Evidence map›Paper›PMID 41489755›Full record

ArticleNeurosurgical review2026

Risk assessment of brain retraction injury based on quantitative evaluation of brain retraction distance during skull-base meningioma surgery.

Kei Yamashiro, Takamichi Kozaki, Hironori Fukumoto, Hiromasa Kobayashi, Takashi Morishita, Koichiro Takemoto, Hiroshi Abe

Abstract read
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In one paragraph

Article in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kei YamashiroDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan. keiyamashiro1577@gmail.com.ORCID http://orcid.org/0000-0002-6871-0792
Takamichi KozakiDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan.
Hironori FukumotoDepartment of Neurosurgery, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan.
Hiromasa KobayashiDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan.
Takashi MorishitaDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan.
Koichiro TakemotoDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan.
Hiroshi AbeDepartment of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0810, Japan.

Funding

The Clinical Research Promotion Foundation 24 clinical-No.14
6 · The paper itself

Abstract

objectiveIn skull-base surgery, excessive brain retraction may cause brain retraction injury (BRI), yet the brain retraction distance (BRD) that contributes to BRI and the potential of skull-base approaches to reduce BRD remain unclear. This study used a virtual reality (VR)-based method to quantify BRD related to BRI and to assess the impact of skull-base approaches on reducing BRD.

methodsWe retrospectively analyzed 18 patients who underwent frontotemporal craniotomy for anterior skull-base tumors. Three-dimensional models were generated from perioperative imaging, and the frontal lobe was virtually elevated on the 3D model to reproduce the surgical exposure. BRD was estimated by comparing pre- and post-retraction configurations, and its association with BRI was assessed. Additionally, a virtual orbitotomy was performed to evaluate how much BRD could be reduced with this approach.

resultsFour patients developed BRI. The median BRD was 6.2 mm in the non-BRI group, whereas it was 12.2 mm in the BRI group, demonstrating a significant difference. Receiver operating characteristic curve analysis identified 10.1 mm as the optimal cutoff value for predicting BRI, yielding a sensitivity of 100% and a specificity of 92.9%. The median BRD decreased from 8.3 mm to 5.8 mm after adding an orbitotomy on the 3D model, with the greatest reduction observed in cases requiring larger BRD.

conclusionVR-based preoperative measurement of BRD may help assess both the risk of BRI and the potential benefit of skull-base approaches. This technique could support selecting an optimal surgical strategy by considering the anticipated BRD for each patient.

Indexed as

Brain InjuriesMeningeal NeoplasmsMeningiomaNeurosurgical ProceduresSkull Base NeoplasmsAdultAgedCraniotomyFemaleHumansImaging, Three-DimensionalMaleMiddle AgedRetrospective StudiesRisk AssessmentAnatomical studyBrain retraction injuryCadaveric studySkull-base tumorVirtual reality

Identifiers

PMID41489755

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.