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Predictors of early postoperative epileptic seizures after awake surgery in supratentorial diffuse gliomas
Marc Zanello, Alexandre Roux, Gilles Zah-Bi, Bénédicte Trancart, Eduardo Parraga, Myriam Edjlali, Arnault Tauziede-Espariat, Xavier Sauvageon, Tarek Sharshar, Catherine Oppenheim, Pascale Varlet, Edouard Dezamis, and Johan Pallud
doi : 10.3171/2020.1.JNS192774
Functional-based resection under awake conditions had been associated with a nonnegligible rate of intraoperative and postoperative epileptic seizures. The authors assessed the incidence of intraoperative and early postoperative epileptic seizures after functional-based resection under awake conditions.
Preoperative embolization versus no embolization for WHO grade I intracranial meningioma: a retrospective matched cohort study
Colin J. Przybylowski, Xiaochun Zhao, Jacob F. Baranoski, Leandro Borba Moreira, Sirin Gandhi, Kristina M. Chapple, Kaith K. Almefty, Nader Sanai, Andrew F. Ducruet, Felipe C. Albuquerque, Andrew S. Little, and Peter Nakaji
doi : 10.3171/2020.1.JNS19788
The controversy continues over the clinical utility of preoperative embolization for reducing tumor vascularity of intracranial meningiomas prior to resection. Previous studies comparing embolization and nonembolization patients have not controlled for detailed tumor parameters before assessing outcomes.
Riluzole enhances the antitumor effects of temozolomide via suppression of MGMT expression in glioblastoma
Tetsuya Yamada, Shohei Tsuji, Shinsuke Nakamura, Yusuke Egashira, Masamitsu Shimazawa, Noriyuki Nakayama, Hirohito Yano, Toru Iwama, and Hideaki Hara
doi : 10.3171/2019.12.JNS192682
Glutamatergic signaling significantly promotes proliferation, migration, and invasion in glioblastoma (GBM). Riluzole, a metabotropic glutamate receptor 1 inhibitor, reportedly suppresses GBM growth. However, the effects of combining riluzole with the primary GBM chemotherapeutic agent, temozolomide (TMZ), are unknown. This study aimed to investigate the efficacy of combinatorial therapy with TMZ/riluzole for GBM in vitro and in vivo.
Hyperostosing sphenoid wing meningiomas: surgical outcomes and strategy for bone resection and multidisciplinary orbital reconstruction
Cecilia L. Dalle Ore, Stephen T. Magill, Roberto Rodriguez Rubio, Maryam N. Shahin, Manish K. Aghi, Philip V. Theodosopoulos, Javier E. Villanueva-Meyer, Robert C. Kersten, Oluwatobi O. Idowu, M. Reza Vagefi, and Michael W. McDermott
doi : 10.3171/2019.12.JNS192543
Hyperostosing sphenoid wing meningiomas cause bony hyperostosis that may extend into the orbit, resulting in proptosis, restriction of extraocular movements, and/or compressive optic neuropathy. The extent of bony removal necessary and the optimal reconstruction strategy to prevent enophthalmos is debated. Herein, the authors present their surgical outcomes and reconstruction results.
Targeting glioma-initiating cells via the tyrosine metabolic pathway
Daisuke Yamashita, Joshua D. Bernstock, Galal Elsayed, Hirokazu Sadahiro, Ahmed Mohyeldin, Gustavo Chagoya, Adeel Ilyas, James Mooney, Dagoberto Estevez-Ordonez, Shinobu Yamaguchi, Victoria L. Flanary, James R. Hackney, Krishna P. Bhat, Harley I. Kornblum, Nicola Zamboni, Sung-Hak Kim, E. Antonio Chiocca, and Ichiro Nakano
doi : 10.3171/2019.11.JNS192028
Despite an aggressive multimodal therapeutic regimen, glioblastoma (GBM) continues to portend a grave prognosis, which is driven in part by tumor heterogeneity at both the molecular and cellular levels. Accordingly, herein the authors sought to identify metabolic differences between GBM tumor core cells and edge cells and, in so doing, elucidate novel actionable therapeutic targets centered on tumor metabolism.
Association of the FGFR1 mutation with spontaneous hemorrhage in low-grade gliomas in pediatric and young adult patients
Yukitomo Ishi, Shigeru Yamaguchi, Kanako C. Hatanaka, Michinari Okamoto, Hiroaki Motegi, Hiroyuki Kobayashi, Shunsuke Terasaka, and Kiyohiro Houkin
doi : 10.3171/2019.12.JNS192155
The authors aimed to investigate genetic alterations in low-grade gliomas (LGGs) in pediatric and young adult patients presenting with spontaneous hemorrhage.
Comparative preoperative characteristics and postoperative outcomes at a private versus a safety-net hospital following endoscopic endonasal transsphenoidal resection of pituitary adenomas
Janelle Cyprich, Dhiraj J. Pangal, Martin Rutkowski, Daniel A. Donoho, Mark Shiroishi, Chia-Shang Jason Liu, John D. Carmichael, and Gabriel Zada
doi : 10.3171/2019.12.JNS192506
Sociodemographic disparities in health outcomes are well documented, but the effects of such disparities on preoperative presentation of pituitary adenomas (PA) and surgical outcomes following resection are not completely understood. In this study the authors sought to compare the preoperative clinical characteristics and postoperative outcomes in patients undergoing PA resection at a private hospital (PH) versus a safety-net hospital (SNH).
How long is the tail end of the learning curve? Results from 1000 consecutive endoscopic endonasal skull base cases following the initial 200 cases
Iyan Younus, Mina M. Gerges, Rafael Uribe-Cardenas, Peter F. Morgenstern, Mahmoud Eljalby, Abtin Tabaee, Jeffrey P. Greenfield, Ashutosh Kacker, Vijay K. Anand, and Theodore H. Schwartz
doi : 10.3171/2019.12.JNS192600
Endoscopic endonasal approaches (EEAs) to the skull base have evolved over the last 20 years to become an essential component of a comprehensive skull base practice. Many case series show a learning curve from the earliest cases, in which the authors were inexperienced or were not using advanced closure techniques. It is generally accepted that once this learning curve is achieved, a plateau is reached with little incremental improvement. Cases performed during the early steep learning curve were eliminated to examine whether the continued improvement exists over the “tail end” of the curve.
Early postoperative MRI and detection of residual adenoma after transsphenoidal pituitary surgery
Lea M. Alhilali, Andrew S. Little, Kevin C. J. Yuen, Jae Lee, Timothy K. Ho, Saeed Fakhran, and William L. White
doi : 10.3171/2019.11.JNS191845
Current practice guidelines recommend delayed (? 3 months after operation) postoperative MRI after transsphenoidal surgery for pituitary adenomas, although this practice defers obtaining important information, such as the presence of a residual adenoma, that might influence patient management during the perioperative period. In this study, the authors compared detection of residual adenomas by means of early postoperative (EPO) MRI (< 48 hours postsurgery) with both surgeon intraoperative assessment and late postoperative (LPO) MRI at 3 months.
Analysis of 7-tesla diffusion-weighted imaging in the prediction of pituitary macroadenoma consistency
John W. Rutland, Joshua Loewenstern, Daniel Ranti, Nadejda M. Tsankova, Christopher P. Bellaire, Joshua B. Bederson, Bradley N. Delman, Raj K. Shrivastava, and Priti Balchandani
doi : 10.3171/2019.12.JNS192940
Endoscopic surgery is an effective treatment strategy for pituitary adenomas; however, intrinsic tumor properties such as tumor consistency can challenge or preclude gross-total resection. Preoperative characterization of tumor consistency may help to guide the surgical approach and to predict the extent of resection that is possible. Advanced radiological modalities such as 7T diffusion-weighted imaging (DWI) may be useful in probing biological tissue properties of pituitary adenomas. The objective of the present study was to examine 7T DWI as a novel method of measuring the consistency of pituitary adenomas.
Surgical outcomes of the endonasal endoscopic approach within a standardized management protocol for repair of spontaneous cerebrospinal fluid rhinorrhea
Daniel C. Kreatsoulas, Varun S. Shah, Bradley A. Otto, Ricardo L. Carrau, Daniel M. Prevedello, and Douglas A. Hardesty
doi : 10.3171/2019.12.JNS192891
Spontaneous CSF leaks are rare, their diagnosis is often delayed, and they can precipitate meningitis. Craniotomy is the historical “gold standard” repair for these leaks. An endonasal endoscopic approach (EEA) offers potentially less invasiveness and lower surgical morbidity than a traditional craniotomy but must yield the same surgical success. A paucity of data exists studying EEA as the primary management for spontaneous CSF leaks.
Role of KCNAB2 expression in modulating hormone secretion in somatotroph pituitary adenoma
Charles Ashton, Suhn K. Rhie, John D. Carmichael, and Gabriel Zada
doi : 10.3171/2019.12.JNS192435
Prior profiling of the human pituitary adenoma (PA) DNA methylome showed the potassium channel subunit–encoding gene KCNAB2 to be highly differentially methylated between nonfunctional PAs (NFPAs) and growth hormone (GH)–secreting PAs, with greater KCNAB2 methylation detected in secretory PAs. KCNAB2 encodes an aldo-keto reductase that, among other things, negatively regulates members of the voltage-gated potassium channel (Kv) family. In this study, the authors aimed to determine whether modulation of Kcnab2 expression would alter GH secretion in the GH3 mammosomatotroph rat cell line. In addition, they examined whether dosing GH3 cells with the antiarrhythmic drug quinidine, a known inhibitor of Kv and voltage-gated sodium channels, would affect hormonal secretion.
Immediate postoperative measurement of thyroid-stimulating hormone as an early predictor of remission in thyroid-stimulating hormone–secreting pituitary adenomas
Soo Heon Kim, Cheol Ryong Ku, Minkyun Na, Jihwan Yoo, Woohyun Kim, In-Ho Jung, Kyung Won Kim, Ju Hyung Moon, Daham Kim, Eun Jig Lee, Sun Ho Kim, and Eui Hyun Kim
doi : 10.3171/2020.1.JNS192787
Thyroid-stimulating hormone (TSH)–secreting pituitary adenoma (TSHoma) is a rare type of pituitary adenoma; thus, little is known about TSHomas. The purpose of this study was to analyze clinical characteristics and therapeutic outcomes of TSHomas based on a single-center experience. The authors also searched for reliable preoperative and early postoperative factors that could predict long-term endocrinological remission.
Impact of Medicaid insurance on outcomes following endoscopic transsphenoidal pituitary surgery
Iyan Younus, Mina Gerges, Theodore H. Schwartz, and Rohan Ramakrishna
doi : 10.3171/2020.1.JNS192707
Despite the rise of studies in the neurosurgical literature suggesting that patients with Medicaid insurance have inferior outcomes, there remains a paucity of data on the impact of insurance on outcomes after endonasal endoscopic transsphenoidal surgery (EETS). Given the increasing importance of complications in quality-based healthcare metrics, the objective of this study was to assess whether Medicaid insurance type influences outcomes in EETS for pituitary adenoma.
Early versus late Gamma Knife radiosurgery for Cushing’s disease after prior resection: results of an international, multicenter study
Adomas Bunevicius, Hideyuki Kano, Cheng-Chia Lee, Michal Krsek, Ahmed M. Nabeel, Amr El-Shehaby, Khaled Abdel Karim, Nuria Martinez-Moreno, David Mathieu, John Y. K. Lee, Inga Grills, Douglas Kondziolka, Roberto Martinez-Alvarez, Wael A. Reda, Roman Liscak, Yan-Hua Su, L. Dade Lunsford, Mary Lee Vance, and Jason P. Sheehan
doi : 10.3171/2019.12.JNS192836
The optimal time to perform stereotactic radiosurgery after incomplete resection of adrenocorticotropic hormone (ACTH)–producing pituitary adenoma in patients with Cushing’s disease (CD) remains unclear. In patients with persistent CD after resection of ACTH-producing pituitary adenoma, the authors evaluated the association of the interval between resection and Gamma Knife radiosurgery (GKRS) with outcomes.
Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study
Khodayar Goshtasbi, Brandon M. Lehrich, Mehdi Abouzari, Arash Abiri, Jack Birkenbeuel, Ming-Ying Lan, Wei-Hsin Wang, Gilbert Cadena, Frank P. K. Hsu, and Edward C. Kuan
doi : 10.3171/2020.1.JNS193062
For symptomatic nonsecreting pituitary adenomas (PAs), resection remains a critical option for treatment. In this study, the authors used a large-population national database to compare endoscopic surgery (ES) to nonendoscopic surgery (NES) for the surgical management of PA.
Cerebrospinal fluid area and syringogenesis in Chiari malformation type I
Davis G. Taylor, Ajay Chatrath, Panagiotis Mastorakos, Gabriella Paisan, Ching-Jen Chen, Thomas J. Buell, and John A. Jane Jr.
doi : 10.3171/2019.11.JNS191439
Syringogenesis in Chiari malformation type I (CM-I) is thought to occur secondary to impaction of the cerebellar tonsils within the foramen magnum (FM). However, the correlation between the CSF area and syringogenesis has yet to be elucidated. The authors sought to determine whether the diminution in subarachnoid space is associated with syringogenesis. Further, the authors sought to determine if syrinx resolution was associated with the degree of expansion of subarachnoid spaces after surgery.
The endoscopic endonasal eustachian tube anterolateral mobilization strategy: minimizing the cost of the extreme-medial approach
Mohamed A. Labib, Evgenii Belykh, Claudio Cavallo, Xiaochun Zhao, Daniel M. Prevedello, Ricardo L. Carrau, Andrew S. Little, Mauro A. T. Ferreira, Mark C. Preul, A. Samy Youssef, and Peter Nakaji
doi : 10.3171/2019.12.JNS192285
The ventral jugular foramen and the infrapetrous region are difficult to access through conventional lateral and posterolateral approaches. Endoscopic endonasal approaches to this region are obstructed by the eustachian tube (ET). This study presents a novel strategy for mobilizing the ET while preserving its integrity. Qualitative and quantitative comparisons with previous ET management paradigms are also presented.
Trautmann-focused mastoidectomy for a simple, safe presigmoid approach: technical note
Kuniaki Tanahashi, Kenji Uda, Yoshio Araki, Kazuhito Takeuchi, Jungsu Choo, Lushun Chalise, Kazuya Motomura, Fumiharu Ohka, Toshihiko Wakabayashi, and Atsushi Natsume
doi : 10.3171/2020.1.JNS193179
The presigmoid approach (PSA) is selected to obtain more lateral access to cerebellopontine angle tumors, brainstem cavernous malformations, or vertebrobasilar artery aneurysms than the standard retrosigmoid approach. However, mastoidectomy for the PSA can be considered time-consuming and to carry a higher risk of complications due to the anatomical complexity of the region. The authors established a method of minimized mastoidectomy focused on exposing Trautmann’s triangle as the corridor for the PSA while maximizing procedural simplicity and safety and maintaining a sufficient operative view. The authors present their method of minimized mastoidectomy in a cadaver dissection and operative cases, showing potential as a useful option for the PSA.
Volumes, outcomes, and complications after surgical versus endovascular treatment of aneurysms in the United States (1993–2015): continued evolution versus steady-state after more than 2 decades of practice
Pedram Golnari, Pouya Nazari, Roxanna M. Garcia, Hannah Weiss, Ali Shaibani, Michael C. Hurley, Sameer A. Ansari, Matthew B. Potts, and Babak S. Jahromi
doi : 10.3171/2019.12.JNS192755
Adoption of endovascular treatment (EVT) and other advances in aneurysm care have shifted practice patterns of cerebral aneurysm treatment over the past 2 decades in the US. The objective of this study was to determine whether resulting trends in volumes, outcomes, and complications have matured in general practice or continue to evolve.
Objective quantification of contrast enhancement of unruptured intracranial aneurysms: a high-resolution vessel wall imaging validation study
Jorge A. Roa, Mario Zanaty, Carlos Osorno-Cruz, Daizo Ishii, Girish Bathla, Santiago Ortega-Gutierrez, David M. Hasan, and Edgar A. Samaniego
doi : 10.3171/2019.12.JNS192746
High-resolution vessel wall imaging (HR-VWI) has emerged as a valuable tool in assessing unruptured intracranial aneurysms (UIAs). There is no standardized method to quantify contrast enhancement of the aneurysm wall. Contrast enhancement can be objectively measured as signal intensity (SI) or subjectively adjudicated. In this study, the authors compared the different methods to quantify wall enhancement of UIAs and determined the sensitivity and specificity of each method as a surrogate of aneurysm instability. They also compared SI quantification between scanners from different manufacturers.
Optical coherence tomography imaging after endovascular thrombectomy: a novel method for evaluating vascular injury in a swine model
Christopher R. Pasarikovski, Julia Keith, Leodante da Costa, Joel Ramjist, Yuta Dobashi, Sandra E. Black, and Victor X. D. Yang
doi : 10.3171/2019.12.JNS192881
Although studies have shown that some degree of iatrogenic endothelial injury occurs during endovascular thrombectomy (EVT), the clinical significance of such injury is uncertain. Furthermore, it is likely that iatrogenic effects such as endothelial denudation, intimal dissection, and tunica media edema will have varying clinical implications. The purpose of this study was to assess the feasibility of endovascular optical coherence tomography (OCT) in quantifying vessel injury in real time after EVT, correlate vessel injury with histological findings, and perform imaging at varying time intervals after EVT to assess the impact of prolonged direct exposure of the vessel to the thrombus.
Aneurysmal subarachnoid hemorrhage: long-term trends in incidence and survival in Olmsted County, Minnesota
Enrico Giordan, Christopher S. Graffeo, Alejandro A. Rabinstein, Robert D. Brown Jr., Walter A. Rocca, Alanna M. Chamberlain, and Giuseppe Lanzino
doi : 10.3171/2019.12.JNS192468
Recent population-based and hospital cohort studies have reported a decreasing incidence of aneurysmal subarachnoid hemorrhage (aSAH) and declining aSAH-associated case-fatality rates. Principal drivers of these trends are debated, but improvements in smoking cessation and hypertension control may be critical factors.
Laboratory assessments of therapeutic platelet inhibition in endovascular neurosurgery: complication prediction using the VerifyNow P2Y12 assay and thromboelastography with platelet mapping
Brian M. Corliss, Rachel Freedman, Meghan M. Brennan, Jessica Smith, John D. Nerva, Neil S. Harris, Adam J. Polifka, Brian L. Hoh, and W. Christopher Fox
doi : 10.3171/2019.12.JNS192396
Inhibition of platelet aggregation is universally used to prevent thromboembolic complications related to stent placement in endovascular neurosurgery, but excessive inhibition potentiates hemorrhagic complications. Previously, the authors demonstrated that two different commercially available measures of adenosine diphosphate (ADP)–dependent platelet inhibition—the VerifyNow P2Y12 clopidogrel assay (measured in platelet reactivity units [PRU]) and maximal amplitude (MA) attributable to ADP activity (MA-ADP) derived from thromboelastography (TEG) with platelet mapping (PM)—yielded wildly different results. This study sought to analyze observed complications to quantify the ideal therapeutic windows for both tests.
Analysis of human emboli and thrombectomy forces in large-vessel occlusion stroke
Yang Liu, Yihao Zheng, Adithya S. Reddy, Daniel Gebrezgiabhier, Evan Davis, Joshua Cockrum, Joseph J. Gemmete, Neeraj Chaudhary, Julius M. Griauzde, Aditya S. Pandey, Albert J. Shih, and Luis E. Savastano
doi : 10.3171/2019.12.JNS192187
This study’s purpose was to improve understanding of the forces driving the complex mechanical interaction between embolic material and current stroke thrombectomy devices by analyzing the histological composition and strength of emboli retrieved from patients and by evaluating the mechanical forces necessary for retrieval of such emboli in a middle cerebral artery (MCA) bifurcation model.
Decreased contrast enhancement on high-resolution vessel wall imaging of unruptured intracranial aneurysms in patients taking aspirin
Jorge A. Roa, Mario Zanaty, Daizo Ishii, Yongjun Lu, David K. Kung, Robert M. Starke, James C. Torner, Pascal M. Jabbour, Edgar A. Samaniego, and David M. Hasan
doi : 10.3171/2019.12.JNS193023
Inflammation plays an integral role in the formation, growth, and progression to rupture of unruptured intracranial aneurysms (UIAs). Animal and human studies have suggested that, due to its antiinflammatory effect, aspirin (ASA) may decrease the risks of growth and rupture of UIAs. High-resolution vessel wall imaging (HR-VWI) has emerged as a noninvasive method to assess vessel wall inflammation and UIA instability. To the authors’ knowledge, to date no studies have found a significant correlation between patient use of ASA and contrast enhancement of UIAs on HR-VWI.
Late (5–20 years) outcomes after STA-MCA anastomosis and encephalo-duro-myo-arterio-pericranial synangiosis in patients with moyamoya disease
Satoshi Kuroda, Naoki Nakayama, Shusuke Yamamoto, Daina Kashiwazaki, Haruto Uchino, Hisayasu Saito, Emiko Hori, Naoki Akioka, Naoya Kuwayama, and Kiyohiro Houkin
doi : 10.3171/2019.12.JNS192938
Surgical revascularization is known to reduce the incidence of further ischemic and hemorrhagic events in patients with moyamoya disease, but the majority of previous studies report only short-term (< 5 years) outcomes. Therefore, in this study the authors aimed to evaluate late (5–20 years) outcomes of moyamoya patients after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis and indirect bypass (encephalo-duro-myo-arterio-pericranial synangiosis [EDMAPS]).
Natural history of brainstem cavernous malformations: prospective hemorrhage rate and adverse factors in a consecutive prospective cohort
Da Li, Ze-Yu Wu, Pan-Pan Liu, Jun-Peng Ma, Xu-Lei Huo, Liang Wang, Li-Wei Zhang, Zhen Wu, and Jun-Ting Zhang
doi : 10.3171/2019.12.JNS192856
Given the paucity of data on the natural history of brainstem cavernous malformations (CMs), the authors aimed to evaluate the annual hemorrhage rate and hemorrhagic risk of brainstem CMs.
Effects of case volume and comprehensive stroke center capabilities on patient outcomes of clipping and coiling for subarachnoid hemorrhage
Ryota Kurogi, Akiko Kada, Kuniaki Ogasawara, Takanari Kitazono, Nobuyuki Sakai, Yoichiro Hashimoto, Yoshiaki Shiokawa, Shigeru Miyachi, Yuji Matsumaru, Toru Iwama, Teiji Tominaga, Daisuke Onozuka, Ataru Nishimura, Koichi Arimura, Ai Kurogi, Nice Ren, Akihito Hagihara, Yuriko Nakaoku, Hajime Arai, Susumu Miyamoto, Kunihiro Nishimura, and Koji Iihara
doi : 10.3171/2019.12.JNS192584
Improved outcomes in patients with subarachnoid hemorrhage (SAH) treated at high-volume centers have been reported. The authors sought to examine whether hospital case volume and comprehensive stroke center (CSC) capabilities affect outcomes in patients treated with clipping or coiling for SAH.
Impact of cortical hemodynamic failure on both subsequent hemorrhagic stroke and effect of bypass surgery in hemorrhagic moyamoya disease: a supplementary analysis of the Japan Adult Moyamoya Trial
Jun C. Takahashi, Takeshi Funaki, Kiyohiro Houkin, Satoshi Kuroda, Miki Fujimura, Yasutake Tomata, and Susumu Miyamoto
doi : 10.3171/2020.1.JNS192392
Here, the authors aimed to determine whether the presence of cerebral hemodynamic failure predicts subsequent bleeding attacks and how it correlates with the effect of direct bypass surgery in hemorrhagic moyamoya disease.
Age dependency and modification of the Subarachnoid Hemorrhage Early Brain Edema Score
Michael Eibach, Sae-Yeon Won, Markus Bruder, Fee Keil, Eva Herrmann, Joachim Berkefeld, Volker Seifert, and Juergen Konczalla
doi : 10.3171/2019.12.JNS192744
The Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) system measures cerebral edema on CT and can be used to predict outcome after subarachnoid hemorrhage (SAH). The authors developed a modified SEBES (SEBES 6c) and assessed whether it could predict outcome after SAH better than the SEBES. Furthermore, they verified the age dependency of these scores.
Plasticity in language cortex and white matter tracts after resection of dominant inferior parietal lobule arteriovenous malformations: a combined fMRI and DTI study
Yuming Jiao, Fuxin Lin, Jun Wu, Hao Li, Weilun Fu, Ran Huo, Yong Cao, Shuo Wang, and Jizong Zhao
doi : 10.3171/2019.12.JNS191987
The dominant inferior parietal lobe (IPL) contains cortical and subcortical structures that serve language processing. A high incidence of postoperative short-term aphasia and good potential for language reorganization have been observed. The authors’ goal was to study the plasticity of the language cortex and language-related fibers in patients with brain arteriovenous malformations (BAVMs) located in the IPL.
Vertebral artery aneurysms and the risk of cord infarction following spinal artery coverage during flow diversion
Adam A. Dmytriw, Anish Kapadia, Alejandro Enriquez-Marulanda, Carmen Parra-Fari?as, Anna Luisa Kühn, Patrick J. Nicholson, Muhammad Waqas, Leonardo Renieri, Caterina Michelozzi, Paul M. Foreman, Kevin Phan, I-Hsiao Yang, Vincent M. Tutino, Christopher S. Ogilvy, Ivan Radovanovic, Mark R. Harrigan, Adnan H. Siddiqui, Elad I. Levy, Nicola Limbucci, Christophe Cognard, Timo Krings, Vitor Mendes Pereira, Ajith J. Thomas, Thomas R. Marotta, and Christoph J. Griessenauer
doi : 10.3171/2020.1.JNS193293
Coverage of the anterior spinal artery (ASA) ostia is a source of considerable consternation regarding flow diversion (FD) in vertebral artery (VA) aneurysms due to cord supply. The authors sought to assess the association between coverage of the ASA, posterior spinal artery (PSA), or lateral spinal artery (LSA) ostia when placing flow diverters in distal VAs and clinical outcomes, with emphasis on cord infarction.
Milrinone for refractory cerebral vasospasm with delayed cerebral ischemia
Yasser B. Abulhasan, Johanna Ortiz Jimenez, Jeanne Teitelbaum, Gabrielle Simoneau, and Mark R. Angle
doi : 10.3171/2020.1.JNS193107
Intravenous (IV) milrinone is a promising option for the treatment of cerebral vasospasm with delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). However, data remain limited on the efficacy of treating cases that are refractory to standard therapy with IV milrinone. The aim of this study was to determine predictors of refractory vasospasm/DCI despite treatment with IV milrinone, and to analyze the outcome of rescue therapy with intraarterial (IA) milrinone and/or mechanical angioplasty.
A register-based SAH study in Japan: high incidence rate and recent decline trend based on lifestyle
Fusao Ikawa, Akio Morita, Takeo Nakayama, Yoshihito Goto, Nobuyuki Sakai, Koji Iihara, Yoshiaki Shiokawa, Isao Date, Kazuhiko Nozaki, Hiroyuki Kinouchi, Kiyohiro Houkin, Nobuhito Saito, Teiji Tominaga, Michiyasu Suzuki, Susumu Miyamoto, Kaoru Kurisu, and Hajime Arai
doi : 10.3171/2020.1.JNS192848
Japan has been reported to have the highest (and increasing) incidence of subarachnoid hemorrhage (SAH) in the world. However, there has never been a report on the nationwide incidence rate and recent trends for SAH in Japan. In this register-based study, the authors aimed to clarify the estimated nationwide SAH incidence rate and the recent trend in SAH incidence in Japan and the reasons for any changes in this trend.
Association of zinc administration with growth suppression of intracranial aneurysms via induction of A20
Kosuke Hayashi, Hiroharu Kataoka, Manabu Minami, Taichi Ikedo, Takeshi Miyata, Kampei Shimizu, Manabu Nagata, Tao Yang, Yu Yamamoto, Masayuki Yokode, and Susumu Miyamoto
doi : 10.3171/2020.1.JNS192047
Zinc is an essential micronutrient with multiple biological effects, including antiinflammation. Previously, the authors demonstrated that the pathogenesis of intracranial aneurysms (IAs) is strongly related to chronic inflammation. In this study, the authors investigated whether administration of zinc inhibits the growth of IAs in a rat model.
Sphenoparietal sinus transposition technique: optimization of the surgical corridor with preservation of prominent bridging veins between the brain and the cranial base during aneurysm clipping via the pterional approach
Takeya Niibo, Katsumi Takizawa, Jurou Sakurai, Seizi Takebayashi, Hiroyasu Koizumi, Toru Kobayashi, Rina Kobayashi, Kouta Kuris, Syusuke Gotou, Ryousuke Tsuchiya, and Hiroyasu Kamiyama
doi : 10.3171/2020.1.JNS192823
The sylvian bridging veins between the brain and the dura on the inner surface of the sphenoid wing can restrict brain retraction for widening of the lateral retrocarotid space during clipping surgery for internal carotid artery (ICA)–posterior communicating artery (PCoA) and basilar apex (BX) aneurysms. In such cases, the authors perform extradural anterior clinoidectomy with peeling of the temporal dura propria from the periosteal dura and inner cavernous membrane around the superior orbital fissure, with the incision of the dura mater stretching from the base of the temporal side to just before the distal dural ring of the ICA (termed by the authors as the sphenoparietal sinus transposition [SPST] technique). This technique displaces the bridging segment of the sylvian vein posteriorly and enables widening of the surgical space without venous injury. In this study, the authors observed the operative nuances and investigated the usefulness of this technique.
Vasospasm: does it cause infarction and poor outcome?
Bryce Weir
doi : 10.3171/2020.7.JNS202551
ABBREVIATIONS CBF = cerebral blood flow; CONSCIOUS = Clazosentan to Overcome Neurological Ischemia and Infarct Occurring after Subarachnoid Hemorrhage; CTA = CT angiography; CTP = CT perfusion; DCI = delayed cerebral ischemia; ICP = intracranial pressure; OR = odds ratio; RR = relative risk; SAH = subarachnoid hemorrhage; VSP = vasospasm.
Letter to the Editor. Gamma Knife radiosurgery for Cushing’s disease after prior resection
Martin H. Weiss, Gabriel Zada, John D. Carmichael, and William T. Couldwell
doi : 10.3171/2020.6.JNS202134
Letter to the Editor. Extent of resection of pituitary adenomas
Jamie J. Van Gompel and Garret Choby
doi : 10.3171/2020.4.JNS201097
Letter to the Editor. The Frazier Scholar Program at Penn Neurosurgery: an adaptable model for nurturing early interest in neurosurgery for current and aspiring medical students
Donald K. Detchou, Gregory Glauser, Ryan Dimentberg, Eileen Maloney Wilensky, Daniel Yoshor, and Neil R. Malhotra
doi : 10.3171/2020.8.JNS203149
Letter to the Editor. Philosophical underpinnings of neurosurgical decision-making in the time of the coronavirus pandemic
Nalini Tata and Nader S. Dahdaleh
doi : 10.3171/2020.9.JNS203459
