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Accuracy and efficiency using frameless transient fiducial registration in stereoelectroencephalography and deep brain stimulation
Kevin Hines MD, PhD , Caio M. Matias MD, PhD , Adam Leibold MD, MS , Ashwini Sharan MD , and Chengyuan Wu MD, MSBmE
doi : 10.3171/2022.5.JNS22804
Volume 138: Issue 2 (Feb 2023)
Stereotactic surgical methods continue to advance technologically. Frameless transient fiducial registration (FTFR) systems have been developed and avoid the need to move or position a patient in a frame after already receiving registration imaging. One such system, Neurolocate, has recently become available as a robotic attachment for the Neuromate stereotactic robot.
Magnetic resonance–guided focused ultrasound thalamotomy restored distinctive resting-state networks in patients with essential tremor
Sachiko Kato  MD , Satoshi Maesawa  MD, PhD , Epifanio Bagarinao  PhD , Daisuke Nakatsubo  MD , Takahiko Tsugawa  MD, PhD , Satomi Mizuno  ST, BAPsy , Kazuya Kawabata  MD, PhD , Takashi Tsuboi  MD, PhD , Masashi Suzuki  MD, PhD , Masashi Shibata  MD , Sou Takai  MD , Tomotaka Ishizaki  MD, PhD , Jun Torii  MD , Manabu Mutoh  MD , Ryuta Saito  MD, PhD , Toshihiko Wakabayashi  MD, PhD , Masahisa Katsuno  MD, PhD , Norio Ozaki  MD, PhD , Hirohisa Watanabe  MD, PhD , and Gen Sobue  MD, PhD
doi : 10.3171/2022.5.JNS22411
Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy ameliorates symptoms in patients with essential tremor (ET). How this treatment affects canonical brain networks has not been elucidated. The purpose of this study was to clarify changes of brain networks after MRgFUS thalamotomy in ET patients by analyzing resting-state networks (RSNs).
Differences in intrinsic functional networks in patients with essential tremor who had good and poor long-term responses after thalamotomy performed using MR-guided ultrasound
Chongwon Pae PhD , Myung Ji Kim MD , Won Seok Chang MD, PhD , Hyun Ho Jung MD, PhD , Kyung Won Chang MD , Jinseok Eo , Hae-Jeong Park PhD , and Jin Woo Chang MD, PhD
doi : 10.3171/2022.5.JNS22324
Thalamotomy at the nucleus ventralis intermedius using MR-guided focused ultrasound has been an effective treatment method for essential tremor (ET). However, this is not true for all cases, even for successful ablation.
Identifying the therapeutic zone in globus pallidus deep brain stimulation for Parkinson’s disease
Marshall T. Holland  MD, MS , Jocelyn Jiao  MD, MS , Alessandra Mantovani  MD , Shannon Anderson  PA-C , Katherine A. Mitchell  BS, PA , Delaram Safarpour  MD, MSCE , and Kim J. Burchiel  MD
doi : 10.3171/2022.5.JNS22152
The globus pallidus internus (GPI) has been demonstrated to be an effective surgical target for deep brain stimulation (DBS) treatment in patients with medication-refractory Parkinson’s disease (PD).
Nucleus accumbens: a systematic review of neural circuitry and clinical studies in healthy and pathological states
Han Yan MD , Nathan A. Shlobin BA , Youngkyung Jung MD , Kristina K. Zhang BMSc , Nebras Warsi MD , Abhaya V. Kulkarni MD, PhD , and George M. Ibrahim MD, PhD
doi : 10.3171/2022.5.JNS212548
The nucleus accumbens (NAcc) of the ventral striatum is critically involved in goal- and reward-based behavior. Structural and functional abnormalities of the NAcc or its associated neural systems are involved in neurological and psychiatric disorders.
Cost-effectiveness analysis of radiosurgical capsulotomy versus treatment as usual for treatment-resistant obsessive-compulsive disorder
Ricardo A. Najera BS, BA , Sean T. Gregory MBA, MS, PhD , Ben Shofty MD, PhD , Adrish Anand BA , Ron Gadot BSc , Brett E. Youngerman MD, MS , Eric A. Storch PhD , Wayne K. Goodman MD , and Sameer A. Sheth MD, PhD
doi : 10.3171/2022.5.JNS22474
Stereotactic radiosurgical capsulotomy (SRS-C) is an effective neurosurgical option for patients with treatment-resistant obsessive-compulsive disorder (TROCD). Unlike other procedures such as deep brain stimulation and radiofrequency ablation, the cost-effectiveness of SRS-C for TROCD has not been investigated. The authors herein report the first cost-effectiveness analysis of SRS-C for TROCD.
Use of fluorescein sodium–assisted intraoperative sample validation to maximize the diagnostic yield of stereotactic brain biopsy: progress toward a new standard of care?
Andrea Bianco  MD , Mattia Del Maestro  MD , Andrea Fanti  MD , Chiara Airoldi  MSc , Thomas Fleetwood  MD , Emanuela Crobeddu  MD, PhD , and Christian Cossandi  MD
doi : 10.3171/2022.4.JNS212954
In patients with contraindication to open resection, histological diagnosis is obtained through a stereotactic biopsy (SB). Missed diagnoses and sampling errors are important limitations of SB; therefore, various ways have been proposed to increase the diagnostic yield (DY).
Development of an ultrafast brain MR neuronavigation protocol for ventricular shunt placement
Erik B. Vanstrum BA , Matthew T. Borzage PhD , Joseph Ha BA , Jason Chu MD , Meenakshi Upreti PhD , Rex A. Moats PhD , Lillian M. Lai MD , and Peter A. Chiarelli MD, Dphil
doi : 10.3171/2022.5.JNS22767
Advancements in MRI technology have provided improved ways to acquire imaging data and to more seamlessly incorporate MRI into modern pediatric surgical practice. One such situation is image-guided navigation for pediatric neurosurgical procedures, including intracranial catheter placement.
Median trans–atlanto-occipital membrane microsurgical approach to the posterior cranial fossa without craniotomy
David Pitskhelauri  MD, PhD , Rinat Sufianov  MD , Alexander Konovalov  MD, PhD , Igor Pronin  MD, PhD , and Alexander Sanikidze  MD, PhD
doi : 10.3171/2022.5.JNS22111
Minimally invasive approaches are becoming increasingly popular and contributing to improving the results of the surgical treatment of a wide variety of intracranial pathologies. Fifteen patients with posterior cranial fossa tumors underwent microsurgery through the atlanto-occipital membrane without resection of any bone structures.
Space-expanding flap in decompressive hemicraniectomy for stroke
Philippe Schucht MD , Andreas Nowacki MD , Armin Osmanagic MD , Michael Murek MD , Werner J. Z’Graggen MD , Matteo Montalbetti MD , Jürgen Beck MD , Lennart Stieglitz MD , and Andreas Raabe MD
doi : 10.3171/2022.5.JNS22381
Decompressive hemicraniectomy (DCE) is the standard of care for space-occupying malignant infarction of the medial cerebral artery in suitable patients. After DCE, the brain is susceptible to trauma and at risk for the syndrome of the trephined. This study aimed to assess the feasibility of using temporary space-expanding flaps, implanted during DCE, to shield the brain from these risks while permitting the injured brain to expand.
Sacrifice or preserve the superior petrosal vein in microvascular decompression surgery: a systematic review and meta-analysis
Shahab Aldin Sattari MD , Ataollah Shahbandi , Risheng Xu MD, PhD , Alice Hung MD , James Feghali MD , Wuyang Yang MD , Ryan P. Lee MD , Chetan Bettegowda MD, PhD , and Judy Huang MD
doi : 10.3171/2022.5.JNS22143
In microvascular decompression (MVD) surgery through the retrosigmoid approach, the surgeon may have to sacrifice the superior petrosal vein (SPV). However, this is a controversial maneuver. To date, high-level evidence comparing the operative outcomes of patients who underwent MVD with and without SPV sacrifice is lacking. Therefore, this study sought to bridge this gap.
Direct cochlear nerve stimulation monitoring through evoked muscle responses during retrosigmoid vestibular schwannoma resection surgery: technical note
Daniele Starnoni MD , Giulia Cossu MD , Rodolfo Maduri MD , Constantin Tuleasca MD, PhD , Mercy George MD , Raphael Maire MD , Mahmoud Messerer MD , Marc Levivier MD, PhD , Etienne Pralong MD , and Roy T. Daniel MD
doi : 10.3171/2022.5.JNS2265
Cochlear nerve preservation during surgery for vestibular schwannoma (VS) may be challenging. Brainstem auditory evoked potentials and cochlear compound nerve action potentials have clearly shown their limitations in surgeries for large VSs. In this paper, the authors report their preliminary results after direct electrical intraoperative cochlear nerve stimulation and recording of the postauricular muscle response (PAMR) during resection of large VSs.
Stereotactic radiosurgery for Koos grade IV vestibular schwannoma: a multi-institutional study
Stylianos Pikis MD, MSc , Georgios Mantziaris MD , Rithika Kormath Anand , Ahmed M. Nabeel MD, PhD , Darrah Sheehan , Kimball Sheehan , Wael A. Reda MD, PhD , Sameh R. Tawadros MD, PhD , Khaled Abdelkarim MD, PhD , Amr M. N. El-Shehaby MD, PhD , Reem Emad Eldin MD, PhD , Selcuk Peker MD , Yavuz Samanci MD , Tehila Kaisman-Elbaz MD, PhD, BPT , Herwin Speckter MSc , Wenceslao Hernández MD , Julio Isidor MD , Manjul Tripathi MCh , Renu Madan MD , Brad E. Zacharia MD , Lekhaj C. Daggubati MD , Nuria MartÃnez Moreno MD, PhD , Roberto MartÃnez Ã�lvarez MD, PhD , Anne-Marie Langlois MD , David Mathieu MD , Christopher P. Deibert MD , Vivek R. Sudhakar MD , Christopher P. Cifarelli MD, PhD, MMM , Denisse Arteaga Icaza MD , Daniel T. Cifarelli MD, MS , Zhishuo Wei MSc , Ajay Niranjan MD, MBA , Gene H. Barnett MD , L. Dade Lunsford MD , Greg N. Bowden MD, MSc , and Jason P. Sheehan MD, PhD
doi : 10.3171/2022.4.JNS22203
Though stereotactic radiosurgery (SRS) is an established safe treatment for small- and medium-sized vestibular schwannomas (VSs), its role in the management of Koos grade IV VS is still unclear. In this retrospective multicenter study, the authors evaluated tumor control and the patient outcomes of primary, single-session SRS treatment for Koos grade IV VS.
Intratumoral hemorrhage in vestibular schwannomas after stereotactic radiosurgery
Othman Bin-Alamer MBBS , David Fogg BS , Zhishuo Wei BS , James Duehr PhD , Arka N. Mallela MD, MS , Ajay Niranjan MD, MBA , L. Dade Lunsford MD , and Hussam Abou-Al-Shaar MD
doi : 10.3171/2022.5.JNS22935
Vestibular schwannomas (VSs) are benign tumors of the cerebellopontine angle that are typically managed with stereotactic radiosurgery (SRS). Intratumoral hemorrhage (ITH) of VSs is a rare occurrence that results in worsening vestibular and new cranial nerve deficits. Few reports have described the management and outcomes of this entity after SRS. To further delineate the incidence and impact of this event, the authors performed a retrospective review of their VS SRS patients at a single center.
Salvage radiosurgery following subtotal resection of vestibular schwannomas: does timing influence tumor control?
Dhanushan Dhayalan MD , Avital Perry MD , Christopher S. Graffeo MD, MS , Øystein Vesterli Tveiten MD, PhD , Amanda Muñoz Casabella MD , Bruce E. Pollock MD , Colin L. W. Driscoll MD , Matthew L. Carlson MD , Michael J. Link MD , and Morten Lund-Johansen MD, PhD
doi : 10.3171/2022.5.JNS22249
The goal of microsurgical resection of vestibular schwannoma (VS) is gross-total resection (GTR) to provide oncological cure. However, a popular strategy is to halt the resection if the surgical team feels the risk of cranial nerve injury is imminent, achieving a maximally safe subtotal resection (STR) instead.
Adjuvant oral tranexamic acid and reoperation after burr hole surgery in patients with chronic subdural hematoma: propensity score–matched analysis using a nationwide inpatient database
Keita Shibahashi  MD, PhD , Hiroyuki Ohbe  MD , and Hideo Yasunaga  MD, PhD
doi : 10.3171/2022.5.JNS22664
Adjuvant medical treatment to reduce the recurrence rate after burr hole surgery for chronic subdural hematoma (CSDH) has not yet been established. This study aimed to investigate the association between tranexamic acid (TXA) use after burr hole surgery and the reoperation rate in patients with CSDH.
Simple wound closure compared with surgery for civilian cranial gunshot wounds
Evan M. Krueger DO, MSc , Ronald J. Benveniste MD, PhD , Victor M. Lu MD, PhD , Ruby R. Taylor BS , Rahul Kumar , Joacir G. Cordeiro MD, PhD , and Jonathan R. Jagid MD
doi : 10.3171/2022.5.JNS22617
A carefully selected subset of civilian cranial gunshot wound (CGSW) patients may be treated with simple wound closure (SWC) as a proactive therapy, but the appropriate clinical scenario for using this strategy is unknown. The aim of this study was to compare SWC and surgery patients in terms of their neurological outcomes and complications, including infections, seizures, and reoperations.
ICP, CPP, and PRx in traumatic brain injury and aneurysmal subarachnoid hemorrhage: association of insult intensity and duration with clinical outcome
Teodor Svedung Wettervik MD, PhD , Anders Hånell PhD , Timothy Howells PhD , Elisabeth Ronne Engström MD, PhD , Anders Lewén MD, PhD , and Per Enblad MD, PhD
doi : 10.3171/2022.5.JNS22560
The primary aim of this study was to determine the combined effect of insult intensity and duration of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and pressure reactivity index (PRx) on outcome measured with the Glasgow Outcome Scale–Extended (GOS-E) in patients with traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (aSAH).
Serum assessment of traumatic axonal injury: the correlation of GFAP, t-Tau, UCH-L1, and NfL levels with diffusion tensor imaging metrics and its prognosis utility
Ana M. Castaño-Leon MD, PhD , Cristina Sánchez Carabias MsC , Amaya Hilario MD, PhD , Ana Ramos MD, PhD , Blanca Navarro-Main MPsy , Igor Paredes MD, PhD , Pablo M. Munarriz MD, PhD , Irene Panero MD , Carla Eiriz Fernández MD , Daniel GarcÃa-Pérez MD, PhD , Luis Miguel Moreno-Gomez MD , Olga Esteban-Sinovas MD , Guillermo Garcia Posadas MD , Pedro A. Gomez MD, PhD , and Alfonso Lagares MD, PhD
doi : 10.3171/2022.5.JNS22638
Diagnosis of traumatic axonal injury (TAI) is challenging because of its underestimation by conventional MRI and the technical requirements associated with the processing of diffusion tensor imaging (DTI). Serum biomarkers seem to be able to identify patients with abnormal CT scanning findings, but their potential role to assess TAI has seldomly been explored.
Changes in patterns of traumatic brain injury in the Michigan Trauma Quality Improvement Program database early in the COVID-19 pandemic
Reid A. Johnson BS , Anne Eaton PhD, MS , Christopher J. Tignanelli MD, MS , Kailey J. Carrabre BA , Christina Gerges MD , George L. Yang MD , Mark R. Hemmila MD , Laura B. Ngwenya MD, PhD , James M. Wright MD , Ann M. Parr MD, PhD , and in affiliation with the Council of State Neurosurgical Societies (CSNS)
doi : 10.3171/2022.5.JNS22244
The authors’ objective was to investigate the impact of the global COVID-19 pandemic on hospital presentation and process of care for the treatment of traumatic brain injuries (TBIs). Improved understanding of these effects will inform sociopolitical and hospital policies in response to future pandemics.
Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools
Sanna A. Eklund , Hanna Israelsson MD, PhD , Bo Carlberg MD, PhD , and Jan Malm MD, PhD
doi : 10.3171/2022.4.JNS22125
Vascular risk factors (VRFs) may act synergistically, and clinical decision support tools (CDSTs) have been developed that present vascular risk as a summarized score.
Factors affecting ventriculoperitoneal shunt revision: a post hoc analysis of the British Antibiotic and Silver Impregnated Catheter Shunt multicenter randomized controlled trial
Geraint J. Sunderland MBChB, MRCS , Elizabeth J. Conroy PhD , Alexandra Nelson MBChB, MRes , Carrol Gamble PhD , Michael D. Jenkinson FRCSEd (NeuroSurg), PhD , Michael J. Griffiths BM, BS, MRCP (Paeds), DPhil , and Conor L. Mallucci MB, BS, FRCS
doi : 10.3171/2022.4.JNS22572
The British Antibiotic and Silver Impregnated Catheter Shunt (BASICS) trial established level I evidence of the superiority of antibiotic-impregnated catheters in the prevention of infection of newly implanted ventriculoperitoneal shunts (VPSs). A wealth of patient, shunt, and surgery-specific data were collected from trial participants beyond that of the prespecified trial objectives.
A standardized infection prevention bundle for reduction of CSF shunt infections in adult ventriculoperitoneal shunt surgery performed without antibiotic-impregnated catheters
Sandeep Muram MD , Albert M. Isaacs MD, PhD , Nicholas Sader MD, MSc , Richard Holubkov PhD , Annie Fong BSc, BN , John Conly MD , and Mark G. Hamilton MD, CM
doi : 10.3171/2022.5.JNS22430
Ventriculoperitoneal (VP) shunt insertion and revision surgeries are some of the most common procedures that are performed by neurosurgeons. Shunt infections within the adult population are associated with significant morbidity and mortality and rates remain high. The objective of the current study was to use quality improvement (QI) methodology to create a standardized infection prevention bundle aimed at reducing the rate of shunt infections.
Extra-axial endoscopic third ventriculostomy: preliminary experience with a technique to circumvent conventional endoscopic third ventriculostomy complications
Sanjeev Kumar MCh , Debabrata Sahana MCh , Lavlesh Rathore MCh , Amit Jain MCh , Manish Tawari MCh , Deepak Singh DM , Rajiv Sahu MCh , and Satya Narayan Madhariya MCh
doi : 10.3171/2022.5.JNS22589
Endoscopic third ventriculostomy (ETV) is mostly safe but may have serious complications. Most of the complications are inherent to the procedure’s intra-axial nature. This study aimed to explore an alternative route to overcome inherent issues with conventional ETV. The authors performed supraorbital, subfrontal extra-axial ETV (EAETV) via the lamina terminalis.
Rates of operative intervention for infection after synthetic or autologous cranioplasty: a National Readmissions Database analysis
Truong H. Do MD , Jinci Lu BA , Elise F. Palzer BS , Samuel W. Cramer MD, PhD , Jared D. Huling PhD , Reid A. Johnson BS , Ping Zhu MMed, PhD , James N. Jean IV BS , Madeleine A. Howard BS , Luke T. Sabal BS , Jacob T. Hanson BA , Alec B. Jonason BS , Kevin W. Sun , Robert A. McGovern MD , and Clark C. Chen MD, PhD
doi : 10.3171/2022.4.JNS22301
The aim of this study was to characterize the clinical utilization and associated charges of autologous bone flap (ABF) versus synthetic flap (SF) cranioplasty and to characterize the postoperative infection risk of SF versus ABF using the National Readmissions Database (NRD).
Endoscopic endonasal approach for infradiaphragmatic craniopharyngiomas: a multicentric Italian study
Domenico Solari MD, PhD , Elena d’Avella MD, PhD , Gianluca Agresta MD , Domenico Catapano MD , Aurelio D’Ecclesia MD, PhD , Davide Locatelli MD , Luca Massimi MD, PhD , Diego Mazzatenta MD , Giannantonio Spena MD , Gianpiero Tamburrini PhD , Cesare Zoia MD, PhD , Matteo Zoli MD, PhD , Giuseppe Cinalli MD , Paolo Cappabianca MD , and Luigi Maria Cavallo MD, PhD
doi : 10.3171/2022.5.JNS212974
Infradiaphragmatic craniopharyngiomas (ICs) represent a distinct subtype, harboring a sellar-suprasellar origin and generally growing in the extra-arachnoidal space contained by the diaphragma sellae. They have been considered ideal for surgical removal through the transsphenoidal approach since the 1960s. The authors present a multicentric national study, intending to selectively analyze IC behavior and the impact of the transsphenoidal endoscopic endonasal approach (EEA) on surgical outcomes.
Breaking boundaries through Doctors Reaching Minority Men Exploring Neuroscience: a mentorship model to foster a pipeline for underrepresented minorities
Ian T. McNeill MD , Alejandro Carrasquilla MD , Zerubabbel K. Asfaw BA , Ernest J. Barthélemy MD, MPH, MA , Alyson Mehr LMSW , Kenya D. Townsend BA , Alexander Joseph MA , Joshua B. Bederson MD , Gary C. Butts MD , and Isabelle M. Germano MD, MBA
doi : 10.3171/2022.5.JNS22196
Preoperative assessment of dominant occipital sinus in patients with Chiari malformation type I: anatomical variations and implications for preventing potentially life-threatening surgical complications
Satoru Tochigi MD , Akira Isoshima MD , Hiroki Ohashi MD, PhD , Daichi Kawamura MD , Kostadin Karagiozov MD, PhD , Keisuke Hatano MD , So Ohashi MD , Hiroyasu Nagashima MD , Yuichi Murayama MD , and Toshiaki Abe MD
doi : 10.3171/2022.5.JNS212973
The surgical treatment of Chiari malformation type I (CM-I) frequently involves dural incision at the posterior cranial fossa. In cases of persistent patent occipital sinus (OS), the sinus is usually obliterated and divided.
Equity in neurosurgery: a worldwide survey of women neurosurgeons
George W. Koutsouras DO , Lu Zhang PhD , Nelci Zanon MD , Sandi Lam MD , Frederick A. Boop MD , and Zulma Tovar-Spinoza MD
doi : 10.3171/2022.6.JNS22466
The global neurosurgery workforce does not have a defined stance on gender equity. The authors sought to study and characterize the demographic features of the international women neurosurgery community and to better understand the perceptions and reflections of their neurosurgical careers. The objective was to define and characterize the workplace inequities faced by the global women neurosurgeon community.
Words matter: using natural language processing to predict neurosurgical residency match outcomes
Alexander V. Ortiz MS , Michael J. Feldman MD , Aaron M. Yengo-Kahn MD , Steven G. Roth MD , Robert J. Dambrino IV MD , Rohan V. Chitale MD , and Lola B. Chambless MD
doi : 10.3171/2022.5.JNS22558
Narrative letters of recommendation (NLORs) are considered by neurosurgical program directors to be among the most important parts of the residency application. However, the utility of these NLORs in predicting match outcomes compared to objective measures has not been determined.
Quality of life and surgical outcomes in incidental pituitary adenomas undergoing endoscopic endonasal resection
Mendel Castle-Kirszbaum MBBS, PhD , Yi Yuen Wang MD, FRACS , James King PhD, FRACS , Jeremy Kam MBBS, FRACS , and Tony Goldschlager PhD, FRACS
doi : 10.3171/2022.5.JNS2286
Erratum. Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis
R. Loch Macdonald MD, PhD
Equity in neurosurgical scientific publication
William W. Ashley Jr. MD, PhD, MBA , Sonia V. Eden MD , and James T. Rutka MD, PhD
doi : 10.3171/2022.7.JNS221407
Letter to the Editor. Puerto Rico medical schools: neurosurgery residents matched during the 2014–2020 period
Orlando De Jesus  MD and Aixa de Jesús Espinosa  MS, MPH
doi : 10.3171/2022.8.JNS221771
Letter to the Editor. PBC for trigeminal neuralgia: predictive power of the balloon shape
Songshan Chai MD, PhD , Kai Fu MD, PhD , Bangkun Yang MD, PhD , Jie Zhang MD, PhD , and Nanxiang Xiong MD, PhD
doi : 10.3171/2022.7.JNS221628
Letter to the Editor. Role of adjuvant medical therapy in chronic subdural hematoma
Yilong Zheng and Kai Rui Wan MBBS, FRCS
doi : 10.3171/2022.7.JNS221715
Accuracy and efficiency using frameless transient fiducial registration in stereoelectroencephalography and deep brain stimulation
Kevin Hines MD, PhD , Caio M. Matias MD, PhD , Adam Leibold MD, MS , Ashwini Sharan MD , and Chengyuan Wu MD, MSBmE
doi : 10.3171/2022.5.JNS22804
Volume 138: Issue 2 (Feb 2023)
Stereotactic surgical methods continue to advance technologically. Frameless transient fiducial registration (FTFR) systems have been developed and avoid the need to move or position a patient in a frame after already receiving registration imaging. One such system, Neurolocate, has recently become available as a robotic attachment for the Neuromate stereotactic robot.
Magnetic resonance–guided focused ultrasound thalamotomy restored distinctive resting-state networks in patients with essential tremor
Sachiko Kato  MD , Satoshi Maesawa  MD, PhD , Epifanio Bagarinao  PhD , Daisuke Nakatsubo  MD , Takahiko Tsugawa  MD, PhD , Satomi Mizuno  ST, BAPsy , Kazuya Kawabata  MD, PhD , Takashi Tsuboi  MD, PhD , Masashi Suzuki  MD, PhD , Masashi Shibata  MD , Sou Takai  MD , Tomotaka Ishizaki  MD, PhD , Jun Torii  MD , Manabu Mutoh  MD , Ryuta Saito  MD, PhD , Toshihiko Wakabayashi  MD, PhD , Masahisa Katsuno  MD, PhD , Norio Ozaki  MD, PhD , Hirohisa Watanabe  MD, PhD , and Gen Sobue  MD, PhD
doi : 10.3171/2022.5.JNS22411
Magnetic resonance–guided focused ultrasound (MRgFUS) thalamotomy ameliorates symptoms in patients with essential tremor (ET). How this treatment affects canonical brain networks has not been elucidated. The purpose of this study was to clarify changes of brain networks after MRgFUS thalamotomy in ET patients by analyzing resting-state networks (RSNs).
Differences in intrinsic functional networks in patients with essential tremor who had good and poor long-term responses after thalamotomy performed using MR-guided ultrasound
Chongwon Pae PhD , Myung Ji Kim MD , Won Seok Chang MD, PhD , Hyun Ho Jung MD, PhD , Kyung Won Chang MD , Jinseok Eo , Hae-Jeong Park PhD , and Jin Woo Chang MD, PhD
doi : 10.3171/2022.5.JNS22324
Thalamotomy at the nucleus ventralis intermedius using MR-guided focused ultrasound has been an effective treatment method for essential tremor (ET). However, this is not true for all cases, even for successful ablation.
Identifying the therapeutic zone in globus pallidus deep brain stimulation for Parkinson’s disease
Marshall T. Holland  MD, MS , Jocelyn Jiao  MD, MS , Alessandra Mantovani  MD , Shannon Anderson  PA-C , Katherine A. Mitchell  BS, PA , Delaram Safarpour  MD, MSCE , and Kim J. Burchiel  MD
doi : 10.3171/2022.5.JNS22152
The globus pallidus internus (GPI) has been demonstrated to be an effective surgical target for deep brain stimulation (DBS) treatment in patients with medication-refractory Parkinson’s disease (PD).
Nucleus accumbens: a systematic review of neural circuitry and clinical studies in healthy and pathological states
Han Yan MD , Nathan A. Shlobin BA , Youngkyung Jung MD , Kristina K. Zhang BMSc , Nebras Warsi MD , Abhaya V. Kulkarni MD, PhD , and George M. Ibrahim MD, PhD
doi : 10.3171/2022.5.JNS212548
The nucleus accumbens (NAcc) of the ventral striatum is critically involved in goal- and reward-based behavior. Structural and functional abnormalities of the NAcc or its associated neural systems are involved in neurological and psychiatric disorders.
Cost-effectiveness analysis of radiosurgical capsulotomy versus treatment as usual for treatment-resistant obsessive-compulsive disorder
Ricardo A. Najera BS, BA , Sean T. Gregory MBA, MS, PhD , Ben Shofty MD, PhD , Adrish Anand BA , Ron Gadot BSc , Brett E. Youngerman MD, MS , Eric A. Storch PhD , Wayne K. Goodman MD , and Sameer A. Sheth MD, PhD
doi : 10.3171/2022.5.JNS22474
Stereotactic radiosurgical capsulotomy (SRS-C) is an effective neurosurgical option for patients with treatment-resistant obsessive-compulsive disorder (TROCD). Unlike other procedures such as deep brain stimulation and radiofrequency ablation, the cost-effectiveness of SRS-C for TROCD has not been investigated. The authors herein report the first cost-effectiveness analysis of SRS-C for TROCD.
Use of fluorescein sodium–assisted intraoperative sample validation to maximize the diagnostic yield of stereotactic brain biopsy: progress toward a new standard of care?
Andrea Bianco  MD , Mattia Del Maestro  MD , Andrea Fanti  MD , Chiara Airoldi  MSc , Thomas Fleetwood  MD , Emanuela Crobeddu  MD, PhD , and Christian Cossandi  MD
doi : 10.3171/2022.4.JNS212954
In patients with contraindication to open resection, histological diagnosis is obtained through a stereotactic biopsy (SB). Missed diagnoses and sampling errors are important limitations of SB; therefore, various ways have been proposed to increase the diagnostic yield (DY).
Development of an ultrafast brain MR neuronavigation protocol for ventricular shunt placement
Erik B. Vanstrum BA , Matthew T. Borzage PhD , Joseph Ha BA , Jason Chu MD , Meenakshi Upreti PhD , Rex A. Moats PhD , Lillian M. Lai MD , and Peter A. Chiarelli MD, Dphil
doi : 10.3171/2022.5.JNS22767
Advancements in MRI technology have provided improved ways to acquire imaging data and to more seamlessly incorporate MRI into modern pediatric surgical practice. One such situation is image-guided navigation for pediatric neurosurgical procedures, including intracranial catheter placement.
Median trans–atlanto-occipital membrane microsurgical approach to the posterior cranial fossa without craniotomy
David Pitskhelauri  MD, PhD , Rinat Sufianov  MD , Alexander Konovalov  MD, PhD , Igor Pronin  MD, PhD , and Alexander Sanikidze  MD, PhD
doi : 10.3171/2022.5.JNS22111
Minimally invasive approaches are becoming increasingly popular and contributing to improving the results of the surgical treatment of a wide variety of intracranial pathologies. Fifteen patients with posterior cranial fossa tumors underwent microsurgery through the atlanto-occipital membrane without resection of any bone structures.
Space-expanding flap in decompressive hemicraniectomy for stroke
Philippe Schucht MD , Andreas Nowacki MD , Armin Osmanagic MD , Michael Murek MD , Werner J. Z’Graggen MD , Matteo Montalbetti MD , Jürgen Beck MD , Lennart Stieglitz MD , and Andreas Raabe MD
doi : 10.3171/2022.5.JNS22381
Decompressive hemicraniectomy (DCE) is the standard of care for space-occupying malignant infarction of the medial cerebral artery in suitable patients. After DCE, the brain is susceptible to trauma and at risk for the syndrome of the trephined. This study aimed to assess the feasibility of using temporary space-expanding flaps, implanted during DCE, to shield the brain from these risks while permitting the injured brain to expand.
Sacrifice or preserve the superior petrosal vein in microvascular decompression surgery: a systematic review and meta-analysis
Shahab Aldin Sattari MD , Ataollah Shahbandi , Risheng Xu MD, PhD , Alice Hung MD , James Feghali MD , Wuyang Yang MD , Ryan P. Lee MD , Chetan Bettegowda MD, PhD , and Judy Huang MD
doi : 10.3171/2022.5.JNS22143
In microvascular decompression (MVD) surgery through the retrosigmoid approach, the surgeon may have to sacrifice the superior petrosal vein (SPV). However, this is a controversial maneuver. To date, high-level evidence comparing the operative outcomes of patients who underwent MVD with and without SPV sacrifice is lacking. Therefore, this study sought to bridge this gap.
Direct cochlear nerve stimulation monitoring through evoked muscle responses during retrosigmoid vestibular schwannoma resection surgery: technical note
Daniele Starnoni MD , Giulia Cossu MD , Rodolfo Maduri MD , Constantin Tuleasca MD, PhD , Mercy George MD , Raphael Maire MD , Mahmoud Messerer MD , Marc Levivier MD, PhD , Etienne Pralong MD , and Roy T. Daniel MD
doi : 10.3171/2022.5.JNS2265
Cochlear nerve preservation during surgery for vestibular schwannoma (VS) may be challenging. Brainstem auditory evoked potentials and cochlear compound nerve action potentials have clearly shown their limitations in surgeries for large VSs. In this paper, the authors report their preliminary results after direct electrical intraoperative cochlear nerve stimulation and recording of the postauricular muscle response (PAMR) during resection of large VSs.
Stereotactic radiosurgery for Koos grade IV vestibular schwannoma: a multi-institutional study
Stylianos Pikis MD, MSc , Georgios Mantziaris MD , Rithika Kormath Anand , Ahmed M. Nabeel MD, PhD , Darrah Sheehan , Kimball Sheehan , Wael A. Reda MD, PhD , Sameh R. Tawadros MD, PhD , Khaled Abdelkarim MD, PhD , Amr M. N. El-Shehaby MD, PhD , Reem Emad Eldin MD, PhD , Selcuk Peker MD , Yavuz Samanci MD , Tehila Kaisman-Elbaz MD, PhD, BPT , Herwin Speckter MSc , Wenceslao Hernández MD , Julio Isidor MD , Manjul Tripathi MCh , Renu Madan MD , Brad E. Zacharia MD , Lekhaj C. Daggubati MD , Nuria MartÃnez Moreno MD, PhD , Roberto MartÃnez Ã�lvarez MD, PhD , Anne-Marie Langlois MD , David Mathieu MD , Christopher P. Deibert MD , Vivek R. Sudhakar MD , Christopher P. Cifarelli MD, PhD, MMM , Denisse Arteaga Icaza MD , Daniel T. Cifarelli MD, MS , Zhishuo Wei MSc , Ajay Niranjan MD, MBA , Gene H. Barnett MD , L. Dade Lunsford MD , Greg N. Bowden MD, MSc , and Jason P. Sheehan MD, PhD
doi : 10.3171/2022.4.JNS22203
Though stereotactic radiosurgery (SRS) is an established safe treatment for small- and medium-sized vestibular schwannomas (VSs), its role in the management of Koos grade IV VS is still unclear. In this retrospective multicenter study, the authors evaluated tumor control and the patient outcomes of primary, single-session SRS treatment for Koos grade IV VS.
Intratumoral hemorrhage in vestibular schwannomas after stereotactic radiosurgery
Othman Bin-Alamer MBBS , David Fogg BS , Zhishuo Wei BS , James Duehr PhD , Arka N. Mallela MD, MS , Ajay Niranjan MD, MBA , L. Dade Lunsford MD , and Hussam Abou-Al-Shaar MD
doi : 10.3171/2022.5.JNS22935
Vestibular schwannomas (VSs) are benign tumors of the cerebellopontine angle that are typically managed with stereotactic radiosurgery (SRS). Intratumoral hemorrhage (ITH) of VSs is a rare occurrence that results in worsening vestibular and new cranial nerve deficits. Few reports have described the management and outcomes of this entity after SRS. To further delineate the incidence and impact of this event, the authors performed a retrospective review of their VS SRS patients at a single center.
Salvage radiosurgery following subtotal resection of vestibular schwannomas: does timing influence tumor control?
Dhanushan Dhayalan MD , Avital Perry MD , Christopher S. Graffeo MD, MS , Øystein Vesterli Tveiten MD, PhD , Amanda Muñoz Casabella MD , Bruce E. Pollock MD , Colin L. W. Driscoll MD , Matthew L. Carlson MD , Michael J. Link MD , and Morten Lund-Johansen MD, PhD
doi : 10.3171/2022.5.JNS22249
The goal of microsurgical resection of vestibular schwannoma (VS) is gross-total resection (GTR) to provide oncological cure. However, a popular strategy is to halt the resection if the surgical team feels the risk of cranial nerve injury is imminent, achieving a maximally safe subtotal resection (STR) instead.
Adjuvant oral tranexamic acid and reoperation after burr hole surgery in patients with chronic subdural hematoma: propensity score–matched analysis using a nationwide inpatient database
Keita Shibahashi  MD, PhD , Hiroyuki Ohbe  MD , and Hideo Yasunaga  MD, PhD
doi : 10.3171/2022.5.JNS22664
Adjuvant medical treatment to reduce the recurrence rate after burr hole surgery for chronic subdural hematoma (CSDH) has not yet been established. This study aimed to investigate the association between tranexamic acid (TXA) use after burr hole surgery and the reoperation rate in patients with CSDH.
Simple wound closure compared with surgery for civilian cranial gunshot wounds
Evan M. Krueger DO, MSc , Ronald J. Benveniste MD, PhD , Victor M. Lu MD, PhD , Ruby R. Taylor BS , Rahul Kumar , Joacir G. Cordeiro MD, PhD , and Jonathan R. Jagid MD
doi : 10.3171/2022.5.JNS22617
A carefully selected subset of civilian cranial gunshot wound (CGSW) patients may be treated with simple wound closure (SWC) as a proactive therapy, but the appropriate clinical scenario for using this strategy is unknown. The aim of this study was to compare SWC and surgery patients in terms of their neurological outcomes and complications, including infections, seizures, and reoperations.
ICP, CPP, and PRx in traumatic brain injury and aneurysmal subarachnoid hemorrhage: association of insult intensity and duration with clinical outcome
Teodor Svedung Wettervik MD, PhD , Anders Hånell PhD , Timothy Howells PhD , Elisabeth Ronne Engström MD, PhD , Anders Lewén MD, PhD , and Per Enblad MD, PhD
doi : 10.3171/2022.5.JNS22560
The primary aim of this study was to determine the combined effect of insult intensity and duration of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and pressure reactivity index (PRx) on outcome measured with the Glasgow Outcome Scale–Extended (GOS-E) in patients with traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (aSAH).
Serum assessment of traumatic axonal injury: the correlation of GFAP, t-Tau, UCH-L1, and NfL levels with diffusion tensor imaging metrics and its prognosis utility
Ana M. Castaño-Leon MD, PhD , Cristina Sánchez Carabias MsC , Amaya Hilario MD, PhD , Ana Ramos MD, PhD , Blanca Navarro-Main MPsy , Igor Paredes MD, PhD , Pablo M. Munarriz MD, PhD , Irene Panero MD , Carla Eiriz Fernández MD , Daniel GarcÃa-Pérez MD, PhD , Luis Miguel Moreno-Gomez MD , Olga Esteban-Sinovas MD , Guillermo Garcia Posadas MD , Pedro A. Gomez MD, PhD , and Alfonso Lagares MD, PhD
doi : 10.3171/2022.5.JNS22638
Diagnosis of traumatic axonal injury (TAI) is challenging because of its underestimation by conventional MRI and the technical requirements associated with the processing of diffusion tensor imaging (DTI). Serum biomarkers seem to be able to identify patients with abnormal CT scanning findings, but their potential role to assess TAI has seldomly been explored.
Changes in patterns of traumatic brain injury in the Michigan Trauma Quality Improvement Program database early in the COVID-19 pandemic
Reid A. Johnson BS , Anne Eaton PhD, MS , Christopher J. Tignanelli MD, MS , Kailey J. Carrabre BA , Christina Gerges MD , George L. Yang MD , Mark R. Hemmila MD , Laura B. Ngwenya MD, PhD , James M. Wright MD , Ann M. Parr MD, PhD , and in affiliation with the Council of State Neurosurgical Societies (CSNS)
doi : 10.3171/2022.5.JNS22244
The authors’ objective was to investigate the impact of the global COVID-19 pandemic on hospital presentation and process of care for the treatment of traumatic brain injuries (TBIs). Improved understanding of these effects will inform sociopolitical and hospital policies in response to future pandemics.
Vascular risk profiles for predicting outcome and long-term mortality in patients with idiopathic normal pressure hydrocephalus: comparison of clinical decision support tools
Sanna A. Eklund , Hanna Israelsson MD, PhD , Bo Carlberg MD, PhD , and Jan Malm MD, PhD
doi : 10.3171/2022.4.JNS22125
Vascular risk factors (VRFs) may act synergistically, and clinical decision support tools (CDSTs) have been developed that present vascular risk as a summarized score.
Factors affecting ventriculoperitoneal shunt revision: a post hoc analysis of the British Antibiotic and Silver Impregnated Catheter Shunt multicenter randomized controlled trial
Geraint J. Sunderland MBChB, MRCS , Elizabeth J. Conroy PhD , Alexandra Nelson MBChB, MRes , Carrol Gamble PhD , Michael D. Jenkinson FRCSEd (NeuroSurg), PhD , Michael J. Griffiths BM, BS, MRCP (Paeds), DPhil , and Conor L. Mallucci MB, BS, FRCS
doi : 10.3171/2022.4.JNS22572
The British Antibiotic and Silver Impregnated Catheter Shunt (BASICS) trial established level I evidence of the superiority of antibiotic-impregnated catheters in the prevention of infection of newly implanted ventriculoperitoneal shunts (VPSs). A wealth of patient, shunt, and surgery-specific data were collected from trial participants beyond that of the prespecified trial objectives.
A standardized infection prevention bundle for reduction of CSF shunt infections in adult ventriculoperitoneal shunt surgery performed without antibiotic-impregnated catheters
Sandeep Muram MD , Albert M. Isaacs MD, PhD , Nicholas Sader MD, MSc , Richard Holubkov PhD , Annie Fong BSc, BN , John Conly MD , and Mark G. Hamilton MD, CM
doi : 10.3171/2022.5.JNS22430
Ventriculoperitoneal (VP) shunt insertion and revision surgeries are some of the most common procedures that are performed by neurosurgeons. Shunt infections within the adult population are associated with significant morbidity and mortality and rates remain high. The objective of the current study was to use quality improvement (QI) methodology to create a standardized infection prevention bundle aimed at reducing the rate of shunt infections.
Extra-axial endoscopic third ventriculostomy: preliminary experience with a technique to circumvent conventional endoscopic third ventriculostomy complications
Sanjeev Kumar MCh , Debabrata Sahana MCh , Lavlesh Rathore MCh , Amit Jain MCh , Manish Tawari MCh , Deepak Singh DM , Rajiv Sahu MCh , and Satya Narayan Madhariya MCh
doi : 10.3171/2022.5.JNS22589
Endoscopic third ventriculostomy (ETV) is mostly safe but may have serious complications. Most of the complications are inherent to the procedure’s intra-axial nature. This study aimed to explore an alternative route to overcome inherent issues with conventional ETV. The authors performed supraorbital, subfrontal extra-axial ETV (EAETV) via the lamina terminalis.
Rates of operative intervention for infection after synthetic or autologous cranioplasty: a National Readmissions Database analysis
Truong H. Do MD , Jinci Lu BA , Elise F. Palzer BS , Samuel W. Cramer MD, PhD , Jared D. Huling PhD , Reid A. Johnson BS , Ping Zhu MMed, PhD , James N. Jean IV BS , Madeleine A. Howard BS , Luke T. Sabal BS , Jacob T. Hanson BA , Alec B. Jonason BS , Kevin W. Sun , Robert A. McGovern MD , and Clark C. Chen MD, PhD
doi : 10.3171/2022.4.JNS22301
The aim of this study was to characterize the clinical utilization and associated charges of autologous bone flap (ABF) versus synthetic flap (SF) cranioplasty and to characterize the postoperative infection risk of SF versus ABF using the National Readmissions Database (NRD).
Endoscopic endonasal approach for infradiaphragmatic craniopharyngiomas: a multicentric Italian study
Domenico Solari MD, PhD , Elena d’Avella MD, PhD , Gianluca Agresta MD , Domenico Catapano MD , Aurelio D’Ecclesia MD, PhD , Davide Locatelli MD , Luca Massimi MD, PhD , Diego Mazzatenta MD , Giannantonio Spena MD , Gianpiero Tamburrini PhD , Cesare Zoia MD, PhD , Matteo Zoli MD, PhD , Giuseppe Cinalli MD , Paolo Cappabianca MD , and Luigi Maria Cavallo MD, PhD
doi : 10.3171/2022.5.JNS212974
Infradiaphragmatic craniopharyngiomas (ICs) represent a distinct subtype, harboring a sellar-suprasellar origin and generally growing in the extra-arachnoidal space contained by the diaphragma sellae. They have been considered ideal for surgical removal through the transsphenoidal approach since the 1960s. The authors present a multicentric national study, intending to selectively analyze IC behavior and the impact of the transsphenoidal endoscopic endonasal approach (EEA) on surgical outcomes.
Breaking boundaries through Doctors Reaching Minority Men Exploring Neuroscience: a mentorship model to foster a pipeline for underrepresented minorities
Ian T. McNeill MD , Alejandro Carrasquilla MD , Zerubabbel K. Asfaw BA , Ernest J. Barthélemy MD, MPH, MA , Alyson Mehr LMSW , Kenya D. Townsend BA , Alexander Joseph MA , Joshua B. Bederson MD , Gary C. Butts MD , and Isabelle M. Germano MD, MBA
doi : 10.3171/2022.5.JNS22196
Preoperative assessment of dominant occipital sinus in patients with Chiari malformation type I: anatomical variations and implications for preventing potentially life-threatening surgical complications
Satoru Tochigi MD , Akira Isoshima MD , Hiroki Ohashi MD, PhD , Daichi Kawamura MD , Kostadin Karagiozov MD, PhD , Keisuke Hatano MD , So Ohashi MD , Hiroyasu Nagashima MD , Yuichi Murayama MD , and Toshiaki Abe MD
doi : 10.3171/2022.5.JNS212973
The surgical treatment of Chiari malformation type I (CM-I) frequently involves dural incision at the posterior cranial fossa. In cases of persistent patent occipital sinus (OS), the sinus is usually obliterated and divided.
Equity in neurosurgery: a worldwide survey of women neurosurgeons
George W. Koutsouras DO , Lu Zhang PhD , Nelci Zanon MD , Sandi Lam MD , Frederick A. Boop MD , and Zulma Tovar-Spinoza MD
doi : 10.3171/2022.6.JNS22466
The global neurosurgery workforce does not have a defined stance on gender equity. The authors sought to study and characterize the demographic features of the international women neurosurgery community and to better understand the perceptions and reflections of their neurosurgical careers. The objective was to define and characterize the workplace inequities faced by the global women neurosurgeon community.
Words matter: using natural language processing to predict neurosurgical residency match outcomes
Alexander V. Ortiz MS , Michael J. Feldman MD , Aaron M. Yengo-Kahn MD , Steven G. Roth MD , Robert J. Dambrino IV MD , Rohan V. Chitale MD , and Lola B. Chambless MD
doi : 10.3171/2022.5.JNS22558
Narrative letters of recommendation (NLORs) are considered by neurosurgical program directors to be among the most important parts of the residency application. However, the utility of these NLORs in predicting match outcomes compared to objective measures has not been determined.
Quality of life and surgical outcomes in incidental pituitary adenomas undergoing endoscopic endonasal resection
Mendel Castle-Kirszbaum MBBS, PhD , Yi Yuen Wang MD, FRACS , James King PhD, FRACS , Jeremy Kam MBBS, FRACS , and Tony Goldschlager PhD, FRACS
doi : 10.3171/2022.5.JNS2286
Erratum. Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis
R. Loch Macdonald MD, PhD
Equity in neurosurgical scientific publication
William W. Ashley Jr. MD, PhD, MBA , Sonia V. Eden MD , and James T. Rutka MD, PhD
doi : 10.3171/2022.7.JNS221407
Letter to the Editor. Puerto Rico medical schools: neurosurgery residents matched during the 2014–2020 period
Orlando De Jesus  MD and Aixa de Jesús Espinosa  MS, MPH
doi : 10.3171/2022.8.JNS221771
Letter to the Editor. PBC for trigeminal neuralgia: predictive power of the balloon shape
Songshan Chai MD, PhD , Kai Fu MD, PhD , Bangkun Yang MD, PhD , Jie Zhang MD, PhD , and Nanxiang Xiong MD, PhD
doi : 10.3171/2022.7.JNS221628
Letter to the Editor. Role of adjuvant medical therapy in chronic subdural hematoma
Yilong Zheng and Kai Rui Wan MBBS, FRCS
doi : 10.3171/2022.7.JNS221715
