Journal of neurosurgery最新文献

{"title":"A novel robot-assisted method for implanting intracortical sensorimotor devices for brain-computer interface studies: principles, surgical techniques, and challenges.","authors":"Naoki Ikegaya, Arka N Mallela, Peter C Warnke, Nicolas G Kunigk, Fang Liu, Hunter R Schone, Ceci Verbaarschot, Nicholas G Hatsopoulos, John E Downey, Michael L Boninger, Robert Gaunt, Jennifer L Collinger, Jorge A Gonzalez-Martinez","doi":"10.3171/2024.7.JNS241296","DOIUrl":"10.3171/2024.7.JNS241296","url":null,"abstract":"<p><p>Precise anatomical implantation of a microelectrode array is fundamental for successful brain-computer interface (BCI) surgery, ensuring high-quality, robust signal communication between the brain and the computer interface. Robotic neurosurgery can contribute to this goal, but its application in BCI surgery has been underexplored. Here, the authors present a novel robot-assisted surgical technique to implant rigid intracortical microelectrode arrays for the BCI. Using this technique, the authors performed surgery in a 31-year-old male with tetraplegia due to a traumatic C4 spinal cord injury that occurred a decade earlier. Each of the arrays was embedded into the parenchyma with a single insertion without complication. Postoperative imaging verified that the devices were placed as intended. With the motor cortex arrays, the participant successfully accomplished 2D control of a virtual arm and hand, with a success rate of 20 of 20 attempts, and recording quality was maintained at 100 and 200 days postimplantation. Intracortical microstimulation of the somatosensory cortex arrays elicited sensations in the fingers and palm. A robotic neurosurgery technique was successfully translated into BCI device implantation as part of an early feasibility trial with the long-term goal of restoring upper-limb function. The technique was demonstrated to be accurate and subsequently contributed to high-quality signal communication.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local control and patient survival after stereotactic radiosurgery for esophageal cancer brain metastases: an international multicenter analysis.","authors":"Othman Bin-Alamer, Hussam Abou-Al-Shaar, Raj Singh, Greg Bowden, David Mathieu, Haley K Perlow, Joshua D Palmer, Shahed Elhamdani, Matthew Shepard, Yun Liang, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdel Karim, Amr M N El-Shehaby, Reem Emad Eldin, Ahmed Hesham Elazzazi, Ronald E Warnick, Yair M Gozal, Megan Daly, Brendan McShane, Marcel Addis-Jackson, Gokul Karthikeyan, Sian Smith, Piero Picozzi, Andrea Franzini, Tehila Kaisman-Elbaz, Huai-Che Yang, Judith Hess, Kelsey Templeton, Zhishuo Wei, Stylianos Pikis, Georgios Mantziaris, Gabriela Simonova, Roman Liscak, Selcuk Peker, Yavuz Samanci, Veronica Chiang, Cheng-Chia Lee, Daniel M Trifiletti, Ajay Niranjan, L Dade Lunsford, Jason P Sheehan","doi":"10.3171/2024.7.JNS24920","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24920","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate local control (LC) of tumors, patient overall survival (OS), and the safety of stereotactic radiosurgery (SRS) for esophageal cancer brain metastases (EBMs).</p><p><strong>Methods: </strong>This retrospective cohort study used data from 15 International Radiosurgery Research Foundation facilities encompassing 67 patients with 185 EBMs managed using SRS between January 2000 and May 2022. The median patient age was 63 years, with a male predominance (92.5%). Most patients (64.2%) had a single brain metastasis, while 7.5% had more than 5 metastases. The median tumor volume was 0.9 cm3, and the median margin dose delivered to the tumor was 20 Gy.</p><p><strong>Results: </strong>The median OS post-SRS was 15.2 months, with 1- and 2-year OS rates of 65.7% and 32.3%, respectively. A significant inverse correlation was found between the number of EBMs and OS in the univariable analysis. LC rates at 1 and 2 years were 89% and 76%, respectively. Adverse radiation effects (AREs) were observed in 17.9% of patients, with 13.4% being mild and transient and 4.5% severely symptomatic (Common Terminology Criteria for Adverse Events grade 3). New intracranial disease developed in 58.2% of patients, with 1- and 2-year rates of 58% and 73%, respectively.</p><p><strong>Conclusions: </strong>SRS for EBMs demonstrated high survival rates and effective tumor control, with a low incidence of severe AREs. These findings highlight the potential role of SRS in the multidisciplinary multimodality management paradigm of EBM.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of the optimal thresholds for the hypoperfusion intensity ratio in moyamoya disease.","authors":"Liuxian Wang, Dongshan Han, Ming Liao, Jing Zha, Lei Li, Huagang Fan, Wenfeng Wei, Xiaoqian Ji, Anming Xie","doi":"10.3171/2024.9.JNS241300","DOIUrl":"https://doi.org/10.3171/2024.9.JNS241300","url":null,"abstract":"<p><strong>Objective: </strong>The authors' objective was to retrospectively compare two methods for defining the hypoperfusion intensity ratio (HIR) in moyamoya disease (MMD) by using hypoperfused volumes calculated from time to maximum of the residue function (Tmax) thresholds of 10 seconds/4 seconds and 10 seconds/6 seconds.</p><p><strong>Methods: </strong>All hemispheres were categorized into normal, ischemic, and hemorrhagic groups. Hypoperfused volumes were calculated using Tmax thresholds of 10 seconds, 6 seconds, and 4 seconds. HIR was computed as Tmax > 10 seconds/Tmax > 4 seconds (HIR10/4) and Tmax > 10 seconds/Tmax > 6 seconds (HIR10/6). Angiographic collaterals were assessed using CT perfusion (CTP)-sourced images (CTP-sis). The 3-month clinical follow-up included primary outcomes (survival or death) and secondary outcomes (modified Rankin Scale [mRS] and Katz activities of daily living [ADL] scale scores). Multivariate logistic regression and correlation analyses were conducted.</p><p><strong>Results: </strong>Thirty patients (54 hemispheres) were included. Patients with poor primary outcomes exhibited higher rates of hypertension (p = 0.015), larger hypoperfused volumes, and elevated HIR10/4 and HIR10/6 (p < 0.001). The regression model with HIR10/4 outperformed that with HIR10/6 for predicting primary outcomes (Z = 2.02, p = 0.044). Both HIR10/4 and HIR10/6 correlated with mRS and ADL scores (p < 0.05). Although there was no correlation between HIR and CTP-sis when all hemispheres were included, a significant association was found between HIR10/4 and CTP-sis when hemispheres with hemorrhagic lesions were excluded (p = 0.013).</p><p><strong>Conclusions: </strong>HIR10/4 exhibited a superior predictive value for primary outcomes in MMD compared to HIR10/6. Additionally, HIR10/4 showed a significant association with angiographic collaterals, particularly in ischemic MMD cases. This study suggested that HIR defined as Tmax > 10 seconds/Tmax > 4 seconds may be more suitable than Tmax > 10 seconds/Tmax > 6 seconds in MMD.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. Mapping and monitoring: considerations on optimizing neurophysiological monitoring parameters.","authors":"Giuseppe Maria Della Pepa, Michele Di Domenico, Salvatore Marino","doi":"10.3171/2024.8.JNS242032","DOIUrl":"https://doi.org/10.3171/2024.8.JNS242032","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser interstitial thermal therapy for cavernous malformations: a meta-analysis of individual patient-level data.","authors":"Adrian E Jimenez, Elias G Geist, E Sander Connolly, Guy M McKhann, Brett E Youngerman","doi":"10.3171/2024.7.JNS241003","DOIUrl":"https://doi.org/10.3171/2024.7.JNS241003","url":null,"abstract":"<p><strong>Objective: </strong>Several case series have investigated the use of laser interstitial thermal therapy (LITT) to treat cavernous malformations (CMs), for either seizure control or reduction of neurological symptoms and future hemorrhage risk. However, pooled outcomes are largely unknown. The authors aimed to quantify posttreatment seizure freedom, symptomatic progression or hemorrhage, perioperative complications, and imaging outcomes from the available literature.</p><p><strong>Methods: </strong>This study was a PRISMA-compliant systematic review and individual patient-level data meta-analysis of studies reporting LITT ablation of CMs. For patients with epilepsy, the pooled Engel seizure freedom rate was calculated. The rate of symptomatic progression or hemorrhage was calculated for all patients. Fixed-effects logistic regression models were used to test for predictors of seizure freedom and postoperative complications. Linear regression models were used to obtain pooled estimates of the percent CM volume ablated.</p><p><strong>Results: </strong>A total of 39 patients (28 with epilepsy) underwent LITT for the treatment of 45 CMs (37 cortical, 8 subcortical) at six centers. Among patients with epilepsy, 88.0% (95% CI 68.7%-96.1%) were seizure free at the last follow-up (median 30.0 months, range 12.0-49.0 months). Six patients (15.4%) experienced immediate postoperative neurological deficits. No perioperative hemorrhage was reported, and no patients experienced subsequent hemorrhage or symptomatic progression during follow-up (median 26.0 months, range 2.0-53.0 months). There was no difference in the odds of seizure freedom or adverse events based on preoperative characteristics. Nonepileptogenic CMs (mean volume 2.5 cm3) were significantly larger than epileptogenic CMs (mean volume 0.8 cm3; p = 0.002). LITT was associated with a mean CM volume reduction of 73.7% (95% CI 64.1%-83.2%, p < 0.0001) for epileptogenic CMs and 53.8% (95% CI 14.2%-93.3%, p < 0.023) for nonepileptogenic CMs (p = 0.14).</p><p><strong>Conclusions: </strong>LITT is a promising therapy for CMs with the goal of seizure control or prevention of symptomatic progression or hemorrhage. While there is a notable risk of immediate postablation neurological deficit, most were transient and nondisabling, and this risk must be weighed against that of continued observation or open resection. Considering the limited number of studies, small number of patients, and limited follow-up time available, additional experience and research with larger patient cohorts and longer-term follow-up will be necessary to validate these findings.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum. Inhibition of motility by NEO100 through the calpain-1/RhoA pathway.","authors":"Thomas C Chen, Nagore I Marín-Ramos","doi":"10.3171/2024.10.JNS19798aa","DOIUrl":"https://doi.org/10.3171/2024.10.JNS19798aa","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct brain network structure of mesial temporal lobe epilepsy compared to that of neocortical epilepsy: functional MRI study with surgically treated patients.","authors":"Hiroki Nishibayashi, Yasuo Nakai, Tomohiro Donishi, Naoyuki Nakao, Yoshiki Kaneoke","doi":"10.3171/2024.7.JNS24407","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24407","url":null,"abstract":"<p><strong>Objective: </strong>Mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy (NE) have different anatomo-clinical characteristics. The authors hypothesized that this may be reflected in the different functional connectivity of the epileptogenic zone between mTLE and NE. The authors, therefore, examined preoperative resting-state functional connectivity MRI with regional global connectivity (rGC) analysis for surgically treated patients. The goal of this study was to detect the different functional networks associated with the epileptogenic zone between mTLE and NE.</p><p><strong>Methods: </strong>Twenty-four patients (12 with mTLE and 12 with NE) who underwent surgery were included in the study. All patients received resting-state functional MRI preoperatively. The mean rGC and number of high-rGC or low-rGC voxels were calculated using preoperative MRI in various regions of interest including the resected area.</p><p><strong>Results: </strong>The ratio of mean rGC in the resected area to that of the whole brain was significantly lower in mTLE patients than in NE patients. Mean rGC was significantly lower than that of the contralateral counterpart of the resected area in mTLE patients, although it was not significantly different in NE patients. Low rGC was more frequently observed in the resected area in mTLE patients than NE patients, and high rGC more frequently observed in NE than mTLE. Multivariate analysis showed that the etiology of hippocampal sclerosis, the ratio of mean rGC in the resected area to that in the whole brain, and the ratio of the number of low- and high-rGC voxels relative to the whole brain were significant factors to distinguish mTLE from NE.</p><p><strong>Conclusions: </strong>The authors revealed a distinct brain network structure between mTLE and NE based on rGC analysis with resting-state functional MRI. The authors' unique functional connectivity analysis may be helpful for providing landmarks for lateralization or epileptogenic zones in mTLE and NE.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of high-definition fiber tractography for preoperative evaluation and surgical planning of brainstem cavernous malformation: long-term outcomes.","authors":"David T Fernandes Cabral, Georgios A Zenonos, Jessica Barrios-Martinez, Gabrielle R Bonhomme, Fang-Cheng Yeh, Juan C Fernandez-Miranda, Robert M Friedlander","doi":"10.3171/2024.7.JNS24454","DOIUrl":"https://doi.org/10.3171/2024.7.JNS24454","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe the role and long-term outcomes of high-definition fiber tractography (HDFT) in the surgical management of brainstem cavernomas.</p><p><strong>Methods: </strong>The authors performed a retrospective evaluation of their database at the HDFT laboratory in a single academic institution.</p><p><strong>Results: </strong>The authors identified 11 patients with brainstem cavernomas who had HDFT for preoperative workup and underwent microsurgical resection. The mean patient age was 39 years (range 20-76 years), and the mean follow-up was 75.2 months (range 37-149 months). Four cavernomas were located anterolaterally in the pons (2 right and 2 left), 2 were left pontomesencephalic, 1 was thalamomesencephalic, 1 was in the posterior midbrain (right superior colliculus), and 3 were in the posterior pontine/floor of the fourth ventricle. Gross-total resection was achieved in 8 patients (72.7%) and subtotal resection in 3 patients (27.3%). Although 5 patients (45.5%) experienced transient worsening of preoperative symptoms or new deficits, all fully improved within 3 months. None of the patients developed new permanent neurological deficit. Preoperative symptoms improved partially in 8 patients (72.7%) and completely in 3 patients (27.3%). There was one asymptomatic new hemorrhage, and another patient had a symptomatic hemorrhage with a recurrence of his presenting symptoms 15 months after his initial surgery. This patient underwent a re-resection of his residual cavernoma, with no improvement in his preoperative symptoms.</p><p><strong>Conclusions: </strong>HDFT provides critical anatomical information guiding an optimal surgical corridor and more importantly defining eloquent perilesional boundaries. In this preliminary experience, preoperative planning with HDFT appeared to decrease morbidity in patients who underwent microsurgical resection of their brainstem cavernoma.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NeurosurGen, Inc.: an academic ancestry database for neurosurgery.","authors":"Avi A Gajjar, Cargill H Alleyne","doi":"10.3171/2024.7.JNS232995","DOIUrl":"https://doi.org/10.3171/2024.7.JNS232995","url":null,"abstract":"<p><strong>Objective: </strong>The mission of NeurosurGen, Inc., is to compile and maintain genealogical data on every neurosurgeon in the US and, eventually, the world.</p><p><strong>Methods: </strong>NeurosurGen's data were compiled from professional organizations, the internet, and historical neurosurgery archives.</p><p><strong>Results: </strong>The NeurosurGen database (https://www.NeurosurGen.com/) meticulously records the lineage and demographic characteristics of over 8800 neurosurgeons, unveiling a pronounced male dominance at 92.96% and cataloging a rich ethnic tapestry with 3399 neurosurgeons identified as White, Asian, Black, and Hispanic. Harvey W. Cushing's monumental influence is evident, with his name recurring 426 times, anchoring the academic roots of many in the field. Data analysis underscores the pivotal role of institutions such as Brigham and Women's Hospital, Columbia University, Massachusetts General Hospital, Montral Neurological Institute, and Johns Hopkins University in molding neurosurgical leaders, reflecting their historical and contemporary impact on the discipline. Moreover, the project shines a light on the strides toward inclusivity within neurosurgical education, spotlighting institutions that stand out for their contributions to diversifying the field by training significant numbers of female, Asian, Black, and Hispanic neurosurgeons, marking a progressive shift toward a more inclusive neurosurgical community.</p><p><strong>Conclusions: </strong>NeurosurGen offers a myriad of benefits, including the preservation of the rich history of neurosurgery and the fostering of camaraderie among its practitioners.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-5"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor. The vectorial technique in skull base dissections.","authors":"Govind S Bhuskute, Jaskaran S Gosal, Mohammad Bilal Alsavaf, Moataz D Abouammo, Ricardo L Carrau, Daniel M Prevedello","doi":"10.3171/2024.8.JNS242067","DOIUrl":"10.3171/2024.8.JNS242067","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"599-601"},"PeriodicalIF":3.5,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}