Neurosurgery Commons^™

Coronavirus Neurosurgical/Head And Neck Drape To Prevent Aerosolization Of Coronavirus Disease 2019 (Covid-19): The Lenox Hill Hospital/Northwell Health Solution, R. S. D'Amico, D. Khatri, K. Kwan, G. Baum, Y. Serulle, D. Silva, M. L. Smith, J. A. Ellis, M. Levine, R. Ortiz, D. J. Langer, J. A. Boockvar

Journal Articles

No abstract provided.

Behavioral Changes Without Respiratory Symptoms As A Presenting Sign Of Covid-19 Encephalitis., T. Rebeiz, K. Lim-Hing, S. Khazanehdari, K. Rebeiz

Journal Articles

The clinical presentation, diagnosis, and treatment of coronavirus disease 2019 (COVID-19) encephalitis are still being characterized. Few case reports describing COVID-19 encephalitis are available in the literature. We present a case of COVID-19 encephalitis who presented with behavioral disturbances without respiratory symptoms.

Covid-19 And Neurosurgical Practice: An Interim Report, S Amin-Hanjani, Nc Bambakidis, Fg Barker, Bs Carter, Km Cockroft, R Du, Jf Fraser, Mg Hamilton, M Schulder, G Zada, +9 Additional Authors

Journal Articles

No abstract provided.

Minimizing Sars-Cov-2 Exposure When Performing Surgical Interventions During The Covid-19 Pandemic, As Pandey, Aj Ringer, At Rai, P Kan, P Jabbour, Ah Siddiqui, E Levy, K Snyder, H Riina, D Langer, +9 Additional Authors

Journal Articles

No abstract provided.

Cerebellar Infarction Requiring Surgical Decompression In Patient With Covid 19 Pathological Analysis And Brief Review, H. N. Patel, A. Syed, J. S. Lobel, R. Galler, J. Georges, M. Carmody, M. Puumala

Journal Articles

© 2020 The Authors Background: This report and literature review describes a case of a COVID-19 patient who suffered a cerebellar stroke requiring neurosurgical decompression. This is the first reported case of a sub-occipital craniectomy with brain biopsy in a COVID-19 patient showing leptomeningeal venous intimal inflammation. Clinical description: The patient is a 48-year-old SARS-COV-2 positive male with multiple comorbidities, who presented with fevers and respiratory symptoms, and imaging consistent with multifocal pneumonia. On day 5 of admission, the patient had sudden change in mental status, increased C-Reactive Protein, ferritin and elevated Interleukin-6 levels. Head CT showed cerebral infarction from …

Extracellular Hmgb1: A Therapeutic Target In Severe Pulmonary Inflammation Including Covid-19?, U Andersson, W Ottestad, Kj Tracey

Journal Articles

No abstract provided.

Letter: Considerations For Performing Emergent Neurointerventional Procedures In A Covid-19 Environment., As Pandey, Aj Ringer, A Rai, Pt Kan, Pm Jabbour, A Siddiqui, E Levy, Kv Snyder, Ha Riina, D Langer, +9 Additional Authors

Journal Articles

No abstract provided.

Comparison Of A Continuous Noninvasive Temperature To Monitor Core Temperature Measures During Targeted Temperature Management, M. Wagner, K. Lim-Hing, M. A. Bautista, B. Blaber, T. Ryder, J. Haymore, N. Badjatia

Journal Articles

No abstract provided.

Author Correction: Noninvasive Sub-Organ Ultrasound Stimulation For Targeted Neuromodulation (Nature Communications, (2019), 10, 1, (952), 10.1038/S41467-019-08750-9), V. Cotero, Y. Fan, T. Tsaava, A. M. Kressel, I. Hancu, T. R. Coleman, S. Zanos, K. J. Tracey, S. S. Chavan, C. Puleo, +10 Additional Authors

Journal Articles

© 2020, The Author(s). This article contained an error in the ordinate axis in Fig. 2d, where the units were reported as nmol/L. The unit should have been reported as pg/ml. This has now been corrected in both the PDF and HTML versions of the Article.

Application Of Multimodal Neuromonitoring In Posterior Inferior Cerebellar Artery Aneurysm Clippings: Review Of Two Cases., J. W. Silverstein, A. Rosenthal, K. Kwan, K. Wagner, J. A. Ellis

Journal Articles

Neurophysiological monitoring is advocated for the prevention of neurological sequelae secondary to the clipping of an aneurysm involved in posterior circulation. Unfortunately, there is a paucity in the literature regarding what neurophysiological monitoring techniques are best employed. The authors here present two cases where multimodal neuromonitoring techniques were used during the clippings of two posterior inferior cerebellar artery (PICA) aneurysms. There is increased neurologic morbidity associated with PICA aneurysm clippings, as a number of eloquent structures live in close proximity to the PICA. The application of a multimodal neuromonitoring paradigm may reduce a poor neurological outcome.

N-Butyl Cyanoacrylate Transvenous Arteriovenous Malformation Embolization With Arterial Balloon Assistance: Defining Parameters For A Transvenous Approach As A Potential Upfront Treatment Option In Managing Cerebral Arteriovenous Malformations., C. Higbie, D. Khatri, B. Ligas, R. Ortiz, D. Langer

Journal Articles

Complete obliteration of arteriovenous malformations (AVMs) using a transvenous approach as the primary and stand-alone treatment modality has been increasingly considered as a useful endovascular approach in the treatment of AVMs. AVMs are typically treated with microsurgery, stereotactic radiosurgery, endovascular embolization, or some combination of the three methods. Preservation of the draining vein is a key requisite common to all treatment modalities. Transvenous embolization (TVE) is conventionally not recommended as a stand-alone treatment for the vast majority of AVMs and has been thought to be best indicated when traditional approaches are considered less safe and when specific evaluation criteria are …

Secondary Encephalocele In An Adult Leading To Subdural Empyema, T. Wang, A. Uddin, N. Mobarakai, R. Gilad, M. Raden, S. Motivala

Journal Articles

© 2020 The Author(s) Brain abscesses are an uncommon but potentially fatal infection. They can spread directly from an adjacent source or hematogenously from a distant source. Encephaloceles represent a rare form of neural tube defects that can potentially be complicated by the development of meningitis or brain abscess. We report a case of a 63-year-old female who presented with bilateral lower extremity weakness and was ultimately found to have a Streptococcus pneumoniae subdural empyema and an associated frontal lobe encephalocele extending through the left frontal sinus. She was treated with surgical drainage, intravenous antimicrobials, and ultimately surgical repair of …

Polio To The Rescue; New Frontiers In Glioblastoma Treatment, Syed Sarmad Bukhari, Aneela Darbar, Muhammad Shahzad Shamim

Section of Neurosurgery

Lack of substantial progress in effective treatment of glioblastomamultiforme has led investigators to explore unconventional treatment options including the use of tumour treating fields and oncolyticvirotherapy. Herein the authors have reviewed some of the recent literature on oncolyticvirotherapy for the treatment of glioblastomamultiforme.

Traumatic Brain Injury, Julian E. Bailes, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

No abstract provided.

Eyeballing Stroke: Blood Flow Alterations In The Eye And Visual Impairments Following Transient Middle Cerebral Artery Occlusion In Adult Rats, Jea-Young Lee, Vanessa Castelli, Brooke Bonsack, Julián García-Sánchez, Chase Kingsbury, Hung Nguyen, Naoki Tajiri, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Middle cerebral artery occlusion in rodents remains a widely used model of ischemic stroke. Recently, we reported the occurrence of retinal ischemia in animals subjected to middle cerebral artery occlusion, owing in part to the circulatory juxtaposition of the ophthalmic artery to the middle cerebral artery. In this study, we examined the eye hemodynamics and visual deficits in middle cerebral artery occlusion-induced stroke rats. The brain and eye were evaluated by laser Doppler at baseline (prior to middle cerebral artery occlusion), during and after middle cerebral artery occlusion. Retinal function-relevant behavioral and histological outcomes were performed at 3 and 14 …

Spleen Participation In Partial Mhc Class Ii Construct Neuroprotection In Stroke, John Brown, Chase Kingsbury, Jea-Young Lee, Arthur A. Vandenbark, Roberto Meza-Romero, Halina Offner, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Pathological progression of stroke in the peripheral and central nervous systems (PNS and CNS) is characterized by multiple converging signalling pathways that exacerbate neuroinflammation-mediated secondary cell death. This creates a need for a novel type of immunotherapy capable of simultaneously lowering the synergistic inflammatory responses in the PNS and CNS, specifically the spleen and brain. Previously, we demonstrated that partial major histocompatibility complex (MHC) class II constructs can be administered subcutaneously to promote histological and behavioural effects that alleviate common symptoms found in a murine model of transient stroke. This MHC class II manipulates T cell cytokine expression in both …

2019 Overview, Cesario Borlongan, Frederic Dorandeu, Giuseppe Di Giovanni, Jian-Sheng Lin, Gang Hu, Johannes Boltze, Jie Wu, Xiaoming Hu, Yumin Luo

Neurosurgery and Brain Repair Faculty Publications

No abstract provided.

Potential Of Mesenchymal Stem Cells Alone, Or In Combination, To Treat Traumatic Brain Injury, Alison E. Willing, Mahasweta Das, Mark Howell, Shyam S. Mohapatra, Subhra Mohapatra

Neurosurgery and Brain Repair Faculty Publications

Traumatic brain injury (TBI) causes death and disability in the United States and around the world. The traumatic insult causes the mechanical injury of the brain and primary cellular death. While a comprehensive pathological mechanism of TBI is still lacking, the focus of the TBI research is concentrated on understanding the pathophysiology and developing suitable therapeutic approaches. Given the complexities in pathophysiology involving interconnected immunologic, inflammatory, and neurological cascades occurring after TBI, the therapies directed to a single mechanism fail in the clinical trials. This has led to the development of the paradigm of a combination therapeutic approach against TBI. …

Novel Titanium Cages For Minimally Invasive Lateral Lumbar Interbody Fusion: First Assessment Of Subsidence, Paul R. Krafft, Brooks Osburn, Andrew C. Vivas, Gautam Rao, Puya Alikhani

Neurosurgery and Brain Repair Faculty Publications

Introduction: Implant subsidence is a potential complication of spinal interbody fusion and may negatively affect patients subjected to procedures relying on indirect decompression such as minimally invasive transpsoas lateral lumbar interbody fusion (LLIF). The porous architecture of a recently developed titanium intervertebral cage maximizes bone-to-implant contact and minimizes stress shielding in laboratory experiments; however, its subsidence rate in patients has not yet been evaluated. The goal of this current study was to evaluate implant subsidence in patients subjected to LLIF.

Methods: Our institutional review board-approved single-center experience included 29 patients who underwent 30 minimally invasive LLIF from July 2017 to …

Mesenchymal Stem Cell Therapy Alleviates The Neuroinflammation Associated With Acquired Brain Injury, Brooke Bonsack, Sydney Corey, Alex Shear, Matt Heyck, Blaise Cozene, Nadia Sadanandan, Henry Zhang, Bella Gonzales-Portillo, Michael Sheyner, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Ischemic stroke and traumatic brain injury (TBI) comprise two particularly prevalent and costly examples of acquired brain injury (ABI). Following stroke or TBI, primary cell death and secondary cell death closely model disease progression and worsen outcomes. Mounting evidence indicates that long-term neuroinflammation extensively exacerbates the secondary deterioration of brain structure and function. Due to their immunomodulatory and regenerative properties, mesenchymal stem cell transplants have emerged as a promising approach to treating this facet of stroke and TBI pathology. In this review, we summarize the classification of cell death in ABI and discuss the prominent role of inflammation. We then …

Advancing Stem Cell Therapy For Repair Of Damaged Lung Microvasculature In Amyotrophic Lateral Sclerosis, Svitlana Garbuzova-Davis, Robert Shell, Hilmi Mustafa, Surafuale Hailu, Alison E. Willing, Paul R. Sanberg, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

Amyotrophic lateral sclerosis (ALS) is a fatal disease of motor neuron degeneration in the brain and spinal cord. Progressive paralysis of the diaphragm and other respiratory muscles leading to respiratory dysfunction and failure is the most common cause of death in ALS patients. Respiratory impairment has also been shown in animal models of ALS. Vascular pathology is another recently recognized hallmark of ALS pathogenesis. Central nervous system (CNS) capillary damage is a shared disease element in ALS rodent models and ALS patients. Microvascular impairment outside of the CNS, such as in the lungs, may occur in ALS, triggering lung damage …

Foraminal Ligaments Tether Upper Cervical Nerve Roots: A Potential Cause Of Postoperative C5 Palsy, Andrew S. Jack, Brooks R. Osburn, Zane A. Tymchak, Wyatt L. Ramey, Rod J. Oskouian, Robert A. Hart, Jens R. Chapman, Line G. Jacques, R. Shane Tubbs

Neurosurgery and Brain Repair Faculty Publications

Background: Nerve root tethering upon dorsal spinal cord (SC) migration has been proposed as a potential mechanism for postoperative C5 palsy (C5P). To our knowledge, this is the first study to investigate this relationship by anatomically comparing C5–C6 nerve root translation before and after root untethering by cutting the cervical foraminal ligaments (FL).

Objective: The aim of this study is to determine if C5 root untethering through FL cutting results in increased root translation.

Methods: Six cadaveric dissections were performed. Nerve roots were exposed via C4–C6 corpectomies and supraclavicular brachial plexus exposure. Pins were inserted into the C5–C6 roots and …

Cell Therapy For Central Nervous System Disorders: Current Obstacles To Progress, Takao Yasuhara, Satoshi Kawauchi, Kyohei Kin, Jun Morimoto, Masahiro Kameda, Tatsuya Sasaki, Brooke Bonsack, Chase Kingsbury, Naoki Tajiri, Cesar V. Borlongan, Isao Date

Neurosurgery and Brain Repair Faculty Publications

Cell therapy for disorders of the central nervous system has progressed to a new level of clinical application. Various clinical studies are underway for Parkinson's disease, stroke, traumatic brain injury, and various other neurological diseases. Recent biotechnological developments in cell therapy have taken advantage of the technology of induced pluripotent stem (iPS) cells. The advent of iPS cells has provided a robust stem cell donor source for neurorestoration via transplantation. Additionally, iPS cells have served as a platform for the discovery of therapeutics drugs, allowing breakthroughs in our understanding of the pathology and treatment of neurological diseases. Despite these recent …

Translating Intracarotid Artery Transplantation Of Bone Marrow-Derived Ncs-01 Cells For Ischemic Stroke: Behavioral And Histological Readouts And Mechanistic Insights Into Stem Cell Therapy, Yuji Kaneko, Jea-Young Lee, Naoki Tajiri, Julian P. Tuazon, Trenton Lippert, Eleonora Russo, Seong-Jin Yu, Brooke Bonsack, Sydney Corey, Alexandreya B. Coats, Chase Kingsbury, Thomas N. Chase, Minako Koga, Cesar V. Borlongan

Neurosurgery and Brain Repair Faculty Publications

The present study used in vitro and in vivo stroke models to demonstrate the safety, efficacy, and mechanism of action of adult human bone marrow-derived NCS-01 cells. Coculture with NCS-01 cells protected primary rat cortical cells or human neural progenitor cells from oxygen glucose deprivation. Adult rats that were subjected to middle cerebral artery occlusion, transiently or permanently, and subsequently received intracarotid artery or intravenous transplants of NCS-01 cells displayed dose-dependent improvements in motor and neurological behaviors, and reductions in infarct area and peri-infarct cell loss, much better than intravenous administration. The optimal dose was 7.5 × 106 cells/mL when …

Early Acid/Base And Electrolyte Changes In Permanent Middle Cerebral Artery Occlusion: Aged Male And Female Rats, Sarah R. Martha, Lisa A. Collier, Stephanie M. Davis, Sarah J. Goodwin, David Powell, Doug Lukins, Justin F. Fraser, Keith R. Pennypacker

Neurosurgery Faculty Publications

BACKGROUND: Early changes in acid/base and electrolyte concentrations could provide insights into the development of neuropathology at the onset of stroke. We evaluated associations between acid/base and electrolyte concentrations, and outcomes in permanent middle cerebral artery occlusion (pMCAO) model.

METHODS: 18-month-old male and female Sprague-Dawley rats underwent pMCAO. Pre-, post- (7 min after occlusion), and at 72 hr of pMCAO venous blood samples provided pH, carbon dioxide, oxygen, glucose, hematocrit, hemoglobin, and electrolyte values of ionized calcium, potassium, and sodium. Multiple linear regression determined predictors of infarct and edema volumes from these values, Kaplan-Meier curve analyzed morality between males and …

Rna Sequencing Of Human Peripheral Nerve In Response To Injury: Distinctive Analysis Of The Nerve Repair Pathways, Andrew S. Welleford, Jorge E. Quintero, Nader El Seblani, Eric M. Blalock, Sumedha Gunewardena, Steven M. Shapiro, Sean M. Riordan, Peter Huettl, Zain Guduru, John A. Stanford, Craig G. Van Horne, Greg A. Gerhardt

Neuroscience Faculty Publications

The development of regenerative therapies for central nervous system diseases can likely benefit from an understanding of the peripheral nervous system repair process, particularly in identifying potential gene pathways involved in human nerve repair. This study employed RNA sequencing (RNA-seq) technology to analyze the whole transcriptome profile of the human peripheral nerve in response to an injury. The distal sural nerve was exposed, completely transected, and a 1 to 2 cm section of nerve fascicles was collected for RNA-seq from six participants with Parkinson's disease, ranging in age between 53 and 70 yr. Two weeks after the initial injury, another …

The Effect Of Haptoglobin Phenotypes On Markers Of Neuroinflammation In Patients With Aneurysmal Subarachnoid Hemorrhage, Kevin Hatton

Theses and Dissertations--Clinical and Translational Science

Aneurysmal subarachnoid hemorrhage (aSAH) is a severe form of hemorrhagic stroke resulting from the spontaneous rupture of an intracranial aneurysm and release of oxygenated blood into the subarachnoid space. In the United States alone, aSAH occurs in approximately 30,000 patients each year and occurs, primarily, in otherwise healthy adults, frequently without warning. Sadly, approximately 40% of patients with aSAH will die in the first 30 days. Of those who survive, only about 75% will be able to live semi-independently again and only about 60% will be able to return to work.

Delayed brain injuries (DBI), which may affect up to …

Dynamic Blood-Brain Barrier Regulation In Mild Traumatic Brain Injury, Eoin O'Keeffe, Eoin Kelly, Yuzhe Liu, Chiara Giordano, Eugene Wallace, Mark Hynes, Stephen Tiernan, Aidan Meagher, Chris Greene, Stephanie Hughes, Tom Burke, John Kealy, Niamh Doyle, Alison Hay, Michael Farrell, Gerald A. Grant, Alon Friedman, Ronel Veksler, Michael G. Molloy, James F. Meaney, Niall Pender, David Camarillo, Colin P. Doherty, Matthew Campbell

Articles

Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast …