Direct STA-MCA Bypass in Moyamoya Disease: Predicting Post-Operative Symptomatic Contralateral Stroke Using Clinical Characteristics and Angiographic Collateralization Patterns.

Background: Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by internal carotid artery narrowing, collateral neovascularization, and symptomatic cerebral ischemia. Select patients can benefit from direct bypass (STA-MCA bypass) by restoring blood flow to hypoperfused territories. Symptomatic contralateral stroke (CS) following STA-MCA bypass is a devastating, poorly understood complication.

Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation.

Introduction: Anatomic factors that predict outcomes following basal ganglia intracranial hemorrhage (bgICH) evacuation are poorly understood. Given the compact neuroanatomic organization of the basal ganglia, we hypothesized that bgICH spatial representation could predict postoperative functional outcomes.

Methods: Patients undergoing minimally invasive surgical bgICH evacuation between 2013 and 2024 at one center were retrospectively reviewed.

Posterior and Transforaminal Lumbar Interbody Fusion: Recent Advances in Technique and Technology.

Posterior approach interbody fusion techniques such as posterior lumbar interbody fusion and transforaminal interbody fusion are known as the workhorse procedures for lumbar spinal fusion. Over the years, advancements in procedural steps, technique, and technology have sought to improve patient outcomes. Within the last 2 decades, considerable emphasis has been placed upon minimally invasive techniques utilizing tubular retractors and conscious sedation.

Neurological Outcomes Following Craniotomy for Extracorporeal Membrane Oxygenation-Associated Intracranial Hemorrhage: Case Series and Literature Review.

Background: Intracranial hemorrhage (ICH) is a potential complication associated with extracorporeal membrane oxygenation (ECMO), which has been increasingly utilized in recent years. A paucity of data exists describing patient outcomes following invasive neurosurgical interventions in patients receiving ECMO therapy. The purpose of this study was to assess the clinical and functional outcomes in patients who underwent cranial neurosurgery for the management of an ECMO-associated intracranial complication.

The incidence of infratentorial arteriovenous malformation-associated aneurysms: an institutional case series and systematic literature review.

Background: Arteriovenous malformation (AVM)-associated aneurysms represent a high-risk feature predisposing them to rupture. Infratentorial AVMs have been shown to have a greater incidence of associated aneurysms, however the existing data is outdated and biased. The aim of our research was to compare the incidence of supratentorial vs infratentorial AVM-associated aneurysms.

Risk assessment of early therapeutic anticoagulation following cranial surgery: an institutional case series.

Objective: Postoperative thrombotic complications represent a unique challenge in cranial neurosurgery as primary treatment involves therapeutic anticoagulation. The decision to initiate therapy and its timing is nuanced, as surgeons must balance the risk of catastrophic intracranial hemorrhage (ICH). With limited existing evidence to guide management, current practice patterns are subjective and inconsistent.

The Use of Cranial Aneurysm Clips for Repair of Incidental Lumbar Durotomy: Operative Technique and Case Series.

Background: Incidental durotomy is a common complication of posterior lumbar spine surgery; however, effective and durable methods for primary repair remain elusive. Multiple existing techniques have previously been reported and extensively described, including sutured repair and the use of nonpenetrating titanium clips. The use of cranial aneurysm clips for primary repair of lumbar durotomy serves as a safe and effective alternative to obtain watertight closure of a dural tear.

Clinical presentation and extent of resection impacts progression-free survival in spinal ependymomas.

Purpose: Primary treatment of spinal ependymomas involves surgical resection, however recurrence ranges between 50 and 70%. While the association of survival outcomes with lesion extent of resection (EOR) has been studied, existing analyses are limited by small samples and archaic data resulting in an inhomogeneous population. We investigated the relationship between EOR and survival outcomes, chiefly overall survival (OS) and progression-free survival (PFS), in a large contemporary cohort of spinal ependymoma patients.

A Multidimensional Model to Facilitate Within Person Comparison of Attributes.

In psychological research and practice, a person's scores on two different traits or abilities are often compared. Such within-person comparisons require that measurements have equal units (EU) and/or equal origins: an assumption rarely validated. We describe a multidimensional SEM/IRT model from the literature and, using principles of conjoint measurement, show that its expected response variables satisfy the axioms of additive conjoint measurement for measurement on a common scale.

Repeat Flow Diversion for Retreatment of Incompletely Occluded Large Complex Symptomatic Cerebral Aneurysms: A Retrospective Case Series.

Background And Objectives: Data regarding radiographic occlusion rates after repeat flow diversion after initial placement of a flow diverter (FD) in large intracranial aneurysms are limited. We report clinical and angiographic outcomes on 7 patients who required retreatment with overlapping FDs after initial flow diversion for large intracranial aneurysms.

Methods: We performed a retrospective review of a prospectively maintained database of cerebrovascular procedures performed at our institution from 2017 to 2021.

The obesity paradox and ventriculoperitoneal shunting in aneurysmal subarachnoid hemorrhage patients undergoing microsurgical clipping.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) can be devastating. Identifying predisposing factors is paramount in reducing aSAH-related mortality. Obesity's negative impact on health is well-established.

Flow diversion for the treatment of intracranial bifurcation aneurysms: a systematic review and meta-analysis.

Background: Flow diversion (FD: flow diversion, flow diverter) is an endovascular treatment for many intracranial aneurysm types; however, limited reports have explored the use of FDs in bifurcation aneurysm management. We analyzed the safety and efficacy of FD for the management of intracranial bifurcation aneurysms.

Methods: A systematic review identified original research articles that used FD for treating intracranial bifurcation aneurysms.

Surgical Resection of Deep-Seated Arteriovenous Malformations Through Stereotactically Guided Tubular Retractor Systems: A Case Series.

Background: Arteriovenous malformations (AVMs) in the subcortical and/or periventricular regions can cause significant intraventricular and intracranial hemorrhage. These AVMs can pose a unique surgical challenge because traditional, open approaches to the periventricular region require significant cortical/white matter retraction to establish sufficient operative corridors, which may result in risk of neurological injury. Minimally invasive tubular retractor systems represent a novel, feasible surgical option for treating deep-seated AVMs.

Comparative effectiveness of stent-assisted coiling and Woven EndoBridge embolization for the treatment of unruptured wide-neck bifurcation intracranial aneurysms.

Objective: Woven EndoBridge (WEB) intrasaccular flow disruptors and stent-assisted coiling (SAC) are viable endovascular treatment options for wide-neck bifurcation intracranial aneurysms (WNBAs). Data directly comparing these two treatment options are limited. The authors aimed to compare radiographic occlusion rates and complication profiles between patients who received WEB and those who received SAC for WNBAs.

InCISE: Instrument for Comprehensive Incisional and Surgical Evaluation.

Objective: The evaluation of healing after head and neck surgery is currently qualitative and non-standardized, limiting the quality of surgical healing assessments in clinical and research settings. We sought to develop an objective, standardized wound assessment score, and hypothesize that a reliable instrument can be developed to evaluate head and neck surgical wounds.

Methods: A prospective cohort study was conducted in a tertiary-care, academic head and neck surgery practice.

Standardized Interview Scoring Methodology for Neurosurgical Residency Applicant Selection.

Interviews are critical to the neurosurgery resident application process. The COVID-19 pandemic forced residency interview activities are conducted virtually. To maintain a degree of control during a period of uncertainty, our department implemented a standardized survey for interviewers to evaluate the noncognitive attributes and program compatibility of applicants.

MOCCA-College: Preliminary Validity Evidence of a Cognitive Diagnostic Reading Comprehension Assessment.

As access to higher education increases, it is important to monitor students with special needs to facilitate the provision of appropriate resources and support. Although metrics such as the "reading readiness" ACT (formerly American College Testing) of provide insight into how many students may need such resources, they do not specify a student may need support or how to provide that support. Increasingly, students are bringing reading comprehension struggles to college.

Novel Use of the Aurora Surgiscope System for Minimally Invasive Resection of Intraparenchymal Lesions: A Case Series.

Background: Minimally invasive surgery (MIS) for intracranial pathology minimizes surgical morbidity but can come at the cost of operator ergonomics and technical surgical success. Here, the authors present a case series to report the first use of a novel 15-mm tubular retraction system with integrated lighting and visualization capabilities for MIS access to intracranial lesions.

Objective: To demonstrate feasibility and effectiveness of the 15-mm Aurora Surgiscope (Integra Lifesciences) for intracranial MIS approaches.

Regression with reduced rank predictor matrices: A model of trade-offs.

A regression model of predictor trade-offs is described. Each regression parameter equals the expected change in Y obtained by trading 1 point from one predictor to a second predictor. The model applies to predictor variables that sum to a constant for all observations; for example, proportions summing to = 1.

A Biomechanical Assessment of Shaken Baby Syndrome: What About the Spine?

Background: Shaken baby syndrome occurs following inertial loading of the pediatric head, resulting in retinal hemorrhaging, subdural hematoma, and encephalopathy. However, the anatomically vulnerable cervical spine receives little attention. Automotive safety literature is replete with biomechanical data involving forward-facing pediatric surrogates in frontal collisions, an environment analogous to shaking.

Use of Surpass Streamline Flow Diverter for the Endovascular Treatment of Craniocervical Aneurysms: A Single-Institution Experience.

Background: Flow diversion has revolutionized endovascular treatment for cerebral aneurysms. The Surpass Streamline flow diverter (SSFD) has shown promise for expanding flow diversion device options for aneurysm treatment. SSFD differs from earlier stents by maintaining high porosity with increased pore density to ensure appropriate flow disruption.

Linear equality constraints: Reformulations of criterion related profile analysis with extensions to moderated regression for multiple groups.

Criterion-related profile analysis (CPA) is a least squares linear regression technique for identifying a criterion-related pattern (CRP) among predictor variables and for quantifying the variance accounted for by the pattern. A CRP is a pattern, described by a vector of contrast coefficients, such that predictor profiles with higher similarity to the pattern have higher expected criterion scores. A review of applications shows that researchers have extended the analysis to meta-analyses, logit regression, canonical regression, and structural equation modeling.

A comparison of successful versus failed nonoperative treatment approaches in patients with degenerative conditions of the lumbar spine.

Identifying an optimal composition of nonoperative therapies to trial in patients suffering from degenerative lumbar spine conditions prior to surgical management remains challenging. Contrasting successful versus failed nonoperative treatment approaches may provide clinicians with valuable insight. The purpose of this study was to compare the nonoperative therapy regimens in degenerative lumbar spine disorder patients successfully managed conservatively versus patients who failed primary treatment and opted for lumbar fusion surgery.

Comparison of Postoperative Opioid Utilization in an ACDF Cohort: Narcotic Naive Patients Versus Preoperative Opioid Users.

Study Design: A retrospective cohort study.

Objective: To compare the postoperative opioid utilization rates and costs after anterior cervical discectomy and fusion (ACDF) procedures between groups of patients who were preoperative opioid users versus opioid naive.

Summary Of Background Data: Opioid medications are frequently prescribed after ACDF procedures.