Salvage craniotomy for treatment-refractory symptomatic cerebral radiation necrosis.

Background: The incidence of symptomatic radiation necrosis (RN) has risen as radiotherapy is increasingly used to control brain tumor progression. Traditionally managed with steroids, symptomatic RN can remain refractory to medical treatment, requiring surgical intervention for control. The purpose of our study was to assess a single institution's experience with craniotomy for steroid-refractory pure RN.

Diagnosis of primary central nervous system lymphoma: a systematic review of the utility of CSF screening and the role of early brain biopsy.

Background: Because less-invasive techniques can obviate the need for brain biopsy in the diagnosis of primary central nervous system lymphoma (PCNSL), it is common practice to wait for a thorough initial work-up, which may delay treatment. We conducted a systematic review and reviewed our own series of patients to define the role of LP and early brain biopsy in the diagnosis of PCNSL.

Methods: Our study was divided into 2 main sections: 1) systematic review assessing the sensitivity of cerebrospinal fluid (CSF) analysis on the diagnosis of PCNSL, and 2) a retrospective, single-center patient series assessing the diagnostic accuracy and safety of early biopsy in immunocompetent PCNSL patients treated at our institution from 2012 to 2018.

Stimulated Raman histology for rapid and accurate intraoperative diagnosis of CNS tumors: prospective blinded study.

Objective: In some centers where brain tumor surgery is performed, the opportunity for expert intraoperative neuropathology consultation is lacking. Consequently, surgeons may not have access to the highest quality diagnostic histological data to inform surgical decision-making. Stimulated Raman histology (SRH) is a novel technology that allows for rapid acquisition of diagnostic histological images at the bedside.

The Role of Laser Interstitial Thermal Therapy in Surgical Neuro-Oncology: Series of 100 Consecutive Patients.

Background: Laser interstitial thermal therapy (LITT) is an adjuvant treatment for intracranial lesions that are treatment refractory or in deep or eloquent brain. Initial studies of LITT in surgical neuro-oncology are limited in size and follow-up.

Objective: To present our series of LITT in surgical neuro-oncology to better evaluate procedural safety and outcomes.

Brain Tumor Surgery is Safe in Octogenarians and Nonagenarians: A Single-Surgeon 741 Patient Series.

Objectives: Elderly patients with surgically accessible brain tumors are often not offered clinically indicated brain tumor surgery (BTS) because of to assumptions of greater risk for perioperative morbidity and mortality. Because brain tumor incidence is highest in the geriatric population, and because the global population is aging, accurate understanding of BTS risk in elderly patients is critical. We aimed to compare safety of BTS in elderly patients with younger counterparts to better understand the risk-benefit profile of BTS for elderly patients.

Machine Learning in Neuro-Oncology: Can Data Analysis From 5346 Patients Change Decision-Making Paradigms?

Background: Machine learning (ML) is an application of artificial intelligence (AI) that gives computer systems the ability to learn data, without being explicitly programmed. Currently, ML has been successfully used for optical character recognition, spam filtering, and face recognition. The aim of the present study was to review the current applications of ML in the field of neuro-oncology.

Perioperative Risk Factors for Thirty-Day Morbidity and Mortality in the Resection of Extradural Thoracic Spine Tumors.

Objective: Resection of epidural thoracic spine tumors is uniquely challenging owing to the dangers posed by the surrounding anatomy and the unforgiving nature of the thoracic spinal cord. We assessed the preoperative and postoperative risk factors for 30-day morbidity and mortality in patients undergoing resection of these tumors.

Methods: Adults who underwent laminectomy for excision of thoracic spine tumors from 2011 to 2014 were included.

The Effect of Parkinson's Disease on Patients Undergoing Lumbar Spine Surgery.

Study Design: Retrospective Database Analysis.

Objective: The purpose of this study was to assess characteristics and outcomes of patients with Parkinson's disease (PD) undergoing lumbar spine surgery for degenerative conditions.

Methods: The Nationwide Inpatient Sample was examined from 2002 to 2011.

Risk Factors for Thirty-Day Morbidity and Mortality in Extradural Lumbar Spine Tumor Resection.

Background: Epidural tumors in the lumbar spine represent a unique cohort of lesions with individual risks and challenges to resection. Knowledge of modifiable risk factors are important in minimizing postoperative complications.

Objective: To determine the risk factors for 30-day morbidity and mortality in patients undergoing extradural lumbar tumor resection.

A step-down unit transfer protocol for low-risk aneurysmal subarachnoid hemorrhage.

OBJECTIVE Patients who have experienced subarachnoid hemorrhage (SAH) often receive care in the setting of the ICU. However, SAH patients may not all require extended ICU admission. The authors established a protocol on January 1, 2015, to transfer select, low-risk patients to a step-down unit (SDU) to streamline care for SAH patients.

Optical Coherence Tomography in the Management of Skull Base Fibrous Dysplasia with Optic Nerve Involvement.

Background: Fibrous dysplasia (FD) of the skull base can manifest with optic nerve compression. As most patients initially do not experience vision loss, controversy exists whether to proceed with prophylactic surgical decompression or elect for conservative observation. Optical coherence tomography (OCT), a physiologic imaging modality widely used to assess the condition of the retinal nerve fiber layer (RNFL), has been useful in monitoring compressive tumors on the optic nerve.

Contemporary spinal oncology treatment paradigms and outcomes for metastatic tumors to the spine: A systematic review of breast, prostate, renal, and lung metastases.

Metastatic spinal disease most frequently arises from carcinomas of the breast, lung, prostate, and kidney. Management of spinal metastases (SpM) is controversial in the literature. Recent studies advocate more aggressive surgical resection than older studies which called for radiation therapy alone, challenging previously held beliefs in conservative therapy.

Academic Productivity of US Neurosurgery Residents as Measured by H-Index: Program Ranking with Correlation to Faculty Productivity.

Engagement in research and academic productivity are crucial components in the training of a neurosurgeon. This process typically begins in residency training. In this study, we analyzed individual resident productivity as it correlated to publications across all Accreditation Council for Graduate Medical Education (ACGME)-accredited neurosurgery training programs in an attempt to identify how programs have developed and fostered a research culture and environment.

The historical origin of the term "meningioma" and the rise of nationalistic neurosurgery.

The historical origin of the meningioma nomenclature unravels interesting social and political aspects about the development of neurosurgery in the late 19th century. The meningioma terminology itself was the subject of nationalistic pride and coincided with the advancement in the rise of medicine in Continental Europe as a professional social enterprise. Progress in naming and understanding these types of tumor was most evident in the nations that successively assumed global leadership in medicine and biomedical science throughout the 19th and 20th centuries, that is, France, Germany, and the United States.

Day of Surgery Impacts Outcome: Rehabilitation Utilization on Hospital Length of Stay in Patients Undergoing Elective Meningioma Resection.

Objective/background: Meningiomas account for approximately one third of all brain tumors in the United States. In high-volume medical centers, the average length of stay (LOS) for a patient is 6.8 days compared with 8.

Impact of Neurosurgery Medical Student Research Grants on Neurosurgery Residency Choice.

Background: Recent decades have seen a rapid expansion of involvement of medical students in biomedical research during medical school training. Research within medical school has been shown to influence medical students with regard to medical knowledge, career development, and residency specialty choice. The objective of this study was to evaluate the impact of neurosurgery medical student research grants on neurosurgery residency choice and provide an insight on the demographics of grant awardees.

Surgical limitations in convexity meningiomas en-plaque: Is radical resection necessary?

Meningiomas-en-plaque (MEP) comprise 2.5% of all meningiomas. While they typically arise in the sphenoid wing, convexity MEP are comparatively rare and are often confused with meningeal sarcoidosis, osteoma, tuberculoma, or fibrous dysplasia, with very little information published in the literature.

Neurosurgical Skills Assessment: Measuring Technical Proficiency in Neurosurgery Residents Through Intraoperative Video Evaluations.

Objectives: Although technical skills are fundamental in neurosurgery, there is little agreement on how to describe, measure, or compare skills among surgeons. The primary goal of this study was to develop a quantitative grading scale for technical surgical performance that distinguishes operator skill when graded by domain experts (residents, attendings, and nonsurgeons). Scores provided by raters should be highly reliable with respect to scores from other observers.

Application of Ultrahigh Field Magnetic Resonance Imaging in the Treatment of Brain Tumors: A Meta-Analysis.

Background: Magnetic resonance imaging (MRI) is the imaging modality of choice for the clinical management of brain tumors, and the majority of scanners operate with static magnetic field strengths of 1.5 or 3.0 Tesla (T).

Pilot Study on Early Postoperative Discharge in Pituitary Adenoma Patients: Effect of Socioeconomic Factors and Benefit of Specialized Pituitary Centers.

Introduction Pituitary neoplasms are benign entities that require distinct diagnostic and treatment considerations. Recent advances in endoscopic transsphenoidal surgery have resulted in shorter lengths of stay (LOS). We implemented a postoperative day (POD) 1 discharge paradigm involving a multidisciplinary approach and detailed preoperative evaluation and review of both medical and socioeconomic factors.

To operate or not?: A literature review of surgical outcomes in 95 patients with Parkinson's disease undergoing spine surgery.

Introduction: Degenerative spondylosis and kyphoscoliosis are increasingly recognized entities in patients with Parkinson's disease. Surgical treatment with spinal fusion can be complicated due to poor bone quality and muscular dysfunction in this patient population. The goal of this paper is to investigate surgical outcomes in Parkinson's patients undergoing spine surgery.

Intracerebral abscess with dissecting pneumocephalus caused by a gas-producing gram-positive rod following craniotomy for glioblastoma multiforme resection.

Propionibacterium acnes (P. acnes), an indolent and slow-growing anaerobic gram-positive bacterium, has largely been known as a commensal organism of the normal skin flora. However, P.