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Recurrent brainstem cavernous malformations following primary resection: blind spots, fine lines, and the right-angle method
Roxanna M. Garcia MD, MS, MPH1, Taemin Oh MD2, Tyler S. Cole MD1, Benjamin K. Hendricks MD1, and Michael T. Lawton MD1
doi : 10.3171/2020.6.JNS201555
Volume 135: Issue 3 Page Range: 671–682
Optimal access route for pontine cavernous malformation resection with preservation of abducens and facial nerve function
Helmut Bertalanffy MD1, Shinya Ichimura MD1,2, Souvik Kar PhD1, Yoshihito Tsuji MD1,3, and Caiquan Huang MD1
doi : 10.3171/2020.7.JNS201023
Volume 135: Issue 3 Page Range: 683–692
The aim of this study was to analyze the differences between posterolateral and posteromedial approaches to pontine cavernous malformations (PCMs) in order to verify the hypothesis that a posterolateral approach is more favorable with regard to preservation of abducens and facial nerve function.
Holmes tremor: a delayed complication after resection of brainstem cavernomas
Marco Cenzato MD1, Davide Colistra MD1, Giorgia Iacopino MD2, Christian Raftopoulos MD, PhD3, Ulrich Sure MD, PhD4, Marcos Tatagiba MD, PhD5, Robert F. Spetzler MD, PhD6, Alexander N. Konovalov MD, PhD7, Andriy Smolanka MD, PhD8, Volodymir Smolanka MD, PhD8, Roberto Stefini MD9, Carlo Bortolotti MD10, Paolo Ferroli MD11, Giampietro Pinna MD12, Angelo Franzini MD11, Philipp Dammann MD4, Georgios Naros MD5, Davide Boeris MD, PhD1, Paolo Mantovani MD10, Domenico Lizio PhD13, Mariangela Piano MD14, and Enrica Fava MD, PhD1,15
doi : 10.3171/2020.7.JNS201352
Volume 135: Issue 3 Page Range: 693–703
In this paper, the authors aimed to illustrate how Holmes tremor (HT) can occur as a delayed complication after brainstem cavernoma resection despite strict adherence to the safe entry zones (SEZs).
Association between flat-panel computed tomography hyperattenuation and clinical outcome after successful recanalization by endovascular treatment
Jang-Hyun Baek MD1,2, Byung Moon Kim MD, PhD3, Ji Hoe Heo MD, PhD2, Dong Joon Kim MD, PhD3, Hyo Suk Nam MD, PhD2, Young Dae Kim MD, PhD2, Hyun Seok Choi MD3, Jun-Hwee Kim MD3, and Jin Woo Kim MD4
doi : 10.3171/2020.7.JNS193214
Volume 135: Issue 3 Page Range: 704–711
Hyperattenuation on CT scanning performed immediately after endovascular treatment (EVT) is known to be associated with the final infarct. As flat-panel CT (FPCT) scanning is readily accessible within their angiography suite, the authors evaluated the ability of the extent of hyperattenuation on FPCT to predict clinical outcomes after EVT.
Functional DTI tractography in brainstem cavernoma surgery
Anna Zdunczyk MD1, Fabia Roth1, Thomas Picht MD1, and Peter Vajkoczy MD1
doi : 10.3171/2020.7.JNS20403
Volume 135: Issue 3 Page Range: 712–721
Surgical resection of brainstem cavernomas is associated with high postoperative morbidity due to the density of local vulnerable structures. Classical mapping of pathways by diffusion tensor imaging (DTI) has proven to be unspecific and confusing in many cases. In the current study, the authors aimed to establish a more reliable, specific, and objective method for somatotopic visualization of the descending motor pathways with navigated transcranial magnetic stimulation (nTMS)–based DTI fiber tracking.
Endoscopic endonasal transsphenoidal direct access and Onyx embolization of a dural arteriovenous fistula mimicking a carotid-cavernous fistula: case report
Patrick J. Karas MD1, Robert Y. North MD, PhD1, Visish M. Srinivasan MD1, Nathan R. Lindquist MD2, K. Kelly Gallagher MD2, Jan-Karl Burkhardt MD1, Daniel Yoshor MD1, and Peter Kan MD1
doi : 10.3171/2020.7.JNS201737
Volume 135: Issue 3 Page Range: 722–726
The classic presentation of a carotid-cavernous fistula (CCF) is unilateral painful proptosis, chemosis, and vision loss. Just as the goal of treatment for a dural arteriovenous fistula (dAVF) is obliteration of the entire fistulous connection and the proximal draining vein, the modern treatment of CCF is endovascular occlusion of the cavernous sinus via a transvenous or transarterial route. Here, the authors present the case of a woman with a paracavernous dAVF mimicking the clinical and radiographic presentation of a CCF. Without any endovascular route available to access the fistulous connection and venous drainage, the authors devised a novel direct hybrid approach by performing an endoscopic endonasal transsphenoidal direct puncture and Onyx embolization of the fistula.
A comparison of radial versus femoral artery access for acute stroke interventions
Omaditya Khanna MD1, Lohit Velagapudi BS1, Somnath Das BS1, Ahmad Sweid MD1, Nikolaos Mouchtouris MD1, Fadi Al Saiegh MD1, Michael B. Avery MD, MSc1, Nohra Chalouhi MD1, Richard F. Schmidt MD1, Kalyan Sajja MD1, M. Reid Gooch MD1, Stavropoula Tjoumakaris MD1, Robert H. Rosenwasser MD1, and Pascal M. Jabbour MD1
doi : 10.3171/2020.7.JNS201174
Volume 135: Issue 3 Page Range: 727–732
In this study, the authors aimed to investigate procedural and clinical outcomes between radial and femoral artery access in patients undergoing thrombectomy for acute stroke.
Outcomes of stereotactic radiosurgery for hemorrhagic arteriovenous malformations with or without prior resection or embolization
Mariko Kawashima MD1, Hirotaka Hasegawa MD, PhD1,3, Masahiro Shin MD, PhD1, Yuki Shinya MD1, Osamu Ishikawa MD, PhD1, Satoshi Koizumi MD1, Atsuto Katano MD, PhD2, Hirofumi Nakatomi MD, PhD1, and Nobuhito Saito MD, PhD1
doi : 10.3171/2020.7.JNS201502
Volume 135: Issue 3 Page Range: 733–741
The major concern about ruptured arteriovenous malformations (rAVMs) is recurrent hemorrhage, which tends to preclude stereotactic radiosurgery (SRS) as a therapeutic modality for these brain malformations. In this study, the authors aimed to clarify the role of SRS for rAVM as a stand-alone modality and an adjunct for a remnant nidus after surgery or embolization.
Stereotactic radiosurgery with versus without prior Onyx embolization for brain arteriovenous malformations
Ching-Jen Chen MD1, Dale Ding MD2, Cheng-Chia Lee MD, PhD4, Kathryn N. Kearns BS1, I. Jonathan Pomeraniec MD, MBA1, Christopher P. Cifarelli MD, PhD5, David E. Arsanious MD5, Roman Liscak MD6, Jaromir Hanuska MD6, Brian J. Williams MD2, Mehran B. Yusuf MD3, Shiao Y. Woo MD3, Natasha Ironside MBChB1, Rebecca M. Burke MD, PhD1, Ronald E. Warnick MD7, Daniel M. Trifiletti MD8, David Mathieu MD9, Monica Mureb BS10, Carolina Benjamin MD10, Douglas Kondziolka MD10, Caleb E. Feliciano MD11, Rafael Rodriguez-Mercado MD11, Kevin M. Cockroft MD, MSc12, Scott Simon MD12, Heath B. Mackley MD13, Samer G. Zammar MD, MPH12, Neel T. Patel MD12, Varun Padmanaban MD12, Nathan Beatson BS14, Anissa Saylany BA14, John Y. K. Lee MD14, Jason P. Sheehan MD, PhD1, and on behalf of the International Radiosurgery Research Foundation
doi : 10.3171/2020.7.JNS201731
Volume 135: Issue 3 Page Range: 742–750
Investigations of the combined effects of neoadjuvant Onyx embolization and stereotactic radiosurgery (SRS) on brain arteriovenous malformations (AVMs) have not accounted for initial angioarchitectural features prior to neuroendovascular intervention. The aim of this retrospective, multicenter matched cohort study is to compare the outcomes of SRS with versus without upfront Onyx embolization for AVMs using de novo characteristics of the preembolized nidus.
Intracranial EEG and laser interstitial thermal therapy in MRI-negative insular and/or cingulate epilepsy: case series
Elakkat D. Gireesh MD1, Kihyeong Lee MD1, Holly Skinner DO1, Joohee Seo MD1, Po-Ching Chen PhD1,4, Michael Westerveld PhD3, Richard D. Beegle MD5, Eduardo Castillo PhD4, and James Baumgartner MD2
doi : 10.3171/2020.7.JNS201912
Volume 135: Issue 3 Page Range: 751–759
The goal of this study was to assess the success rate and complications of stereo-electroencephalogra-phy (sEEG) and laser interstitial thermal therapy (LITT) in the treatment of nonlesional refractory epilepsy in cingulate and insular cortex.
Resective temporal lobe surgery in refractory temporal lobe epilepsy: prognostic factors of postoperative seizure outcome
Valeri Borger MD1, Motaz Hamed MD1, Julia Taube MSc2, Gülsah Aydin MD1, Inja Ilic MD1, Matthias Schneider MD1, Patrick Schuss MD, PhD1, Erdem Güresir MD, PhD1, Albert Becker MD, PhD3, Christoph Helmstaedter PhD2, Christian E. Elger MD, PhD2, and Hartmut Vatter MD, PhD1
doi : 10.3171/2020.7.JNS20284
Volume 135: Issue 3 Page Range: 760–769
Temporal lobe epilepsy (TLE) is one of the most common forms of epilepsy. In approximately 30% of patients, seizures are refractory to drug treatment. Despite the achievements of modern presurgical evaluation in recent years, the presurgical prediction of seizure outcome remains difficult. The aim of this study was to evaluate the seizure outcome in patients with drug-refractory TLE who underwent resective temporal lobe surgery (rTLS) and to determine features associated with unfavorable postsurgical seizure outcome.
MRI-guided stereotactic laser corpus callosotomy for epilepsy: distinct methods and outcomes
Christopher W. Rich MD1, Rebecca E. Fasano MD2, Faical Isbaine PhD3, Amit M. Saindane MD4, Deqiang Qiu PhD4, Daniel J. Curry MD5, Robert E. Gross MD, PhD3, and Jon T. Willie MD, PhD3,6
doi : 10.3171/2020.7.JNS20498
Volume 135: Issue 3 Page Range: 770–782
Several small series have described stereotactic MRI-guided laser interstitial thermal therapy for partial callosotomy of astatic and generalized tonic-clonic (GTC) seizures, especially in association with Lennox-Gastaut syndrome. Larger case series and comparison of distinct stereotactic methods for stereotactic laser corpus callosotomy (SLCC), however, are currently lacking. The objective of this study was to report seizure outcomes in a series of adult patients with epilepsy following anterior, posterior, and complete SLCC procedures and to compare the results achieved with a frameless stereotactic surgical robot versus direct MRI guidance frames.
Outcomes following surgical management of vagus nerve stimulator–related infection: a retrospective multi-institutional study
Hirotaka Hasegawa MD, PhD1,3, Jamie J. Van Gompel MD1, W. Richard Marsh MD1, Robert E. Wharen Jr. MD4, Richard S. Zimmerman MD5, David B. Burkholder MD2, Brian N. Lundstrom MD, PhD2, Jeffrey W. Britton MD2, and Fredric B. Meyer MD1
doi : 10.3171/2020.7.JNS201385
Volume 135: Issue 3 Page Range: 783–791
Surgical site infection (SSI) is a rare but significant complication after vagus nerve stimulator (VNS) placement. Treatment options range from antibiotic therapy alone to hardware removal. The optimal therapeutic strategy remains open to debate. Therefore, the authors conducted this retrospective multicenter analysis to provide insight into the optimal management of VNS-related SSI (VNS-SSI).
MR-guided focused ultrasound pallidotomy for Parkinson’s disease: safety and feasibility
Howard M. Eisenberg MD1, Vibhor Krishna MD, SM4, W. Jeffrey Elias MD5, G. Rees Cosgrove MD6, Dheeraj Gandhi MD2, Charlene E. Aldrich RN, MSN1, and Paul S. Fishman MD, PhD3
doi : 10.3171/2020.6.JNS192773
Volume 135: Issue 3 Page Range: 792–798
Stereotactic radiofrequency pallidotomy has demonstrated improvement in motor fluctuations in patients with Parkinson’s disease (PD), particularly levodopa (L-dopa)–induced dyskinesias. The authors aimed to determine whether or not unilateral pallidotomy with MR-guided focused ultrasound (MRgFUS) could safely improve Unified Dyskinesia Rating Scale (UDysRS; the primary outcome measure) scores over baseline scores in patients with PD.
Unilateral pallidothalamic tractotomy for akinetic-rigid Parkinson’s disease: a prospective open-label study
Shiro Horisawa MD1, Atsushi Fukui MD, PhD1, Hayato Yamahata MD1, Yukiko Tanaka MD1, Atsushi Kuwano MD1, Oji Momosaki MD1, Mutsumi Iijima MD, PhD2, Magi Nanke MD3, Takakazu Kawamata MD, PhD1, and Takaomi Taira MD, PhD1
doi : 10.3171/2020.7.JNS201547
Volume 135: Issue 3 Page Range: 799–805
Neurosurgical ablation is an effective treatment for medically refractory motor symptoms of Parkinson’s disease (PD). A limited number of studies have reported the effect of ablation of the pallidothalamic tract for PD. In this study, the authors evaluated the safety and efficacy of unilateral pallidothalamic tractotomy for akinetic-rigid (AR)–PD.
DBS targeting for essential tremor using intersectional dentato-rubro-thalamic tractography and direct proton density visualization of the VIM: technical note on 2 cases
Melanie A. Morrison PhD2, Anthony T. Lee MD, PhD1, Alastair J. Martin PhD2, Cameron Dietiker MD3, Ethan G. Brown MD3, and Doris D. Wang MD, PhD1
doi : 10.3171/2020.8.JNS201378
Volume 135: Issue 3 Page Range: 806–814
Direct visualization of the ventral intermediate nucleus (VIM) of the thalamus on standard MRI sequences remains elusive. Therefore, deep brain stimulation (DBS) surgery for essential tremor (ET) indirectly targets the VIM using atlas-derived consensus coordinates and requires awake intraoperative testing to confirm clinical benefits. The objective of this study was to evaluate the utility of proton density (PD)–weighted MRI and tractography of the intersecting dentato-rubro-thalamic tract (DRTT) for direct “intersectional” targeting of the VIM in ET.
Deciphering the frontostriatal circuitry through the fiber dissection technique: direct structural evidence on the morphology and axonal connectivity of the fronto-caudate tract
Spyridon Komaitis MD, MSc1,2,4,5, Christos Koutsarnakis MD, MSc1,2,4,5, Evgenia Lani MD1,4, Theodosis Kalamatianos PhD1,5, Evangelos Drosos MD, MSc1,2,5, Georgios P. Skandalakis MD, MSc1,4,7, Faidon Liakos MD1,4, Evangelia Liouta PhD1,5, Aristotelis V. Kalyvas MD, MSc1,4,6, and George Stranjalis MD, PhD1,2,4,5
doi : 10.3171/2020.7.JNS201287
Volume 135: Issue 3 Page Range: 815–827
The authors sought to investigate the very existence and map the topography, morphology, and axonal connectivity of a thus far ill-defined subcortical pathway known as the fronto-caudate tract (FCT) since there is a paucity of direct structural evidence regarding this pathway in the relevant literature.
Superselective pseudocontinuous arterial spin labeling in patients with meningioma: utility in prediction of feeding arteries and preoperative embolization feasibility
Dong Hyun Yoo MD1, Chul-Ho Sohn MD, PhD1, Young Dae Cho MD, PhD1, Hyun-Seung Kang MD, PhD2, Chul-Kee Park MD, PhD2, Jin Wook Kim MD, PhD2, and Jae Hyoung Kim MD, PhD3
doi : 10.3171/2020.7.JNS201915
Volume 135: Issue 3 Page Range: 828–834
Superselective pseudocontinuous arterial spin labeling (ss-pCASL) is an MRI technique in which individual vessels are labeled to trace their perfusion territories. In this study, the authors assessed its merit in defining feeding vessels and gauging preoperative embolization feasibility for patients with meningioma, using digital subtraction angiography (DSA) as the reference method.
Clinical and genomic factors associated with seizures in meningiomas
Trisha P. Gupte BS1,8, Chang Li BS1,8,9,10, Lan Jin PhD1,2,8,11, Kanat Yalcin MD1,8, Mark W. Youngblood MD, PhD12, Danielle F. Miyagishima BA1,8, Ketu Mishra-Gorur PhD1,8, Amy Y. Zhao BS1,8, Joseph Antonios MD, PhD1,8, Anita Huttner MD3,8, Declan McGuone MD3,8, Nicholas A. Blondin MD5,8, Joseph N. Contessa MD, PhD6,8, Yawei Zhang PhD2,11, Robert K. Fulbright MD4,8, Murat Gunel MD1,7,8, Zeynep Erson-Omay PhD1,8, and Jennifer Moliterno MD1,8
doi : 10.3171/2020.7.JNS201042
Volume 135: Issue 3 Page Range: 835–844
The association of seizures with meningiomas is poorly understood. Moreover, any relationship between seizures and the underlying meningioma genomic subgroup has not been studied. Herein, the authors report on their experience with identifying clinical and genomic factors associated with preoperative and postoperative seizure presentation in meningioma patients.
Efficacy of decitabine in malignant meningioma cells: relation to promoter demethylation of distinct tumor suppressor and oncogenes and independence from TERT
Louise Stögbauer1, Christian Thomas Dr med2, Andrea Wagner1, Nils Warneke Dr med1, Eva Christine Bunk Dr med, PhD1, Oliver Grauer Dr med, PhD3, Julian Canisius1, Werner Paulus Dr med2, Walter Stummer Dr med1, Volker Senner Dr rer nat2, and Benjamin Brokinkel Dr med1
doi : 10.3171/2020.7.JNS193097
Volume 135: Issue 3 Page Range: 845–854
Chemotherapeutic options for meningiomas refractory to surgery or irradiation are largely unknown. Human telomerase reverse transcriptase (hTERT) promoter methylation with subsequent TERT expression and telomerase activity, key features in oncogenesis, are found in most high-grade meningiomas. Therefore, the authors investigated the impact of the demethylating agent decitabine (5-aza-2?-deoxycytidine) on survival and DNA methylation in meningioma cells.
Internal dose escalation associated with increased local control for melanoma brain metastases treated with stereotactic radiosurgery
William R. Kennedy MD1, Todd A. DeWees PhD3, Sahaja Acharya MD4, Mustafaa Mahmood MD1, Nels C. Knutson PhD1, S. Murty Goddu PhD1, James A. Kavanaugh PhD1, Timothy J. Mitchell PhD1, Keith M. Rich MD2, Albert H. Kim MD, PhD2, Eric C. Leuthardt MD2, Joshua L. Dowling MD2, Gavin P. Dunn MD, PhD2, Michael R. Chicoine MD2, Stephanie M. Perkins MD1, Jiayi Huang MD1, Christina I. Tsien MD1, Clifford G. Robinson MD1, and Christopher D. Abraham MD1
doi : 10.3171/2020.7.JNS192210
Volume 135: Issue 3 Page Range: 855–861
The internal high-dose volume varies widely for a given prescribed dose during stereotactic radiosurgery (SRS) to treat brain metastases (BMs). This may be altered during treatment planning, and the authors have previously shown that this improves local control (LC) for non–small cell lung cancer BMs without increasing toxicity. Here, they seek to identify potentially actionable dosimetric predictors of LC after SRS for melanoma BM.
Stereotactic radiosurgery for treatment of radiation-induced meningiomas: a multiinstitutional study
Adomas Bunevicius MD, PhD1, Mohand Suleiman MD1, Samir Patel MD2, Roberto Martínez Álvarez PhD, MD3, Nuria E. Martinez Moreno PhD, MD3, Roman Liscak MD4, Jaromir Hanuska MD4, Anne-Marie Langlois MD5, David Mathieu MD5, Christine Mau MD6, Catherine Caldwell BS6, Leonard C. Tuanquin MD6, Brad E. Zacharia MD6, James McInerney MD6, Cheng-Chia Lee MD, PhD7, Huai-Che Yang MD7, Jennifer L. Peterson MD8, Daniel M. Trifiletti MD8, Akiyoshi Ogino MD, PhD9, Hideyuki Kano MD, PhD9, Ronald E. Warnick MD10, Anissa Saylany BA11, Love Y. Buch BS11, John Y. K. Lee MD11, Ben A. Strickland MD12, Gabriel Zada MD12, Eric L. Chang MD12, L. Dade Lunsford MD9, and Jason Sheehan MD, PhD1
doi : 10.3171/2020.7.JNS202064
Volume 135: Issue 3 Page Range: 862–870
Radiation-induced meningiomas (RIMs) are associated with aggressive clinical behavior. Stereotactic radiosurgery (SRS) is sometimes considered for selected RIMs. The authors investigated the effectiveness and safety of SRS for the management of RIMs.
Neuropsychological assessments before and after awake surgery for incidental low-grade gliomas
Sam Ng MD1, Guillaume Herbet PhD1,2,3, Anne-Laure Lemaitre PhD1,2, Jérôme Cochereau MD, MSc3,4, Sylvie Moritz-Gasser PhD1,2,3, and Hugues Duffau MD, PhD1,2,3
doi : 10.3171/2020.7.JNS201507
Volume 135: Issue 3 Page Range: 871–880
Early surgery in presumed asymptomatic patients with incidental low-grade glioma (ILGG) has been suggested to improve maximal resection rates and overall survival. However, no study has reported on the impact of such preventive treatment on cognitive functioning. The aim of this study was to investigate neuropsychological outcomes in patients with ILGG who underwent preventive surgery.
Resection of vestibular schwannomas after stereotactic radiosurgery: a systematic review
Max Whitmeyer BS1, Bledi C. Brahimaj MD2, André Beer-Furlan MD, PhD2, Sameer Alvi MD3, Madeline J. Epsten BA4, Fred Crawford BS4, Richard W. Byrne MD2, and R. Mark Wiet MD2,5
doi : 10.3171/2020.7.JNS2044
Volume 135: Issue 3 Page Range: 881–889
Multiple short series have evaluated the efficacy of salvage microsurgery (MS) after stereotactic radiosurgery (SRS) for treatment of vestibular schwannomas (VSs); however, there is a lack of a large volume of patient data available for interpretation and clinical adaptation. The goal of this study was to provide a comprehensive review of tumor characteristics, management, and surgical outcomes of salvage of MS after SRS for VS.
Editorial. The quintessential nerve injury model
Daniel Umansky MD1 and Rajiv Midha MSc, MD1
doi : 10.3171/2020.6.JNS201799
Volume 135: Issue 3 Page Range: 890–892
Rapid-stretch injury to peripheral nerves: comparison of injury models
Stewart Yeoh PhD1, Wesley S. Warner BA1, Ilyas Eli MD1, and Mark A. Mahan MD1
doi : 10.3171/2020.5.JNS193448
Volume 135: Issue 3 Page Range: 893–903
Traditional animal models of nerve injury use controlled crush or transection injuries to investigate nerve regeneration; however, a more common and challenging clinical problem involves closed traction nerve injuries. The authors have produced a precise traction injury model and sought to examine how the pathophysiology of stretch injuries compares with that of crush and transection injuries.
Femoral nerve decompression and sartorius-to-quadriceps nerve transfers for partial femoral nerve injury: a cadaveric study and early case series
Colin W. McInnes MD1, Austin Y. Ha MD2, Hollie A. Power MD3, Thomas H. Tung MD2, and Amy M. Moore MD4
doi : 10.3171/2020.6.JNS20251
Volume 135: Issue 3 Page Range: 904–911
Partial femoral nerve injuries cause significant disability with ambulation. Due to their more proximal and superficial location, sartorius branches are often spared in femoral nerve injuries. In this article, the authors report the benefits of femoral nerve decompression, demonstrate the feasibility of sartorius-to-quadriceps nerve transfers in a cadaveric study, describe the surgical technique, and report clinical results.
Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes
Victor M. Lu MD, PhD1, S. Shelby Burks MD1, Rainya N. Heath MS1, Tizeta Wolde MPH1, Robert J. Spinner MD2, and Allan D. Levi MD, PhD1
doi : 10.3171/2020.7.JNS202191
Volume 135: Issue 3 Page Range: 912–922
Meralgia paresthetica is caused by entrapment of the lateral femoral cutaneous nerve (LFCN) and often presents with pain. Multiple treatment options targeting the LFCN can be pursued to treat the pain should conservative measures fail, with the most common options being injection, neurolysis, and neurectomy. However, their efficacy in causing pain relief and their clinical outcomes have yet to be directly compared. The aim of this study was to interrogate the contemporary literature and quantitatively define how these options compare.
The role of indocyanine green fluorescence in endoscopic endonasal skull base surgery and its imaging correlations
Mostafa Shahein MD1,5, Daniel M. Prevedello MD1,2, Thomas L. Beaumont MD, PhD1, Khalid Ismail MD5, Radwan Nouby MD5, Marilly Palettas MPH3, Luciano M. Prevedello MD, MPH4, Bradley A. Otto MD1,2, and Ricardo L. Carrau MD1,2
doi : 10.3171/2020.6.JNS192775
Volume 135: Issue 3 Page Range: 923–933
The use of endoscope-integrated indocyanine green (E-ICG) has recently been introduced in skull base surgery. The quantitative correlation between E-ICG and T1-weighted gadolinium-enhanced (T1WGd) images for skull base tumors has not been previously assessed, to the authors’ knowledge. In this study, the authors investigated the indications for use and the limitations of E-ICG and sought to correlate the endoscopic fluorescence pattern with MRI contrast enhancement.
Postoperative 30-day emergency department utilization after 7294 cranial neurosurgery procedures at a tertiary neuroscience center
Douglas A. Hardesty MD1,2, Michael A. Mooney MD1, Benjamin K. Hendricks MD1, Joshua S. Catapano MD1, Scott T. Brigeman MD1, Michael A. Bohl MD1, John P. Sheehy MD1, and Andrew S. Little MD1
doi : 10.3171/2020.8.JNS202404
Volume 135: Issue 3 Page Range: 934–942
Hospital readmission and the reduction thereof has become a major quality improvement initiative in organized medicine and neurosurgery. However, little research has been performed on why neurosurgical patients utilize hospital emergency rooms (ERs) with or without subsequent admission in the postoperative setting.
Gender diversity in United States neurosurgery training programs
Katelyn Donaldson MD1, Katherine E. Callahan1, Aaron Gelinne MD5, Wyll Everett1, S. Elizabeth Ames MD2, Ellen L. Air MD, PhD4, and Susan R. Durham MD, MS3
doi : 10.3171/2020.7.JNS192647
Volume 135: Issue 3 Page Range: 943–948
Neurosurgery continues to be one of the medical specialties with the lowest representation of females in both the resident and faculty workforce. Currently, there are limited available data on the gender distribution of faculty and residents in Accreditation Council for Graduate Medical Education (ACGME)–accredited neurosurgery training programs. This information is critical to accurately measure the results of any effort to improve both the recruitment and retention of women in neurosurgery. The objective of the current study was to define the current gender distribution of faculty and residents in ACGME-accredited neurosurgery training programs.
Resident evaluations in the age of competency-based medical education: faculty perspectives on minimizing burdens
Jessica E. Rabski MD, MEd1, Ashirbani Saha PhD1, Michael D. Cusimano MD, and FRCSC DABNS PhD, MHPE1,3
doi : 10.3171/2020.7.JNS201688
Volume 135: Issue 3 Page Range: 949–954
Competency-based medical education (CBME), an outcomes-based approach to medical education, continues to be implemented across many postgraduate medical education programs worldwide, including a recent introduction into Canadian neurosurgical training programs (July 2019). The success of this educational paradigm shift requires frequent faculty observation and evaluation of residents performing defined tasks of the specialty. A main challenge involves providing residents with frequent performance evaluations and feedback that are feasible for faculty to complete. This study aims to define what is currently happening and what changes are needed to make CBME successful for the certification of neurosurgeons' competence.
The mediums of dissemination of knowledge and illustration in neurosurgery: unraveling the evolution
Bharath Raju MD, MCh1, Fareed Jumah MD1, Vinayak Narayan MD1, Anika Sonig BA2, Hai Sun MD1, and Anil Nanda MD, MPH1
doi : 10.3171/2020.7.JNS201053
Volume 135: Issue 3 Page Range: 955–961
The earliest evidence of man’s attempts in communicating ideas and emotions can be seen on cave walls and ceilings from the prehistoric era. Ingenuity, as well as the development of tools, allowed clay tablets to become the preferred method of documentation, then papyrus and eventually the codex. As civilizations advanced to develop structured systems of writing, knowledge became a power available to only those who were literate. As the search to understand the intricacies of the human brain moved forward, so did the demand for teaching the next generation of physicians. The different methods of distributing information were forced to advance, lest the civilization falls behind. Here, the authors present a historical perspective on the evolution of the mediums of illustration and knowledge dissemination through the lens of neurosurgery. They highlight how the medium of choice transitioned from primitive clay pots to cutting-edge virtual reality technology, aiding in the propagation of medical literature from generation to generation across the centuries.
Historical overview of the Department of Neurosurgery at Yonsei University College of Medicine in the Republic of Korea
Dong Ah Shin MD, PhD1 and Dong Kyu Chin MD, PhD1
doi : 10.3171/2020.8.JNS201076
Volume 135: Issue 3 Page Range: 962–968
Originally founded in 1885, Gwanghyewon later became the Severance Hospital (named after philanthropist Louis Severance, who supported and funded the construction of a modern hospital) and Yonsei University College of Medicine. The Department of Neurosurgery at Severance Hospital was established in 1957, and its residency program began in 1961. Currently, the Department of Neurosurgery has 34 professors and 17 fellows; specialties include vascular, functional, pediatric, tumor, skull base, and spine neurosurgery. With its state-of-the-art neurosurgical facilities and services, the Department of Neurosurgery has developed into a department of excellence within the Yonsei University Health System. In this vignette, the authors present a historic overview of the Department of Neurosurgery.
Predicting the consistency of intracranial meningiomas using apparent diffusion coefficient maps derived from preoperative diffusion-weighted imaging
Kenya Miyoshi MD1, Tsukasa Wada MD1, Ikuko Uwano PhD2, Makoto Sasaki MD2, Hiroaki Saura MD1, Shunrou Fujiwara PhD1, Fumiaki Takahashi PhD3, Eiki Tsushima PhD4, and Kuniaki Ogasawara MD1
doi : 10.3171/2020.6.JNS20740
Volume 135: Issue 3 Page Range: 969–976
The consistency of meningiomas is a critical factor affecting the difficulty of resection, operative complications, and operative time. The apparent diffusion coefficient (ADC) is derived from diffusion-weighted imaging (DWI) and is calculated using two optimized b values. While the results of comparisons between the standard ADC and the consistency of meningiomas vary, the shifted ADC has been reported to be strongly correlated with liver stiffness. The purpose of the present prospective cohort study was to determine whether preoperative standard and shifted ADC maps predict the consistency of intracranial meningiomas.
Erratum. Holmes tremor: a delayed complication after resection of brainstem cavernomas
Davide Colistra MD1
doi : 10.3171/2021.2.JNS201352a
Volume 135: Issue 3 Page Range: 977
Letter to the Editor. Bleeding risk after cavernous malformation surgery: remnant or recurrence?
Edoardo Agosti MD1, Francesco Doglietto MD, PhD1, and Marco M. Fontanella MD1
doi : 10.3171/2020.12.JNS204192
Volume 135: Issue 3 Page Range: 978–979
Letter to the Editor. Intracranial physiology and ICP
Kaveh Barami MD, PhD1
doi : 10.3171/2020.12.JNS204282
Volume 135: Issue 3 Page Range: 980
Letter to the Editor. Traumatic axonal injury: causes and effects
Mónica Patricia Herrera-Martinez MD1,3, Ezequiel García-Ballestas MD1,3, Ivan David Lozada-Martínez MS2,3,4, Luis Rafael Moscote-Salazar MD1,2,3,4, and Mohammed Al-Dhahir MD5
doi : 10.3171/2021.1.JNS204452
Volume 135: Issue 3 Page Range: 981–982
Letter to the Editor. On the right side of history: expanding diversity within neurosurgery
Marianne I. J. Tissot BA1, Andre E. Boyke MS2, Alvin Onyewuenyi MPH3, Gregory Glauser MBA1, Evalyn S. Mackenzie BA1, Bethany J. Thach BA1, and Donald K. E. Detchou BA1
doi : 10.3171/2021.1.JNS21176
Volume 135: Issue 3 Page Range: 982–983
Letter to the Editor. A new approach for local tumor control
Grazia Menna MD1, Alessandro Olivi MD1, and Giuseppe Maria Della Pepa MD1
doi : 10.3171/2021.2.JNS21409
Volume 135: Issue 3 Page Range: 984–985
Letter to the Editor. Don’t blame the resilient corticotroph
Michael P. Catalino MD, MSc1, Carolyn S. Quinsey MD1, and G. Stephen DeCherney MD, MPH1
doi : 10.3171/2021.2.JNS21473
Volume 135: Issue 3 Page Range: 986–987
