Natural history of dolichoectatic vertebrobasilar aneurysms: a multinational study.

Objective: Dolichoectatic vertebrobasilar aneurysms (DVBAs) are expansions of arterial tissue leading to aneurysmal formations without an obvious neck. Their natural history is poorly understood; usually patients are admitted with thromboembolic complications and/or neurological symptoms from the mass effect. There have not been international collective data, and correct timing for highly risky treatments has been under discussion.

Single-View Fluoroscopic X-Ray Pose Estimation: A Comparison of Alternative Loss Functions and Volumetric Scene Representations.

Many tasks performed in image-guided procedures can be cast as pose estimation problems, where specific projections are chosen to reach a target in 3D space. In this study, we construct a framework for fluoroscopic pose estimation and compare alternative loss functions and volumetric scene representations. We first develop a differentiable projection (DiffProj) algorithm for the efficient computation of Digitally Reconstructed Radiographs (DRRs) from either Cone-Beam Computerized Tomography (CBCT) or neural scene representations.

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Bibliometric Analysis.

Background: Middle meningeal artery embolization (MMAE) is an endovascular technique that has been rapidly adopted in the management of chronic subdural hematoma (cSDH), with numerous positive results across the literature. This study aimed to summarize the body of original research published on MMAE for the treatment of cSDH through bibliometric methods.

Methods: The Web of Science, Science Citation Index Expanded database was queried on October 1, 2024 for articles related to MMAE for cSDH.

Neuroanatomy of the vertebrobasilar perforators: implications for aneurysm treatment.

The anatomy of vertebrobasilar perforators has been widely studied in human cadavers, with most reports found in the neurosurgical literature. These arterial perforators are extremely hard to visualize consistently with traditional two-dimensional digital subtraction angiography, but are reliably visible with cross sectional cone beam CT techniques. A clear understanding of this specific neurovascular anatomy and pathology is essential for informed treatment decisions.

Laparoscopic-Assisted Peritoneal Access in Ventriculoperitoneal Shunt Placement: Systematic Review and Meta-Analysis.

Background And Objectives: The most common treatment of hydrocephalus is ventriculoperitoneal (VP) shunting. Peritoneal access is commonly conducted through an open laparotomy, but laparoscopic peritoneal access is gaining popularity. Many studies have reported the benefits of minimally invasive laparoscopic peritoneal access, but there is no consensus on its use.

Volume-staged versus dose-staged stereotactic radiosurgery, with or without embolization, in the treatment of large brain arteriovenous malformations: A systematic review and meta-analysis.

Background And Objective: While safe and effective modalities exist to treat small arteriovenous malformations (AVMs), large (>10 cm) AVMs remain difficult to cure via surgical or endovascular means. Staged stereotactic radiosurgery (SRS), either volume-staged (VS) or dose-staged (DS), has been proposed for large AVMs. The relative efficacy of these two strategies, with or without endovascular embolization, is unclear.

Deconstructing Intratumoral Heterogeneity through Multiomic and Multiscale Analysis of Serial Sections.

Tumors may contain billions of cells, including distinct malignant clones and nonmalignant cell types. Clarifying the evolutionary histories, prevalence, and defining molecular features of these cells is essential for improving clinical outcomes, since intratumoral heterogeneity provides fuel for acquired resistance to targeted therapies. Here we present a statistically motivated strategy for deconstructing intratumoral heterogeneity through multiomic and multiscale analysis of serial tumor sections (MOMA).

Navigating the Neurosurgery Match Process: Insights from the National Resident Matching Program - Program Director Surveys.

Objective: Neurosurgery is one of the most competitive specialties, and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties.

Methods: We evaluated 7 surveys administered from 2012 to 2022.

Bivalirudin as a substitute for heparin in neurointervention for patients with heparin-induced thrombocytopenia.

Objectives: Heparin-induced thrombocytopenia is a known complication of heparin exposure with potentially life-threatening sequelae. Direct thrombin inhibitors can be substituted for heparin in patients with heparin-induced thrombocytopenia that require anticoagulation. However, the use of direct thrombin inhibitors as a substitute for heparin has not been widely reported in the neuroendovascular literature.

Fixed- Versus Variable-Dose Prothrombin Complex Concentrate for the Emergent Reversal of Vitamin K Antagonists: A Systematic Review and Meta-Analysis.

Objectives: Four-factor prothrombin complex concentrate (4-PCC) is recommended for rapid reversal of vitamin K antagonists (VKAs) such as warfarin, yet optimal dosing remains uncertain.

Data Sources: A systematic review was conducted of PubMed, Embase, and Ovid MEDLINE (Wolters Kluwer) databases from January 2000 to August 2023 for clinical studies comparing fixed- vs. variable-dose 4-PCC for emergent VKA reversal with at least one reported clinical outcome.

Background Subtraction Angiography with Deep Learning Using Multi-frame Spatiotemporal Angiographic Input.

Catheter Digital Subtraction Angiography (DSA) is markedly degraded by all voluntary, respiratory, or cardiac motion artifact that occurs during the exam acquisition. Prior efforts directed toward improving DSA images with machine learning have focused on extracting vessels from individual, isolated 2D angiographic frames. In this work, we introduce improved 2D + t deep learning models that leverage the rich temporal information in angiographic timeseries.

Charlson Comorbidity Index and Frailty as Predictors of Resolution Following Middle Meningeal Artery Embolization for Chronic Subdural Hematoma.

Background: Research on variables associated with chronic subdural hematoma (cSDH) resolution following middle meningeal artery embolization (MMAE) is limited. This study investigated the clinical utility of age-adjusted Charlson Comorbidity Index (ACCI) and modified 5-item Frailty Index (mFI - 5) for predicting cSDH resolution following MMAE.

Methods: We identified patients who underwent MMAE at our institution between January 2018 and December 2022, with at least 20 days of follow-up and one radiographic follow-up study.

Radionuclide shuntography for cerebrospinal fluid shunt flow evaluation in adults.

Objective: Radionuclide shuntography (RS) performed using 99mTc-DTPA injected into the reservoir of CSF shunts enables evaluation of CSF flow for suspected shunt malfunctions. The goal of this study was to report the authors' institutional experience with RS and evaluate its utility and associated complications.

Methods: The authors retrospectively reviewed all RS studies performed between November 2003 and June 2022.

Deconstructing intratumoral heterogeneity through multiomic and multiscale analysis of serial sections.

Tumors may contain billions of cells including distinct malignant clones and nonmalignant cell types. Clarifying the evolutionary histories, prevalence, and defining molecular features of these cells is essential for improving clinical outcomes, since intratumoral heterogeneity provides fuel for acquired resistance to targeted therapies. Here we present a statistically motivated strategy for deconstructing intratumoral heterogeneity through multiomic and multiscale analysis of serial tumor sections (MOMA).

Quantifying the Effect Size of Management Actions on Aboveground Carbon Stocks in Forest Plantations.

Purpose Of The Review: Improved forest management is a promising avenue for climate change mitigation. However, we lack synthetic understanding of how different management actions impact aboveground carbon stocks, particularly at scales relevant for designing and implementing forest-based climate solutions. Here, we quantitatively assess and review the impacts of three common practices-application of inorganic NPK fertilizer, interplanting with N-fixing species, and thinning-on aboveground carbon stocks in plantation forests.

Outpatient telemedicine in neurosurgery: 15,677 consecutive encounters in a comparative analysis of its effectiveness and impact on the surgical conversion rate.

Objective: The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of telehealth visits (THVs). The effects on neurosurgical practice have not been well characterized, especially concerning new-patient THVs. Therefore, the authors of this study reviewed their institution's experience with outpatient clinic visits and THVs from before the COVID-19 pandemic to the present to focus on clinical metrics, rates of surgery, and the effects of implementing THVs in order to better understand their implications for clinical practice as more data emerge over time.

Fabrication of a positional brain shift phantom through the utilization of the frozen intermediate hydrogel state.

Synthetic models (phantoms) of the brain-skull system are useful tools for the study of surgical events that are otherwise difficult to study directly in humans. To date, very few studies can be found which replicate the full anatomical brain-skull system. Such models are required to study the more global mechanical events that can occur in neurosurgery, such as positional brain shift.

Socio-ecological factors shape the distribution of a cultural keystone species in Malaysian Borneo.

Biophysical and socio-cultural factors have jointly shaped the distribution of global biodiversity, yet relatively few studies have quantitatively assessed the influence of social and ecological landscapes on wildlife distributions. We sought to determine whether social and ecological covariates shape the distribution of a cultural keystone species, the bearded pig (Sus barbatus). Drawing on a dataset of 295 total camera trap locations and 25,755 trap days across 18 field sites and three years in Sabah and Sarawak, Malaysian Borneo, we fitted occupancy models that incorporated socio-cultural covariates and ecological covariates hypothesized to influence bearded pig occupancy.

Concomitant cervical spine fractures are the primary driver of disability after traumatic vertebral artery dissection: A Case series of 123 patients.

Background: Traumatic vertebral artery dissections (tVADs) occur in up to 20% of patients with head trauma, yet data on their presentation and associated sequelae are limited.

Aims And Objectives: To characterize the tVAD population and identify factors associated with clinical outcomes.

Materials And Methods: We retrospectively analyzed all cases of tVAD at our institution from January 2004 to December 2018 with respect to mechanism of injury, clinical presentation, anatomic factors, associated pathologies, and relevant outcomes.

measurement of human brain material properties under quasi-static loading.

Computational modelling of the brain requires accurate representation of the tissues concerned. Mechanical testing has numerous challenges, in particular for low strain rates, like neurosurgery, where redistribution of fluid is biomechanically important. A finite-element (FE) model was generated in FEBio, incorporating a spring element/fluid-structure interaction representation of the pia-arachnoid complex (PAC).