Neurosurgery Commons^™

Hydrogel Matrix Human Stem Cell Based Nucleus Pulposus Intervertebral Disc Regeneration, Mick J. Perez-Cruet, Siddharth Ramanathan, Rasul Chaudhry, Leon Chieng, Christina Mckee, Aaron Rapp

Conference Presentation Abstracts

Introduction

Degenerative disc disease (DDD) is one of the leading causes of chronic debilitating low back pain. DDD is characterized by changes in cellular characteristics resulting in loss of extracellular matrix(ECM) water holding capacity of the nucleus pulposus(NP). DDD can lead to translation of physiological loads from the anterior 2/3 of the spinal column to the posterior 1/3, resulting in increased stress on the facets and ligamentum flavum causing facet hypertrophy and canal stenosis. Novel stem cell regenerative therapies could restore the anterior column load via NP regeneration.

Methods

A hydrogel scaffold was created composed of self-assembling polyethylene glycol(PEG) functionalized …

Ten-Year Safety Of Pluripotent Stem Cell Transplantation In Acute Thoracic Spinal Cord Injury., Stephen L Mckenna, Reza Ehsanian, Charles Y Liu, Gary K Steinberg, Linda Jones, Jane S Lebkowski, Edward Wirth, Richard G Fessler

Department of Medicine Faculty Papers

OBJECTIVE: The purpose of this study was to evaluate the safety of oligodendrocyte progenitor cells (LCTOPC1) derived from human pluripotent stem cells administered between 7 and 14 days postinjury to patients with T3 to T11 neurologically complete spinal cord injury (SCI). The rationale for this first-in-human trial was based on evidence that administration of LCTOPC1 supports survival and potential repair of key cellular components and architecture at the SCI site.

METHODS: This study was a multisite, open-label, single-arm interventional clinical trial. Participants (n = 5) received a single intraparenchymal injection of 2 × 106 LCTOPC1 caudal to the epicenter of …

Citation Analysis Of The Most Influential Ependymoma Research Articles Illustrates Improved Knowledge Of The Molecular Biology Of Ependymoma, Nolan J Brown, Bayard Wilson, Brian V Lien, Alexander Himstead, Ali R Tafreshi, Shane Shahrestani, Jack Birkenbeuel, Katelynn Tran, David Horton, Anushka Paladugu, Lydia R Kirillova, Chen Yi Yang, Seth C Ransom, Ronald Sahyouni, Isaac Yang

Faculty, Staff and Student Publications

The history of academic research on ependymoma is expansive. This review summarizes its history with a bibliometric analysis of the 100 most cited articles on ependymoma. In March 2020, we queried the Web of Science database to identify the most cited articles on ependymoma using the terms "ependymoma" or "ependymal tumors," yielding 3145 publications. Results were arranged by the number of times each article was cited in descending order. The top 100 articles spanned across nearly a century; the oldest article was published in 1924, while the most recent was in 2017. These articles were published in 35 unique journals, …

Role Of Surgery In Multifocal Glioblastoma, Syeda Kubra Kishwar Jafri, Syed Sarmad Bukhari, Muhammad Shahzad Shamim

Section of Neurosurgery

The management of multifocal glioblastomas is a point of constant discussion amongst neuro-oncologists. Best outcomes in glioblastoma management come from gross total resection (GTR) followed by concomitant radiation and chemotherapy (CCRT). Multifocal disease is resistant to GTR. Conventional management of these lesion is usually biopsy only followed by CCRT. Recent evidence has shown that there may be some benefit to attempting GTR of the largest lesion whenever safe to do so.

Characterization Of Patient-Derived Bone Marrow Human Mesenchymal Stem Cells As Oncolytic Virus Carriers For The Treatment Of Glioblastoma, Yuzaburo Shimizu, Joy Gumin, Feng Gao, Anwar Hossain, Elizabeth J Shpall, Akihide Kondo, Brittany C Parker Kerrigan, Jing Yang, Daniel Ledbetter, Juan Fueyo, Candelaria Gomez-Manzano, Frederick F Lang

Faculty, Staff and Student Publications

Objective: Delta-24-RGD is an oncolytic adenovirus that is capable of replicating in and killing human glioma cells. Although intratumoral delivery of Delta-24-RGD can be effective, systemic delivery would improve its clinical application. Bone marrow-derived human mesenchymal stem cells (BM-hMSCs) obtained from healthy donors have been investigated as virus carriers. However, it is unclear whether BM-hMSCs can be derived from glioma patients previously treated with marrow-toxic chemotherapy or whether such BM-hMSCs can deliver oncolytic viruses effectively. Herein, the authors undertook a prospective clinical trial to determine the feasibility of obtaining BM-hMSCs from patients with recurrent malignant glioma who were previously exposed …

Seizure Prediction In Epilepsy Patients, Gary Dean Cravens

NSU REACH and IPE Day

Purpose/Objective: Characterize rigorously the preictal period in epilepsy patients to improve the development of seizure prediction techniques. Background/Rationale: 30% of epilepsy patients are not well-controlled on medications and would benefit immensely from reliable seizure prediction. Methods/Methodology: Computational model consisting of in-silico Hodgkin-Huxley neurons arranged in a small-world topology using the Watts-Strogatz algorithm is used to generate synthetic electrocorticographic (ECoG) signals. ECoG data from 18 epilepsy patients is used to validate the model. Unsupervised machine learning is used with both patient and synthetic data to identify potential electrophysiologic biomarkers of the preictal period. Results/Findings: The model has shown states corresponding to …

Short Chain Fatty Acids Taken At Time Of Thrombectomy In Acute Ischemic Stroke Patients Are Independent Of Stroke Severity But Associated With Inflammatory Markers And Worse Symptoms At Discharge, Nicholas Henry, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Andrew J. Morris, Jianzhong Chen, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

Introduction: Short chain fatty acids (SCFA) are gut microbiota-derived metabolites that contribute to the gut-brain axis and may impact stroke outcomes following gut dysbiosis. We evaluated plasma SCFA concentrations against stroke severity parameters and identified SCFA-associated protein networks.

Methods: The Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC), a continuously enrolling tissue bank, was used to obtain stroke samples. Arterial blood distal and proximal to the thrombus was obtained from Acute Ischemic Stroke (AIS) Patients (n=53) during thrombectomy. Patient demographics, stroke presentation and outcome parameters were reported. The SCFAs were isolated from proximal plasma via chemical derivatization UHPLC coupled tandem …

Laser Interstitial Thermal Therapy For Posterior Fossa Lesions: A Systematic Review And Analysis Of Multi-Institutional Outcomes, Mohammadmahdi Sabahi, Stephen J. Bordes, Edinson Najera, Alireza M. Mohammadi, Gene H. Barnett, Badih Adada, Hamid Borghei-Razavi

School of Medicine Faculty Publications

Background: Laser interstitial thermal therapy (LITT) has emerged as a treatment option for deep-seated primary and metastatic brain lesions; however, hardly any data exist regarding LITT for lesions of the posterior fossa. Methods: A quantitative systematic review was performed. Article selection was performed by searching MEDLINE (using PubMed), Scopus, and Cochrane electronic bibliographic databases. Inclusion criteria were studies assessing LITT on posterior fossa tumors. Results: 16 studies comprising 150 patients (76.1% female) with a mean age of 56.47 years between 2014 and 2021 were systematically reviewed for treatment outcomes and efficacy. Morbidity and mortality data could be extracted for 131 …

Surgical Management During The Covid-19 Era At A Private Tertiary Care Hospital Of Karachi, Pakistan: A Cross-Sectional Study, Nida Zahid, Erum Baig, Gulzar S. Lakhani, Hasnain Zafar, Asad Latif, Syed Ather Enam

Department of Surgery Docs

Background: The coronavirus disease 2019 (COVID-19), declared a pandemic in March 2020, has affected the entire healthcare system, including the surgical practice. Guidelines for the management of surgical patients during this COVID-19 era need to be established to provide timely yet safe surgical care. In this study, we aimed to evaluate the outcomes of the COVID-19 testing algorithm established for surgery patients presenting to a tertiary care hospital in Karachi, Pakistan, and to compare the outcomes among patients who underwent elective versus emergency surgery.
Methodology: This is a cross-sectional study conducted at a tertiary care hospital in Pakistan to apply …

Issues To Publish In Latin America, Fiacro Jiménez Ponce, José Antonio Soriano Sánchez, José Alberto Israel Romero Rangel

Archives of Neurosurgery

Scientific knowledge is essential to the development of civilization, particularly in our case for anatomy and physiology of the central nervous system and neurosurgical practice. In this editorial, we are reviewing three critical aspects of scientific publications: The scientific training of physicians, the impact of publications, and the ethical aspects related to elaborating a paper.

Aneurysmal Subarachnoid Hemorrhage And Acute Subdural Hematoma, Neurosurgical And Endovascular Rescue. Case Report., José Omar Santellan Resident, José Ramón Aguilar Dr., Abraham Ibarra Dr., Ulises García Dr.

Archives of Neurosurgery

Introduction: Acute subdural hemorrhage (aSDH) in association with aneurismal subarachnoid hemorrhage (SAH) is a severe disease with an incidence of 0.5% to 7.9% of all SAH. Due to the rarity of aneurysmal aSDH, it remains difficult to define a comprehensive management protocol. In this case review, following the CARE guidelines, we show the hybrid management of this pathology to know the importance of using different types of neurosurgical treatments in case of two severe diseases in critical patients.

We present two patients who developed sudden onset cephalea and neurological impairment secondary to aneurysmal subarachnoid hemorrhage associated with acute subdural hematoma. …

The Scientific Divulgation In Neurosurgery., Rodrigo Ramos-Zuñiga, Sergio Manuel Ibarra-Navarro

Archives of Neurosurgery

The communication of scientific findings in a young discipline in the evolution of knowledge about the human nervous system, has had a consistent and significant advance. This interdisciplinary and multidisciplinary vision has been a fundamental educational axis in the development of neurosurgery in terms of innovation, scientific progress, technological development and quality of patient care. It is therefore essential that scientific writing and communication channels continue to preserve these quality standards, to validate without bias and with certainty, the value and strength of the advances of neurosurgery as a science.

Passive Functional Mapping Using Infrared Thermography In Epilepsy Awake Surgery: Case Report, Enrique De Font-Réaulx, Javier Terrazo-Lluch, Paul Shkurovich-Bialik, Miguel Ángel Collado-Corona, Ernesto Ramírez-Navarrete, Luis Díaz-López Md, Alma Rosa Martínez-Rosas Msc, Adalberto González-Astiazarán

Archives of Neurosurgery

Background: Active Functional Mapping (AFM) is the gold standard method for localizing cortical and subcortical brain functional areas and tracts. By definition, it requires direct application of controlled electrical stimuli under established protocols. Nevertheless, it entails inherent risks, such as causing intraoperative seizures. On the other hand, Passive Functional Mapping (PFM) doesn´t require electrical stimulation of the nervous system. PFM is based on the knowledge that brain metabolism generates different electromagnetic radiation patterns depending on its metabolism, that are invisible to the human eye, but infrared thermographic cameras can show those changes related to brain activity without the use of …

The Many Worlds Of Neurosurgery And The Labyrinth Of Borges, Juan F. Villalonga, Giulia Guizzardi, Domenico Solari

Archives of Neurosurgery

Nowadays, an apprentice of neurosurgery has to complete long and different pathways of education.The encounter between the schools of Napoli and Tucuman, make us identify a common strategy of neurosurgical education. In attempt of defining the philosophy behind it we attempt a comparison in between the life and training of a modern neurosurgeon and the character of a tale of Borges (i.e. Ts'ui Pên). As neurosurgeons of the 21st century we must be like the inextricable Ts'ui Pên.

L5-S1 Collapsed Space Is Not A Contraindication For Elif. Technical Note And Preliminary Clinical Results, Iris Tatiana Montes González, Sergio Soriano Solis, Manuel Eduardo Soto García, Manuel Rodríguez García, Gerson Reyes Rodríguez., Víctor David López García, José Antonio Soriano Sánchez

Archives of Neurosurgery

INTRODUCTION: Extraforaminal lumbar interbody fusion (ELIF) avoids vascular, neural, and genitourinary risks of anterior and lateral techniques. However, many authors consider ELIF to be contraindicated in L5-S1, especially in the case of a collapsed space. Therefore, we aim to provide a technical note for ELIF in the context of an L5-S1 collapsed space and present our experience and the postoperative clinical results of our patients. MATERIALS AND METHODS: We collected data from the records of patients with ELIF L5-S1 level collapsed between March 2020 to June 2021, using for this study sex, age, clinical symptoms, diagnosis, L5-S1 height space, EVA, …

Innocuous Expectoration Of An Anterior C3 Loosened Screw—Case Report And Literature Review About A Benevolent Evolution With No Esophageal Injury, Gerson Reyes Rodriguez, José Alberto Israel Romero Rangel, Manuel Soto García, Manuel Rodriguez Garcia, Victor David Lopez Garcia, Iris Tatiana Montes González, José Antonio Soriano Sánchez

Archives of Neurosurgery

The anterior cervical discectomy and fusion (ACDF) technique is the gold-standard treatment for myeloradiculopathy. We present the case of a seventy-five years old female who came to revision because of worsening solids dysphagia, dry cough, and foreign body sensation in the past two weeks; we had practiced her an ACDF procedure four years ago. She denied presenting neurological deficit or neck pain. The physical examination was normal. Cephalic migration of the left C3 screw was evident on cervical plain and dynamic films and CT-Scan. She was admitted to the hospital for an upper gastrointestinal endoscopy that visualized retropharyngeal ulceration. Thirty …

Clinical Applications Of Direct Cortical Stimulation During Awake Craniotomies. Commentary On Passive Functional Mapping Using Infrared Thermography In Epilepsy Awake Surgery., Ramiro Antonio Perez De La Torre, Ramanathan Siddarth, Pérez Ramírez Pedro, Santiago Noé

Archives of Neurosurgery

As clinicians, we rely on various imaging methods to identify abnormal brain lesions. We can distinguish this myriad of neurological disorders by using imaging alone or together with either or both electrophysiological monitoring and direct cortical stimulation. This last alternative is the most frequently used approach to diagnosing brain lesions requiring awake craniotomies for adequate management. Awake craniotomies have become the standard of care for focal lesions, including vascular malformations like cavernous angiomas, intrinsic brain tumors, gliomas, vasculitic brain lesions, postinfectious brain lesions, brain metastasis, and also for epilepsy surgery. Surgery for epileptic patients requires multidisciplinary team interactions and a …

Archives Of Neurosurgery Volume 1 Issue 2 - Full Issue

Archives of Neurosurgery

Archives of Neurosurgery Volume 1 Issue 2 - Full Issue

Microvascular Decompression For Hemifacial Spasm: Surgical Technical Nuances And Results After 300 Microvascular Decompression Surgeries, Rogelio Revuelta Gutiérrez, Miguel Vega-Arroyo, Olivia L. Vales-Hidalgo, Cynthia E. López-Rafael, Jesús Martínez-Manrique, Sergio Moreno Jiménez

Archives of Neurosurgery

Introduction: Hemifacial spasm (HFS) is characterized by the involuntary, paroxysmal, painless, and progressive spasmodic contractions of facial muscles innervated by the ipsilateral seventh cranial nerve. To date, neuroimaging studies (Computed Tomography scan [CT] and Magnetic Resonance Imaging [MRI]) are unable to establish the diagnosis. HFS medical treatment with antiepileptic drugs, and Botulinum toxin application are temporarily effective, however, both have shown side effects and lesser cost-effective results. Currently, surgical Micro Vascular Decompression (MVD) for HFS has the highest curative rates and lower operative morbidity. We analyze the demographics, clinical manifestations, outcomes, and complications that to our knowledge, is the largest …

An Unusual Case Of A Giant Intradiploic Epidermoid Cyst Removed Using A Combined Supra-Infratentorial Retromastoid Approach., César Adán Almendárez-Sánchez, Saúl Solorio-Pineda, Abrahan Alfonso Tafur-Grandett, Miguel Ángel Ramírez-Sosa Dr., Gabriel Arturo Ramos Martínez, Leonardo Álvarez-Vázquez

Archives of Neurosurgery

Background: Epidermoid cysts (EC) are relatively rare congenital lesions. They arise from ectodermal debris during aberrant closure of the neural tube, are benign, and of slow growth. They are found predominantly in the cistern of the cerebellopontine angle, most are intradural, and very rarely, there is underlying compression of the venous sinuses, leading to benign intracranial hypertension.

Case description: We present the case of a patient diagnosed with a giant extradural, intradiploic EC with compression of the left transverse sinus and its successful management by using ultrasonic aspiration, performing a combined supra-infratentorial retromastoid approach with occipitotemporal craniotomy, without subsequent …