Managing Cerebrospinal Fluid Leak After Lumbar Spinal Fusion: When Conservative Treatment is Not the Answer?

Objective: Cerebrospinal fluid (CSF) leaks are a known complication of lumbar fusion surgery. There is a scarcity of literature describing the management of this complication. The aim of this study was to identify patients who are at risk of requiring further intervention for managing CSF leaks.

The World Neurosurgery Global Champions Program: First-Year Experience of a Model Initiative for Reducing Disparities in Global Neurosurgical Literature.

Objective: Most surgical journals are published in English, representing a challenge for researchers from non-Anglophone countries. We describe the implementation, workflow, outcomes, and lessons learned from the WORLD NEUROSURGERY Global Champions Program (GCP), a novel journal-specific English language editing program for articles rejected because of poor English grammar or usage.

Methods: The GCP was advertised via the journal website and social media.

Current landscape of social media use pertaining to glioblastoma by various stakeholders.

Background: Given the potential for social media to allow widespread public engagement, its role in healthcare, including in cancer care as a support network, is garnering interest. To date, the use of social media in neuro-oncology has not been systematically explored. In the current manuscript, we sought to review Twitter use on glioblastoma among patients, caregivers, providers, researchers, and other stakeholders.

Robotic assistance in lumbar fusion surgery: trends and patterns from 2016-2019.

Purpose: Robotic-assisted spine surgery is an emerging field that is growing in utilization. Intraoperative robotic surgical units cost upwards of $600,000 for medical facilities to purchase. Despite significant cost barriers, these devices are highly marketable for hospitals and physicians.

Analysis of Neurosurgery Influencers on Instagram: Trends and Patterns of the Neurosurgeon's Social Media Footprint.

Objective: Social media outlets such as Instagram have recently become a popular tool for medical professionals to disseminate medical information to a large public audience. In this study, we identify the top neurosurgery influencers on Instagram and analyze trends between content type, audience interaction, and user engagement.

Methods: A list of neurosurgeon Instagram profiles based on the number of followers, user engagement, and average interaction were compiled.

Palliative Care Effects on Survival in Glioblastoma: Who Receives Palliative Care?

Background: High-grade glioma has a poor overall survival with profoundly negative effects on the patient's quality of life and their caregivers. In this study, we investigate the factors associated with receiving palliative care in patients diagnosed with glioblastoma (GBM) and the association of receiving or not receiving palliative care with overall survival.

Methods: The National Cancer Database was analyzed for patterns of care in patients ≥18 years old who were diagnosed with histologically confirmed grade IV GBM between 2004 and 2017.

Tumor Derived Extracellular Vesicles Modulate Gene Expression in T cells.

Extracellular vesicles (EVs) are excreted from all cells in the human body and are heterogeneous lipid bilayer particles containing proteins, RNA, DNA, and other cargo. T cells are primary players of the adaptive immune system and have a significant role in anti-cancer immunotherapies. Tumor derived EVs have diverse effects on host cells including modulating the immune response.

Cerebrospinal fluid (CSF) leak after elective lumbar spinal fusion: Who is at risk?

Purpose: CSF leaks are a known complication of lumbar fusion surgery. There is a scarcity of literature describing the incidence and risk factors associated with this complication. The aim of this study was to identify patients who are at risk of developing postoperative CSF leak.

Thirty-Day Stroke and Mortality After Carotid Revascularization Among Octogenarians with Symptomatic Carotid Stenosis: Real-World Evidence from a National Surgical Quality Registry.

Background: The outcomes of carotid revascularization among octogenarians are not well studied. We present analyses of 30-day stroke and mortality of patients aged ≥80 years using real-world data from a national surgical quality registry.

Methods: The National Surgical Quality Improvement Program targeted data set for carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS) was queried for patients aged ≥80 years undergoing CEA and CAS between 2012 and 2019.

Murine Leukemia-Derived Extracellular Vesicles Elicit Antitumor Immune Response.

Background: Extracellular vesicles (EVs) are heterogeneous lipid bilayer particles secreted by cells. EVs contain proteins, RNA, DNA and other cargo that can have immunomodulatory effects. Cancer-derived EVs have been described as having immunomodulating effects in vivo with immunosuppressive and pro-tumor growth capabilities.

Induction of anti-leukemic responses by stimulation of leukemic CD3+ cells with allogeneic stimulator cells.

Background: Immunotherapeutic protocols have focused on identification of stimuli that induce effective anti-leukemic immune responses. One potent immune stimulus is the encounter with allogeneic cells. Our group previously showed that the infusion of haploidentical donor white blood cells (1-2 × 10 CD3+ cells/kg) into patients with refractory hematological malignancies induced responses of varying magnitude in over half of the patients.

Extracellular vesicles in leukemia.

Extracellular vesicles (EV) are nano-sized membrane enclosed vehicles that are involved in cell-to-cell communication and carry cargo that is representative of the parent cell. Recent studies have highlighted the significant roles leukemia EVs play in tumor progression, and ways in which they can lead to treatment evasion, thus meriting further investigation. Leukemia EVs are involved in crosstalk between the leukemia cell and its surroundings, transforming it into a cancer favorable microenvironment.

Eye-Movement Training Results in Changes in qEEG and NIH Stroke Scale in Subjects Suffering from Acute Middle Cerebral Artery Ischemic Stroke: A Randomized Control Trial.

Context: Eye-movement training (EMT) can induce altered brain activation and change the functionality of saccades with changes of the brain in general.

Objective: To determine if EMT would result in changes in quantitative electroencephalogram (qEEG) and NIH Stroke Scale (NIHSS) in patients suffering from acute middle cerebral artery (MCA) infarction. Our hypothesis is that there would be positive changes in qEEG and NIHSS after EMT in patients suffering from acute MCA ischemic stroke.

Vegetative state is a pejorative term.

The term persistent vegetative state (PVS) refers to the only circumstance in which an apparent dissociation of both components of consciousness is found, characterized by preservation of wakefulness with an apparent loss of awareness. Several authors have recently demonstrated by functional neuroimaging studies that a small subset of unresponsive "vegetative" patients may show unambiguous signs of consciousness and command following that is inaccessible to clinical examination at the bedside. The term "estado vegetativo" used in Spanish to describe the PVS syndrome by physicians came from the English-Spanish translation.

A Cuban perspective on management of persistent vegetative state.

The Cuban Group for Study of Disorders of Consciousness is developing several research protocols to search for possible preservation of residual brain and autonomic functions in cases of persistent vegetative and minimally conscious states. We present examples showing the importance of 3D anatomic reconstruction of brain structures and MRI tractography for assessing white matter connectivity. We also present results of use of proton magnetic resonance spectroscopy technique to follow up cognitive recovery in persistent vegetative state patients transitioning to minimally conscious state.

Brain death diagnosis and apnea test safety.

The apnea test is a mandatory examination for determining brain death (BD), because it provides an essential sign of definitive loss of brainstem function. However, several authors have expressed their concern about the safety of this procedure as there are potential complications such as severe hypotension, pneumothorax, excessive hypercarbia, hypoxia, acidosis, and cardiac arrhythmia or asystole. These complications may constrain the examiner to abort the test, thereby compromising BD diagnosis.

Assessing acute middle cerebral artery ischemic stroke by quantitative electric tomography.

This paper focuses on the application of quantitative electric tomography (qEEGT) to map changes in EEG generators for detection of early signs of ischemia in patients with acute middle cerebral artery stroke. Thirty-two patients were studied with the diagnosis of acute ischemic stroke of the left middle cerebral artery territory, within the first 24 hours of their clinical evolution. Variable Resolution Electrical Tomography was used for estimating EEG source generators.