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Michael W Collins, Anthony P Kontos, David O Okonkwo, Jon Almquist, Julian Bailes, Mark Barisa, Jeffrey Bazarian, O Josh Bloom, David Brody, Robert Cantu, Javier Cardenas, Jay Clugston, Randall Cohen, Ruben Echemendia, R J Elbin, Richard Ellenbogen, Janna Fonseca, Gerard Gioia, Kevin Guskiewicz, Robert Heyer, Gillian Hotz, Grant L Iverson, Barry Jordan, Geoffrey Manley, Joseph Maroon, Thomas McAllister, Michael McCrea, Anne Mucha, Elizabeth Pieroth, Kenneth Podell, Matthew Pombo, Teena Shetty, Allen Sills, Gary Solomon, Danny G Thomas, Tamara C Valovich McLeod, Tony Yates, Ross Zafonte
BACKGROUND: Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment. OBJECTIVE: To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion...
October 12, 2016: Neurosurgery
John Y-K Lee, Jayesh P Thawani, John Pierce, Ryan Zeh, Maria Martinez-Lage, Michelle Chanin, Ollin Venegas, Sarah Nims, Kim Learned, Jane Keating, Sunil Singhal
BACKGROUND: Although real-time localization of gliomas has improved with intraoperative image guidance systems, these tools are limited by brain shift, surgical cavity deformation, and expense. OBJECTIVE: To propose a novel method to perform near-infrared (NIR) imaging during glioma resections based on preclinical and clinical investigations, in order to localize tumors and to potentially identify residual disease. METHODS: Fifteen patients were identified and administered a Food and Drug Administration-approved, NIR contrast agent (Second Window indocyanine green [ICG], 5 mg/kg) before surgical resection...
October 11, 2016: Neurosurgery
Nickalus R Khan, Matthew A VanLandingham, Tamara M Fierst, Caroline Hymel, Kathryn Hoes, Linton T Evans, Rory Mayer, Fred Barker, Paul Klimo
BACKGROUND: Posttraumatic seizure (PTS) is a significant complication of traumatic brain injury (TBI). OBJECTIVE: To perform a systematic review and meta-analysis to compare levetiracetam with phenytoin for seizure prophylaxis in patients diagnosed with severe TBI. METHODS: An inclusive search of several electronic databases and bibliographies was conducted to identify scientific studies that compared the effect of levetiracetam and phenytoin on PTS...
September 30, 2016: Neurosurgery
Nancy Carney, Annette M Totten, Cindy OʼReilly, Jamie S Ullman, Gregory W J Hawryluk, Michael J Bell, Susan L Bratton, Randall Chesnut, Odette A Harris, Niranjan Kissoon, Andres M Rubiano, Lori Shutter, Robert C Tasker, Monica S Vavilala, Jack Wilberger, David W Wright, Jamshid Ghajar
: The scope and purpose of this work is 2-fold: to synthesize the available evidence and to translate it into recommendations. This document provides recommendations only when there is evidence to support them. As such, they do not constitute a complete protocol for clinical use. Our intention is that these recommendations be used by others to develop treatment protocols, which necessarily need to incorporate consensus and clinical judgment in areas where current evidence is lacking or insufficient...
September 20, 2016: Neurosurgery
Martin Seule, Rimmon Isaak, Renan Sanchez-Porras, Oliver Sakowitz, Emanuela Keller, Andreas Unterberg, Berk Orakcioglu
BACKGROUND: Bedside monitoring of cerebral blood flow (CBF) may provide new insights into the pathophysiology of brain injury, allow early detection of secondary ischemia, and help guide therapy. OBJECTIVE: To evaluate a new brain tissue probe for serial CBF monitoring using near-infrared spectroscopy and indocyanine green dye dilution (NeMo Probe) compared with the existing thermal diffusion probe (QFlow 500 Probe). METHODS: In 7 pigs, the NeMo Probe and QFlow 500 Probe were inserted into the subcortical white matter...
September 9, 2016: Neurosurgery
Leonardo Kapural, Cong Yu, Matthew W Doust, Bradford E Gliner, Ricardo Vallejo, B Todd Sitzman, Kasra Amirdelfan, Donna M Morgan, Thomas L Yearwood, Richard Bundschu, Thomas Yang, Ramsin Benyamin, Abram H Burgher
BACKGROUND: Pain relief with spinal cord stimulation (SCS) has focused historically on paresthesias overlapping chronically painful areas. A higher level evidence supports the use of SCS in treating leg pain than supports back pain, as it is difficult to achieve adequate paresthesia coverage, and then pain relief, in the low back region. In comparison, 10-kHz high-frequency (HF10) SCS therapy does not rely on intraoperative paresthesia mapping and remains paresthesia-free during therapy...
September 6, 2016: Neurosurgery
Aria Nouri, Lindsay Tetreault, Kristian Dalzell, Juan J Zamorano, Michael G Fehlings
BACKGROUND: Degenerative cervical myelopathy encompasses a group of conditions resulting in progressive spinal cord injury through static and dynamic compression. Although a constellation of changes can present on magnetic resonance imaging (MRI), the clinical significance of these findings remains a subject of controversy and discussion. OBJECTIVE: To investigate the relationship between clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathy...
September 5, 2016: Neurosurgery
Wuyang Yang, Judy Huang
No abstract text is available yet for this article.
August 30, 2016: Neurosurgery
Maya A Babu, Robert F Heary, Brian V Nahed
BACKGROUND: The Open Payments Database (OPD) was launched by the Centers for Medicare & Medicaid Services in 2014. Through this online searchable database, the public can explore physician-industry interactions. To date, there is no published literature on the accuracy of the database for neurosurgeons or any physician specialty. OBJECTIVE: To study the accuracy of published records and scope of industry-neurosurgeon relationships between neurosurgeons and industry within the OPD...
August 30, 2016: Neurosurgery
Peter Grunert, Phillip M Reyes, Anna G U S Newcomb, Sara B Towne, Brian P Kelly, Nicholas Theodore, Roger Härtl
BACKGROUND: Multilevel lumbar stenosis, in which 1 level requires stabilization due to spondylolisthesis, is routinely treated with multilevel open laminectomy and fusion. We hypothesized that a minimally invasive (MI) decompression is biomechanically superior to open laminectomy and may allow decompression of the level adjacent the spondylolisthesis without additional fusion. OBJECTIVE: To study the mechanical effect of various decompression procedures adjacent to instrumented segments in cadaver lumbar spines...
August 30, 2016: Neurosurgery
Diego M Morales, Shawgi A Silver, Clinton D Morgan, Deanna Mercer, Terri E Inder, David M Holtzman, Michael J Wallendorf, Rakesh Rao, James P McAllister, David D Limbrick
BACKGROUND: Intraventricular hemorrhage (IVH) is the most frequent, severe neurological complication of prematurity and is associated with posthemorrhagic hydrocephalus (PHH) in up to half of cases. PHH requires lifelong neurosurgical care and is associated with significant cognitive and psychomotor disability. Cerebrospinal fluid (CSF) biomarkers may provide both diagnostic information for PHH and novel insights into its pathophysiology. OBJECTIVE: To explore the diagnostic ability of candidate CSF biomarkers for PHH...
August 26, 2016: Neurosurgery
Malene Kirchmann, Kirstine Karnov, Søren Hansen, Thomas Dethloff, Sven-Eric Stangerup, Per Caye-Thomasen
BACKGROUND: Reports on the natural history of tumor growth and hearing in patients with a vestibular schwannoma (VS) are almost exclusively short-term data. Long-term data are needed for comparison with results of surgery and radiotherapy. OBJECTIVE: To report the long-term occurrence of tumor growth and hearing loss in 156 patients diagnosed with an intracanalicular VS and managed conservatively. METHOD: In this longitudinal cohort study, diagnostic and follow-up magnetic resonance imaging and audiometry were compared...
August 26, 2016: Neurosurgery
Nuria E Martínez Moreno, Jorge Gutiérrez-Sárraga, Germán Rey-Portolés, Roberto Martínez Álvarez
BACKGROUND: Gamma knife radiosurgery (GKRS) is one of the alternatives for treatment for classical trigeminal neuralgia (TN). OBJECTIVE: To retrospectively analyze long-term outcomes for TN using GKRS achieved at our institution. METHODS: One hundred seventeen patients with medically refractory TN treated by GKRS at our institution were followed up between 1993 and 2011. Mean maximum dose was 86.5 Gy (range: 80-90 Gy; median: 90 Gy). Clinical response was defined based on the Burchiel classification...
August 23, 2016: Neurosurgery
David S Hersh, Anthony J Kim, Jeffrey A Winkles, Howard M Eisenberg, Graeme F Woodworth, Victor Frenkel
: Transcranial focused ultrasound (FUS) can noninvasively transmit acoustic energy with a high degree of accuracy and safety to targets and regions within the brain. Technological advances, including phased-array transducers and real-time temperature monitoring with magnetic resonance thermometry, have created new opportunities for FUS research and clinical translation. Neuro-oncology, in particular, has become a major area of interest because FUS offers a multifaceted approach to the treatment of brain tumors...
August 22, 2016: Neurosurgery
Max C Keuken, Andreas Schäfer, Birte U Forstmann
No abstract text is available yet for this article.
August 16, 2016: Neurosurgery
Maria Kamenova, Katharina Lutz, Sabine Schaedelin, Javier Fandino, Luigi Mariani, Jehuda Soleman
BACKGROUND: Antiplatelet therapy in patients with chronic subdural hematoma (cSDH) presents significant neurosurgical challenges. Given the lack of guidelines regarding perioperative management with antiplatelet therapy, it is difficult to balance the patient's increased cardiovascular risk and prevalence of cSDH. OBJECTIVE: To better understand the risk and recurrence rates related to resuming low-dose acetylsalicylic acid (ASA) by evaluating our patients' resumption of low-dose ASA at various times after burr-hole drainage of the hematoma...
August 16, 2016: Neurosurgery
Russell R Lonser, Gautam U Mehta, Bogdan A Kindzelski, Abhik Ray-Chaudhury, Alexander O Vortmeyer, Robert Dickerman, Edward H Oldfield
BACKGROUND: Carney complex (CNC) is a familial neoplasia syndrome that is associated with pituitary-associated hypersecretion of growth hormone (GH) (acromegaly). The underlying cause of pituitary GH hypersecretion and its management have been incompletely defined. OBJECTIVE: To provide biological insight into CNC-associated pituitary pathology and improve management, we analyzed findings in CNC patients who underwent transsphenoidal surgery. METHODS: Consecutive CNC patients at the National Institutes of Health with acromegaly and imaging evidence of a pituitary adenoma(s) who underwent transsphenoidal resection of tumor(s) were included...
August 9, 2016: Neurosurgery
Adam M Sonabend, Brad E Zacharia, Michael B Cloney, Aarón Sonabend, Christopher Showers, Victoria Ebiana, Matthew Nazarian, Kristin R Swanson, Anne Baldock, Henry Brem, Jeffrey N Bruce, William Butler, Daniel P Cahill, Bob Carter, Daniel A Orringer, David W Roberts, Oren Sagher, Nader Sanai, Theodore H Schwartz, Daniel L Silbergeld, Michael B Sisti, Reid C Thompson, Allen E Waziri, Guy McKhann
BACKGROUND: Extent of resection (EOR) correlates with glioblastoma outcomes. Resectability and EOR depend on anatomical, clinical, and surgeon factors. Resectability likely influences outcome in and of itself, but an accurate measurement of resectability remains elusive. An understanding of resectability and the factors that influence it may provide a means to control a confounder in clinical trials and provide reference for decision making. OBJECTIVE: To provide proof of concept of the use of the collective wisdom of experienced brain tumor surgeons in assessing glioblastoma resectability...
August 4, 2016: Neurosurgery
Christopher D Frisch, Jeffrey T Jacob, Matthew L Carlson, Robert L Foote, Colin L W Driscoll, Brian A Neff, Bruce E Pollock, Michael J Link
BACKGROUND: The optimum treatment for cystic vestibular schwannoma (VS) remains controversial. Anecdotally, many treating physicians feel that cystic VSs do not respond to stereotactic radiosurgery (SRS) as well as noncystic tumors. OBJECTIVE: To present outcomes after treatment of predominantly cystic VS with SRS. METHODS: A prospectively maintained clinical database of patients undergoing Gamma Knife (Elekta Instruments, Stockholm, Sweden) radiosurgery (GKRS) for VS at a single tertiary academic referral center was retrospectively reviewed...
August 4, 2016: Neurosurgery
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