Neurosurgery

Minimally invasive surgery improves outcomes and cost-effectiveness in basal ganglia hypertensive ICH

In hypertensive basal ganglia ICH, both endoscopic evacuation and frameless navigated aspiration yielded higher 6‑month mRS 0–2 rates than small-bone flap craniotomy. Favorable outcome rates were roughly doubled versus craniotomy, with similar performance between endoscopy and aspiration. Hospitalization costs were lowest with navigated aspiration and intermediate with endoscopy, both undercutting craniotomy costs. Both minimally invasive approaches dominated craniotomy on QALYs and cost, with aspiration showing the most favorable incremental cost-effectiveness. 1

Tislelizumab plus low-dose bevacizumab prolongs survival in recurrent glioblastoma

In rGBM, combining tislelizumab with low-dose bevacizumab increased median overall survival to 13.3 months versus 6.6 months with control therapy. Objective response and disease control rates were 32.6% and 79.1%, respectively, indicating meaningful tumor control for a subset. The regimen showed good tolerability without grade 4 toxicities or treatment discontinuations in the experimental arm. Tumor in situ fluid profiling showed reduced detectable genomic alterations, while recurrent tumors developed CD163+ macrophage infiltration and elevated GDF‑15, suggesting emerging immune escape mechanisms. 2

Oncolytic HSV-1 ON-01 shows safety and promising survival in recurrent WHO grade 4 glioma

Intratumoral stereotactic ON‑01 infusion in recurrent WHO grade 4 glioma produced a median overall survival of 12 months with acceptable toxicity. Adverse events were mostly grade 1–2, with only two grade 3 events and no reported neurotoxicity. Median progression-free survival was 3 months, and 2‑year overall survival was 27.7%, exceeding historical expectations in this setting. Regression of non-injected lesions in multifocal cases suggests possible distant antitumor activity. Higher herpesvirus entry mediator expression correlated with longer survival, indicating a potential predictive biomarker for ON‑01 response. 3

Digital DBS programming in Parkinson’s disease maintains 12‑month benefit under real-world conditions

Remote, internet-based DBS programming for Parkinson’s disease accelerates postoperative clinical benefit by improving access to stimulation optimization. This study shows that motor outcomes, quality of life, and safety remain sustained for at least 12 months after the digital phase. The embedded randomized trial within a broader cohort demonstrates scalability of remote programming in routine care. These data support incorporating structured teleprogramming into follow-up models for appropriately selected DBS patients. 4