Frame-based stereotactic biopsy has long been the gold standard for diagnostic brain biopsy, whereas robot-assisted stereotactic techniques have emerged as promising alternatives. However, rigorous methodological comparisons between these approaches remain scarce. To compare the diagnostic yield and complication rates of frame-and robot-assisted stereotactic brain biopsy using a rigorously matched cohort methodology. This retrospective, bicentric, comparative analysis included adult patients who underwent stereotactic brain biopsy between January 2011 and December 2019. Each patient who underwent robot-assisted biopsy (n = 230) was matched in a 2:1 ratio with patients who underwent frame-based biopsy (n = 460). Matching was performed based on clinically relevant criteria including lesion location, size, contrast enhancement, histopathology, and patient age. The primary outcomes were diagnostic yield and complication rates. The diagnostic yield was identical for both techniques 97.4

Adolescents and young adults (AYAs) diagnosed with primary central nervous system tumors (PCNST) often face long-term socio-economic challenges and reduced health-related quality of life (HRQoL). This study aims to evaluate the long-term socio-economic outcomes and HRQoL of AYAs more than ten years after diagnosis. A national, retrospective study conducted between 2019 and 2022, including AYAs aged 15–25 diagnosed with PCNST in 2009–2010, identified through the French Brain Tumor Database. Socio-economic data and HRQoL were assessed using a structured questionnaire and the Short Form-12 (SF-12) Health Survey. Descriptive statistical analyses were performed. Questionnaires were available for 70 patients. Educational level improved over time, but 11.4

Background/Objectives: Tissue-based metabolomic readouts in IDH-wild-type glioblastoma may be strongly shaped by how tumor tissue is surgically accessed and sampled. We aimed to determine whether, and to what extent, surgical sampling context structures the HRMAS metabolic landscape, and to disentangle sampling-related contributions from clinico-anatomical confounders. Methods: We retrospectively analyzed 99 patients with de novo IDH-wild-type glioblastoma (35 biopsy-only, 64 resection: 40 gross-total, 21 near-total, 3 subtotal), yielding 166 HRMAS spectra and 47 quantified metabolites (nmol/mg). Patient-level profiles were compared using PCA, metabolite-wise testing, pathway-level aggregation (10 pathways), and variance partitioning by PERMANOVA, both unadjusted and adjusted for age, WHO PS, deep-seated location, midline involvement, multifocality, MGMT methylation, and eloquent area. Sensitivity analyses included clinico-anatomically restricted subgroups, 15 canonical metabolite ratios, and Probabilistic Quotient Normalization. Intratumoral heterogeneity was assessed in 44 multi-sampled patients. Results: Biopsy-only and resection-derived cases separated along PC1 in unsupervised PCA (62.6% variance; p < 0.001), with 42/47 metabolites differing after FDR correction. However, the surgical group explained only 2.6% of the total variance (PERMANOVA p = 0.026), and this share was no longer significant after confounder adjustment (p = 0.39). Clinico-anatomical restriction progressively attenuated the effect (42/47 → 1/47 significant metabolites). Ratio-based and PQN analyses showed a residual compositional difference beyond scaling (13/15 ratios; 16/47 metabolites). Intratumoral heterogeneity was greater in resections and preserved in an n-matched analysis (p = 0.020). Conclusions: The apparent biopsy-versus-resection metabolic difference is largely a composite signal reflecting clinico-anatomical patient selection with a smaller tissue-composition contribution. Biopsy-only and resection-derived specimens should not be pooled uncritically in tissue-based metabolomic studies of glioblastoma.

Glioblastoma (GBM) is the most common malignant brain tumor in adults. The current treatment is surgery followed by chemoradiotherapy (CRT) and adjuvant temozolomide (TMZ). Three out of four patients experience recurrence within the year following diagnosis. The management of first GBM recurrence remains challenging with no standardized guidelines. This study aimed to evaluate multimodal strategies combining systemic therapy, radiotherapy, surgery as a potential promising approach to enhance patient outcomes. The FROST study is a real-life multicenter study. All patients with primary GBM treated for recurrence after prior CRT were included. The Kaplan–Meier method, Cox regression model, and propensity score were employed. Two hundred seventy-one patients were included. One hundred ninety (70

In Cushing’s disease, the rate of endocrine remission after surgery reaches 80

Background/Objectives: Cryotherapy involves the insertion of cryoprobes into tumors to induce cell destruction through exposure to extremely low temperatures over several minutes. This localized treatment modality may enhance the efficacy of established therapies, such as radiotherapy, particularly for glioblastomas. Our study aimed to provide proof-of-concept for the efficacy of combining cryotherapy and radiotherapy in the treatment of subcutaneous murine brain tumors (GL-261) in immunocompetent C57BL/6 mice. Methods: Tumor growth, survival and response were evaluated using MRI and histological analysis. Results: Partial cryotherapy alone showed no therapeutic efficacy. However, combining cryotherapy with radiotherapy significantly potentiated treatment outcomes. A statistically significant survival benefit was observed in the combined therapy group compared to control, cryotherapy and radiotherapy groups. Notably, 40% of mice receiving the combined treatment exhibited complete responses, with no detectable tumor cells on MRI or histological analysis. Furthermore, MRI-based monitoring revealed that the Apparent Diffusion Coefficient (ADC) map could predict complete response 14 days post-treatment, unlike caliper-based measurements. Conclusions: These findings suggest that cryotherapy may enhance radiotherapy efficacy, resulting in complete tumor regression in 4 out of 10 cases. ADC distribution may serve as a predictive marker for therapeutic response. However, given the limitations of the model, further studies in orthotopic models are needed to validate these findings and assess their clinical relevance.

Whenever the radiological and clinical presentation of diffuse spinal cord lesions pose diagnostic and therapeutic dilemmas, the role of primary spinal cord biopsies (SCB) can represent a crucial surgical step to guide further management. However, the benefits of SCB comes with the risks of significant neurological worsening and potentially non-diagnostic findings. An evidence-based algorithm to assess the appropriateness of SCB and its chances of successful diagnosis is currently lacking. A multicenter retrospective study was conducted across 8 tertiary neurosurgery European centers and included all patients undergoing primary SCB between January 2005 and December 2020. The main objective of this study was to assess the positive diagnostic rate, while the secondary objective was to evaluate the rate of neurological deterioration. Histological diagnoses were obtained in 91.8

The urgent etiological diagnosis represents the main management objective of cervical spondylodiscitis (CSD) to start as soon as possible antibiotic treatment to prevent neurological deterioration. The present study aimed to evaluate a multicenter experience implementing a minimally invasive surgical approach (MISA) to manage CSD such pathology vs the most complex and aggressive surgical strategies currently used.This retrospective multicenter study used a database of 70 patients from five European neurosurgical centers. Patients with primary CSD underwent MISA via a limited funnel shaped cervical microdiscectomy with 4-mm anterior and 6-mm posterior longitudinal ligaments incision, PUS drainage, and extensive washing of the interbody and epidural space without fusion. Diagnosis was confirmed by clinical, imaging, laboratory, and perioperative histopathology and bacteriology.Of the 70 patients, 41 were men (58,5

Radiotherapy is considered as a second or third-line treatment for recurrent pituitary adenomas. As it is a benign tumor, the balance should clearly favor the benefit and induce the least amount of side effects. This retrospective study aims to evaluate the incidence of side effects after treatment and their actual causality with radiotherapy through dosimetric analysis. A cohort of 35 patients who underwent normofractionated radiation therapy following unsuccessful surgical or medical interventions was identified. 48.6

This systematic review assessed the efficacy and safety of preoperative stereotactic radiotherapy (PreopSRT) in the treatment of resectable brain metastases (BM). A PRISMA systematic review was conducted using Web of Science, Scopus, and PubMed. The search terms included “(brain or cerebral) and (metastasis or metastases) and (radiotherapy or radiosurgery or radiation) and (neoadjuvant or preoperative).” Of the 2061 articles identified, 12 studies met the inclusion criteria: patients with resectable BM who received PreopSRT in single or multiple fractions. Literature reviews, protocols, and studies on salvage resections were excluded. Local control at 6 months ranged from 81.8 to 100

BACKGROUND AND OBJECTIVES:Central neurocytoma (CN) is a rare grade 2 intraventricular tumor according to the 2021 World Health Organization classification. Surgical resection is the recommended management. This study aimed at assessing patients' health-related quality of life (HRQoL) and functional outcomes at long-term postoperative follow-up. METHODS:A multicenter retrospective study was conducted in 42 French neurosurgical centers. CN patients treated by surgical resection between 2006 and 2015 were included. We collected clinical, imaging, and surgical data. HRQoL was assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (QLQ-C30) and its brain cancer-specific module (QLQ-BN20). Functional outcomes were evaluated by professional integration, return to driving, epileptic disease, and Karnofsky Performance Status (KPS) score. RESULTS:Among 65 long-term postsurgery patients (median 11 years of follow-up), self-reported overall HRQoL score was 75.5 ± 18.4. Favorable cognitive, asthenia, and emotional scores were observed in 36.9%, 84.6%, and 72.3% of cases, respectively. Various degrees of professional integration were observed in 63.1%, driving resumption in 72.3%, and favorable KPS (>70) in 78.4% of cases; 33.8% of patients experienced daily epileptic treatment. The absence of acute postoperative hydrocephalus was significantly related with favorable functional outcomes for asthenia, professional integration, and global KPS. CONCLUSION:CN patients treated by surgical resection showed generally high long-term HRQoL scores. However, cognitive outcomes remain severely affected with only one-third of patients achieving favorable results. Management of acute postoperative hydrocephalus represents a crucial factor for patients' functional prognosis and warrants clinicians' attention.

Background/Objectives: High-grade glioma shows marked metabolic heterogeneity. We performed a PRISMA-guided systematic review and meta-analysis to quantify PET accuracy for pseudoprogression (PsP) and for recurrence/progression versus treatment-related change (TRC), assess pool baseline associations with overall (OS) and progression-free survival (PFS), summarize PET-based prediction of molecular markers, and assess the PET–stereotactic biopsy–ex vivo metabolomics workflow. Methods: We searched PubMed/MEDLINE and the Web of Science Core Collection (Clarivate) from inception to 1 September 2025 for HGG cohorts with baseline PET. Eligibility: Adults with HGG; diagnostic syntheses required per-patient 2 × 2; prognostic syntheses required for HR with 95% CI. Risk of bias: QUADAS-2 (diagnostic) and QUIPS (prognostic). Random-effects models pooled log-HRs and sensitivity/specificity; molecular studies were summarized by AUCs. Imaging-to-omics concordance was reviewed narratively owing to the absence of co-registered PET–metabolite maps in human HGG. Results: The results included the following: OS k = 10; PFS k = 3; PsP k = 2 (N = 76); and TRC k = 3 (N = 152). For PsP, two amino acid PET cohorts yielded a sensitivity of 0.943 and a specificity of 0.826. For TRC, pooled FDOPA across two cohorts gave rise to a sensitivity of 0.879 and a specificity of 0.771. OS meta-analyses were non-significant under Hartung–Knapp modification—FDG HR of 1.09 (95% CI 0.69–1.73) and amino acid HR of 1.03 (0.72–1.46)—with substantial heterogeneity. PFS effects varied by tracer/metric; examples include FDOPA HR of 7.92 (2.17–28.90) and MET metabolic tumor volume HR of 1.60 (1.20–2.30). Conclusions: Amino acid PET is sensitive to PsP and, with FDOPA, aids TRC discrimination when MRI is equivocal, whereas baseline PET–survival associations are weak and heterogeneous. Prospective co-registered PET/MR with stereotactic biopsies and HR-MAS NMR spectroscopy/MALDI-MSI is required to quantify imaging-to-omics concordance and standardize spatial endpoints. Study registration: PROSPERO CRD420251113416. Funding: none.

BACKGROUND:Ruptured middle cerebral artery aneurysm (MCAa) with intraparenchymal hematoma (IPH) can benefit at the same time from evacuation of the hematoma and exclusion of the aneurysm of a decompressive craniectomy (DC). To date, there are no clear recommendations for performing a DC in such cases. METHODS:We retrospectively collected data from nine French neurosurgical units from January 1, 2013 to December 31, 2020. All MCAa patients with IPH requiring evacuation of the IPH were included in this study. Poor outcomes were defined by an mRs score of 3-6 at 6 months. Propensity score matching was used to analyze the potential effects of DC. RESULTS:Between January 2013 and December 2020, 198 MCAa ruptured with IPH were treated, including 162 MCAa requiring evacuation of the IPH. 50 were treated with DC and 112 without DC. After matching 72 patients, poor neurological prognosis was observed in 27/36 patients (75%) in the DC group versus 18/36 (50%) in the non-DC group (p = 0.026). CONCLUSION:Primary decompressive craniectomy in patients with ruptured MCAa and IPH requiring surgical evacuation increases the risk of poor neurological outcome. RCT are needed to confirm this hypothesis.

Purpose: Neurocytomas represent 0.25 to 0.5% of primary brain tumours and are mainly found in young adults. These tumours have neuronal differentiation. The cornerstone treatment is neurosurgery. The efficacy of other therapies, including radiotherapy, is still unclear. The objective of this study was to evaluate the management of central neurocytomas and the role of radiotherapy. Materials and methods: All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included. Results: One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found. Conclusion: The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.

Background: Contrast-enhanced magnetic resonance imaging (MRI) is the imaging modality routinely used to follow up patients who have undergone surgical resection of brain meningiomas. There are growing concerns about the massive use of gadolinium-based contrast agents (GBCA). Our aim was to evaluate the performance of a new imaging protocol, performed without GBCA injection, in the detection of tumoral residue or local recurrence after surgery of parafalcine and convexity meningiomas. Materials and methods: Only adult patients with a documented resected parafalcine or convexity meningioma were included. We performed a dedicated MRI protocol that included non-contrast and post-contrast sequences. The presence or absence of residue on the unenhanced sequences was independently recorded by three observers: first blindly, then in comparison with a baseline enhanced MRI examination. Results: A total of 51 patients were included. 37 of them featured a tumor residue on the reference enhanced sequence. Overall, an average of 32 of 37 (87%) residues were identified on the unenhanced sequences that were blindly reviewed; and more than 34 of 37 (93%) were identified with the help of the comparative baseline enhanced examination, with a high sensitivity. The missed cases were related to small residues. Conclusion: Unenhanced MRI sequences are highly sensitive and specific in identifying a tumor residue or a local recurrence in the post operative follow up of brain meningiomas. Sensitivity is even higher with the help of a comparative baseline enhanced MRI examination, whatever the strength of magnetic field. (c) 2023 Elsevier Masson SAS. All rights reserved.

MEN1 loss of heterozygosity in meningiomas of patients #8, #15 and #16. Electropherogram of Sanger sequencing on tumor DNA showing falsely homozygous MEN1 pathogenic variants due to loss of heterozygosity at a somatic level. Patient #8: c.1037_1038delCT, p.(Thr346SerfsTer20), patient #15: c.249_252delGTCT, p.(Ile85SerfsTer33), patient #16: c.515A>T, p.(Asp172Val)

Visual dysfunction is a prevalent symptom in patients with non-functioning pituitary macroadenoma (NFPM); the role of OCT in such patients has not been yet determined. This is a prospective longitudinal observational study over a period of 6 years, on 20 patients presenting a radiological compression of the optic chiasma without visual acuity (VA) and visual field (VF) disturbances. The primary endpoint was to evaluate the impact of NFPA on neuro-axonal loss by measuring RNFL thickness using OCT at inclusion (T0), 12 months (T1), 24 months (T2), and 36 months (T3), respectively. The secondary endpoint was to monitor the evolution of OCT over time and assess any relationship between the degree of OCT alteration and the degree of radiological and clinical optic chiasm compression syndrome. Among the 20 patients included, eight (40%) showed an altered RNFL-OCT at diagnosis, while the remaining 12 (60%) showed a normal pattern. During a mean ophthalmologic follow-up of 60 months, 4 patients (20%) presented an asymptomatic reduction of RNFL-OCT thickness although all 20 had a VA/VF stable. To our knowledge, this study represents the first attempt to longitudinally evaluate the natural history and evolution of RNFL-OCT in patients with radiologically asymptomatic chiasmatic compression syndrome. The results do not clearly demonstrate the role of the OCT as an early prognostic factor for visual dysfunction.

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Sporadic meningothelial meningiomas characteristics