Background/Objectives: Keratinocyte carcinomas (KCs), including squamous cell carcinomas (SCCs) and basal cell carcinomas (BCCs), are the most common malignancies worldwide. Accurate delineation of surgical margins is essential to ensure oncological control while preserving favourable aesthetic outcomes. Optical coherence tomography (OCT) is a non-invasive, real-time, high-resolution technique that may facilitate preoperative and intraoperative margin assessment. This systematic review aims to analyse existing evidence on the use of in vivo OCT in the assessment of surgical margins in KC. Methods: This systematic review was conducted in accordance with the PRISMA guidelines. The articles included were retrieved from the PubMed, Web of Science, Scopus and EBSCO databases. The search was limited to studies published between 2010 and November 2025. The inclusion criteria were the application of in vivo OCT as an adjunctive method in the surgical excision of KC. A total of 11 studies involving 303 patients met the inclusion criteria. OCT was used preoperatively, intraoperatively, combined pre- and intraoperatively and both pre-, intra- and postoperatively, with most studies focused on margin delineation by itself. Results: Agreement between OCT and histopathology ranges from 84% to 95.5%. Surgical benefits were observed in both conventional surgery and Mohs micrographic surgery, including reduction in MMS stages (1.89 to 1.23), fewer stages required, and narrower excision margins. Conclusions: Based on data analysis, it may be assumed that in vivo OCT may have potential in non-invasive margin assessment in the surgical treatment of KC. The available evidence is limited by the heterogeneity of protocols and devices and variability between lesion types, as well as the small sample sizes and limited comparability. Further research should focus on randomised multicentre trials involving large cohorts, cost–benefit analysis and evaluation of operator-dependent variability.

Introduction: Acute subdural hematoma (aSDH) represents one of the most lethal and debilitating forms of traumatic brain injury (TBI) encountered in neurosurgical emergency settings, carrying high mortality rates and severe long-term functional deficits. Historically, the timing of surgical decompression has been considered a critical modifiable prognostic factor. However, contemporary evidence regarding the relationship between time to surgery and clinical outcomes remains inconsistent. This systematic review and meta-analysis evaluates the impact of surgical timing on mortality and functional status in adult patients undergoing evacuation for acute subdural hematoma. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines and registered in PROSPERO. A database search was performed across PubMed, Scopus, Embase and Web of Science for relevant studies published between 2009 and 2026. Peer-reviewed cohort studies and clinical trials including adults (>18 years) with CT- or MRI-confirmed aSDH were included. Data extraction focused on baseline characteristics, surgical timing thresholds, and primary outcomes of mortality and functional status assessed using the Glasgow Outcome Scale (GOS). Methodological quality was assessed using the Newcastle-Ottawa Scale. Relative risks (RR) and risk differences (RD) with 95% confidence intervals (CI) were calculated using a random-effects model. Results: The search identified 1815 records, of which six studies, including 926 patients, met the inclusion criteria. Meta-analysis found no statistically significant association between time to surgery and mortality (RR 1.01, 95% CI [0.69, 1.48], p = 0.96; RD −0.02, 95% CI [−0.19, 0.15]). High statistical heterogeneity was observed (I² = 80%) across the included cohorts. Most studies indicated that patients who underwent rapid neurosurgical intervention frequently presented with significantly worse baseline neurological status, which acts as a primary confounding factor and drives poorer prognostic trends. Conclusions: While historical paradigms emphasize a 4h period for subdural hematoma evacuation, our meta-analysis indicates that a straightforward linear relationship between time to intervention and improved survival or functional outcome is absent in contemporary clinical studies. Surgical timing thresholds must be interpreted cautiously, as the decision-making process is heavily guided by clinical triage bias, where rapidly deteriorating patients are prioritized for urgent decompression. Crude timing thresholds do not reflect a lack of causal benefit of early intervention but rather highlight the profound confounding by indication embedded in contemporary neurotrauma literature. Future multicenter investigations adjusting for admission severity, pupillary reactivity, associated intracranial pathology and other confounding factors are crucial to isolate the true prognostic value of surgical timing in aSDH.

Background: Intraventricular central nervous system (CNS) lymphoma is an atypical presentation of extranodal lymphoma, whether primary or secondary. The most commonly diagnosed subtype of lymphoma is diffuse large B-cell lymphoma (DLBCL). There is a documented relation of HIV, EBV and KSHV infections with lymphomagenesis. AIDS-related lymphomas (ARLs) are described as a defining illness of the acquired immunodeficiency syndrome (AIDS). This study presents a novel case and systematic review of clinical, radiographic and histopathological features of intraventricular lymphomas. Methods: We report on a 27-year-old woman with a left lateral ventricle DLBCL with surrounding edema treated with steroids. A systematic review of 147 additional cases (1977–2025) was conducted, analyzing patient demographics, tumor characteristics, clinical features, imaging, treatment, and outcomes. The tumor locations were divided into three groups depending on the extent of ventricular involvement. Descriptive statistics summarized findings. Findings: 147 cases (mean age, 54.2 years; range, 3–87; 63.3% male) were analyzed. Immunodeficiency in patients was unusual (6.1%). Fully intraventricular lesions were the most common presentation (52.4%), with systemic involvement solely in 10 cases (6.8%). The lesions were predominantly located in the lateral ventricles or fourth ventricles (46 times each), and bilateral involvement was noted 37 additional times. DLBCL was diagnosed in 101 cases (78.9%). Interpretation: Intraventricular involvement in central nervous system lymphoma poses a diagnostic and therapeutic challenge due to non-specific symptoms and atypical locations. Adding to the diagnostic difficulty of intraventricular masses in young patients, we wish to highlight that immunocompromised patients are a notably insignificant subgroup of patients in our study.

Background and Objectives: Keloids are fibroproliferative disorders marked by excessive fibroblast activity, abnormal collagen deposition, and impaired wound healing. They are frequently associated with pain, pruritus, and significant aesthetic concerns, leading to reduced quality of life. Surgical excision alone is burdened by high recurrence rates, underscoring the need for effective adjuvant therapies. This systematic review aimed to assess the effectiveness of surgical excision combined with adjuvant physical and pharmacological therapies in keloid management, with particular emphasis on recurrence rates. Materials and Methods: The review was conducted in accordance with PRISMA guidelines. A systematic search of PubMed and Web of Science identified studies evaluating surgical excision of keloids with adjunctive therapies. Twenty-one studies involving more than 8627 patients met the inclusion criteria. Extracted data included study design, patient and lesion characteristics, treatment modalities, and recurrence rates. Due to marked heterogeneity among treatment protocols, a meta-analysis was not performed. Results: Among physical adjuvant therapies, postoperative brachytherapy showed the lowest recurrence rates (3.1–15%), outperforming radiotherapy and external-beam radiation therapy (14–29.3%). Compression therapy achieved recurrence rates of 10.66% and 14%, particularly effective in auricular keloids. Pharmacological adjuvant therapies demonstrated variable efficacy. Triamcinolone acetonide injections were associated with recurrence rates ranging from 6.6% to 33%, depending on the protocol. Adjuvant 5-fluorouracil reduced recurrence compared with surgery alone, whereas imiquimod 5% showed higher and less consistent recurrence rates. Combination pharmacological therapies consistently yielded better outcomes than monotherapy. Conclusions: Surgical excision combined with adjuvant therapy is the most effective strategy for keloid treatment. Multimodal approaches significantly reduce recurrence compared with surgery alone. However, substantial heterogeneity in lesion characteristics, treatment timing, and therapeutic protocols limits comparability between studies. Further high-quality, standardised clinical trials are needed to optimise management strategies and develop evidence-based guidelines.

Introduction Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare congenital eyelid disorder that leads to drooping eyelids, narrowing of the palpebral fissures, and a characteristic facial appearance. It is a genetic condition, typically inherited in an autosomal dominant pattern, and is primarily caused by mutations in the FOXL2 gene, which is essential for eyelid development. Two types of BPES have been described: type II presents eyelid malformations and facial dysmorphism, while type I is additionally associated with premature ovarian insufficiency. If untreated, these features can lead to visual impairment and psychosocial consequences. A pronounced epicanthal fold may lead to a reduction in the visual field and contribute to visual disturbances, including strabismus. BPES is associated with underdeveloped or dysplastic levator palpebrae muscles, leading to four clinical features—telecanthus, ptosis, epicanthus inversus, and blepharophimosis—with reduced horizontal palpebral fissure length. Methods A systematic review of the literature was performed to summarize current surgical management strategies for BPES. Surgical indications, outcomes, and complications were extracted and analyzed. Results Surgical treatment remains the standard of care for BPES. In recent years, numerous techniques have been developed to correct deformities including both classic and modern methods of epicanthoplasty, canthoplasty, and forehead muscle suspension using autologous and synthetic materials. Complication rates vary depending on technique and patient factors. This systematic review summarizes current surgical strategies, indications, outcomes and complications, highlighting modern approaches that optimize visual function and aesthetic outcomes. Conclusion Surgical management of BPES is essential to restore eyelid function, improve the visual field, and achieve favorable cosmetic outcomes. A range of classical and contemporary techniques are available, and selection should be individualized. Modern approaches optimize both functional and aesthetic results, though further prospective studies are needed to standardize procedures and minimize complications.

Background: Disseminated intracranial and spinal dysembryoplastic neuroepithelial tumors (DNETs) are exceptionally rare, with only five prior cases reported. Methods: This study presents a case of a 47-year-old woman with DNETs in the right hippocampus and lumbar spine, treated surgically, and systematically reviews the existing literature (total n = 6). Results: While primary tumors occurred in both locations, secondary lesions were predominantly spinal (83%). The key features included frequent obstructive hydrocephalus (67%, often requiring shunting) but rare epilepsy (n = 1, 17%). Two fatal outcomes were possibly associated with West Nile virus infection (the S100B protein pathway). MRI was performed in all cases, and surgical intervention (craniotomy/laminectomy) constituted the primary treatment modality (67%). Conclusions: This multifocal presentation poses significant challenges, underscoring the potential need for spinal MRI in intracranial DNET cases and multidisciplinary management. Further molecular studies and case registries are crucial to understand pathogenesis and optimize care.