Neurosurgery Commons^™

Multiparametric Mri Along With Machine Learning Predicts Prognosis And Treatment Response In Pediatric Low-Grade Glioma, Anahita Fathi Kazerooni, Adam Kraya, Komal Rathi, Meen Chul Kim, Arastoo Vossough, Nastaran Khalili, Ariana Familiar, Deep Gandhi, Neda Khalili, Varun Kesherwani, Debanjan Haldar, Hannah Anderson, Run Jin, Aria Mahtabfar, Sina Bagheri, Yiran Guo, Qi Li, Xiaoyan Huang, Yuankun Zhu, Alex Sickler, Matthew R Lueder, Saksham Phul, Mateusz Koptyra, Phillip Storm, Jeffrey Ware, Yuanquan Song, Christos Davatzikos, Jessica Foster, Sabine Mueller, Michael J Fisher, Adam Resnick, Ali Nabavizadeh

Department of Neurosurgery Faculty Papers

Pediatric low-grade gliomas (pLGGs) exhibit heterogeneous prognoses and variable responses to treatment, leading to tumor progression and adverse outcomes in cases where complete resection is unachievable. Early prediction of treatment responsiveness and suitability for immunotherapy has the potential to improve clinical management and outcomes. Here, we present a radiogenomic analysis of pLGGs, integrating MRI and RNA sequencing data. We identify three immunologically distinct clusters, with one group characterized by increased immune activity and poorer prognosis, indicating potential benefit from immunotherapies. We develop a radiomic signature that predicts these immune profiles with over 80% accuracy. Furthermore, our clinicoradiomic model predicts progression-free …

Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, José Alberto Israel Romero Rangel, Manuel Eduardo Soto García, Sergio Soriano Solís, Carlos Raúl Rangel Morales, Gerson Reyes Rodríguez, José Antonio Soriano Sánchez

Archives of Neurosurgery

BACKGROUND: Chiari's Malformation surgical treatment has significantly changed since the "classical" technique description by Gardner (1950). It is probably the most commonly performed approach, even when multiple techniques are available because no substantial changes nor any clear surgical objectives have been made. OBJECTIVE: To demonstrate a new cutting-edge surgical technique mastering the advantage of each surgical procedure ever described in the history of Chiari's Malformation establishing three critical points in surgical technique: clear patient-specific surgical goals, dynamic posterior fossa reconstruction, and extradural occipitoatlantal dense-adhesions release. METHODS: A comprehensive review of historically described approaches, proof of concept of surgical technique in …

Traumatic Injuries Of The Common Peroneal Nerve And Current Surgical Strategies For Improving Foot Drop. A Clinical Series And Literature Review., Carlos Alberto Rodríguez Aceves, María Elena Córdoba Mosqueda, Racob Alberto García Velazco, Humberto González Ugalde, Héctor Antonio Soriano Solís, Fabiola Estela Elizabeth Ortega Ponce, Kartik G. Krishnan

Archives of Neurosurgery

Background: Common peroneal nerve injuries are the most frequent nerve injuries in the lower extremity. They may produce severe gait deficits because of weakness or absence in ankle dorsiflexion. Functional improvement after injury, despite any intervention, remains unpredictable. There are various surgical strategies aimed to restore foot drop, but no consensus exists regarding the best surgical treatment.

Objective: In this article, we report our experience and reviewing general aspects of common peroneal nerve anatomy and lesions, current surgical strategies to restore functionality, and the overall outcomes previously published in the literature.

Methods: Retrospective review of patients with foot drop secondary …

Validation Of The Distress Thermometer In A Mexican Population With Brain Tumors: A Diagnostic Accuracy Study, Dan Morgenstern-Kaplan, Sergio Moreno-Jiménez, Fernanda Páez-Plascencia, Angel Ruiz-Chow, Fabiola Flores-Vázquez

Archives of Neurosurgery

Objective: Mental health in cancer patients must be addressed. This study's main objective was to evaluate the sensitivity and specificity of the DT in a population of patients with brain tumors and determine the optimal cut-off point for the DT. Methods: We performed a cross-sectional study at the National Institute of Neurology and Neurosurgery in Mexico City, in a cohort of 110 patients. Results: Of the 108 participants with brain tumors that were included in the analysis (2 patients excluded by incomplete DT), 40 had gliomas, 31 had pituitary adenomas, 21 had meningiomas, and 16 had other types of tumors. …

Suprameatal Tubercle Classification; Its Implementation On Clinical Cases, Humberto Reyna Mendez, Jose Alfredo Espinosa Mora, Laura Ubaldo Reyes, Alberto Angeles Castellanos, Ignacio Mora Magaña, Mauro Alberto Segura Lozano, Rachel Blue, John Yk Lee, Diego Mendez Rosito

Archives of Neurosurgery

Abstract:

Background: The suprameatal tubercle (SMT) is a variable prominence of the petrosal surface of the temporal bone that lies above the internal acoustic meatus. An enlarged SMT may present an obstacle during surgeries of the posterior fossa, including microvascular decompression or by itself cause trigeminal neuralgia.

Methods: Based on our prior study of 200 temporal bones, its data collection and establishing a classification of the SMT this extension study exemplifies its clinical application.

Results: According to the classification of the SMT four selected cases are clinically and anatomically correlated to exemplify the utility of this classification.

Conclusion: The SMT …

The Pipeline Endovascular Device Versus The Flow Re-Direction Endoluminal Device For Cerebral Aneurysm. A One-Year Follow-Up In A Single-Center Experience, Omar Pichardo, Alan Picazo, Omar Castillon, Jonathan Zuniga, Gustavo Alan Juarez Jimenez

Archives of Neurosurgery

Background: The Flow Diverters are devices derived from brain stents, made up of a network of microfilaments of various materials that allow the vessel remodeling. The Pipeline Embolization Device and The Flow Re-Direction Endoluminal Device are the two devices with more global clinical experience. Our objective is to compare the 1-year results using these devices in a cohort of patients assessing their occlusion rate and their clinical outcome as by the modified Rankin Score (mRS).

Methods: In this retrospective nested case-control cohort study, we reviewed the medical records of patients undergoing treatment with a Flow Diverter stent for brain aneurysms …

Chiari Formation And Atlantoaxial Instability. Commentary On Minimally Invasive Non-Expansile Tubular Extradural Posterior Fossa Decompression (Minted Technique) For The Management Of Chiari I.5 Malformation: Historical Overview Of Surgical Techniques, Technical Note, Proof Of Concept, Illustrative Case And Case Series. Lesser Is Better, Atul Goel

Archives of Neurosurgery

The authors have reviewed Chiari formation treatment and have put-forth their personal experience with minimally invasive techniques to perform foramen magnum decompression surgery. Based on the historical review of the subject, the authors have discussed the historical validity of only bone decompression, extra-arachnoidal decompression, and tonsillectomy. The article falls in line with the current minimally invasive surgery wave, a slightly larger cousin of the buttonhole surgery trend. It may be pertinent that I review my understanding of the subject based on the ongoing experience of nearly four decades. In the year 1998, we identified that the posterior fossa volume in …

Archives Of Neurosurgery: The Scientific Home Of Neurosurgery. The Creation Of The Unique Diamond-Open Access Journal In Neurosurgery With An Author-Friendly Advisory Peer-Reviewing And Publishing Policy Within Reach Of Everyone In The World… Born From The Ashes Of A World-Chaos., José Alberto Israel Romero Rangel, Fiacro Jiménez Ponce, José Antonio Soriano Sánchez

Archives of Neurosurgery

This is an editorial article.

Microendoscopic Versus Open Discectomy For The Treatment Of Extruded Lumbar Disc Herniation: A Comparative Cohort Study, Juan Guapo Mendoza, Antonio Guapo Mendoza, Juan Arturo Muciño Mercado, Sonia Melisa Juarez, Arturo Gonzalez, Vianney Guapo Ortiz

Archives of Neurosurgery

Background: Lumbosciatica syndrome affects millions of people worldwide, usually caused by a herniated disc. Most patients with extruded herniated discs are highly symptomatic, and they respond better to surgical treatment. Several studies have tried to compare the efficacy and benefits of microendoscopic discectomy (MED) and open discectomy (OD).

Objective: The objective of this study was to compare the results and complications of our MED experience versus standard OD in patients with lumbar disc extrusion.

Material and methods: We included patients from 18 to 60 years with radicular pain syndrome and single-level extruded disc herniation between January 2015 and December 2020. …

Hypothalamic Hamartoma Related To Pallister-Hall Syndrome In An Adolescent Patient: Illustrative Case., Victor Ramzes Chavez-Herrera, Roberto Casarrubias-Islas, Karen A Leal-Tapia, Rosa L Margarita Flores-Salgado, Juan C Huicochea-Montiel, Bayron A Sandoval-Bonilla

Archives of Neurosurgery

Background: Hypothalamic hamartomas in relationship to Pallister-Hall syndrome are extremely rare; just over 100 cases have been reported. Most hypothalamic hamartomas are sporadic.

Observation(s): A 17-year-old boy presented with a 3-year history of gelastic seizures and a suprasellar mass. The complete physical examination, blood work, and study images resulted in bilateral mesial-polydactyl, metacarpal syndactyly, glandular hypospadias, and hypoplastic nails. There were no hormone or neurological manifestations. MRI studies demonstrated a large non-enhancing suprasellar mass adjacent to the hypothalamus and displaced normal structures. An open biopsy of the mass and genetic studies were carried out to confirm the presumptive diagnosis. After …

Congress Proceedings Of The Xxviii Meeting Of The Mexican Society Of Neurological Surgery

Archives of Neurosurgery

No Abstract for this article.

High-Grade Avm. Educational Vignette And Clinical Cases, Marcos Devanir Silva Da Costa, Marcelo Augusto Acosta Goiri, Daniela Coelho, Juan Alberto Paz Archila, Talita Helena Martins Sarti, Feres Chaddad-Neto

Archives of Neurosurgery

The arteriovenous malformation (AVM) is a vascular malformation characterized by fistulas between arteries and veins forming a nidus, without interposition of capillary vessels and of which early draining vein is identified at the digital angiography. Potential reports of its existence date from the second century AD. Spetzler and Martin (S-M) proposed a classification considering three features and Lawton then added new predictors. A maximum of 10 score can be achieved by applying the modified S-M grade system. This classification guides decision-making and the possible choice of the multimodal treatment (surgery, radiosurgery and embolization). We discuss historical, pathological, clinical and therapeutic …

“Primum Non Nocere”, The Role Of Research In Meeting This Primary Objective In Neurosurgical Praxis., José Antonio Soriano Sánchez, Fiacro Jiménez Ponce, José Alberto Israel Romero Rangel

Archives of Neurosurgery

The present editorial object is to make us aware of the role that scientific production has in patient safety. Our goal shall be to provide the best neurosurgical praxis parameters supported by the best scientific evidence, developed in strict alignment to current research and publishing ethics, to warrant patient safety in every process of neurosurgical care. Once this has been said, be the worldwide neurosurgical scientific community welcome to publish in Archives of Neurosurgery, a new journal that will make publishing possible for every neurosurgeon around the world, to become the scientific home of Neurosurgery.

Endoscopic–Assisted Surgery For Cerebello Pontine Angle Pathology: Technical Note And Surgical Results In A Series Of Patients, Jaime Jesus Martinez Anda, Pablo David Guerrero Suarez, Diego Pineda Martínez, Rafael Avendaño Pradel, Ernesto Javier Jurado Delgado, Ricardo Santiago Villlagrana Sánchez, Juan Carlos Cisneros Lesser, Carolina De La Llata Segura, Rogelio Revuelta Gutiérrez

Archives of Neurosurgery

Objectives: Endoscopic–assisted surgery combined with the operating microscope has been described for several surgical techniques and pathologies of the cerebellopontine angle (CPA). The use of an endoscope allows for a panoramic view of the CPA cistern and a high degree of maneuverability in narrow cisternal spaces that enable the surgeon to deal with most CPA lesions safely. We performed an observational study to describe the surgical anatomy and technique for endoscopic-assisted CPA surgery, describing our experience in a case series of patients with CPA pathology. Methods: Anatomical and surgical technique description of endoscopic-assisted surgery for CPA pathology, based on observations …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Converting “Nonlesional” Imaging Occult Epilepsy Into A Focal Lesional Entity Using Advanced Imaging Techniques: Illustrative Case, Muhammad Usman Khalid, Flavius D. Raslau, Valentinos Zachariou, David Powell, Zachary Winder, Ryan Cloyd, Sarah Helen Thomas, John Kuipers, Rachel Ward Mitchell, Riham H. El Khouli, Timothy J. Ainger, Sally Mathias, Farhan A. Mirza

Neurosurgery Faculty Publications

BACKGROUND To achieve the best possible outcome in surgical refractory epilepsy, the seizure onset zone must be accurately identified prior to treatment.

OBSERVATIONS A 38-year-old man presented with tonic-clonic and focal seizures 2–3 times per month, refractory to antiseizure medications. Scalp EEG, MRI, PET, ictal SPECT, magnetoencephalography, and stereo-EEG (SEEG) did not provide conclusive seizure onset zone localization. Subsequently, the patient was included in the authors’ ongoing postictal arterial spin labeling (ASL) study and additional postprocessing was performed with a morphometric analysis program (MAP) and texture analysis. Using these results, the authors reexamined the original structural MR images, with attention …

Efficacy Of Deferoxamine Mesylate In Serum And Serum-Free Media: Adult Ventral Root Schwann Cell Survival Following Hydrogen Peroxide-Induced Cell Death, Yee Hang Ethan Ma, Abhinay R. Putta, Cyrus H. H. Chan, Stephen R. Vidman, Paula V. Monje, Giles W. Plant

Neurosurgery Faculty Publications

Schwann cell (SC) transplantation shows promise in treating spinal cord injury as a pro-regenerative agent to allow host endogenous neurons to bridge over the lesion. However, SC transplants face significant oxidative stress facilitated by ROS in the lesion, leading to poor survival. deferoxamine mesylate (DFO) is a neuroprotective agent shown to reduce H₂O₂-induced cell death in serum-containing conditions. Here we show that DFO is not necessary to induce neuroprotection under serum-free conditions by cell survival quantification and phenotypic analysis via immunohistochemistry, Hif1α and collagen IV quantification via whole cell corrected total cell fluorescence, and cell death …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

Assessment Of Cerebrospinal Fluid And Blood-Based Biomarkers In Degenerative Cervical Myelopathy: Systematic Review And Meta-Analysis, Harshit Arora, Hassan Darabi, Cassandra C. Wolsh, Kelsey N. Karnik, John C. Gensel, Francis Farhadi

Neurosurgery Faculty Publications

Study Design: Systematic Review and Meta-Analysis.

Objectives: Degenerative cervical myelopathy (DCM), the leading cause of spinal cord injury globally, may clinically manifest with hand numbness and tingling, loss of hand dexterity and impaired balance and gait. Biomarkers have been identified as disease indicators with recent studies exploring the role of structural and inflammatory biomarkers in diagnostic and treatment outcome prediction. The review aims to identify relevant cerebrospinal fluid (CSF) and blood-based biomarkers associated with DCM diagnosis and prognostication.

Methods: The systematic review was conducted as per PRISMA guidelines. A comprehensive search strategy was devised to identify articles evaluating biomarkers in …