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Washington Committee for Neurological Surgery: the evolution of neurosurgery’s involvement in public policy
Ann R. Stroink MD1, Katie O. Orrico JD2, and James R. Bean MD3
doi : 10.3171/2021.7.JNS211242
Volume 135: Issue 5, page: 1287–1292
The American Association of Neurological Surgeons/Congress of Neurological Surgeons Washington Committee was formed in 1975 to establish a means for neurosurgery to influence federal health care policy. In response to growing federal health care legislation and regulation, the Washington Committee expanded from its original six members in 1975 to 35 invited liaisons and members by 2020. The Washington Committee, through the Washington Office, expanded political lobbying capacity into numerous important areas of health care policy, including Current Procedural Terminology coding and Medicare reimbursement, Federal Drug Administration (FDA) regulation, healthcare quality oversight, emergency medical services, treatment guidelines, treatment outcome registries, medical liability reform, research funding, and information dissemination. Over 45 yr, the Washington Committee has become an indispensable resource for shaping public policy affecting neurosurgery training, research, and practice.
Editorial. Craniopharyngioma classification
Stephen T. Magill MD, PhD1, John A. Jane Jr. MD2, and Daniel M. Prevedello MD1
doi : 10.3171/2020.8.JNS202666
Volume 135: Issue 5, page: 1293–1295
Endoscopic endonasal versus transcranial surgery for primary resection of craniopharyngiomas based on a new QST classification system: a comparative series of 315 patients
Jun Fan MD, PhD,1, Yi Liu MD, PhD1, Jun Pan MD, PhD1, Yuping Peng MD, PhD1, Junxiang Peng MD, PhD1, Yun Bao MD, PhD1, Jing Nie MD, PhD1, Chaohu Wang MD, PhD1, Binghui Qiu MD, PhD1, and Songtao Qi MD, PhD1
doi : 10.3171/2020.7.JNS20257
Volume 135: Issue 5, page: 1298–1309
An assessment of the transcranial approach (TCA) and the endoscopic endonasal approach (EEA) for craniopharyngiomas (CPs) according to tumor types has not been reported. The aim of this study was to evaluate both surgical approaches for different types of CPs.
Radiological and clinical outcomes of pituitary apoplexy: comparison of conservative management versus early surgical intervention
Matthew J. Shepard MD1,2, M. Harrison Snyder BS1, Sauson Soldozy BA1, Leonel L. Ampie MD1,3, Saul F. Morales-Valero MD1, and John A. Jane Jr. MD1
doi : 10.3171/2020.9.JNS202899
Volume 135: Issue 5, page: 1310–1318
Early surgical intervention for patients with pituitary apoplexy (PA) is thought to improve visual outcomes and decrease mortality. However, some patients may have good clinical outcomes without surgery. The authors sought to compare the radiological and clinical outcomes of patients with PA who were managed conservatively versus those who underwent early surgery.
The rhinopharyngeal flap for reconstruction of lower clival and craniovertebral junction defects
Pierre-Olivier Champagne MD, PhD1, Georgios A. Zenonos MD1, Eric W. Wang MD2, Carl H. Snyderman MD2, and Paul A. Gardner MD1
doi : 10.3171/2020.8.JNS202193
Volume 135: Issue 5, page: 1319–1327
The endoscopic endonasal approach (EEA) to the lower clivus and craniovertebral junction (CVJ) has been traditionally performed via resection of the nasopharyngeal soft tissues. Alternatively, an inferiorly based rhinopharyngeal (RP) flap (RPF) can be dissected to help reconstruct the postoperative defect and separate it from the oropharynx. To date, there is no evidence regarding the viability and potential clinical impact of the RPF. The aim of this study was to assess RPF viability and its impact on clinical outcome.
Suction mask device: a simple, inexpensive, and effective method of reducing spread of aerosolized particles during endoscopic endonasal surgery in the era of COVID-19
Takuma Hara MD, PhD1,4, Marcus A. Zachariah MD, PhD3, Ruichun Li MD1, Rafael Martinez-Perez MD, PhD1, Ricardo L. Carrau MD, MBA1,2, and Daniel M. Prevedello MD1,2
doi : 10.3171/2020.10.JNS203196
Volume 135: Issue 5, page: 1328–1334
Aerosol-generating procedures, including endoscopic endonasal surgery (EES), are a major risk for physicians during the COVID-19 pandemic. Techniques for reducing aerosolization and risk of transmission of COVID-19 during these procedures would be valuable to the neurosurgical community. The authors aimed to simulate the generation of small-particle aerosols during EES and craniectomy in order to develop methods to reduce the spread of aerosolized particles, and to test the effectiveness of these methods.
Endoscope-assisted far-lateral transcondylar approach for craniocervical junction chordomas: a retrospective case series and cadaveric dissection
Arianna Fava MD1,2, Paolo di Russo MD1,2, Valentina Tardivo MD1,2, Thibault Passeri MD1,3, Breno Câmara MD1, Nicolas Penet MD1,2,3, Rosaria Abbritti MD1, Lorenzo Giammattei MD1,2,3, Hamid Mammar MD, PhD4, Anne Laure Bernat MD1,3, Emmanuel Mandonnet MD, PhD1,3, and Sébastien Froelich MD1,2,3
doi : 10.3171/2020.9.JNS202611
Volume 135: Issue 5, page: 1335–1346
Craniocervical junction (CCJ) chordomas are a neurosurgical challenge because of their deep localization, lateral extension, bone destruction, and tight relationship with the vertebral artery and lower cranial nerves. In this study, the authors present their surgical experience with the endoscope-assisted far-lateral transcondylar approach (EA-FLTA) for the treatment of CCJ chordomas, highlighting the advantages of this corridor and the integration of the endoscope to reach the anterior aspect and contralateral side of the CCJ and the possibility of performing occipitocervical fusion (OCF) during the same stage of surgery.
Improved surgeon performance following cadaveric simulation of internal carotid artery injury during endoscopic endonasal surgery: training outcomes of a nationwide prospective educational intervention
Daniel A. Donoho MD1, Dhiraj J. Pangal BS1, Guillaume Kugener MEng1, Martin Rutkowski MD1, Alexander Micko MD, PhD1,4, Shane Shahrestani MS1,5, Andrew Brunswick MD1, Michael Minneti MEd2, Bozena B. Wrobel MD3, and Gabriel Zada MD, MS1
doi : 10.3171/2020.9.JNS202672
Volume 135: Issue 5, page: 1347–1355
Internal carotid artery injury (ICAI) is a rare, life-threatening complication of endoscopic endonasal approaches that will be encountered by most skull base neurosurgeons and otolaryngologists. Rates of surgical proficiency for managing ICAI are not known, and the role of simulation to improve performance has not been studied on a nationwide scale.
Outcomes for various dural graft materials after posterior fossa decompression with duraplasty for Chiari malformation type I: a systematic review and meta-analysis
Alexander T Yahanda MS1,3, Laura E Simon MLIS3, and David D. Limbrick Jr. MD, PhD1,2,3
doi : 10.3171/2020.9.JNS202641
Volume 135: Issue 5, page: 1356–1369
Posterior fossa decompression with duraplasty (PFDD) is often used for Chiari malformation type I (CM-I), but outcomes associated with different dural graft materials are not well characterized. In this meta-analysis, the authors examined complication rates and outcomes after PFDD for CM-I for autografts and four types of nonautologous grafts.
Prevalence and site of predilection of carotid webs focusing on symptomatic and asymptomatic Japanese patients
Tao Yang MD1, Kazumichi Yoshida MD, PhD1, Takakuni Maki MD, PhD2, Yasutaka Fushimi MD, PhD3, Kiyofumi Yamada MD, PhD1, Masakazu Okawa MD, PhD1, Yu Yamamoto MD1, Naoki Takayama MD1, Keita Suzuki MD1, and Susumu Miyamoto MD, PhD1
doi : 10.3171/2020.8.JNS201727
Volume 135: Issue 5, page: 1370–1376
Carotid webs (CWs) have increasingly been recognized as a cause of recurrent ischemic stroke. However, the natural history and clinical course of CWs remain unclear. The authors aimed to clarify the prevalence, imaging features, and optimal treatment of CWs in a Japanese cohort study.
Detrimental effects of intrahospital transport on cerebral metabolism in patients suffering severe aneurysmal subarachnoid hemorrhage
Arthur Hosmann MD, PhD1, Carmen Angelmayr MD1, Andreas Hopf MD1,2, Steffen Rauscher MD1,3, Jonas Brugger4, Lavinia Ritscher MD1, Isabelle Bohl MD1, Philipp Schnackenburg MD1, Adrian Engel MD1,5, Walter Plöchl MD6, Markus Zeitlinger MD7, Andrea Reinprecht MD1, Karl Rössler MD1, and Andreas Gruber MD8
doi : 10.3171/2020.8.JNS202280
Volume 135: Issue 5, page: 1377–1384
Intrahospital transport for CT scans is routinely performed for neurosurgical patients. Particularly in the sedated and mechanically ventilated patient, intracranial hypertension and blood pressure fluctuations that might impair cerebral perfusion are frequently observed during these interventions. This study quantifies the impact of intrahospital patient transport on multimodality monitoring measurements, with a particular focus on cerebral metabolism.
Double-barrel STA-MCA bypass for cerebral revascularization: lessons learned from a 10-year experience
Peter Kan MD1, Visish M. Srinivasan MD1, Aditya Srivatsan MS1, Ascher B. Kaufmann MD2, Jacob Cherian MD3, Jan-Karl Burkhardt MD1, Jeremiah Johnson MD1, and Edward A. M. Duckworth MD4
doi : 10.3171/2020.9.JNS201976
Volume 135: Issue 5, page: 1385–1393
In select patients, extracranial-intracranial (EC-IC) bypass remains an important tool for cerebral revascularization. Traditionally, superficial temporal artery–middle cerebral artery (STA-MCA) bypass was performed using one limb of the STA only. In an attempt to augment flow and to direct flow to different ischemic areas of the brain, the authors adopted a “double-barrel” technique in which both branches of the STA are used to revascularize distinct MCA territories.
Flow-diverter stents in the early management of acutely ruptured brain aneurysms: effective rebleeding protection with low thromboembolic complications
José E. Cohen MD1, J. Moshe Gomori MD2, Samuel Moscovici MD1, Andrew H. Kaye MD1,4, Yigal Shoshan MD1, Sergey Spektor MD, PhD1, and Ronen R. Leker MD3
doi : 10.3171/2020.10.JNS201642
Volume 135: Issue 5, page: 1394–1401
Flow-diverter stents (FDSs) are not generally used for the management of acutely ruptured aneurysms with associated subarachnoid hemorrhage (SAH). Herein, the authors present their experience with FDSs in this scenario, focusing on the antiplatelet regimen, perioperative management, and outcome.
Endovascular treatment for calcified cerebral emboli in patients with acute ischemic stroke
Agnetha A. E. Bruggeman MD1, Manon Kappelhof MD1,2, Nerea Arrarte Terreros MSc1,2, Manon L. Tolhuisen MSc1,2, Praneeta R. Konduri MSc1,2, Nikki Boodt MD4,6, Heleen M. M. van Beusekom PhD7, Hajo M. Hund MD7,9, Aladdin Taha MD5,7, Aad van der Lugt MD, PhD4, Yvo B. W. E. M. Roos MD, PhD3, Adriaan C. G. M. van Es MD, PhD10, Wim H. van Zwam MD, PhD11, Alida A. Postma MD, PhD11, Diederik W. J. Dippel MD, PhD5, Hester F. Lingsma PhD6, Henk A. Marquering PhD1,2, Bart J. Emmer MD, PhD1, Charles B. L. M. Majoie MD, PhD1, and on behalf of the MR CLEAN Registry Investigators
doi : 10.3171/2020.9.JNS201798
Volume 135: Issue 5, page: 1402–1412
Calcified cerebral emboli (CCE) are a rare cause of acute ischemic stroke. The authors aimed to assess the association of CCE with functional outcome, successful reperfusion, and mortality. Furthermore, they aimed to assess the effectiveness of intravenous alteplase treatment and endovascular treatment (EVT), as well as the best first-line EVT approach in patients with CCE.
Aspirin versus anticoagulation for stroke prophylaxis in blunt cerebrovascular injury: a propensity-matched retrospective cohort study
Robert H. Bonow MD1,2, Cordelie E. Witt MD, MPH1,3, Mahmud Mossa-Basha MD1,4, Joseph Cuschieri MD1,5, Saman Arbabi MD, MPH1,5, Monica S. Vavilala MD1,6, Frederick P. Rivara MD1,7, and Randall M. Chesnut MD1,2
doi : 10.3171/2020.10.JNS201836
Volume 135: Issue 5, page: 1413–1420
The goal of this study was to compare the odds of stroke 24 hours or more after hospital arrival among patients with blunt cerebrovascular injury (BCVI) who were treated with therapeutic anticoagulation versus aspirin.
Perioperative complications of deep brain stimulation among patients with advanced age: a single-institution retrospective analysis
Andre A. Wakim BS1, Jennifer B. Mattar BS2, Margaret Lambert RN, BSN, CNRN3, and Francisco A. Ponce MD3
doi : 10.3171/2020.8.JNS201283
Volume 135: Issue 5, page: 1421–1428
Deep brain stimulation (DBS) is an elective procedure that can dramatically enhance quality of life. Because DBS is not considered lifesaving, it is important that providers produce consistently good outcomes, and one factor they usually consider is patient age. While older age may be a relative contraindication for some elective surgeries, the progressive nature of movement disorders treated with DBS may suggest that older patients stand to benefit substantially from surgery. To better understand the risks of treating patients of advanced age with DBS, this study compares perioperative complication rates in patients ? 75 to those < 75 years old.
Striatal dopamine transporter availability and individual clinical course within the 1-year follow-up of deep brain stimulation of the subthalamic nucleus in patients with Parkinson’s disease
Julia Löser1,2,3, Julia Luthardt PhD1, Michael Rullmann PhD1,4, David Weise MD5, Osama Sabri MD1, Jürgen Meixensberger MD2, Swen Hesse MD1,4, and Dirk Winkler MD2
doi : 10.3171/2020.8.JNS192740
Volume 135: Issue 5, page: 1429–1435
Degeneration of dopaminergic neurons in the substantia nigra projecting to the striatum is responsible for the motor symptoms in Parkinson’s disease (PD). Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established procedure to alleviate these symptoms in advanced PD. Yet the mechanism of action, especially the effects of STN-DBS on the availability of striatal dopamine transporter (DAT) as a marker of nigrostriatal nerve cell function, remains largely unknown. The aim of this study was therefore to evaluate whether 1) DAT availability changes within 1 year of STN-DBS and 2) the clinical outcome can be predicted based on preoperative DAT availability.
Correction of the skull density ratio for transcranial MRI-guided focused ultrasound thalamotomy: clinical significance of predicting therapeutic temperature
Hiroki Hori RT, PhD1, Hirokazu Iwamuro MD, PhD6, Masayuki Nakano MD, PhD3, Takahiro Ouchi MD4, Takashi Kawahara RT1, Takaomi Taira MD, PhD7, Keiichi Abe MD, PhD7, Ken Iijima MD5, and Toshio Yamaguchi MD, PhD2
doi : 10.3171/2020.9.JNS201109
Volume 135: Issue 5, page: 1436–1444
In transcranial magnetic resonance imaging–guided focused ultrasound (TcMRgFUS), a high skull density ratio (SDR) is advantageous to achieve a sufficiently high temperature at the target. However, it is not easy to estimate the temperature rise because the SDR shows different values depending on the reconstruction filter used. The resolution characteristic of a computed tomography (CT) image depends on a modulation transfer function (MTF) defined by the reconstruction filter. Differences in MTF induce unstable SDRs. The purpose of this study was both to standardize SDR by developing a method to correct the MTF and to enable effective patient screening prior to TcMRgFUS treatment and more accurate predictions of focal temperature.
A literature review of magnetic resonance imaging sequence advancements in visualizing functional neurosurgery targets
Alexandre Boutet MD, PhD1,2, Aaron Loh MB BCh BAO1, Clement T. Chow BKin1, Alaa Taha1, Gavin J. B. Elias BA1, Clemens Neudorfer MD1, Jurgen Germann PhD1, Michelle Paff MD1, Ludvic Zrinzo MD, PhD3, Alfonso Fasano MD, PhD4,5, Suneil K. Kalia MD, PhD1, Christopher J. Steele PhD6,7, David Mikulis MD1,2, Walter Kucharczyk MD1,2, and Andres M. Lozano MD, PhD1
doi : 10.3171/2020.8.JNS201125
Volume 135: Issue 5, page: 1445–1458
Historically, preoperative planning for functional neurosurgery has depended on the indirect localization of target brain structures using visible anatomical landmarks. However, recent technological advances in neuroimaging have permitted marked improvements in MRI-based direct target visualization, allowing for refinement of “first-pass” targeting. The authors reviewed studies relating to direct MRI visualization of the most common functional neurosurgery targets (subthalamic nucleus, globus pallidus, and thalamus) and summarize sequence specifications for the various approaches described in this literature.
Awake CT-guided percutaneous stylomastoid foramen puncture and radiofrequency ablation of facial nerve for treatment of hemifacial spasm
Bing Huang MD1, Ming Yao MD1, QiLiang Chen MD, PhD2, Huidan Lin MD3, Xindan Du MD4, Hao Huang MD5, Xian Zhao MD6, Huy Do MD7, and Xiang Qian MD, PhD2
doi : 10.3171/2020.10.JNS203209
Volume 135: Issue 5, page: 1459–1465
Hemifacial spasm (HFS) is a debilitating neuromuscular disorder with limited treatment options. The current study describes a novel minimally invasive procedure that provided effective and sustained relief for patients with HFS. The authors provide a detailed description of the awake CT-guided percutaneous radiofrequency ablation (RFA) of the facial nerve for treatment of HFS, and they examine its clinical efficacy. This is the first time in the literature that this procedure has been applied and systematically analyzed for HFS.
Stereoelectroencephalographic language mapping of the basal temporal cortex predicts postoperative naming outcome
Chifaou Abdallah MSc, MD1,4, Hélène Brissart PhD1, Sophie Colnat-Coulbois MD, PhD2, Ludovic Pierson MSc1, Olivier Aron MD1, Natacha Forthoffer MS1, Jean-Pierre Vignal MD1, Louise Tyvaert MD, PhD1,3, Jacques Jonas MD, PhD1,3, and Louis Maillard MD, PhD1,3
doi : 10.3171/2020.8.JNS202431
Volume 135: Issue 5, page: 1466–1476
In drug-resistant temporal lobe epilepsy (TLE) patients, the authors evaluated early and late outcomes for decline in visual object naming after dominant temporal lobe resection (TLR) according to the resection status of the basal temporal language area (BTLA) identified by cortical stimulation during stereoelectroencephalography (SEEG).
Frame-based and robot-assisted insular stereo-electroencephalography via an anterior or posterior oblique approach
Kathrin Machetanz MD1,2, Florian Grimm MD1,2, Thomas V. Wuttke MD1,3, Josua Kegele MD3, Holger Lerche MD3, Marcos Tatagiba MD1, Sabine Rona MD, PhD1, Alireza Gharabaghi MD1,2, Jürgen Honegger MD1, and Georgios Naros MD1,2
doi : 10.3171/2020.10.JNS201843
Volume 135: Issue 5, page: 1477–1486
There is an increasing interest in stereo-electroencephalography (SEEG) for invasive evaluation of insular epilepsy. The implantation of insular SEEG electrodes, however, is still challenging due to the anatomical location and complex functional segmentation in both an anteroposterior and ventrodorsal (i.e., superoinferior) direction. While the orthogonal approach (OA) is the shortest trajectory to the insula, it might insufficiently cover these networks. In contrast, the anterior approach (AOA) or posterior oblique approach (POA) has the potential for full insular coverage, with fewer electrodes bearing a risk of being more inaccurate due to the longer trajectory. Here, the authors evaluated the implantation accuracy and the detection of epilepsy-related SEEG activity with AOA and POA insular trajectories.
Anterior insula stimulation increases pain threshold in humans: a pilot study
Chang-Chia Liu PhD1, Shayan Moosa MD1, Mark Quigg MD, MSc2, and W. Jeffrey Elias MD1
doi : 10.3171/2020.10.JNS203323
Volume 135: Issue 5, page: 1487–1492
Chronic pain results in an enormous societal and financial burden. Opioids are the mainstay of treatment, but opioid abuse has led to an epidemic in the United States. Nonpharmacological treatment strategies like deep brain stimulation could be applied to refractory chronic pain if safe and effective brain targets are identified. The anterior insula is a putative mediator of pain-related affective-motivational and cognitive-evaluative cerebral processing. However, the effect of anterior insula stimulation on pain perception is still unknown. Here, the authors provide behavioral and neurophysiological evidence for stimulating the anterior insula as a means of potential therapeutic intervention for patients with chronic pain.
Novel intraoperative online functional mapping of somatosensory finger representations for targeted stimulating electrode placement: technical note
David P. McMullen MD1, Tessy M. Thomas BS2, Matthew S. Fifer PhD8, Daniel N. Candrea MS2, Francesco V. Tenore PhD8, Robert W. Nickl PhD3, Eric A. Pohlmeyer PhD8, Christopher Coogan MS4, Luke E. Osborn PhD8, Adam Schiavi PhD, MD5, Teresa Wojtasiewicz MD6, Chad R. Gordon DO7, Adam B. Cohen MD4,8, Nick F. Ramsey PhD9, Wouter Schellekens PhD9, Sliman J. Bensmaia PhD10, Gabriela L. Cantarero PhD3, Pablo A. Celnik MD3, Brock A. Wester PhD8, William S. Anderson MD, PhD6, and Nathan E. Crone MD4
doi : 10.3171/2020.9.JNS202675
Volume 135: Issue 5, page: 1493–1500
Defining eloquent cortex intraoperatively, traditionally performed by neurosurgeons to preserve patient function, can now help target electrode implantation for restoring function. Brain-machine interfaces (BMIs) have the potential to restore upper-limb motor control to paralyzed patients but require accurate placement of recording and stimulating electrodes to enable functional control of a prosthetic limb. Beyond motor decoding from recording arrays, precise placement of stimulating electrodes in cortical areas associated with finger and fingertip sensations allows for the delivery of sensory feedback that could improve dexterous control of prosthetic hands. In this study, the authors demonstrated the use of a novel intraoperative online functional mapping (OFM) technique with high-density electrocorticography to localize finger representations in human primary somatosensory cortex. In conjunction with traditional pre- and intraoperative targeting approaches, this technique enabled accurate implantation of stimulating microelectrodes, which was confirmed by postimplantation intracortical stimulation of finger and fingertip sensations. This work demonstrates the utility of intraoperative OFM and will inform future studies of closed-loop BMIs in humans.
Penfield, focal microgyria, and epilepsy
Richard Leblanc MD, FRCSC1
doi : 10.3171/2020.9.JNS202900
Volume 135: Issue 5, page: 1501–1507
Wilder Penfield (1891–1976) is widely regarded as a dominant figure in 20th century neurobiology for his singular contributions to the structure-function relationship of the brain, his discovery of the language function of the supplementary motor area, the discovery (with Herbert Jasper and Brenda Milner) of the anatomy of recall, and his pioneering work in the surgical treatment of focal epilepsy. But another of his significant discoveries has escaped notice: the recognition that focal microgyria can generate epileptic seizures, and that these can be treated surgically. Penfield discussed the case of the patient through which this discovery was made during his Shattuck Lecture to the Massachusetts Medical Society in 1939. As Penfield gave only a fragmentary account of this case, the patient's chart was retrieved from the Montreal Neurological Institute archives, and his operative note and brain map, intraoperative photographs, and the histopathological and cytological examinations of the resected specimen were reviewed. Based on these primary sources, this paper provides a complete, detailed account of the first case in which microgyria was recognized as a cause of focal epilepsy, which was successfully treated surgically.
Pilot study on the effects of low intensity focused ultrasound in a swine model of neuropathic pain
Abigail Hellman BA2, Teresa Maietta BS2, Alicia Clum2, Kanakaharini Byraju2, Nataly Raviv MD1, Michael D. Staudt MD, MSc1, Erin Jeannotte BS4, Goutam Ghoshal PhD5, Damian Shin MSc, PhD2, Paul Neubauer BSE5, Emery Williams BS5, Tamas Heffter MSc5, Clif Burdette PhD5, Jiang Qian MD, PhD3, Julia Nalwalk MSc2, and Julie G. Pilitsis MD, PhD1,2
doi : 10.3171/2020.9.JNS202962
Volume 135: Issue 5, page: 1508–1515
The authors’ laboratory has previously demonstrated beneficial effects of noninvasive low intensity focused ultrasound (liFUS), targeted at the dorsal root ganglion (DRG), for reducing allodynia in rodent neuropathic pain models. However, in rats the DRG is 5 mm below the skin when approached laterally, while in humans the DRG is typically 5–8 cm deep. Here, using a modified liFUS probe, the authors demonstrated the feasibility of using external liFUS for modulation of antinociceptive responses in neuropathic swine.
Development of a common peroneal nerve injury model in domestic swine for the study of translational neuropathic pain treatments
Abigail Hellman BA2, Teresa Maietta BS2, Alicia Clum2, Kanakaharini Byraju2, Nataly Raviv MD1, Michael D. Staudt MD, MSc1, Erin Jeannotte BS3, Julia Nalwalk MSc2, Sophie Belin PhD2, Yannick Poitelon PhD2, and Julie G. Pilitsis MD, PhD1,2
doi : 10.3171/2020.9.JNS202961
Volume 135: Issue 5, page: 1516–1523
To date, muscular and bone pain have been studied in domestic swine models, but the only neuropathic pain model described in swine is a mixed neuritis model. Common peroneal nerve injury (CPNI) neuropathic pain models have been utilized in both mice and rats.
Patterns of median nerve branching in the cubital fossa: implications for nerve transfers to restore motor function in a paralyzed upper limb
Jayme A. Bertelli MD, PhD1,2, Neehar Patel MD3, Francisco Soldado MD, PhD4,5, and Elisa Cristiana Winkelmann Duarte PhD6
doi : 10.3171/2020.9.JNS202742
Volume 135: Issue 5, page: 1524–1533
The purpose of this study was to describe the anatomy of donor and recipient median nerve motor branches for nerve transfer surgery within the cubital fossa.
Incorporating conditional survival into prognostication for gunshot wounds to the head
Patrick D. Kelly MD, MSCI,1, Pious D. Patel BA2, Aaron M. Yengo-Kahn MD1, Daniel I. Wolfson MD2, Fakhry Dawoud BS1,3, Ranbir Ahluwalia BS1,4, Oscar D. Guillamondegui MD, MPH5, and Christopher M. Bonfield MD1
doi : 10.3171/2020.9.JNS202723
Volume 135: Issue 5, page: 1550–1559
Several scores estimate the prognosis for gunshot wounds to the head (GSWH) at the point of hospital admission. However, prognosis may change over the course of the hospital stay. This study measures the accuracy of the Baylor score among patients who have already survived the acute phase of hospitalization and generates conditional outcome curves for the duration of hospital stay for patients with GSWH.
The value of simplicity: externally validating the Baylor cranial gunshot wound prognosis score
Aaron M. Yengo-Kahn MD,1, Pious D. Patel BA2, Patrick D. Kelly MD, MSCI1, Daniel I. Wolfson MD2, Fakhry Dawoud BS1,3, Ranbir Ahluwalia BS1,4, Christopher M. Bonfield MD1, and Oscar D. Guillamondegui MD, MPH5
doi : 10.3171/2020.9.JNS201891
Volume 135: Issue 5, page: 1560–1568
Gunshot wounds to the head (GSWH) are devastating injuries with a grim prognosis. Several prognostic scores have been created to estimate mortality and functional outcome, including the so-called Baylor score, an uncomplicated scoring method based on bullet trajectory, patient age, and neurological status on admission. This study aimed to validate the Baylor score within a temporally, institutionally, and geographically distinct patient population.
Surgical intervention and patient factors associated with poor outcomes in patients with traumatic brain injury at a tertiary care hospital in Uganda
Charis A. Spears BA1,3, Syed M. Adil BS1,3, Brad J. Kolls MD, PhD, MMCi1,2, Michael E. Muhumza MBChB, MMed4, Michael M. Haglund MD, PhD, MACM1,3,5,6, Anthony T. Fuller MD, MScGH1,3,5,6, and Timothy W. Dunn PhD1,5,7,8
doi : 10.3171/2020.9.JNS201828
Volume 135: Issue 5, page: 1569–1578
The purpose of this study was to investigate whether neurosurgical intervention for traumatic brain injury (TBI) is associated with reduced risks of death and clinical deterioration in a low-income country with a relatively high neurosurgical capacity. The authors further aimed to assess whether the association between surgical intervention and acute poor outcomes differs according to TBI severity and various patient factors.
Democratizing access to the residency application process: capitalizing on technology to improve information flow
Jasmine A. Thum DiCesare MSE, MD1, David J. Segar MD2, Brian V. Nahed MD, MSc3, and Maya Babu MD, MBA4
doi : 10.3171/2020.12.JNS203530
Volume 135: Issue 5, page: 1579–1581
Letter to the Editor. DBS in elderly patients: neurological challenges versus neurosurgical complications
Fahd Baig PhD, MRCP1 and Erlick A. C. Pereira DM, FRCS(SN)1
doi : 10.3171/2021.2.JNS21484
Volume 135: Issue 5, page: 1582–1583
Letter to the Editor. Methodology and interpretation of intraoperative neuromonitoring during intracranial aneurysm clipping
Dimitrios Kefalas MSc1, Gemma Pérez-Fajardo MD2, Juan Solivera MD, PhD2, Mario Méndez-García MD2, and Kostas N. Fountas MD, PhD3
doi : 10.3171/2021.3.JNS21520
Volume 135: Issue 5, page: 1583–1584
Letter to the Editor. A UK perspective on gender diversity in American neurosurgery training programs
Ellie Edlmann PhD1, Phillip Copley MRCS2, Mark Hughes PhD3, and Julie Woodfield PhD3
doi : 10.3171/2021.3.JNS21548
Volume 135: Issue 5, page: 1585–1586
Letter to the Editor. Age at death: a neglected outcome measure in oncology
Michael D. Cusimano MD, PhD1,2,3 and Paul J. Muller MD, FRCSC3
doi : 10.3171/2021.3.JNS21553
Volume 135: Issue 5, page: 1586–1587
Letter to the Editor. Intrahospital transport and SAH: possible impact on low- and middle-income countries
Ivan David Lozada-Martínez MS1,2,3, William Camargo-Martínez MS1, Amit Agrawal MCh4, Rakesh Mishra MD5, Bukkambudhi V. Murlimanju MD6, Adesh Shrivastava MCh4, and Luis Rafael Moscote-Salazar MD1,2,3
doi : 10.3171/2021.3.JNS21734
Volume 135: Issue 5, page: 1587–1588
