Journal of Neurosurgery




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Design and validation of a hemispherectomy simulator for neurosurgical education

Grace M. Thiong’o  MD , Thomas Looi  PhD , James T. Rutka  MD, PhD, FRCSC , Abhaya V. Kulkarni  MD, PhD, FRCSC , and James M. Drake  MBBCh

doi : 10.3171/2022.5.JNS22545

Volume 138: Issue 1 (Jan 2023)

Early adaptors of surgical simulation have documented a translation to improved intraoperative surgical performance. Similar progress would boost neurosurgical education, especially in highly nuanced epilepsy surgeries. This study introduces a hands-on cerebral hemispheric surgery simulator and evaluates its usefulness in teaching epilepsy surgeries.

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Seizure-free outcome and safety of repeated epilepsy surgery for persistent or recurrent seizures

Mathias Kunz  MD , Philipp Karschnia  MD , Ingo Borggraefe  MD , Soheyl Noachtar  MD , Joerg-Christian Tonn  MD , and Christian Vollmar  MD, PhD

doi : 10.3171/2022.4.JNS212753

Reoperation may be an option for select patients with unsatisfactory seizure control after their first epilepsy surgery. The aim of this study was to describe the seizure-free outcome and safety of repeated epilepsy surgery in our tertiary referral center.

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Factors associated with preoperative and postoperative seizures in patients undergoing resection of brain metastases

Joseph H. Garcia  BS , Ramin A. Morshed  MD , Jason Chung  MD, PhD , Miguel A. Millares Chavez  MD , Vivek Sudhakar  MD , Satvir Saggi  BS , Lauro N. Avalos  BS , Aaron Gallagher  BS , Jacob S. Young  MD , Mariza Daras  MD , Michael W. McDermott  MD , Paul A. Garcia  MD , Edward F. Chang  MD , and Manish K. Aghi  MD, PhD

doi : 10.3171/2022.3.JNS212285

Epileptic seizures are a common and potentially devastating complication of metastatic brain tumors. Although tumor-related seizures have been described in previous case series, most studies have focused on primary brain tumors and have not differentiated between different types of cerebral metastases.

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Value of functional connectivity in outcome prediction for pallidal stimulation in Parkinson disease

Yijie Lai  MD , Naying He  MD, PhD , Hongjiang Wei  PhD , Lifu Deng  PhD , Haiyan Zhou  MD, PhD , Jun Li  PhD , Marcus Kaiser  PhD , Chencheng Zhang  MD, PhD , Dianyou Li  MD, PhD , and Bomin Sun  MD, PhD

doi : 10.3171/2022.3.JNS212732

Functional connectivity shows the ability to predict the outcome of subthalamic nucleus deep brain stimulation (DBS) in Parkinson disease (PD).

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Cutoff values for the best management strategy for magnetic resonance–guided focused ultrasound ablation for essential tremor

Jun Torii  MD , Satoshi Maesawa  MD, PhD , Daisuke Nakatsubo  MD , Takahiko Tsugawa  MD, PhD , Sachiko Kato  MD , Tomotaka Ishizaki  MD, PhD , Sou Takai  MD , Masashi Shibata  MD , Toshihiko Wakabayashi  MD, PhD , Takashi Tsuboi  MD, PhD , Masashi Suzuki  MD, PhD , and Ryuta Saito  MD, PhD

doi : 10.3171/2022.3.JNS212460

The efficacy of magnetic resonance–guided focused ultrasound (MRgFUS) ablation for essential tremor (ET) is well known; however, no prognostic factors have been established. The authors aimed to retrospectively investigate MRgFUS ablation outcomes and associated factors and to define the cutoff values for each prognostic factor.

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Comparison of the impact of skull density ratio with alternative skull metrics on magnetic resonance–guided focused ultrasound thalamotomy for tremor

Jason Yuen  MSci, BMBCh , Abhinav Goyal  BS , Timothy J. Kaufmann  MD, MS , Lauren M. Jackson  MD , Kai J. Miller  MD, PhD , Bryan T. Klassen  MD , Neha Dhawan  MS , Kendall H. Lee  MD, PhD , and Vance T. Lehman  MD

doi : 10.3171/2022.5.JNS22350

One of the key metrics that is used to predict the likelihood of success of MR-guided focused ultrasound (MRgFUS) thalamotomy is the overall calvarial skull density ratio (SDR). However, this measure does not fully predict the sonication parameters that would be required or the technical success rates. The authors aimed to assess other skull characteristics that may also contribute to technical success.

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Editorial. Supramaximal resection of eloquent glioblastoma: a continued paradigm shift in neurosurgical oncology

Noah M. Nichols  MD and Constantinos G. Hadjipanayis  MD, PhD

doi : 10.3171/2022.3.JNS22564

Extent of resection (EOR) is a significant modifiable prognostic factor in patients undergoing treatment for newly diagnosed glioblastoma (nGBM).1–3

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Radical supramaximal resection for newly diagnosed left-sided eloquent glioblastoma: safety and improved survival over gross-total resection

Long Di  MD , Ashish H. Shah  MD , Anil Mahavadi  MD , Daniel G. Eichberg  MD , Raghuram Reddy  BS , Alexander D. Sanjurjo  BS , Alexis A. Morell  MD , Victor M. Lu  MD, PhD , Leonel Ampie  MD , Evan M. Luther  MD , Ricardo J. Komotar  MD , and Michael E. Ivan  MD, MBS

doi : 10.3171/2022.3.JNS212399

Supramaximal resection (SMR) has arisen as a possible surrogate to gross-total resection (GTR) to improve survival in newly diagnosed glioblastoma (nGBM).

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Comparison of supratentorial meningioma resection outcomes by dural reconstruction technique

Silky Chotai  MD , Alan R. Tang  BA , Jake R. McDermott  BA , Bradley S. Guidry  BS , Candace J. Grisham  BE , Aaron M. Yengo-Kahn  MD , Peter J. Morone  MD, MSCI , Reid C. Thompson  MD , and Lola B. Chambless  MD

doi : 10.3171/2022.4.JNS22290

Excision of intracranial meningiomas often requires resection or coagulation of the dura mater. The choice of dural closure technique is individualized and based on surgeon preference. The objective of this study was to determine outcomes following various dural closure techniques for supratentorial meningiomas.

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Features of postoperative hearing function changes in patients with cerebellopontine angle and intratemporal tumors other than vestibular schwannomas

Norio Ichimasu  MD , Michihiro Kohno  MD , Nobuyuki Nakajima  MD , Hiroki Sakamoto  MD , Ken Matsushima  MD , Masanori Yoshino  MD , and Kiyoaki Tsukahara  MD

doi : 10.3171/2022.3.JNS212477

Tumors around the cerebellopontine angle (CPA) and temporal bone can potentially affect hearing function. In patients with such tumors other than vestibular schwannomas (VSs), auditory tests were investigated before and after surgery to characterize the auditory effect of each tumor and to determine prognostic factors.

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Supervised machine learning algorithms demonstrate proliferation index correlates with long-term recurrence after complete resection of WHO grade I meningioma

Minh P. Nguyen  BS , Ramin A. Morshed  MD , Cecilia L. Dalle Ore  MD , Daniel D. Cummins  BS , Satvir Saggi  BS , William C. Chen  MD , Abrar Choudhury  PhD , Akshay Ravi  MD , David R. Raleigh  MD, PhD , Stephen T. Magill  MD, PhD , Michael W. McDermott  MD , and Philip V. Theodosopoulos  MD

doi : 10.3171/2022.4.JNS212516

Meningiomas are the most common primary intracranial tumor, and resection is a mainstay of treatment. It is unclear what duration of imaging follow-up is reasonable for WHO grade I meningiomas undergoing complete resection.

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Multidisciplinary management of carotid body tumors: a single-institution case series of 22 patients

Alexander Ramos  MD, PhD , Joseph A. Carnevale  MD , Kashif Majeed  MD , Gary Kocharian  MD , Ibrahim Hussain  MD , Jacob L. Goldberg  MD , Justin Schwarz  MD , David I. Kutler  MD , Jared Knopman  MD , and Philip Stieg  PhD, MD

doi : 10.3171/2022.3.JNS22136

Carotid body tumors (CBTs) are rare, slow-growing neoplasms derived from the parasympathetic paraganglia of the carotid bodies. Although inherently vascular lesions, the role of preoperative embolization prior to resection remains controversial.

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Adverse radiation effect and freedom from progression following repeat stereotactic radiosurgery for brain metastases

Penny K. Sneed  MD , Jason W. Chan  MD , Lijun Ma  PhD , Steve E. Braunstein  MD, PhD , Philip V. Theodosopoulos  MD , Shannon E. Fogh  MD , Jean L. Nakamura  MD , Lauren Boreta  MD , David R. Raleigh  MD, PhD , Benjamin P. Ziemer  PhD , Olivier Morin  PhD , Shawn L. Hervey-Jumper  MD , and Michael W. McDermott  MD

doi : 10.3171/2022.4.JNS212597

The authors previously evaluated risk and time course of adverse radiation effects (AREs) following stereotactic radiosurgery (SRS) for brain metastases, excluding lesions treated after prior SRS.

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Pineal cyst: results of long-term MRI surveillance and analysis of growth and shrinkage rates

Hirotaka Hasegawa  MD, PhD , Akitoshi Inoue  MD, PhD , Ahmed Helal  MBBCh, MSc , Kosuke Kashiwabara  PhD , and Fredric B. Meyer  MD

doi : 10.3171/2022.4.JNS22276

Pineal cyst (PC) is a relatively common true cyst in the pineal gland. Its long-term natural course remains ill defined. This study aims to evaluate the long-term natural history of PC and examine MRI risk factors for cyst growth and shrinkage to help better define which patients might benefit from surgical intervention.

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High intratumoral susceptibility signal grade on susceptibility-weighted imaging: a risk factor for hemorrhage after stereotactic biopsy

Masahiro Tanji  MD, PhD , Yohei Mineharu  MD, PhD , Akihiko Sakata  MD, PhD , Sachi Okuchi  MD, PhD , Yasutaka Fushimi  MD, PhD , Masahiro Oishi  MD, PhD , Yukinori Terada  MD, PhD , Noritaka Sano  MD, PhD , Yukihiro Yamao  MD, PhD , Yoshiki Arakawa  MD, PhD , Kazumichi Yoshida  MD, PhD , and Susumu Miyamoto  MD, PhD

doi : 10.3171/2022.4.JNS212505

This study aimed to examine the association of preoperative intratumoral susceptibility signal (ITSS) grade with hemorrhage after stereotactic biopsy (STB).

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A taxonomy for brainstem cavernous malformations: subtypes of medullary lesions

Joshua S. Catapano  MD , Kavelin Rumalla  MD , Visish M. Srinivasan  MD , Peter M. Lawrence  MS, CMI , Kristen Larson Keil  MS, CMI , and Michael T. Lawton  MD

doi : 10.3171/2022.3.JNS22626

Medullary cavernous malformations are the least common of the brainstem cavernous malformations (BSCMs), accounting for only 14% of lesions in the authors’ surgical experience. In this article, a novel taxonomy for these lesions is proposed based on clinical presentation and anatomical location.

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Association of circumferential aneurysm wall enhancement with recurrence after coiling of unruptured intracranial aneurysms: a preliminary vessel wall imaging study

Takeshi Hara  MD , Toshinori Matsushige  MD , Michitsura Yoshiyama  MD , Yukishige Hashimoto  MD , Shohei Kobayashi  MD , and Shigeyuki Sakamoto  MD

doi : 10.3171/2022.4.JNS22421

Recent histopathological studies of unruptured intracranial aneurysms (UIAs) have confirmed that aneurysm wall enhancement (AWE) on MR vessel wall imaging (VWI) is related to wall degeneration with in vivo inflammatory cell infiltration. Therefore, pretreatment aneurysm wall status on VWI may be associated with recurrence after endovascular treatment.

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Long-term functional independence after minimally invasive endoscopic intracerebral hemorrhage evacuation

Muhammad Ali  BA , Xiangnan Zhang  MS , Luis C. Ascanio  MD , Zachary Troiani  BS , Colton Smith  BS , Neha S. Dangayach  MD , John W. Liang  MD , Magdy Selim  MD, PhD , J Mocco  MD , and Christopher P. Kellner  MD

doi : 10.3171/2022.3.JNS22286

Intracerebral hemorrhage (ICH) is a devastating form of stroke with no proven treatment. However, minimally invasive endoscopic evacuation is a promising potential therapeutic option for ICH.

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A quantitative model to differentiate nonaneurysmal perimesencephalic subarachnoid hemorrhage from aneurysmal etiology

Daniel Mandel  MD , Scott Moody  BA , Kelly Pan  BS , Thanujaa Subramaniam  MD , Bradford B. Thompson  MD , Linda C. Wendell  MD , Michael E. Reznik  MD , Karen L. Furie  MD, MPH , and Ali Mahta  MD

doi : 10.3171/2022.3.JNS22157

Nonaneurysmal perimesencephalic subarachnoid hemorrhage (pmSAH) is considered to have a lower-risk pattern than other types of subarachnoid hemorrhage (SAH).

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The profile of cognitive impairment and hemodynamic compromise in moyamoya: a single-center prospective cohort study

Annick Kronenburg  MD , Pieter T. Deckers  MD , Esther van den Berg  PhD , Monique M. van Schooneveld  PhD , Evert-Jan Vonken  MD, PhD , Albert van der Zwan  MD, PhD , Bart N. M. van Berckel  MD, PhD , Maqsood Yaqub  PhD , Willem Otte  PhD , Catharina J. M. Klijn  MD, PhD , and Kees P. J. Braun  MD, PhD

doi : 10.3171/2022.3.JNS212844

Patients with moyamoya vasculopathy often experience cognitive impairments. In this prospective single-center study, the authors investigated the profile of neurocognitive impairment and its relation with the severity of ischemic brain lesions and hemodynamic compromise.

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Morphological evaluation of the risk of posterior communicating artery aneurysm rupture: a mirror aneurysm model

Wei-Dong Xu  MS , Ru-Dong Chen  BS , Sheng-Qi Hu  BS , Yu-Yang Hou  BS , and Jia-Sheng Yu  MD

doi : 10.3171/2022.4.JNS22490

The aim of this study was to use morphological parameters of mirror posterior communicating artery (PCoA) aneurysms to evaluate aneurysm rupture risk.

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Activation of the NLRP3/IL-1β/MMP-9 pathway and intracranial aneurysm rupture associated with the depletion of ERα and Sirt1 in oophorectomized rats

Tadashi Yamaguchi  MD , Takeshi Miyamoto  MD PhD , Eiji Shikata  MD , Izumi Yamaguchi  MD, PhD , Kenji Shimada  MD, PhD , Kenji Yagi  MD, PhD , Yoshiteru Tada  MD, PhD , Masaaki Korai  MD, PhD , Keiko T. Kitazato  MS , Yasuhisa Kanematsu  MD, PhD , and Yasushi Takagi  MD, PhD

doi : 10.3171/2022.4.JNS212945

Subarachnoid hemorrhage (SAH) due to intracranial aneurysm (IA) rupture is often a devastating event. Since the incidence of SAH increases especially in menopause, it is crucial to clarify the detailed pathogenesis of these events.

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Not a trifecta: complementary use of carotid artery revascularization techniques in the era of hybrid neurosurgery

Bennett R. Levy  BA , Muhammad Waqas  MBBS , Andre Monteiro  MD , Justin M. Cappuzzo  MD , Ammad A. Baig  MD , Wasiq I. Khawar  BA , Jason M. Davies  MD, PhD , Kenneth V. Snyder  MD, PhD , Adnan H. Siddiqui  MD, PhD , Howard A. Riina  MD, MPhil , and Elad I. Levy  MD, MBA

doi : 10.3171/2022.4.JNS22420

Carotid stenosis is currently treated by carotid endarterectomy (CEA), carotid artery stenting (CAS), or transcarotid artery revascularization (TCAR). This study sought to add to the literature by providing real-world data comparing the safety and effectiveness associated with the performance of these carotid revascularization techniques by dual-trained neurosurgeons.

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Effect of endovascular treatment within 6 hours for acute basilar artery occlusion

Jie Yang  MS , Fengli Li  MD , Zhongming Qiu  MD , Yan Wang  MS , Jun Luo  MS , Youlin Wu  MS , Guoyong Zeng  MS , Yue Wan  MS , Shuai Liu  MS , Chengsong Yue  MS , Jiaxing Song  MS , Weidong Luo  MS , Chang Liu  MD , Linyu Li  MS , Ruidi Sun  MS , Jiacheng Huang  MD , Hongfei Sang  MD , Chenhao Zhao  MD , Qingwu Yang  MD , and Wenjie Zi  MD

doi : 10.3171/2022.4.JNS22355

The aim of this study was to investigate the efficacy and safety of endovascular treatment (EVT) plus standard medical treatment (SMT) in patients with acute basilar artery occlusion (BAO) within 6 hours of the estimated occlusion time, based on a Chinese population.

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Clinical characteristics, endovascular choices, and surgical outcomes of intracranial vertebral artery dissecting aneurysms: a consecutive series of 196 patients

Peixi Liu  MD , Zongze Li  MD , Liuxun Hu  MD , Yingjun Liu  MD, PhD , Peiliang Li  MD, PhD , Wei Zhu  MD, PhD , Yanlong Tian  MD, PhD , and Ying Mao  MD, PhD

doi : 10.3171/2022.4.JNS22609

The authors aimed to evaluate the clinical features, endovascular strategy selection, and outcomes of vertebral artery (VA) dissecting aneurysms (VADAs) near the origin of the posterior inferior cerebellar artery (PICA).

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Cost-effectiveness analysis of endovascular treatment with or without intravenous thrombolysis in acute ischemic stroke

Adnan I. Qureshi  MD , Yasemin Akinci  MD , Wei Huang  MA , Muhammad F. Ishfaq  MD , Ameer E. Hassan  DO , Farhan Siddiq  MD , and Camilo R. Gomez  MD

doi : 10.3171/2022.4.JNS22514

Intravenous (IV) recombinant tissue plasminogen activator (r-tPA) may not provide additional benefit in terms of functional outcomes in patients with acute ischemic stroke (AIS) who undergo endovascular treatment (EVT). In this context, the cost-effectiveness of EVT alone compared with its application following IV r-tPA has not been evaluated.

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Target Ultra and Nano coils in the endovascular treatment of small intracranial aneurysms (ULTRA Registry)

Gaurav Jindal  MD , Ranyah Almardawi  MBBS, MPH , Rishi Gupta  MD , Geoffrey P. Colby  MD, PhD , Clemens M. Schirmer  MD, PhD, MBA , Sudhakar R. Satti  MD , Bryan Pukenas  MD , Ferdinand K. Hui  MD , Justin Caplan  MD , Timothy Miller  MD , Jacob Cherian  MD , Francois Aldrich  MD , Gulam Kibria  MBBS, MSPH , J. Marc Simard  MD , and for the ULTRA Study Investigators

doi : 10.3171/2022.5.JNS2296

The ULTRA Registry is a national multicenter prospective study designed to assess aneurysm occlusion rates and safety profiles of the Target Ultra and Nano coils in the treatment of small intracranial aneurysms (IAs).

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Compactness index: a radiosurgery outcome predictor for patients with unruptured brain arteriovenous malformations

Po-Wei Huang  MD , Syu-Jyun Peng  PhD , David Hung-Chi Pan  MD , Huai-Che Yang  MD , Jo-Ting Tsai  MD, PhD , Cheng-Ying Shiau  MD , I-Chang Su  MD , Ching-Jen Chen  MD , Hsiu-Mei Wu  MD , Chung-Jung Lin  MD , Wen-Yuh Chung  MD , Wan-Yuo Guo  MD, PhD , Wei-Lun Lo  MD , Shao-Wen Lai , and Cheng-Chia Lee  MD, PhD

doi : 10.3171/2022.4.JNS212369

The goal of the study was to define and quantify brain arteriovenous malformation (bAVM) compactness and to assess its effect on outcomes after Gamma Knife radiosurgery (GKRS) for unruptured bAVMs.

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Recruitment of women in neurosurgery: a 7-year quantitative analysis

James Feghali  MD , Albert Antar  BS , Elizabeth E. Wicks  BA , Shahab Aldin Sattari  MD , Sean Li , Timothy F. Witham  MD , Henry Brem  MD , and Judy Huang  MD

doi : 10.3171/2022.4.JNS22410

The authors aimed to characterize which US medical schools have the most female neurosurgery residents and to identify potential associations between medical school characteristics and successful recruitment of women pursuing a neurosurgery career.

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The New England Neurosurgical Society: growth and evolution over 70 years

Andy Y. Wang  AB , Vaishnavi Sharma  BA , Wenya Linda Bi  MD, PhD , William T. Curry  MD , Jeffrey E. Florman  MD , Michael W. Groff  MD , Carl B. Heilman  MD , Jennifer Hong  MD , James Kryzanski  MD , S. Scott Lollis  MD , Gerald T. McGillicuddy  MD , Jennifer Moliterno  MD , Christopher S. Ogilvy  MD , Dennis S. Oh  MD , Adetokunbo A. Oyelese  MD, PhD , Mark R. Proctor  MD , Perry A. Shear  MD , Andrew E. Wakefield  MD , Robert G. Whitmore  MD , and Ron I. Riesenburger  MD

doi : 10.3171/2022.3.JNS212777

The New England Neurosurgical Society (NENS) was founded in 1951 under the leadership of its first President (Dr. William Beecher Scoville) and Secretary-Treasurer (Dr. Henry Thomas Ballantine).

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Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia

Risheng Xu  MD, PhD , Joshua Materi  BS , Divyaansh Raj  BS , Safwan Alomari  MD , Yuanxuan Xia  MD , Sumil K. Nair  BA , Pavan P. Shah  BS , Nivedha Kannapadi  BA , Timothy Kim  BS , Judy Huang  MD , Chetan Bettegowda  MD, PhD , and Michael Lim  MD

doi : 10.3171/2022.3.JNS212956

Internal neurolysis (IN) and intraoperative glycerin rhizotomy (ioGR) are emerging surgical options for patients with trigeminal neuralgia without neurovascular contact. The objective of this study was to compare the neurological outcomes of patients who underwent IN with those of patients who underwent ioGR.

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Surgical morbidity of the extradural anterior petrosal approach: the Lariboisière experience

Lorenzo Giammattei  MD , Thibault Passeri  MD , Rosaria Abbritti  MD , Stefan Lieber  MD , Fumihiro Matano  MD, PhD , Tuan Le Van  MD , Atsushi Okano  MD , Arianna Fava  MD , Paolo di Russo  MD , and Sébastien Froelich  MD

doi : 10.3171/2022.3.JNS212962

Concerns about the approach-related morbidity of the extradural anterior petrosal approach (EAPA) have been raised, especially regarding temporal lobe and venous injuries, hearing impairment, facial nerve palsy, cerebrospinal fluid fistula, and seizures. There is lack in the literature of studies with detailed analysis of surgical complications.

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Early outcomes of the American Academy of Neurological Surgery Emerging Investigator Program in promoting neurosurgeon-scientists

Anja I. Srienc  MD, PhD , Sophie C. Church  BA , Stephen J. Korn  PhD , Russell R. Lonser  MD , and Gregory J. Zipfel  MD

doi : 10.3171/2022.5.JNS212846

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Letter to the Editor. Supramaximal resection for newly diagnosed eloquent glioblastoma

Binghao Zhao  MD , Hao Xing  MD , Yu Xia  MD , and Wenbin Ma  MD

doi : 10.3171/2022.6.JNS221338

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Letter to the Editor. Surgical treatment options for trigeminal neuralgia

Songshan Chai  MD, PhD , Qiangqiang Zhou  MD , Yuankun Cai  MD , Zhimin Mei  MD , and Nanxiang Xiong  MD, PhD

doi : 10.3171/2022.6.JNS221342

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Letter to the Editor. Dopaminergic transmission as the mechanism of action of STN-DBS

Josue M. Avecillas-Chasin  MD, PhD

doi : 10.3171/2022.7.JNS221572

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Letter to the Editor. Stereotactic radiosurgery for cavernous malformations: does it beat the natural history?

Basel A. Taweel  MPhil , Cathal J. Hannan  MRCS , and Emmanuel Chavredakis  FRCS

doi : 10.3171/2022.5.JNS22904

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