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Mohammed Jaber, Christian Ewelt, Johannes Wölfer, Benjamin Brokinkel, Christian Thomas, Martin Hasselblatt, Oliver Grauer, Walter Stummer
BACKGROUND: Approximately 20% of low-grade gliomas (LGG) display visible protoporphyrin fluorescence during surgery after 5-aminolevulinic acid (5-ALA) administration. OBJECTIVE: To determine if fluorescence represents a prognostic marker in LGG. METHODS: Seventy-four consecutive patients with LGG (World Health Organization 2016) were operated on with 5-ALA. Fluorescent tissue was specifically biopsied. Tumor size, age, Karnofsky index, contrast-enhancement, fluorescence, and molecular factors (IDH1/IDH2-mutations, Ki67/MIB1 Index, 1p19q codeletions, ATRX, EGFR, p53 expression, and O6-methylguanine DNA methyltransferase promotor methylation), were related to progression-free survival (PFS), malignant transformation-free survival (MTFS) and overall survival (OS)...
August 9, 2018: Neurosurgery
Christian Heinen, Patrick Dömer, Thomas Schmidt, Bettina Kewitz, Ulrike Janssen-Bienhold, Thomas Kretschmer
BACKGROUND: Clinical and electrophysiological assessments prevail in evaluation of traumatic nerve lesions and their regeneration following nerve surgery in humans. Recently, high-resolution neurosonography (HRNS) and magnetic resonance neurography have gained significant importance in peripheral nerve imaging. The use of the grey-scale-based "fascicular ratio" (FR) was established using both modalities allowing for quantitative assessment. OBJECTIVE: To find out whether FR using HRNS can assess nerve trauma and structural reorganization in correlation to postoperative clinical development...
August 9, 2018: Neurosurgery
Alice L Hung, Wuyang Yang, Bowen Jiang, Tomas Garzon-Muvdi, Justin M Caplan, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Judy Huang
BACKGROUND: Previous reports indicated an association between hemorrhagic presentation and flow-related aneurysms in arteriovenous malformation (AVM) patients. However, it remains unclear whether these flow-related aneurysms result in the hemorrhage of AVM. OBJECTIVE: To characterize this hemorrhage risk using our institutional experience over 25 yr. METHODS: We retrospectively reviewed records of patients at our institution diagnosed with AVM from 1990 to 2015...
August 9, 2018: Neurosurgery
Jason Pui Yin Cheung, Karen Yiu, Kenny Kwan, Kenneth M C Cheung
BACKGROUND: There is no agreement on frequency of distractions of magnetically controlled growing rods (MCGRs) but more frequent and smaller amounts of distractions mimic physiological spine growth. The mid- to long-term follow-up and management at skeletal maturity is unknown. OBJECTIVE: To analyze patients with mean 6 yr of follow-up and describe the fate of MCGR graduates. METHODS: Early onset scoliosis (EOS) patients treated with MCGRs with minimum 4 yr of follow-up and/or at graduation were studied...
August 9, 2018: Neurosurgery
Maya A Babu, Ann R Stroink, Shelly D Timmons, Katie O Orrico, J Adair Prall
Traditionally, neurosurgeons have responded to calls to treat new patients or address emergent, acute neurosurgical pathology in the hospitals they staff as part of their duty to the medical profession and community. Due to increasing financial pressures placed upon neurosurgical practice from hospitals and regulatory mandates, remuneration for neurosurgeon availability to serve on trauma call has become more frequent and is increasingly seen as essential. In this study, we present the first peer-review published survey of neurosurgical emergency and trauma call coverage patterns, scope, schedules, compensation, liability exposure, and call cessation...
August 8, 2018: Neurosurgery
John T Pierce, Steve S Cho, Shayoni Nag, Ryan Zeh, Jun Jeon, David Holt, Amy Durham, MacLean P Nasrallah, Sunil Singhal, John Y K Lee
BACKGROUND: Meningiomas are well-encapsulated benign brain tumors and surgical resection is often curative. Nevertheless, this is not always possible due to the difficulty of identifying residual disease intraoperatively. We hypothesized that meningiomas overexpress folate receptor alpha (FRα), allowing intraoperative molecular imaging by targeting FRα with a near-infrared (NIR) dye. OBJECTIVE: To determine FRα expression in both human and canine meningioma cohorts to prepare for future clinical studies...
August 3, 2018: Neurosurgery
Paul Park, David R Nerenz, Ilyas S Aleem, Lonni R Schultz, Michael Bazydlo, Shujie Xiao, Hesham M Zakaria, Jason M Schwalb, Muwaffak M Abdulhak, Mark E Oppenlander, Victor W Chang
BACKGROUND: Most studies have evaluated 30-d readmissions after lumbar fusion surgery. Evaluation of the 90-d period, however, allows a more comprehensive assessment of factors associated with readmission. OBJECTIVE: To assess the reasons and risk factors for 90-d readmissions after lumbar fusion surgery. METHODS: The Michigan Spine Surgery Improvement Collaborative (MSSIC) registry is a prospective, multicenter, and spine-specific database of patients surgically treated for degenerative disease...
August 3, 2018: Neurosurgery
Yen-Ying Chen, Hsiang-Ling Ho, Shih-Chieh Lin, Chih-Yi Hsu, Donald Ming-Tak Ho
BACKGROUND: IDH mutation is an important prognostic factor of diffuse astrocytomas. Although the majority of IDH mutations could be identified by immunohistochemical (IHC) stain for R132H-mutant IDH1, DNA sequencing would be required for IHC negative cases to determine their IDH mutation status. This approach is not cost-effective for tumors with low IDH mutation rates. OBJECTIVE: To investigate whether BCAT1 could be used as a surrogate marker for IDH mutations, because BCAT1 is an enzyme related to IDH genes...
August 3, 2018: Neurosurgery
Jonathan G Hobbs, Akash S Patel, Anisse N Chaker, Nazmul Hasan, Prateek Kumar, Edwin Ramos, Ankit I Mehta
BACKGROUND: Steroid administration is part of a standard treatment regimen in metastatic spinal cord compression, though the appropriate dose, duration, efficacy, and risks remain controversial. OBJECTIVE: To analyze the risk of preoperative steroid use on 30-d mortality in surgical metastatic spinal tumors with dissemination disease using a large multicenter national database. METHODS: Adult patients who underwent surgical treatment for metastatic spine tumors between 2005 and 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
August 3, 2018: Neurosurgery
Michel Roethlisberger, Rita Achermann, Schatlo Bawarjan, Martin N Stienen, Christian Fung, Donato D'Alonzo, Nicolai Maldaner, Andrea Ferrari, Marco V Corniola, Daniel Schöni, Johannes Goldberg, Daniele Valsecchi, Thomas Robert, Rodolfo Maduri, Martin A Seule, Jan-Karl Burkhardt, Serge Marbacher, Philippe Bijlenga, Kristine A Blackham, Heiner C Bucher, Luigi Mariani, Raphael Guzman, Daniel W Zumofen
BACKGROUND: One-third of patients with aneurysmal subarachnoid hemorrhage (aSAH) have multiple intracranial aneurysms (MIA). OBJECTIVE: To determine the predictors of outcome in aSAH patients with MIA compared to aSAH patients with a single intracranial aneurysm (SIA). METHODS: The Swiss Study of Subarachnoid Hemorrhage dataset 2009-2014 was used to evaluate outcome in aSAH patients with MIA compared to patients with SIA with the aid of descriptive and multivariate regression analysis...
August 3, 2018: Neurosurgery
Min Lang, John Tsiang, Nina Z Moore, Mark D Bain, Michael P Steinmetz
Robert J. White is probably best known as the first neurosurgeon to perform successful "cephalic exchange" on monkeys in 1971. However, he was also a pioneer in the field of neurosurgery and contributed tremendously to the field of neuroanesthesia and bioethics. White received medical training at the University of Minnesota, Harvard University, Peter Bent Brigham Hospital, and Mayo Clinic before becoming the first Chief of Neurosurgery at Metrohealth Hospital in Cleveland, Ohio. He made significant strides in the field of spinal cord cooling and hypothermia...
August 3, 2018: Neurosurgery
T Forcht Dagi
No abstract text is available yet for this article.
August 3, 2018: Neurosurgery
Whitney E Muhlestein, Dallin S Akagi, Jason M Davies, Lola B Chambless
BACKGROUND: Current outcomes prediction tools are largely based on and limited by regression methods. Utilization of machine learning (ML) methods that can handle multiple diverse inputs could strengthen predictive abilities and improve patient outcomes. Inpatient length of stay (LOS) is one such outcome that serves as a surrogate for patient disease severity and resource utilization. OBJECTIVE: To develop a novel method to systematically rank, select, and combine ML algorithms to build a model that predicts LOS following craniotomy for brain tumor...
August 3, 2018: Neurosurgery
Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Karlen Law, Vishal Borse, Yuk Ming Lau, Ling Fung Mak, Aldous Cheng, Dino Samartzis, Kenneth Man Chee Cheung
BACKGROUND: Cervical collars are used after laminoplasty to protect the hinge opening, reduce risks of hinge fractures, and avoid spring-back phenomena. However, their use may lead to reduced range of motion and worse neck pain. OBJECTIVE: To investigate the clinical, radiological, and functional outcomes of patients undergoing single-door laminoplasty with or without collar immobilization. METHODS: This was a prospective, parallel, single-blinded randomized controlled trial...
August 3, 2018: Neurosurgery
Ali I Rae, Fabio M Iwamoto, Adam M Sonabend
No abstract text is available yet for this article.
August 2, 2018: Neurosurgery
Chang Su, Giorgos Karakousis, Paul J Zhang, Harrison X Bai
No abstract text is available yet for this article.
August 2, 2018: Neurosurgery
Si Hu, NianZu Yu, YiYun Li, Zheng Hao, Zheng Liu, Mei-Hua Li
BACKGROUND: Understanding the risk factors for the formation of de novo intracranial aneurysms (IAs) is important for patients who have ever suffered a cerebral aneurysm. OBJECTIVE: To estimate the risk factors for the development of a de novo IA to identify which patients need more aggressive surveillance after aneurysm treatment. METHODS: We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and searched the PubMed, CENTRAL, EMBASE, and LILACS databases using the key words cerebral aneurysms, de novo, IAs, risk factors combined using and/or...
July 30, 2018: Neurosurgery
Karl Balsara, Mary Gallagher, Andrew Jea
No abstract text is available yet for this article.
July 30, 2018: Neurosurgery
Daniel Y Zhang, Sunil Singhal, John Y K Lee
Fluorescence-guided surgery is a rapidly growing field that has produced some of the most important innovations in surgical oncology in the past decade. These intraoperative imaging technologies provide information distinguishing tumor tissue from normal tissue in real time as the surgery proceeds and without disruption of the workflow. Many of these fluorescent tracers target unique molecular or cellular features of tumors, which offers the opportunity for identifying pathology with high precision to help surgeons achieve their primary objective of a maximal safe resection...
July 30, 2018: Neurosurgery
Faith C Robertson, Nicole J Ullrich, Peter E Manley, Hasan Al-Sayegh, Clement Ma, Liliana C Goumnerova
BACKGROUND: Intraoperative electrocorticography (ECoG) has been utilized in patients with tumor-associated seizures; however, its effectiveness for seizure control remains controversial. OBJECTIVE: To evaluate clinical outcomes in pediatric patients undergoing lesionectomy with or without ECoG. METHODS: Patients undergoing brain tumor resection at Boston Children's Hospital were examined retrospectively (2005-2014). Inclusion criteria involved diagnosis of a supratentorial tumor, ≥2 unequivocal seizures, and ≥6 mo follow-up...
July 30, 2018: Neurosurgery
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