Functional prediction of response to therapy prior to therapeutic intervention is associated with improved survival in patients with high-grade glioma.

Patients with high-grade glioma (HGG) have an extremely poor prognosis compounded by a lack of advancement in clinical care over the past few decades. Regardless of classification, most newly diagnosed patients receive the same treatment, radiation and temozolomide (RT/TMZ). We developed a functional precision oncology test that prospectively identifies individual patient's response to this treatment regimen.

Expected motor function change following decompressive surgery for spinal metastatic disease.

Background: Motor function in patients with spinal metastatic disease (SMD) directly impacts a patient's ability to receive systemic therapy and overall survival. Spine surgeons may be in the challenging position to advise a patient on expected motor function outcomes and determine a patient's suitability as a surgical candidate. We present this study to provide this critical information on anticipated motor function change to spine surgeons.

[Ga]Ga-DOTA-TATE uptake in subacute stroke following craniotomy for meningioma: a diagnostic tool for stroke?

Gallium 68 (Ga) 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid labelled octreotate ([Ga]Ga-DOTA-TATE) positron emission tomography (PET) is an established imaging technique for identifying tumours of neuroendocrine origin and meningiomas; the radiotracer binds to somatostatin receptor type 2 (SSTR2), which is richly expressed by these malignancies. Here, we present a rare case hinting at novel ischaemic stroke detection by [Ga]Ga-DOTA-TATE PET scan. The scan was performed 14 days post resection of an atypical meningioma with the intention to assess the extent of residual tumour for radiosurgical treatment of the operative cavity.

Prospective prediction of clinical drug response in high-grade gliomas using an ex vivo 3D cell culture assay.

Background: Clinical outcomes in high-grade glioma (HGG) have remained relatively unchanged over the last 3 decades with only modest increases in overall survival. Despite the validation of biomarkers to classify treatment response, most newly diagnosed (ND) patients receive the same treatment regimen. This study aimed to determine whether a prospective functional assay that provides a direct, live tumor cell-based drug response prediction specific for each patient could accurately predict clinical drug response prior to treatment.

Case Report of a Primary Pituitary Abscess and Systematic Literature Review of Pituitary Abscess with a Focus on Patient Outcomes.

Background: Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2%-1.1% of operative pituitary lesions.

Idiopathic Transverse Myelitis Mimicking an Intramedullary Spinal Cord Tumor.

The differential diagnoses for spinal cord lesions include spinal tumors and inflammatory processes. The distinction between these pathologies can be difficult if solely based on imaging. We report for the first time to our knowledge a case of idiopathic transverse myelitis (ITM) mimicking a discrete cervical spinal lesion in a 66-year-old man who presented with gait instability and neck pain.

Association between trauma and acute hemorrhage of cavernous malformations in children: report of 3 cases.

OBJECTIVE Cavernous hemangiomas are benign congenital vascular abnormalities. Intracerebral cavernous hemangiomas have an appreciable risk of spontaneous hemorrhage. Little is known as to whether head trauma increases the risk of bleeding for these lesions.

Patient variables and referral paradigms associated with osteoporosis screening and treatment in neurosurgical patients undergoing kyphoplasty.

OBJECT Vertebral fractures are the most common osteoporotic fracture. Bone density testing and medical treatment with bisphosphonates or parathormone are recommended for all patients with an osteoporotic fracture diagnosis. Inadequate testing and treatment of patients presenting with low-impact fractures have been reported in various specialties.

Recurrent intraneural ganglion cysts: Pathoanatomic patterns and treatment implications.

The etiology of intraneural ganglion cysts has been poorly understood. This has resulted in the development of multiple surgical treatment strategies and a high recurrence rate. We sought to analyze these recurrences in order to provide a pathoanatomic explanation and staging classification for intraneural cyst recurrence.

The Impact of Preoperative Angiographic Identification of the Artery of Adamkiewicz on Surgical Decision Making in Patients Undergoing Thoracolumbar Corpectomy.

Study Design: Retrospective study.

Objective: To investigate the impact of spinal angiography on selection of surgical side in patients undergoing thoracolumbar corpectomy.

Summary Of Background Data: The artery of Adamkiewicz provides the major blood supply to the thoracolumbar spinal cord.

Reversible changes in diffusion- and perfusion-based imaging in cerebral venous sinus thrombosis.

Diffusion- and perfusion-based imaging studies are regularly used in patients with ischemic stroke. Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and is primarily treated by systemic anticoagulation. Endovascular intervention can be considered in cases of failed medical therapy, yet the prognostic value of diffusion- and perfusion-based imaging for CVST has not been clearly established.

Reversible changes in diffusion- and perfusion-based imaging in cerebral venous sinus thrombosis.

Diffusion- and perfusion-based imaging studies are regularly used in patients with ischemic stroke. Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke and is primarily treated by systemic anticoagulation. Endovascular intervention can be considered in cases of failed medical therapy, yet the prognostic value of diffusion- and perfusion-based imaging for CVST has not been clearly established.

Peroneal intraneural ganglion cysts at the fibular neck: the layered "U" surgical approach to the articular branch and superior tibiofibular joint.

Background: Intraneural ganglia most commonly occur within the peroneal nerve near the fibular neck. Disconnection of the articular branch is required in their treatment. Surgical intervention can be challenging because of unfamiliarity with the region or scarring from previous surgery.

Neurolysis, neurectomy, and nerve repair/reconstruction for chronic pain.

Neuropathic pain may be a result of focal injury to a peripheral nerve. The treatment algorithm begins with nonoperative, then operative, options. In our practice, first-line surgical treatment should directly treat the injured nerve.

Assessment of long-term kyphosis following transthoracic corpectomy with single adjacent level posterior instrumentation.

Anterior thoracic spinal instrumentation has traditionally been supported by a posterior thoracic construct spanning from at least two levels above to two levels below; however, instrumentation at a single-level above and below may be adequate to support such a construct. We report two cases of transthoracic corpectomy with short-segment posterior fixation with success in long-term stabilization. Two patients with thoracic vertebral malignancy resulting in spinal deformity and spinal cord compression underwent transthoracic corpectomy with placement of an expandable cage proceeded by posterior fixation one level above and one level below.

Spinal accessory neuropathy following dual tunneling of lead extensions for motor cortex stimulation.

Background: Spinal accessory nerve (SAN) injury is a known complication of surgery involving the posterior cervical triangle. Because the nerve lies in a plane that is traversed by extension leads for neuromodulation, the SAN is at risk during tunneling for these procedures.

Methods: We report a 50-year-old man who developed spinal accessory neuropathy after tunneling of two sets of extension leads through his neck to connect to the pulse generator at the chest wall.

Method for securing titanium cerebellar retractors.

Background: Traditional stainless steel retractors can interfere with electromagnetic neuronavigation and intraoperative magnetic resonance imaging (ioMRI). In such cases, titanium instruments are frequently used; however, they often shift during the procedure. The authors describe a simple technique, illustrated with intraoperative photographs, for securing titanium cerebellar retractors into place to keep both the retractors and tissues in their desired locations throughout a craniotomy.

The treatment of nasal fractures: a changing paradigm.

Objectives: To compare the efficacy of closed vs open treatment of nasal fractures, and to suggest an algorithm for nasal fracture management that includes closed and open techniques.

Methods: Retrospective study of 86 patients with nasal fractures who received either closed treatment (41 patients) or open treatment (45 patients) between January 1, 1997, and December 30, 2007. Fractures were classified as 1 of 5 types.

Secondary central compartment surgery for thyroid cancer.

Objectives/hypothesis: To report surgical outcomes in a large series of patients with a history of thyroid cancer who underwent secondary central compartment surgery (SCCS).

Study Design: Retrospective chart review.

Methods: The records of 44 patients who underwent 47 secondary central compartment surgeries for thyroid cancer were reviewed.