Neurocirugia最新文献

{"title":"Resultados clínicos y radiológicos de la discectomía cervical anterior con fusión utilizando jaulas de polieteretercetona con tornillos de titanio: una serie retrospectiva","authors":"Francisco Verdú-López,&nbsp;Vicente Vanaclocha,&nbsp;Alejandra Hernández-Valido,&nbsp;David Aliaga,&nbsp;José-María Gallego-Sánchez,&nbsp;Ana-María Morales-Codina","doi":"10.1016/j.neucir.2026.500778","DOIUrl":"10.1016/j.neucir.2026.500778","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical and radiological outcomes of anterior cervical discectomy and fusion (ACDF) using titanium-screw PEEK cages, focusing on fusion rates, cervical alignment, pain relief, and complications.</div></div><div><h3>Methods</h3><div>Retrospective observational study of 40 consecutive patients treated between May 2017 and December 2018. Outcomes included Neck Disability Index (NDI), Numerical Rating Scale (NRS) for cervical and radicular pain, and radiological parameters (fusion status, Cobb angles, disk height). Complications were systematically documented, and longitudinal changes were analyzed using the Friedman test for repeated measures.</div></div><div><h3>Results</h3><div>At 2-year follow-up, all patients achieved radiological fusion (Bridwell grades I–II). Median NDI improved from 56% to 20% (<em>p</em> <!-->&lt;<!--> <!-->0.001). Cervical and radicular pain scores decreased significantly (median NRS from 8 to 2 and 7 to 1; <em>p</em> <!-->&lt;<!--> <!-->0.001). Cervical alignment and disk height improved and remained stable. Dysphagia and dysphonia occurred in 5% and 2.5% of cases, respectively, resolving spontaneously.</div></div><div><h3>Conclusions</h3><div>ACDF using titanium-screw PEEK cages is safe and effective, providing high fusion rates, significant clinical improvement, and low complication rates. These zero-profile hybrid devices offer a reliable alternative to traditional cage-plate constructs.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500778"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El laboratorio de microcirugía en la formación del neurocirujano","authors":"Emilio González Martínez,&nbsp;Belén Álvarez Fernández,&nbsp;María Victoria Diago Santamaría,&nbsp;Giancarlo Mattos Piaggio,&nbsp;Javier Robla Costales,&nbsp;Javier Ibáñez Plágaro,&nbsp;José García-Cosamalón","doi":"10.1016/j.neucir.2026.500765","DOIUrl":"10.1016/j.neucir.2026.500765","url":null,"abstract":"<div><div>The complexity of the dissection and nerve, vascular, arachnoid, and dural reconstruction techniques faced by neurosurgeons in their daily practice demands microsurgical training in the laboratory. Vascular microanastomosis techniques are essential for cerebral revascularization, the treatment of complex aneurysms, and the resection of some skull base tumors. However, training in microvascular surgery presents the challenge of being difficult to teach intraoperatively, along with the disadvantage of a limited number of clinical cases due to the rise of endovascular procedures.</div><div>Microsurgical training should be conducted through a structured and supervised program, using validated models of increasing difficulty. For preliminary exercises, synthetic models and ex-vivo biological tissues are useful. Proficiency is achieved by performing microanastomosis (end-to-end and end-to-side) in living animals.</div><div>In this article, we describe the most suitable models for training neurosurgery residents in the microsurgery laboratory, based on over three decades of our teaching experience in microsurgery.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500765"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metástasis hipofisiaria de carcinoma de células renales: reporte de caso, revisión sistemática y análisis de la distribución mundial","authors":"Alma R. García-Nájera,&nbsp;Carolina Vásquez-Rafael,&nbsp;Francisco J. Benítez-Rodríguez,&nbsp;Omar García-Nájera,&nbsp;Tania I. Gamboa-Jiménez,&nbsp;Wendy Martínez-Pineda,&nbsp;Josué Vergara-Juárez,&nbsp;Armando Armas-Salazar,&nbsp;José D. Carrillo-Ruiz,&nbsp;Fiacro Jiménez-Ponce,&nbsp;Jesús Q. Beltrán","doi":"10.1016/j.neucir.2025.500740","DOIUrl":"10.1016/j.neucir.2025.500740","url":null,"abstract":"<div><div>Pituitary metastases from renal cell carcinoma (PM-RCC) are rare, with an unfavorable prognosis and survival ranging from 6 to 22 months. The objectives of this study were (1) to present a case of a 61-year-old male who achieved a 44-month survival, and (2) to analyze the literature focusing on survival and worldwide distribution. The reported case achieved one of the longest survivals documented after multimodal treatment including surgery, radiotherapy, and targeted therapy. The systematic review showed that PM-RCC predominantly affects males (73.7%) and has a mean survival of 10.9 months, lower than that reported for other pituitary metastases (median 16.5 months). Metastasis was initially suspected in only 13.1% of cases, and surgery was the most common treatment (84%), with wide variation in adjuvant therapy use. Most cases originated from high-income countries, with very limited or no representation from some regions. Relevant characteristics and prognostic factors are discussed.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500740"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilidad y aplicaciones de la resonancia intraoperatoria de alto campo-1,5 T en la actividad neuroquirúrgica pediátrica tras 5 años de experiencia","authors":"Victoria Becerra Castro,&nbsp;José Hinojosa Mena-Bernal,&nbsp;Diego Culebras Palao,&nbsp;Mariana Alamar Abril,&nbsp;Marta Gómez Chiari,&nbsp;Jordi Muchart López","doi":"10.1016/j.neucir.2026.500783","DOIUrl":"10.1016/j.neucir.2026.500783","url":null,"abstract":"<div><h3>Background and objectives</h3><div>High-field 1.5<!--> <!-->T intraoperative magnetic resonance imaging (iMRI) was installed in our institution in 2020. Since then, it has been routinely used in pediatric neurosurgical practice. The purpose of this study was to describe our experience with this intraoperative imaging modality in a cohort of pediatric patients, focusing on the benefits, risks, and limitations in neurooncological practice and other entities such as the management of hydrocephalus and vascular disease.</div></div><div><h3>Materials and methods</h3><div>From February 2020 to April 2025, a series of consecutive pediatric cases involving various neurosurgical procedures were analyzed to describe the usefulness, safety, and challenges of using iMRI. Patients were categorized into five groups based on the type of surgery. Additional tumor resection after iMRI, early reoperation rate, and complications were analyzed.</div></div><div><h3>Results</h3><div>During this period, a total of 374 surgeries were performed with MRI. Of these, 141 were oncological surgeries; 7 were for vascular pathology; 10 were for hydrocephalus management; and 6 miscellaneous; 188 epilepsy surgeries and 22 functional pathology, which will be detailed in another submission. The mean age was 9.62<!--> <!-->years (range: 2<!--> <!-->months-18<!--> <!-->years). After iMRI, the degree of surgical resection was improved in 11.4% (11/96) of cases of tumor resection surgeries. The early reoperation rate was 0% in the first month. This imaging control adapted postoperative management in 6 patients in whom complications were detected. In 52 of 164 of the patients analyzed (32%), iMRI was used as a final control, saving the patient from a second sedation that would have been necessary for early postoperative iMRI. The mean duration of the intraoperative imaging process was 54<!--> <!-->minutes ±<!--> <!-->6<!--> <!-->minutes, and 3-4<!--> <!-->minutes for the check list.</div></div><div><h3>Conclusions</h3><div>iMRI in pediatric neurosurgical procedures was a useful, safe, and reliable tool. Its use improved the extension of tumor removal and avoids the need for early reintervention. Limitations were associated with the application of strict safety protocols to prevent accidents in highly complex environments and the inherent challenges associated with positioning pediatric patients due to headrests and non-compatible surgical tables.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500783"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La evolución del Sistema de Residencia en Neurocirugía en Norteamérica. Parte II. Desde los años 1970 a la actualidad","authors":"Ramiro D. Lobato,&nbsp;Luis Jiménez-Roldán,&nbsp;Igor Paredes,&nbsp;Pablo M. Munarriz,&nbsp;Beatriz Pascual,&nbsp;Andreea Baciu,&nbsp;Alfonso Lagares","doi":"10.1016/j.neucir.2026.500760","DOIUrl":"10.1016/j.neucir.2026.500760","url":null,"abstract":"<div><div>In this second part of the article on the Residency System in North America we analyze the impact of the changes in the management and financing of healthcare on the evolution of training. The restriction of financial resources introduced by the <em>third-party payer</em> system and duty hour regulations ultimately deterioraterd the quality of training and the conduct of research by residents. The potential strategies to sustain and improve the Residency System at the end of the first quarter of the 21st century are commented.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500760"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumores del plexo braquial: diagnóstico, tratamiento, abordaje quirúrgico y resultados de 47 pacientes","authors":"Alberto Isla,&nbsp;Sabela Vázquez,&nbsp;Beatriz Mansilla,&nbsp;María Santiago,&nbsp;Susana Santiago,&nbsp;Pablo García-Feijoo","doi":"10.1016/j.neucir.2026.500755","DOIUrl":"10.1016/j.neucir.2026.500755","url":null,"abstract":"<div><h3>Introduction</h3><div>Brachial plexus tumors are uncommon, with a prevalence of less than 5% of upper extremity tumors, and their surgical resection represents a major challenge due to the anatomical complexity of the region. The aim of this retrospective study is to analyze, in a large patient series, the clinical, radiological, and surgical characteristics of brachial plexus tumors, as well as to evaluate the different surgical approaches used according to tumor location and characteristics.</div></div><div><h3>Material and methods</h3><div>A retrospective study was conducted of all patients operated on for brachial plexus tumors between 2000 and 2025 at a tertiary center. Clinical, radiological, histological, surgical, and follow-up variables were collected. Approaches were classified as supraclavicular, infraclavicular, supra-infraclavicular, and posterior. Mild and severe neurological deficits were defined. Descriptive statistics and χ² tests were used to analyze the relationship between tumor size and malignancy.</div></div><div><h3>Results</h3><div>Forty-seven patients were included (mean age: 48.5 years; 55.3% women). The most common symptom was pain (72.3%). The tumors were: schwannomas 29.8%, neurofibromas 27.7%, malignant 25.5%, metastases 4.3%, and miscellaneous 12.8%. Complete resection was achieved in 53.2%, being more frequent in schwannomas. The most frequent locations were the posterior cord and the inferior trunk. The size-malignancy relationship showed a non-significant trend towards higher malignancy in tumors &gt;<!--> <!-->50<!--> <!-->mm (<em>P</em>=072). After surgery, 46.8% were left without sequelae; new motor deficit was more common in patients without prior deficits. Recurrences were recorded in 23.4% and progression of residual tumor in 14.9%.</div></div><div><h3>Conclusions</h3><div>Surgical resection of brachial plexus tumors depends on histological type, size, and their relationship with neurovascular structures. Schwannomas allowed a higher rate of total resection, unlike neurofibromas and malignant tumors, which were limited by infiltration and size. We highlight the usefulness of surgery for functional improvement, as most patients improved in this aspect, aided by intraoperative neurophysiological monitoring.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500755"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La evolución del sistema de residencia en neurocirugía en Norteamérica. Parte I. Desde los orígenes a la década de los 1970s","authors":"Ramiro D. Lobato,&nbsp;Luis Jiménez-Roldán,&nbsp;Ángel Pérez Núñez,&nbsp;Pedro González,&nbsp;Ana María Castaño-León,&nbsp;Mónica Maldonado,&nbsp;Alfonso Lagares","doi":"10.1016/j.neucir.2026.500759","DOIUrl":"10.1016/j.neucir.2026.500759","url":null,"abstract":"<div><div>This article analyzes the evolution of the residency system in the United States of America, from its inception at Johns Hopkins Hospital and Medical School to the 1970s, and is followed by a second paper (Part II) completing the analysis up to the present day. The establishment of a formal residency system began with the altruistic commitment of an academic staff dedicated full-time to clinical care, teaching, and research, along with the equally unconditional dedication of the first residents, who, in exchange for their exhausting work, received only the knowledge they acquired. This initial scenario contrasts sharply with the current situation, in which —despite having excellent technical resources and stable working conditions— the academic hospital staff and residents experience a decline in the quality of teaching and research. A decline caused, among other factors, by funding cuts and the reduction of residents’ working hours, which have forced them to «compress» their workload to the detriment of both patient care and their own learning. A better understanding of the advances and setbacks experienced by the residency system throughout the 20th century and the first two decades of the 21st may help address some of the dysfunctions that currently affect it.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 5","pages":"Article 500759"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148965051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fijación directa mínimamente invasiva de C1 con tornillos en las fracturas de Jefferson: serie de casos y nota técnica","authors":"Ivan Lvov,&nbsp;Andrey Grin,&nbsp;Anton Kordonskiy,&nbsp;Zaali Barbakadze,&nbsp;Aleksandr Talypov,&nbsp;Aleksandr Tupikin","doi":"10.1016/j.neucir.2026.500766","DOIUrl":"10.1016/j.neucir.2026.500766","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the feasibility of a minimally invasive technique for direct C1 screw fixation and to evaluate short- and long-term clinical and radiological outcomes in a case series.</div></div><div><h3>Materials and methods</h3><div>This study included a consecutive series of patients with type<!--> <!-->II or<!--> <!-->III fractures of the C1 vertebra according to the Landells classification. The surgical technique is described in detail, along with short- and long-term outcomes. Owing to the absence of comparison groups, only descriptive statistical methods were used.</div></div><div><h3>Results</h3><div>This case series included 8 patients (5 men and 3 women; mean age, 50.8<!--> <!-->±<!--> <!-->20.0 years). All patients were neurologically intact at presentation. Most patients had concomitant transverse atlantal ligament injury or associated unstable spinal trauma. The mean operative time was 216.3<!--> <!-->±<!--> <!-->100.3 minutes, and the mean intraoperative blood loss was 125.0<!--> <!-->±<!--> <!-->71.5<!--> <!-->mL. Seven patients were discharged with clinical improvement, whereas 1 patient died on postoperative day<!--> <!-->11 due to severe pneumonia and concomitant injury.</div><div>Six patients were available for final assessment. The mean follow-up duration was 39.7<!--> <!-->±<!--> <!-->31.2 months. The mean VAS score was 2.2<!--> <!-->±<!--> <!-->1.1, and the mean NDI score was 6.8<!--> <!-->±<!--> <!-->3.0. Solid fusion was achieved in all patients. No implant-related complications were observed. In five patients, no degenerative changes were detected in the C1-C2 lateral joints, whereas one patient showed grade<!--> <!-->2 degenerative changes.</div></div><div><h3>Conclusion</h3><div>Our initial clinical experience suggests that minimally invasive posterior direct C1 screw fixation is a feasible and safe procedure, providing consistently favorable clinical outcomes in this case series. This technique allowed optimal screw trajectories to be achieved without additional tissue trauma or widening of the surgical exposure. Its application enabled preservation of C1-C2 segmental mobility in all patients included in this series.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 4","pages":"Article 500766"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148545128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracturas sacras complejas: complicaciones quirúrgicas y resultados clínicos a largo plazo en una serie de pacientes","authors":"Luis Miguel Moreno-Gómez,&nbsp;Alfonso Lagares,&nbsp;Juan Delgado-Fernández,&nbsp;Francisco Javier Ortega-García,&nbsp;Pedro Caba-Doussoux,&nbsp;Igor Paredes","doi":"10.1016/j.neucir.2026.500777","DOIUrl":"10.1016/j.neucir.2026.500777","url":null,"abstract":"<div><h3>Background</h3><div>Complex sacral fractures with spinopelvic dissociation are rare high-energy injuries in polytrauma patients, and evidence on surgical complications and long-term health-related quality of life (HRQoL) remains limited.</div></div><div><h3>Objectives</h3><div>To describe surgical complications and long-term clinical, radiological, and HRQoL outcomes after spinopelvic fixation, and to analyze associations between pain/disability and clinical or radiological variables.</div></div><div><h3>Methods</h3><div>An ambispective single-center cohort (2012-2022) of patients with complex sacral fractures treated with spinopelvic fixation and ≥12 months of follow-up was evaluated. Clinical, radiological, and HRQoL data were collected, and bivariate correlations were performed with spinopelvic parameters and clinical variables.</div></div><div><h3>Results</h3><div>Twenty-eight patients (13 males, 15 females; mean age 35 years) were included. Six sustained high-speed accidents and the remaining suffered falls. According to the AO classification, 16 fractures were type C and 12 type B. Fourteen patients presented neurological deficits at admission. Postoperatively, seven patients developed deep wound infections, and two experienced new neurological deficits. At long-term follow-up, more than 60% reported persistent pain and gait disturbances. Ten patients showed neurological improvement, whereas eleven had permanent deficits. Spinopelvic parameters demonstrated overall moderate postoperative deformity, with no correlation to long-term clinical outcomes. Age correlated with Oswestry Disability Index (ODI) and Visual Analogue Scale (EVA) scores (all <em>P</em>&lt;.05). ODI scores were also associated with Intensive Care Unit (ICU) length of stay and neurological deficits (all <em>P</em>&lt;.05).</div></div><div><h3>Conclusions</h3><div>Spinopelvic fixation was associated with frequent postoperative complications —primarily deep infections and new neurological deficits— and with sustained HRQoL impairment driven by pain, mobility limitation, and reduced physical functioning. Radiological spinopelvic parameters were not related to pain or disability, while older age, prolonged ICU stay, and residual neurological deficits were associated with poorer outcomes. These findings highlight the need for improved infection prevention, neurological protection, and long-term multidisciplinary follow-up.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 4","pages":"Article 500777"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148545129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estudio de los niveles de proteína básica de mielina (MBP) y albúmina modificada por isquemia (IMA) en sangre y líquido cefalorraquídeo, y su relación con el vasoespasmo, la evolución clínica y el pronóstico en pacientes con hemorragia subaracnoidea no traumática","authors":"Adil Ugur Yavuz,&nbsp;Ali Rıza Guvercin,&nbsp;Ali Samet Topsakal,&nbsp;Eda Altunbag Yavuz,&nbsp;Suleyman Caner Karahan,&nbsp;Erhan Arslan","doi":"10.1016/j.neucir.2026.500776","DOIUrl":"10.1016/j.neucir.2026.500776","url":null,"abstract":"<div><h3>Background</h3><div>Non-traumatic subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, mainly due to secondary brain injury mechanisms such as cerebral vasospasm and delayed cerebral ischemia. Reliable biochemical biomarkers for monitoring disease progression and early outcome assessment remain limited.</div></div><div><h3>Objective</h3><div>To investigate temporal changes in serum and cerebrospinal fluid (CSF) levels of myelin basic protein (MBP) and ischemia-modified albumin (IMA) in patients with non-traumatic SAH and to evaluate their associations with clinical severity and functional outcome.</div></div><div><h3>Methods</h3><div>In this prospective single-center study, 20<!--> <!-->patients with non-traumatic SAH were included. Serum and CSF MBP and IMA levels were measured on days<!--> <!-->1, 5, and 10 after admission. Clinical severity was assessed using the Modified Fisher scale, Glasgow Coma Scale (GCS), Hunt-Hess scale (HHS), and World Federation of Neurosurgical Societies (WFNS) scale. Functional outcome was evaluated at discharge using the Glasgow Outcome Scale (GOS). Temporal changes and correlations between biomarkers and clinical parameters were analyzed.</div></div><div><h3>Results</h3><div>Serum and CSF MBP levels increased significantly over time (<em>P</em> <!-->&lt;<!--> <!-->.001), reflecting progressive tissue injury, but showed no consistent association with clinical scores or functional outcome. Serum IMA levels remained elevated without significant temporal variation. In contrast, CSF IMA levels demonstrated a late-phase increase and were significantly associated with clinical deterioration. On day<!--> <!-->10, CSF IMA levels correlated negatively with GCS and GOS scores and positively with WFNS scores.</div></div><div><h3>Conclusion</h3><div>MBP reflects cumulative brain injury following SAH, whereas CSF IMA is more closely associated with late-phase neurological deterioration and early functional outcome. CSF IMA may represent a complementary biomarker for prognostic assessment in non-traumatic SAH.</div></div>","PeriodicalId":51145,"journal":{"name":"Neurocirugia","volume":"37 4","pages":"Article 500776"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148545130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}