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Relationship of brainstem infarction to rupture of nonsaccular vertebrobasilar aneurysms
Lorenzo Rinaldo MD, PhD1, Deena M. Nasr DO2, Kelly D. Flemming MD2, Giuseppe Lanzino MD1,3, and Waleed Brinjikji MD1,3
doi : 10.3171/2020.9.JNS201937
Volume 135: Issue 6, page: 1591–1597
Symptomatic nonsaccular vertebrobasilar aneurysms (NSVBAs) are associated with high rates of aneurysm-related death. Anecdotal evidence suggests that brainstem infarction may be a harbinger of aneurysm rupture. The authors aimed to investigate the association between brainstem infarction and subsequent NSVBA rupture.
The safety profile and angioarchitectural changes after acute targeted embolization of ruptured arteriovenous malformations
Ann Mansur MD1, Alex Kostynskyy MBBS2, Timo Krings MD, PhD2, Ronit Agid MD2, Ivan Radovanovic MD, PhD3,4, and Vitor Mendes Pereira MD2,3
doi : 10.3171/2020.9.JNS201558
Volume 135: Issue 6, page: 1598–1607
The aim of this study was to 1) compare the safety and efficacy of acute targeted embolization of angiographic weak points in ruptured brain arteriovenous malformations (bAVMs) versus delayed treatment, and 2) explore the angioarchitectural changes that follow this intervention.
Cost-effectiveness analysis in patients with an unruptured cerebral aneurysm treated with observation or surgery
Charlotte Dandurand MD, MSc, FRCSC1,3, Lily Zhou MD, MSc, FRCSC2,3, Swetha Prakash MSc1, Gary Redekop MD, MSc, FRCSC1, Peter Gooderham MD, FRCSC1, and Charles S. Haw MD, MSc, FRCSC1
doi : 10.3171/2020.11.JNS202892
Volume 135: Issue 6, page: 1608–1616
The main goal of preventive treatment of unruptured intracranial aneurysms (UIAs) is to avoid the morbidity and mortality associated with aneurysmal subarachnoid hemorrhage. A comparison between the conservative approach and the surgical approach combining endovascular treatment and microsurgical clipping is currently lacking. This study aimed to conduct an updated evaluation of cost-effectiveness comparing the two approaches in patients with UIA.
Cavernous malformations of the hypothalamus: a single-institution series of 12 cases and review of the literature
Anadjeet S. Khahera MD1, Yiping Li MD1, and Gary K. Steinberg MD, PhD1
doi : 10.3171/2020.10.JNS201419
Volume 135: Issue 6, page: 1617–1626
There remains a paucity of literature on hypothalamic cavernous malformations (HCMs). Here, the authors present the largest series of HCMs to date and review the literature to gain additional insight into this rare disease subset.
Perioperative prophylactic middle meningeal artery embolization for chronic subdural hematoma: a series of 44 cases
Justin Schwarz MD1, Joseph A. Carnevale MD1, Jacob L. Goldberg MD1, Alexander D. Ramos MD, PhD1, Thomas W. Link MD1, and Jared Knopman MD1
doi : 10.3171/2020.10.JNS202856
Volume 135: Issue 6, page: 1627–1635
Chronic subdural hematoma (cSDH) is a common and challenging pathology to treat due to both the historically high recurrence rate following surgical evacuation and the medical comorbidities inherent in the aging patient population that it primarily affects. Middle meningeal artery (MMA) embolization has shown promise in the treatment of cSDHs, most convincingly to avoid surgical evacuation in relatively asymptomatic patients. Symptomatic patients requiring surgical evacuation may also benefit from perioperative MMA embolization to prevent cSDH recurrence. The goal of this study was to determine the utility of perioperative MMA embolization for symptomatic cSDH requiring surgical evacuation and to assess if there is a decrease in the cSDH recurrence rate compared to historical recurrence rates following surgical evacuation alone.
Results of transvenous embolization of intracranial dural arteriovenous fistula: a consecutive series of 136 patients with 142 fistulas
Alexis Guédon MD1,2,4, Jean-Pierre Saint-Maurice MD1, Cédric Thépenier MD, PhD3, Marc-Antoine Labeyrie MD1, Vittorio Civelli MD1, Carine El Sissy MD2, Michael Eliezer MD1, Armand Aymard MD1, Jean-Pierre Guichard MD1, and Emmanuel Houdart MD1,2
doi : 10.3171/2020.10.JNS203604
Volume 135: Issue 6, page: 1636–1644
Intracranial dural arteriovenous fistula (DAVF) is mainly treated with an endovascular approach. Two major treatment advances include transvenous embolization (TVE) with coils in 1989 and, more recently, transarterial embolization with Onyx. The aim of this study was to present a large monocentric series of patients with DAVF treated with TVE. This series reports more than 20 years of experience and describes the evolution of the medical management of these patients, as well as current indications for this treatment at the authors’ center.
Cost-effectiveness of endovascular thrombectomy in patients with low Alberta Stroke Program Early CT Scores (< 6) at presentation
Xiao Wu MD1, Sam Payabvash MD1, Charles C. Matouk MD1,2, Michael H. Lev MD3, Max Wintermark MD4, Pina Sanelli MD5, Dheeraj Gandhi MD6, and Ajay Malhotra MD1
doi : 10.3171/2020.9.JNS202965
Volume 135: Issue 6, page: 1645–1655
The utility of endovascular thrombectomy (EVT) in patients with acute ischemic stroke, large vessel occlusion (LVO), and low Alberta Stroke Program Early CT Scores (ASPECTS) remains uncertain. The objective of this study was to determine the health outcomes and cost-effectiveness of EVT versus medical management in patients with ASPECTS < 6.
Individualized blood pressure targets in the postoperative care of patients with intracerebral hemorrhage
Anna Lindner MD1, Verena Rass MD1, Bogdan-Andrei Ianosi MD1,4, Alois Josef Schiefecker MD, PhD1, Mario Kofler MD1, Max Gaasch MD1, Alberto Addis MD5, Paul Rhomberg MD2, Bettina Pfausler MD1, Ronny Beer MD1, Erich Schmutzhard MD1, Claudius Thomé MD3, and Raimund Helbok MD1
doi : 10.3171/2020.9.JNS201024
Volume 135: Issue 6, page: 1656–1665
Recent guidelines recommend targeting a systolic blood pressure (SBP) < 140 mm Hg in the early management of patients with spontaneous intracerebral hemorrhage (ICH). The optimal SBP targets for ICH patients after hematoma evacuation (HE) remain unclear. Here, the authors aimed to define the optimal SBP range based on multimodal neuromonitoring data.
Blood volume flow in the superficial temporal artery assessed by duplex sonography: predicting extracranial-intracranial bypass patency in moyamoya disease
Florian Connolly MD,1, Joan Alsolivany1, Marcus Czabanka MD2, Peter Vajkoczy MD2, Jose M. Valdueza MD3, Jens E. Röhl MD1, Eberhard Siebert MD4, and Leon A. Danyel MD1
doi : 10.3171/2020.9.JNS202709
Volume 135: Issue 6, page: 1666–1673
Superficial temporal artery–middle cerebral artery (STA-MCA) bypass surgery is an important therapy for symptomatic moyamoya disease. Its success depends on bypass function, which may be impaired by primary or secondary bypass insufficiency. Catheter angiography is the current gold standard to assess bypass function, whereas the diagnostic value of ultrasonography (US) has not been systematically analyzed so far.
Tumor location and reduction in functional MRI estimates of language laterality
Monika M. Po?czy?ska PhD, DLitt1, Lilian Beck BA1, Taylor Kuhn PhD1, Christopher F. Benjamin PhD,2,3,4, Timothy K. Ly BS1, Kevin Japardi BA1, Lucia Cavanagh PhD1, and Susan Y. Bookheimer PhD1
doi : 10.3171/2020.9.JNS202036
Volume 135: Issue 6, page: 1674–1684
Brain tumors located close to the language cortex may distort functional MRI (fMRI)–based estimates of language dominance. The nature of this distortion, and whether this is an artifact of numerous confounders, remains unknown. The authors hypothesized tumor bias based on laterality estimates independent of confounders and that the effects are the greatest for tumors proximal to Broca's area.
Development and validation of a patient-centered, meningioma-specific quality-of-life questionnaire
Ami Baba MRes1, Ashirbani Saha PhD1, Melissa D. McCradden PhD1, Kanwar Boparai HBSc1, Shudong Zhang BM1, Farhad Pirouzmand MD, MSc3, Kim Edelstein PhD4,5, Gelareh Zadeh MD, PhD6, and Michael D. Cusimano MD, PhD1,2,7
doi : 10.3171/2020.11.JNS201761
Volume 135: Issue 6, page: 1685–1694
Meningiomas can have significant impact on health-related quality of life (HRQOL). Patient-centered, disease-specific instruments for assessing HRQOL in these patients are lacking. To this end, the authors sought to develop and validate a meningioma-specific HRQOL questionnaire through a standardized, patient-centered questionnaire development methodology.
Time to administration of stereotactic radiosurgery to the cavity after surgery for brain metastases: a real-world analysis
Diana A. Roth O’Brien MD, MPH1, Sydney M. Kaye BA, BS2, Phillip J. Poppas BS2, Sean S. Mahase MD1, Anjile An MPH3, Paul J. Christos MS, DrPH3, Benjamin Liechty MD4, David Pisapia MD4, Rohan Ramakrishna MD2, AG Wernicke MD, MSc5, Jonathan P. S. Knisely MD1, Susan C. Pannullo MD2, and Theodore H. Schwartz MD2,6,7
doi : 10.3171/2020.10.JNS201934
Volume 135: Issue 6, page: 1695–1705
Publications on adjuvant stereotactic radiosurgery (SRS) are largely limited to patients completing SRS within a specified time frame. The authors assessed real-world local recurrence (LR) for all brain metastasis (BM) patients referred for SRS and identified predictors of SRS timing.
Silent corticotroph pituitary adenomas: clinical characteristics, long-term outcomes, and management of disease recurrence
Ben A. Strickland MD1, Shane Shahrestani MS1, Robert G. Briggs MD1, Anna Jackanich MD1, Sherwin Tavakol MPH1, Kyle Hurth MD, PhD2, Mark S. Shiroishi MD, MS3, Chia-Shang J. Liu MD, PhD3, John D. Carmichael MD4, Martin Weiss MD1, and Gabriel Zada MD1
doi : 10.3171/2020.10.JNS203236
Volume 135: Issue 6, page: 1706–1713
Silent corticotroph adenomas (SCAs) are a distinct subtype of nonfunctioning pituitary adenomas (NFAs) that demonstrate positive immunohistochemistry for adrenocorticotropic hormone (ACTH) without causing Cushing’s disease. SCAs are hypothesized to exhibit more aggressive behavior than standard NFAs. The authors analyzed their institution’s surgical experience with SCAs in an effort to characterize rates of invasion, postoperative clinical outcomes, and patterns of disease recurrence and progression. The secondary objectives were to define the best treatment strategies in the event of tumor recurrence and progression.
The predictive value of intraoperative visual evoked potential for visual outcome after extended endoscopic endonasal surgery for adult craniopharyngioma
Ning Qiao MD1, Xiaocui Yang MD2, Chuzhong Li MD1,3, Guofo Ma MD1, Jie Kang MD1, Chunhui Liu MD1, Lei Cao MD1, Yazhuo Zhang MD1,3, and Songbai Gui MD1
doi : 10.3171/2020.10.JNS202779
Volume 135: Issue 6, page: 1714–1724
Due to the proximity of craniopharyngioma to the optic apparatus, one of the most common complications after surgery is visual deterioration. Intraoperative visual evoked potential (VEP), as a means of real-time visual function monitoring, has been integrated into transsphenoidal surgery for pituitary adenoma to predict postoperative visual outcome. Compared with pituitary tumor, craniopharyngioma often adheres to optic nerves, with increased risk of postoperative visual impairment. Furthermore, extended endoscopic endonasal surgery (EEES) can provide direct visualization of the surgical plane between the craniopharyngioma and the optic nerves, which contributes to analysis of the mechanism of real-time VEP changes during surgery. Therefore, VEP monitoring applied during EEES for craniopharyngioma may have more clinical value. However, only 9 patients who underwent EEES with VEP monitoring for craniopharyngioma have been sporadically reported to date. In this paper, the authors present the largest series to date analyzing the clinical value of VEP to predict postoperative visual outcome in adult patients with craniopharyngioma.
The Stanford stereotactic radiosurgery experience on 7000 patients over 2 decades (1999–2018): looking far beyond the scalpel
Nida Fatima MBBS, MD1, Antonio Meola MD, PhD1, Victoria Y. Ding MS1, Erqi Pollom MD, MS2, Scott G. Soltys MD2, Cynthia F. Chuang PhD2, Nastaran Shahsavari MD1, Steven L. Hancock MD2, Iris C. Gibbs MD2, John R. Adler MD1, and Steven D. Chang MD1
doi : 10.3171/2020.9.JNS201484
Volume 135: Issue 6, page: 1725–1741
The CyberKnife (CK) has emerged as an effective frameless and noninvasive method for treating a myriad of neurosurgical conditions. Here, the authors conducted an extensive retrospective analysis and review of the literature to elucidate the trend for CK use in the management paradigm for common neurosurgical diseases at their institution.
Extent of parahippocampal ablation is associated with seizure freedom after laser amygdalohippocampotomy
David Satzer MD1, James X. Tao MD, PhD2, and Peter C. Warnke MD1
doi : 10.3171/2020.11.JNS203261
Volume 135: Issue 6, page: 1742–1751
The authors aimed to examine the relationship between mesial temporal subregion ablation volume and seizure outcome in a diverse cohort of patients who underwent stereotactic laser amygdalohippocampotomy (SLAH) for mesial temporal lobe epilepsy (MTLE).
Status epilepticus after intracranial neurosurgery: incidence and risk stratification by perioperative clinical features
Michael C. Jin BS1, Jonathon J. Parker MD, PhD1, Michael Zhang MD1, Zack A. Medress MD1, Casey H. Halpern MD1, Gordon Li MD1, John K. Ratliff MD1, Gerald A. Grant MD1, Robert S. Fisher MD, PhD2, and Stephen Skirboll MD1,3
doi : 10.3171/2020.10.JNS202895
Volume 135: Issue 6, page: 1752–1764
Status epilepticus (SE) is associated with significant mortality, cost, and risk of future seizures. In one of the first studies of SE after neurosurgery, the authors assess the incidence, risk factors, and outcome of postneurosurgical SE (PNSE).
Surgically treatable adult epilepsy: a changing patient population. Experience from a level 4 epilepsy center
Jacob R. Lepard MD1, Esther Dupépé MD, MSPH1, Matthew Davis MD, MPH1, Jennifer DeWolfe DO2, Bonita Agee PhD, MPH1, J. Nicole Bentley MD1, and Kristen Riley MD1
doi : 10.3171/2020.10.JNS201629
Volume 135: Issue 6, page: 1765–1770
Invasive monitoring has long been utilized in the evaluation of patients for epilepsy surgery, providing localizing information to guide resection. Stereoelectroencephalography (SEEG) was introduced at the authors’ level 4 epilepsy surgery program in 2013, with responsive neurostimulation (RNS) becoming available the following year. The authors sought to characterize patient demographics and epilepsy-related variables before and after SEEG introduction to understand whether differences emerged in their patient population. This information will be useful in understanding how SEEG, possibly in conjunction with RNS availability, may have changed practice patterns over time.
Symptom-specific differential motor network modulation by deep brain stimulation in Parkinson’s disease
William S. Gibson MD, PhD1,6, Aaron E. Rusheen BS1,5, Yoonbae Oh PhD1,2, Myung-Ho In PhD3, Krzysztof R. Gorny PhD3, Joel P. Felmlee PhD3, Bryan T. Klassen MD4, Sung Jun Jung MD, PhD7, Hoon-Ki Min PhD3, Kendall H. Lee MD, PhD1,2, and Hang Joon Jo PhD1,3,4,7
doi : 10.3171/2020.10.JNS202277
Volume 135: Issue 6, page: 1771–1779
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established neurosurgical treatment for the motor symptoms of Parkinson’s disease (PD). While often highly effective, DBS does not always yield optimal therapeutic outcomes, and stimulation-induced adverse effects, including paresthesia, muscle contractions, and nausea/lightheadedness, commonly occur and can limit the efficacy of stimulation. Currently, objective metrics do not exist for monitoring neural changes associated with stimulation-induced therapeutic and adverse effects.
Technical and operative factors affecting magnetic resonance imaging–guided focused ultrasound thalamotomy for essential tremor: experience from 250 treatments
Myung Ji Kim MD1, So Hee Park MD1, Kyung Won Chang MD1, Yuhee Kim MSc2, Jing Gao PhD2, Maya Kovalevsky MSc2, Itay Rachmilevitch BSc2, Eyal Zadicario PhD2, Won Seok Chang MD, PhD1, Hyun Ho Jung MD, PhD1, and Jin Woo Chang MD, PhD1
doi : 10.3171/2020.11.JNS202580
Volume 135: Issue 6, page: 1780–1788
Magnetic resonance imaging–guided focused ultrasound (MRgFUS) provides real-time monitoring of patients to assess tremor control and document any adverse effects. MRgFUS of the ventral intermediate nucleus (VIM) of the thalamus has become an effective treatment option for medically intractable essential tremor (ET). The aim of this study was to analyze the correlations of clinical and technical parameters with 12-month outcomes after unilateral MRgFUS thalamotomy for ET to help guide future clinical treatments.
Results of three or more Gamma Knife radiosurgery procedures for recurrent trigeminal neuralgia
Mihir Gupta MD1, Varun Sagi BS2, Aditya Mittal BS3, Anudeep Yekula MBBS4, Devan Hawkins ScD5, Justin Shimizu6, Pate J. Duddleston MD7, Kathleen Thomas RN8, Steven J. Goetsch PhD9, John F. Alksne MD1,9, David W. Hodgens MD9, Kenneth Ott MD9, Kenneth T. Shimizu MD9, Christopher Duma MD8, and Sharona Ben-Haim MD1,9
doi : 10.3171/2020.10.JNS202323
Volume 135: Issue 6, page: 1789–1798
Gamma Knife radiosurgery (GKRS) is an established surgical option for the treatment of trigeminal neuralgia (TN), particularly for high-risk surgical candidates and those with recurrent pain. However, outcomes after three or more GKRS treatments have rarely been reported. Herein, the authors reviewed outcomes among patients who had undergone three or more GKRS procedures for recurrent TN.
Outcomes associated with brain tissue oxygen monitoring in patients with severe traumatic brain injury undergoing intracranial pressure monitoring
Haydn Hoffman MD1, Karl Abi-Aad MD2, Katherine M. Bunch MS1, Timothy Beutler MD1,3, Fadar O. Otite MD3, and Lawrence S. Chin MD1
doi : 10.3171/2020.11.JNS203739
Volume 135: Issue 6, page: 1799–1806
Brain tissue oxygen monitoring combined with intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) may confer better outcomes than ICP monitoring alone. The authors sought to investigate this using a national database.
The Kempe incision for decompressive craniectomy, craniotomy, and cranioplasty in traumatic brain injury and stroke
Isaac Josh Abecassis MD1, Christopher C. Young MD, PhD1, David J. Caldwell PhD1, Abdullah H. Feroze MD1, John R. Williams MD1, R. Michael Meyer MD1, Ryan T. Kellogg MD3, Robert H. Bonow MD1,2, and Randall M. Chesnut MD1
doi : 10.3171/2020.11.JNS203567
Volume 135: Issue 6, page: 1807–1816
Decompressive craniectomy (DC) is an effective, lifesaving option for reducing intracranial pressure (ICP) in traumatic brain injury (TBI), stroke, and other pathologies with elevated ICP. Most DCs are performed via a standard trauma flap shaped like a reverse question mark (RQM), which requires sacrificing the occipital and posterior auricular arteries and can be complicated by wound dehiscence and infections. The Ludwig Kempe hemispherectomy incision (Kempe) entails a T-shaped incision, one limb from the midline behind the hairline to the inion and the other limb from the root of the zygoma to the coronal suture. The authors’ objective in this study was to define their implementation of the Kempe incision for DC and craniotomy, report clinical outcomes, and quantify the volume of bone removed compared with the RQM incision.
Balancing task sensitivity with reliability for multimodal language assessments
Alexander A. Aabedi BS1, Sofia Kakaizada BS1, Jacob S. Young MD1, EunSeon Ahn BS2, Daniel H. Weissman PhD2, Mitchel S. Berger MD1, David Brang PhD2, and Shawn L. Hervey-Jumper MD1
doi : 10.3171/2020.10.JNS202947
Volume 135: Issue 6, page: 1817–1824
Intraoperative tasks for awake language mapping are typically selected based on the language tracts that will likely be encountered during tumor resection. However, diminished attention and arousal secondary to perioperative sedatives may reduce a task’s usefulness for identifying eloquent cortex. For instance, accuracy in performing select language tasks may be high preoperatively but decline in the operating room. In the present study, the authors sought to identify language tasks that can be performed with high accuracy in both situational contexts so the neurosurgical team can be confident that speech errors committed during awake language mapping result from direct cortical stimulation to eloquent cortex, rather than from poor performance in general.
Development and validation of a patient face-mounted, negative-pressure antechamber for reducing exposure of healthcare workers to aerosolized particles during endonasal surgery
Mark Lee BS, BA1, Hazel T. Rivera-Rosario BS2, Matthew H. Kim MD1, Gregory P. Bewley PhD2, Jane Wang PhD2, Zellman Warhaft PhD2, Bradley Stylman MS, MPA3, Angela I. Park BS4, Aoife MacMahon BA1, Ashutosh Kacker MD1, and Theodore H. Schwartz MD5
doi : 10.3171/2020.10.JNS202745
Volume 135: Issue 6, page: 1825–1832
The authors developed a negative-pressure, patient face-mounted antechamber and tested its efficacy as a tool for sequestering aerated particles and improving the safety of endonasal surgical procedures.
Editorial. Myths, misquotes, and the perpetuation of errors through the published literature: the double-edged sword of progress
Charles J. Prestigiacomo MD1
doi : 10.3171/2020.11.JNS203624
Volume 135: Issue 6, page: 1833–1835
Dandy’s hemispherectomies: historical vignette
Ignacio Jusue-Torres MD1, Vikram C. Prabhu MD1, and G. Alexander Jones MD1
doi : 10.3171/2020.9.JNS202824
Volume 135: Issue 6, page: 1836–1842
To better understand Walter Dandy’s intentions and the historical context of his work on hemispherectomy, the authors reviewed his original 1928 publication. Gliomas were considered incurable at that time. Presuming that the loss of motor function denoted a lack of useful tissue in that hemisphere, he pioneered radical removal of the involved cerebral hemisphere. Of the 5 patients operated on by Dandy, 1 died within 48 hours of hemorrhage because of a displaced vascular clip; 1 died of pneumonia in 2 weeks; 2 died of tumor recurrence, at 3 months and 3.5 years, respectively; and a fifth patient was lost to follow-up beyond the 2nd postoperative week.
Charcot's motor brain map and 19th-century neurosurgery
Richard Leblanc MD, FRCSC1
doi : 10.3171/2020.10.JNS202651
Volume 135: Issue 6, page: 1843–1848
Neurosurgery is predicated on the knowledge of the structure-function relationship of the brain. When the topic is broached in its historiography, it begins with Fritch and Hitzig's report on the localization of motor function in the cortex of the dog and skips rapidly to Wilder Penfield's homunculus. In that gap are found the origins of modern neurosurgery in 3 papers published by Jean-Martin Charcot and Albert Pitres between 1877 and 1879 in which they describe the somatotopic organization of the human motor cortex and draw the first human brain map. Their findings, obtained through the clinicopathological method, gave relevance to David Ferrier's observations in animals. Their work was extensively cited, and their illustrations reproduced by Ferrier in his landmark lecture to the Royal College of Physicians in 1878. It was known to William Macewen, who used localization to guide him in resecting intracranial mass lesions, and to William Osler and John Hughlings Jackson, who were early advocates of intracranial surgery. This paper describes Charcot and Pitres' discovery of the cortical origin of human voluntary movement and its somatotopic organization, and their influence on 19th-century intracranial surgery. It fills a gap in the historiography of cerebral localization and neurosurgery.
Neurosurgery at UT Southwestern Medical Center: 1956–2020
Christopher L. Taylor MD, MBA1
doi : 10.3171/2020.12.JNS203527
Volume 135: Issue 6, page: 1849–1856
The history of neurosurgery at UT Southwestern Medical Center in Dallas, Texas, is reviewed. Kemp Clark, MD, started the academic neurosurgical practice at Parkland Hospital in 1956. Clark developed a robust training program that required the resident to operate early. In 1972, the Dallas Veterans Affairs Hospital was added to the training program. Duke Samson, MD, became chair in 1988. He emphasized technical excellence and honest reporting of surgical outcomes. In 1989, Zale Lipshy University Hospital opened and became a center for neurosurgical care, and Hunt Batjer, MD, became chair in 2012. The program expanded significantly. Along with principles established by his predecessors, Batjer emphasized the need for all neurosurgeons to engage the community and to be active in policy leadership through local and national organizations. During his tenure, the pediatric neurosurgery group at Children’s Medical Center Dallas was integrated with the department, and a multidisciplinary spine service was developed. In 2014, the Peter O’Donnell Jr. Brain Institute was established, and the William P. Clements Jr. University Hospital opened. For 64 years, UT Southwestern Medical Center has been fertile ground for academic neurosurgery, with a strong emphasis on excellence in patient care.
Enhanced Recovery After Surgery strategies for elective craniotomy: a systematic review
Vittorio Stumpo MD2, Victor E. Staartjes BMed1,2, Ayesha Quddusi MBBS3, Marco V. Corniola MD4, Enrico Tessitore MD4, Marc L. Schröder MD, PhD5, Erich G. Anderer MD6, Martin N. Stienen MD, FEBNS1,7, Carlo Serra MD1, and Luca Regli MD1
doi : 10.3171/2020.10.JNS203160
Volume 135: Issue 6, page: 1857–1881
Enhanced Recovery After Surgery (ERAS) has led to a paradigm shift in perioperative care through multimodal interventions. Still, ERAS remains a relatively new concept in neurosurgery, and there is no summary of evidence on ERAS applications in cranial neurosurgery.
Making a match: trends in the application, interview, and ranking process for the neurological surgery residency programs
Kurt A. Yaeger MD1, Alexander J. Schupper MD1, Jeffrey T. Gilligan MD1, and Isabelle M. Germano MD, MBA1
doi : 10.3171/2020.11.JNS203637
Volume 135: Issue 6, page: 1882–1888
Neurosurgery is a highly competitive residency field with a match rate lower than that of other specialties. The aim of this study was to analyze trends associated with the residency match process from the applicants’ and program directors’ perspectives.
Are preoperative chlorhexidine gluconate showers associated with a reduction in surgical site infection following craniotomy? A retrospective cohort analysis of 3126 surgical procedures
Simon G. Ammanuel BS1, Caleb S. Edwards BA1, Andrew K. Chan MD1, Praveen V. Mummaneni MD, MBA1, Joseph Kidane BS1, Enrique Vargas BA1, Sarah D’Souza BS1, Amy D. Nichols RN2, Sujatha Sankaran MD3, Adib A. Abla MD1, Manish K. Aghi MD, PhD1, Edward F. Chang MD1, Shawn L. Hervey-Jumper MD1, Sandeep Kunwar MD1, Paul S. Larson MD1, Michael T. Lawton MD1, Philip A. Starr MD, PhD1, Philip V. Theodosopoulos MD1, Mitchel S. Berger MD1, and Michael W. McDermott MD1
doi : 10.3171/2020.10.JNS201255
Volume 135: Issue 6, page: 1889–1897
Surgical site infection (SSI) is a complication linked to increased costs and length of hospital stay. Prevention of SSI is important to reduce its burden on individual patients and the healthcare system. The authors aimed to assess the efficacy of preoperative chlorhexidine gluconate (CHG) showers on SSI rates following cranial surgery.
Cellular transplantation for Parkinson’s disease: a strategy whose time has passed
Ron L. Alterman MD1
doi : 10.3171/2021.1.JNS203748
Volume 135: Issue 6, page: 1898–1902
DBS = deep brain stimulation; GID = graft-induced dyskinesia; hENTT = human embryonic nigral tissue transplantation; iPSC = induced pluripotent stem cell; PD = Parkinson’s disease; PET = positron emission tomography.
Letter to the Editor. Repeated Gamma Knife radiosurgery for recurrent trigeminal neuralgia: is it the next over-the-counter treatment?
Manjul Tripathi MCh1
doi : 10.3171/2021.5.JNS211086
Volume 135: Issue 6, page: 1903
Letter to the Editor. Treatment of MGMT-positive glioblastoma
Jimmy Ming-Jung Chuang MD1 and Dueng-Yuan Hueng MD, PhD2
doi : 10.3171/2021.3.JNS21571
Volume 135: Issue 6, page: 1904–1905
Letter to the Editor. How to reduce the recurrence rate in chronic subdural hematoma surgery
Nathan Beucler MD1
doi : 10.3171/2021.4.JNS21884
Volume 135: Issue 6, page: 1905–1906
Letter to the Editor. Management of hyperostotic spheno-orbital meningiomas
Alfio Spina MD1, Nicola Boari MD1, and Pietro Mortini MD1
doi : 10.3171/2021.4.JNS21952
Volume 135: Issue 6, page: 1907
