Publications by authors named "Mari Groves"
Unlabelled: Patients who have radiographically detectable lesions in their brain or other symptoms compatible with brain tumors pose challenges for diagnosis. The only definitive way to diagnose such patients is through brain biopsy, an obviously invasive and dangerous procedure. Here we present a new workflow termed "CSF-BAM" that simultaneously identifies cell or T cell receptor rearrangements, neuploidy, and using PCR-mediated amplification of both strands of the DNA from CSF samples.
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- The study reviewed six pediatric osteosarcoma patients with brain metastases at Johns Hopkins Hospital, revealing a grim median survival of just 2.5 months post-diagnosis.
- Despite various treatments like chemotherapy, surgery, and radiation, most outcomes were fatal, although one patient showed a remarkable 13-month survival with a combination treatment, suggesting the potential of multimodal therapies.
- The findings stress the importance of careful monitoring for neurological symptoms and highlight the need for further research into new treatment strategies and the biology of metastasis to improve patient outcomes.
Background And Objectives: The optimal management strategy for pediatric patients with symptomatic moyamoya disease (MMD) is not well established. This systematic review and meta-analysis compares surgical vs conservative management and direct/combined bypass (DB/CB) vs indirect bypass (IB) for pediatric patients with symptomatic MMD.
Methods: MEDLINE and PubMed were searched from inception to March 17, 2024.
Article Synopsis
- The study focused on posterior vertebral column subtraction osteotomy (PVCSO), a surgical procedure aimed at alleviating symptoms in patients with recurrent tethered cord syndrome (TCS) by shortening the spinal column and relieving tension on the spinal cord.
- Researchers retrospectively analyzed six patients who underwent PVCSO from 2019 to 2023, measuring changes in spinal cord dimensions through MRI and recording clinical outcomes such as motor function and pain relief after surgery.
- Results showed significant improvements in motor function for all patients, sensory function for 40%, and pain relief for 83%, along with notable anatomical changes in the spinal cord, indicating successful outcomes and minimal complications associated with the surgery.
Article Synopsis
- The RASopathies are a group of genetic syndromes caused by mutations in the RAS/MAPK signaling pathway, affecting conditions like neurofibromatosis type 1, Noonan syndrome, and others, often leading to similar symptoms due to abnormal cell growth.
- Epidermal nevus syndromes are characterized by skin nevi alongside other systemic issues, with recent findings indicating that mosaic RAS mutations may contribute to these conditions.
- A case study details a child's treatment with the MEK inhibitor selumetinib, demonstrating stabilization of nerve hypertrophy and improvement of skin lesions, highlighting the potential for targeted therapies beyond currently established uses for RASopathy-related symptoms.
Article Synopsis
- - The study investigates outcomes of prenatal versus postnatal surgical repair of myelomeningocele (MMC), a severe form of spina bifida, focusing on factors like spinal cord tethering and other complications.
- - A total of 18 patients were reviewed from 2002 to 2020, with equal groups for prenatal and postnatal repair, and demographic data collected included age, sex, and medical history.
- - Results showed that patients who had prenatal closure experienced fewer detethering procedures and lower rates of requiring a ventriculoperitoneal shunt compared to those with postnatal repair, highlighting potential benefits of prenatal surgery.
Background: The current neurosurgical workforce is not large enough to address the significant burden of neurosurgical disease worldwide, and women are under-represented in this surgical specialty. However, trainee opportunities are particularly scarce in lower- and middle-income countries, where the burden of neurosurgical disease is high. Thus, the primary aim of this study was to assess the effects of gender and country on perceived access to neurosurgical research and mentorship opportunities.
View Article and Find Full Text PDFMedulloblastoma is the most frequently encountered malignant brain tumor in the pediatric population. The standard of care currently consists of surgical resection, craniospinal irradiation, and multi-agent chemotherapy. However, despite this combination of multiple aggressive modalities, recurrence of the disease remains a substantial concern, and treatment resistance is a rising issue.
View Article and Find Full Text PDFObjective: The PEDSPINE I and PEDSPINE II scores were developed to determine when patients require advanced imaging to rule out cervical spine injury (CSI) in children younger than 3 years of age with blunt trauma. This study aimed to evaluate these scores in an institutional cohort.
Methods: The authors identified patients younger than 3 years with blunt trauma who received cervical spine MRI from their institution's prospective database from 2012 to 2015.
Background: Nigeria has an inadequate number of neurosurgeons to meet the population's demand for neurosurgical care. Furthermore, few Nigerian neurosurgeons are female. This study sought to evaluate perceived barriers to pursuing neurosurgery among Nigerian trainees.
View Article and Find Full Text PDFPurpose: To investigate differences in sociodemographic characteristics and short-term outcomes between patients undergoing prenatal versus postnatal myelomeningocele repair.
Methods: Patients who underwent myelomeningocele repair at our institution were stratified based on prenatal or postnatal timing of repair. Baseline characteristics and outcomes were compared.
Article Synopsis
- - High- and middle-income countries (LMICs) have higher rates of neural tube defects (NTDs) and hydrocephalus due to limited access to neurosurgery, leading to a need for better prenatal care and surgical management for affected families.
- - A scoping review analyzed 70 studies on prenatal care and surgical management of spinal dysraphism and hydrocephalus, finding that most research is concentrated in LMICs and highlighting seven main themes related to these conditions.
- - The review concluded that while NTDs are a significant public health issue in LMICs, there is a lack of high-quality studies on prevention and management, especially concerning hydrocephalus, indicating a need for future research
Article Synopsis
- Scientists have created a new method called Real-CSF to help tell the difference between brain cancer and non-cancerous spots.
- This technique looks at DNA in a special fluid around the brain to find signs of cancer more accurately than regular tests.
- In tests with 280 samples, Real-CSF correctly identified most of the cancerous and non-cancerous cases, making it a useful tool for doctors.
Introduction: We performed a systematic review and meta-analysis on the incidence of secondary tethered spinal cord (TSC) between prenatal and postnatal closure in patients with MMC. The objectives was to understand the incidence of secondary TSC after prenatal surgery for MMC compared to postnatal surgery for MMC.
Material And Methods: On May 4, 2023, a systematic search was conducted in Medline, Embase, and the Cochrane Library to gather relevant data.
Background: Spinal conditions, such as scoliosis and spinal tumors, are prevalent in neurofibromatosis type 1 (NF1). Despite the recognized importance of their early detection and treatment, there remain knowledge gaps in how to approach these manifestations. The purpose of this study was to utilize the experience of a multidisciplinary committee of experts to establish consensus-based best practice guidelines (BPGs) for spinal screening and surveillance, surgical intervention, and medical therapy in pediatric patients with NF1.
View Article and Find Full Text PDFObjective: The focus of this modified Delphi study was to investigate and build consensus regarding the medical management of children with moderate and severe acute spinal cord injury (SCI) during their initial inpatient hospitalization. This impetus for the study was based on the AANS/CNS guidelines for pediatric SCI published in 2013, which indicated that there was no consensus provided in the literature describing the medical management of pediatric patients with SCIs.
Methods: An international, multidisciplinary group of 19 physicians, including pediatric neurosurgeons, orthopedic surgeons, and intensivists, were asked to participate.
Background: Neurosurgical capacity building efforts attempt to address the shortage of neurosurgeons and lack of neurosurgical capacity in low- and middle-income countries. This review sought to characterize neurosurgical capacity building efforts in low- and middle-income countries and the challenges they face, and identify factors that predict higher engagement, better training, and performance of high-impact activities.
Methods: A scoping review using PubMed and Embase databases was performed and relevant articles were identified.
Objective: Cervical spine disorders in children are relatively uncommon; therefore, paradigms for surgical and nonsurgical clinical management are not well established. The purpose of this study was to bring together an international, multidisciplinary group of pediatric cervical spine experts to build consensus via a modified Delphi approach regarding the clinical management of children with cervical spine disorders and those undergoing cervical spine stabilization surgery.
Methods: A modified Delphi method was used to identify consensus statements for the management of children with cervical spine disorders requiring stabilization.
Article Synopsis
- The study evaluates the neurosurgical literature in Ghana, highlighting the need for more comprehensive research to address various disease challenges and opportunities in the field.
- A total of 927 articles were reviewed, with only 66 qualifying for the analysis; the majority were retrospective cohort studies focused on non-infectious spinal pathologies, with a notable absence of randomized controlled trials.
- The findings suggest that improving the research landscape in Ghana can be achieved through enhanced funding, the creation of clinical databases, better research training, and stronger collaborative efforts in the neurosurgical community.
Background: Despite clinical concerns associated with pediatric traumatic brain injuries (TBIs), they remain grossly underreported. This is the first retrospective study to characterize concomitant pediatric TBIs and craniomaxillofacial (CMF) trauma patients, including frequency, presentation, documentation, and outcomes.
Methods: An institutional review board-approved retrospective cohort study was performed to identify all pediatric patients presenting with CMF fractures at a high-volume, tertiary trauma center between the years 1990 and 2010.
Background: Low- and middle-income countries experience numerous challenges in the provision of neurosurgical care. However, limited information exists on the neurosurgical workforce and the constraints under which care is delivered in Ghana, West Africa.
Methods: A 19-item survey assessing neurosurgical workforce, infrastructure, and education was administered to Ghanaian consultant neurosurgeons and neurosurgeon trainees between November 8, 2021, and January 20, 2022.
Objective: Screening for cervical spine injury after blunt trauma is common, but there remains varied practice patterns and clinical uncertainty regarding adequate radiographic evaluation. An oft-cited downside of MRI is the added risk compared to CT in the pediatric population; however, these specific risks have not yet been reported. This study examines the risks of cervical spine MRI in pediatric trauma patients in the context of what value MRI adds.
View Article and Find Full Text PDFObjective: Female neurosurgeon representation has increased, but women still represent only 8.4% of neurosurgeons in the US. Women are significantly underrepresented as authors in neurosurgical and spine journals, a key indicator of professional success in academic medicine.
View Article and Find Full Text PDFThe objective of this systematic review was to synthesize evidence regarding spinal screening recommendations, types of spinal and thoracic neurofibromatosis type 1 (NF1) tumors, medical therapy for NF1-associated neoplasms, and treatment with magnetically controlled growing rods (MCGRs) or cervical kyphosis correction in pediatric patients with NF1. We queried PubMed, Embase, Cochrane Library, Web of Science, Scopus, Clinicaltrials.gov, and medRxiv for studies reporting spinal screening recommendations, prognosis, and medical therapy for NF1-associated spinal tumors and MCGR use or cervical kyphosis correction in pediatric NF1 patients, yielding 758 publications, 33 of which were included.
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