Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section

by

A large cross-sectional survey conducted by Schär et al. (2025) included 154 European spine surgeons across multiple countries and centers. It assessed treatment patterns for geriatric (≥70 years) Odontoid Fracture Type II.

3)

Critical Review: This EANS survey illustrates current opinion but lacks clinical depth:

Final Verdict: A wide but superficial overview. Confirms heterogeneity without offering concrete guidance. Rating: 4.5 / 10 Takeaway for Practicing Neurosurgeons: Reinforces need for individualized decisions; does not replace prospective trials. Publication Date: 2025-06-14 Contact: ralph.schaer@insel.ch

Schär RT, Wilson JR, Ivanov M, Barbagallo G, Petrova Y, Reizinho C, Gandia González ML, Tessitore E, Maciejczak A, Gabrovsky N, Depreitre B, Shiban E, Demetriades AK, Ringel F. Treatment practices for geriatric type II odontoid fractures – A survey by the European Association of Neurosurgical Societies Spine Section. Brain Spine. 2025 Jun 14;5:104295. doi: 10.1016/j.bas.2025.104295. PMID: 40599220; PMCID: PMC12210293.

Trigemino-Vocal Reflex: A potential indicator of brainstem integration

by

In a Letter Choi *et al.* from the Korea University Anam Hospital, Seoul published in the Journal Clinical Neurophysiology they proposes a novel “Trigemino‑Vocal Reflex” as a potential marker of brainstem integrative function. The concept is introduced, but no data or methodology is shared in this letter format—its validity and clinical relevance remain unproven 1). 2)

1. **Content**

– The paper merely *introduces* the term “Trigemino‑Vocal Reflex” without specifying stimulation parameters, recording techniques, patient cohort, control populations, or results. – Without any empirical data or case illustration, this contribution feels speculative and lacks evidence.

Read more

Engineered retargeting to overcome systemic delivery challenges in oncolytic adenoviral therapy

by

Type of study: Original research (experimental study, engineering approach) First author: Leparc et al. Affiliations:

  • Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
  • Laboratory of Nervous System Disorders and Therapy, GIGA Institute, University of Liège, Liège, Belgium

Journal: Molecular Therapy – Oncolytics Purpose: To engineer adenoviruses with modified tropism for systemic delivery—aiming to reduce off-target accumulation and enhance tumor retention via retargeting strategies.

Conclusions: Engineered vectors exhibited improved immune evasion, diminished sequestration by non-tumor tissues, and improved intratumoral delivery, indicating the feasibility of retargeting modifications for systemic adenoviral therapy.

Critical Review

Methodology: The study lacks transparency in the engineering protocol. Crucial elements such as ligand selection, targeting affinity, and vector modifications are insufficiently described. No rigorous dose-responsiveness or replication kinetics are provided.

Read more

Clinical outcome and deep learning imaging characteristics of patients treated by radio-chemotherapy for a “molecular” glioblastoma

by

In a retrospective observational cohort study, Zerbib et al., from the Department of Radiation Oncology, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Claudius Regaud; INSERM UMR 1037, Cancer Research Center of Toulouse (CRCT); IRT Saint-Exupéry; Department of Engineering and Medical Physics, IUCT-Oncopole; Biostatistics & Health Data Science Unit, IUCT-Oncopole; Department of Neuroradiology, Hôpital Pierre-Paul Riquet, CHU Purpan; Department of Medical Oncology & Clinical Research Unit, IUCT-Oncopole; Pathology and Cytology Department, CHU Toulouse, IUCT-Oncopole; CerCo, Université de Toulouse, CNRS, UPS, CHU Purpan; Department of Neurosurgery, Hôpital Pierre-Paul Riquet, CHU Purpan; and University Toulouse III – Paul Sabatier, published in The Oncologist, sought to evaluate and compare the clinical outcomes of patients with molecular glioblastoma (molGB) and histological glioblastoma (histGB) treated with standard radio-chemotherapy. They also assessed whether artificial intelligence (AI) models could accurately distinguish molGB without contrast enhancement (CE) from low-grade gliomas (LGG) using MRI FLAIR imaging features.

Conclusion: Patients with molGB and histGB showed similar overall survival under standard treatment.

  • However, molGB without contrast enhancement (CE) demonstrated a significantly better median overall survival (31.2 vs 18 months).
  • AI models based on FLAIR MRI features were able to differentiate non-enhancing molGB from LGG, achieving a best-performing ROC AUC of 0.85.

→ These findings support the clinical relevance of non-enhancing molGB as a distinct subgroup with better prognosis and highlight the potential diagnostic utility of AI tools in radiologically ambiguous cases.

This study presents itself as cutting-edge — mixing radiotherapy outcomes with artificial intelligence — but beneath the polished language and deep learning jargon lies a set of predictable flaws:

Read more

Subarachnoid Hemorrhage From Ruptured Pseudoaneurysm Secondary to Dissection of the Anterior Cerebral Artery

by

In a single-patient case report Fuentes et al. from The Medical City, Pasig City published in Cureus to report a rare case of subarachnoid hemorrhage (SAH) from a ruptured pseudoaneurysm secondary to anterior cerebral artery (ACA-A1 segment) dissection, and its successful treatment with stent-assisted coiling. The authors document a favorable outcome following endovascular treatment of a rare ACA-A1 dissection-induced pseudoaneurysm, arguing for its consideration in similar cases despite the absence of clear guidelines 1)

Critical Review

This case report contributes to the sparse literature on anterior cerebral artery dissections—particularly in the A1 segment—and their endovascular management. However, while the case is clinically relevant, the article offers limited scientific depth.

Read more

Efficacy of Adding Clonidine to Bupivacaine 0.25% Versus Plain Bupivacaine 0.25% Infiltration in Scalp Blocks for Supratentorial Craniotomy

by

In a prospective randomized controlled trial Lemos et al. from the Netaji Subhash Chandra Bose Medical College, Jabalpur published in Cureus, to assess whether the addition of clonidine (2 mcg/kg) to 0.25% bupivacaine in scalp blocks improves perioperative analgesia and hemodynamic control during supratentorial craniotomy. Clonidine significantly prolonged analgesia duration and improved perioperative hemodynamic stability, with lower postoperative pain scores, reduced need for rescue analgesia, and decreased intraoperative and postoperative analgesic consumption 3)

Critical Review

While the study is prospective and randomized, the sample size of 60 patients (30 per group) is underpowered for robust generalization. The statistical significance of the analgesic duration and pain scores (p<0.001) is compelling, but it is unclear whether the effect size translates into meaningful clinical benefit beyond delayed rescue analgesia. Hemodynamic data is selectively highlighted, and potential bradycardia and hypotension risks with clonidine are underexplored. Additionally, the lack of blinding of the assessors and a placebo control weakens internal validity. The study does not account for potential long-term side effects or the impact on overall surgical outcomes.

Read more

Inadvertent intrathecal application of vindesine and its neurological outcome: case report and systematic review of the literature

by

In a case report + systematic review Babaee et al. from:

  1. Department of Neurosurgery, University Hospital OWL, Campus Bethel, Bielefeld, NRW, Germany
  2. Institute for Neuroradiology, University Hospital OWL, Campus Bethel, Bielefeld, NRW, Germany

* Journal: Brain & Spine * Purpose: Assess outcomes and optimal management—particularly CSF irrigation—following inadvertent intrathecal administration of vinca alkaloids (vindesine or vincristine). * Conclusions: Intrathecal vinca alkaloids are nearly universally fatal without aggressive intervention; CSF irrigation improves survival odds (40% vs 0%) but survivors suffer severe neurological deficits 1).

This paper offers a sobering update, but several critical flaws undermine its impact:

Read more

Transient Cortical Blindness: A Rare Sequelae Following Endovascular Embolization of a Basilar Tip Aneurysm

by

In a case report Govindasamy et al. from the James Cook University Hospital, Middlesbrough published in Cureus to describe a rare complication—transient cortical blindness—following endovascular treatment of a basilar tip aneurysm. A 60-year-old woman developed transient cortical blindness post-endovascular embolization for a 1.2 cm incidental basilar tip aneurysm. Symptoms included bilateral vision loss and confusion, with full visual recovery within 48 hours. MRI showed no infarction, and Posterior Reversible Encephalopathy Syndrome (PRES) was ruled out due to the absence of other characteristic features. The authors suggest contrast-induced transient cortical blindness as the most likely etiology 1)

Critical Review

This is a single-case report documenting a rare but recognized complication of endovascular procedures involving posterior circulation—the transient cortical blindness, likely due to contrast-induced neurotoxicity. The case is clearly described and provides a succinct narrative of presentation, procedural details, and post-operative events. However, the scientific value remains modest due to several limitations:

Read more

Fluids, Electrolytes, and Nutrition in the Critically Ill Patient with Neurotrauma

by

* Type of Study: Narrative Review * Authors: Thomas et al. * Institution and City: University of Pennsylvania, Philadelphia, PA, USA * Journal: Neurosurgical Clinics of North America*, July 2025 * Purpose: To synthesize current clinical practices and considerations for fluid, electrolyte, and Nutritional Management in Critically Ill Neurotrauma Patients. * Conclusions: Isotonic saline remains the fluid of choice for resuscitation in TBI. Hypertonic saline is increasingly favored over mannitol for hyperosmolar therapy. Electrolyte imbalances are prevalent and necessitate close management. Nutritional optimization requires multidisciplinary coordination due to the elevated metabolic demands in TBI 1).

Critical Peer Review

1. Scientific Rigor & Methodology:

This narrative review lacks systematic methodology, which limits reproducibility and objectivity. There is no explicit discussion of inclusion/exclusion criteria for literature cited, nor a transparency framework for evaluating evidence quality. Future iterations would benefit from at least a semi-structured approach or alignment with PRISMA-ScR guidelines for scoping reviews.

Read more

Challenges in Pulmonary Management after Traumatic Brain and Spinal Cord Injury

by

In a review Zhou et al. published in Neurosurgery clinics of North America the most common pulmonary complications following traumatic brain injury (TBI) and spinal cord injury (SCI) — such as neurogenic pulmonary edema, Acute Respiratory Distress Syndrome, Ventilator-Associated Pneumonia, and thromboembolic events — and summarize current understanding of their pathophysiology and treatment, with the goal of guiding early recognition and management to improve outcomes in neurotrauma patients 3)

🧨 Verdict: ❝A clinically themed PowerPoint stretched into ten pages. No risk. No depth. No new thought.❞

⚠️ Fundamental Flaws No Original Contribution → This is not a review — it’s a recitation. The article contributes zero new data, no expert algorithm, and no provocative insight into managing a leading cause of secondary injury in neurotrauma.

Read more