Dorsal arachnoid web of the thoracic spine associated with an arachnoid cyst and a presyrinx state as an unexplained cause of thoracic myelopathy: illustrative case.

Background: Dorsal thoracic arachnoid web is a rare diagnosis and is not commonly seen in neurosurgical practice. Patients can present with symptoms and signs of thoracic myelopathy in the setting of an arachnoid cyst and a presyrinx state.

Observations: A 57-year-old male with a 10-year history of worsening bilateral leg weakness and chronic back pain re-presented to the neurosurgery clinic after being seen by neurology and orthopedic spine surgery.

The History of the Development and Use of Suction Devices in Neurosurgery.

This article reviews the major devices, individuals, and other historical landmarks in the development of suction in the field of neurosurgery, where the operating fields are characteristically deep and narrow. Our review spans the 159 years since the first use of aspiration in surgery to modern applications. This report exemplifies a comprehensive history of suction, the minute iteration of devices, and the massive impact this technological development has had on medicine and neurosurgery.

Focused update to guidelines for endovascular therapy for emergent large vessel occlusion: basilar artery occlusion patients.

Background: Endovascular therapy (EVT) dramatically improves clinical outcomes for patients with anterior circulation emergent large vessel occlusion (ELVO) strokes. With recent publication of two randomized controlled trials in favor of EVT for basilar artery occlusions, the Society of NeuroInterventional Surgery (SNIS) Standards and Guidelines Committee provides this focused update for the existing SNIS guideline, 'Current endovascular strategies for posterior circulation large vessel occlusion stroke.'

Methods: A structured literature review and analysis of studies related to posterior circulation large vessel occlusion (basilar or vertebral artery) strokes treated by EVT was performed.

Rapid presentation of a de novo intracranial aneurysm: illustrative case.

Background: Intracranial aneurysms are prevalent, particularly with advancing age. De novo aneurysms, occurring independently from the initial lesion, pose a unique challenge because of their unpredictable nature. Although risk factors such as female sex, smoking history, and hypertension have been proposed, the mechanisms underlying de novo aneurysm development remain unclear.

Lumbar decompression and fusion for symptomatic spinal stenosis in a patient with chronic thoracic sensory level from prior transverse myelitis: a case report.

Background: Many patients with transverse myelitis suffer from sensory loss below the spinal level of the lesion. This is commonly associated with chronic neuropathic pain. However, the presence of somatic pain below a complete thoracic sensory level after transverse myelitis is exceptionally rare, and it is unclear if surgical decompression is an effective form of treatment for these patients.

Genomic characterization of an esthesioneuroblastoma with spinal metastases: illustrative case.

Background: Esthesioneuroblastoma (ENB) is a rare neoplasm of the sinonasal tract. Currently, the optimal treatment includes maximal resection combined with radiotherapy and/or chemotherapy. Although ENBs often recur and have an aggressive clinical course, spinal metastases are extremely rare and the underlying molecular mechanisms are poorly understood.

Sir Rickman John Godlee-Contributions in Addition to His 1884 Tumor Resection, A Review.

Background: Sir Rickman John Godlee (1849-1925) was widely known for performing the first documented surgery to resect a tumor from the brain.

Methods: The case was performed on November 25, 1884, on a 25-year-old farmer who presented with a left-sided Jacksonian March seizure.

Results: The case was highly publicized because the tumor was localized by Dr.

Recruitment into Academic Neurosurgery Using a Model for Successful Cross-Campus Research Collaboration: A Premedical Student Survey.

Objective: Recruitment of diverse and talented students to the field of neurosurgery is key to its continued growth and scientific advancement. Barriers, including poor perceptions and lack of early exposure, can impact recruitment and have been compounded by the ongoing COVID-19 pandemic. This study examines the impact of an inaugural Neurosurgery Research Consortium meeting on premedical students, assessing whether this exposure generated interest and improved perceptions of a career in neurosurgery.

Predictive validity of the All Patients Refined Diagnosis Related Group modifiers for costs and outcomes from intracranial hemorrhage.

Objective: The All Patients Refined Diagnosis Related Group (APR-DRG) modifiers-severity of illness (SOI) and risk of mortality (ROM)-inform hospital reimbursement nationally. The ubiquitous APR-DRG data bear the potential to inform public health research; however, the algorithms that generate these modifiers are proprietary and therefore should be independently verified. This study evaluated the predictive value of APR-DRG modifiers for the outcomes and costs of intracranial hemorrhage.

Antiplatelets and antithrombotics in neurointerventional procedures: Guideline update.

Background: Antiplatelet and antithrombotic medication management before, during, and after neurointerventional procedures has significant practice variation. This document updates and builds upon the 2014 Society of NeuroInterventional Surgery (SNIS) Guideline 'Platelet function inhibitor and platelet function testing in neurointerventional procedures', providing updates based on the treatment of specific pathologies and for patients with specific comorbidities.

Methods: We performed a structured literature review of studies that have become available since the 2014 SNIS Guideline.

Ruptured arteriovenous malformation mortality: Incidence, risk factors, and inpatient outcome score.

Background: Limited literature exists on the morbidity and mortality of AVM associated intracerebral hemorrhage (ICH) compared with non-AVM ICH.

Objective: We examine morbidity and mortality in cAVM in a large nationwide inpatient sample to create a prognostic inpatient ruptured AVM mortality score.

Methods: This retrospective cohort study from 2008 to 2014 compares outcomes in cAVM related hemorrhages and ICH utilizing the National Inpatient Sample database.

DNA methylation provides diagnostic value for meningioma recurrence in clinical practice.

Background: Meningiomas are the most common intracranial tumors. Recent advancements in the genetic profiling of tumors have allowed information including DNA copy number analysis, mutational analysis, and RNA sequencing to be more frequently reported, in turn allowing better characterization of meningiomas. In recent years, analysis of tumor methylomes that reflects both cell-origin methylation signatures and somatically acquired DNA methylation changes has been utilized to better classify meningiomas with great success.

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Review.

Middle meningeal artery embolization (MMAE) for chronic subdural hematomas (cSDHs) has evolved as a potential treatment alternative for these lesions. The indications for using this treatment modality and the pathophysiology of cSDHs are an area of considerable interest. A retrospective review was performed including all major papers addressing this topic.

Middle Meningeal Artery Embolization for Primary Treatment of a Chronic Subdural Hematoma in a Pediatric Patient: A Systematic Review of the Literature and Case Report.

Background: Middle meningeal artery (MMA) embolization is becoming increasingly studied as a safe, effective treatment for chronic subdural hematoma (cSDH) in adults. Among pediatric patients, however, MMA embolization for cSDH has been rarely described, and the potential benefit of this approach for pediatric patients remains unknown.

Objective: To systematically review the literature and identify cases of pediatric MMA embolization for cSDH.

Pilocytic Astrocytoma Arising from the Conus Medullaris in an Adult: A Case Report.

Low-grade, sporadic, pilocytic astrocytomas (PAs) are rare spinal cord tumors diagnosed in adult patients. Their localization to the conus medullaris is exceedingly rare, having only been described in a limited number of case reports. Here, we describe a case of a 22-year-old female presenting with back pain, lower extremity weakness, hypoesthesia, and urinary incontinence.

Molecular mediators of angiogenesis and neurogenesis after ischemic stroke.

The mechanisms governing neurological and functional recovery after ischemic stroke are incompletely understood. Recent advances in knowledge of intrinsic repair processes of the CNS have so far translated into minimal improvement in outcomes for stroke victims. Better understanding of the processes underlying neurological recovery after stroke is necessary for development of novel therapeutic approaches.

History of Virtual Reality and Augmented Reality in Neurosurgical Training.

Virtual reality (VR) and augmented reality (AR) are rapidly growing technologies. Both have been applied within neurosurgery for presurgical planning and intraoperative navigation, but VR and AR technology is particularly promising for the education of neurosurgical trainees. With the increasing demand for high impact yet efficient educational strategies, VR- and AR-based simulators allow neurosurgical residents to practice technical skills in a low-risk setting.

Landscape of genetic variants in sporadic meningiomas captured with clinical genomics.

Background: Meningiomas are the most common primary central nervous system tumor. Previous studies have characterized recurrent genetic alterations that can predict patient prognosis and potentially provide new avenues for therapeutic intervention. Continued efforts to characterize the genomic changes in meningioma samples can aid in the discovery of therapeutic targets and appropriate patient stratification.