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Stereotactic radiofrequency thermocoagulation and resective surgery for patients with hypothalamic hamartoma
Shu Wang, Meng Zhao, Tianfu Li, Chunsheng Zhang, Jian Zhou, Mengyang Wang, Xiongfei Wang, Zhao Liu, Kaiqiang Ma, Guoming Luan, and Yuguang Guan
doi : 10.3171/2020.2.JNS193423
In this study, the authors compared the efficacy and safety of stereotactic radiofrequency thermocoagulation (SRT) and resective surgery (RS) for patients with hypothalamic hamartoma (HH).
Subsecond EEG-fMRI analysis for presurgical evaluation in focal epilepsy
Yuji Ito, Satoshi Maesawa, Epifanio Bagarinao, Yu Okai, Daisuke Nakatsubo, Hiroyuki Yamamoto, Hiroyuki Kidokoro, Naotaka Usui, Jun Natsume, Minoru Hoshiyama, Toshihiko Wakabayashi, Gen Sobue, and Norio Ozaki
doi : 10.3171/2020.1.JNS192567
The authors recently reported a novel subsecond analysis method of analyzing EEG–functional MRI (fMRI) to improve the detection rate of epileptic focus. This study aims to validate the utility of this method for presurgical evaluation in pharmacoresistant focal epilepsy.
Preoperative localization of seizure onset zones by magnetic source imaging, EEG-correlated functional MRI, and their combination
Assaf Berger, Noa Cohen, Firas Fahoum, Mordekhay Medvedovsky, Aaron Meller, Dana Ekstein, Mony Benifla, Orna Aizenstein, Itzhak Fried, Tomer Gazit, and Ido Strauss
doi : 10.3171/2020.3.JNS192794
Preoperative localization of seizure onset zones (SOZs) is an evolving field in the treatment of refractory epilepsy. Both magnetic source imaging (MSI), and the more recent EEG-correlated functional MRI (EEG-fMRI), have shown applicability in assisting surgical planning. The purpose of this study was to evaluate the capability of each method and their combination in localizing the seizure onset lobe (SL).
Temporopolar amygdalohippocampectomy: seizure control and postoperative outcomes
Jo?o Paulo Sant Ana Santos de Souza, Gabriel Ayub, Mateus Nogueira, Tamires Zanao, T?tila Martins Lopes, Luciana Ramalho Pimentel-Silva, Vinicius Domene, Gabriel Marquez, Clarissa Lin Yasuda, Let?cia Franceschet Ribeiro, Brunno M. Campos, José Vasconcellos, Fabio Rogerio, Andrei Fernandes Joaquim, Fernando Cendes, Helder Tedeschi, and Enrico Ghizoni
doi : 10.3171/2020.3.JNS192624
The objective of this study was to evaluate the efficacy and safety of a modified surgical approach for the treatment of temporal lobe epilepsy secondary to hippocampal sclerosis (HS). This modified approach, called temporopolar amygdalohippocampectomy (TP-AH), includes a transsylvian resection of the temporal pole and subsequent amygdalohippocampectomy utilizing the limen insula as an anatomical landmark.
Defining the optimal target for anterior thalamic deep brain stimulation in patients with drug-refractory epilepsy
Wendy Guo, Bang-Bon Koo, Jae-Hun Kim, Rafeeque A. Bhadelia, Dae-Won Seo, Seung Bong Hong, Eun Yeon Joo, Seunghoon Lee, Jung-Il Lee, Kyung Rae Cho, and Young-Min Shon
doi : 10.3171/2020.2.JNS193226
The anterior thalamic nucleus (ATN) is a common target for deep brain stimulation (DBS) for the treatment of drug-refractory epilepsy. However, no atlas-based optimal DBS (active contacts) target within the ATN has been definitively identified. The object of this retrospective study was to analyze the relationship between the active contact location and seizure reduction to establish an atlas-based optimal target for ATN DBS.
Feasibility and performance of a frameless stereotactic system for targeting subcortical nuclei in nonhuman primates
Felipe Branco de Paiva, Brett A. Campbell, Leonardo A. Frizon, Adriana Martin, Andres Maldonado-Naranjo, André G. Machado, and Kenneth B. Baker
doi : 10.3171/2019.12.JNS192946
Deep brain stimulation (DBS) is an effective therapy for different neurological diseases, despite the lack of comprehension of its mechanism of action. The use of nonhuman primates (NHPs) has been historically important in advancing this field and presents a unique opportunity to uncover the therapeutic mechanisms of DBS, opening the way for optimization of current applications and the development of new ones. To be informative, research using NHPs should make use of appropriate electrode implantation tools. In the present work, the authors report on the feasibility and accuracy of targeting different deep brain regions in NHPs using a commercially available frameless stereotactic system (microTargeting platform).
Clinical outcomes of globus pallidus deep brain stimulation for Parkinson disease: a comparison of intraoperative MRI– and MER-guided lead placement
Yarema B. Bezchlibnyk, Vibhash D. Sharma, Kushal B. Naik, Faical Isbaine, John T. Gale, Jennifer Cheng, Shirley D. Triche, Svjetlana Miocinovic, Cathrin M. Buetefisch, Jon T. Willie, Nicholas M. Boulis, Stewart A. Factor, Thomas Wichmann, Mahlon R. DeLong, and Robert E. Gross
doi : 10.3171/2019.12.JNS192010
Deep brain stimulation (DBS) lead placement is increasingly performed with the patient under general anesthesia by surgeons using intraoperative MRI (iMRI) guidance without microelectrode recording (MER) or macrostimulation. The authors assessed the accuracy of lead placement, safety, and motor outcomes in patients with Parkinson disease (PD) undergoing DBS lead placement into the globus pallidus internus (GPi) using iMRI or MER guidance.
Predicting final lesion characteristics during MR-guided focused ultrasound pallidotomy for treatment of Parkinson’s disease
Timothy R. Miller, Sijia Guo, Elias R. Melhem, Howard M. Eisenberg, Jiachen Zhuo, Nathaniel Kelm, Mor Dayan, Rao P. Gullapalli, and Dheeraj Gandhi
doi : 10.3171/2020.2.JNS192590
Magnetic resonance–guided focused ultrasound (MRgFUS) ablation of the globus pallidus interna (GPi) is being investigated for the treatment of advanced Parkinson’s disease symptoms. However, GPi lesioning presents unique challenges due to the off-midline location of the target. Furthermore, it remains uncertain whether intraprocedural MR thermometry data can predict final lesion characteristics.
Quantifying eloquent locations for glioblastoma surgery using resection probability maps
Domenique M. J. Müller, Pierre A. Robe, Hilko Ardon, Frederik Barkhof, Lorenzo Bello, Mitchel S. Berger, Wim Bouwknegt, Wimar A. Van den Brink, Marco Conti Nibali, Roelant S. Eijgelaar, Julia Furtner, Seunggu J. Han, Shawn L. Hervey-Jumper, Albert J. S. Idema, Barbara Kiesel, Alfred Kloet, Jan C. De Munck, Marco Rossi, Tommaso Sciortino, W. Peter Vandertop, Martin Visser, Michiel Wagemakers, Georg Widhalm, Marnix G. Witte, Aeilko H. Zwinderman, and Philip C. De Witt Hamer
doi : 10.3171/2020.1.JNS193049
Decisions in glioblastoma surgery are often guided by presumed eloquence of the tumor location. The authors introduce the “expected residual tumor volume” (eRV) and the “expected resectability index” (eRI) based on previous decisions aggregated in resection probability maps. The diagnostic accuracy of eRV and eRI to predict biopsy decisions, resectability, functional outcome, and survival was determined.
The impact of high functional connectivity network hub resection on language task performance in adult low- and high-grade glioma
Anthony T. Lee, Claire Faltermeier, Ramin A. Morshed, Jacob S. Young, Sofia Kakaizada, Claudia Valdivia, Anne M. Findlay, Phiroz E. Tarapore, Srikantan S. Nagarajan, Shawn L. Hervey-Jumper, and Mitchel S. Berger
doi : 10.3171/2020.1.JNS192267
Gliomas are intrinsic brain tumors with the hallmark of diffuse white matter infiltration, resulting in short- and long-range network dysfunction. Preoperative magnetoencephalography (MEG) can assist in maximizing the extent of resection while minimizing morbidity. While MEG has been validated in motor mapping, its role in speech mapping remains less well studied. The authors assessed how the resection of intraoperative electrical stimulation (IES)–negative, high functional connectivity (HFC) network sites, as identified by MEG, impacts language performance.
How safe are elective craniotomies in elderly patients in neurosurgery today? A prospective cohort study of 1452 consecutive cases
Ralph T. Sch?r, Shpend Tashi, Mattia Branca, Nicole S?ll, Debora Cipriani, Christa Schwarz, Claudio Pollo, Philippe Schucht, Christian T. Ulrich, Jürgen Beck, Werner J. Z’Graggen, and Andreas Raabe
doi : 10.3171/2020.2.JNS193460
With global aging, elective craniotomies are increasingly being performed in elderly patients. There is a paucity of prospective studies evaluating the impact of these procedures on the geriatric population. The goal of this study was to assess the safety of elective craniotomies for elderly patients in modern neurosurgery.
Stereotactic radiosurgery for central neurocytomas: an international multicenter retrospective cohort study
Yi-Chieh Hung, Cheng-Chia Lee, Huai-che Yang, Nasser Mohammed, Kathryn N. Kearns, Shi-Bin Sun, David Mathieu, Charles J. Touchette, Ahmet F. Atik, Inga S. Grills, Bryan Squires, Dale Ding, Brian J. Williams, Mehran B. Yusuf, Shiao Y. Woo, Roman Liscak, Jaromir Hanuska, Jay C. Shiao, Douglas Kondziolka, L. Dade Lunsford, Zhiyuan Xu, and Jason P. Sheehan
doi : 10.3171/2020.1.JNS191515
Central neurocytomas (CNs) are uncommon intraventricular tumors, and their rarity renders the risk-to-benefit profile of stereotactic radiosurgery (SRS) unknown. The aim of this multicenter, retrospective cohort study was to evaluate the outcomes of SRS for CNs and identify predictive factors.
Pituitary adenomas in the setting of multiple endocrine neoplasia type 1: a single-institution experience
Salomon Cohen-Cohen, Desmond A. Brown, Benjamin T. Himes, Lydia P. Wheeler, Michael W. Ruff, Brittny T. Major, Naykky M. Singh Ospina, John L. D. Atkinson, Fredric B. Meyer, Irina Bancos, William F. Young Jr., and Jamie J. Van Gompel
doi : 10.3171/2020.1.JNS193538
Multiple endocrine neoplasia type 1 (MEN1) is a rare, autosomal-dominant tumor disorder characterized by the development of pituitary tumors and other endocrine neoplasms. Diagnosis is made clinically based on the development of 2 or more canonical lesions (parathyroid gland, anterior pituitary, and enteropancreatic tumors) or in family members of a patient with a clinical diagnosis of MEN1 and the occurrence of one of the MEN1-associated tumors. The goal of this study was to characterize pituitary tumors arising in the setting of MEN1 at a single institution. The probability of tumor progression and the likelihood of surgical intervention in patients with asymptomatic nonfunctional pituitary adenomas were also analyzed.
Expression of additional transcription factors is of prognostic value for aggressive behavior of pituitary adenomas
Alexander Micko, Thomas R?tzer, Romana Hoftberger, Greisa Vila, Johannes Oberndorfer, Josa M. Frischer, Engelbert Knosp, and Stefan Wolfsberger
doi : 10.3171/2020.2.JNS2018
According to the latest WHO classification of tumors of endocrine organs in 2017, plurihormonal adenomas are subclassified by their transcription factor (TF) expression. In the group of plurihormonal adenomas with unusual immunohistochemical combinations (PAWUC), the authors identified a large fraction of adenomas expressing TFs for gonadotroph adenoma (TFGA) cells in addition to other TFs. The aim of this study was to compare clinicopathological parameters of PAWUC with TFGA expression to gonadotroph adenomas that only express TFGA.
Subclinical imaging changes in cerebral cavernous angiomas during prospective surveillance
Juli?n Carri?n-Penagos, Hussein A. Zeineddine, Sean P. Polster, Romuald Girard, Se?n B. Lyne, Janne Koskim?ki, Sharbel Romanos, Abhinav Srinath, Dongdong Zhang, Ying Cao, Agnieszka Stadnik, Kristina Piedad, Robert Shenkar, and Issam A. Awad
doi : 10.3171/2020.1.JNS193479
The purpose of this study was to systematically assess asymptomatic changes (ACs), including subclinical hemorrhage, growth, or new lesion formation (NLF) during longitudinal follow-up of cerebral cavernous angiomas (CAs), and to correlate these with symptomatic hemorrhage (SH) during the same period and with clinical features of the disease.
Combined structural and diffusion tensor imaging detection of ischemic injury in moyamoya disease: relation to disease advancement and cerebral hypoperfusion
Ken Kazumata, Kikutaro Tokairin, Masaki Ito, Haruto Uchino, Taku Sugiyama, Masahito Kawabori, Toshiya Osanai, Khin Khin Tha, and Kiyohiro Houkin
doi : 10.3171/2020.1.JNS193260
The microstructural integrity of gray and white matter is decreased in adult moyamoya disease, suggesting covert ischemic injury as a mechanism of cognitive dysfunction. Establishing a microstructural brain imaging marker is critical for monitoring cognitive outcomes following surgical interventions. The authors of the present study determined the pathophysiological basis of altered microstructural brain injury in relation to advanced arterial occlusion, cerebral hypoperfusion, and cognitive function.
Prediction of the difficulty of proximal vascular control using 3D-CTA for the surgical clipping of internal carotid artery–posterior communicating artery aneurysms
Takeya Niibo, Katsumi Takizawa, Jurou Sakurai, Seizi Takebayashi, Hiroyasu Koizumi, Toru Kobayashi, Rina Kobayashi, Kouta Kuris, Syusuke Gotou, Ryousuke Tsuchiya, and Hiroyasu Kamiyama
doi : 10.3171/2020.1.JNS192728
During surgical clipping of internal carotid artery (ICA)–posterior communicating artery (PCoA) aneurysms, proximal vascular control (PVC) is difficult to achieve in some cases because of variations in the anatomy of this type of aneurysm and its parent arteries. The authors investigated morphometric features that may be predictive for the necessity of anterior clinoidectomy (ACL) or cervical ICA exposure for PVC.
Predictors of an academic career among fellowship-trained open vascular and endovascular neurosurgeons
Adham M. Khalafallah, Adrian E. Jimenez, Justin M. Caplan, Cameron G. McDougall, Judy Huang, Debraj Mukherjee, and Rafael J. Tamargo
doi : 10.3171/2020.2.JNS2033
Although previous studies have explored factors that predict an academic career among neurosurgery residents in general, such predictors have yet to be determined within specific neurosurgical subspecialties. The authors report on predictors they identified as correlating with academic placement among fellowship-trained vascular neurosurgeons.
Delayed hospital admission of patients with aneurysmal subarachnoid hemorrhage: clinical presentation, treatment strategies, and outcome
Lukas Goertz, Muriel Pflaeging, Christina Hamisch, Christoph Kabbasch, Lenhard Pennig, Niklas von Spreckelsen, Kai Laukamp, Marco Timmer, Roland Goldbrunner, Gerrit Brinker, and Boris Krischek
doi : 10.3171/2020.2.JNS20148
Timely aneurysm occlusion and neurointensive care treatment are key principles in the management of aneurysmal subarachnoid hemorrhage (aSAH) to prevent secondary brain injury. Patients with early (EHA) and delayed hospital admission (DHA) were compared in terms of clinical presentation, treatment strategies, aSAH-related complications, and outcome.
Construction of a comprehensive endovascular test bed for research and device development in mechanical thrombectomy in stroke
Adithya S. Reddy, Yang Liu, Joshua Cockrum, Daniel Gebrezgiabhier, Evan Davis, Yihao Zheng, Aditya S. Pandey, Albert J. Shih, and Luis E. Savastano
doi : 10.3171/2020.1.JNS192732
The development of new endovascular technologies and techniques for mechanical thrombectomy in stroke has greatly relied on benchtop simulators. This paper presents an affordable, versatile, and realistic benchtop simulation model for stroke.
Clip retraction of the tentorium: application of a novel technique for tentorial retraction during supracerebellar transtentorial approaches
Jacob F. Baranoski, Ankush Bajaj, Colin J. Przybylowski, Joshua S. Catapano, Fabio A. Frisoli, Michael J. Lang, and Michael T. Lawton
doi : 10.3171/2020.2.JNS192952
Supracerebellar transtentorial (SCTT) approaches have become a popular option for treatment of a variety of pathologies in the medial and basal temporal and occipital lobes and thalamus. Transtentorial approaches provide numerous advantages over transcortical approaches, including obviating the need to traverse eloquent cortex, not requiring parenchymal retraction, and circumventing critical vascular structures. All of these approaches require a tentorial opening, and numerous techniques for retraction of the incised tentorium have been described, including sutures, fixed retractors, and electrocautery. However, all of these techniques have considerable drawbacks and limitations. The authors describe a novel application of clip retraction of the tentorium to the supracerebellar approaches in which an aneurysm clip is used to suspend the tentorial flap, and an illustrative case is provided. Clip retraction of the tentorium is an efficient, straightforward adaptation of an established technique, typically used for subtemporal approaches, that improves visualization and surgical ergonomics with little risk to nearby venous structures. The authors find this technique particularly useful for the contralateral SCTT approaches.
Echolucent carotid plaque is associated with restenosis after carotid endarterectomy
Qing Li, Beibei Liu, Yue Zhao, Yumei Liu, Mingjie Gao, Lingyun Jia, Liqun Jiao, and Yang Hua
doi : 10.3171/2020.2.JNS193397
The mechanism of carotid endarterectomy (CEA) restenosis remains unclear. Our research aimed to investigate the relationship between the carotid plaque grayscale median (GSM) value and restenosis after CEA.
Readmission and reoperation for hydrocephalus: a population-based analysis across the spectrum of age
Allison LeHanka and Joseph Piatt
doi : 10.3171/2020.3.JNS20528
Hydrocephalus is a common, chronic illness that generally requires lifelong, longitudinal, neurosurgical care. Except at select research centers, surgical outcomes in the United States have not been well documented. Comparative outcomes across the spectrum of age have not been studied.
Predictors of ventriculostomy infection in a large single-center cohort
Ahmad Sweid, Joshua H. Weinberg, Rawad Abbas, Kareem El Naamani, Stavropoula Tjoumakaris, Christine Wamsley, Erica J. Mann, Christopher Neely, Jeffery Head, David Nauheim, Julie Hauge, M. Reid Gooch, Nabeel Herial, Hekmat Zarzour, Tyler D. Alexander, Symeon Missios, David Hasan, Nohra Chalouhi, James Harrop, Robert H. Rosenwasser, and Pascal Jabbour
doi : 10.3171/2020.2.JNS192051
External ventricular drain (EVD) placement is a common neurosurgical procedure. While this procedure is simple and effective, infection is a major limiting factor. Factors predictive of infection reported in the literature are not conclusive. The aim of this retrospective, single-center large series was to assess the rate and independent predictors of ventriculostomy-associated infection (VAI).
Development and validation of prediction scores for nosocomial infections, reoperations, and adverse events in the daily clinical setting of neurosurgical patients with cerebral and spinal tumors
Sebastian Lohmann, Tobias Brix, Julian Varghese, Nils Warneke, Michael Schwake, Eric Suero Molina, Markus Holling, Walter Stummer, and Stephanie Schipmann
doi : 10.3171/2020.1.JNS193186
Various quality indicators are currently under investigation, aiming at measuring the quality of care in neurosurgery; however, the discipline currently lacks practical scoring systems for accurately assessing risk. The aim of this study was to develop three accurate, easy-to-use risk scoring systems for nosocomial infections, reoperations, and adverse events for patients with cerebral and spinal tumors.
Results of a third Gamma Knife radiosurgery for trigeminal neuralgia
Corbin A. Helis, Ryan T. Hughes, Michael T. Munley, J. Daniel Bourland, Travis Jacobson, John T. Lucas Jr., Christina K. Cramer, Stephen B. Tatter, Adrian W. Laxton, and Michael D. Chan
doi : 10.3171/2020.2.JNS192876
Gamma Knife radiosurgery (GKRS) is a commonly used procedure for medically refractory trigeminal neuralgia (TN), with repeat GKRS routinely done in cases of pain relapse. The results of a third GKRS in cases of further pain relapse have not been well described. In this study, the authors report the largest series of patients treated with a third GKRS for TN to date.
Peripheral nerve field stimulation in medically refractory trigeminal neuralgia attributed to multiple sclerosis
Johann Klein, Timo Siepmann, Gabriele Schackert, Tjalf Ziemssen, and Tareq A. Juratli
doi : 10.3171/2019.12.JNS192261
Case reports and small patient series have suggested peripheral nerve field stimulation (PNFS) as a treatment for refractory trigeminal neuralgia attributed to multiple sclerosis (MS). Here, the authors aimed to assess the effects of this technique on long-term pain severity.
Relationship between direct cortical stimulation and induced high-frequency activity for language mapping during SEEG recording
Pauline Cuisenier, Bénédicte Testud, Lorella Minotti, Samuel El Bouzaïdi Tiali, Laurence Martineau, Anne-Sophie Job, Agnès Trébuchon, Pierre Deman, Manik Bhattacharjee, Dominique Hoffmann, Jean-Philippe Lachaux, Monica Baciu, Philippe Kahane, and Marcela Perrone-Bertolotti
doi : 10.3171/2020.2.JNS192751
The authors assessed the clinical relevance of preoperative task-induced high-frequency activity (HFA) for language mapping in patients with refractory epilepsy during stereoelectroencephalography recording. Although HFA evaluation was described as a putative biomarker of cognition, its clinical relevance for mapping language networks was assessed predominantly by studies using electrocorticography (ECOG).
An altered posterior question-mark incision is associated with a reduced infection rate of cranioplasty after decompressive hemicraniectomy
Michael Veldeman, Lorina Daleiden, Hussam Hamou, Anke H?llig, and Hans Clusmann
doi : 10.3171/2020.2.JNS193335
Performing a cranioplasty (CP) after decompressive craniotomy is a straightforward neurosurgical procedure, but it remains associated with a high complication rate. Surgical site infection (SSI), aseptic bone resorption (aBR), and need for a secondary CP are the most common complications. This observational study aimed to identify modifiable risk factors to prevent CP failure.
Neuromodulation of the lingual nerve: a novel technique
Christopher E. Talbot, Kevin Zhao, Max Ward, Aron Kandinov, Antonios Mammis, and Boris Paskhover
doi : 10.3171/2020.2.JNS193109
Acute injury of the trigeminal nerve or its branches can result in posttraumatic trigeminal neuropathy (PTTN). Affected patients suffer from chronic debilitating symptoms long after they have recovered from the inciting trauma. Symptoms vary but usually consist of paresthesia, allodynia, dysesthesia, hyperalgesia, or a combination of these symptoms. PTTN of the trigeminal nerve can result from a variety of traumas, including iatrogenic injury from various dental and maxillofacial procedures. Treatments include medications, pulsed radiofrequency modulation, and microsurgical repair. Although trigeminal nerve stimulation has been reported for trigeminal neuropathy, V3 implantation is often avoided because of an elevated migration risk secondary to mandibular motion, and lingual nerve implantation has not been documented. Here, the authors report on a patient who suffered from refractory PTTN despite multiple alternative treatments. He elected to undergo novel placement of a lingual nerve stimulator for neuromodulation therapy. To the best of the authors’ knowledge, this is the first documented case of lingual nerve stimulator implantation for lingual neuropathy, a technique for potentially reducing the risk of electrode migration.
Comparative anatomical analysis between the minipterional and supraorbital approaches
Rafael Mart?nez-Pérez, Thiago Albonette-Felicio, Douglas A. Hardesty, and Daniel M. Prevedello
doi : 10.3171/2019.12.JNS193196
Keyhole approaches, namely the minipterional approach (MPTa) and the supraorbital approach (SOa), are alternatives to the standard pterional approach to treat lesions located in the anterior and middle cranial fossae. Despite their increasing popularity and acceptance, the indications and limitations of these approaches require further assessment. The purpose of the present study was to determine the differences in the area of surgical exposure and surgical maneuverability provided by the MPTa and SOa.
Estimating prognosis for traumatic brain injury patients in a low-resource setting: how do providers compare to the CRASH risk calculator?
Cyrus Elahi, Theresa Williamson, Charis A. Spears, Sarah Williams, Josephine Nambi Najjuma, Catherine A. Staton, Jo?o Ricardo Nickenig Vissoci, Anthony Fuller, David Kitya, and Michael M. Haglund
doi : 10.3171/2020.2.JNS192512
Traumatic brain injury (TBI), a burgeoning global health concern, is one condition that could benefit from prognostic modeling. Risk stratification of TBI patients on presentation to a health facility can support the prudent use of limited resources. The CRASH (Corticosteroid Randomisation After Significant Head Injury) model is a well-established prognostic model developed to augment complex decision-making. The authors’ current study objective was to better understand in-hospital decision-making for TBI patients and determine whether data from the CRASH risk calculator influenced provider assessment of prognosis.
Spreading depolarization may represent a novel mechanism for delayed fluctuating neurological deficit after chronic subdural hematoma evacuation
Laila M. Mohammad, Mohammad Abbas, C. William Shuttleworth, Rosstin Ahmadian, Annapoorna Bhat, Deirdre A. Hill, and Andrew P. Carlson
doi : 10.3171/2020.1.JNS192914
Most patients with chronic subdural hematoma (cSDH) recover after surgical evacuation with a straightforward course. There is a subset of patients who develop transient and fluctuating deficits not explained by seizures, stroke, or mass effect after evacuation. The objective of this study was to investigate whether these postoperative neurological deficits may be related to temporary brain dysfunction caused by cortical spreading depolarizations (SDs).
Hospital volume-outcome relationship in severe traumatic brain injury: stratified analysis by level of trauma center
Sung Huang Laurent Tsai, Anshit Goyal, Mohammed Ali Alvi, Panagiotis Kerezoudis, Yagiz Ugur Yolcu, Waseem Wahood, Elizabeth B. Habermann, Terry C. Burns, and Mohamad Bydon
doi : 10.3171/2020.1.JNS192115
The nature of the volume-outcome relationship in cases with severe traumatic brain injury (TBI) remains unclear, with considerable interhospital variation in patient outcomes. The objective of this study was to understand the state of the volume-outcome relationship at different levels of trauma centers in the United States.
Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach
Anthony T. Fuller, Ariana Barkley, Robin Du, Cyrus Elahi, MScGH, Ali R. Tafreshi, Megan Von Isenburg, and Michael M. Haglund
doi : 10.3171/2020.2.JNS192517
Global neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no centralized report detailing these efforts. This scoping review aims to characterize the field of global neurosurgery by identifying partnerships between high-income countries (HICs) and low- and/or middle-income countries (LMICs) that seek to increase neurosurgical capacity.
Pregnancy and parental leave among neurosurgeons and neurosurgical trainees
Mihir Gupta, Allison Reichl, Luis Daniel Diaz-Aguilar, Pate J. Duddleston, Jamie S. Ullman, Karin M. Muraszko, Shelly D. Timmons, Isabelle M. Germano, Aviva Abosch, Jennifer A. Sweet, Susan C. Pannullo, Deborah L. Benzil, and Sharona Ben-Haim
doi : 10.3171/2020.2.JNS193345
Despite recently heightened advocacy efforts relating to pregnancy and family leave policies in multiple surgical specialties, no studies to date have described female neurosurgeons’ experiences with childbearing. The AANS/CNS Section of Women in Neurosurgery created the Women and Pregnancy Task Force to ascertain female neurosurgeons’ experiences with and attitudes toward pregnancy and the role of family leave policies.
Dissecting the default mode network: direct structural evidence on the morphology and axonal connectivity of the fifth component of the cingulum bundle
Georgios P. Skandalakis, Spyridon Komaitis, Aristotelis Kalyvas, Evgenia Lani, Chrysoula Kontrafouri, Evangelos Drosos, Faidon Liakos, Maria Piagkou, Dimitris G. Placantonakis, John G. Golfinos, Kostas N. Fountas, Eftychia Z. Kapsalaki, Constantinos G. Hadjipanayis, George Stranjalis, and Christos Koutsarnakis
doi : 10.3171/2020.2.JNS193177
Although a growing body of data support the functional connectivity between the precuneus and the medial temporal lobe during states of resting consciousness as well as during a diverse array of higher-order functions, direct structural evidence on this subcortical circuitry is scarce. Here, the authors investigate the very existence, anatomical consistency, morphology, and spatial relationships of the cingulum bundle V (CB-V), a fiber tract that has been reported to reside close to the inferior arm of the cingulum (CingI).
Letter to the Editor. Spreading depolarizations in chronic subdural hematoma
Christian Iorio-Morin and Mathieu Levesque
doi : 10.3171/2020.6.JNS202185
Letter to the Editor. The minipterional craniotomy: beyond the keyhole concept
N?collas Nunes Rabelo, Manoel Jacobsen Teixeira, Robert F. Spetzler, and Eberval Gadelha Figueiredo
doi : 10.3171/2020.4.JNS201241
Letter to the Editor. An altered posterior question-mark incision
Qingjia Lai and Yuanhong Ge
doi : 10.3171/2020.7.JNS202703
Letter to the Editor. Global health and neurosurgery training
Shujhat Khan, Ismail Anwar, and Rafiullah Akberzai
doi : 10.3171/2020.5.JNS201708
Letter to the Editor. The COVID-19 pandemic and the inequities of the neurosurgery match
Michael D. White, Brandon M. Fox, and Nitin Agarwal
doi : 10.3171/2020.9.JNS203365
