Journal of Neurosurgery




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Using postoperative remodeling of donor arteries on MR angiography to predict the development of surgical collaterals in moyamoya disease

Haruto Uchino, Shusuke Yamamoto, Daina Kashiwazaki, Naoki Akioka, Naoya Kuwayama, Kyo Noguchi, and Satoshi Kuroda

doi : 10.3171/2019.8.JNS191846

No Description

The calibers of donor arteries can change dynamically after bypass surgery in patients with moyamoya disease (MMD). The present study aimed to evaluate the cutoffs of caliber changes in donor arteries associated with good surgical revascularization and to assess the impact of clinical factors potentially related to bypass development.

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Pregnancy after direct cerebral bypass for moyamoya disease

Ephraim W. Church, Rabia Qaiser, Teresa E. Bell-Stephens, Mark G. Bigder, Eric K. Chow, Summer S. Han, Yasser Y. El-Sayed, and Gary K. Steinberg

doi : 10.3171/2019.8.JNS191372

No Description

Moyamoya disease (MMD) disproportionately affects young to middle-aged women. The main treatment for this challenging disease is cerebral bypass surgery. Vascular neurosurgeons often need to counsel women regarding pregnancy following bypass for MMD, but there is a paucity of data. The authors set out to examine neurological and obstetric outcomes in an extensive cohort of MMD patients who had pregnancies following cerebral revascularization at the Stanford Medical Center.

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Hemodynamic analysis of the recipient parasylvian cortical arteries for predicting postoperative hyperperfusion during STA-MCA bypass in adult patients with moyamoya disease

Jianjian Zhang, Sirui Li, Miki Fujimura, Tsz Yeung Lau, Xiaolin Wu, Miao Hu, Hanpei Zheng, Haibo Xu, Wenyuan Zhao, Xiang Li, and Jincao Chen

doi : 10.3171/2019.10.JNS191207

No Description

Superficial temporal artery–middle cerebral artery (STA-MCA) bypass is a common approach for treating moyamoya disease (MMD); however, the selection of recipient vessels is still controversial, and its relationship with postoperative cerebral hyperperfusion (CHP) has not been revealed. The aim of the study was to investigate the relationship between the hemodynamic sources of the recipient parasylvian cortical arteries (PSCAs) and the occurrence of postoperative CHP.

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Hyperoxemia during the hyperacute phase of aneurysmal subarachnoid hemorrhage is associated with delayed cerebral ischemia and poor outcome: a retrospective observational study

Shinya Fukuda, Yasutaka Koga, Motoki Fujita, Eiichi Suehiro, Kotaro Kaneda, Yasutaka Oda, Hideyuki Ishihara, Michiyasu Suzuki, and Ryosuke Tsuruta

doi : 10.3171/2019.9.JNS19781

No Description

The harmful effects of hyperoxemia have been reported in critically ill patients with various disorders, including those with brain injuries. However, the effect of hyperoxemia on aneurysmal subarachnoid hemorrhage (aSAH) patients is unclear. In this study the authors aimed to determine whether hyperoxemia during the hyperacute or acute phase in patients with aSAH is associated with delayed cerebral ischemia (DCI) and poor neurological outcome.

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Cognitive outcomes after unruptured intracranial aneurysm treatment with flow diversion

Kathryn Wagner, Aditya Srivatsan, Alina Mohanty, Visish M. Srinivasan, Yasir Saleem, Jacob Cherian, Robert F. James, Stephen Chen, Jan-Karl Burkhardt, Jeremiah Johnson, and Peter Kan

doi : 10.3171/2019.9.JNS191910

No Description

Flow diversion is increasingly used to treat a variety of intracranial aneurysms with good safety and efficacy; however, there is some evidence that this treatment is associated with a larger postoperative ischemic burden on imaging than that with other traditional endovascular modalities. These findings typically do not manifest as neurological deficits, but any subtle effects on cognition remain unknown. In this study, the authors describe the neurocognitive performance of a cohort of patients with unruptured intracranial aneurysms (UIAs) before and after treatment with flow diversion. This is the first report of cognitive outcomes following aneurysm treatment with flow diversion.

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Long-term outcomes of wide-necked intracranial bifurcation aneurysms treated with T-stent–assisted coiling

Kubilay Aydin, Christian Paul Stracke, Mehmet Barburoglu, Elif Yamac, Mynzhylky Berdikhojayev, Serra Sencer, and René Chapot

doi : 10.3171/2019.9.JNS191733

No Description

The endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent–assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. However, the intraluminal struts at the intersection point in X- and Y-stents are not amenable to endothelialization, which may lead to thromboembolic complications. Stenting in the T configuration is a relatively new double-stent coiling technique. T-stenting differs from X- or Y-stenting in that there are no overlapping or intersecting stent segments. Promising short-term results of T-stent–assisted coiling were recently reported. However, the long-term results have not yet been demonstrated. This retrospective study investigated the long-term angiographic and clinical results in patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent–assisted coiling.

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Giant intracranial aneurysms: natural history and 1-year case fatality after endovascular or surgical treatment

Julius Dengler, Daniel Rüfenacht, Bernhard Meyer, Veit Rohde, Matthias Endres, Pavlina Lenga, Konstantin Uttinger, Viktoria Rücker, Maria Wostrack, Adisa Kursumovic, Bujung Hong, Dorothee Mielke, Nils Ole Schmidt, Jan-Karl Burkhardt, Philippe Bijlenga, Edoardo Boccardi, Christophe Cognard, Peter U. Heuschmann, Peter Vajkoczy, and On behalf of the Giant Intracranial Aneurysm Study Group

doi : 10.3171/2019.8.JNS183078

No Description

Clinical evidence on giant intracranial aneurysms (GIAs), intracranial aneurysms with a diameter of at least 25 mm, is limited. The authors aimed to investigate the natural history, case fatality, and treatment outcomes of ruptured and unruptured GIAs.

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Sex-related differences in wall remodeling and intraluminal thrombus resolution in a rat saccular aneurysm model

Sandrine Morel, Agnieszka Karol, Vanessa Graf, Graziano Pelli, Henning Richter, Esther Sutter, Vincent Braunersreuther, Juhana Fr?sen, Philippe Bijlenga, Brenda R. Kwak, and Katja M. Nuss

doi : 10.3171/2019.9.JNS191466

No Description

Intracranial aneurysms (IAs) are more often diagnosed in women. Hormones and vessel geometry, which influences wall shear stress, may affect pathophysiological processes of the arterial wall. Here, the authors investigated sex-related differences in the remodeling of the aneurysm wall and in intraluminal thrombus resolution.

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Lateral transorbital approach: an alternative microsurgical route for supratentorial cerebral aneurysms

Murat Ulutas, Kadir ?inar, Ihsan Dogan, Mehmet Secer, Semra Isik, and Kaya Aksoy

doi : 10.3171/2019.9.JNS191683

No Description

Transorbital approaches for neurosurgery have recently attracted attention and several anatomical studies have aimed to improve these techniques, but significant deficiencies in clinical practice remain, especially for aneurysm surgery. The authors present an alternative microsurgical route and the results of an analysis of patients with intracranial aneurysms who underwent a lateral transorbital approach (LTOA) using lateral orbito-zygoma-sphenotomy (LOZYGS).

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New endovascular perforation subarachnoid hemorrhage model for investigating the mechanisms of delayed brain injury

Kosuke Kumagai, Arata Tomiyama, Satoru Takeuchi, Naoki Otani, Masanori Fujita, Kazuya Fujii, Kojiro Wada, and Kentaro Mori

doi : 10.3171/2019.9.JNS191934

No Description

Delayed brain injury (DBI) is considered one of the most important causes of mortality and morbidity after subarachnoid hemorrhage (SAH). However, no suitable experimental rat endovascular perforation (EVP) SAH model was available for investigating DBI. The authors added early cerebral hypoperfusion to a mild EVP SAH model by unilateral common carotid artery occlusion (UCCAO) 24 hours after induction of SAH to mimic the clinical course of early cerebral hypoperfusion after SAH.

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Nimodipine pharmacokinetics after intraventricular injection of sustained-release nimodipine for subarachnoid hemorrhage

R. Loch Macdonald, Daniel H?nggi, Poul Strange, Hans Jakob Steiger, J Mocco, Michael Miller, Stephan A. Mayer, Brian L. Hoh, Herbert J. Faleck, Nima Etminan, Michael N. Diringer, Andrew P. Carlson, Francois Aldrich, and the NEWTON Investigators

doi : 10.3171/2019.9.JNS191366

No Description

The objective of this study was to measure the concentration of nimodipine in CSF and plasma after intraventricular injection of a sustained-release formulation of nimodipine (EG-1962) in patients with aneurysmal subarachnoid hemorrhage (SAH).

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Disruption of P2X4 purinoceptor and suppression of the inflammation associated with cerebral aneurysm formation

Miyuki Fukuda, Shunichi Fukuda, Joji Ando, Kimiko Yamamoto, Naohiro Yonemoto, Takashi Suzuki, Youko Niwa, Takayuki Inoue, Noriko Satoh-Asahara, Koji Hasegawa, Akira Shimatsu, and Tetsuya Tsukahara

doi : 10.3171/2019.9.JNS19270

No Description

There are no effective therapeutic drugs for cerebral aneurysms, partly because the pathogenesis remains unresolved. Chronic inflammation of the cerebral arterial wall plays an important role in aneurysm formation, but it is not clear what triggers the inflammation. The authors have observed that vascular endothelial P2X4 purinoceptor is involved in flow-sensitive mechanisms that regulate vascular remodeling. They have thus hypothesized that shear stress–associated hemodynamic stress on the endothelium causes the inflammatory process in the cerebral aneurysm development.

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Predictor of 90-day functional outcome after mechanical thrombectomy for large vessel occlusion stroke: NIHSS score of 10 or less at 24 hours

Mirja M. Wirtz, Philipp Hendrix, Oded Goren, Lisa A. Beckett, Heather R. Dicristina, Clemens M. Schirmer, Shamsher Dalal, Gregory Weiner, Paul M. Foreman, Ramin Zand, and Christoph J. Griessenauer

doi : 10.3171/2019.10.JNS191991

No Description

Mechanical thrombectomy is the established treatment for acute ischemic stroke due to large vessel occlusion (LVO). The authors sought to identify early predictors of a favorable outcome in stroke patients treated with mechanical thrombectomy.

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Soluble receptor for advanced glycation end products as a biomarker of symptomatic vasospasm in subarachnoid hemorrhage

Yasuhiro Aida, Tomoya Kamide, Hiroshi Ishii, Yasuko Kitao, Naoyuki Uchiyama, Mitsutoshi Nakada, and Osamu Hori

doi : 10.3171/2019.8.JNS191269

No Description

The receptor for advanced glycation end products (RAGE) is a membrane protein associated with the induction of oxidative stress and inflammation in several pathological conditions. Previous studies have demonstrated that soluble RAGE (sRAGE) acts as a decoy for RAGE and protects cells against RAGE-mediated injury. The authors and other groups have reported that the expression of RAGE increases after brain ischemia and subarachnoid hemorrhage (SAH), and deletion of RAGE or overexpression of sRAGE improves neuronal survival. It has also been demonstrated that the plasma sRAGE level could be a predictor of the outcome after ischemic stroke. This study aimed to evaluate plasma sRAGE as a biomarker for symptomatic vasospasm (SVS) in SAH patients, as well as a rat model.

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Histology of the vertebral artery–dural junction: relevance to posterolateral approaches to the skull base

Robert C. Rennert, Martin P. Powers, Jeffrey A. Steinberg, Takanori Fukushima, John D. Day, Alexander A. Khalessi, and Michael L. Levy

doi : 10.3171/2019.9.JNS191394

No Description

The far-lateral and extreme-lateral infrajugular transcondylar–transtubercular exposure (ELITE) and extreme-lateral transcondylar transodontoid (ELTO) approaches provide access to lesions of the foramen magnum, inferolateral to mid-clivus, and ventral pons and medulla. A subset of pathologies in this region require manipulation of the vertebral artery (VA)–dural interface. Although a cuff of dura is commonly left on the VA to avoid vessel injury during these approaches, there are varying descriptions of the degree of VA-dural separation that is safely achievable. In this paper the authors provide a detailed histological analysis of the VA-dural junction to guide microsurgical technique for posterolateral skull base approaches.

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Stimulated Raman histology for rapid and accurate intraoperative diagnosis of CNS tumors: prospective blinded study

Daniel G. Eichberg, Ashish H. Shah, Long Di, Alexa M. Semonche, George Jimsheleishvili, Evan M. Luther, Christopher A. Sarkiss, Allan D. Levi, Sakir H. Gultekin, Ricardo J. Komotar, and Michael E. Ivan

doi : 10.3171/2019.9.JNS192075

No Description

In some centers where brain tumor surgery is performed, the opportunity for expert intraoperative neuropathology consultation is lacking. Consequently, surgeons may not have access to the highest quality diagnostic histological data to inform surgical decision-making. Stimulated Raman histology (SRH) is a novel technology that allows for rapid acquisition of diagnostic histological images at the bedside.

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A nomogram to predict the progression-free survival of clival chordoma

Yixuan Zhai, Jiwei Bai, Mingxuan Li, Shuai Wang, Chuzhong Li, Xinting Wei, and Yazhuo Zhang

doi : 10.3171/2019.10.JNS192414

No Description

Chordoma shows poor patient prognosis because of its high recurrence rate. Even though many clinical factors and biomarkers are reported to be associated with prognosis, no prediction model has been applied clinically. Thus, the authors aim to derive and validate a prognostic nomogram to predict progression-free survival (PFS) of chordoma.

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Incidence and impact of stroke following surgery for low-grade gliomas

Assaf Berger, Gali Tzarfati, Matias Costa, Marga Serafimova, Akiva Korn, Irina Vendrov, Tali Alfasi, Dana Krill, Daniel Aviram, Shlomit Ben Moshe, Alon Kashanian, Zvi Ram, and Rachel Grossman

doi : 10.3171/2019.10.JNS192301

No Description

Ischemic complications are a common cause of neurological deficits following low-grade glioma (LGG) surgeries. In this study, the authors evaluated the incidence, risk factors, and long-term implications of intraoperative ischemic events.

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Outcomes of stereotactic radiosurgery for pilocytic astrocytoma: an international multiinstitutional study

Erin S. Murphy, Shireen Parsai, Hideyuki Kano, Jason P. Sheehan, Roberto Martinez-Alvarez, Nuria Martinez-Moreno, Douglas Kondziolka, Gabriela Simonova, Roman Liscak, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, John Y. Lee, Brendan J. McShane, Fang Fang, Daniel M. Trifiletti, Mayur Sharma, and Gene H. Barnett

doi : 10.3171/2019.9.JNS191335

No Description

The current standard initial therapy for pilocytic astrocytoma is maximal safe resection. Radiation therapy is considered for residual, recurrent, or unresectable pilocytic astrocytomas. However, the optimal radiation strategy has not yet been established. Here, the authors describe the outcomes of stereotactic radiosurgery (SRS) for pilocytic astrocytoma in a large multiinstitutional cohort.

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An artificial intelligence framework for automatic segmentation and volumetry of vestibular schwannomas from contrast-enhanced T1-weighted and high-resolution T2-weighted MRI

Jonathan Shapey, Guotai Wang, Reuben Dorent, Alexis Dimitriadis, Wenqi Li, Ian Paddick, Neil Kitchen, Sotirios Bisdas, Shakeel R. Saeed, Sebastien Ourselin, Robert Bradford, and Tom Vercauteren

doi : 10.3171/2019.9.JNS191949

No Description

Automatic segmentation of vestibular schwannomas (VSs) from MRI could significantly improve clinical workflow and assist in patient management. Accurate tumor segmentation and volumetric measurements provide the best indicators to detect subtle VS growth, but current techniques are labor intensive and dedicated software is not readily available within the clinical setting. The authors aim to develop a novel artificial intelligence (AI) framework to be embedded in the clinical routine for automatic delineation and volumetry of VS.

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Sagittal bending of the optic nerve at the entrance from the intracranial to the optic canal and ipsilateral visual acuity in patients with sellar and suprasellar lesions

Rei Yamaguchi, Masahiko Tosaka, Takaaki Miyagishima, Tadashi Osawa, Keishi Horiguchi, Fumiaki Honda, and Yuhei Yoshimoto

doi : 10.3171/2019.9.JNS191365

No Description

Visual acuity impairment due to sellar and suprasellar tumors is not fully understood. The relationship between these tumors and disturbance of visual function was examined using preoperative MRI.

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Masson’s tumor presenting as a left frontal intraparenchymal hemorrhage resulting in severe expressive aphasia during pregnancy: case report

Eric W. Sankey, Jenna S. Hynes, Jordan M. Komisarow, Jake Maule, Andrew S. Griffin, Sarah K. Dotters-Katz, Courtney J. Mitchell, and Allan H. Friedman

doi : 10.3171/2019.8.JNS191767

No Description

Intravascular papillary endothelial hyperplasia (IPEH), commonly known as Masson’s tumor, is a benign lesion that manifests as an excessive proliferation of endothelial cells within a vessel wall. IPEH is extremely rare in the brain, with only 36 intracranial cases previously described in the literature. It is commonly mistaken for more malignant pathologies, such as angiosarcoma. Careful histopathological examination is required for diagnosis, as no clinical or radiographic features are characteristic of this lesion. In this first published case of intracranial IPEH presenting during pregnancy, the authors describe a 32-year-old female with a left frontal intraparenchymal hemorrhage resulting in complete expressive aphasia at 28 weeks 6 days’ gestation. An MRI scan obtained at a local hospital demonstrated an area of enhancement within the hemorrhage. The patient underwent a left frontoparietal craniotomy for hematoma evacuation and gross-total resection (GTR) of an underlying hemorrhagic mass at 29 weeks’ gestation. This case illustrates the importance of multidisciplinary patient care and the feasibility of intervention in the early third trimester with subsequent term delivery. While GTR of IPEH is typically curative, the decision to proceed with surgical treatment of any intracranial lesion in pregnancy must balance maternal stability, gestational age, and suspected pathology.

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Deep brain stimulation versus pallidotomy for status dystonicus: a single-center case series

Vincenzo Levi, Giovanna Zorzi, Giuseppe Messina, Luigi Romito, Irene Tramacere, Ivano Dones, Nardo Nardocci, and Angelo Franzini

doi : 10.3171/2019.10.JNS191691

No Description

First-line pharmacological therapies have shown limited efficacy in status dystonicus (SD), while surgery is increasingly reported as remediable in refractory cases. In this context, there is no evidence regarding which neurosurgical approach is the safest and most effective. The aim of this study was to assess the clinical outcomes and surgery-related complications of globus pallidus internus deep brain stimulation (GPi DBS) and pallidotomy for the treatment of drug-resistant SD.

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Deep brain stimulation in the caudal zona incerta in patients with essential tremor: effects on cognition 1 year after surgery

Johanna Philipson, Patric Blomstedt, Marwan Hariz, and Marjan Jahanshahi

doi : 10.3171/2019.9.JNS191646

No Description

The ventral intermediate nucleus (VIM) of the thalamus is currently the established target in the use of deep brain stimulation (DBS) to treat essential tremor (ET). In recent years, the caudal zona incerta (cZi), a brain target commonly used during the lesional era, has been revived as the primary target in a number of DBS studies that show evidence of the efficacy of cZi targeting in DBS treatment for controlling the symptoms of ET. The authors sought to obtain comprehensive neuropsychological data and thoroughly investigate the cognitive effects of cZi targeting in patients with ET treated with DBS.

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Unilateral pallidotomy in the treatment of cervical dystonia: a retrospective observational study

Shiro Horisawa, Atsushi Fukui, Kotaro Kohara, Takakazu Kawamata, and Takaomi Taira

doi : 10.3171/2019.9.JNS191202

No Description

The objective of this study was to assess the efficacy of unilateral pallidotomy in patients with asymmetrical cervical dystonia.

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In-depth characterization of a long-term, resuscitated model of acute subdural hematoma–induced brain injury

Thomas Datzmann, Thomas Kapapa, Angelika Scheuerle, Oscar McCook, Tamara Merz, Sarah Unmuth, Andrea Hoffmann, René Mathieu, Simon Mayer, Uwe Max Mauer, Stefan R?hrer, Deniz Yilmazer-Hanke, Peter M?ller, Benedikt Lukas Nussbaum, Enrico Calzia, Michael Gr?ger, Clair Hartmann, Peter Radermacher, and Martin Wepler

doi : 10.3171/2019.9.JNS191789

No Description

Acute subdural hematoma (ASDH) is a leading entity in brain injury. Rodent models mostly lack standard intensive care, while large animal models frequently are only short term. Therefore, the authors developed a long-term, resuscitated porcine model of ASDH-induced brain injury and report their findings.

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Treatment of chronic subdural hematoma with atorvastatin combined with low-dose dexamethasone: phase II randomized proof-of-concept clinical trial

Dong Wang, Chuang Gao, Xin Xu, Tao Chen, Ye Tian, Huijie Wei, Shu Zhang, Wei Quan, Yi Wang, Shuyuan Yue, Zengguang Wang, Ping Lei, Craig Anderson, Jingfei Dong, Jianning Zhang, and Rongcai Jiang

doi : 10.3171/2019.11.JNS192020

No Description

The authors sought to test the hypothesis that adding dexamethasone (DXM) to atorvastatin (ATO) potentiates the effects of ATO on chronic subdural hematoma (CSDH).

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A mixed-methods needs assessment of traumatic brain injury care in a low- and middle-income country setting: building neurocritical care capacity at two major hospitals in Cambodia

Ariana S. Barkley, Laura J. Spece, Lia M. Barros, Robert H. Bonow, Ali Ravanpay, Richard Ellenbogen, Phearum Huoy, Try Thy, Seang Sothea, Sopheak Pak, James LoGerfo, and Abhijit V. Lele

doi : 10.3171/2019.10.JNS192118

No Description

The high global burden of traumatic brain injury (TBI) disproportionately affects low- and middle-income countries (LMICs). These settings also have the greatest disparity in the availability of surgical care in general and neurosurgical care in particular. Recent focus has been placed on alleviating this surgical disparity. However, most capacity assessments are purely quantitative, and few focus on concomitantly assessing the complex healthcare system needs required to care for these patients. The objective of the present study was to use both quantitative and qualitative assessment data to establish a comprehensive approach to inform capacity-development initiatives for TBI care at two hospitals in an LMIC, Cambodia.

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Distal pronator teres motor branch transfer for wrist extension restoration in radial nerve paralysis

Jayme Augusto Bertelli, Sushil Nehete, Elisa Cristiana Winkelmann Duarte, Neehar Patel, and Marcos Fl?vio Ghizoni

doi : 10.3171/2019.10.JNS192110

No Description

The authors describe the anatomy of the motor branches of the pronator teres (PT) as it relates to transferring the nerve of the extensor carpi radialis brevis (ECRB) to restore wrist extension in patients with radial nerve paralysis. They describe their anatomical cadaveric findings and report the results of their nerve transfer technique in several patients followed for at least 24 months postoperatively.

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Thoracic outlet syndrome causing epidural hematoma: case illustration

Nicolas Mélé, Grégoire Boulouis, Eric Bozier, Abderrazak Akhrouf, and Johan Pallud

doi : 10.3171/2019.12.JNS192397

No Description

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Fluorescein-guided removal of peripheral nerve sheath tumors: a preliminary analysis of 20 cases

Ignazio G. Vetrano, Francesco Acerbi, Jacopo Falco, Grazia Devigili, Sara Rinaldo, Giuseppe Messina, Francesco Prada, Antonio D’Ammando, and Vittoria Nazzi

doi : 10.3171/2019.9.JNS19970

No Description

Benign peripheral nerve sheath tumors (PNSTs) include mainly schwannomas—the most common tumors arising from peripheral nerves—and neurofibromas. Due to their origin, distinguishing between functional intact nerve and the fibers from whence the PNST arose may not always be easy to perform. The introduction of intraoperative tools to better visualize these tumors could be helpful in achieving a gross-total resection. In this study, the authors present a series of patients harboring PNST in which the surgery was performed under fluorescein guidance.

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Comparison between optical coherence tomography imaging and histological sections of peripheral nerves

Anne E. Carolus, Jens M?ller, Martin R. Hofmann, Johannes A. P. van de Nes, Hubert Welp, Kirsten Schmieder, and Christopher Brenke

doi : 10.3171/2019.8.JNS191278

No Description

Optical coherence tomography (OCT) is an imaging technique that uses the light-backscattering properties of different tissue types to generate an image. In an earlier feasibility study the authors showed that it can be applied to visualize human peripheral nerves. As a follow-up, this paper focuses on the interpretation of the images obtained.

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Changes in the muscles of mastication before and after primary stereotactic radiosurgery in patients with idiopathic trigeminal neuralgia

Nasser Mohammed, Yi-Chieh Hung, Thomas J. Eluvathingal Muttikkal, Roy C. Bliley, Zhiyuan Xu, and Jason P. Sheehan

doi : 10.3171/2019.8.JNS191455

No Description

The motor root of the trigeminal nerve runs close to the sensory root and receives considerable radiation during Gamma Knife radiosurgery (GKRS) for trigeminal neuralgia (TN). The object of this study was to evaluate via MRI the changes in the muscles of mastication before and after upfront GKRS in patients with idiopathic TN.

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Correlation of spontaneous and traumatic anterior skull base CSF leak flow rates with fluid pattern on early, delayed, and subtraction volumetric extended echo train T2-weighted MRI

John W. Rutland, Satish Govindaraj, Corey M. Gill, Michael Shohet, Alfred M. C. Iloreta Jr., Joshua B. Bederson, Raj K. Shrivastava, and Bradley N. Delman

doi : 10.3171/2019.10.JNS192500

No Description

CSF leakage is a potentially fatal condition that may result when a skull base dural defect permits CSF communication between the cranial vault and sinonasal cavities. Flow rate is an important property of CSF leaks that can contribute to surgical decision-making and predispose patients to complications and inferior outcomes. Noninvasive preoperative prediction of the leak rate is challenging with traditional diagnostic tools. The present study compares fluid configurations on early and late volumetric extended echo train T2-weighted MRI by using image tracings and sequence subtraction as a novel method of quantifying CSF flow rate, and it correlates radiological results with intraoperative findings and clinical outcomes.

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Impact of master’s degree attainment upon academic career placement in neurosurgery

Adham M. Khalafallah, Adrian E. Jimenez, Rafael J. Tamargo, Timothy Witham, Judy Huang, Henry Brem, and Debraj Mukherjee

doi : 10.3171/2019.9.JNS192346

No Description

Previous authors have investigated many factors that predict an academic neurosurgical career over private practice, including attainment of a Doctor of Philosophy (PhD) and number of publications. Research has yet to demonstrate whether a master’s degree predicts an academic neurosurgical career. This study quantifies the association between obtaining a Master of Science (MS), Master of Public Health (MPH), or Master of Business Administration (MBA) degree and pursuing a career in academic neurosurgery.

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For the further training of individuals in neurosurgery II: the academic legacy of the William P. Van Wagenen Fellowship

D. Ryan Ormond, Mohab Abozeid, Shekar Kurpad, and Stephen J. Haines

doi : 10.3171/2019.9.JNS191998

No Description

William P. Van Wagenen pursued a research fellowship in Europe early in his career under the recommendation of Harvey Cushing. Later, Van Wagenen would be instrumental in the establishment of the William P. Van Wagenen Fellowship, a postgraduate fellowship for neurosurgeons from the AANS that requires study outside of a fellow’s country of residency training with plans to return to academic practice.

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Corpus callosotomy performed with laser interstitial thermal therapy

Jarod L. Roland, Syed Hassan A. Akbari, Afshin Salehi, and Matthew D. Smyth

doi : 10.3171/2019.9.JNS191769

No Description

Corpus callosotomy is a palliative procedure that is effective at reducing seizure burden in patients with medically refractory epilepsy. The procedure is traditionally performed via open craniotomy with interhemispheric microdissection to divide the corpus callosum. Concerns for morbidity associated with craniotomy can be a deterrent to patients, families, and referring physicians for surgical treatment of epilepsy. Laser interstitial thermal therapy (LITT) is a less invasive procedure that has been widely adopted in neurosurgery for the treatment of tumors. In this study, the authors investigated LITT as a less invasive approach for corpus callosotomy.

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Letter to the Editor. The third ventricle bowing and ETV success

Qiguang Wang, Si Zhang, and Yan Ju

doi : 10.3171/2020.5.JNS202016

No Description

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Letter to the Editor. Is time-weighted PaO? during the hyperacute phase of aneurysmal subarachnoid hemorrhage really helpful in usual care settings?

Tomoya Okazaki, Shota Yokoyama, Kenya Kawakita, and Yasuhiro Kuroda

doi : 10.3171/2020.1.JNS20177

No Description

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