Neurosurgery Commons^™

Intraoperative Changes In Somatosensory Evoked Potentials As A Predictor Of Perioperative Stroke In Carotid Endarterectomy, Justin W. Meinert Bphil, Parthatharasy D. Thirumala Md, Jeffrey R. Balzer Phd, Donald J. Crammond Phd, Eyad E. Saca Md

Tower Health Research Day

No abstract provided.

Cases In Psychiatric Neurosurgery, Wael Asaad, Michael Staudt, Darin Dougherty, Wayne Goodman, Robert M. Richardson, Sameer Sheth

Conference Presentation Abstracts

In this session, multidisciplinary teams - surgeon plus psychiatrist - will discuss their own cases and approaches to the innovative management of psychiatric disorders.

Outcomes Of Children With Low-Grade Gliomas In Low- And Middle-Income Countries: A Systematic Review, Richard Ward, Hannah M Jones, Davis Witt, Frederick Boop, Eric Bouffet, Carlos Rodriguez-Galindo, Ibrahim Qaddoumi, Daniel C Moreira

Department of Medical Oncology Faculty Papers

Purpose: Pediatric CNS tumors are increasingly a priority, particularly with the WHO designation of low-grade glioma (LGG) as one of six index childhood cancers. There are currently limited data on outcomes of pediatric patients with LGGs in low- and middle-income countries (LMICs).

Methods: To better understand the outcomes of LGGs in LMICs, this systematic review interrogated nine literature databases.

Results: The search identified 14,977 publications. Sixteen studies from 19 countries met the selection criteria and were included for data abstraction and analysis. Eleven studies (69%) were retrospective reviews from single institutions, and one (6%) captured institutional data prospectively. The studies …

Myeloarchitectonic Maps Of Cat Auditory Cortex, Austin Robertson

Electronic Thesis and Dissertation Repository

The cerebral cortex contains myriad cortical areas that differ in structure, function, and connectivity. Current methods of delineating cortical structures and their subregions are insufficient for in vivo applications, either being highly invasive or requiring a detailed knowledge of a region’s tuning properties. To address this, we seek to establish a structural biomarker capable of delineating the cortex that possesses a non-invasive correlate. We explore myelin as a potential candidate by evaluating its efficacy in parcellating the feline auditory cortex through the generation of depthwise myelin density profiles for each of the 13 auditory cortical subregions. Our analyses revealed significant …

Pineal Cyst Apoplexy And Memory Loss: A Novel Complication, Areez Shafqat, Hanin Jaber Algethami, Shameel Shafqat, Syed Shafqat Ul Islam

Medical College Documents

An 8-year-old boy presented to our hospital complaining of a bilateral headache associated with episodes of anterograde amnesia. He had a road traffic accident 3 years ago when a computed tomography (CT) scan revealed traumatic brain injury. In addition, a small pineal cyst (PC) was noted with minor intramural calcifications. A follow-up CT a day later demonstrated increased density in the pineal gland of 60 Hounsfield Units, suggestive of apoplectic changes in the PC. However, the patient was lost to follow-up and presented with memory loss a year and a half later, upon which CT and magnetic resonance imaging revealed …

Association Between Vitamin D Supplementation And Cancer Mortality: A Systematic Review And Meta-Analysis, Renjie Zhang, Yu Zhang, Zheran Liu, Yiyan Pei, Ping Xu, Weelic Chong, Yang Hai, Ling He, Yan He, Jiayi Yu, Jingjing Wang, Fang Fang, Xingchen Peng

Department of Medical Oncology Faculty Papers

Background: Vitamin D deficiency is related to increased cancer risk and deaths. However, whether vitamin D supplementation reduces cancer mortality remains unclear, and several randomized controlled trials yield inconsistent results.

Methods: Medline, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception until 28 June 2022, for randomized controlled trials investigating vitamin D supplementation. Pooled relative risks (RRs) and their 95% confidence intervals (CIs) were estimated. Trials with vitamin D supplementation combined with calcium supplementation versus placebo alone and recruiting participants with cancer at baseline were excluded in the present study.

Results: This study included 12 …

Evolution Of The Ao Spine Sacral And Pelvic Classification System: A Systematic Review, Barry Ting Sheen Kweh, Jin W. Tee, F. Cumhur Oner, Klaus J. Schnake, Emiliano N. Vialle, Frank Kanziora, Shanmuganathan Rajasekaran, Marcel Dvorak, Jens R. Chapman, Lorin M. Benneker, Gregory Schroeder, Alexander R. Vaccaro

Rothman Institute Faculty Papers

OBJECTIVE: The purpose of this study was to describe the genesis of the AO Spine Sacral and Pelvic Classification System in the context of historical sacral and pelvic grading systems.

METHODS: A systematic search of MEDLINE, EMBASE, Google Scholar, and Cochrane databases was performed consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all existing sacral and pelvic fracture classification systems.

RESULTS: A total of 49 articles were included in this review, comprising 23 pelvic classification systems and 17 sacral grading schemes. The AO Spine Sacral and Pelvic Classification System represents both the evolutionary …

Metastatic Primary Brain Rhabdomyosarcoma In A Pediatric Patient: Illustrative Case, Michel Gustavo Mondragón-Soto, Luis Del Valle, José Alfredo González-Soto, Roberto Alfonso De Leo-Vargas

School of Medicine Faculty Publications

BACKGROUND: Primary intracranial rhabdomyosarcoma is an extraordinarily rare malignant tumor, with even fewer presenting with distant metastasis. To date, only five cases, including the one presented here, have been reported to present metastatic activity. OBSERVATIONS: A 12-year-old boy presented with a few days of headache, nausea, vomiting, but no neurological deficit. Brain computed tomography and magnetic resonance imaging demonstrated hydrocephalus and a cystic lesion with left parieto-occipital extension. After resection, pathology reported primary rhabdomyosarcoma, with positive desmin and myogenin on immunohistochemistry. The patient presented with pulmonary metastasis. The patient had an overall survival of 21 months after diagnosis with optimal …

Primary Middle Meningeal Artery Embolization For A Chronic Subdural Hematoma After Non-Accidental Trauma In A Child: A Case Report, Saisree Ravi, Sohum Desai, Ameer E. Hassan, Wondwossen G. Tekle

School of Medicine Publications and Presentations

Chronic subdural hematoma in children can be pathognomonic of abusive head trauma. Treatment options for these range from observation to surgical evacuation depending on clinical circumstance and presenting features, which can include mental status changes, headaches, focal neurologic deficits, or asymptomatic presentation. Standalone endovascular treatments represent an area of growing interest in the adult population as an effective treatment modality. However, embolization as a singular treatment approach has not been reported in the pediatric population. We report the first case of stand-alone middle meningeal artery (MMA) embolization of a chronic subdural hematoma as a sequela of abusive head trauma in …

Clinical Trial Innovations In A Post-Covid World, Francisco A. Ponce, Ludy Chen Shih, Michael Staudt

Conference Presentation Abstracts

No abstract provided.

Utilization Of The Nurse Practitioner Skillset In Partnership With The Medical Device Industry, Daniel C. Rowland

Doctor of Nursing Practice (DNP) Projects

BACKGROUND: Millions of nurse practitioners (NP), physician assistants (PA), and registered nurses (RN) are optimistic that their current employers will help them reach their full potential. One area that can add value to the hospital and empower employees to work to the full scope of their practice, and utilize the skillsets like that of an NP, is to train these providers to support medical device equipment in the operating room instead of relying on medical device representatives (MDRs) of medical device companies.

METHODS: Training NPs, PAs, or RNs how to support neurological medical device equipment will better utilize the skillset …

Lumbar Motion Is Maintained With Paraspinous Tension Band For Degenerative Spondylolisthesis: Results From 24-Month Fda Study, Kee D. Kim, Rick Sasso, Serena Hu, Alan Villavicencio, S Tim Yoon, William Lavelle, Harvinder Sandhu, Hyun Bae, Jeffrey Fischgrund, Mick Perez-Cruet

Conference Presentation Abstracts

Introduction

Durable outcome for degenerative spondylolisthesis (DS) usually requires decompression and fusion. Fusion, however, places greater stress at adjacent levels with increased incidence of adjacent segment disease. A novel interspinous tension band is proposed for segmental stabilization after decompression for DS, as an alternative to fusion. An FDA IDE study (NCT03115983) compares decompression and stabilization with the tension band (treatment group) to decompression and transforaminal interbody instrumented fusion (control group) for symptomatic DS.

Methods

Prospectively enrolled IDE study subjects with 24 months postoperative radiographic follow-up were included in this analysis. X-rays obtained during the follow-up period for both the treatment …

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 …

The Impact Of Volume Of Tissue Activation On Cortical-Striatal Networks And Verbal Fluency Declines In Post-Deep Brain Stimulation Parkinson's Disease Patients., Alexander Luke Alley

Electronic Theses and Dissertations

This study investigated the cortical-striatal networks of verbal fluency declines in 6-month, post-operative, deep brain stimulation Parkinson’s Disease patients. Nine Parkinson’s disease participants with implanted STN or GPi DBS systems were recruited for this study. Verbal fluency data was obtained from each patient preoperatively and 6- months post implantation. The stimulation-based volume of tissue activated area (VTA) of each target site (STN or GPi) was analyzed using Lead-DBS and Lead-Group. The white matter tracks intersecting each patient’s VTA, terminating in the pre-SMA, SMA, caudate nucleus, and anterior cingulate were investigated and correlated with verbal fluency declines. We found statistically significant …

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 …

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.

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 …

Exploring The Effects Of Spinal Cord Stimulation For Freezing Of Gait In Parkinsonian Patients, Olivia Samotus

Electronic Thesis and Dissertation Repository

Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is …

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 …