Volume 136: Issue 1 (Jan 2022)
inJournal of NeurosurgeryIllustration from Schneider et al. (pp 205–214). Copyright Elyssa Siegel. Published with permission.
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Tito Vivas-Buitrago,Ricardo A. Domingo,Shashwat Tripathi,Gaetano De Biase,Desmond Brown,Oluwaseun O. Akinduro,Andres Ramos-Fresnedo,David S. Sabsevitz,Bernard R. Bendok,Wendy Sherman,Ian F. Parney,Mark E. Jentoft,Erik H. Middlebrooks,Fredric B. Meyer,Kaisorn L. Chaichana, andAlfredo Quinones-Hinojosa
In Brief
Supramarginal resection (SMR)—resection beyond T1-weighted post-contrast enhancement but within the boundaries of FLAIR-hyperintense signal—may have a beneficial influence on the overall survival (OS) of patients diagnosed with IDH-wild-type glioblastoma who undergo gross-total resection of the contrast-enhanced tumor. The results show that increased SMR was associated with significantly beneficial OS, regardless of age or any other factor. A minimum SMR of 20% was associated with beneficial OS, with no significant influence seen with SMR greater than 60%.
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Sadahiro Kaneko,Eric Suero Molina,Peter Sporns,Stephanie Schipmann,David Black, andWalter Stummer
In Brief
The objective of this study was to investigate the real-time kinetics of protoporphyrin IX in low-grade glioma (LGG) based on hyperspectral fluorescence-based measurements and identify factors that predict fluorescence. Maximum fluorescence was measured within a 7- to 8-hour time frame. Gadolinium enhancement, Ki-67/MIB-1 index,18F-fluoroethyl-l-tyrosine (18F-FET) PET uptake ratio, and apparent diffusion coefficient–based tumor cellularity differed significantly between fluorescing and nonfluorescing tissue. Logistic regression demonstrated18F-FET PET uptake and Ki-67/MIB-1 index as independently related to fluorescence. These findings have implications for the timing and case selection of 5-aminolevulinic acid administration in LGG.
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Marco Rossi,Guglielmo Puglisi,Marco Conti Nibali,Luca Viganò,Tommaso Sciortino,Lorenzo Gay,Antonella Leonetti,Paola Zito,Marco Riva, andLorenzo Bello
In Brief
By analyzing a series of patients with tumors located in the nondominant perirolandic area who underwent operations with brain-mapping techniques, the authors identified clinical and imaging variables associated with asleep versus awake motor mapping in order to generate a score. The clinical validity of this score was validated in a prospective series.
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Desmond A. Brown,Anshit Goyal,Kent R. Richter,Jack M. Haglin,Benjamin T. Himes,Victor M. Lu,Kendall Snyder,Joshua Hughes,Paul A. Decker,Michael Opoku-Darko,Michael J. Link,Terry C. Burns, andIan F. Parney
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Alvin Y. Chan,Elliot H. Choi,Michael Y. Oh,Sumeet Vadera,Jefferson W. Chen,Kiarash Golshani,William C. Wilson, andFrank P. K. Hsu
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Domenique M. J. Müller,Pierre A. Robe,Hilko Ardon,Frederik Barkhof,Lorenzo Bello,Mitchel S. Berger,Wim Bouwknegt,Wimar A. Van den Brink,Marco Conti Nibali,Roelant S. Eijgelaar,Julia Furtner,Seunggu J. Han,Shawn L. Hervey-Jumper,Albert J. S. Idema,Barbara Kiesel,Alfred Kloet,阿马ndonnet,Jan C. De Munck,Marco Rossi,Tommaso Sciortino,W. Peter Vandertop,Martin Visser,Michiel Wagemakers,Georg Widhalm,Marnix G. Witte,Aeilko H. Zwinderman, andPhilip C. De Witt Hamer
In Brief
The authors used resection probability maps to quantify and compare glioblastoma surgery decisions from each of 12 neurosurgical teams with those of the other teams. The neurosurgical teams were found to generally agree on which glioblastoma-infiltrated brain regions to biopsy and which to resect, and the few observed differences indicated surgical controversies. The benchmark probability maps of glioblastoma surgery decisions will serve quality-of-care discussions and may steepen the learning curve of neurosurgical education.
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Pavan P. Shah,Jennifer L. Franke,Ravi Medikonda,Christopher M. Jackson,Siddhartha Srivastava,John Choi,Patrick M. Forde,Julie R. Brahmer,David S. Ettinger,Josephine L. Feliciano,Benjamin P. Levy,Kristen A. Marrone,Jarushka Naidoo,Kristin J. Redmond,Lawrence R. Kleinberg, andMichael Lim
In Brief
这一回顾性队列研究的目的as to determine the associations of driver mutation status and targeted therapy with survival of patients with non-small cell lung cancer after resection of brain metastasis. Patients with EGFR mutation who received targeted tyrosine kinase inhibitor therapy had significantly improved survival compared with patients with wild-type tumor. This study highlights the heterogeneity of lung cancer and the need for precision therapy to determine prognosis and treatment.
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Lianwang Li,Shengyu Fang,Guanzhang Li,Kenan Zhang,Ruoyu Huang,Yinyan Wang,Chuanbao Zhang,Yiming Li,Wei Zhang,Zhong Zhang,Qiang Jin,Dabiao Zhou,Xing Fan, andTao Jiang
In Brief
Researchers investigated the epidemiological characteristics, associated risk factors, and prognostic value of glioma-related epilepsy in patients with diffuse high-grade gliomas diagnosed after implementation of the 2016 updated World Health Organization classification. The occurrence of preoperative and postoperative glioma-related epilepsy was associated with 3 and 4 clinical characteristics, respectively. Postoperative glioma-related epilepsy predicted longer overall survival time. The results provided new insights into the management of glioma-related epilepsy for the benefit of patients with diffuse high-grade gliomas.
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Kenichiro Asano,Seiko Hasegawa,Masashi Matsuzaka, andHiroki Ohkuma
In Brief
This study aimed to determine the incidence of brain tumor–related epilepsy (BTE) associated with metastatic brain tumors and retrospectively investigate the risk factors. BTE was recorded in 24.6% of patients during the entire course of treatment. Logistic regression analysis identified young age, male sex, breast cancer, eloquent area, peritumoral edema, dissemination, and maximum tumor volume as significant risk factors. BTE was more common with tumor volumes greater than the cutoff value of 1.92 ml.
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Josh Neman,Meredith Franklin,Zachary Madaj,Krutika Deshpande,Timothy J. Triche Jr.,Gal Sadlik,John D Carmichael,Eric Chang,Cheng Yu,Ben A Strickland, andGabriel Zada
In Brief
The authors asked whether nonrandom distributions of brain metastasis vary according to primary cancer subtype and stereotactic radiosurgery coordinates utilized for treatment of brain metastasis. The authors concluded that nonuniform spatial distributions of metastasis to preferential brain regions vary according to primary cancer subtype. These cancer-specific brain topographic patterns may underlie the ability of tumor cells to adapt to regional neural microenvironments in order to facilitate colonization and establish metastasis.
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Meeki Lad,Radhika Gupta,Alex Raman,Neil Parikh,Raghav Gupta,Ankush Chandra,Ashok Para,Manish K. Aghi, andJustin Moore
In Brief
The authors used Medicare data from 2009 to 2018 to elucidate trends in intracranial neoplasm treatment and compare reimbursements for stereotactic radiosurgery (SRS) and open resection. The authors found that the increase in the number of SRS procedures outpaced the baseline expansion of Medicare enrollees, while the relative number of comparable craniotomies declined. The authors also found that Medicare reimbursed 2.9 times as much for open resection than SRS during the study period.
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Nasser Mohammed,Yi-Chieh Hung,Zhiyuan Xu,Tomas Chytka,Roman Liscak,Manjul Tripathi,David Arsanious,Christopher P. Cifarelli,Marco Perez Caceres,David Mathieu,Herwin Speckter,Gautam U. Mehta,Gregory P. Lekovic, andJason P. Sheehan
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Ofer Sadan,Hannah Waddel,Reneé Moore,陈冯,Yajun Mei,David Pearce,Jacqueline Kraft,Cederic Pimentel,Subin Mathew,Feras Akbik,Pouya Ameli,Alexis Taylor,Lisa Danyluk,Kathleen S. Martin,Krista Garner,Jennifer Kolenda,Amit Pujari,William Asbury,Blessing N. R. Jaja,R. Loch Macdonald,C. Michael Cawley,丹尼尔·l·巴罗, andOwen Samuels
In Brief
The authors report the largest subarachnoid hemorrhage (SAH) patient cohort treated with intrathecal (IT) nicardipine (n = 422) for cerebral vasospasm. IT nicardipine led to a rapid and lasting improvement in arterial transcranial Doppler velocities. In a propensity score-based comparison with the SAH International Trialists database, treatment with IT nicardipine was associated with reduced delayed cerebral ischemia and improved functional outcomes. These encouraging data will assist in planning a randomized controlled clinical trial treating SAH-related vasospasm.
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Joshua S. Catapano,Fabio A. Frisoli,Candice L. Nguyen,Mohamed A. Labib,Tyler S. Cole,Jacob F. Baranoski,Helen Kim,Robert F. Spetzler, andMichael T. Lawton
In Brief
We analyzed the operability boundary for AVMs and characterized the AVM subsets with good or poor patient outcomes. Patients with supplemented Spetzler-Martin (Supp-SM) grade 7 AVMs had worse outcomes, making Supp-SM grade 6 an appropriate operability cutoff. Interestingly, patients with Supp-SM grade 7 AVMs characterized by young age and a small AVM nidus had favorable outcomes. These findings assist neurosurgeons in decision making for lesions at the operability boundary (Supp-SM grades 6 and 7 AVMs).
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Michael L. Martini,Sean N. Neifert,William H. Shuman,Emily K. Chapman,Alexander J. Schüpper,Eric K. Oermann,J Mocco,Michael Todd,James C. Torner,Andrew Molyneux,Stephan Mayer,Peter Le Roux,Mervyn D. I. Vergouwen,Gabriel J. E. Rinkel,George K. C. Wong,Peter Kirkpatrick,Audrey Quinn,Daniel Hänggi,Nima Etminan,Walter M. van den Bergh,Blessing N. R. Jaja,Michael Cusimano,Tom A. Schweizer,Jose I. Suarez,Hitoshi Fukuda,Sen Yamagata,Benjamin Lo,Airton Leonardo de Oliveira Manoel,Hieronymus D. Boogaarts,R. Loch Macdonald, andon behalf of the SAHIT Collaboration
In Brief
Researchers applied explainable machine learning techniques to identify factors associated with better outcomes after rescue therapy for postsubarachnoid hemorrhage vasospasm. Younger age and absence of delayed cerebral ischemia/infarction were linked to better rescue outcomes. A machine learning-based, propensity score-matched analysis showed that rescue was associated with higher odds of better 3-month outcome. These findings suggest that trials focusing on preventative or therapeutic interventions in patients with delayed cerebral ischemia/infarction may be most able to demonstrate improvements in outcomes.
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Sen Gao,Jeffrey Nelson,Shantel Weinsheimer,Ethan A. Winkler,Caleb Rutledge,Adib A. Abla,Nalin Gupta,Joseph T. Shieh,Daniel L. Cooke,Steven W. Hetts,Tarik Tihan,Christopher P. Hess,Nerissa Ko,Brian P. Walcott,Charles E. McCulloch,Michael T. Lawton,Hua Su,Ludmila Pawlikowska, andHelen Kim
In Brief
The study objectives were to screen mitogen-activated protein kinase (MAPK) pathway genes for somatic mutations in patients with sporadic brain arteriovenous malformation (BAVM) and to evaluate associations between somatic mutations and phenotypes of BAVM severity. The study replicated the high prevalence of somatic KRAS mutations in patients with BAVM and identified candidate somatic mutations in other MAPK pathway genes, but it did not find associations with phenotype. The study confirms the importance of KRAS mutations in patients with sporadic BAVM and provides additional MAPK pathway targets for investigation.
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Seppo Juvela
In Brief
In an almost lifelong prospective follow-up study of patients with unruptured intracranial aneurysms and with minimal treatment selection bias, the author compared the population, hypertension, age, size of aneurysm, earlier aneurysm rupture, site of aneurysm (PHASES) score with his own new one for predicting aneurysm rupture risk. Both scores predicted the long-term aneurysm rupture risk moderately well, with the new one, which also included smoking, being easier and slightly better in clinical practice. The findings suggest that decisions about the treatment of unruptured aneurysms in patients of working age can be made with an improved cost-effectiveness.
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Ali Tayebi Meybodi,Arjun Gadhiya,Leandro Borba Moreira, andMichael T. Lawton
In Brief
Bypass surgery has evolved into a complex art that incorporates a variety of donors, recipients, interpositional grafts, anastomoses, and suturing techniques. Given these contemporary advancements in bypass techniques, the existing nomenclature that joins abbreviations for donor and recipient arteries with a hyphen is simplistic and uninformative. The authors propose a new nomenclature system based on segmental anatomy and anastomotic details that uses alphanumeric shorthand to code bypasses simply, succinctly, and accurately and clarify technical details, thus encouraging greater descriptive precision.
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Richard Voldřich,David Netuka,František Charvát, andVladimír Beneš
In Brief
Transarterial embolization using Onyx is the method of choice for the treatment of dural arteriovenous fistulas (DAVFs). The long-term stability of Onyx has been questioned, and digital subtraction angiography (DSA) has been dogmatically used in patient follow-up. The authors' cohort is one of the largest series with long-term follow-up and the only study in which DSA and MR angiography (MRA) findings are prospectively compared. The results confirm the long-term stability of Onyx and suggest that MRA may be a sufficient diagnostic method in patients with embolized DAVFs.
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Mark Bigder,Omar Choudhri,Mihir Gupta,Santosh Gummidipundi,Summer S. Han,Ephraim W. Church,Steven D. Chang,Richard P. Levy,Huy M. Do,Michael P. Marks, andGary K. Steinberg
In Brief
The authors report a large series of patients with arteriovenous malformations that were treated with preoperative stereotactic radiosurgery as a surgical adjunct. They discuss the utility of multimodal therapy and presurgical stereotactic radiosurgery. Despite the majority of lesions being Spetzler-Martin grade III-V arteriovenous malformations, high rates of arteriovenous malformation obliteration and optimal outcomes were obtained in their series.
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Yang Liu,Daniel Gebrezgiabhier,Adithya S. Reddy,Evan Davis,Yihao Zheng,Jorge L. Arturo Larco,Albert J. Shih,Aditya S. Pandey, andLuis E. Savastano
In Brief
This cadaveric study enhances the understanding of the failure modes of thrombectomy in stroke and provides new knowledge for the development of next-generation devices and techniques. The artery/device/clot interactions were analyzed in more than 100 recanalization attempts with aspiration catheters and stent retrievers by transmural visualization, revealing intraluminal clot fragmentation and iatrogenic embolization, weak device/clot integration with persistent occlusion, residual occlusion in small branching and perforating arteries, arterial collapse, and arterial traction with avulsion.
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Julia R. Schneider,Amrit K. Chiluwal,Mohsen Nouri,Giyarpuram N. Prashant, andAmir R. Dehdashti
In Brief
The authors sought to investigate use of the retrosigmoid transhorizontal (RSTH) approach to dissect the horizontal fissure and to gain better access for resection of lateral pontine cavernous malformation. This approach had a shorter operative time than the transpetrosal presigmoid retrolabyrinthine technique. Also, the RSTH approach provided a direct and safer route to the lesion via the infratrigeminal safe entry zone. The RSTH route should be considered an alternative technique for selected patients with pontine cavernous malformation.
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Philippe De Vloo,Alexandre Boutet,Gavin J. B. Elias,Robert M. Gramer,Suresh E. Joel,Maheleth Llinas,Walter Kucharczyk,Alfonso Fasano,Clement Hamani, andAndres M Lozano
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Clara Kwon Starkweather,Sarah K. Bick,Jeffrey M. McHugh,Darin D. Dougherty, andZiv M. Williams
In Brief
In patients with obsessive-compulsive disorder (OCD), the authors evaluated the relation of the neuroanatomical location of cingulotomy treatment to symptomatic improvement to determine whether the lesion placement sites during treatment are related to responder status. Using an anatomical registration matrix, the authors found that cingulotomy lesions that were placed more superiorly and posteriorly within Brodmann area 32 conferred a higher likelihood of response, a finding that is important because the precise underlying neuroanatomical basis for the beneficial effects of this treatment in OCD patients has thus far been poorly understood.
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Takashi Morishita,Yuki Sakai,Hitoshi Iida,Saki Yoshimura,Atsushi Ishii,Shinsuke Fujioka,Saori C. Tanaka, andTooru Inoue
In Brief
本研究旨在评估选择的关系ween the anatomical location of stimulation fields and clinical responses in thalamic deep brain stimulation for treatment-resistant Tourette syndrome. The existence of a sweet spot to ameliorate the tic symptoms and the stimulation field associated with limbic side effects was revealed. This study demonstrates one strategy for effective deep brain stimulation lead implantation and programming.
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Ana M. Castaño-Leon,Marta Cicuendez,Blanca Navarro-Main,Igor Paredes,Pablo M. Munarriz,Amaya Hilario,Ana Ramos,Pedro A. Gomez, andAlfonso Lagares
In Brief
Researchers described the presence of macroscopic traumatic axonal injury-related lesions by conventional MRI and alterations in fractional anisotropy in 28 white matter bundles by diffusion tensor imaging in 277 patients with moderate to severe TBI. The combination of the information provided by the two neuroimaging techniques in a model improved the performance of the model compared to traditional prognostic models, suggesting a complementary role. External validation of the new model has yet to be determined.
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Jin Young Youm,Jae Hoon Lee, andHyun Seok Park
In Brief
The exact method of defining the boundary in the optic nerve sheath diameter (ONSD) measurements has not been determined. The authors aimed to compare different methods of obtaining this measurement. They found that, compared with the ONSD excluding the dura mater, the ONSD including the dura mater better estimated the intracranial pressure (ICP). The ONSD/eyeball transverse diameter ratio including the dura mater with a cutoff value of 0.264 best predicted increased ICP. This measurement may be helpful in patients who require invasive ICP monitoring.
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Brian H. Rowe,Esther H. Yang,Lindsay A. Gaudet,Leeor Eliyahu,Daniela R. Junqueira,Jeremy Beach,Martin Mrazik,Garnet Cummings, andDonald Voaklander
In Brief
This study examined the differences in outcomes and risk factors for persistent symptoms between men and women in a community sample of adult patients with concussion who presented to three Canadian emergency departments. While demographic differences between the sexes were uncommon, women reported more symptoms and experienced a delay in recovery after discharge. These results represented real-world evidence of sex differences in patients with concussion and reinforced the need to consider patient sex in the management and future research.
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Neha Siddiqui,Ryan G. Chiu,Ravi S. Nunna,格鲁吉亚Glastris, andAnkit。梅塔
In Brief
Researchers determine the impact of the FDA Safety Innovation Act (SIA), which is meant to increase diversity in clinical trials for device approvals, on neurosurgical devices. It was found that race and ethnicity were significantly different from the general population in neurosurgical device trials, both before and after the implementation of the SIA. This study demonstrates the need for more effective mechanisms to increase participant diversity in the realm of neurosurgery device clinical trials.
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Robert Herrmann,Maureen Dreher,Andrew Farb,Michael Hoffmann,Christopher M. Loftus,Nina Mezu-Nwaba,Vivek Pinto,Xiaolin Zheng, andCarlos Peña
In Brief
The authors provided an overview of FDA efforts to facilitate the initiation of early feasibility clinical studies using novel neurological and physical medicine devices. The FDA uses several approaches to work with innovators and developers to initiate these early feasibility clinical studies in the US. The approaches outlined in this article will help ensure that high-quality, safe, and effective neurological devices reach US patients in a timely manner.
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Luke G. F. Smith,E. Antonio Chiocca,Gregory J. Zipfel,Adam G. F. Smith,Michael W. Groff,Regis W. Haid, andRussell R. Lonser
In Brief
作者评估了promisi之间的联系ng neurosurgeon-scientists of being awarded Neurosurgery Research and Education Foundation (NREF) in-training and early career funding with subsequently receiving National Institutes of Health (NIH) funding. The study results indicate that a significant portion of awardees of NREF grants went on to obtain NIH funding, which resulted in a large multiplicative impact of NREF in-training and early career funding.
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Wuyang Yang,Jordina Rincon-Torroella,James Feghali,Adham M. Khalafallah,Wataru Ishida,Alexander Perdomo-Pantoja,Alfredo Quiñones-Hinojosa,Michael Lim,Gary L. Gallia,Gregory J. Riggins,William S. Anderson,Sheng-Fu Larry Lo,Daniele Rigamonti,Rafael J. Tamargo,Timothy F. Witham,阿里Bydon,Alan R. Cohen,George I. Jallo,Alban Latremoliere,Mark G. Luciano,Debraj Mukherjee,Alessandro Olivi,Lintao Qu,Ziya L. Gokaslan,Daniel M. Sciubba,Betty Tyler,Henry Brem, andJudy Huang
In Brief
本文的目的是展示交流ademic impact of international research fellows in the field of neurosurgery. Despite facing major challenges, international research fellows make substantial academic contributions and reciprocate mentorship in the neurosurgical department. This finding should encourage continued recruitment of global talents to the field of neurosurgery.
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Sakibul Huq,Chris A. Philips,Walavan Sivakumar,David L. Dornbos III,Christopher S. Graffeo,Debraj Mukherjee,Stacey Q. Wolfe, andJeremiah N. Johnson
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Nathan Beucler,Aurore Sellier, andArnaud Dagain
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Chidinma M. Wilson,Nolan J. Brown, andDonald K. E. Detchou
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Rakesh Mishra,Adesh Shrivastava,Sumit Raj,Pradeep Chouksey, andAmit Agrawal
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Ariana Alejandra Chacón-Aponte,Erika Andrea Durán-Vargas,Ivan David Lozada-Martínez,Yelson Alejandro Picón-Jaimes,Tariq Janjua, andLuis Rafael Moscote-Salazar
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Robert N. Holdefer,Christoph N. Seubert,Stanley A. Skinner, and安德鲁·t·亨伯特
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