Cost-Effectiveness Analyses of Bone Morphogenetic Protein 2 (rhBMP-2) in Spinal Fusion: A Systematic Review.

Study Design: Systematic Review Study.

Objectives: The objective of this study is to assess the cost-effectiveness and cost-utility of rhBMP-2 in spine surgeries.

Methods: PubMed, MEDLINE, OVID and CENTRAL (Cochrane Central Register of Controlled Trials) databases were systematically searched for studies reporting the use of rhBMP-2 for spinal procedures in comparison to autograft and/or allograft and alternative graft materials under consideration of cost-effectiveness, cost-benefit, cost minimization, and/or cost-utility analysis.

Advances in Cranial Surgery.

The landscape of the cranial neurosurgery has changed tremendously in past couple of decades. The main frontiers including introduction of neuro-endoscopy, minimally invasive skull base approaches, SRS, laser interstitial thermal therapy and use of tubular retractors have revolutionized the management of intracerebral hemorrhages, deep seated tumors other intracranial pathologies. Introduction of these novel techniques is based on smaller incisions with maximal operative corridors, decreased blood loss, shorter hospital stays, decreased post-operative pain and cosmetically appealing scars that improves patient satisfaction and clinical outcomes.

Gearing Up for the U.S. Medical Licensing Examination Step 1 Pass/Fail Transition, Evaluating the Role of Research Productivity as an Alternative During the Neurosurgical Residency Selection Process: An Overview.

Neurosurgery residency programs are the most competitive among the surgical specialties for applicants to match into. U.S.

The role of non-stenosing carotid artery plaques in embolic stroke of undetermined source, is it a silent offender? A review of literature.

Purpose: Atherosclerotic cervical internal carotid artery disease is one of the major causes of ischemic stroke and transient ischemic attacks. The risk of stroke from mild to moderate stenoses (i.e.

A modern history of neurosurgery and neurology in India: lessons for the world.

The compendia of medical knowledge of the great ancient Indian physicians Suśruta, Caraka, Jīvaka, and Vāgbhaṭa all attest to the practice of neurosurgery and neurology starting in the 1st millennium bce. Although a period of scientific stagnation ensued between the 12th and 20th centuries ce, Indian medical neurosciences once again flourished after India's independence from British rule in 1947. The pioneers of modern Indian neurosurgery, neurology, and their ancillary fields made numerous scientific and clinical discoveries, advancements, and innovations that proved influential on a global scale.

Surgical Resection and Clipping of an Atherosclerotic Partially Calcified Middle Cerebral Artery Trifurcation Aneurysm with Clipping of an Anterior Communicating Artery Aneurysm: 2-Dimensional Operative Video.

It is estimated within the western population that 10%-13% of patients possess multiple intracranial aneurysms and are linked to certain risk factors. Thrombotic aneurysms are a rare subgroup of complex aneurysms characterized by an organized intraluminal thrombus. They differ from typical saccular aneurysms in terms of morphology, natural history, symptomatology, and difficulty in treatment with conventional strategies.

Characteristics and Outcomes of Discharge Against Medical Advice and 30-Day Readmissions After Concussion: Analysis of the Nationwide Readmissions Database.

Background: Little is known about the impact of discharge against medical advice (DAMA) in patients admitted with concussion.

Objective: To explore the prevalence of DAMA and its effect on 30-day readmissions and cost in concussion using a nationally representative sample.

Methods: The Nationwide Readmissions Database was queried for concussion admissions and their disposition at discharge between 2010 and 2014.

Surgical Technique and Nuances of Resection of a Trochlear Schwannoma: Operative Video.

Cranial nerve schwannomas accounts for around 8% of all benign intracranial tumors, arising most commonly from the vestibular nerve, followed by the trigeminal nerve and other lower cranial nerves. However, trochlear schwannoma in a patient without neurofibromatosis-2 are extremely rare and to date, fewer than 100 cases have been reported in the literature. They are either asymptomatic or present with ophthalmologic or neurologic symptoms.

Interhemispheric Approach for Clipping of a Pericallosal Artery Aneurysm: 2-Dimensional Operative Video.

Pericallosal artery aneurysms are rare, accounting for 2%-9% of all intracranial aneurysms. They are most commonly saccular and wide necked. Although typically small, they are more prone to rupture compared with other aneurysms in the anterior circulation.

Outcomes of Mechanical Thrombectomy for Ischemic Stroke in Nonagenarians: A 10-Year Institutional Experience.

Background: Nonagenarians have been underrepresented in stroke trials that established endovascular treatment as the standard for acute ischemic stroke (AIS). Evidence remains inconclusive regarding the efficacy of thrombectomy in this population.

Objectives: To report our experience with thrombectomy in nonagenarians with stroke, and to identify predictors of mortality.

Tribute to William Edward Hunt and Robert McDonald Hess Jr.: Pioneers in the Clinical Classification of Ruptured Intracranial Aneurysms.

William Edward Hunt (1921-1999) and Robert McDonald Hess Jr. (1931-2019) were pioneers in revolutionizing the early surgical management of ruptured intracranial aneurysms. Early on in his career as a professor of neurosurgery at Ohio State University, Dr.

Uncharted Waters of Machine and Deep Learning for Surgical Phase Recognition in Neurosurgery.

Recent years have witnessed artificial intelligence (AI) make meteoric leaps in both medicine and surgery, bridging the gap between the capabilities of humans and machines. Digitization of operating rooms and the creation of massive quantities of data have paved the way for machine learning and computer vision applications in surgery. Surgical phase recognition (SPR) is a newly emerging technology that uses data derived from operative videos to train machine and deep learning algorithms to identify the phases of surgery.

Gamma Knife Radiosurgery in the Management of Hypothalamic Glioma: A Case Report with Long-Term Follow-Up.

Background: Optic pathway/hypothalamic gliomas are rare pediatric brain tumors. The management paradigm for these challenging tumors includes chemotherapy, radiotherapy, or surgical resection, but the optimal management strategy remains elusive. Gamma knife radiosurgery (GKRS) has emerged as a promising treatment for such lesions as documented by a small number of cases in the literature.

Terson's syndrome, the current concepts and management strategies: A review of literature.

Terson's Syndrome describes intraocular hemorrhage secondary to an acutely raised intracranial pressure (ICP). Although Terson's Syndrome is common amongst patients with subarachnoid hemorrhage (SAH), it is underdiagnosed and often overlooked. This review discusses the current understanding of the etiopathogenesis, clinical features, and management of Terson's Syndrome and highlights the visual and prognostic implications to stress the importance of timely diagnosis and management.

Charles Jacques Bouchard (1837-1915) and the Charcot-Bouchard aneurysm.

Charles Jacques Bouchard was a distinguished French physician and scientist of the early 19th century. Despite his humble beginnings, Bouchard was able to achieve meteoric success within the scientific and medical fields, establishing himself as one of the most influential physician-scientists of his time. This was in part due to his superb commitment, as well as the prosperity engendered by the strong influence of his teachers, which can be seen as a testament to the importance of mentorship in medicine.

Aortic arch anomalies, embryology and their relevance in neuro-interventional surgery and stroke: A review.

Background: Congenital aortic arch anomalies are commonly encountered during neurointerventional procedures. While some anomalies are identified at an early age, many are incidentally discovered later in adulthood during endovascular evaluations or interventions. Proper understanding of the normal arch anatomy and its variants is pivotal to safely navigate normal aortic arch branches and to negotiate the catheter through anomalies during neurointerventional procedures.

The contributions of William A. Hammond (1828-1900) to Civil War medicine & modern neurology.

William Alexander Hammond was an American military physician and a main driving force for the development of modern-day clinical Neurology in America. Hammond served as the 11th Surgeon General of the United States Army, acting during the Civil War. Throughout his time as Surgeon General, with influence from Florence Nightingale, Hammond enforced strict hygienic measures and called for the construction of pavilion style hospitals in order to decrease non-wound mortalities.

The Evolution of 3D Anatomical Models: A Brief Historical Overview.

For thousands of years, anatomical models have served as essential tools in medical instruction. While human dissections have been the regular source of information for medical students for the last few centuries, the scarcity of bodies and the religious and social taboos of previous times made the process of acquiring human cadavers a challenge. The dissection process was dependent on the availability of fresh cadavers and thus was met with a major time constraint; with poor preservation techniques, decomposition turned the process of employing bodies for instruction into a race against time.

Current applications and safety profile of laser interstitial thermal therapy in the pediatric population: a systematic review of the literature.

Objective: Laser interstitial thermal therapy (LITT) provides a minimally invasive alternative to open brain surgery, making it a powerful neurosurgical tool especially in pediatric patients. This systematic review aimed to highlight the indications and complications of LITT in the pediatric population.

Methods: In line with the PRISMA guidelines, the authors conducted a systematic review to summarize the current applications and safety profiles of LITT in pediatrics.

Legacies of Neurosurgery and its Implications on Global Neurosurgery Today.

Trephination, the practice of boring a hole in the skull, is one of the oldest surgical procedures performed by and on humans. Fossil records show evidence of trephined skulls on separate continents throughout ancient history. Even more remarkably, fossils show that ancient humans actually survived the procedure, some more than once.

Multiple cerebral hemorrhages in sepsis-disseminated intravascular coagulation versus septic embolism: An image report.

Background: Septic emboli are commonly attributed to infective endocarditis and can present with a variety of symptoms including altered mental status and focal neurological deficits. Here, we reviewed images of septic emboli with hemorrhagic conversion in a patient with sepsis and a psoas abscess. We aim to show the classical image findings in septic embolism to brain, which is sparsely described in literature and the report differentiates the septic embolism from disseminated intravascular coagulation which can present with almost identical image findings.

Compliance With Preferred Reporting Items for Systematic Review and Meta-Analysis Individual Participant Data Statement for Meta-Analyses Published for Stroke Studies.

Background And Purpose: Individual-participant data meta-analyses (IPD-MA) are powerful evidence synthesis studies which are considered the gold-standard of MA. The quality of reporting in these studies is guided by the 2015 Preferred Reporting Items for Systematic Review and Meta-Analysis of Individual Participant Data (PRISMA-IPD) guidelines. The growing number of IPD-MA published for stroke studies calls for an assessment of the compliance of these studies with the PRISMA-IPD statement.