Journal of neurosurgery最新文献

{"title":"Erratum. Intracranial Aneurysms Managed by Parent Artery Reconstruction Using Tubridge Flow Diverter study: 1-year outcomes.","authors":"Jianmin Liu","doi":"10.3171/2024.8.JNS232116a","DOIUrl":"https://doi.org/10.3171/2024.8.JNS232116a","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":3.5,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289460","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: Can there be any unbled cerebral cavernous malformations?","authors":"Sandeep Mishra, Shakti Pratap Singh, Manjul Tripathi","doi":"10.3171/2024.7.JNS241551","DOIUrl":"https://doi.org/10.3171/2024.7.JNS241551","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143090","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 use of NSAIDs after adult craniotomy for tumor.","authors":"Yabin Liu, Xiaohua Jiang, Guowu Chen","doi":"10.3171/2024.6.JNS241170","DOIUrl":"https://doi.org/10.3171/2024.6.JNS241170","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143091","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":"Prediction of contralateral progression in patients with bilateral nonhemorrhagic moyamoya disease following unilateral revascularization surgery.","authors":"Chang Hwan Pang, Sang Hyo Lee, Tae Won Choi, Hyoung Soo Byoun, Young-Deok Kim, Seung Pil Ban, Jae Seung Bang, O-Ki Kwon, Chang Wan Oh, Si Un Lee","doi":"10.3171/2024.5.JNS2411","DOIUrl":"https://doi.org/10.3171/2024.5.JNS2411","url":null,"abstract":"<p><strong>Objective: </strong>This study was designed to identify predictive factors associated with substantial contralateral progression in adult patients with bilateral nonhemorrhagic moyamoya disease (MMD) who undergo revascularization surgery (RS) on one hemisphere.</p><p><strong>Methods: </strong>The authors retrospectively analyzed 174 contralateral hemispheres of patients with bilateral nonhemorrhagic MMD (non-hMMD) who underwent RS on one side. The primary endpoint was defined as substantial contralateral progression requiring additional RS 6 months after the initial RS. The annual risk and predictive factors for contralateral progression were also analyzed.</p><p><strong>Results: </strong>Of 174 patients included in the study, 57 (32.8%) experienced contralateral progression over a mean follow-up of 45.3 ± 31.6 months (range 12-196 months). The annual risk for contralateral progression after initial unilateral RS was 7.7% per person-year. Multivariable analysis revealed that age (HR 0.967, 95% CI 0.944-0.992; p = 0.009) and a BMI ≥ 25 (HR 1.946, 95% CI 1.126-3.362; p = 0.017) were significant predictors of contralateral progression. Specifically, the annual risk of contralateral progression was 12.1% in the higher BMI (≥ 25) group and 4.0% in the lower BMI (< 25) group per person-year.</p><p><strong>Conclusions: </strong>The study revealed a 7.7% per person-year rate of contralateral progression in patients with bilateral non-hMMD following unilateral RS. Younger age and a BMI ≥ 25 were identified as significant risk factors. For these patients, careful weight management and the use of antilipid agents may be crucial strategies for reducing the risk of contralateral progression after unilateral RS.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143093","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":"Novel application of latent class analysis to outcome assessment in traumatic brain injury with multiple injury subtypes or poly-TBI.","authors":"Samuel Doty, Jordan C Petitt, Ahmed Kashkoush, Benjamin B Whiting, Tianqi Xiao, John J Francis, Douglas Gunzler, Mary Joan Roach, Michael L Kelly","doi":"10.3171/2024.5.JNS232842","DOIUrl":"https://doi.org/10.3171/2024.5.JNS232842","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to stratify poly-traumatic brain injury (poly-TBI) patterns into discrete classes and to determine the association of these classes with mortality and withdrawal of life-sustaining treatment (WLST).</p><p><strong>Methods: </strong>The authors performed a single-center retrospective review of their institutional trauma registry from 2018 to 2020 to identify patients with traumatic brain injury (TBI). Patients were included if they had moderate to severe TBI, defined as Glasgow Coma Scale score ≤ 12 and Abbreviated Injury Scale (AIS) head score ≥ 3, and the presence of more than one TBI subtype. TBI subtypes were defined as subdural hemorrhage (SDH), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and epidural hemorrhage (EDH). Latent class analysis was used to identify patient classes based on TBI subtypes and Rotterdam CT (RCT) scores. The authors then evaluated class membership in relation to categorical outcomes of in-hospital mortality and WLST by using Lanza et al.'s method.</p><p><strong>Results: </strong>A total of 125 patients met inclusion criteria for poly-TBI. Latent class analysis yielded 3 poly-TBI classes: class 1-mixed; class 2-SDH/SAH; and class 3-EDH/SAH. Class 1-mixed had a higher likelihood of SDH, SAH, and ICH, and a lower likelihood of EDH. Class 2-SDH/SAH had a higher likelihood of only SDH and SAH. Class 3-EDH/SAH had a higher likelihood of EDH and SAH, and a lower likelihood of SDH and ICH. Class 1-mixed was relatively more likely to have an RCT score of 2. Class 2-SDH/SAH was relatively more likely to have an RCT score of 2, 3, and 4. Class 3-EDH/SAH had a higher likelihood of an RCT score of 3, 4, and 5. Class 1-mixed had significantly lower mortality (χ2 = 7.968; p = 0.005) and less WLST (χ2 = 4.618; p = 0.032) than Class 2-SDH/SAH. Class 2-SDH/SAH had the highest probability of death (0.612), followed by class 3-EDH/SAH (0.385) and class 1-mixed (0.277). Similarly, class 2-SDH/SAH had the highest WLST probability (0.498), followed by class 3-EDH/SAH (0.615) and class 1-mixed (0.238).</p><p><strong>Conclusions: </strong>Distinct poly-TBI classes were associated with increased in-hospital mortality and WLST. Further research with larger datasets will allow for more comprehensive poly-TBI class definitions and outcomes analysis.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-8"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143092","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":"Academic productivity and career trajectory of international medical graduates in US neurosurgery residency programs.","authors":"M Maher Hulou, Muhammed Amir Essibayi, Christopher Ala Samaan, Annabel M McAtee, Christopher J McLouth, Humberto José Madriñán-Navia, Dimitri Benner, Marian T Park, Jacob T Howshar, Farhan A Mirza, Christopher S Graffeo, Michael T Lawton","doi":"10.3171/2024.4.JNS232885","DOIUrl":"https://doi.org/10.3171/2024.4.JNS232885","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to review and compare the research experiences and career outcomes of international medical graduates (IMGs) with those of US medical graduates (USMGs).</p><p><strong>Methods: </strong>Neurosurgery graduates from 2018 to 2020 were evaluated on the basis of medical school, degree, residency program, publications before and during residency, postresidency fellowships, and career progression. Publications were further categorized by author order and type (laboratory, comprehensive clinical, or short communication).</p><p><strong>Results: </strong>Of 550 neurosurgery graduates, 39 (7%) were IMGs, with the largest percentages from India (8/39, 21%) and in a residency position in Pennsylvania (5/39, 13%). Prior to residency, IMGs had a higher median number of all publications (4 vs 1, p < 0.001), first-author articles (2 vs 0, p < 0.001), comprehensive clinical articles (1 vs 0, p = 0.002), and short communication articles (1 vs 0, p < 0.001) than USMGs. Similarly, the median number of papers published by IMGs during residency was also higher compared with that of USMGs for all publications (20 vs 9, p = 0.004), laboratory articles (1 vs 0, p < 0.001), and short communication articles (4 vs 3, p = 0.04). The percentage of early academic appointments was higher for IMGs (25/39, 64%) than for USMGs (232/511, 45%) (p = 0.03). No significant difference was observed between the percentages of postresidency clinical fellowships completed by IMGs (28/39, 72%) and USMGs (302/511, 59%) (p = 0.15). No statistical significance was found between the ranking of neurosurgery residency programs attended by IMGs and USMGs (p = 0.65).</p><p><strong>Conclusions: </strong>The results indicate that IMGs often exhibit higher academic productivity than USMGs. Although there was no discernible difference in residency program rankings or postresidency fellowships completed, early academic appointments were more prevalent among IMGs.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143088","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. Confocal laser endomicroscopy of fluorescein uptake in the brain tumor microenvironment.","authors":"Thomas J On, Yuan Xu, Irakliy Abramov, Oscar Alcantar-Garibay, Mark C Preul","doi":"10.3171/2024.5.JNS24967","DOIUrl":"https://doi.org/10.3171/2024.5.JNS24967","url":null,"abstract":"","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-2"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143089","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":"A taxonomy for cerebellar cavernous malformations: subtypes of cerebellar lesions.","authors":"Lea Scherschinski, Adam T Eberle, Satvir Saggi, Kate N Jensen, Ramin A Morshed, Ethan A Winkler, Joshua S Catapano, Christopher S Graffeo, Danielle VanBrabant, Peter M Lawrence, Michael T Lawton","doi":"10.3171/2024.4.JNS24448","DOIUrl":"https://doi.org/10.3171/2024.4.JNS24448","url":null,"abstract":"<p><strong>Objective: </strong>An anatomical taxonomy has been established to guide surgical approach selection for resecting brainstem and deep and superficial cerebral cavernous malformations (CMs). The authors propose a novel taxonomy for cerebellar CMs, introduce 6 distinct neuroanatomical subtypes, and assess their clinical outcomes.</p><p><strong>Methods: </strong>This bi-institutional, 2-surgeon cohort study included 143 cerebellar CMs that were microsurgically treated over a 25-year period. The proposed taxonomy classifies cerebellar CMs into 6 subtypes on the basis of anatomical location as identified on preoperative MR imaging. Neurological outcomes were assessed using the modified Rankin Scale (mRS), and outcomes were compared among the subtypes, with favorable outcomes defined as mRS scores ≤ 2.</p><p><strong>Results: </strong>A total of 143 cerebellar CMs were resected in 140 patients. The mean (SD) age was 42.3 (15.2) years; 86 (60%) of the cerebellar CMs were in women, and 57 (40%) were in men. Cerebellar subtypes were suboccipital (17%, 25/143); tentorial (9%, 13/143); petrosal (43%, 62/143); vermian (13%, 18/143); tonsillar (2%, 3/143); and deep nuclear (15%, 22/143). Overall, 78 of 143 (55%) cerebellar CMs presenting to a cerebellar surface were resected without tissue transgression, and the remaining CMs (65/143, 45%) required translobular or transsulcal approaches. Complete resection was achieved in 134 of 143 cases (94%). Favorable outcomes were achieved in 91% (129/141) of cases with follow-up at a mean (SD) follow-up duration of 37.4 (53.8) months. Relative outcomes were unchanged or improved relative to the preoperative baseline in 93% (131/141) of cases with follow-up, without differences between subtypes.</p><p><strong>Conclusions: </strong>Most cerebellar CMs are convexity lesions that do not require deep dissection. However, transsulcal and fissural approaches are used for those beneath the cerebellar surface to minimize tissue transgression and preserve associated function. Complete resection without any new deficit is accomplished in most patients. The proposed taxonomy for cerebellar CMs (suboccipital, tentorial, petrosal, vermian, tonsillar, and deep nuclear) guides the selection of craniotomy and approach to enhance patient safety and optimize neurological outcomes.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-14"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143087","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":"Functional mapping of movement and speech using task-based electrophysiological changes in stereoelectroencephalography.","authors":"Michael A Jensen, Anthony Fine, Panagiotis Kerezoudis, Lily Wong-Kisiel, Eva C Alden, Dora Hermes, Kai J Miller","doi":"10.3171/2024.5.JNS24434","DOIUrl":"10.3171/2024.5.JNS24434","url":null,"abstract":"<p><strong>Objective: </strong>Stereoelectroencephalography (SEEG) has become the predominant method for intracranial seizure localization. When imaging, semiology, and scalp EEG findings are not in full agreement or definitively localizing, implanted SEEG recordings are used to test candidate seizure onset zones (SOZs). Discovered SOZs may then be targeted for resection, laser ablation, or neurostimulation. If an SOZ is eloquent, resection and ablation are both contraindicated, so identifying functional representation is crucial for therapeutic decision-making. The authors present a novel functional brain mapping technique that utilizes task-based electrophysiological changes in SEEG during behavioral tasks and test this in pediatric and adult patients.</p><p><strong>Methods: </strong>SEEG was recorded in 20 patients with epilepsy who ranged in age from 6 to 39 years (12 female, 18 of 20 patients < 21 years of age) and underwent implanted monitoring to identify seizure onset. Each performed 1) visually cued simple repetitive movements of the hand, foot, or tongue while electromyography was recorded; and 2) simple picture-naming or verb-generation speech tasks while audio was recorded. Broadband changes in the power spectrum of the SEEG recording were compared between behavior and rest.</p><p><strong>Results: </strong>Electrophysiological functional mapping of movement and/or speech areas was completed in all 20 patients. Eloquent representation was identified in both cortex and white matter and generally corresponded to classically described functional anatomical organization as well as other clinical mapping results. Robust maps of brain activity were identified in healthy brain, regions of developmental or acquired structural abnormality, and SOZs.</p><p><strong>Conclusions: </strong>Task-based electrophysiological mapping using broadband changes in the SEEG signal reliably identifies movement and speech representation in pediatric and adult epilepsy patients.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-13"},"PeriodicalIF":3.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108254","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":"Efficacy of high-resolution vessel wall MRI in the postoperative assessment of intracranial aneurysms following flow diversion treatment.","authors":"So Matsukawa, Akira Ishii, Yasutaka Fushimi, John Grinstead, Sinyeob Ahn, Takayuki Kikuchi, Hiroki Yamada, Masakazu Okawa, Yukihiro Yamao, Yu Abekura, Natsuhi Sasaki, Hirofumi Tsuji, Ryo Akiyama, Yoshiki Arakawa","doi":"10.3171/2024.5.JNS24174","DOIUrl":"https://doi.org/10.3171/2024.5.JNS24174","url":null,"abstract":"<p><strong>Objective: </strong>Certain patients must undergo frequent postoperative digital subtraction angiography (DSA) after flow diversion (FD) therapy. No imaging modality with an efficacy comparable to that of DSA has been established. This study was conducted to determine the efficacy of contrast-enhanced delay alternating with nutation for tailored excitation (DANTE) T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE), a high-resolution vessel wall magnetic resonance imaging technique for evaluating the occlusion status of intracranial aneurysms after FD treatment, with DSA serving as the reference standard.</p><p><strong>Methods: </strong>This retrospective study included 23 patients with 26 aneurysms who had undergone FD treatment between April 2016 and May 2022. Contrast-enhanced DANTE T1-SPACE and DSA were performed as postoperative follow-up imaging studies at 45 time points, both in the same period. The agreement rates for aneurysm occlusion status in the 45 imaging studies were examined.</p><p><strong>Results: </strong>Contrast-enhanced DANTE T1-SPACE had a sensitivity and specificity of 96.3% (26/27) and 83.3% (15/18), respectively, for detecting aneurysm remnants. Overall, 91.1% (41/45) of findings detected on contrast-enhanced DANTE T1-SPACE were consistent with those on DSA. The findings detected on contrast-enhanced DANTE T1-SPACE were completely consistent with those of intraaneurysmal residual blood flow identified on DSA or high-resolution cone-beam computed tomography images in 74.1% (20/27) of the examinations that showed incomplete occlusion on DSA. Furthermore, parent artery status after FD treatment on contrast-enhanced DANTE T1-SPACE was consistent with that observed on DSA in 97.8% (44/45) of examinations.</p><p><strong>Conclusions: </strong>Contrast-enhanced DANTE T1-SPACE is a very useful option in the follow-up of aneurysms after FD treatment.</p>","PeriodicalId":16505,"journal":{"name":"Journal of neurosurgery","volume":" ","pages":"1-10"},"PeriodicalIF":3.5,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108253","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}