Volume 132: Issue 2 (Feb 2020): Pages 333-679
in Journal of NeurosurgeryImage from Ryu et al. (pp 442–455).
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In Brief
The authors conducted a subgroup analysis of the Japan Adult Moyamoya Trial focusing on the nonhemorrhagic hemisphere in hemorrhagic moyamoya disease and revealed the significance of choroidal collateral vessels as a risk factor for de novo hemorrhage.
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In Brief
This pilot study evaluated the effect of a medical agent, Dl-3-N-butylphthalide (NBP), on perioperative stroke and neurological deficits in patients with moyamoya disease (MMD). The results suggest that this novel medical therapy might reduce neurological deficits after revascularization surgery for MMD. These preliminary data should be helpful for designing future randomized controlled trials to improve preoperative management and alternative therapies for patients with MMD.
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In Brief
This analysis of angiographic occult aneurysms found during microsurgical dissection of another known aneurysm demonstrates the importance of meticulous inspection of common aneurysm sites within the surgical field. Simultaneous identification and treatment of these additional undiagnosed aneurysms can spare patients later rupture or reoperation, particularly in those with multiple known aneurysms and a history of subarachnoid hemorrhage. Although extra inspection might require more subarachnoid dissection, limited microsurgical exploration around a known aneurysm can be performed safely without causing additional morbidity.
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In Brief
The authors describe an adipose-derived mesenchymal stem cell sheet–based therapy that they expect to not only provide an indirect (paracrine) effect but also to have a direct cell effect (post-stroke tissue restoration) without the cell-trapping phenomenon regularly seen, and therefore they expect the technique to become a candidate cell replacement therapy to repair the damaged neurovascular unit.
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In Brief
A meta-analysis was performed to determine the incidence of de novo and recurrent aneurysms after neck clipping in order to guide patient follow-up.
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In Brief
The authors investigated the association between facility type (academic or non-academic) and volume (high vs low) and glioblastoma treatment outcomes using the National Cancer Database. The study shows a significant survival benefit for patients treated at academic centers and high-facilities and should be helpful in efforts to optimize quality of care.
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In Brief
The authors tested how a drug, lapatinib, affects patients with brain metastases from HER2-positive breast cancer. They concluded that when lapatinib is added to stereotactic radiosurgery, it improved the probability of controlling the disease where it was treated.
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In Brief
The authors compared survival and local CNS lesional control after stereotactic radiosurgery (SRS) in patients with non–small cell lung cancer brain metastases who had received either chemotherapy or immunotherapy. It is important to understand how immunotherapy changes outcomes in patients with brain metastases who undergo SRS treatment.
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In Brief
The authors investigated the utility of in vivo fluorescence guidance for increasing the diagnostic yield of stereotactic biopsies (STBs). Because STB for obtaining suspicious tissue from deep or eloquent brain regions fails to yield diagnostic tissue in some cases, this technique may improve patient care by ensuring tissue obtained during STB will be useful for generating a histopathological diagnosis.
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In Brief
This study assessed whether abnormalities in clotting and other types of blood tests in patients with severe traumatic brain injury (TBI) were important in determining their long-term neurological outcome. The results showed that patients with abnormalities in their clotting blood tests were associated with a worse outcome, but they did not supplement the utility of a validated prognostic model. New potential predictors of outcome after TBI should be evaluated in conjunction with a comprehensive prognostic model.
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In Brief
The authors of this study created a means of placing patients with head bleeds into different risk categories based on their individual characteristics. This is important for determining which patients are at higher risk to allow for more efficient resource allocation. It can also be used to help guide family discussions regarding goals of care and can separate patients into similar groups in future research studies.
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In Brief
This study demonstrated that focused ultrasound used for management of essential tremor results in significant changes of fractional anisotropy in the targeted area, both at 1 day and 1 year after intervention. Moreover, these modifications showed significant associations with clinical outcome, which suggests their possible use for early prediction of treatment effectiveness.
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In Brief
This study shows that under specific conditions, patients with deep brain stimulation implants may safely undergo 3-T MRI head imaging. These findings may be a step toward decreased restrictions on MRI use in the care of DBS patients, often clinically required and potentially a powerful research tool.
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In Brief
A novel guiding device has been developed that allows for accurate targeting of specific brain regions. The small profile and unique design of the device allow for accurate targeting of specific brain regions without the requirement of specialized MR software.
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In Brief
Based on these results, our clinical practice is to consider invasive EEG monitoring in patients with normal MRI findings, given that 40% will have seizure recurrence after ATL. It is possible that some patients could benefit from neurostimulation of the remaining postresection ECoG field generating IEDs; however, this needs to be investigated further in a prospective manner.
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In Brief
Using anatomical dissection and imaging methods the authors illustrate the connections between the anterior part of the temporal lobe and the insula, the temporoinsular projection system (TIPS), which is important for the experience of emotions and in epilepsy.
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In Brief
The study identified a novel means of identifying the location of the foramen ovale without the use of soft tissues. The method will improve the approach to the foramen ovale and decrease the amount of radiation exposure to both the patient and surgeon.
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