Publish Before Print
in Journal of Neurosurgery
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In Brief
The motor root of the trigeminal nerve runs close to the sensory root and receives considerable radiation during Gamma Knife radiosurgery (GKRS) for trigeminal neuralgia (TN). The study objective was to evaluate the changes in the muscles of mastication before and after upfront GKRS in patients with idiopathic TN by using MRI. A subset of patients with TN with significant pain on chewing have pre-GKRS disuse atrophy of the muscles of mastication. A reversal of the atrophy occurs in a majority of the patients following GKRS. New-onset motor neuropathy post-GKRS was rare. The study reveals some interesting changes that occur in the muscles of mastication in trigeminal neuralgia.
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In Brief
In this work the authors present Frazier's contributions to the treatment of craniopharyngiomas (a true accomplishment), and a comprehensive review of Frazier's complete craniopharyngioma series, which he never published.
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In Brief
The authors reviewed the early postmarket results, including outcomes, technical nuances, and challenges, of the PulseRider device for treatment of wide-necked intracranial aneurysms. This study furthers the knowledge and collective experience with the new PulseRider as it takes its place in the armamentarium of treatments for wide-necked bifurcation aneurysms.
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In Brief
The authors report for the first time a single-institution validation of the Brain Injury Guidelines. Implementation of care protocol improvements in neurotrauma offers the possibility of both improved care and resource savings in trauma systems.
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In Brief
The authors compared academic rank achievement in men versus women neurosurgeons after controlling for their institution, number of years in practice, and number of publications. It was found that men were twice as likely as women to achieve the highest academic rank, full professor, after controlling for years in practice and institution. This trend was near significant when controlling for years in practice, institution, and number of publications.
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In Brief
The authors analyzed data from 114 patients with a posterior fossa arteriovenous malformation and identified a predictor of bad outcome after endovascular treatment that has never been described before.
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In Brief
This study compares two different approaches to the upper third of the retroclival area: the open pretemporal transcavernous approach and the endoscopic endonasal transcavernous approach. This is the first study to directly compare these approaches and objectively outline the anatomical boundaries of each approach using actual data obtained from human cadaveric specimens.
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In Brief
This study used MRA to evaluate the quantitative changes in the calibers of donor arteries associated with combined direct and indirect bypass procedures in adults and children with moyamoya disease. The study is important because caliber changes in the donor arteries can be easily measured by MRA and could be used as indicators of direct and indirect bypass development.
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In Brief
The authors advocate a novel operative method for Rathke’s cleft cyst to prevent recurrences, and they evaluate the outcomes with comparison between this new method and a conventional method. This method is a safe, simple, and effective way to reduce recurrences, therefore it should be widely recognized for readers.
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In Brief
The infratemporal fossa (ITF) and parapharyngeal space are anatomical regions that can be challenging to access without the use of complex, cosmetically disfiguring approaches. With advances in endoscopic techniques, a new group of surgical approaches to access the intracranial space through the orbit has been recently referred to as transorbital neuroendoscopic surgery. The objective of this study was to establish a transorbital endoscopic approach utilizing the inferior orbital fissure to gain access to the ITF and parapharyngeal space and provide a detailed endoscopic anatomical description of this approach.
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In Brief
Researchers analyzed clinical outcomes of 142 patients undergoing treatment of unruptured brain arteriovenous malformations. Contrary to the only randomized clinical trial (ARUBA), they found that treatment at a center with a high level of expertise yields good clinical outcomes, with key safety endpoints (stroke, death, and disability) better than ARUBA. Compared to natural history studies, results were favorable at follow-up times of 5–10 years. These findings support current arteriovenous malformation registry studies and future randomized controlled trials.
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In Brief
This study is the first to report the difference in plasma soluble receptor for advanced glycation end products (sRAGE) levels in a subset of patients with subarachnoid hemorrhage (SAH). The results show that the plasma sRAGE levels could be used as a potential biomarker for the prediction of symptomatic vasospasm after SAH.
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In Brief
This historical vignette recounts the first 100 years of the Department of Neurosurgery at Virginia Commonwealth University, which is important because it was the first Neurosurgery Department in the Southeast and home to one of the first four residency programs; prominent graduates include Frank Mayfield and Gayle Crutchfield.
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In Brief
This study is the first to report the difference in plasma soluble receptor for advanced glycation end products (sRAGE) levels in a subset of patients with subarachnoid hemorrhage (SAH). The results show that the plasma sRAGE levels could be used as a potential biomarker for the prediction of symptomatic vasospasm after SAH.
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In Brief
To date, no human studies have correlated the effect of aspirin on intracranial aneurysm (IA) growth. This paper describes a 10-year retrospective analysis of patients who harbored multiple IAs, had the primary aneurysm treated by surgical or endovascular means, and had remaining aneurysms observed over a follow-up period of at least 5 years after the initial treatment. The authors’ results suggest that, in patients with multiple IAs ≤ 5 mm, aspirin use significantly decreases the risk of aneurysm growth.
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In Brief
In this study, the authors aimed to evaluate the role of extent of surgical resection in diffuse low-grade gliomas (LGGs), in light of the latest WHO molecular classification. The study results highlight differences in the effects of surgery across the 3 prognostically diverse LGG subgroups, oligodendrogliomas, IDH-mutant astrocytomas, and IDH-wildtype astrocytomas, and can thus help guide surgical decision making.
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In Brief
This study investigates the correlations between molecular subgroup and clinical features in a large cohort of meningiomas. The authors identify previously undescribed relationships with age, histology, sex, precise location, volume, and Ki-67 index, and confirm earlier associations with location, histology, grade, and volume. These findings suggest that noninvasive patient features carry predictive value for the underlying driver event.
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In Brief
The authors evaluated the extent of resection and postsurgical outcomes in epilepsy patients with ulegyria who underwent intracranial electroencephalography (iEEG) monitoring prior to resection to clarify the efficacy of iEEG-guided partial resection of ulegyria.
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In Brief
The authors conducted a nationwide survey of neurosurgical residency program directors, with 93% completion rate, in order to establish the current role of evidence-based medicine curricula in neurosurgical residency training and education. These data can help program directors improve evidence-based medicine curricula at their institutions.
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In Brief
The authors report a cohort study assessing for the first time the risk of ICA stenosis/occlusion after stereotactic radiosurgery (SRS) for benign parasellar neoplasms. Based on the study results, the incidence of ICA stenosis/occlusion appears to be higher than previously assumed; however, the risk of ensuing clinical symptoms is very low. These findings will helpfully inform provider education and patient counseling, particularly regarding the favorable risk-benefit profile of observation when post-SRS ICA stenosis/occlusion is encountered clinically.
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In Brief
The authors assessed whether atypical neurofibromas in patients with neurofibromatosis type 1 can be successfully resected around the tumor capsule with minimal to no injury to the patients. This study is important because it presents a surgical technique that may be more effective than the standard partial resection approach in preventing tumor recurrence.
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In Brief
In this study, the authors found that lipopolysaccharide-binding protein (LBP) could be detected not only in glioma tissue but also in blood serum of F98 glioma-bearing rats; that OKN-007 decreased the levels of LBP; that LBP levels are highly expressed in human high-grade glioma tissues; and that LBP could potentially be used as a serum diagnostic marker of treatment response in high-grade gliomas.
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In Brief
In acute neurosurgical cases, a large part of the cranium may be removed to lower intracranial pressure (ICP) and save the patient’s life. Because the large cranial defect resulting from the treatment might affect brain functioning through altered ICP and intracranial fluid movements, the removed bone is usually re-implanted in a subsequent procedure (cranioplasty). The authors used wireless ICP sensor technology to study ICP before and after cranioplasty and provide new data to aid understanding of intracranial physiology.
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In Brief
The authors performed kinomic analysis with a spatial heterogeneity approach in glioblastoma (GBM), demonstrating elevated tumor core expression of Bruton’s tyrosine kinase (BTK). Genetic and pharmacological inhibition of BTK was determined to suppress GBM core-like and core-derived neurosphere survival. The identification of potential therapeutic benefit via the application of this spatial heterogeneity model carries implications of interest toward the development of therapeutics targeting the classically therapy-resistant core cell population in GBM.
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In Brief
The authors investigated the suitability of an endonasally harvested longus capitis muscle graft as a patch to control bleeding from injury to the internal carotid artery (ICA), the most critical situation in endoscopic endonasal surgery (EES) of the skull base. Obtaining muscle graft tissue has typically required access to another surgical site, but this study demonstrates that in the stressful event of an ICA injury, a nasopharyngeal muscle graft can be easily and quickly harvested during EES without the need to remove the endoscope, change instruments, or expose an additional operative site.
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In Brief
This work reports a new, purely surgical cerebral hyperperfusion animal model. Such a model is ideal to study hyperperfusion pathology and to develop therapies, in contrast to the currently available models that include pharmacological induction.
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In Brief
The authors retrospectively analyzed the risk factors and outcomes of postoperative hemorrhage after direct or combined bypass in patients with moyamoya disease, which provided a basis for the clinical treatment of these patients.
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In Brief
In the present study the authors used 7-T structural MRI to perform a retinotopic investigation of the primary visual cortex in patients with pituitary adenoma. The authors provide compelling evidence of localized cortical thinning in regions of the primary visual cortex that correspond with areas of vision loss in the visual field.
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In Brief
The authors studied the risk of rupture and growth of 290 carotid cave aneurysms and found that there were no instances of rupture or growth over the follow-up period. This is important because there have not been any large studies of the natural history of carotid cave aneurysms in the literature.
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In Brief
The authors conducted a retrospective study to investigate whether 2-session Gamma Knife surgery (GKS), a new method, improves treatment outcomes for patients with symptomatic midsize brain metastases, as compared to 1-session GKS, a conventional method, and found that patients treated with 2-session GKS had more durable local tumor control and greater functional improvement. This study offers an important message to cancer patients and their relatives that there still remains room for further investigation to optimize treatment technique for difficult-to-treat brain metastases.
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In Brief
A literature review of old and new publications was performed. This was done to determine the efficacy of an underused neurosurgical treatment that may benefit patients with medically refractory obsessive-compulsive disorder.
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In Brief
The researchers used clinical MRI to explore the relation between the cause of moderate and severe traumatic brain injury (TBI) and the presence and grade of traumatic axonal injury (TAI). Although pedestrians hit by cars, car drivers or passengers, and alpine skiers had the highest prevalence and grade of TAI, TAI was also found after more low-energy injuries. These findings are important because they suggest that TAI should be considered after moderate or severe TBI, no matter the cause of injury, and also when CT images show cortical contusions or mass lesions.
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In Brief
Intraoperative MRI (iMRI)–guided lead placement in deep brain stimulation is a relatively new technique and there is limited literature on clinical outcomes. In this paper the authors present clinical outcomes after lead placement using iMRI guidance in primarily adult patients with dystonia. To their knowledge this is the largest cohort of patients with adult-onset dystonia undergoing iMRI-guided lead placement in the globus pallidus pars internus, particularly at a center other than where this technique was developed.
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In Brief
This study examines long-term outcome of transsphenoidal surgery in acromegalic patients with GH-secreting adenomas. The authors analyzed relevant clinical, biochemical, and radiological variables to identify predictive factors and propose a new clinical stratification that may help in the clinical management of these patients and inform current practice.
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In Brief
Quantitative susceptibility mapping–based images improve visualization of the globus pallidus internus, providing superior views compared with T1-weighted and T2-weighted images. These more useful images can be used to precisely and directly localize the globus pallidus internus targeting for deep brain stimulation surgery.
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In Brief
The present study identifies several risk factors for postoperative persistent seizure occurrence, enabling one to preoperatively select for a subpopulation of patients that requires special attention in clinical management. However, multivariate analysis revealed a high extent of tumor resection as the only surgically amenable predictor for a seizure-free favorable outcome.
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In Brief
The authors studied macrophage migration inhibitory factor (MIF) as a biomarker in relation to cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study is important because identification of a novel biomarker such as MIF may aid in the prediction of which patients with aSAH are vulnerable to developing vasospasm, cerebral ischemia, and neurological deterioration.
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