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Toshikazu Kimura, Chikayuki Ochiai, Kensuke Kawai, Akio Morita, and Nobuhito Saito

A neurysmal subarachnoid hemorrhage (aSAH) continues to be associated with high morbidity and death despite the refinement of treatment modalities. Rupture rates and risk factors associated with bleeding from unruptured cerebral aneurysms (UCAs) have been reported in many retrospective and several prospective studies using Kaplan-Meier curves and Cox proportional-hazards analyses. 2–5 , 7–10 , 12 , 13 , 16 , 19–23 , 25 , 26 However, Kaplan-Meier survival analysis is known to be less informative in the presence of competing risks, 6 which should be discussed in

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Cyrus Elahi, Thiago Augusto Hernandes Rocha, Núbia Cristina da Silva, Francis M. Sakita, Ansbert Sweetbert Ndebea, Anthony Fuller, Michael M. Haglund, Blandina T. Mmbaga, João Ricardo Nickenig Vissoci, and Catherine A. Staton

, for severe TBI. 1 , 9 , 22 , 27 The causes of these mortality rates are multifactorial, including the prehospital and inpatient care settings. Although prehospital quality data in low-resource settings are scarce, the availability of quality inpatient TBI registries from LMICs invites exploration of in-hospital care for patients with TBI in SSA. 22 A survival analysis performed using a Cox regression model is a powerful statistical technique to quantify the association between a treatment and outcome for two groups. 5 For TBI, this technique has potential to

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Claudia L. Craven, Paul Gissen, Rebecca Bower, Laura Lee, Kristian Aquilina, and Dominic N. P. Thompson

longevity and survival of the VADs used in the BioMarin trial and examined the causes of device failure. We aim to use this information when counseling patients and their parents for surgery. Methods Study Design We performed a single-center survival analysis of VAD insertions and revisions conducted over a period of 5 years 6 months (January 2014 to June 2020). Patients Patients were included in this survival analysis if they received infusions of cerliponase alfa via an ICV reservoir. The infusions were administered every 2 weeks, and each infusion

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Sunil Kukreja, Sudheer Ambekar, Anthony Hunkyun Sin, and Anil Nanda

adjuvant RT), critical events (progression, recurrence, and death), time to critical events, and follow-up duration were included for the cumulative survival analysis. Case reports were excluded; however, an isolated patient from the case series whose age was ≤ 20 years was considered for inclusion. 32 In articles that described the outcomes in all age groups, patients in the first 2 decades of life were selected for the analysis. 1 , 2 , 7 , 13 , 17 , 19–21 , 26 , 32 Patients presenting with a history of previous surgery were not considered for inclusion. 7

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Victor M. Lu, Kyle P. O’Connor, Benjamin T. Himes, Desmond A. Brown, Cody L. Nesvick, Ruby G. Siada, Toba N. Niazi, Jonathan Schwartz, and David J. Daniels

depicting identification of all relevant cases from our institution and the literature for integrated survival analysis. Figure is available in color online only. Delivery Characteristics When reported, the median age of the mother at delivery was 31 years (range 15–43 years), with median gravidity and parity of 1.5 (range 1–4) and 0 (range 0–2), respectively. Prenatal hydrocephalus was reported in 8/20 (40%) patients. Delivery was by cesarean section in 13/24 (54%) cases, and by vaginal delivery in the remaining cases. The median Apgar scores at 1 and 5 minutes were 6

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Shelly Wang, Scellig Stone, Alexander G. Weil, Aria Fallah, Benjamin C. Warf, John Ragheb, Sanjiv Bhatia, and Abhaya V. Kulkarni

surgeon), and postoperative outcome were collected and assessed. ETV/CPC failure was defined as the need for a second definitive hydrocephalus surgery with either repeat endoscopic treatment or shunt placement. A crude analysis of the ETV/CPC treatment failure of these 2 cohorts was performed using logistic regression and Cox proportional hazards regression survival analysis, to account for variable follow-up durations. A commonly used survival analysis method, the Cox model assumes that the relative failure rate (i.e., hazard ratio [HR]) of ETV/CPC remains constant

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Claudia L. Craven

TO THE READERSHIP: An error appeared in the article by Craven et al. ( Craven CL, Gissen P, Bower R, et al. A survival analysis of ventricular access devices for delivery of cerliponase alfa. J Neurosurg Pediatr . 2022;29[1]:115-121 ). In the Results section of the abstract and text, the median number of punctures was incorrectly stated. The corrected sentence appears below. The median (interquartile range) number of punctures was 12.0 (7.5–82.0) for unrevised VADs (n = 17) versus 29.0 (6–87.5) for revised VADs (n = 9) (p = 0.70). The article

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Zoe E. Teton, Daniel Blatt, Amr AlBakry, James Obayashi, Gulsah Ozturk, Vural Hamzaoglu, Philippe Magown, Nathan R. Selden, Kim J. Burchiel, and Ahmed M. Raslan


Despite rapid development and expansion of neuromodulation technologies, knowledge about device and/or therapy durability remains limited. The aim of this study was to evaluate the long-term rate of hardware and therapeutic failure of implanted devices for several neuromodulation therapies.


The authors performed a retrospective analysis of patients’ device and therapy survival data (Kaplan-Meier survival analysis) for deep brain stimulation (DBS), vagus nerve stimulation (VNS), and spinal cord stimulation (SCS) at a single institution (years 1994–2015).


During the study period, 450 patients underwent DBS, 383 VNS, and 128 SCS. For DBS, the 5- and 10-year initial device survival was 87% and 73%, respectively, and therapy survival was 96% and 91%, respectively. For VNS, the 5- and 10-year initial device survival was 90% and 70%, respectively, and therapy survival was 99% and 97%, respectively. For SCS, the 5- and 10-year initial device survival was 50% and 34%, respectively, and therapy survival was 74% and 56%, respectively. The average initial device survival for DBS, VNS, and SCS was 14 years, 14 years, and 8 years while mean therapy survival was 18 years, 18 years, and 12.5 years, respectively.


The authors report, for the first time, comparative device and therapy survival rates out to 15 years for large cohorts of DBS, VNS, and SCS patients. Their results demonstrate higher device and therapy survival rates for DBS and VNS than for SCS. Hardware failures were more common among SCS patients, which may have played a role in the discontinuation of therapy. Higher therapy survival than device survival across all modalities indicates continued therapeutic benefit beyond initial device failures, which is important to emphasize when counseling patients.

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Richard D. Penn, Michelle M. York, and Judith A. Paice

critical to any analysis, survival curves provide the best way to view the performance of the catheter system. 7 The results in Fig. 2 provide a benchmark for any future catheter designs. As Fig. 3 clearly demonstrates, the “improved” design using a single catheter with an inner titanium coil was much worse, and this became obvious by 20 months. Future designs intended to increase longevity can similarly be compared to the reliability of the standard catheter (model 8703) by using survival analysis. The types of complications that were documented could have been

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Frederick L. Hitti, Ashwin G. Ramayya, Brendan J. McShane, Andrew I. Yang, Kerry A. Vaughan, and Gordon H. Baltuch

%) F Target 304 (95%) STN, 16 (5%) GPi Laterality 295 (92%) bilateral, 25 (8%) unilateral Mean ± SEM IPG longevity, yrs 3.7 ± 0.1 Values are number of patients (%) and means are presented ± SD unless otherwise indicated. Survival Analysis In a subset of patients who had at least 10 years of follow-up, we performed a Kaplan-Meier survival analysis ( Fig. 1 ). We found that 51% of patients survived through the follow-up interval. For patients who died during the follow-up interval, the mean age of death was 73 years. We performed multivariate regression analysis to