis (CL) parameters, modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI) score and visual analogue scale score, and these were evaluated preoperatively and postoperatively statistically.RESULTS: A total of 21 patients with PLK were evaluated. In terms of radiographic parameters, postoperative cSVA was significantly lower than the preoperative cSVA, and postoperative CL was significantly higher than the preoperative CL (p<0.001, p<0.001, respectively). Postoperative mJOA scores were significantly higher than the preoperative scores (p < 0.001). Both postoperative NDI and VAS scores were significantly lower than the preoperative scores (p<0.001, p<0.001 respectively).CONCLUSION: Pedicle screw fixation was found to be an effective treatment for cervical PLK. Although this technique is not preferred by many spine surgeons because of its high complication rate, it has a positive effect on the quality of life scores and provides optimal correction.