Neurosurgery Commons^™

Endovascular Thrombectomy For Large Ischemic Stroke Across Ischemic Injury And Penumbra Profiles, Amrou Sarraj, Ameer E Hassan, Michael G Abraham, Santiago Ortega-Gutierrez, Scott E Kasner, Muhammad Shazam Hussain, Michael Chen, Leonid Churilov, Hannah Johns, Clark W Sitton, Vignan Yogendrakumar, Felix C Ng, Deep K Pujara, Spiros Blackburn, Sophia Sundararajan, Yin C Hu, Nabeel A Herial, Juan F Arenillas, Jenny P Tsai, Ronald F Budzik, William J Hicks, Osman Kozak, Bernard Yan, Dennis J Cordato, Nathan W Manning, Mark W Parsons, Andrew Cheung, Ricardo A Hanel, Amin N Aghaebrahim, Teddy Y Wu, Pere Cardona Portela, Chirag D Gandhi, Fawaz Al-Mufti, Natalia Pérez De La Ossa, Joanna D Schaafsma, Jordi Blasco, Navdeep Sangha, Steven Warach, Timothy J Kleinig, Faris Shaker, Faisal Al Shaibi, Gabor Toth, Mohammad A Abdulrazzak, Gagan Sharma, Abhishek Ray, Jeffrey Sunshine, Amanda Opaskar, Kelsey R Duncan, Wei Xiong, Edgar A Samaniego, Laith Maali, Colleen G Lechtenberg, Arturo Renú, Nirav Vora, Thanh Nguyen, Johanna T Fifi, Stavropoula I Tjoumakaris, Pascal Jabbour, Georgios Tsivgoulis, Vitor Mendes Pereira, Maarten G Lansberg, Michael Degeorgia, Cathy A Sila, Nicholas Bambakidis, Michael D Hill, Stephen M Davis, Lawrence Wechsler, James C Grotta, Marc Ribo, Greg W Albers, Bruce C Campbell

Faculty, Staff and Student Publications

Importance: Whether endovascular thrombectomy (EVT) efficacy for patients with acute ischemic stroke and large cores varies depending on the extent of ischemic injury is uncertain.

Objective: To describe the relationship between imaging estimates of irreversibly injured brain (core) and at-risk regions (mismatch) and clinical outcomes and EVT treatment effect.

Design, setting, and participants: An exploratory analysis of the SELECT2 trial, which randomized 352 adults (18-85 years) with acute ischemic stroke due to occlusion of the internal carotid or middle cerebral artery (M1 segment) and large ischemic core to EVT vs medical management (MM), across 31 global centers between October 2019 …

Analysis Of Antibody Drug Conjugate On Cellular Senescent Human Glioblastoma, Ariel P. Walker, Renee Hirte, Cecile Riviere-Cazaux, Authur Warrington, Terry Burns

Medical Student Research Symposium

Background: Glioblastoma Multiforme (GBM) is an aggressive and malignant brain tumor known for its rapid progression and unfavorable prognosis. The standard treatment options primarily involve radiation and temozolomide, however recurrence is inevitable.

B7H3/CD276, an immunomodulatory transmembrane glycoprotein, demonstrates tumor-specific expression, with limited presence in normal healthy tissue, making it a promising and attractive treatment target in GBM. AbbV155 is an antibody drug conjugate that inhibits BCL-XL and specifically targets B7H3 (CD276) on GBM cells with the goal of selectively eliminating viable tumor cells.

Objectives: First, we sought to confirm the presence of B7H3/CD276 in our selected cell line via …

Insular And Amygdala Origin Seizures: Unmasked With Electrocorticography (Ecog), Younes Motii, Arichenaramanathan Manmatharayan, Parthasarathi Chamiraju, Mona Elsayed

Medical Student Research Symposium

Insular and Amygdala Origin Seizures: Unmasked with Electrocorticography (ECOG)

Introduction:

Insula and amygdala have a large network of connections to other cortical regions. Seizures originating from these structures may become evident only after propagation to other structures. High degree of attention must be paid to auras and seizure semiology in patients with medically intractable epilepsy.

Methodology:

We have described a series of three adult male patients with focal intractable epilepsy who did not have structural lesions on Magnetic Resonance Imaging (MRI). Patients underwent MRI, Positron Emission Tomography (PET) scan, scalp electroencephalography (EEG), and stereo EEG implantation.

Results:

All three patients …

A Case Of Parkinsonian Symptoms Secondary To Chronic Subdural Hematoma, Willbroad Kyejo, Frank Swai, Clement Mugisha, Philip Adebayo

Internal Medicine, East Africa

Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases.

Autologous Cell Immunotherapy (Igv-001) With Igf-1r Antisense Oligonucleotide In Newly Diagnosed Glioblastoma Patients, Ian Y. Lee, Simon Hanft, Michael Schulder, Kevin D. Judy, Eric T. Wong, J. Bradley Elder, Linton T. Evans, Mario Zuccarello, Julian Wu, Sonikpreet Aulakh, Vijay Agarwal, Rohan Ramakrishna, Brian J. Gill, Alfredo Quiñones-Hinojosa, Cameron Brennan, Brad E. Zacharia, Carlos Eduardo Silva Correia, Madhavi Diwanji, Gregory K. Pennock, Charles Scott, Raul Perez-Olle, David W. Andrews, John A. Boockvar

Department of Neurosurgery Faculty Papers

Standard-of-care first-line therapy for patients with newly diagnosed glioblastoma (ndGBM) is maximal safe surgical resection, then concurrent radiotherapy and temozolomide, followed by maintenance temozolomide. IGV-001, the first product of the Goldspire™ platform, is a first-in-class autologous immunotherapeutic product that combines personalized whole tumor-derived cells with an antisense oligonucleotide (IMV-001) in implantable biodiffusion chambers, with the intent to induce a tumor-specific immune response in patients with ndGBM. Here, we describe the design and rationale of a randomized, double-blind, phase IIb trial evaluating IGV-001 compared with placebo, both followed by standard-of-care treatment in patients with ndGBM. The primary end point is progression-free …

The Pug Flap: Conjoined Profunda Artery Perforator And Upper Gracilis Flap For Breast Reconstruction, Isra Abdulwadood, Lacey R Pflibsen, Nicholas R Jarvis, Sebastian Winocour, Alanna M Rebecca, William J Casey, Edward M Reece

Faculty, Staff and Students Publications

Abdominal-based free flaps are the mainstay of autologous breast reconstruction; however, the region may not be ideal for patients with inadequate soft tissue or history of abdominal surgery. This case describes the use of a novel conjoined flap based on the profunda artery perforator and upper gracilis pedicles, named the perforator and upper gracilis (PUG) flap. This flap design aims to maximize medial thigh flap volume while ensuring robust tissue perforation. Here, we present our experience with the PUG flap in a breast cancer patient undergoing autologous reconstruction. The patient was a 41-year-old woman seeking nipple-sparing mastectomy and immediate autologous …

Experience With A Hybrid Recruitment Approach Of Patient-Facing Web Portal Screening And Subsequent Phone And Medical Record Review For A Neurosurgical Intervention Trial For Chronic Ischemic Stroke Disability (Pisces Iii), Brad J Kolls, Keith W Muir, Sean I Savitz, Lawrence R Wechsler, Julie G Pilitsis, Scott Rahimi, Richard L Beckman, Vincent Holmes, Peng R Chen, David S Albers, Daniel T Laskowitz

Faculty, Staff and Student Publications

BACKGROUND: Recruitment of participants is the greatest risk to completion of most clinical trials, with 20-40% of trials failing to reach the targeted enrollment. This is particularly true of trials of central nervous system (CNS) therapies such as intervention for chronic stroke. The PISCES III trial was an invasive trial of stereotactically guided intracerebral injection of CTX0E03, a fetal derived neural stem cell line, in patients with chronic disability due to ischemic stroke. We report on the experience using a novel hybrid recruitment approach of a patient-facing portal to self-identify and perform an initial screen for general trial eligibility (tier …

Stereotactic Electroencephalogram Recordings In Temporal Lobectomy Patients Demonstrates The Predictive Value Of Interictal Cross-Frequency Correlations: A Retrospective Study, Anish Sathe, Mahdi Alizadeh, Emily Johannan, Christian Raimondo, Michael R Sperling, Ashwini Sharan, Michael Kogan

Department of Neurosurgery Faculty Papers

BACKGROUND: Positive correlations between low- and high-frequency spectra from stereotactic electroencephalogram (SEEG) recordings have been implicated in pathological brain activity interictally and have been used for ictal detection in both focal and network models.

OBJECTIVE: We evaluated SEEG signals in patients who ultimately underwent temporal lobectomy to evaluate their utility in seizure localization and prediction of seizure freedom post-resection.

METHODS: We retrospectively analyzed cross-frequency correlations between beta and high gamma (HG) interictal SEEG signals from 22 patients. We compared signals based on temporal versus extra-temporal locations, seizure-free (SF) versus non-seizure-free (NSF) outcomes, and mesial (M) versus mesial temporal-plus (M+) onset. …

Thsd1 Suppresses Autophagy-Mediated Focal Adhesion Turnover By Modulating The Fak-Beclin 1 Pathway, Zhen Xu, Jiayi Lu, Song Gao, Yan-Ning Rui

Faculty, Staff and Student Publications

Focal adhesions (FAs) play a crucial role in cell spreading and adhesion, and their autophagic degradation is an emerging area of interest. This study investigates the role of Thrombospondin Type 1 Domain-Containing Protein 1 (THSD1) in regulating autophagy and FA stability in brain endothelial cells, shedding light on its potential implications for cerebrovascular diseases. Our research reveals a physical interaction between THSD1 and FAs. Depletion of THSD1 significantly reduces FA numbers, impairing cell spreading and adhesion. The loss of THSD1 also induces autophagy independently of changes in mTOR and AMPK activation, implying that THSD1 primarily governs FA dynamics rather than …

Safety And Timing Of Early Therapeutic Anticoagulation Therapy After Craniotomy, John M. Wilson, Kierany B. Shelvin, Sarah E. Lawhon, George A. Crabill, Ellery A. Hayden, Alan J. Velander

School of Medicine Faculty Publications

Background: To date, there are few guidelines and studies to guide the timing of initiation of therapeutic anticoagulation (AC) after craniotomy. The goal of this study was to assess the timing, safety, and outcomes of patients following the administration of therapeutic AC after craniotomy. Methods: A retrospective case–control study was performed evaluating all craniotomy patients from August 2017 to July 2021. Cases were selected if they received therapeutic AC within ten days of craniotomy. Nineteen out of 1013 craniotomy patients met the inclusion criteria. Indications for therapeutic AC were diverse, including deep venous thrombosis, pulmonary embolism, dural venous sinus thrombosis, …

Kinase-Impaired Btk Mutations Are Susceptible To Clinical-Stage Btk And Ikzf1/3 Degrader Nx-2127, Skye Montoya, Jessie Bourcier, Mark Noviski, Hao Lu, Meghan C Thompson, Alexandra Chirino, Jacob Jahn, Anya K Sondhi, Stefan Gajewski, Ying Siow May Tan, Stephanie Yung, Aleksandra Urban, Eric Wang, Cuijuan Han, Xiaoli Mi, Won Jun Kim, Quinlan Sievers, Paul Auger, Hugo Bousquet, Nivetha Brathaban, Brandon Bravo, Melissa Gessner, Cristiana Guiducci, James N Iuliano, Tim Kane, Ratul Mukerji, Panga Jaipal Reddy, Janine Powers, Mateo Sanchez Garcia De Los Rios, Jordan Ye, Carla Barrientos Risso, Daniel Tsai, Gabriel Pardo, Ryan Q Notti, Alejandro Pardo, Maurizio Affer, Vindhya Nawaratne, Tulasigeri M Totiger, Camila Pena-Velasquez, Joanna M Rhodes, Andrew D Zelenetz, Alvaro Alencar, Lindsey E Roeker, Sanjoy Mehta, Ralph Garippa, Adam Linley, Rajesh Kumar Soni, Sigrid S Skånland, Robert J Brown, Anthony R Mato, Gwenn M Hansen, Omar Abdel-Wahab, Justin Taylor

Faculty, Staff and Student Publications

INTRODUCTION:

Bruton’s tyrosine kinase (BTK) is a nonreceptor kinase in the B cell receptor (BCR) signaling cascade critical for B cell survival. As such, chronic lymphocytic leukemia (CLL) and other B cell cancers are sensitive to inhibition of BTK. Covalent and noncovalent inhibitors of BTK have revolutionized the treatment of these cancers. Therefore, understanding mechanisms by which acquired mutation in BTK confer drug resistance and developing new therapies to overcome resistance are critically important.

RATIONALE:

We recently discovered BTK mutations that confer resistance across covalent and noncovalent BTK inhibitors. In this study, we found that a group of these mutants …

Effect Of Vitamin E Enhanced Highly Cross-Linked Polyethylene On Wear Rate And Particle Debris In Anatomic Total Shoulder Arthroplasty: A Biomechanical Comparison To Ultrahigh-Molecular-Weight Polyethylene, Adam Khan, Andrew Jawa, Matthew J. Smith, J Michael Wiater, Derek J. Cuff, Anand M. Murthi, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: Particle-induced osteolysis resulting from polyethylene wear remains a source of implant failure in anatomic total shoulder designs. Modern polyethylene components are irradiated in an oxygen-free environment to induce polyethylene cross-linking, but an unfortunate byproduct of this process is free radical production. Melting or heat annealing is one method of reducing free radicals but can compromise the component’s mechanical properties. The antioxidant, Vitamin E, has been introduced as an alternative adjuvant to neutralize free radicals. Specifically, in anatomic shoulder arthroplasty with a ceramic head component, the vitamin E-enhanced polyethylene showed improved wear compared to the conventional highly-cross linked polyethylene. This …

Potential Causal Association Between Gut Microbiome And Posttraumatic Stress Disorder, Qiang He, Wenjing Wang, Dingkang Xu, Yang Xiong, Chuanyuan Tao, Chao You, Lu Ma, Junpeng Ma, Caroline M. Nievergelt, Adam X. Maihofer, Torsten Klengel, Elizabeth G. Atkinson, Chia Yen Chen, Karmel W. Choi, Jonathan R.I. Coleman, Shareefa Dalvie, Laramie E. Duncan, Mark W. Logue, Allison C. Provost, Andrew Ratanatharathorn, Murray B. Stein, Katy Torres, Allison E. Aiello, Lynn M. Almli, Ananda B. Amstadter, Søren B. Andersen, Ole A. Andreassen, Paul A. Arbisi, Ariane Rung, Et Al

School of Public Health Faculty Publications

Background: The causal effects of gut microbiome and the development of posttraumatic stress disorder (PTSD) are still unknown. This study aimed to clarify their potential causal association using mendelian randomization (MR). Methods: The summary-level statistics for gut microbiome were retrieved from a genome-wide association study (GWAS) of the MiBioGen consortium. As to PTSD, the Freeze 2 datasets were originated from the Psychiatric Genomics Consortium Posttraumatic Stress Disorder Working Group (PGC-PTSD), and the replicated datasets were obtained from FinnGen consortium. Single nucleotide polymorphisms meeting MR assumptions were selected as instrumental variables. The inverse variance weighting (IVW) method was employed as the …

It's Not That We Care Less: Insights Into Health Care Utilization For Comorbid Diabetes And Depression Among Latinos, Sharon Borja, Miriam G Valdovinos, Kenia M Rivera, Natalia Giraldo-Santiago, Robin E Gearing, Luis R Torres

Faculty, Staff and Student Publications

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos and their social support systems (i.e., family members) regarding comorbid diabetes and depression and to identify barriers and facilitators to their help-seeking behaviors and treatment engagement. Bilingual and bicultural researchers conducted eight focus groups with 94 participants in a large U.S. metropolitan area and were primarily conducted in Spanish. The participants either had a …

Important Features For Protein Foldings In Two Acyl Carrier Proteins From Enterococcus Faecalis, Seoyeong Yoo, Jiwon Yeon, Eunhee Kim, Yangmee Kim

Faculty, Staff and Student Publications

The emergence of multi-drug resistant Enterococcus faecalis raises a serious threat to global public health. E. faecalis is a gram-positive intestinal commensal bacterium found in humans. E. faecalis can endure extreme environments such as high temperature, pressure, and high salt, which facilitates them to cause infection in hospitals. E. faecalis has two acyl carrier proteins, AcpA (EfAcpA) in de novo fatty acid synthesis (FAS) and AcpB (EfAcpB) which utilizes exogenous fatty acids. Previously, we determined the tertiary structures of these two ACPs and investigated their structure-function relationships. Solution structures revealed that overall folding of these two ACPs is similar to …

Intratumoral Biosynthesis Of Gold Nanoclusters By Pancreatic Cancer To Overcome Delivery Barriers To Radiosensitization, Aaron S Schwartz-Duval, Yuri Mackeyev, Iqbal Mahmud, Philip L Lorenzi, Mihai Gagea, Sunil Krishnan, Konstantin V Sokolov

Faculty, Staff and Student Publications

Nanoparticle delivery to solid tumors is a prime challenge in nanomedicine. Here, we approach this challenge through the lens of biogeochemistry, the field that studies the flow of chemical elements within ecosystems as manipulated by living cellular organisms and their environments. We leverage biogeochemistry concepts related to gold cycling against pancreatic cancer, considering mammalian organisms as drivers for gold nanoparticle biosynthesis. Sequestration of gold nanoparticles within tumors has been demonstrated as an effective strategy to enhance radiotherapy; however, the desmoplasia of pancreatic cancer impedes nanoparticle delivery. Our strategy overcomes this barrier by applying an atomic-scale agent, ionic gold, for intratumoral …

Microsurgical Clipping Of Unruptured Anterior Circulation Aneurysms-A Global Multicenter Investigation Of Perioperative Outcomes, Jennifer Sauvigny, Richard Drexler, Tobias Pantel, Franz Ricklefs, Joshua Catapano, John Wanebo, Michael Lawton, Aminaa Sanchin, Nils Hecht, Peter Vajkoczy, Kunal Raygor, Daniel Tonetti, Adib Abla, Kareem El Naamani, Stavropoula Tjoumakaris, Pascal Jabbour, Brian Jankowitz, Mohamed Salem, Jan-Karl Burkhardt, Arthur Wagner, Maria Wostrack, Jens Gempt, Bernhard Meyer, Michael Gaub, Justin Mascitelli, Philippe Dodier, Gerhard Bavinzski, Karl Roessler, Nico Stroh, Matthias Gmeiner, Andreas Gruber, Eberval Figueiredo, Antonio Carlos Samaia Da Silva Coelho, Anatoliy Bervitskiy, Egor Anisimov, Jamil Rzaev, Harald Krenzlin, Naureen Keric, Florian Ringel, Dougho Park, Mun-Chul Kim, Eleonora Marcati, Marco Cenzato, Linda Krause, Manfred Westphal, Lasse Dührsen, Thomas Sauvigny

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Microsurgical aneurysm repair by clipping continues to be highly important despite increasing endovascular treatment options, especially because of inferior occlusion rates. This study aimed to present current global microsurgical treatment practices and to identify risk factors for complications and neurological deterioration after clipping of unruptured anterior circulation aneurysms.

METHODS: Fifteen centers from 4 continents participated in this retrospective cohort study. Consecutive patients who underwent elective microsurgical clipping of untreated unruptured intracranial aneurysm between January 2016 and December 2020 were included. Posterior circulation aneurysms were excluded. Outcome parameters were postsurgical complications and neurological deterioration (defined as decline on …

The Geriatric Nutritional Risk Index As A Predictor Of Complications In Geriatric Trauma Patients, Daniel H Wang, Yoko Fujita, Antonio Dono, Ana G Rodriguez Armendariz, Mauli Shah, Nagireddy Putluri, Pavel S Pichardo-Rojas, Chirag B Patel, Jay-Jiguang Zhu, Jason T Huse, Brittany C Parker Kerrigan, Frederick F Lang, Yoshua Esquenazi, Leomar Y Ballester

Faculty, Staff and Student Publications

Cerebrospinal fluid (CSF) analysis is underutilized in patients with glioblastoma (GBM), partly due to a lack of studies demonstrating the clinical utility of CSF biomarkers. While some studies show the utility of CSF cell-free DNA analysis, studies analyzing CSF metabolites in patients with glioblastoma are limited. Diffuse gliomas have altered cellular metabolism. For example, mutations in isocitrate dehydrogenase enzymes (e.g., IDH1 and IDH2) are common in diffuse gliomas and lead to increased levels of D-2-hydroxyglutarate in CSF. However, there is a poor understanding of changes CSF metabolites in GBM patients. In this study, we performed targeted metabolomic analysis of CSF …

Clinical Rarity: Simultaneous Choroid Plexus Papilloma And Extraventricular Neurocytoma Presenting As Intraventricular Hemorrhage In An Adolescent, Kaleb Derouen, Kierany Shelvin, Wesley Shoap, Randall Craver, Jerome Volk, Oritsejolomi A. Roberts

School of Medicine Faculty Publications

We present a patient with an intraventricular hemorrhage. Imaging identified a left atrial intraventricular mass and a vague adjacent second periventricular cystic lesion. A guided trans-sulcal approach via a left parietal craniotomy resulted in a gross total resection of both lesions. These represented two distinct lesions, the periventricular cystic lesion was an extraventricular neurocytoma (EVN) and a World Health Organization grade 1 choroid plexus papilloma (CPP). The neurocytoma required methylation studies for confirmatory diagnosis. The patient had an uneventful recovery with a normal neurological exam at 12-weeks. This documents the occurrence of two distinct central nervous system tumors, a CPP …

The Effects Of Physical Activity On Experimental Models Of Vascular Dementia; A Systematic Review And Meta-Analysis, Ifechukwude J. Biose, Wesley H. Chastain, Rebecca J. Solch-Ottaiano, Viktoriya S. Grayson, Hanyun Wang, Somdeb Banerjee, Gregory J. Bix

School of Medicine Faculty Publications

Background; Physical activity is associated with improved brain health and cognition in humans. However, the validity, range, and quality of evidence for the beneficial outcomes linked to exercise in experimental models of vascular dementia (VaD) have not been evaluated. We performed a systematic review and meta-analysis of studies that assessed the effect of exercise intervention on models of VaD to provide an unbiased and comprehensive determination of the cognitive function and brain morphology benefits of exercise. Summary; A systematic search in three databases as well as study design characteristics and experimental data extraction were completed in December 2021. We investigated …

A Structurally Precise Mechanism Links An Epilepsy-Associated Kcnc2 Potassium Channel Mutation To Interneuron Dysfunction, Jerome Clatot, Christopher B. Currin, Qiansheng Liang, Tanadet Pipatpolkai, Shavonne L. Massey, Ingo Helbig, Lucie Delemotte, Tim P. Vogels, Manuel Covarrubias, Ethan M. Goldberg

Farber Institute for Neuroscience Staff Papers and Presentations

De novo heterozygous variants in KCNC2 encoding the voltage-gated potassium (K+) channel subunit Kv3.2 are a recently described cause of developmental and epileptic encephalopathy (DEE). A de novo variant in KCNC2 c.374G > A (p.Cys125Tyr) was identified via exome sequencing in a patient with DEE. Relative to wild-type Kv3.2, Kv3.2-p.Cys125Tyr induces K+ currents exhibiting a large hyperpolarizing shift in the voltage dependence of activation, accelerated activation, and delayed deactivation consistent with a relative stabilization of the open conformation, along with increased current density. Leveraging the cryogenic electron microscopy (cryo-EM) structure of Kv3.1, molecular dynamic simulations suggest that a strong π-π stacking …

Exploring Functional Connectivity In Chronic Spinal Cord Injury Patients With Neuropathic Pain Versus Without Neuropathic Pain, Shreya Mandloi, Mashaal Syed, Isaiah Ailes, Omid Shoraka, Benjamin Leiby, J. Miao, Sara Thalheimer, Joshua Pelta-Heller, Feroze Mohamed, Ashwini Sharan, James Harrop, Laura Krisa, M. Alizadeh

Farber Institute for Neuroscience Faculty Papers

The great majority of spinal cord injury (SCI) patients have debilitating chronic pain. Despite decades of research, these pain pathways of neuropathic pain (NP) are unknown. SCI patients have been shown to have abnormal brain pain pathways. We hypothesize that SCI NP patients’ pain matrix is altered compared to SCI patients without NP. This study examines the functional connectivity (FC) in SCI patients with moderate-severe chronic NP compared to SCI patients with mild-no NP. These groups were compared to control subjects. The Neuropathic Pain Questionnaire and neurological evaluation based on the International Standard Neurological Classification of SCI were utilized to …

Surgical Management Of Choanal Atresia: Two Classic Cases And Review Of The Literature, Philipp Karschnia, Jorg Dietrich, Francesco Bruno, Antonio Dono, Stephanie T Juenger, Nico Teske, Jacob S Young, Tommaso Sciortino, Levin Häni, Martin Van Den Bent, Michael Weller, Michael A Vogelbaum, Ramin A Morshed, Alexander F Haddad, Annette M Molinaro, Nitin Tandon, Juergen Beck, Oliver Schnell, Lorenzo Bello, Shawn Hervey-Jumper, Niklas Thon, Stefan J Grau, Yoshua Esquenazi, Roberta Rudà, Susan M Chang, Mitchel S Berger, Daniel P Cahill, Joerg-Christian Tonn

Faculty, Staff and Student Publications

BACKGROUND: Resection of the contrast-enhancing (CE) tumor represents the standard of care in newly diagnosed glioblastoma. However, some tumors ultimately diagnosed as glioblastoma lack contrast enhancement and have a 'low-grade appearance' on imaging (non-CE glioblastoma). We aimed to (a) volumetrically define the value of non-CE tumor resection in the absence of contrast enhancement, and to (b) delineate outcome differences between glioblastoma patients with and without contrast enhancement.

METHODS: The RANO resect group retrospectively compiled a global, eight-center cohort of patients with newly diagnosed glioblastoma per WHO 2021 classification. The associations between postoperative tumor volumes and outcome were analyzed. Propensity score-matched …

Technology Decreases Treatment Decision Times, Angela Moscho

Nursing Posters

Patients who experience a stroke while hospitalized have a higher mortality rate than those who present to the emergency department. Our plan is to utilize technology to allow the stroke provider to evaluate the patient while in their hospital room, instead of waiting until the patient is in the CT scanner. Utilizing technology of an iPad for inpatient code strokes will allow for quicker assessment of the patient, resulting in faster treatment decision for this population.

Archives Of Neurosurgery Volume 1 Issue 1 - Full Issue

Archives of Neurosurgery

Archives of Neurosurgery Volume 1 Issue 1 - Full Issue

Misdiagnosis Between Coccygeal Dislocation Fracture And Lumbosacral Disc Herniation, Gilberto Gardea-Loera, Gilberto Gardea-Ramírez, Ylián Ramírez-Tapia

Archives of Neurosurgery

INTRODUCTION: Coccydynia is the condition of disabling pain in the coccyx that occurs when sitting or moving to a standing position. Due to a lack of knowledge by spine specialists, many patients suffer for years without adequate treatment. We highlight the relevance of diagnosing and treating coccygodynia correctly to avoid lumbosacral pathology overestimation. METHODS: We present a series of patients with painful coccygeal segment syndrome associated with different lumbar alterations who underwent coccygectomy from 1996 to 2021 in our spine clinic. We describe VAS and MacNab scores and complication rates. We used Student-T-Test for statistical analysis. RESULTS: We included 40 …

Extraforaminal Minimally Invasive Lumbar Conjoined Nerve Root Decompression And Segment Fusion: Surgical Technique, Case Report And Literature Review, Manuel Rodríguez García, José Antonio Soriano Sánchez, Sergio Soriano Solis, Oscar Sánchez Escandón, Iris Tatiana Montes González

Archives of Neurosurgery

INTRODUCTION

Associated or conjoined nerve roots are an embryological anomaly presented primarily as bifid nerve roots arising from the dura. They are susceptible to trauma with radicular symptoms and even neurological deterioration of patients presenting them, due to space they occupy and adhesions to adjacent structures. We report a case treat with a minimally invasive technique.

CASE REPORT

A 68-year-old woman with lumbar and radicular pain in the right lower limb, with findings of L4-L5 instability and L4-L5, L5-S1 degenerative disc changes on imaging studies with bilateral L5 and S1 radiculopathy predominantly on the right side on preoperatory neurophysiological studies. …

Dr. Mauro Loyo: Mexican Icon Of World Neurosurgery. Posthumous Tribute, Ramiro Del Valle

Archives of Neurosurgery

Dr. Mauro Loyo Varela was born on November 30th, 1941, in the city of Veracruz. Not only was he an extraordinary surgeon, but he was also an unforgettable teacher. He held several academic positions in and outside the country. He taught 83 Latin American and Caribbean neurosurgeons with patience and devotion, always willing to share his knowledge without reservation. A man of singular talent, his contributions to neurosurgery were outstanding. From 1977 to 1986, he was the Chief of Neurosurgery Services at the IMSS National Medical Center. Between 1982 and 1990, he contributed to the design of numerous instruments and …

Why The Neurosurgeon Should Apply The Concepts Of Neuroethics In Their Daily Clinical Practice, Miguel Antonio Sandoval Balanzario, Lizbeth Itzel Sandoval Olivares, Noe Santiago Ramírez, Noe Santiago Rea

Archives of Neurosurgery

The human being is a community and social being, thus, he was capable to establish rules and humanize he's environment, allowed by the development of he's intelligence, as well as moral behavior. Nevertheless, morals and ethics have also evolved along the history, allowing the birth of neuroethics in 2002 with the objective to study ethical behavior of neurological research procedures and study ethics from the neuroscientific point.

Using Intersurgeon Variation To Inform Cost-Reduction Strategies In Anterior Cervical Discectomy And Fusion (Acdf), Ken Porche, Sasha Vaziri, Alan Stein, Omar Awan, Brandon Lucke-Wold, Paul S. Kubilis, Paul Lipori, Daniel J Hoh, Adam Polifka, W. Christopher Fox

Archives of Neurosurgery

Background: Inter-surgeon variability is a potential driver of variation in bundled care costs associated with cervical spine surgery.

Objective: This study aims to determine modifiable inter-surgeon factors that predict hospital cost variations associated with anterior cervical discectomy and fusions (ACDF).

Methods: This is a retrospective review of ACDF cases performed at a single institution by 15 surgeons from 2011 to 2017. Univariate analyses and mixed linear regression models were then used with the surgeon as a random effects variable to determine which factors were associated with surgical episode costs and surgical time. Signs and symptoms of cervical myelopathy were collected …