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Intraoperative confocal laser endomicroscopy: prospective in vivo feasibility study of a clinical-grade system for brain tumors
Irakliy Abramov MD, PhD , Marian T. Park BS , Evgenii Belykh MD, PhD , Alexander B. Dru MD , Yuan Xu MD , Timothy C. Gooldy MD , Lea Scherschinski MD , S. Harrison Farber MD , Andrew S. Little MD , Randall W. Porter MD , Kris A. Smith MD , Michael T. Lawton MD , Jennifer M. Eschbacher MD , and Mark C. Preul MD
doi : 10.3171/2022.5.JNS2282
Volume 138: Issue 3 (Mar 2023)
The authors evaluated the feasibility of using the first clinical-grade confocal laser endomicroscopy (CLE) system using fluorescein sodium for intraoperative in vivo imaging of brain tumors.
Contralateral subfrontal approach for tuberculum sellae meningioma: techniques and clinical outcomes
Yeong Jin Kim MD PhD , Kyung-Sub Moon MD, PhD , Woo-Youl Jang MD , Tae-Young Jung MD, PhD , In-Young Kim MD, PhD , and Shin Jung MD, PhD
doi : 10.3171/2022.5.JNS212899
Tuberculum sellae meningiomas (TSMs) present a burdensome surgical challenge because of their adjacency to vital neurovascular structures. The contralateral subfrontal approach provides an outstanding corridor for removing a TSM with an excellent visual outcome and limited complications. The authors present their long-term surgical experience in treating TSMs via the contralateral subfrontal approach and discuss patient selection, surgical techniques, and clinical outcomes.
Impact of radiotherapy delay following biopsy for patients with unresected glioblastoma
Sarah Gao MD , Lan Jin PhD, MSc , Jennifer Moliterno MD , Zachary A. Corbin MD , Ranjit S. Bindra MD, PhD , Joseph N. Contessa MD, PhD , James B. Yu MD, MHS , and Henry S. Park MD, MPH
doi : 10.3171/2022.5.JNS212761
Because of the aggressive nature of glioblastoma, patients with unresected disease are encouraged to begin radiotherapy within approximately 1 month after craniotomy. The aim of this study was to investigate the potential association between time interval from biopsy to radiotherapy with overall survival in patients with unresected glioblastoma.
Evaluating risk of recurrence in patients with meningioma
Jeffrey I. Traylor MD , Aaron R. Plitt MD , William H. Hicks BS , Tabarak M. Mian BS , Bruce E. Mickey MD , and Samuel L. Barnett MD
doi : 10.3171/2022.6.JNS221162
Meningioma prognostication and treatment continues to evolve with an increasing understanding of tumor biology. In this study, the authors aimed to test conventional predictors of meningioma recurrence, histopathology variables for which there exists some controversy (brain invasion), as well as a novel molecular-based location paradigm.
Molecular characteristics of incidental lower-grade glioma for treatment decision-making
Jeongman Park BS , Jeongmin Sim MS , Juwon Ahn PhD , Yu Jin Kim MS , Sojung Hwang MS , Kyunggi Cho MD, PhD , Da-Young Chang PhD , Jin-Hwa Jung PhD , Ju Hyung Moon MD, PhD , KyoungSu Sung MD , and Jaejoon Lim MD, PhD
doi : 10.3171/2022.6.JNS22967
Several limitations are associated with the early diagnosis and treatment of incidental lower-grade glioma (iLGG), and due to its unknown molecular features, its management is categorized as either the “wait-and-see� strategy or immediate treatment. Therefore, in this study the authors explored iLGG’s clinical and molecular landscape to improve its management.
COL1A2 inhibition suppresses glioblastoma cell proliferation and invasion
Yi Wang MD , Maki Sakaguchi MD , Hemragul Sabit PhD , Sho Tamai MD , Toshiya Ichinose MD , Shingo Tanaka MD, PhD , Masashi Kinoshita MD, PhD , Yasuo Uchida PhD , Sumio Ohtsuki PhD , and Mitsutoshi Nakada MD, PhD
doi : 10.3171/2022.6.JNS22319
An extracellular matrix such as collagen is an essential component of the tumor microenvironment. Collagen alpha-2(I) chain (COL1A2) is a chain of type I collagen whose triple helix comprises two alpha-1 chains and one alpha-2 chain.
Impact of a cell cycle and an extracellular matrix remodeling transcriptional signature on tumor progression and correlation with EZH2 expression in meningioma
Benedito Jamilson Araújo Pereira PhD , Antonio Marcondes Lerario PhD , Paula Rodrigues Sola MSc , Talita de Sousa Laurentino MSc , Dipika R. Mohan PhD , Antonio Nogueira de Almeida PhD , Paulo Henrique Pires de Aguiar PhD , Wellingson da Silva Paiva PhD , Alda Wakamatsu MSc , Manoel Jacobsen Teixeira PhD , Sueli Mieko Oba-Shinjo PhD , and Suely Kazue Nagahashi Marie PhD
doi : 10.3171/2022.7.JNS22953
The authors searched for genetic and transcriptional signatures associated with tumor progression and recurrence in their cohort of patients with meningiomas, combining the analysis of targeted exome, NF2-LOH, transcriptome, and protein expressions.
Use of thyroid transcription factor 1 and napsin A to predict local failure and survival after Gamma Knife radiosurgery in patients with brain metastases from lung adenocarcinoma
Haewon Roh MD , Sung Yong Lee MD, PhD , Jinhwan Lee MD , Soon-Young Hwang PhD , and Jong Hyun Kim MD, PhD
doi : 10.3171/2022.6.JNS22450
Stereotactic radiosurgery (SRS), combined with contemporary targeted therapies and immunotherapies, has improved the overall survival of patients with lung adenocarcinoma (ADC).
Conventionally fully fractionated Gamma Knife Icon re-irradiation of primary recurrent intracranial tumors: the first report indicating feasibility and safety
Michael Yan MD, MPH , Lori Holden APRT(T) , Jay Detsky MD, PhD , Chia-Lin Tseng MD , Hany Soliman MD , Sten Myrehaug MD , Zain Husain MD , Sunit Das MD, PhD , Collins Yeboah PhD , Nir Lipsman MD, PhD , Mark Ruschin PhD , and Arjun Sahgal MD
doi : 10.3171/2022.6.JNS22998
With the incorporation of real-time image guidance on the Gamma Knife system allowing for mask-based immobilization (Gamma Knife Icon [GKI]), conventionally fully fractionated (1.8–3.0 Gy/day) GKI radiation can now be delivered to take advantage of an inherently minimal margin for delivery uncertainty, sharp dose falloff, and inhomogeneous dose distribution.
Prediction of hemorrhagic cerebral hyperperfusion syndrome after direct bypass surgery in adult nonhemorrhagic moyamoya disease: combining quantitative parameters on RAPID perfusion CT with clinically related factors
Chang Hwan Pang MD , Si Un Lee MD , Yongjae Lee MD , Woong-Beom Kim MD , Min-Yong Kwon MD , Leonard Sunwoo MD , Tackeun Kim MD , Jae Seung Bang MD , O-ki Kwon MD , and Chang Wan Oh MD
doi : 10.3171/2022.5.JNS212838
The aim of this study was to identify predictive factors for hemorrhagic cerebral hyperperfusion syndrome (hCHS) after direct bypass surgery in adult nonhemorrhagic moyamoya disease (non-hMMD) using quantitative parameters on rapid processing of perfusion and diffusion (RAPID) perfusion CT software.
First-pass effect in patients with acute basilar artery occlusions undergoing stent retriever thrombectomy
Chenhao Zhao MD , Ting Hu MD , Weilin Kong MD , De Yang MD , Junfang Wan MD , Kefeng Lv MD , Jiasheng Liao MD , Zhao Chen MS , He Jiang MS , Deping Wu MD , Ping Yang MS , Wenjie Zi MD , Fengli Li MD , and Qingwu Yang MD
doi : 10.3171/2022.5.JNS22751
First-pass effect (FPE), defined as successful reperfusion (modified Thrombolysis in Cerebral Infarction score 2b–3) with a single stent retriever attempt without salvage treatment, has not been fully identified in patients with acute basilar artery occlusion (BAO). The authors’ aim was to assess the impact of FPE on efficacy and safety for patients with BAO.
Association between underlying autoimmune disease and small aneurysm size at rupture
Abhijith V. Matur MD , Ali S. Yamani BA , Michael W. Robinson MD, PhD , Matthew S. Smith MD , Peyman Shirani MD , Aaron W. Grossman MD, PhD , and Charles J. Prestigiacomo MD
doi : 10.3171/2022.5.JNS22750
Although the role of inflammation in the development of aneurysms is established, less is known about the development of intracranial aneurysms in the setting of underlying autoimmune disease.
Long noncoding RNA profile of the intracranial artery in patients with moyamoya disease
Takashi Mamiya MD , Fumiaki Kanamori MD, PhD , Kinya Yokoyama MD, PhD , Akinobu Ota PhD , Sivasundaram Karnan PhD , Kenji Uda MD, PhD , Yoshio Araki MD, PhD , Satoshi Maesawa MD, PhD , Kazuhiro Yoshikawa PhD , and Ryuta Saito MD, PhD
doi : 10.3171/2022.5.JNS22579
Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by progressive stenosis of the internal carotid artery (ICA) and secondary formation of collateral vessels.
Risk of intracranial aneurysm recurrence after microsurgical clipping based on 3D digital subtraction angiography
Serge Marbacher MD, PhD , Basil Erwin Grüter MD , Stefan Wanderer MD , Lukas Andereggen MD , Marco Cattaneo PhD , Patricia Trost MD , Philipp Gruber MD , Michael Diepers MD , Luca Remonda MD , and Hans-Jakob Steiger MD, PhD
doi : 10.3171/2022.5.JNS22424
Current knowledge of recurrence rates after intracranial aneurysm (IA) surgery relies on 2D digital subtraction angiography (DSA), which fails to detect more than 75% of small aneurysm remnants.
Antiplatelet therapy discontinuation after stent-assisted coil embolization for intracranial aneurysms: a single-center, long-term, retrospective, observational study
Shunsaku Goto MD, PhD , Takashi Izumi MD, PhD , Masahiro Nishihori MD, PhD , Tasuku Imai MD, PhD , Yoshio Araki MD, PhD , Fumiaki Kanamori MD, PhD , Kenji Uda MD, PhD , Kinya Yokoyama MD, PhD , and Ryuta Saito MD, PhD
doi : 10.3171/2022.6.JNS22815
The protocol for antiplatelet therapy after stent-assisted coil embolization (SACE) for intracranial aneurysms is not well established. In particular, the indications for single antiplatelet therapy (SAPT) discontinuation remain controversial. The authors investigated the long-term outcomes of SAPT discontinuation after SACE among patients at a single institution.
Seven bypasses simulation set: description and validity assessment of novel models for microneurosurgical training
Evgenii Belykh MD, PhD , Irakliy Abramov MD, PhD , Liudmila Bardonova MD, PhD , Ruchi Patel BS , Sarah McBryan MS , Lara Enriquez Bouza MD, MHCM , Neil Majmundar MD , Xiaochun Zhao MD , Vadim A. Byvaltsev MD, PhD , Stephen A. Johnson MD , Amit Singla MD , Gaurav Gupta MD , Hai Sun MD, PhD , James K. Liu MD , Anil Nanda MD, MPH , Mark C. Preul MD , and Michael T. Lawton MD
doi : 10.3171/2022.5.JNS22465
Microsurgical training remains indispensable to master cerebrovascular bypass procedures, but simulation models for training that accurately replicate microanastomosis in narrow, deep-operating corridors are lacking.
Rupture-related quantitative hemodynamics of the supratentorial arteriovenous malformation nidus
Yu Chen MD, PhD , Pingting Chen PhD , Ruinan Li MD , Heze Han MD , Zhipeng Li MD , Li Ma MD, PhD , Debin Yan MD , Haibin Zhang MD , Fa Lin MD , Runting Li MD , Xiangyu Meng MD , Hengwei Jin MD , Youxiang Li MD , Xun Ye MD , Shuai Kang MD , Hao Wang MD , Xiaolin Chen MD, PhD , and Yuanli Zhao MD, PhD
doi : 10.3171/2022.6.JNS212818
The hemodynamics of a brain arteriovenous malformation (AVM) nidus may be closely related to clinical presentation. The authors of this study aimed to explore the hemorrhagic quantitative hemodynamic indicators of the nidus through quantitative digital subtraction angiography (QDSA).
Impact of cerebral small vessel disease on symptomatic in-stent restenosis in intracranial atherosclerosis
Weilun Fu MD , Long Yan MD , Zhikai Hou MD , Ying Yu MD , Weiyi Zhang MD , RongRong Cui MD , Feng Gao MD , Dapeng Mo MD , Xin Lou MD , Zhongrong Miao MD , and Ning Ma MD
doi : 10.3171/2022.6.JNS221103
Cerebral small vessel disease (CSVD) commonly coexists with intracranial atherosclerotic stenosis (ICAS). In-stent restenosis (ISR) affects the nonprocedural outcome of severe symptomatic ICAS after intracranial stenting.
Neuronal dysfunction and hemodynamic disturbance due to venous congestion in dural arteriovenous fistula revealed by 123I-iomazenil SPECT
Kazuya Kanemaru MD, PhD , Hideyuki Yoshioka MD, PhD , Koji Hashimoto MD, PhD , Takuma Wakai MD, PhD , Nobuo Senbokuya MD, PhD , Toru Tateoka MD , Norito Fukuda MD, PhD , Takako Umeda MD , Hiroshi Onishi MD, PhD , and Hiroyuki Kinouchi MD, PhD
doi : 10.3171/2022.6.JNS22885
Retrograde leptomeningeal venous drainage (RLVD) of a dural arteriovenous fistula (dAVF) is associated with neurological morbidity and unfavorable outcomes. However, the direct damage to cortical neurons by dAVF with RLVD has not been elucidated.
A system of anatomical triangles defining dissection routes to brainstem cavernous malformations: definitions and application to a cohort of 183 patients
Dimitri Benner BS , Benjamin K. Hendricks MD , Arnau Benet MD, PhD , Christopher S. Graffeo MD, MS , Lea Scherschinski MD , Visish M. Srinivasan MD , Joshua S. Catapano MD , Peter M. Lawrence MS, CMI , Mark Schornak MS, CMI , and Michael T. Lawton MD
doi : 10.3171/2022.6.JNS212907
Anatomical triangles defined by intersecting neurovascular structures delineate surgical routes to pathological targets and guide neurosurgeons during dissection steps.
Intraarterial encephalography from an acutely implanted aneurysm embolization device in awake humans
Luyuan Li MD , Kenji Ibayashi MD, PhD , Anthony Piscopo BS , Carolina Deifelt Streese PhD , Haiming Chen MSEE , Jeremy D. W. Greenlee MD , and David M. Hasan MD
doi : 10.3171/2022.6.JNS22932
Endovascular electroencephalography (evEEG) uses the cerebrovascular system to record electrical activity from adjacent neural structures. The safety, feasibility, and efficacy of using the Woven EndoBridge Aneurysm Embolization System (WEB) for evEEG has not been investigated.
Back to basal: contemporary cerebrovascular cohort study of the supratentorial-infraoccipital approach
Visish M. Srinivasan MD , Katherine Karahalios MS , Vamsi P. Reddy MD , Lea Scherschinski MD , Joseph D. DiDomenico MD , Redi Rahmani MD , Joshua S. Catapano MD , Mohamed A. Labib MD, CM , Kavelin Rumalla MD , Christopher S. Graffeo MD, MS , and Michael T. Lawton MD
doi : 10.3171/2022.5.JNS22506
The objective of this paper was to assess applications of the supratentorial-infraoccipital (STIO) approach for cerebrovascular neurosurgery.
Stereotactic radiosurgery for intermediate- and high-grade arteriovenous malformations: outcomes stratified by the supplemented Spetzler-Martin grading system
Ryan M. Naylor MD, PhD , Christopher S. Graffeo MD, MS , Cody L. Nesvick MD , Michael J. Link MD , Paul D. Brown MD , Scott L. Stafford MD , Nadia N. Laack MD , and Bruce E. Pollock MD
doi : 10.3171/2022.5.JNS22761
The supplemented Spetzler-Martin (Supp-SM) grading system was developed to improve the predictive accuracy of surgical risk for patients with brain arteriovenous malformations (AVMs).
Arousal and salience network connectivity alterations in surgical temporal lobe epilepsy
Hernán F. J. González MD, PhD , Saramati Narasimhan PhD , Sarah E. Goodale BE , Graham W. Johnson BS , Derek J. Doss BE , Danika L. Paulo MD , Victoria L. Morgan PhD , Catie Chang PhD , and Dario J. Englot MD, PhD
doi : 10.3171/2022.5.JNS22837
It is poorly understood why patients with mesial temporal lobe epilepsy (TLE) have cognitive deficits and brain network changes that extend beyond the temporal lobe, including altered extratemporal intrinsic connectivity networks (ICNs).
Modern intracranial electroencephalography for epilepsy localization with combined subdural grid and depth electrodes with low and improved hemorrhagic complication rates
Anthony T. Lee MD, PhD , Noah M. Nichols BS , Benjamin A. Speidel MS , Joline M. Fan MD , Iahn Cajigas MD, PhD , Robert C. Knowlton MD , and Edward F. Chang MD
doi : 10.3171/2022.5.JNS221118
Recent trends have moved from subdural grid electrocorticography (ECoG) recordings toward stereo-electroencephalography (SEEG) depth electrodes for intracranial localization of seizures, in part because of perceived morbidity from subdural grid and strip electrodes.
Asymmetry index in anatomically symmetrized FDG-PET for improved epileptogenic focus detection in pharmacoresistant epilepsy
Shameer Aslam MTech , Natesan Damodaran MCh , Ramiah Rajeshkannan MD, DNB , Manjit Sarma DNB , Siby Gopinath MD, DNB , and Ashok Pillai MD, DNB
doi : 10.3171/2022.6.JNS22717
Positron emission tomography (PET) imaging has assumed an essential role in the presurgical evaluation of epileptogenic foci in drug-resistant epilepsy by identifying the hypometabolic cerebral cortex.
Stereo-electroencephalography–guided radiofrequency thermocoagulation in patients with MRI-negative focal epilepsy
LuÃÂsa Panadés-de Oliveira  MD , Carmen Pérez-EnrÃÂquez  PhD , Ainara Barguilla  MD , Klaus Langohr  PhD , Gerardo Conesa  PhD , Nazaret Infante  MD , Alessandro Principe  PhD , and Rodrigo Rocamora  PhD
doi : 10.3171/2022.6.JNS22733
Coupled with stereo-electroencephalography (SEEG), radiofrequency thermocoagulation (RFTC) has emerged as a therapeutic alternative for patients with refractory focal epilepsy, with proven safe but highly variable results across studies. The authors aimed to describe the outcomes and safety of SEEG-RFTC, focusing on patients with MRI-negative epilepsy.
Dissociation of Broca’s area from Broca’s aphasia in patients undergoing neurosurgical resections
John P. Andrews  MD , Nathan Cahn  BA , Benjamin A. Speidel  MS , Jason E. Chung  MD, PhD , Deborah F. Levy  PhD , Stephen M. Wilson  PhD , Mitchel S. Berger  MD , and Edward F. Chang  MD
doi : 10.3171/2022.6.JNS2297
Broca’s aphasia is a syndrome of impaired fluency with retained comprehension. The authors used an unbiased algorithm to examine which neuroanatomical areas are most likely to result in Broca’s aphasia following surgical lesions.
Successful retrograde regeneration using a sensory branch for motor nerve transfer
Saud Alzahrani MD , Harley Brito da Silva MD , Tak-Ho Chu PhD , Zain Tariq , Daniel Umansky MD , David A. Elliott PhD , and Rajiv Midha MD, MSc
doi : 10.3171/2022.6.JNS22734
The objective of this study was to test whether regenerating motor axons from a donor nerve can travel in a retrograde fashion using sensory branches to successfully reinnervate a motor nerve end organ.
A history of Colombian neurosurgery: events, persons, and outcomes that have shaped the specialty in the country
Enrique Osorio Fonseca MD , Luis C. Cadavid MD , Jorge Cespedes BHSc , John Vargas BHSc , Matthew Grady MA , L. Fernando Gonzalez MD , Miguel Enrique Berbeo MD , Edgar G. Ordóñez-Mora MD , Edgar G. Ordóñez-Rubiano MD , and Jorge E. Alvernia MD
doi : 10.3171/2022.6.JNS22830
The history of Colombian neurosurgery is a collective legacy of neurosurgeon-scientists, scholars, teachers, innovators, and researchers. Anchored in the country’s foundational values of self-determination and adaptability, these pioneers emerged from the Spanish colonial medical tradition and forged surgical alliances abroad.
Ernesto Bustamante Zuleta (1922–2021): pioneering teacher and practitioner of Colombian neurosurgery
Jorge E. Alvernia  MD , Miguel Enrique Berbeo Calderón  MD , Jorge Cespedes  BHSc , John Vargas  BHSc , Matthew Grady  MA , Luis C. Cadavid  MD , Enrique Osorio Fonseca  MD , and Adolfo Cumplido Posada  MD
doi : 10.3171/2022.5.JNS22537
Ernesto Bustamante Zuleta (1922–2021) was an impactful Colombian neurosurgeon whose legacy is inextricably linked with the development of the neurosurgery specialty in Colombia. His detail-oriented approach to treatment complemented his reputation for mastery of the neurosciences.
Mass shootings in the United States: an alarming trend of violence and public health threat
Caple A. Spence MD , Sonia V. Eden MD , Brenton Pennicooke MD , Owoicho Adogwa MD, MPH , Langston T. Holly MD , Babu G. Welch MD , Nnenna Mbabuike MD , Edjah Nduom MD , and William W. Ashley Jr. MD, PhD, MBA
doi : 10.3171/2022.8.JNS221725
Letter to the Editor. Questions regarding autoimmune disease and intracranial aneurysms
Wei Chen MD, PhD and Yu Hu MD, PhD
doi : 10.3171/2022.8.JNS221990
Letter to the Editor. SEEG and subdural grids: differences that go beyond morbidity
Arka N. Mallela MD, MS , Hussam Abou-Al-Shaar MD , and Jorge González-MartÃnez MD, PhD
doi : 10.3171/2022.8.JNS221901
Letter to the Editor. Proximal and distal ventriculoperitoneal shunt failure
Ebtesam Abdulla MD , Mrinmoy Kundu MBBS , Sabrina Rahman MPH , and Md M. Rahman MS
doi : 10.3171/2022.8.JNS221699
Letter to the Editor. Stratifying by publication type in Charting Outcomes in the Match reports
Yusuf Mehkri BS , Ramy Sharaf MMCi , Sophie Liu , Moshe Shalom BS , and Julian Gendreau MD
doi : 10.3171/2022.8.JNS222011
