Rachel H Muster, BS, Jacob S Young, MD, Peter Y M Woo, MD, Ramin A Morshed, MD, Gayathri Warrier, MS ...
doi : 10.1093/neuros/nyaa364
Volume 88, Issue 6, June 2021, Pages 1043–1050
Gliomas are often in close proximity to functional regions of the brain; therefore, electrocortical stimulation (ECS) mapping is a common technique utilized during glioma resection to identify functional areas. Stimulation-induced seizure (SIS) remains the most common reason for aborted procedures. Few studies have focused on oncological factors impacting cortical stimulation thresholds.
Gregg W Luther, JD
doi : 10.1093/neuros/nyab077
Volume 88, Issue 6, June 2021, Pages 1051–1055
American tort law (a.k.a. negligence) is designed to be flexible and elastic to adapt to changes in time and public policy. It provides a structure of elements and factors to be applied to each case's specific facts on a case-by-case basis. The purpose of this structure is to achieve as much uniformity as possible in the application of tort law. One side effect is that this structure makes predicting the outcome difficult because of so many variables. In addition, there is no national tort law. Instead, each state has developed its own law in the area of torts, which has resulted in differing exceptions and requirements based on where the medical care was given. The purpose of this article is to explain the first element of a negligence case—“duty to use care”—and its accompanying factors/variables.
Lisa Feldman, MD, PhD, Christine Brown, PhD, Behnam Badie, MD
doi : 10.1093/neuros/nyaa584
Volume 88, Issue 6, June 2021, Pages 1056–1064
Glioblastoma multiforme (GBM) are the most common and among the deadliest brain tumors in adults. Current mainstay treatments are insufficient to treat this tumor, and therefore, more effective therapies are desperately needed. Immunotherapy, which takes advantage of the body's natural defense mechanism, is an exciting emerging field in neuro-oncology. Adoptive cell therapy with chimeric antigen receptor (CAR) T cells provides a treatment strategy based on using patients’ own selected and genetically engineered cells that target tumor-associated antigens. These cells are harvested from patients, modified to target specific proteins expressed by the tumor, and re-introduced into the patient with the goal of destroying tumor cells. Here, we review the history of CAR T-cell therapy, and describe the characteristics of various generations of CAR T therapies, and the challenges inherent to treatment of GBM. Finally, we describe recent and current CAR T clinical trials designed to combat GBM.
Kenny Yat Hong Kwan, BMBCh, FRCSEd, FHKCOS, FHKAM, J Naresh-Babu, MBBS, MS, FNB, Wilco Jacobs, PhD, Marinus de Kleuver, MD, PhD, David W Polly, Jr, MD ...
doi : 10.1093/neuros/nyab023
Volume 88, Issue 6, June 2021, Pages 1065–1073
Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking.
Franco Rubino, MD, Daniel G Eichberg, MD, Ashish H Shah, MD, Evan M Luther, MD, Victor M Lu, MD, PhD ...
doi : 10.1093/neuros/nyab043
Volume 88, Issue 6, June 2021, Pages 1074–1087
The intracerebral occurrence of malignant peripheral nerve sheath tumors (MPNSTs) is exceedingly rare, and despite aggressive treatments, local recurrence and poor prognosis are very frequent. Like other brain tumors, these tumors could be primary or secondary, making the term “peripheral” an imprecise term for a primary brain tumor.
Ryan K Badiee, BA, BS, Andrew K Chan, MD, Joshua Rivera, BA, Annette Molinaro, PhD, Dean Chou, MD ...
doi : 10.1093/neuros/nyaa593
Volume 88, Issue 6, June 2021, Pages 1088–1094
Posterior cervical decompression and fusion (PCF) is a common procedure used to treat various cervical spine pathologies, but the 90-d outcomes following PCF surgery continue to be incompletely defined.
Jun-Qiang Yin, MD, Yi-Wei Fu, MD, Zhen-Hua Gao, MD, Chang-Ye Zou, MD, Xian-Biao Xie, MD ...
doi : 10.1093/neuros/nyaa589
Volume 88, Issue 6, June 2021, Pages 1095–1102
More effective therapies are needed to treat progressive desmoid tumors when active surveillance and systemic therapy fail.
Megan M Jack, MD, PhD, Brandon W Smith, MD, Robert J Spinner, MD
doi : 10.1093/neuros/nyab026
Volume 88, Issue 6, June 2021, Pages E489–E490
Yin et al1 describe a sandwich isolation technique of wrapping the adjacent neurovascular structures to protect them from invasion following resection of recurrent desmoid. ?zger et al2 previously described a similar technique using synthetic vascular grafts in 2 patients to prevent neurovascular invasion of desmoid tumors. The current authors do not report any tumor recurrences surrounding or within the grafts nor do they report any progressive neurological symptoms on long-term follow-up.
Harley Brito da Silva, MD, Rajiv Midha, MD
doi : 10.1093/neuros/nyab017
Volume 88, Issue 6, June 2021, Pages E491–E492
We read with great interest the article entitled “A Novel Method to Treat Progressive Desmoid Tumors Involving Neurovascular Bundles: A Retrospective Cohort Study.”1 Well-accepted principles of oncological surgery are to resect a soft tissue tumor until a tumor-free margin is reached, and in 1977, the American Joint Committee on Cancer2,3 recommended a classification for the degree of resection. This classification has been used in surgical oncology since then, and accordingly the authors base their retrospective study on it as well. Thus, in this article, a group of patients with desmoid tumors that had R2 resection margins for neurovascular structures, ie, macroscopic residual tumor at the neurovascular structures, were isolated using their described sandwich techniques to prevent local spread and...
Fabio A Frisoli, MD, Joshua S Catapano, MD, Dara S Farhadi, MS, Megan S Cadigan, BS, Candice L Nguyen, BS ...
doi : 10.1093/neuros/nyab020
Volume 88, Issue 6, June 2021, Pages 1103–1110
The modified Spetzler-Martin (SM) grading system proposes that grade III arteriovenous malformation (AVM) subtypes are associated with variable microsurgical risks, with small AVMs (III?) having lower risk and medium/eloquent AVMs (III+) having higher risk. Adding patient age and AVM bleeding status and compactness to the SM grade produces a score – the supplemented SM (Supp-SM) grade – to more accurately assess preoperative risk.
Ching-Jen Chen, MD, Thomas J Buell, MD, Dale Ding, MD, Ridhima Guniganti, MD, Akash P Kansagra, MD, MS ...
doi : 10.1093/neuros/nyab024
Volume 88, Issue 6, June 2021, Pages 1111–1120
Low-grade intracranial dural arteriovenous fistulas (dAVF) have a benign natural history in the majority of cases. The benefit from treatment of these lesions is controversial.
Lee A Tan, MD
doi : 10.1093/neuros/nyab071
Volume 88, Issue 6, June 2021, Pages E493–E494
Frailty is defined as “a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems.”1 The concept of “frailty” was first introduced in 1979 by Vaupel et al2 and historically has been a topic of research in the field of geriatrics.3-5 Over the last decade, there have been multiple studies of patients undergoing nonspine surgery and demonstrating that increased frailty is associated with worse surgical outcome.6-8 Most of the literature regarding frailty and its impact on spinal surgery outcome had only been published in the last 5 yr.
Katherine E Pierce, BS, Peter G Passias, MD, Alan H Daniels, MD, Renaud Lafage, MS, Waleed Ahmad, MS ...
doi : 10.1093/neuros/nyab039
Volume 88, Issue 6, June 2021, Pages 1121–1127
Frailty severity may be an important determinant for impaired recovery after cervical spine deformity (CD) corrective surgery.
Nicole C R McLaughlin, PhD, Peter M Lauro, BA, Morgan T Patrick, ScB, Francesco G Pucci, MD, Adriel Barrios-Anderson, ScB ...
doi : 10.1093/neuros/nyab050
Volume 88, Issue 6, June 2021, Pages 1128–1135
Obsessive-compulsive disorder (OCD) is a disabling condition characterized by intrusive thoughts and repetitive behaviors. A subset of individuals have severe, treatment-resistant illness and are nonresponsive to medication or behavioral therapies. Without response to conventional therapeutic options, surgical intervention becomes an appropriate consideration.
Peng Wang, MD, Chen Luo, MD, Peng-jie Hong, MM, Wen-ting Rui, MD, Shuai Wu, MD, PhD
doi : 10.1093/neuros/nyab052
Volume 88, Issue 6, June 2021, Pages 1136–1144
While maximizing extent of resection (EOR) is associated with longer survival in lower-grade glioma (LGG) patients, the number of cases remains insufficient in determining a EOR threshold to elucidate the clinical benefits, especially in IDH-wild-type LGG patients.
Scott L Zuckerman, MD, MPH, Aaron M Yengo-Kahn, MD, Alan R Tang, BA, Julian E Bailes, MD, Kathryn Beauchamp, MD ...
doi : 10.1093/neuros/nyab041
Volume 88, Issue 6, June 2021, Pages E495–E504
Sport-related structural brain injury (SRSBI) is intracranial pathology incurred during sport. Management mirrors that of non-sport-related brain injury. An empirical vacuum exists regarding return to play (RTP) following SRSBI.
Joshua S Catapano, MD, Andrew F Ducruet, MD, Candice L Nguyen, BS, Neil Majmundar, MD, D Andrew Wilkinson, MD ...
doi : 10.1093/neuros/nyab036
Volume 88, Issue 6, June 2021, Pages E505–E509
Transradial artery (TRA) catheterization for neuroendovascular procedures is associated with a lower risk of complications than transfemoral artery (TFA) procedures. However, the majority of literature on TRA access pertains to diagnostic procedures rather than interventional treatments.
Ahmad Sweid, MD, Joshua H Weinberg, BS, Omaditya Khanna, MD, Somnath Das, BS, Julie Kim, BS ...
doi : 10.1093/neuros/nyab084
Volume 88, Issue 6, June 2021, Pages E510–E522
The radial approach has been gaining more widespread use by neurointerventionalists fueled by data from the cardiology literature showing better safety and overall reduced morbidity.
Nicholas J Erickson, MD, James H Mooney, MD, Beverly C Walters, MD, MSc, FRCSC, Bonita Agee, PhD, Winfield S Fisher, III, MD
doi : 10.1093/neuros/nyab086
Volume 88, Issue 6, June 2021, Pages E523–E528
The Koos classification of vestibular schwannomas is designed to stratify tumors based on extrameatal extension and compression of the brainstem. Our prior study demonstrated excellent reliability. No study has yet assessed its validity.
Chunyan Li, PhD, Timothy G White, MD, Kevin A Shah, MD, Wayne Chaung, PhD, Keren Powell, BA ...
doi : 10.1093/neuros/nyab053
Volume 88, Issue 6, June 2021, Pages E529–E536
The trigeminal nerve directly innervates key vascular structures both centrally and peripherally. Centrally, it is known to innervate the brainstem and cavernous sinus, whereas peripherally the trigemino-cerebrovascular network innervates the majority of the cerebral vasculature. Upon stimulation, it permits direct modulation of cerebral blood flow (CBF), making the trigeminal nerve a promising target for the management of cerebral vasospasm. However, trigeminally mediated cerebral vasodilation has not been applied to the treatment of vasospasm.
Arsalaan Salehani, MD, James Mooney, MD, Jacob Lepard, MD, James R Hackney, MD, Daniel Harmon, MD
doi : 10.1093/neuros/nyab044
Volume 88, Issue 6, June 2021, Pages E537–E542
Ameloblastic carcinoma (AC) is a malignant neoplasm of epithelial origin that typically arises from the mandible or maxilla. It represents approximately 2% of all odontogenic tumors. Gross total resection is the surgical goal given AC’s aggressiveness and propensity for recurrence. We present the first reported AC metastasis to the cervical spine.
Thomas G Luerssen, MD, Marion L Walker, MD, Andrew Jea, MD
doi : 10.1093/neuros/nyab082
Volume 88, Issue 6, June 2021, Pages 1145–1146
We wish to alert readers of Neurosurgery who might not already know that William R. Cheek Jr died peacefully on January 3, 2021, after an extended battle with Parkinson Disease. Dr Cheek was Professor Emeritus of Neurosurgery at the Baylor College of Medicine and former Chief of Neurosurgery at Texas Children's Hospital in Houston, Texas.
Carrie R Muh, MD
doi : 10.1093/neuros/nyab069
Volume 88, Issue 6, June 2021, Page E543
There are not many children's books about being a neurosurgeon, but who better to write such a book than the daughters of neurosurgeons?
Kevin Shiue, MD, James C Miller, MD, Tim Lautenschlaeger, MD, Stephanie K Schaub, MD, Simon S Lo, MD, MB, ChB
doi : 10.1093/neuros/nyab093
Volume 88, Issue 6, June 2021, Pages E544–E545
Surgery is often the first step in the management of spinal cord compression for medically appropriate patients with reasonable performance status and life expectancy, with postoperative radiotherapy to follow to maximize the chance of optimal functional outcomes.1 Conventionally, fractionated radiotherapy with simple parallel opposed fields or a single posterior field is administered postoperatively (typically 20 Gy in 5 fractions or 30 Gy in 10 fractions) to provide improved local control (LC). Data on LC rates in this setting are limited, as most studies did not employ regular follow-up imaging or even report LC. As such, LC rates in such publications are typically reflective of clinical evaluation without strict imaging follow-up.
Myron L Rolle, MD, Deen L Garba, BSPH, Andres M Rubiano, MD, PhD
doi : 10.1093/neuros/nyab072
Volume 88, Issue 6, June 2021, Pages E546–E547
The magnitude of traumatic brain injury (TBI) worldwide is staggering, with over 70 million individuals suffering from TBI annually.1 Aptly dubbed the “silent epidemic”, TBI continues to disproportionately affect individuals from lower to middle-income countries (LMICs).1,2 TBI not only causes death and disability, but it significantly hamstrings healthcare systems and national economies through high treatment costs and loss of economic productivity.
Badih J Daou, MD, Sravanthi Koduri, MD, Aditya S Pandey, MD
doi : 10.1093/neuros/nyab076
Volume 88, Issue 6, June 2021, Pages E548–E549
We read with interest the article titled “Survival, Dependency, and Health-Related Quality of Life in Patients with Ruptured Intracranial Aneurysm: Ten-Year Follow-up of the UK Cohort of the International Subarachnoid Aneurysm Trial (ISAT),”1 reporting on the long-term health-related quality of life benefits of endovascular coiling compared to neurosurgical clipping in patients treated for a ruptured intracranial aneurysm. The study provides key long-term data extrapolated from the UK cohort of the ISAT trial and presents data over a 10-yr period.2 The study concludes that endovascular coiling leads not only to better survival outcomes but also results in increased quality of life, long-term quality-adjusted life years (QALYs), and independence status, all of which remained true throughout the follow-up period.
Jaimie M Henderson, MD
doi : 10.1093/neuros/nyab035
Volume 88, Issue 6, June 2021, Pages E550–E551
Despite progress on many fronts (including understanding of basic neurobiology, improvements in surgical targeting, and increased diagnostic precision), neurosurgical procedures for psychiatric disorders remain controversial, with the lay public often suspicious of outcomes and motivations.
Joshua M Rosenow, MD
doi : 10.1093/neuros/nyab075
Volume 88, Issue 6, June 2021, Pages E552–E553
The authors1 have undertaken a 5-yr review of previously published evidence-based guidelines2 for the use of deep brain stimulation (DBS) for the treatment of medically refractory obsessive compulsive disorder (OCD). The authors are to be commended both for following a rigorous process for developing the guidelines, as they have both updated the evidence tables with publications that have appeared since the previous paper, as well as repeating and broadening the previous literature search by including the EMBASE database. OCD DBS in the anterior limb of the internal capsule (ALIC) remains approved by the Food and Drug Administration (FDA) under a humanitarian device exemption (HDE),3 but continues to be listed as experimental/investigational by many insurance plans, thus, hindering access to the...
Ali R Rezai, MD, Manish Ranjan, MCh, Martijn Figee, MD, PhD, Brian Harris Kopell, MD
doi : 10.1093/neuros/nyab078
Volume 88, Issue 6, June 2021, Pages E554–E555
Obsessive-compulsive disorder (OCD) is a major cause of disability worldwide. Neurosurgical interventions for treatment refractory OCD targeting cortico-striato-thalamo-cortical (CSTC) circuits, such as anterior capsulotomy and cingulotomy via radiofrequency or Gamma Knife (Elekta AB) lesioning or deep brain stimulation (DBS), have been reported with a response rate of 50% to 70%.1-3 Since the first report of DBS for OCD in 1999,4 over 300 cases have been reported from case studies to larger clinical trials.5,6
Idrees K Sher, BAppSc (MRS), BMedSc, MBBS, FRACS, Gavin A Davis, MBBS, FRACS
doi : 10.1093/neuros/nyab055
Volume 88, Issue 6, June 2021, Pages E556–E557
Asymptomatic spinal cord compression (ASCC) in an athlete is a confronting condition for the neurosurgeon, and the primary questions to address are “does this require surgical treatment?” and “can the athlete return to play?” The title of the paper by Lee et al1 suggests that they have addressed these 2 questions; however, their paper actually addresses different questions—“can the athlete return to play after cervical cord neurapraxia (CCN)?”, “is cervical canal stenosis associated with spinal cord injury?”, and “should asymptomatic athletes be screened for congenital canal stenosis?”.
Theresa Williamson, MD, Ali Giusto, PhD, Michael Haglund, MD, PhD, Katherine McDaniel, PhD, Laura Weisberg, PhD
doi : 10.1093/neuros/nyab049
Volume 88, Issue 6, June 2021, Pages E558–E561
A total of 40% of neurosurgeons report burnout symptoms.1 Undoubtedly, the stresses of COVID-19, social isolation, and rise in awareness of systemic racism have increased the prevalence of burnout among providers. We are left with the question: “What helps the burned-out neurosurgeon?”
Bo-Wen Zheng, MD, PhD, Ming-Xiang Zou, MD, PhD, Hua-Qing Niu, MS, Bo-Yv Zheng, MD, PhD, Fu-Sheng Liu, MD, PhD ...
doi : 10.1093/neuros/nyab067
Volume 88, Issue 6, June 2021, Pages E562–E563
Ping-Yeh Chiu, MD, Fu-Cheng Kao, MD, Ming-Kai Hsieh, MD, Tsung-Ting Tsai, MD, PhD, Wen-Jer Chen, MD ...
doi : 10.1093/neuros/nyab087
Volume 88, Issue 6, June 2021, Pages E564–E565
Jin Liu, MD, Jing Tang, MD
doi : 10.1093/neuros/nyab073
Volume 88, Issue 6, June 2021, Pages E566–E567
Liverana Lauretti, MD, Quintino Giorgio D’Alessandris, MD, Marco Luigetti, MD
doi : 10.1093/neuros/nyab068
Volume 88, Issue 6, June 2021, Page E568
Thomas J Wilson, MD, MPH
doi : 10.1093/neuros/nyab070
Volume 88, Issue 6, June 2021, Pages E569–E570
Jacob S Young, MD, Taemin Oh, MD, Tarun Arora, MD, Lewis S Blevins, MD, Manish K Aghi, MD, PhD ...
doi : 10.1093/neuros/nyab054
Volume 88, Issue 6, June 2021, Pages E571–E572
Sunny Chi Lik Au, MBChB, MRCSEd, AFCOphthHK, Callie Ka Li Ko, MBBS, FCOphthHK, FHKAM (Ophthalmology)
doi : 10.1093/neuros/nyab056
Volume 88, Issue 6, June 2021, Pages E573–E574
Frank van Someren Gréve, MD, Ingrid J B Spijkerman, MD, PhD, K Mariam Slot, MD, PhD, Constance Schultsz, MD, PhD, W Peter Vandertop, MD, PhD
doi : 10.1093/neuros/nyab074
Volume 88, Issue 6, June 2021, Pages E575–E576
Alfredo Conti, MD, PhD, FEBNS, Constantin Tuleasca, MD, PhD
doi : 10.1093/neuros/nyab080
Volume 88, Issue 6, June 2021, Pages E577–E578
John R Adler, MD, Georg Weidlich, PhD
doi : 10.1093/neuros/nyab081
Volume 88, Issue 6, June 2021, Page E579
Ivan Lozada-Mart?nez, MS, Juan Maiguel-Lapeira, MS, Daniela Torres-Llin?s, MS, Luis Moscote-Salazar, MD, Md Moshiur Rahman, MD ...
doi : 10.1093/neuros/nyab088
Volume 88, Issue 6, June 2021, Pages E580–E581
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doi : 10.1093/neuros/nyab122
Volume 88, Issue 6, June 2021, Page 1147
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doi : 10.1093/neuros/nyab163
Volume 88, Issue 6, June 2021, Page 1147
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