Neurosurgery Commons^™

Prognostic Evaluation Of Re-Resection For Recurrent Glioblastoma Using The Novel Rano Classification For Extent Of Resection: A Report Of The Rano Resect Group, Philipp Karschnia, Antonio Dono, Jacob S Young, Stephanie T Juenger, Nico Teske, Levin Häni, Tommaso Sciortino, Christine Y Mau, Francesco Bruno, Luis Nunez, Ramin A Morshed, Alexander F Haddad, Michael Weller, Martin Van Den Bent, Juergen Beck, Shawn Hervey-Jumper, Annette M Molinaro, Nitin Tandon, Roberta Rudà, Michael A Vogelbaum, Lorenzo Bello, Oliver Schnell, Stefan J Grau, Susan M Chang, Mitchel S Berger, Yoshua Esquenazi, Joerg-Christian Tonn

Faculty, Staff and Student Publications

BACKGROUND: The value of re-resection in recurrent glioblastoma remains controversial as a randomized trial that specifies intentional incomplete resection cannot be justified ethically. Here, we aimed to (1) explore the prognostic role of extent of re-resection using the previously proposed Response Assessment in Neuro-Oncology (RANO) classification (based upon residual contrast-enhancing (CE) and non-CE tumor), and to (2) define factors consolidating the surgical effects on outcome.

METHODS: The RANO resect group retrospectively compiled an 8-center cohort of patients with first recurrence from previously resected glioblastomas. The associations of re-resection and other clinical factors with outcome were analyzed. Propensity score-matched analyses were …

International Consensus Statement On Allergy And Rhinology: Sinonasal Tumors, Edward C. Kuan, Eric W. Wang, Nithin D. Adappa, Daniel M. Beswick, Nyall R. London, Shirley Y. Su, Marilene B. Wang, Waleed M. Abuzeid, Borislav Alexiev, Jeremiah A. Alt, Paolo Antognoni, Michelle Alonso-Basanta, Pete S. Batra, Mihir Bhayani, Diana Bell, Manuel Bernal-Sprekelsen, Christian S. Betz, Jean Yves Blay, Benjamin S. Bleier, Juliana Bonilla-Velez, Claudio Callejas, Ricardo L. Carrau, Roy R. Casiano, Paolo Castelnuovo, Rakesh K. Chandra, Vasileios Chatzinakis, Simon B. Chen, Alexander G. Chiu, Stephen C. Hernandez, Et Al

School of Medicine Faculty Publications

Background; Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology; Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. Methods; In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the …

Abnormal Motion Capture In Acute Stroke (Bionics): A Low-Cost Tele-Evaluation Tool For Automated Assessment Of Upper Extremity Function In Stroke Patients, Syed A Zamin, Kaichen Tang, Emily A Stevens, Melissa Howard, Dorothea M Parker, Allyson Seals, Xiaoqian Jiang, Sean Savitz, Shayan Shams

Faculty, Staff and Student Publications

BACKGROUND: The incidence of stroke and stroke-related hemiparesis has been steadily increasing and is projected to become a serious social, financial, and physical burden on the aging population. Limited access to outpatient rehabilitation for these stroke survivors further deepens the healthcare issue and estranges the stroke patient demographic in rural areas. However, new advances in motion detection deep learning enable the use of handheld smartphone cameras for body tracking, offering unparalleled levels of accessibility.

METHODS: In this study we want to develop an automated method for evaluation of a shortened variant of the Fugl-Meyer assessment, the standard stroke rehabilitation scale …

Brain Imaging With Portable Low-Field Mri, W Taylor Kimberly, Annabel J Sorby-Adams, Andrew G Webb, Ed X Wu, Rachel Beekman, Ritvij Bowry, Steven J Schiff, Adam De Havenon, Francis X Shen, Gordon Sze, Pamela Schaefer, Juan Eugenio Iglesias, Matthew S Rosen, Kevin N Sheth

Faculty, Staff and Student Publications

The advent of portable, low-field MRI (LF-MRI) heralds new opportunities in neuroimaging. Low power requirements and transportability have enabled scanning outside the controlled environment of a conventional MRI suite, enhancing access to neuroimaging for indications that are not well suited to existing technologies. Maximizing the information extracted from the reduced signal-to-noise ratio of LF-MRI is crucial to developing clinically useful diagnostic images. Progress in electromagnetic noise cancellation and machine learning reconstruction algorithms from sparse k-space data as well as new approaches to image enhancement have now enabled these advancements. Coupling technological innovation with bedside imaging creates new prospects in …

False-Positive Early Indium-111 Leukocyte Scan, F Lomena, R Abello, A Garcia, C Piera, R Herranz, J Pavia, J Setoain

Faculty, Staff and Student Publications

Introduction

We aimed to evaluate IDH1 p.R132H mutation and 2-hydroxyglutarate (2HG) in cerebrospinal fluid (CSF) as biomarkers for patients with IDH-mutant gliomas.

Methods

CSF was collected from patients with infiltrating glioma, and 2HG levels were measured by liquid chromatographymass spectrometry. IDH1 p.R132H mutant allele frequency (MAF) in CSF-ctDNA was measured by digital droplet PCR (ddPCR). Tumor volume was measured from standard-of-care magnetic resonance images.

Results

The study included 48 patients, 6 with IDH-mutant and 42 with IDH-wildtype gliomas, and 57 samples, 9 from the patients with IDH-mutant and 48 from the patients with IDH-wildtype gliomas. …

Platelet-Derived Exerkine Cxcl4/Platelet Factor 4 Rejuvenates Hippocampal Neurogenesis And Restores Cognitive Function In Aged Mice, Odette Leiter, David Brici, Stephen J Fletcher, Xuan Ling Hilary Yong, Jocelyn Widagdo, Nicholas Matigian, Adam B Schroer, Gregor Bieri, Daniel G Blackmore, Perry F Bartlett, Victor Anggono, Saul A Villeda, Tara L Walker

Faculty, Staff and Student Publications

The beneficial effects of physical activity on brain ageing are well recognised, with exerkines, factors that are secreted into the circulation in response to exercise, emerging as likely mediators of this response. However, the source and identity of these exerkines remain unclear. Here we provide evidence that an anti-geronic exerkine is secreted by platelets. We show that platelets are activated by exercise and are required for the exercise-induced increase in hippocampal precursor cell proliferation in aged mice. We also demonstrate that increasing the systemic levels of the platelet-derived exerkine CXCL4/platelet factor 4 (PF4) ameliorates age-related regenerative and cognitive impairments in …

Evidenced-Based Practice Competency Assessment For Competency-Based Orientation Protocol To Improve Competency Level Among Medical-Surgical Nurses, Maryann Ornelas

Student Scholarly Projects

Practice Problem: Within a 12-month period, high incidences of severe post-spinal surgical complications resulted in a host of concerns in this clinical site when patients either returned to the operating room for spine revision or increased the length of stay.

PICOT: The PICOT question that guided this project was: "In Medical Surgical (Med-Surg) nurses (P), how would a Competency-Based Orientation (CBO) protocol with the inclusions of four critical elements of postoperative spinal care [POSC] (I) compared to the usual postoperative practice (C) enhance competency level in Med-Surg nurses when delivering postoperative practice at an inpatient setting (O) over 10 weeks …

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

Farber Institute for Neuroscience Faculty Papers

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Primary Balloon Angioplasty Of Venous Sinus Stenosis In Idiopathic Intracranial Hypertension, Juan Carlos Martinez-Gutierrez, Matthew J Kole, Victor Lopez-Rivera, Mehmet Enes Inam, Rosa Tang, Nagham Al-Zubidi, Ore-Ofeoluwatomi Adesina, Elvira Lekka, Allison C Engstrom, Sunil Sheth, Claudia Pedroza, Arthur L Day, Peng Roc Chen

Faculty, Staff and Student Publications

Background: Venous sinus stenosis (VSS) stenting has emerged as an effective treatment for patients with Idiopathic Intracranial Hypertension (IIH). However, stenting carries risk of in-stent stenosis/thrombosis and cumulative bleeding risk from long-term dual antiplatelet (DAPT) use. Thus, we investigated the potential safety and efficacy of primary balloon angioplasty as an alternative to stenting in IIH.

Methods: A prospectively maintained single-center registry of IIH patients undergoing endovascular procedures was queried. Inclusion criteria included patients with confirmed IIH and angiographically demonstrable VSS who underwent interventions from 2012- 2021. Patients were dichotomized into primary balloon angioplasty (Group A) and primary stenting (Group S), …

Catalytic Enantioselective Synthesis Of 3-Piperidines From Arylboronic Acids And Pyridine, Sourabh Mishra, Sedef Karabiyikoglu, Stephen P Fletcher

Faculty, Staff and Student Publications

Piperidines are frequently found in natural products and are of importance to the pharmaceutical industry. A generally useful asymmetric route to enantiomerically enriched 3-substituted piperidines remains elusive. Here we report a cross-coupling approach to enantioenriched 3-piperidines from pyridine- and sp²-hybridized boronic acids. The key step involves a Rh-catalyzed asymmetric reductive Heck reaction of aryl, heteroaryl, or vinyl boronic acids and phenyl pyridine-1(2H)-carboxylate to provide 3-substituted tetrahydropyridines in high yield and excellent enantioselectivity with a wide functional group tolerance. A three-step process involving i) partial reduction of pyridine, ii) Rh-catalyzed asymmetric carbometalation, and then iii) another reduction …

The Genetics Of Primary Ciliary Dyskinesia In Puerto Rico, Paolo Zanoni, Katharina Steindl, Heinrich Sticht, Beatrice Oneda, Pascal Joset, Ivan Ivanovski, Anselm H C Horn, Elena M Cabello, Julia Laube, Markus Zweier, Alessandra Baumer, Anita Rauch, Nadia Khan

Faculty, Staff and Student Publications

Pediatric Moyamoya Angiopathy (MMA) is a progressive intracranial occlusive arteriopathy that represents a leading cause of transient ischemic attacks and strokes in childhood. Despite this, up to now no large, exclusively pediatric MMA cohort has been subjected to systematic genetic investigation. In this study, we performed molecular karyotyping, exome sequencing and automated structural assessment of missense variants on a series of 88 pediatric MMA patients and correlated genetic, angiographic and clinical (stroke burden) findings. The two largest subgroups in our cohort consisted of RNF213 and neurofibromatosis type 1 (NF1) patients. While deleterious RNF213 variants were associated with a severe MMA …

Association Between Intraoperative Steroid And Postoperative Mortality In Patients Undergoing Craniotomy For Brain Tumor, Jialing He, Shuanghong He, Yu Zhang, Yixin Tian, Pengfei Hao, Tiangui Li, Yangchun Xiao, Liyuan Peng, Yuning Feng, Xin Cheng, Haidong Deng, Peng Wang, Weelic Chong, Yang Hai, Lvlin Chen, Chao You, Lu Jia, Dengkui Chen, Fang Fang

Department of Medical Oncology Faculty Papers

BACKGROUND: Despite the widespread use of intraoperative steroids in various neurological surgeries to reduce cerebral edema and other adverse symptoms, there is sparse evidence in the literature for the optimal and safe usage of intraoperative steroid administration in patients undergoing craniotomy for brain tumors. We aimed to investigate the effects of intraoperative steroid administration on postoperative 30-day mortality in patients undergoing craniotomy for brain tumors.

METHODS: Adult patients who underwent craniotomy for brain tumors between January 2011 to January 2020 were included at West China Hospital, Sichuan University in this retrospective cohort study. Stratified analysis based on the type of …

An Erk5-Nrf2 Axis Mediates Senescence-Associated Stemness And Atherosclerosis, Jun-Ichi Abe, Masaki Imanishi, Shengyu Li, Aijun Zhang, Kyung Ae Ko, Venkata S K Samanthapudi, Ling-Ling Lee, Angelica Paniagua Bojorges, Young Jin Gi, Brian P Hobbs, Anita Deswal, Joerg Herrmann, Steven H Lin, Eduardo N Chini, Ying H Shen, Keri L Schadler, Thi-Hong-Minh Nguyen, Anisha A Gupte, Cielito Reyes-Gibby, Sai-Ching J Yeung, Rei J Abe, Elizabeth A Olmsted-Davis, Sunil Krishnan, Robert Dantzer, Nicolas L Palaskas, John P Cooke, Henry J Pownall, Momoko Yoshimoto, Keigi Fujiwara, Dale J Hamilton, Jared K Burks, Guangyu Wang, Nhat-Tu Le, Sivareddy Kotla

Faculty, Staff and Student Publications

BACKGROUND: ERK5 (extracellular signal-regulated kinase 5) is a dual kinase transcription factor containing an N-terminal kinase domain and a C-terminal transcriptional activation domain. Many ERK5 kinase inhibitors have been developed and tested to treat cancer and inflammatory diseases. However, recent data have raised questions about the role of the catalytic activity of ERK5 in proliferation and inflammation. We aimed to investigate how ERK5 reprograms myeloid cells to the proinflammatory senescent phenotype, subsequently leading to atherosclerosis.

METHODS: A ERK5 S496A (dephosphorylation mimic) knock in (KI) mouse model was generated using CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/clustered regularly interspaced short palindromic …

Adapting And Testing The Care Partner Hospital Assessment Tool For Use In Dementia Care: Protocol For A 2 Sequential Phase Study, Beth Fields, Nicole Werner, Manish N Shah, Scott Hetzel, Blair P Golden, Andrea Gilmore-Bykovskyi, Dorothy Farrar Edwards

Faculty, Staff and Student Publications

Background

Research and policy demonstrate the value of and need for systematically identifying and preparing care partners for their caregiving responsibilities while their family member or friend living with dementia is hospitalized. The Care Partner Hospital Assessment Tool (CHAT) has undergone content and face validation and has been endorsed as appropriate by clinicians to facilitate the timely identification and preparation of care partners of older adult patients during their hospitalization. However, the CHAT has not yet been adapted or prospectively evaluated for use with care partners of hospitalized people living with dementia. Adapting and testing the CHAT via a pilot …

A Novel Specific Aptamer Targets Cerebrovascular Endothelial Cells After Ischemic Stroke, Heng Hu, Silin Wu, Tae Jin Lee, Aaron M Gusdon, Yuxin Liu, Huimahn A Choi, Xuefang Sophie Ren

Faculty, Staff and Student Publications

Cell specific-targeted therapy (CSTT) for acute ischemic stroke remains underdeveloped. Cerebrovascular endothelial cells (CECs) are key components of the blood-brain barrier and are the first brain cells affected by ischemic stroke. After stroke, CEC injury causes insufficient energy supply to neurons and leads to cytotoxic and vasogenic brain edema. Aptamers are short single-stranded RNA or DNA molecules that can bind to specific ligands for cell specific delivery. The expression of vascular cell adhesion molecule-1 (VCAM-1) is increased on CECs after stroke. Herein, we report that an RNA-based VCAM-1-aptamer can specifically target CECs in stroke brains following transient middle cerebral artery …

Magnetite-Supported Montmorillonite (K10) (Nanocat-Fe-Si-K10): An Efficient Green Catalyst For Multicomponent Synthesis Of Amidoalkyl Naphthol, Shripad M Patil, Runjhun Tandon, Nitin Tandon, Iqubal Singh, Ashwini Bedre, Vilas Gade

Faculty, Staff and Student Publications

Montmorillonite (K₁₀) loaded on magnetite silica-coated nanoparticles was made using simple co-precipitation methods. The prepared nanocat-Fe-Si-K₁₀ was analyzed using some techniques including field emission-scanning electron microscopy (FE-SEM), inductive coupling plasma-optical emission spectroscopy (ICP-OES), X-ray diffraction (XRD), thermo-gravimetric analysis (TGA), Fourier transmission-infrared spectra (FT-IR), energy dispersive X-ray spectroscopy (EDS), and wavelength-dispersive spectroscopy (WDX). The catalytic activity of the synthesized nanocat-Fe-Si-K₁₀ has been examined in one-pot multicomponent transformations for the synthesis of 1-amidoalkyl 2-naphthol derivatives under solvent-free conditions. Nanocat-Fe-Si-K₁₀ was determined to be very active, having the ability to be reused 15 times without significant loss of …

Neurosurgeons Deliver Similar Quality Care Regardless Of First Assistant Type: Resident Physician Versus Nonphysician Surgical Assistant, Grace Y. Ng, Ryan S. Gallagher, Austin J. Borja, Rashad Jabarkheel, Jianbo Na, Scott D. Mcclintock, H. Isaac Chen, Dmitriy Petrov, Brian T. Jankowitz, Neil R. Malhotra

Mathematics Faculty Publications

OBJECTIVE: There are limited data evaluating the out-comes of attending neurosurgeons with different types of first assistants. This study considers a common neurosurgical procedure (single-level, posterior-only lumbar fusion surgery) and examines whether attending surgeons deliver equal patient outcomes, regardless of the type of first assistant (resident physician vs. nonphysician surgical assistant [NPSA]), among otherwise exact-matched patients. -METHODS: The authors retrospectively analyzed 3395 adult patients undergoing single-level, posterior-only lumbar fusion at a single academic medical center. Primary outcomes included readmissions, emergency department visits, reoperation, and mortality within 30 and 90 days after surgery. Secondary outcome measures included discharge disposition, length of …

Leucine-Rich Alpha-2-Glycoprotein 1 Is A Systemic Biomarker Of Early Brain Injury And Delayed Cerebral Ischemia After Subarachnoid Hemorrhage, Jude P J Savarraj, Devin W Mcbride, Eunsu Park, Sarah Hinds, Atzhiry Paz, Aaron Gusdon, Ren Xuefang, Sheng Pan, Hilda Ahnstedt, Gabriela Delevati Colpo, Eunhee Kim, Zhongming Zhao, Louise Mccullough, Huimahn Alex Choi

Faculty, Staff and Student Publications

BACKGROUND: After subarachnoid hemorrhage (SAH), early brain injury (EBI) and delayed cerebral ischemia (DCI) lead to poor outcomes. Discovery of biomarkers indicative of disease severity and predictive of DCI is important. We tested whether leucine-rich alpha-2-glycoprotein 1 (LRG1) is a marker of severity, DCI, and functional outcomes after SAH.

METHODS: We performed untargeted proteomics using mass spectrometry in plasma samples collected at < 48 h of SAH in two independent discovery cohorts (n = 27 and n = 45) and identified LRG1 as a biomarker for DCI. To validate our findings, we used enzyme-linked immunosorbent assay and confirmed this finding in an internal validation cohort of plasma from 72 study participants with SAH (22 DCI and 50 non-DCI). Further, we investigated the relationship between LRG1 and markers of EBI, DCI, and poor functional outcomes (quantified by the modified Rankin Scale). We also measured cerebrospinal fluid (CSF) levels of LRG1 and investigated its relationship to EBI, DCI, and clinical outcomes.

RESULTS: Untargeted proteomics revealed higher plasma LRG1 levels across EBI severity and DCI in both discovery cohorts. In the validation cohort, the levels of LRG1 were higher in the DCI group compared with the non-DCI group (mean (SD): …

Characterization Of The Cholesterol Biosynthetic Pathway In Dioscorea Transversa, Lauren J Salisbury, Stephen J Fletcher, Jeanette E Stok, Luke R Churchman, Joanne T Blanchfield, James J De Voss

Faculty, Staff and Student Publications

Cholesterol is the precursor of bioactive plant metabolites such as steroidal saponins. An Australian plant, Dioscorea transversa, produces only two steroidal saponins: 1β-hydroxyprotoneogracillin and protoneogracillin. Here, we used D. transversa as a model in which to elucidate the biosynthetic pathway to cholesterol, a precursor to these compounds. Preliminary transcriptomes of D. transversa rhizome and leaves were constructed, annotated, and analyzed. We identified a novel sterol side-chain reductase as a key initiator of cholesterol biosynthesis in this plant. By complementation in yeast, we determine that this sterol side-chain reductase reduces Δ^24,28 double bonds required for phytosterol biogenesis as well …

An End-To-End In-Silico And In-Vitro Drug Repurposing Pipeline For Glioblastoma, Ko-Hong Lin, Jay-Jiguang Zhu, Judith A Smith, Yejin Kim, Xiaoqian Jiang

Faculty, Staff and Student Publications

Our study aims to address the challenges in drug development for glioblastoma, a highly aggressive brain cancer with poor prognosis. We propose a computational framework that utilizes machine learning-based propensity score matching to estimate counterfactual treatment effects and predict synergistic effects of drug combinations. Through our in-silico analysis, we identified promising drug candidates and drug combinations that warrant further investigation. To validate these computational findings, we conducted in-vitro experiments on two GBM cell lines, U87 and T98G. The experimental results demonstrated that some of the identified drugs and drug combinations indeed exhibit strong suppressive effects on GBM cell growth. Our …

Therapeutic Strategies Targeting Respiratory Recovery After Spinal Cord Injury: From Preclinical Development To Clinical Translation, Pauline Michel-Flutot, Michael A. Lane, Angelo C. Lepore, Stéphane Vinit

Farber Institute for Neuroscience Faculty Papers

High spinal cord injuries (SCIs) lead to permanent functional deficits, including respiratory dysfunction. Patients living with such conditions often rely on ventilatory assistance to survive, and even those that can be weaned continue to suffer life-threatening impairments. There is currently no treatment for SCI that is capable of providing complete recovery of diaphragm activity and respiratory function. The diaphragm is the main inspiratory muscle, and its activity is controlled by phrenic motoneurons (phMNs) located in the cervical (C3–C5) spinal cord. Preserving and/or restoring phMN activity following a high SCI is essential for achieving voluntary control of breathing. In this review, …

Stat5 Confers Lactogenic Properties In Breast Tumorigenesis And Restricts Metastatic Potential, Richard S Lampitt, Stephen Fletcher, Matthew Cole, Alice Kloker, Stefan Krause, Fran O'Hara, Peter Ryde, Mahua Saha, Anastasia Voronkova, Adrian Whyle

Faculty, Staff and Student Publications

Progress to reduce plastic pollution has been painfully slow and the consequent damage to the natural environment and to human health is likely to increase further. This has been because the views and ways of working of four distinct stakeholder communities are not sufficiently well integrated. (1) Scientists, (2) industry, (3) society at large and (4) those making policy and legislation must in future find ways to work together.

Next-Generation Boron Drugs And Rational Translational Studies Driving The Revival Of Bnct, Danushka S Seneviratne, Omran Saifi, Yuri Mackeyev, Timothy Malouff, Sunil Krishnan

Faculty, Staff and Student Publications

BNCT is a high-linear-energy transfer therapy that facilitates tumor-directed radiation delivery while largely sparing adjacent normal tissues through the biological targeting of boron compounds to tumor cells. Tumor-specific accumulation of boron with limited accretion in normal cells is the crux of successful BNCT delivery. Given this, developing novel boronated compounds with high selectivity, ease of delivery, and large boron payloads remains an area of active investigation. Furthermore, there is growing interest in exploring the immunogenic potential of BNCT. In this review, we discuss the basic radiobiological and physical aspects of BNCT, traditional and next-generation boron compounds, as well as translational …

Newly Diagnosed Papillary Craniopharyngioma With Braf V600e Mutation Treated With Single-Agent Selective Braf Inhibitor Dabrafenib: A Case Report, Mayank Rao, Meenakshi Bhattacharjee, Scott Shepard, Sigmund Hsu

Faculty, Staff and Student Publications

We report a case of a patient with newly diagnosed, locally extensive and cystic, suprasellar papillary craniopharyngioma successfully treated with single-agent Dabrafenib. The patient was symptomatic with gait imbalance with falls, lethargic episodes, fatigue and incontinence. Diagnostic imaging demonstrated a cystic suprasellar tumor extending into the third ventricle causing obstructive hydrocephalus. The tumor was partially debulked, and bilateral shunts were placed. NGS sequencing demonstrated BRAF V600E mutation, and the patient was prescribed dual agent Dabrafenib and Trametinib. However, due to insurance denial for Trametinib, he only received single-agent Dabrafenib (150mg BID). The treatment resulted in a major response (over two …

Obstructive Hydrocephalus Caused By A Colloid Cyst Presenting As A Transient Ischemic Attack (Tia), Muhammad Nadeem

Rowan-Virtua Research Day

Colloid cysts are benign growths commonly found in the third ventricle or at the Foramen of Monroe. They are composed of epithelial lining filled with gelatinous material that contain cholesterol, mucin, old blood and ions. Most colloid cysts are asymptomatic but can present with a variety of symptoms that range from headaches, diplopia, memory problems, and vertigo. They can also present as an obstructive hydrocephalus with the classic “Wet, wacky and wobbly” triad. Rarely colloid cysts have been reported to cause sudden death. They can present to the ED with any spectrum of these symptoms.

Comparison Of Clinical And Radiographic Efficacy Of Particles Versus Nbca/Onyx In Middle Meningeal Artery Embolization For Chronic Subdural Hematoma, Jane Khalife, Mohamed Salem, Victoria Wong Murray, Allen Karimov, Brian Jankowitz, Jan Karl Burkhardt, Hamza Shaikh, Daniel Tonetti, Pratit Patel, Tudor Jovin, Ajith Thomas

Rowan-Virtua Research Day

Different embolic materials are utilized in MMA embolization of chronic subdural hematoma per operators’ discretion. We aim to compare the clinical and radiographic efficacy of different embolic materials in a pooled retrospective cohort of two US centers.

Case Study Of Horner Syndrome Due To Internal Carotid Artery Dissection, Kajel Patel

Rowan-Virtua Research Day

Carotid artery dissection can occur either spontaneously or because of trauma. It is usually the most common cause of stroke in middle-aged patients. The symptoms can be transient or persistent and typically occur a few days after the inciting traumatic event.

Aneurysmal Subarachnoid Hemorrhage In Pregnancy: National Trends Of Treatment, Predictors, And Outcomes, Kasra Khatibi, Hamidreza Saber, Smit Patel, Lucido Luciano Ponce Mejia, Naoki Kaneko, Viktor Szeder, May Nour, Reza Jahan, Satoshi Tateshima, Geoffrey Colby, Gary Duckwiler, Yalda Afshar

School of Medicine Faculty Publications

Introduction Aneurysmal subarachnoid hemorrhage (aSAH) is a rare event associated with significant pregnancy-associated maternal and neonatal morbidity and mortality. The optimal treatment strategy and clinical outcome of aSAH in pregnancy remains unclear. We aimed to investigate the treatment utilizations and outcomes of aSAH in pregnant people. Methods Using the 2010-2018 National Inpatient Sample, we identified all birth hospitalizations of women between ages of 18 to 45 associated with subarachnoid hemorrhage and aneurysm treatment were included. Multivariate analyses were used to evaluate the effect of pregnancy state, mode of treatment of aneurysms, severity of subarachnoid hemorrhage on mortality and discharge destination …

Prognostic Validation Of A New Classification System For Extent Of Resection In Glioblastoma: A Report Of The Rano Resect Group, Philipp Karschnia, Jacob S Young, Antonio Dono, Levin Häni, Tommaso Sciortino, Francesco Bruno, Stephanie T Juenger, Nico Teske, Ramin A Morshed, Alexander F Haddad, Yalan Zhang, Sophia Stoecklein, Michael Weller, Michael A Vogelbaum, Juergen Beck, Nitin Tandon, Shawn Hervey-Jumper, Annette M Molinaro, Roberta Rudà, Lorenzo Bello, Oliver Schnell, Yoshua Esquenazi, Maximilian I Ruge, Stefan J Grau, Mitchel S Berger, Susan M Chang, Martin Van Den Bent, Joerg-Christian Tonn

Faculty, Staff and Student Publications

BACKGROUND: Terminology to describe extent of resection in glioblastoma is inconsistent across clinical trials. A surgical classification system was previously proposed based upon residual contrast-enhancing (CE) tumor. We aimed to (1) explore the prognostic utility of the classification system and (2) define how much removed non-CE tumor translates into a survival benefit.

METHODS: The international RANO resect group retrospectively searched previously compiled databases from 7 neuro-oncological centers in the USA and Europe for patients with newly diagnosed glioblastoma per WHO 2021 classification. Clinical and volumetric information from pre- and postoperative MRI were collected.

RESULTS: We collected 1,008 patients with newly …

Assessment Of Attitudes And Knowledge Of Osteopathic Manipulative Medicine Amongst Neurosurgeons, Devin Kolmetzky, Dillon B. Gooder, Evan Polly, Sarah Glisan, Zein Al-Atrache, Clint Badger, Steven Yocom, Alan Turtz, Donald Allison

Research Day

Introduction: Osteopathic Manipulative Medicine (OMM) is highly researched and integrated into many medical and surgical subspecialties. Though OMM has been shown to have benefits in treating non-specific cervical and lower back pain and managing post-operative pain, it has rarely been integrated or studied in the neurosurgical community.

Method: Using SurveyMonkey, a survey was dispersed to physicians of the American Association of Neurological Surgeons (AANS). Information collected included the provider’s type of practice, degree type (MD vs. DO), familiarity with the tenets of OMM, frequency of referral/use of OMM, comfort level with OMM as a non-surgical pre-op option, a post-op pain …