Neurosurgery Commons^™

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 …

Intrasellar Neurocytoma. A Case Report & Literature Review, Gabriel Carrillo-Marhx, Mariana Flores-Núñez Dr., Basilio Fernández-Alvarado Dr., Pedro Pablo De Juambelz-Cisneros Dr., Fernando Pazos-Gómez Dr.

Archives of Neurosurgery

Background: Neurocytoma is an unusual intracranial neoplasm; it represents 0.1-0.5% of brain neoplasms. The first report of an extraventricular neurocytoma (EVN) was published in 1989. Suprasellar neurocytomas are classified as EVN, representing a scarce variant of neurocytoma. There are only 22 cases of sellar neurocytomas reported in the literature, including the present one.

Observations: A 48-year-old woman arrived at the emergency department (ED) with a previously made MRI, which reported a sellar neoplasm. Due to the clinical presentation, location, and image characteristics, the lesion was managed as a pituitary neuroendocrine tumor. The final pathology report established the final diagnosis of …

A Combination Of Glossopharyngeal And Trigeminal Neuralgia Secondary To Covid-19: Case Report., Mauro Alberto Segura-Lozano, Adriana Fernanda Segura-Zenón, Alejandro González-Silva, Octavio Carranza-Rentería, Yael Rodrigo Torres-Torres, Aarón Giovanni Munguía-Rodríguez

Archives of Neurosurgery

Background: During the COVID-19 pandemic, a wide variety of neurological symptoms have appeared as part of SARS-CoV-2 infection, including cranial nerve impairments. Case Description: We describe a 33-year-old woman who developed glossopharyngeal neuralgia (GPN) and trigeminal neuralgia (TN) immediately after the curse of COVID-19. MRI demonstrated two vascular structures contacting the right trigeminal nerve and possible vascular contact on the ipsilateral glossopharyngeal nerve. Severe arachnoiditis was identified during microvascular decompression of the right glossopharyngeal and trigeminal nerves. After the intervention and during the last follow-up, the patient remains without neuropathic pain. Conclusions: SARS-CoV-2 is a possible etiology of …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

When Divergent Worlds Collide: Dr. Santiago Ramón Y Cajal’S Influence On The Surrealism Movement, William J. Hardman Iii, Md

MA Theses

Dr. Santiago Ramón y Cajal’s drawings were created for the sole purpose of illustrating his newly discovered and earth-shattering revelations in the field of neuroscience culminating with his magnum opus: the “Neuron theory” and the “Theory of Dynamic Polarization.” For these discoveries and many others, he shared the 1906 Nobel Prize in medicine and physiology with his rival Dr. Camilo Golgi, an Italian pathologist. At no time did he envision that his drawings would capture the interest of artists as it did with members of the Surrealism Movement. This thesis will explore and present for the first time supporting evidence …

Phase 1 Trial Of Tpi 287, A Microtubule Stabilizing Agent, In Combination With Bevacizumab In Adults With Recurrent Glioblastoma, Samuel A Goldlust, Louis B Nabors, Sigmund Hsu, Nimish Mohile, Paul J Duic, Tara Benkers, Samuel Singer, Mayank Rao, Lori Cappello, Sandra L Silberman, George Farmer

Faculty, Staff and Student Publications

BACKGROUND: Recurrent glioblastoma (rGBM) has limited treatment options. This phase 1 protocol was designed to study the safety and preliminary efficacy of TPI 287, a central nervous system penetrant microtubule stabilizer, in combination with bevacizumab (BEV) for the treatment of rGBM.

METHODS: GBM patients with up to 2 prior relapses without prior exposure to anti-angiogenic therapy were eligible. A standard 3 + 3 design was utilized to determine the maximum tolerated dose (MTD) of TPI 287. Cohorts received TPI 287 at 140-220 mg/m

RESULTS: Twenty-four patients were enrolled at 6 centers. Treatment was generally well tolerated. Fatigue, myelosuppression, and peripheral …

The Impact Of Covid-19 Pandemic On Global Neurosurgery Collaborations., Alvan Emeka Ukachukwu, Nancy Abu Bonsrah, Andreas Seas, Zoey Petitt, Romaric Waguia Kouam, Samantha Ramos, Alyssa Edwards, Di Deng, Michael Haglund, Mahmood Qureshi

General Surgery, East Africa

No abstract provided.

Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman

Undergraduate Research Posters

Early intervention in Alzheimer's is vital for treatment. The earlier a professional can detect symptoms and make a diagnosis the earlier a prognosis can be implemented. With the prevalence of data in our day-to-day world combined with Artificial intelligence (AI), utilizing both for machine learning can pave the way for more accurate and efficient detection of Alzheimer's and other neurodegenerative diseases. AI combined with Machine learning (ML) increases diagnostic efficiency and reduces human errors, making it a valuable resource for physicians and clinicians alike. With the increasing amount of data processing and image interpretation required, the ability to use AI …

Mir-29 And Mir-140 Regulate Trail-Induced Drug Tolerance In Lung Cancer, Suyeon Kim, Ki Wook Lee, Yongjin Yoo, Sang Hee Park, Ji Won Lee, Suhyun Jeon, Shaginyan Illia, Pooja Joshi, Hyun Woo Park, Han-En Lo, Jimin Seo, Yeonwoo Kim, Min Chang, Tae Jin Lee, Jong Bae Seo, Sung-Hak Kim, Carlo M Croce, Inki Kim, Sung-Suk Suh, Young-Jun Jeon

Faculty, Staff and Student Publications

Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has chemotherapeutic potential as a regulator of an extrinsic apoptotic ligand, but its effect as a drug is limited by innate and acquired resistance. Recent findings suggest that an intermediate drug tolerance could mediate acquired resistance, which has made the main obstacle for limited utility of TRAIL as an anti-cancer therapeutics. We propose miRNA-dependent epigenetic modification drives the drug tolerant state in TRAIL-induced drug tolerant (TDT). Transcriptomic analysis revealed miR-29 target gene activation in TDT cells, showing oncogenic signature in lung cancer. Also, the restored TRAIL-sensitivity was associated with miR-29ac and 140-5p expressions, which …

20-Year Inflation-Adjusted Medicare Reimbursements (Years: 2000-2020) For Common Lumbar And Cervical Degenerative Disc Disease Procedures, Pedram Honarpisheh, Samantha L Parker, Christopher R Conner, Sami Anjum, Jessica R Stark, John C Quinn, John M Caridi

Faculty, Staff and Student Publications

OBJECTIVE: Reimbursement trends for common procedures have persistently declined over the past 2 decades. Spinal instrumentational and fusion procedures are increasingly utilized and have increased in clinical complexity, yet longitudinal inflation-adjusted data for Medicare reimbursements of these procedures have not been evaluated.

METHODS: The Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule Look-Up Tool was used to extract Medicare reimbursements for the 5 most common spinal procedures and associated instrumentations from 2000-2020. Current Procedural Terminology (CPT) codes include 22551, 22600, 22633, 63030, and 63047 as well as instrumentation CPT codes 22840 and 22842-6. The nominal values were adjusted …

Coronary Laser With Simultaneous Contrast Injection For The Treatment Of Stent Underexpansion, Mohsen Mohandes, Alberto Pernigotti, Cristina Moreno, Luis Mauricio Torres, Francisco Fernández, Diego Zambrano, Alfredo Bardají

Faculty, Staff and Student Publications

BACKGROUND: Stent underexpansion is a challenge in interventional cardiology. Some off-label treatments, such as rotational atherectomy, intravascular lithotripsy (IVL) and coronary lasing, have been used to overcome the problem. The purpose of this study is to evaluate the safety and efficacy of coronary laser atherectomy with simultaneous contrast injection and subsequent balloon dilation to optimize stent expansion.

METHODS: Coronary laser atherectomy with simultaneous contrast injection was used. After lasing, non-compliant balloon dilation at high pressure was performed to overcome the underexpanded point. The average increase in the minimum stent area (MSA) was measured by intravascular ultrasound (IVUS), and any complication …

Impact Of Successful Recanalization And Clinical Outcomes Of Patients With Acute Ischemic Stroke With 5 Or More Thrombectomy Passes, Kazutaka Uchida, Mohammad-Mahdi Sowlat, Hidetoshi Matsukawa, Sameh Samir Elawady, Ali Alawieh, Conor Cunningham, Sami Al Kasab, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Adam Arthur, Hugo Cuellar, Jonathan A Grossberg, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Joshua Osbun, Roberto Crosa, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Richard Williamson, Pedro Navia, Peter Kan, Reade De Leacy, Shakeel Chowdhry, Mohamad Ezzeldin, Shinichi Yoshimura, Alejandro M Spiotta, Stroke Thrombectomy And Aneurysm Registry (Star) Collaborators

Faculty, Staff and Students Publications

Background: As the number of thrombectomy passes increases during endovascular therapy (EVT) for acute stroke, neurointerventionalists must weigh the risks of potential complications against the risk of failing to recanalize the affected vessel. Thus, we investigated the effectiveness and safety of EVT for patients with acute stroke in which ≥5 EVT passes were performed.

Methods: This retrospective cohort study from January 2013 to December 2022 included 31 thrombectomy-capable centers. Patients in whom ≥5 EVT passes were made were included in the analysis. The patients with successful recanalization defined as modified Thrombolysis in Cerebral Infarction ≥2b at 5, 6, 7, or …

Updates Of The Role Of B-Cells In Ischemic Stroke, Silin Wu, Sidra Tabassum, Cole T Payne, Heng Hu, Aaron M Gusdon, Huimahn A Choi, Xuefang S Ren

Faculty, Staff and Student Publications

Ischemic stroke is a major disease causing death and disability in the elderly and is one of the major diseases that seriously threaten human health and cause a great economic burden. In the early stage of ischemic stroke, neuronal structure is destroyed, resulting in death or damage, and the release of a variety of damage-associated pattern molecules induces an increase in neuroglial activation, peripheral immune response, and secretion of inflammatory mediators, which further exacerbates the damage to the blood-brain barrier, exacerbates cerebral edema, and microcirculatory impairment, triggering secondary brain injuries. After the acute phase of stroke, various immune cells initiate …

Translational Approaches To Address The Metastatic/Resistant (Mr) Phenotype Of Non-Small Cell Lung Cancer Brain Metastases, Kent L. Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Lung cancer remains the most frequently diagnosed malignant neoplasm shared in men and women worldwide, second only to the sexually dimorphic prostate cancer in men and breast cancer in women. Overall, lung cancer was responsible for 12.5% of new cancer cases globally in the year 2022. Of these cases, 80-85% are non-small cell lung cancer (NSCLC), a highly genotypically diverse sub-type of lung cancer. Over the past three decades, extraordinary improvement in screening, smoking cessation, early diagnosis and targeted therapy have been made, improving NSCLC survival markedly. However, as patients are surviving their primary disease better, there is a temporal …

Genetic Loss Of Mir-205 Causes Increased Mammary Gland Development, Alessandra Cataldo, Douglas G Cheung, John P Hagan, Matteo Fassan, Sukhinder Sandhu-Deol, Carlo M Croce, Gianpiero Di Leva, Marilena V Iorio

Faculty, Staff and Student Publications

MiRNAs play crucial roles in a broad spectrum of biological processes, both physiological and pathological. Different reports implicate miR-205 in the control of breast stem cell properties. Differential miR-205 expression has been observed in different stages of mammary gland development and maturation. However, a functional role in this process has not been clearly demonstrated. We generated an miR-205 knockout in the FVB/N mouse strain, which is viable and characterized by enhanced mammary gland development. Indeed, mammary glands of miR-205

A Rare Case Of Candida Glabrata Cervical Spondylodiscitis, Angelina Hong, Lily Hyungjung Lim, Ali Tariq Alvi, Pallavi Aneja

HCA Healthcare Journal of Medicine

Introduction

Invasive candidiasis can lead to numerous life-threatening sequelae. Candida glabrata is the second-most common causative species of invasive candidiasis. This species possesses a high risk for persistent infection and candidemia. An uncommon complication of invasive candidiasis is spondylodiscitis and can rarely affect the cervical spine.

Case Presentation

The patient is a female in her late 50s with a complex medical history inclusive of chronic obstructive pulmonary disease, chronic pain, multiple abdominal surgeries, prolonged intensive care unit admission, and administration of total parenteral nutrition and broad-spectrum antibiotics who presented with complaints of worsening neck pain. She was last hospitalized 3 …

Risk Factors For Unplanned Readmissions In Paediatric Neurosurgery: A Systematic Review Protocol, Lance Vincent Caburian Sese, Ma Celina Legaspi Guillermo

Ateneo School of Medicine and Public Health Publications

Introduction Unplanned hospital readmission (UHR) following surgical procedures reflects patient outcomes. While adult readmission studies are abundant, limited research exists in paediatric populations, especially in the context of neurosurgery. Methods and analysis This protocol outlines a systematic review aimed at identifying reasons for unplanned readmissions (30-day and 90-day readmissions) and risk factors following paediatric neurosurgical procedures. Narrative synthesis, sensitivity analyses, subgroup analyses, and meta-analysis, when appropriate, will be done. Ethics and dissemination There are no primary data involved and no access to confidential patient information. The findings aim to contribute to refining clinical practice, enhance patient counselling, and optimise healthcare …

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Donald Penney

The Journal of Integrated Primary Care

Every year thousands of Americans die awaiting an organ transplant. While our knowledge and experience with organ transplantation has only improved, organ availability continues to be a major issue due to a lack of suitable donor organs. A large population of organ donors are those who have been clinically diagnosed as brain dead. Brain death is defined as the irreversible loss of all brain and brainstem functions. Despite brainstem functions being lost, mechanical ventilation and perfusion techniques allow for proper organ maintenance. This gives brain-dead individuals a unique opportunity to serve as multiple organ donors. However, due to mistrust of …

Robotic-Assisted Navigation For Stereotactic Neurosurgery: A Cadaveric Investigation Of Accuracy, Time, And Radiation, William Anderson, Francisco Ponce, Michael Kinsman, Sepehr Sani, Brian Hwang, Diana Ghinda, Michael Kogan, Jonathan M Mahoney, Dhara Amin, Margaret Van Horn, Joshua Mcguckin, Dominic Razo-Castaneda, Brandon Bucklen

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Despite frequent use, stereotactic head frames require manual coordinate calculations and manual frame settings that are associated with human error. This study examines freestanding robot-assisted navigation (RAN) as a means to reduce the drawbacks of traditional cranial stereotaxy and improve targeting accuracy.

METHODS: Seven cadaveric human torsos with heads were tested with 8 anatomic coordinates selected for lead placement mirrored in each hemisphere. Right and left hemispheres of the brain were randomly assigned to either the traditional stereotactic arc-based (ARC) group or the RAN group. Both target accuracy and trajectory accuracy were measured. Procedural time and the …