Volume 135: Issue 4 (Oct 2021)
inJournal of NeurosurgeryIllustration from Kim et al. (pp 1164–1172). Copyright Eui Hyun Kim. Published with permission.
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Jacob S. Young,Andrew J. Gogos,Matheus P. Pereira,Ramin A. Morshed,Jing Li,Matthew J. Barkovich,Shawn L. Hervey-Jumper, andMitchel S. Berger
在Brief
The objective of this study was to demonstrate that entering the ventricle during glioblastoma resection did not increase complications such as tumor spread or dissemination. Therefore, there should be no indication to avoid entering the ventricle to obtain an extensive resection. The key finding is that extent of resection is critical for glioblastoma outcome, and if this means removing tumor and entering the ventricle, that is well tolerated without complications. This important observation should change the way in which surgeons deal with tumors that abut the ventricle and require extensive resection to enhance outcome.
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Kazuya Motomura,Lushun Chalise,Hiroyuki Shimizu,Junya Yamaguchi,Tomohide Nishikawa,Fumiharu Ohka,Kosuke Aoki,Kuniaki Tanahashi,Masaki Hirano,Toshihiko Wakabayashi, andAtsushi Natsume
在Brief
The goal of this study was to evaluate the efficacy of levetiracetam (LEV) combined with perampanel (PER) therapy for intraoperative seizure treatment during awake surgery. The authors showed that LEV combined with PER therapy is significantly associated with a lower risk of intraoperative seizures, compared with LEV therapy alone, in patients with glioma during awake brain mapping. These findings will help neurosurgeons conduct safe and reliable awake surgeries and reduce the rate of intraoperative intractable seizures during such procedures.
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Stephen T. Magill,Minh P. Nguyen,Manish K. Aghi,Philip V. Theodosopoulos,Javier E. Villanueva-Meyer, andMichael W. McDermott
在Brief
The objective of this study was to determine whether postoperative diffusion restriction, reflective of ischemia, was associated with neurological deficit after convexity meningioma resection and to identify risk factors for postoperative diffusion. The authors found that diffusion restriction is associated with increased neurological deficits and that older age, greater blood loss, tumor location over motor cortex, and peritumoral edema placed patients at greater risk for postoperative diffusion restriction, which is useful for informing patients of surgical risk.
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Nadav Schellekes,Arianna Barbotti,Yael Abramov,Razi Sitt,Francesco Di Meco,Zvi Ram, andRachel Grossman
在Brief
A possible prolonged survival after resection for primary central nervous system lymphoma (PCNSL) lesions in selected patients has been suggested, but selection criteria for surgery, especially for solitary lesions, have never been established. In this study, the authors identified a specific subgroup of patients with solitary PCNSL who gained significant survival benefit from resection compared with undergoing only a diagnostic biopsy. The authors' results suggest that the option for resection of single lesions should be included in the clinical decision-making process.
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Clare W. Teng,史蒂夫·s·曹,Yash Singh,Emma De Ravin,克伦萨默斯,Love Buch,Steven Brem,Sunil Singhal,Edward J. Delikatny, andJohn Y. K. Lee
在Brief
The authors present a prospective trial evaluating intraoperative imaging and clinical outcomes for high-dose, delayed imaging of second window indocyanine green (SWIG) in 51 brain metastases. Near-infrared fluorescence was detected in all cases, allowing dose-dependent, transdural localization of intracranial metastases. The absence of residual fluorescence in the postresection cavity better predicted improved progression-free survival compared to postoperative MRI. The study demonstrates potential clinical benefits of SWIG in surgery for patients with brain metastases.
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Ken Matsushima,Michihiro Kohno,Norio Ichimasu,Yujiro Tanaka,Nobuyuki Nakajima, andMasanori Yoshino
在Brief
The purpose of this study was to establish real-time and quantitative monitoring of vagus nerve function throughout microsurgery for jugular foramen tumors. The amplitude preservation ratio of the novel continuous monitoring significantly correlated with postoperative dysphagia and/or hoarseness. This monitoring is essential to avoid permanent vagus nerve palsy when sufficient resection of jugular foramen tumors is achieved.
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Anne-Marie Langlois,Christian Iorio-Morin,Andrew Faramand,Ajay Niranjan,L. Dade Lunsford,Nasser Mohammed,Jason P. Sheehan,Roman Liščák,Dušan Urgošík,Douglas Kondziolka,Cheng-chia Lee,Huai-che Yang,Ahmet F. Atik, andDavid Mathieu
在Brief
在vestigators assessed the role of stereotactic radiosurgery (SRS) for schwannomas of the oculomotor nerves. SRS was found to provide tumor control and symptom improvement in the majority of cases with minimal risks. This multicenter study is the largest case series in the literature.
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Akiyoshi Ogino,L. Dade Lunsford,Hao Long,Stephen Johnson,Andrew Faramand,Ajay Niranjan,John C. Flickinger, andHideyuki Kano
在Brief
This study evaluated outcomes after stereotactic radiosurgery (SRS) for patients with intracanalicular vestibular schwannomas. The progression-free survival rate was 92.1% at 10 years, and the rate of freedom from the need for additional intervention was 98.3% at 10 years. The 5-year serviceable hearing preservation rate was 63.5%. Patients with initially better hearing and smaller tumor volume had enhanced serviceable hearing preservation during an observation interval up to 10 years after SRS.
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Akiyoshi Ogino,L. Dade Lunsford,Hao Long,Stephen Johnson,Andrew Faramand,Ajay Niranjan,John C. Flickinger, andHideyuki Kano
在Brief
The aim of this study was to evaluate outcomes after stereotactic radiosurgery (SRS) for patients with Koos grade IV vestibular schwannomas (VSs) whose tumor volume ranged from 5 to 20 cm³. When the margin dose was from 12 to 13 Gy, the progression-free survival was 90.7% at 10 years and the probability of delayed facial neuropathy was 1.1% at 10 years. SRS should be considered an effective alternative to surgery in most patients with Koos grade IV VSs.
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Joshua S. Catapano,Mohamed A. Labib,Fabio A. Frisoli,Megan S. Cadigan,Jacob F. Baranoski,Tyler S. Cole,詹姆斯·j·周,Candice L. Nguyen,Alexander C. Whiting,Andrew F. Ducruet,Felipe C. Albuquerque, andMichael T. Lawton
在Brief
This article assesses the long-term predictive capability of the SAFIRE grading scale using the Barrow Ruptured Aneurysm Trial (BRAT) patient population by comparing patient outcomes at the 1- and 6-year follow-ups. The SAFIRE grading scale is a simple bedside assessment that predicts the prognostic outcome of aSAH patients at 2 months. Furthermore, this study finds that the grading scale may also be used as a predictor of long-term outcomes in these patients.
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Daniel Gebrezgiabhier,Yang Liu,Adithya S. Reddy,Evan Davis,Yihao Zheng,Albert J. Shih,Aditya S. Pandey, andLuis E. Savastano
在Brief
作者已经开发和验证一个韦夫交货o human brain test bed to gain further understanding of the mechanics of embolization and of embolus removal with stent retrievers and suction catheters. The test bed allowed high-definition and radiation-free visualization of 184 thrombectomy passes for 105 cases of large vessel occlusion in real cerebrovascular anatomy and flow conditions. This test bed enables high-fidelity analysis of artery-embolus-device interaction and can facilitate the development of future thrombectomy devices and stroke research.
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Christine Park,Lefko T. Charalambous,Zidanyue Yang,Syed M. Adil,Sarah E. Hodges,Hui-Jie Lee,Laura Zitella Verbick,Aaron R. McCabe, andShivanand P. Lad
在Brief
Complications of nontraumatic, primary intracerebral hemorrhage (ICH) can serve as useful prognostic factors of early mortality and morbidity. In this study, the authors aimed to explore the incidence and cost of care associated with the major complications of ICH. In this analysis, hydrocephalus resulted in the greatest mortality rate and cost of care. Healthcare costs associated with complications of ICH are considerable. Further research needs to be conducted to identify the critical time of intervention to minimize the development of, and the consequent cost to treat, ICH complications.
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Jong-Hoon Kim,Young-Jin荣格, andChul-Hoon Chang
在Brief
This study aimed to compare treatment outcomes of the strategy of first stenting without retrieval (FRESH) using the Solitaire FR versus stent retrieval thrombectomy in patients with intracranial atherosclerosis-related emergent large-vessel occlusion. In the FRESH group, the puncture-to-recanalization time was significantly shorter, and favorable functional outcomes were significantly more common. FRESH, rather than rescue stenting, could be a treatment option for intracranial atherosclerosis-related emergent large-vessel occlusion.
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Adam de Havenon,Kole Mickolio,Steven O’Donnell,Greg Stoddard,J. Scott McNally,Matthew Alexander,Philipp Taussky, andAl-Wala Awad
在Brief
The authors retrospectively identified stroke patients to develop a simple clinical risk index to help identify which stroke patients warrant transfer or further diagnostic imaging. Three clinical variables were identified that accurately predicted which patients had salvageable penumbra in a range of clinical scenarios and treatment cutoffs and would benefit from transfer. These hypothesis-generating findings warrant additional prospective study to determine whether this risk index can help mitigate health costs and determine patient eligibility for treatment requiring transfer to another hospital with capabilities for diagnostic CT and MR perfusion imaging.
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Fangke Xie,Qiang Tan,Anyong Yu,Peiwen Guo,Ling Wang,Zongwei Zeng,Liang Liang,Jishu Xian,Hua Feng, andZhi Chen
在Brief
The purpose of this study was to observe whether cell-free DNA (cfDNA), the main framework of neutrophil extracellular traps, is involved in fibrinolysis resistance. It was found that cfDNA damaged the tPA fibrinolysis of intraventricular hemorrhage (IVH), while the degradation of cfDNA promoted the fibrinolysis of IVH. This study provides a new target for fibrinolytic therapy for IVH that might have practical implications.
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Yiping Li,Anadjeet Khahera,Jason Kim,Mauricio Mandel,Summer S. Han, andGary K. Steinberg
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The authors report the largest case series of basal ganglia cavernous malformations in the literature, analyzing the clinical course of these surgically managed lesions. They also performed a systematic review of the literature, revealing a total of 90 additional surgically treated cases. Nearly a quarter of patients will experience a temporary neurological decline in the immediate perioperative period with a permanent morbidity rate of around 10%. They also identified clinical factors associated with the risk of developing perioperative deficits.
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Suguru Igarashi,Toshihiko Ando,Tatsuhiko Takahashi,Jun Yoshida,Masakazu Kobayashi,Kenji Yoshida,Kazunori Terasaki,Shunrou Fujiwara,Yoshitaka Kubo, andKuniaki Ogasawara
在Brief
The purpose of this prospective study was to determine whether cerebral hyperperfusion following carotid endarterectomy (CEA) leads to the development of cerebral microbleeds (CMBs) and if postoperative cognitive decline is related to these developed CMBs. Cerebral hyperperfusion was associated with an increase in CMBs, and increased CMBs were associated with cognitive decline after surgery. CMBs as toxic substances may leak through the blood-brain barrier that is disrupted by cerebral hyperperfusion and injure neural tissue, resulting in cognitive decline.
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Keita Shibahashi,Hidenori Hoda,Takuto Ishida,Takayuki Motoshima,Kazuhiro Sugiyama, andYuichi Hamabe
在Brief
The authors derived and internally validated a new screening model for blunt cerebrovascular injury (BCVI) using a nomogram that allows clinicians to quantify BCVI risk. They evaluated 258,935 patients who experienced blunt injury from the Japan Trauma Data Bank (January 2009–December 2018). Patients were randomly divided into training (n = 129,468) and validation (n = 129,467) cohorts. A new screening model that comprised 13 significant risk factors for BCVI was derived. In the validation cohort, the model had an area under the receiver operating characteristic curve of 0.83 (95% CI 0.81–0.86).
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Adriana Fonseca,Palma Solano,Vijay Ramaswamy,Uri Tabori,Annie Huang,James M. Drake,Derek S. Tsang,Normand Laperriere,Ute Bartels,Abhaya V. Kulkarni, andEric Bouffet
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Aaron Lawson McLean,Aimun A. B. Jamjoom,Michael T. C. Poon,Difei Wang,Isaac Phang,Mohamed Okasha,Matthew Boissaud-Cooke,Adam P. Williams, andAminul I. Ahmed
在Brief
This large-scale survey of contemporary practice in the United Kingdom and Ireland demonstrates that, as currently utilized and contrary to expectation, navigated external ventricular drain (EVD) placement using computer-assisted neuronavigation or ultrasound was not associated with an increased likelihood of achieving optimal EVD catheter position, with a lower rate of catheter blockage, or with the need for continued CSF diversion at 30 days. Despite commonly being proposed as a technical solution to optimize external ventriculostomy success, image guidance was not sufficient to enhance procedural effectiveness.
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Badih J. Daou,Siri Sahib S. Khalsa,Sharath Kumar Anand,Craig A. Williamson,Noah S. Cutler,Bryan L. Aaron,Sudharsan Srinivasan,Venkatakrishna Rajajee,Kyle Sheehan, andAditya S. Pandey
在Brief
在this study, the authors used a volumetric quantitative analysis tool in patients with aneurysmal subarachnoid hemorrhage (aSAH) to evaluate the association of aSAH volume with shunt-dependent hydrocephalus and seizures. Larger hemorrhage volumes were found to be associated with increased odds of seizures and shunt-dependent hydrocephalus. Quantitative analysis of hemorrhage volume may complement clinical grading scales to assist in aSAH patient prognostication and management.
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Eui Hyun Kim,Jihwan Yoo,在-Ho Jung,Ji Woong Oh,Ju-Seong Kim,Jin Sook Yoon,Ju Hyung Moon,Seok-Gu Kang,Jong Hee Chang, andTae Hoon Roh
在Brief
The objective of this study was to evaluate the feasibility of an endoscopic transorbital approach to the insular region. The authors' cadaveric study demonstrated that the insula was safely accessed and removed without violation of major blood vessels via an endoscopic transorbital approach. In a clinical case, the endoscopic transorbital approach was successfully performed for a high-grade glioma (grade III) in the right insula. This study suggests that the transorbital route may serve as a potential alternative to the classic transcranial approach to access tumors located in the insula.
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Alice Senta Ryba,Juan Sales-Llopis,Stefan Wolfsberger,Aki Laakso,Roy Thomas Daniel, andPablo González-López
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Hiroki Morisako,Hiroki Ohata,Bharat Shinde,Atsufumi Nagahama,Yusuke Watanabe, andTakeo Goto
在Brief
The authors simplified the anterior and posterior combined (APC) transpetrosal approach by minimizing petrosectomy, and the clinical outcomes of this approach for large petroclival meningiomas were evaluated. The minimal APC transpetrosal approach allows adequate accessibility with safe surgical maneuverability to perform radical resection of large petroclival meningiomas while avoiding major neurovascular complications.
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Halinder S. Mangat,Xian Wu,Linda M. Gerber,Hamisi K. Shabani,Albert Lazaro,Andreas Leidinger,Maria M. Santos,Paul H. McClelland,Hanna Schenck,Pascal Joackim,Japhet G. Ngerageza,Franziska Schmidt,Philip E. Stieg, andRoger Hartl
在Brief
The objective of this paper was to explore quantitatively the utility and adherence to guideline-based therapy in patients with severe traumatic brain injury accessing care at a tertiary referral center in a resource-restricted setting in Tanzania. The authors found that critical care monitoring and interventions were significantly underutilized; less than half of the patients were urgently intubated or received any locally available neurology-specific intracranial pressure–lowering therapy.
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Postoperative recurrence of chronic subdural hematoma is more frequent in patients with blood type A
Satoshi Hirai,Kenji Yagi,Keijiro Hara,Eiichiro Kanda,Shunji Matsubara, andMasaaki Uno在Brief
Authors of the present study investigated the association between ABO blood type and postoperative chronic subdural hematoma (CSDH) recurrence. Blood type A was found to be a significant independent predictor of the recurrence of CSDH. Therefore, patients with blood type A should be carefully followed up. Moreover, a new treatment strategy may be needed for them.
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Joshua S. Catapano,Andrew F. Ducruet,Candice L. Nguyen,Tyler S. Cole,Jacob F. Baranoski,Neil Majmundar,D. Andrew Wilkinson,Vance L. Fredrickson,Daniel D. Cavalcanti,Michael T. Lawton, andFelipe C. Albuquerque
在Brief
This study compared middle meningeal artery (MMA) embolization with conventional therapy for chronic subdural hematomas (cSDHs) using a propensity-adjusted analysis. Both surgery and conservative therapy were predictors of treatment failure when compared with MMA embolization. The study suggests that MMA embolization for cSDHs is associated with a lower risk of treatment failure compared with conventional therapy. MMA embolization may be effective in the treatment of both primary cSDHs and cases that recur after surgery.
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Igor Lima Maldonado,Christophe Destrieux,Eduardo Carvalhal Ribas,Bruna Siqueira de Abreu Brito Guimarães,Patrícia Pontes Cruz, andHugues Duffau
在Brief
The authors detailed the composition of the sagittal stratum (SS), an important region of the human brain white matter. Layer-by-layer fiber dissection from the superolateral aspect to the ventricular cavity was performed in 20 cadaveric human hemispheres to systematize the general organization of the SS and provide important updates to data on the composition of the SS outer layer in relation to earlier definitions. The presented data may influence how neurosurgeons plan operative approaches to the brain and how neuroscientists model neurophysiological networks.
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Roberto Sergio Martins,Mario Gilberto Siqueira,Carlos Otto Heise,Luciano Foroni,Hugo Sterman Neto, andManoel Jacobsen Teixeira
在Brief
作者描述提肌的神经scapulae muscle (LSN) as a donor nerve in brachial plexus surgery and present the results from a surgical series. The results demonstrate that the LSN can be consistently used as donor nerve for reinnervation of the lateral pectoral nerve. This study provides practical information that will assist surgeons in identifying and routinely using the LSN in brachial plexus surgery.
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Thomas J. Wilson,Forrest Hamrick,Saud Alzahrani,Christopher F. Dibble,Sravanthi Koduri,Courtney Pendleton,Sara Saleh,Zarina S. Ali,Mark A. Mahan,Rajiv Midha,Wilson Z. Ray,Lynda J. S. Yang,Eric L. Zager, andRobert J. Spinner
在Brief
The goal of this study was to examine the role of intraoperative neuromonitoring (IONM) during resection of benign peripheral nerve sheath tumors in achieving gross-total resection and reducing postoperative neurological complications. Formal IONM was associated with a reduced likelihood of gross-total resection and had no association with neurological complications. Understanding the benefits and consequences of using IONM will help surgeons choose when to selectively utilize IONM during these operations.
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S. Shelby Burks,Anthony Diaz,Agnes E. Haggerty,Natalia de la Oliva,Rajiv Midha, andAllan D. Levi
在Brief
作者在本研究中demonstrated that Schwann cells transplanted into a novel collagen conduit enhance nerve recovery in a rat sciatic nerve injury model with a critical length gap. The objective was to build translational data in nerve grafting and lay foundational work for a clinical trial. The ability to use such a conduit loaded with human Schwann cells may provide patients with an alternative to autograft harvesting, reducing surgical time and morbidity, and improve neurological outcomes.
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Erin J. Torell,Tyler S. Pistone, andAndrew P. Gard
在Brief
The article is a history of neurosurgery at the University of Nebraska Medical Center in Omaha, Nebraska. The article highlights the important and innovative contributions to the field of neurosurgery by University of Nebraska Medical Center faculty.
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Visish M. Srinivasan,Caroline C. Hadley,Akash J. Patel,Bruce L. Ehni,Howard L. Weiner,Ganesh Rao,Frederick F. Lang Jr.,Raymond E. Sawaya, andDaniel Yoshor
在Brief
The history of neurosurgery at Baylor College of Medicine is a reflection of the evolution of neurosurgery as a field as well as the development of the Texas Medical Center, the nation's largest medical center. This article describes how neurosurgery at Baylor has evolved from an informal coalition of pioneering private practice neurosurgeons to one of the largest and most academically and clinically productive programs in the nation.
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Lena Mary Houlihan,Evgenii Belykh,Xiaochun Zhao,Michael G. J. O’Sullivan, andMark C. Preul
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This vignette details the philosophical and historical evolution of the transorbital approach, describing its intriguing, wide-reaching, and checkered development. The progression of this approach within different surgical fields resulted in polarized opinions and a divergence in the use of the corridor. This article illustrates the factors that have influenced neurosurgery's perception and use of the transorbital approach, ranging from influential, enigmatic individuals and societal stigma, to technological developments and a trend toward multidisciplinary collaboration.
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James R. Bean,Alex B. Valadka, andFrederic T. Knape
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Giuseppe Maria Della Pepa,Quintino Giorgio D’Alessandris,Benedetta Burattini,Davide Quaranta,Carmelo Lucio Sturiale,Pier Paolo Mattogno,Roberto Pallini, andAlessandro Olivi
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