Volume 138: Issue 6 (Jun 2023)
inJournal of NeurosurgeryFigure from Xu et al. (pp 1766–1772). With permission from Juan Carlos Fernandez-Miranda and The Neurosurgical Atlas by Aaron A. Cohen-Gadol.
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艾哈迈德Kashkoush,Mohamed E. El-Abtah,Shaarada Srivatsa,Ansh Desai,Mark Davison,Rebecca Achey,Ashutosh Mahapatra,Thomas Patterson,Nina Moore, andMark Bain
In Brief
本研究的目的是比较radiographic outcomes of Woven EndoBridge (WEB) and stent-assisted coil (SAC) embolization for unruptured wide-neck bifurcation aneurysms (WNBAs). Radiographic occlusion rates were similar across treatment groups, although SAC trended toward a higher thromboembolic rate. WEB embolization may be a useful adjunct for the treatment of WNBAs in patients who cannot tolerate the dual antiplatelet therapy required for SAC.
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MirHojjat Khorasanizadeh,Max Shutran,Alfonso Garcia,Alejandro Enriquez-Marulanda,Justin Moore,Christopher S. Ogilvy, andAjith J. Thomas
In Brief
研究人员的调查结果中产男性eal artery (MMA) embolization for the treatment of chronic subdural hematomas to determine whether selection of the MMA branches that are embolized affects treatment outcomes. They found that neither proximal or distal MMA branch embolization nor the number of branches that are embolized affects outcomes. These findings can reduce the technical complexity of the procedure, enhance its safety, and reassure clinicians in anatomically challenging cases.
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Jiangli Han,Fei Liu,Jigang Chen,Xin Tong,Mingyang Han,Fei Peng,Hao Niu,Lang Liu, andAihua Liu
In Brief
Researchers undertook an evaluation of periprocedural cerebrovascular complications and 30–day outcomes of endovascular treatment for intracranial vertebral artery dissecting aneurysms. Hyperlipidemia, ischemic stroke history, and subarachnoid hemorrhage were independent predictors of complications. Preprocedural modified Rankin Scale score > 2 and periprocedural complications were independent risk factors of 30-day unfavorable clinical outcomes. These findings may help to assess the risk of complications and to improve prognosis by guiding better control of risk factors.
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Xiaokang Zhang,Guobin Zhang,Yonggang Wang,Huawei Huang,Haoyi Li,Mingxiao Li,Chuanwei Yang,Ming Li,Hongyan Chen,Bin Jing, andSong Lin
In Brief
The authors used MRI analysis to investigate cortical brain functional mechanisms underlying executive dysfunction in patients with frontal glioma. Abnormally increased resting-state activity and enhanced functional connectivity of the default mode network characterized the development of executive dysfunction in patients with frontal gliomas and were independent of tumor malignancy, volume, and spatial location. This is a new finding, to the authors' knowledge, and could provide a reference for surgical planning to protect executive function in glioma patients.
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Jakob V. E. Gerstl,Alexander G. Yearley,John L. Kilgallon,Philipp Lassarén,Faith C. Robertson,Vendela Herdell,Andy Y. Wang,David J. Segar,Joshua D. Bernstock,Edward R. Laws,Kavitha Ranganathan, andTimothy R. Smith
In Brief
作者第一次执行他们knowledge, a study using a value of lost welfare model to determine the macroeconomic losses attributable to CNS cancer in 173 specific countries. Macroeconomic losses were found to vary across high- and low-income settings and appeared to be region specific. Increased awareness of such country-level economic data is known to incentivize attention to the global financial burden of CNS disease and prioritization of policies to address this problem.
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Sam Ng,Jeremy Deverdun,Anne-Laure Lemaitre,Davide Giampiccolo,Emmanuelle Le Bars,Sylvie Moritz-Gasser,Nicolas Menjot de Champfleur,Hugues Duffau, andGuillaume Herbet
In Brief
The precuneus is at the center of multiple networks and its damage may cause widespread remodeling of the functional connectome. The authors show that low-grade glioma infiltrating this medial area causes remote and large-scale hyperconnectivity patterns that predict the maintenance of executive functions after awake-guided neurosurgery. These findings provide a new vision of the mechanistic underlying neuroplasticity and cognitive compensation in brain tumors and may have implications for elaborating surgical pre-planning in patients with neuro-oncological conditions.
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Emma Kofoed Lauridsen,Urszula Maria Ciochon,Anders Tolver,Mark Bech Knudsen,Laura Giraldi,Jacob Bertram Springborg,Lars Bøgeskov,Lars Poulsgaard,Tiit Mathiesen,Karin Piil, andKåre Fugleholm
In Brief
The authors investigated long-term health-related quality of life (HRQOL), anxiety, and depression after bifrontal craniotomy in patients with subfrontal meningioma. The unexpected key findings were better HRQOL and lower anxiety/depression scores than in general populations and other meningioma and glioblastoma cohorts. This new finding provides hope and comfort for patients, families, and neurosurgeons alike when challenged with the frightening diagnosis of a subfrontal meningioma.
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Kuan-Yu Chen,Shang-Gin Wu,Dar-Ming Lai,Lu-Ting Kuo, andAbel Po-Hao Huang
In Brief
Leptomeningeal metastasis (LM) has been regarded as a terminal disease in patients with non-small cell lung cancer. The authors report the outcomes of treatment modalities stratified by chronological patterns between LM and brain metastasis (BM). Patients who had LM without BM had better survival outcomes (11.6 months) compared with those who had LM after BM (5.4 months) or concurrent LM and BM (5.5 months). This study demonstrated the prolonged survival of patients with LM in the tyrosine kinase inhibitor era and the overall surgical outcome of these patients.
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Ishaan Ashwini Tewarie,Alexander W. Senko,Charissa A. C. Jessurun,Abigail Tianai Zhang,Alexander F. C. Hulsbergen,Luis Rendon,Jack McNulty,Marike L. D. Broekman,Luke C. Peng,Timothy R. Smith, andJohn G. Phillips
In Brief
Researchers used machine learning (ML) to predict leptomeningeal disease (LMD) occurrence and prognosis in surgically treated brain metastasis (BM) patients. Outcomes of LMD patients in the BM population are predictable using a synthetic minority oversampling technique (SMOTE) and ML. LN metastasis of the primary tumor at BM diagnosis and a cerebellar BM location were the strongest LMD risk factors. This study explores LMD risk factors and the ability of ML to enhance LMD prediction performance in a cohort of 1054 surgically treated BMs.
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Takahiro Sasaki,Jun Watanabe,Xingyao He,Hiroaki Katagi,Amreena Suri,Yukitomo Ishi,Kouki Abe,Manabu Natsumeda,William H. Frey II,Peng Zhang, andRintaro Hashizume
In Brief
The authors used a noninvasive drug delivery system, intranasal delivery (IND), combined with nanoliposome formulation of anticancer SN-38 for the treatment of diffuse midline glioma (DMG). IND of liposomal SN-38 increased the drug concentration in tumor cells and antitumor activity, without damaging healthy tissues. The inability of traditional chemotherapy to change the dismal prognosis of this deadly brain cancer makes the potential breakthrough in this new therapeutic approach all the more critical for children with DMG.
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Eun Jung Lee,Hyun-Tai Chung,Hangeul Park,Jin-Wook Kim,Dong Gyu Kim, andSun Ha Paek
In Brief
Researchers thoroughly investigated various dosimetric factors to elucidate an appropriate radiation dose window for benign meningiomas, and D98% and normal tissue volume irradiated with more than 14 Gy were associated with long-term tumor control after Gamma Knife surgery and development of symptomatic radiation toxicity, respectively. The insights gained from this study are an essential step forward to standardizing stereotactic radiosurgery and optimizing outcomes.
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Shoji Yomo,Kyota Oda, andKazuhiro Oguchi
In Brief
Researchers retrospectively investigated, using inverse probability treatment weighting analysis, whether stereotactic radiosurgery (SRS) with concurrent immune checkpoint inhibitors (ICIs) for brain metastases from renal cell carcinomas enhances therapeutic efficacy. SRS with concurrent ICIs provided significant improvements in both patient survival and intracranial disease control, to similar extents (HR 0.3 for both), with no detectable increase in treatment-related adverse events. The optimal radiation dose and timing for inducing a desired immune response remains to be determined.
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Ammoren E. Dohm,Joseph D. Tang,Matthew N. Mills,Casey L. Liveringhouse,Maria L. Sandoval,Bradford A. Perez,Timothy J. Robinson,Benjamin C. Creelan,Jhanelle E. Gray,Arnold B. Etame,Michael A. Vogelbaum,Peter Forsyth,Hsiang-Hsuan Michael Yu,Daniel E. Oliver, andKamran A. Ahmed
In Brief
In a series of 171 non-small cell lung cancer patients with 646 brain metastases, the authors compared treatment with stereotactic radiosurgery (SRS) and immune checkpoint inhibitors (ICIs), epidermal growth factor receptor-tyrosine kinase inhibitors, ICIs and chemotherapy, or chemotherapy alone. Significant differences in distant intracranial control (DIC) following SRS based on systemic therapy were noted. Treatment with SRS prior to receipt of systemic therapy improved DIC. No differences in radionecrosis were noted between groups. Prospective evaluation of the potential synergistic effect between systemic therapy and SRS is warranted.
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Roman O. Kowalchuk,Ajay Niranjan,Judith Hess,Joseph P. Antonios,Michael Y. Zhang,Steve Braunstein,Richard B. Ross,Stylianos Pikis,Christopher P. Deibert,Cheng-chia Lee,Huai-che Yang,Anne-Marie Langlois,David Mathieu,Selcuk Peker,Yavuz Samanci,Chad G. Rusthoven,Veronica Chiang,Zhishuo Wei,L. Dade Lunsford,Daniel M. Trifiletti, andJason P. Sheehan
In Brief
This study explores the value of stereotactic radiosurgery (SRS) for brain metastases from triple-negative breast cancer. Favorable local control is demonstrated, particularly for small metastatic lesions. These results suggest that, despite the poor prognosis of triple-negative breast cancer with brain metastases, SRS may offer clinical benefit for carefully selected patients.
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Pierre-Yves Borius,Anne Christine Januel,Jean Yves Plas,Pierre Duthil,Jean Albert Lotterie,Igor Latorzeff, andJean Sabatier
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You-Cong Chen,Chieh-Chih Tsai,Shih-Jen Chen,Hsiu-Mei Wu,Huai-Che Yang,Ching-Jen Chen,Yong-Sin Hu,Chung-Jung Lin,Wan-Yuo Guo,David Hung-Chi Pan,Wen-Yuh Chung, andCheng-Chia Lee
In Brief
Gamma Knife radiosurgery (GKRS) has been a good option for the treatment of orbital cavernous hemangiomas, but its long-term outcome remained unknown. This retrospective cohort study spanning 22 years showed that single-session GKRS is associated with a high rate of regression in orbital cavernous hemangiomas and remarkable improvement in visual acuity and visual field deficits. GKRS appears to be safe and efficacious in the treatment of orbital cavernous hemangiomas over long-term follow-up.
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Lucas Troude,Valentin Avinens,Kaissar Farah,Mohamed Boucekine,Anne Balossier,Jean Regis,Guillaume Baucher, andPierre-Hugues Roche
In Brief
In this study, the authors assessed the functional and oncological outcomes of nonradical resection of large cerebellopontine angle (CPA) meningiomas followed by additional radiosurgery or careful observation of the residual tumor (wait-and-rescan policy). Important findings were that this strategy provides excellent facial nerve and hearing preservation. Treatment of residual tumor with proactive Gamma Knife radiosurgery resulted in long-term tumor control close to that obtained with gross-total resection. In contrast, tumor regrowth occurred in 50% of patients treated with a wait-and-rescan policy. This case series sheds light on the behavior of CPA meningioma remnants.
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Thibault Passeri,Pierre-Olivier Champagne,Lorenzo Giammattei,Rosaria Abbritti,Jérôme Cartailler,Valentin Calugaru,Loïc Feuvret,Jean-Pierre Guichard,Marc Polivka,Homa Adle-Biassette,Hamid Mammar,Damien Bresson,Philippe Herman,Emmanuel Mandonnet,Bernard George, andSébastien Froelich
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Doo-Sik Kong,Yong Hwy Kim,Won-Jae Lee,Young-Hoon Kim, andChang-Ki Hong
In Brief
Trigeminal schwannoma is a rare CNS tumor and involves a multicompartmental skull base. Researchers evaluated the optimal indications and clinical outcomes of the endoscopic transorbital approach (ETOA) for trigeminal schwannomas based on the tumor classification. The results of the study showed that trigeminal schwannomas can be effectively treated with a minimally invasive ETOA in all types of tumors except those predominantly involving the posterior fossa (type B).
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Georgios Mantziaris,Stylianos Pikis,Tomas Chytka,Roman Liščák,Kimball Sheehan,Darrah Sheehan,Selcuk Peker,Yavuz Samanci,Shray K. Bindal,Ajay Niranjan,L. Dade Lunsford,Rupinder Kaur,Renu Madan,Manjul Tripathi,Dhiraj J. Pangal,Ben A. Strickland,Gabriel Zada,Anne-Marie Langlois,David Mathieu,Ronald E. Warnick,Samir Patel,Zayda Minier,Herwin Speckter,Zhiyuan Xu,Rithika Kormath Anand, andJason P. Sheehan
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Robert C. Osorio,Matheus P. Pereira,Taemin Oh,Rushikesh S. Joshi,Alexander F. Haddad,Kaitlyn M. Pereira,Kevin C. Donohue,Zain Peeran,William Carson,Aarav Badani,Elaina J. Wang,Sweta Sudhir,Ankush Chandra,Saket Jain,Angad Beniwal,José Gurrola II,Ivan H. El-Sayed,Lewis S. Blevins Jr.,Philip V. Theodosopoulos,Sandeep Kunwar, andManish K. Aghi
In Brief
This study examined how preoperative serum prolactin level, tumor volume, and volume-adjusted prolactin level were correlated with postoperative remission status in patients who underwent transsphenoidal prolactinoma resection. Patients without remission had greater volume-adjusted prolactin levels than those who achieved remission, and receiver operating characteristic analysis identified preoperative prolactin and tumor volume thresholds that predicted remission failure. These results may help identify prolactinomas for which surgery offers an increased or decreased likelihood of postoperative remission.
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Fu Zhao,Shi-wei Li,Shun Zhang,Peng Li,Chi Zhao,Xiao-bin Zhao,Chun-Hong Wang,Jing Zhang,Bo Wang, andPi-nan Liu
In Brief
The authors performed a phase II clinical trial to assess the antitumor activity of the epidermal growth factor receptor inhibitor icotinib in patients with neurofibromatosis type 2 (NF2), a rare genetic syndrome. Icotinib treatment was well tolerated, leading to tumor shrinkage of vestibular schwannomas, and protected the hearing function in patients with NF2. These findings may support icotinib treatment as a potential therapeutic approach in this patient population.
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Mitch R. Paro,Michal Dyrda,Srinath Ramanan,Grant Wadman,Stacey-Ann Burke,Isabella Cipollone,Cory Bosworth,Sarah Zurek, andPatrick B. Senatus
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Ali Rajabian,Saman Vinke,Joseph Candelario-Mckeown,Catherine Milabo,Maricel Salazar,Abdul Karim Nizam,Nadia Salloum,Jonathan Hyam,Harith Akram,Eileen Joyce,Thomas Foltynie,Patricia Limousin,Marwan Hariz, andLudvic Zrinzo
In Brief
The accuracy, precision, and safety of frame-based stereotactic MRI to both guide and verify deep brain stimulation (DBS) lead placement were examined. The targeting error was 0.9 mm. Acceptable placement was achieved with a single brain pass for 97% (n = 1164 of 1201) of the leads in 650 consecutive procedures. Two bleeds coincided with immediate lead relocation (p = 0.0058). There were no MRI-related complications, no permanent motor deficits, and no deaths. This is the largest series to date on MRI-guided and MRI-verified DBS.
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Bei Luo,Chang Qiu,Lei Chang,Yue Lu,Wenwen Dong,Dongming Liu,Chen Xue,Jun Yan, andWenbin Zhang
In Brief
Researchers aimed to evaluate the effects of deep brain stimulation (DBS) (off stimulation) on whole-brain degree centrality (DC) and seed-based functional connectivity in Parkinson's disease patients. This study found that DBS can reduce the DC values of default mode network-related brain areas and increase the DC value of the motor cortex. These results suggest that postoperative improvement in motor symptoms and decline in verbal fluency performance may be related to large-scale network reorganization.
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Zhihao Guo,Chao Zhang,Xiu Wang,Chang Liu,Baotian Zhao,Jiajie Mo,Zhong Zheng,Xiaoqiu Shao,Jianguo Zhang,Kai Zhang, andWenhan Hu
In Brief
Researchers aimed to explore whether intracranial electroencephalography (EEG) monitoring is mandatory for MRI-negative neocortical epilepsy surgery. When clinical and EEG features are strongly suggestive of focal cortical dysplasia type II, direct neocortical resection may be a feasible surgical procedure if the focal hypometabolism is confined to a single gyrus or sulcus and is consistent with the electroclinical findings. These findings could contribute to guiding clinical decision-making and rational allocation of medical resources.
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Jonathan P. Funnell,Kawsar Noor,Danyal Z. Khan,Linda D’Antona,Richard J. B. Dobson,John G. Hanrahan,Christopher Hepworth,Eleanor M. Moncur,Benjamin M. Thomas,Lewis Thorne,Laurence D. Watkins,Simon C. Williams,Wai Keong Wong,Ahmed K. Toma, andHani J. Marcus
In Brief
本文描述了一个自然的发展language processing algorithm to recognize features of idiopathic normal pressure hydrocephalus in electronic health records. The trained model showed high precision and recall, most frequently extracting symptoms and signs relating to mobility, cognitive impairment, and falls or balance. This is valuable to the development of natural language processing tools in neurosurgery and suggests future potential for the automated detection of patients with idiopathic normal pressure hydrocephalus from electronic health records.
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Wilson A. M. Fisher,Michael P. Catalino,E. Alice Woolard,Bethany J. Andrews,Scott Elton, andCarolyn Quinsey
In Brief
Investigators analyzed the impact of surgical instrument, technique, and catheter type on the mechanical integrity of the ventriculoperitoneal shunt system. Mosquito forceps with shods caused the least amount of catheter damage, DeBakey forceps caused the most damage, a superior shunt assembly technique was demonstrated, and no difference in durability of rifampin and barium catheters was found. This was the first study to characterize how commonly used surgical instruments can cause physical damage to shunt hardware components.
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Elijah M. Persad-Paisley,Sarah B. Andrea,Owen P. Leary,Orianna D. Carvalho,Victoria G. Zeyl,Amanda R. Laguna,Matthew N. Anderson,Belinda Shao,Steven A. Toms,Adetokunbo A. Oyelese,Ziya L. Gokaslan, andKatherine M. Sharkey
In Brief
Researchers used a novel statistical approach to measure racial diversity trends in the neurosurgery pipeline, evaluating cohorts of students from their entry into medical school through their application to and entry into neurosurgery residency programs. Disproportionately fewer Black medical students apply to neurosurgery residencies, while Hispanic individuals are becoming increasingly represented in neurosurgery residency but remain underrepresented relative to the US population. Understanding the weaknesses in the neurosurgery pipeline will help focus ongoing diversity efforts.
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Krystal L. Tomei,Tiffany R. Hodges,Ellie Ragsdale,Tyler Katz,Marjorie Greenfield, andJennifer A. Sweet
In Brief
As the number of women in the neurosurgical workforce increases, unique circumstances that may disproportionately impact their training and safety must be considered. The objective of this paper was to examine risks inherent to the pregnant neurosurgical resident from occupational exposures and pregnancy physiology. The authors have come up with recommendations for both the pregnant resident and their residency programs to mitigate these risks with a focus on the impact on their education as well as on their colleagues.
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Yuanzhi Xu,Vera Vigo,Joshua Klein,Maximiliano Alberto Nunez,Juan C. Fernandez-Miranda,Aaron A. Cohen-Gadol, andYing Mao
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Mareshah N. Sowah,Anthony T. Fuller,Stephanie H. Chen,Barth A. Green,Michael E. Ivan,Henri R. Ford,Gregory J. Zipfel,Brenton Pennicooke,Nicholas Theodore, andAllan D. Levi
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Luigi Albano,Marco Losa,Lina Raffaella Barzaghi, andPietro Mortini
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