The authors retrospectively identified stroke patients to develop a simple clinical risk index to help identify which stroke patients warrant transfer or further diagnostic imaging. Three clinical variables were identified that accurately predicted which patients had salvageable penumbra in a range of clinical scenarios and treatment cutoffs and would benefit from transfer. These hypothesis-generating findings warrant additional prospective study to determine whether this risk index can help mitigate health costs and determine patient eligibility for treatment requiring transfer to another hospital with capabilities for diagnostic CT and MR perfusion imaging.
The researchers evaluated the usefulness and applicability of available neurosurgical morbidity scoring scales in a large cohort of pediatric brain tumors from a single center; their results were favorably comparable to those in the literature. An improved tool to quantify morbidity from pediatric neurooncology is necessary to enable comparative surgical and unit data and reporting.
The objective of this work was to simplify the complex field of predictive models for the practicing neurosurgeon. The authors graded each model based on characteristics of the original study, in addition to its performance in subsequent validation studies. They found this to stratify existing models in a useful manner. The hope is that in addition to simplifying these models, the utility of prediction model score can push future model development to incorporate the most generalizable and statistically robust methodologies.
The aim of this study was to evaluate the prevalence of postconcussive symptoms and their relation to health-related quality of life in pediatric and adolescent patients with mild traumatic brain injury (mTBI) with an indication for head CT imaging. Postconcussive symptoms were present in up to one-third of the patients and were significantly associated with decreased health-related quality of life. The authors report a considerable prevalence of postconcussive symptoms in the rarely studied subgroup of young mTBI patients receiving head CT imaging.
Researchers investigated phase-amplitude coupling of fast activity modulated by slow waves on scalp electroencephalography to evaluate the strength of the modulation index before and after disconnection surgery in children with intractable nonlesional epileptic spasms. A decreased modulation index value due to surgery correlates with good seizure outcomes. The modulation index may indicate epileptogenic neuronal modulation of the interhemispheric corpus callosum and intrahemispheric subcortical network for epileptic spasms.
This study compared middle meningeal artery (MMA) embolization with conventional therapy for chronic subdural hematomas (cSDHs) using a propensity-adjusted analysis. Both surgery and conservative therapy were predictors of treatment failure when compared with MMA embolization. The study suggests that MMA embolization for cSDHs is associated with a lower risk of treatment failure compared with conventional therapy. MMA embolization may be effective in the treatment of both primary cSDHs and cases that recur after surgery.
In this conversation, Drs. Nidal Omar and Melissa Chambers (University of Alabama at Birmingham) and Dr. E. Antonio Chiocca (Brigham and Women’s Hospital) discuss Drs. Omar, Chambers, and colleagues' paper, "Safety and interim survival data after intracranial administration of M032, a genetically engineered oncolytic HSV-1 expressing IL-12, in pet dogs with sporadic gliomas” published in the February 2021 issue of Neurosurgical Focus. Moderated by Dr. Gelareh Zadeh (University of Toronto). With Drs. Aaron Cohen-Gadol (Associate Editor, Neurosurgical Focus) and William Couldwell (EIC, Neurosurgical Focus).
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AANS members enjoy a discount on annual subscriptions to the Journal of Neurosurgery. To find out more please visit the member subscriptions webpage:
AANS members enjoy a discount on annual subscriptions to the Journal of Neurosurgery. To find out more please visit the member subscriptions webpage: