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Neurosurgery

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https://www.readbyqxmd.com/read/28541503/reduced-efficacy-of-the-pipeline-embolization-device-in-the-treatment-of-posterior-communicating-region-aneurysms-with-fetal-posterior-cerebral-artery-configuration
#1
Anil K Roy, Brian M Howard, Diogo C Haussen, Joshua W Osbun, Sameer H Halani, Susana L Skukalek, Frank Tong, Raul G Nogueira, Jacques E Dion, Charles M Cawley, Jonathan A Grossberg
BACKGROUND: Aneurysms at the origin of the posterior communicating artery (PcommA) have been demonstrated to be effectively treated with the pipeline embolization device (PED). Much less is known about the efficacy of the PED for aneurysms associated with a fetal posterior cerebral artery (fPCA) variant. OBJECTIVE: To study PED treatment efficacy of PcommA aneurysms, including fPCA aneurysms. METHODS: A prospectively maintained university database of aneurysm patients treated with the PED was retrospectively reviewed...
May 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541411/better-outcomes-and-reduced-hospitalization-cost-are-associated-with-ultra-early-treatment-of-ruptured-intracranial-aneurysms-a-us-nationwide-data-sample-study
#2
Ashish Sonig, Hussain Shallwani, Sabareesh K Natarajan, Hakeem J Shakir, L Nelson Hopkins, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: The benefit of surgical treatment of ruptured aneurysms is well established. OBJECTIVE: To determine whether ultra-early ruptured aneurysm treatment leads to not only improved outcomes but also reduced hospitalization cost. METHODS: Using 2008-2011 Nationwide Inpatient Sample data, we analyzed demographic, clinical, and hospital factors for nontraumatic subarachnoid hemorrhage (SAH) patients who were "directly" admitted to the treating hospital where they underwent intervention (clipping/coiling)...
May 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541497/improved-survival-with-decreased-wait-time-to-surgery-in-glioblastoma-patients-presenting-with-seizure
#3
Patrick M Flanigan, Arman Jahangiri, Ruby Kuang, Albert Truong, Sarah Choi, Alvin Chou, Jonathan W Rick, Susan M Chang, Annette M Molinaro, Michael W McDermott, Mitchel S Berger, Manish K Aghi
BACKGROUND: Preoperative seizure is reported to confer favorable prognosis in glioblastoma patients, but studies to date have not investigated how broadly applicable seizure is as a prognostic factor. OBJECTIVE: To investigate if prompter surgical intervention affects the relationship between preoperative seizure and prognosis in glioblastoma patients, focusing on the development of tumor growth and/or additional preoperative symptoms after seizure. METHODS: Retrospective analysis of 443 patients (mean age = 60...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541463/reducing-surgical-infections-and-implant-costs-via-a-novel-paradigm-of-enhanced-physician-awareness
#4
Nitin Agarwal, Prateek Agarwal, Ashley Querry, Anna Mazurkiewicz, Brittany Whiteside, Oscar C Marroquin, Stephen F Koscumb, Daniel A Wecht, Robert M Friedlander
BACKGROUND: Studies have demonstrated that physicians are often unaware of prescription drug, laboratory, diagnostic, and surgical supply costs. OBJECTIVE: To investigate the effects of increased physician awareness on infection incidence and surgical device cost containment. METHODS: Within our institution, physicians were informed of individual, independently adjudicated, craniotomy and ventricular shunt infection incidence and rankings among peers, after which a protocol aimed at reducing skin bacterial burden was implemented for craniotomies...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541431/emerging-safety-of-intramedullary-transplantation-of-human-neural-stem-cells-in-chronic-cervical-and-thoracic-spinal-cord-injury
#5
Allan D Levi, David O Okonkwo, Paul Park, Arthur L Jenkins, Shekar N Kurpad, Ann M Parr, Aruna Ganju, Bizhan Aarabi, Dong Kim, Steven Casha, Michael G Fehlings, James S Harrop, Kim D Anderson, Allyson Gage, Jane Hsieh, Stephen Huhn, Armin Curt, Raphael Guzman
BACKGROUND: Human central nervous system stem cells (HuCNS-SC) are multipotent adult stem cells with successful engraftment, migration, and region-appropriate differentiation after spinal cord injury (SCI). OBJECTIVE: To present data on the surgical safety profile and feasibility of multiple intramedullary perilesional injections of HuCNS-SC after SCI. METHODS: Intramedullary free-hand (manual) transplantation of HuCNS-SC cells was performed in subjects with thoracic (n = 12) and cervical (n = 17) complete and sensory incomplete chronic traumatic SCI...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541420/surgical-decompression-of-high-grade-spinal-cord-compression-from-hormone-refractory-metastatic-prostate-cancer
#6
Muhammad Omar Chohan, Sweena Kahn, Gustav Cederquist, Anne S Reiner, Joseph Schwab, Ilya Laufer, Mark Bilsky
BACKGROUND: Spine and nonspine skeletal metastases occur in more than 80% of patients with prostate cancer. OBJECTIVE: To examine the characteristics of the patient population undergoing surgery for the treatment of prostate cancer metastatic to the spine. METHODS: A retrospective chart review was performed on all patients treated at our institution from June 1993 to August 2014 for surgical management of metastatic spine disease from prostate cancer...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28531340/in-reply-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#7
Marcus D Mazur, Philipp Taussky, Joel D MacDonald, Min S Park
No abstract text is available yet for this article.
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#8
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28521032/a-neglected-cause-of-iatrogenic-brachial-plexus-injuries-in-psychiatric-patients
#9
José Fernando Guedes-Corrêa, Maristella Reis da Costa Pereira, Francisco José Lourenço Torrão-Junior, José Vicente Martins, Daniel Alves Neiva Barbosa
BACKGROUND: Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE: To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS: We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28520927/preoperative-stratification-of-transsphenoidal-pituitary-surgery-patients-based-on-surgical-urgency
#10
Hasan A Zaidi, Amy J Wang, David J Cote, Timothy R Smith, Daniel Prevedello, Domenico Solari, Paolo Cappabianca, Monica Quiroga, Edward R Laws
BACKGROUND: Currently, there is no prioritization scale available to distinguish those patients with pituitary tumors who require urgent surgical intervention from those who are candidates for elective treatment. OBJECTIVE: To develop a classification system that can help primary care physicians, endocrinologists, neurosurgeons, ancillary support staff, and hospital administrators identify high-priority surgical candidates. METHODS: An expert international panel of clinicians consisting of endocrinologists and neurosurgeons who are involved in the diagnosis and management of sellar disease was convened...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28521059/pediatric-clival-chordoma-a-curable-disease-that-conforms-to-collins-law
#11
Marcio S Rassi, M Maher Hulou, Kaith Almefty, Wenya Linda Bi, Svetlana Pravdenkova, Ian F Dunn, Timothy R Smith, Ossama Al-Mefty
BACKGROUND: Skull base chordomas in children are extremely rare. Their course, management, and outcome have not been defined. OBJECTIVE: To describe the preeminent clinical and radiological features in a series of pediatric patients with skull base chordomas and analyze the outcome of a cohort who underwent uniform treatment. We emphasize predictors of overall survival and progression-free survival, which aligns with Collins' law for embryonal tumors. METHODS: Thirty-one patients with a mean age of 10...
May 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28520916/a-comparison-of-diffusion-weighted-imaging-abnormalities-following-balloon-remodeling-for-aneurysm-coil-embolization-in-the-ruptured-vs-unruptured-setting
#12
Stephen R Lowe, Tarun Bhalla, Holly Tillman, M Imran Chaudry, Aquilla S Turk, Raymond D Turner, Alejandro M Spiotta
BACKGROUND: The prothrombotic milieu seen in subarachnoid hemorrhage (SAH) poses a unique challenge to neurovascular surgeons with regard to device use and microcatheter practice. OBJECTIVE: To determine how demographic factors and balloon practices impact diffusion-weighted imaging (DWI) abnormalities and outcomes in patients with SAH compared to those without (non-SAH). METHODS: We retrospectively analyzed 77 patients with SAH treated by balloon-assisted coiling in a single institution compared with 81 consecutive patients with unruptured aneurysms treated by balloon-assisted coiling at the same institution...
May 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28521026/tracking-career-paths-of-women-in-neurosurgery
#13
Jaclyn J Renfrow, Analiz Rodriguez, Taylor A Wilson, Isabelle M Germano, Aviva Abosch, Stacey Quintero Wolfe
BACKGROUND: Women represent a growing cohort of US neurosurgeons. OBJECTIVE: To describe postresidency fellowship, practice environment, and updated academic rank among female neurosurgeons. METHODS: Databases from the American Association of Neurological Surgeons (AANS) and the American Board of Neurological Surgery (ABNS) from 1964 to 2013 were reviewed for female neurosurgery residency graduates. Data on postresidency fellowships, practice environment (private vs academic), academic rank, board certification, and AANS/CNS (Congress of Neurological Surgeons) Joint Section on Women in Neurosurgery (WINS) membership were collected in 2016...
May 16, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28499020/letter-rerupture-of-a-blister-aneurysm-after-treatment-with-a-single-flow-diverting-stent
#14
Leonardo B C Brasiliense, Christina M Walter, Mauricio J Avila, Travis M Dumont
No abstract text is available yet for this article.
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498930/risk-factors-for-intracranial-aneurysm-rupture-a-systematic-review
#15
Rachel Kleinloog, Nikki de Mul, Bon H Verweij, Jan Andries Post, Gabriel J E Rinkel, Ynte M Ruigrok
BACKGROUND: Intracranial aneurysm rupture prediction is poor, with only a few risk factors for rupture identified and used in clinical practice. OBJECTIVE: To provide an overview of all the risk factors (including genetic, molecular, morphological, and hemodynamic factors) that have potential for use in clinical practice. METHODS: We systematically searched PubMed and EMBASE and focused on factors that can be easily assessed in clinical practice, might be used for rupture prediction in clinical practice, and/or are potential targets for further research...
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498922/outpatient-vs-inpatient-anterior-cervical-discectomy-and-fusion-a-population-level-analysis-of-outcomes-and-cost
#16
David A Purger, Arjun V Pendharkar, Allen L Ho, Eric S Sussman, Lingyao Yang, Manisha Desai, Anand Veeravagu, John K Ratliff, Atman Desai
BACKGROUND: Outpatient anterior cervical discectomy and fusion (ACDF) is a promising candidate for US healthcare cost reduction as several studies have demonstrated that overall complications are relatively low and early discharge can preserve high patient satisfaction, low morbidity, and minimal readmission. OBJECTIVE: To compare clinical outcomes and associated costs between inpatient and ambulatory setting ACDF. METHODS: Demographics, comorbidities, emergency department (ED) visits, readmissions, reoperation rates, and 90-d charges were retrospectively analyzed for patients undergoing elective ACDF in California, Florida, and New York from 2009 to 2011 in State Inpatient and Ambulatory Databases...
May 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28499016/minimally-invasive-transforaminal-lumbar-interbody-fusion-using-banana-shaped-and-straight-cages-radiological-and-clinical-results-from-a-prospective-randomized-clinical-trial
#17
Won-Suh Choi, Jin-Sung Kim, Jung-Woo Hur, Ji-Hoon Seong
BACKGROUND: In minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF), cage type and position play important roles in fusion achievement and sagittal alignment correction. However, no prospective randomized comparison of the results using different types of cage has been reported to date. OBJECTIVE: To compare the radiological and clinical outcomes of unilateral MIS-TLIF using 2 types of cage. METHODS: All candidates for single-level MIS-TLIF were randomized into banana-shaped cage and straight-cage groups...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498938/healthcare-resource-utilization-and-patient-reported-outcomes-following-elective-surgery-for-intradural-extramedullary-spinal-tumors
#18
Silky Chotai, Scott L Zuckerman, Scott L Parker, Joseph B Wick, David P Stonko, Andrew T Hale, Matthew J McGirt, Joseph S Cheng, Clinton J Devin
BACKGROUND: Healthcare resource utilization and patient-reported outcomes (PROs) for intradural extramedullary (IDEM) spine tumors are not well reported. OBJECTIVE: To analyze the PROs, costs, and resource utilization 1 year following surgical resection of IDEM tumors. METHODS: Patients undergoing elective spine surgery for IDEM tumors and enrolled in a single-center, prospective, longitudinal registry were analyzed. Baseline and postoperative 1-year PROs were recorded...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28498936/a-phase-1-dose-escalation-study-of-oral-5-aminolevulinic-acid-in-adult-patients-undergoing-resection-of-a-newly-diagnosed-or-recurrent-high-grade-glioma
#19
Jeffrey W Cozzens, Barbara C Lokaitis, Brian E Moore, Devin V Amin, José A Espinosa, Margaret MacGregor, Alex P Michael, Breck A Jones
BACKGROUND: The utility of oral 5-aminolevulinic acid (5-ALA)/protoporphyrin fluorescence for the resection of high-grade gliomas is well documented. This drug has received regulatory approval in Europe but awaits approval in the United States. OBJECTIVE: To identify the appropriate dose and toxicity or harms of 5-ALA used for enhanced intraoperative visualization of malignant brain tumors, reported from a single medical center in the United States. METHODS: Prior to craniotomy for resection of a presumed high-grade glioma, individuals were given oral 5-ALA as part of a rapid dose-escalation scheme...
May 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28486687/analysis-of-national-rates-cost-and-sources-of-cost-variation-in-adult-spinal-deformity
#20
Corinna C Zygourakis, Caterina Y Liu, Malla Keefe, Christopher Moriates, John Ratliff, R Adams Dudley, Ralph Gonzales, Praveen V Mummaneni, Christopher P Ames
BACKGROUND: Several studies suggest significant variation in cost for spine surgery, but there has been little research in this area for spinal deformity. OBJECTIVE: To determine the utilization, cost, and factors contributing to cost for spinal deformity surgery. METHODS: The cohort comprised 55 599 adults who underwent spinal deformity fusion in the 2001 to 2013 National Inpatient Sample database. Patient variables included age, gender, insurance, median income of zip code, county population, severity of illness, mortality risk, number of comorbidities, length of stay, elective vs nonelective case...
May 9, 2017: Neurosurgery
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