Publications by authors named "Michael W McDermott"

Background And Objectives: Intracranial epidermoid cysts are rare, slow-growing but highly recurrent tumors with incompletely understood symptoms, progression, complications, and outcomes. The aim of the study was to characterize the symptomatology, surgical management, and long-term outcomes of these tumors.

Methods: This single-center retrospective analysis identified patients with pathologically confirmed intracranial epidermoid cysts from 1989 to 2023.

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Purpose: This report describes routine machine quality assurance (QA) (daily, monthly, and annual QA) tests for the Zap-X Gyroscopic Radiosurgery platform.

Methods: Following the recommendations of the American Association of Physicists in Medicine Task Group (AAPM TG)-142 and Medical Physics Practice guideline (MPPG) 8.b, routine machine QA tests for the Zap-X system were implemented.

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Background: Stereotactic radiosurgery (SRS) for patients with brain metastases (BM) is associated with a risk of distant intracranial failure (DIF). This study evaluates the impact of integrating dedicated 3D-TSE sequences to MPRAGE in BM detection and DIF prolongation in a histology-agnostic patient cohort.

Methods: The study population included adults treated with SRS from February 2019 to January 2024 who underwent MPRAGE alone or dual-sequence with the addition of 3D-TSE starting from February 2020.

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Article Synopsis
  • Postgraduate residency training is vital to academic medicine in the U.S., relying on the ERAS platform and NRMP for matching applicants and programs, but rising applicants per spot have created matching challenges.
  • The 2020-2021 Match Cycle introduced a supplemental application system using preference signals/tokens, allowing applicants to indicate interest in specific programs, which showed positive results in specialties like otolaryngology and urology.
  • Neurosurgery adopted this signaling system for its residency applications starting in the 2022-2023 Cycle, providing applicants with 25 signals to enhance their chances of securing interviews and ultimately improve the match process.
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Article Synopsis
  • Brain surgeons need standardized rules for handling brain tumors during surgery to improve diagnosis and treatment.*
  • Right now, guidelines mainly exist for one type of brain tumor, but others could also benefit from these rules.*
  • Having experts from different fields work together is important for creating these standardized practices to help patients and research better.*
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Purpose: Surgically targeted radiation therapy (STaRT) with Cesium-131 seeds embedded in a collagen tile is a promising treatment for recurrent brain metastasis. In this study, the biological effective doses (BED) for normal and target tissues from STaRT plans were compared with those of external beam radiotherapy (EBRT) modalities.

Methods: Nine patients (n = 9) with 12 resection cavities (RCs) who underwent STaRT (cumulative physical dose of 60 Gy to a depth of 5 mm from the RC edge) were replanned with CyberKnife (CK), Gamma Knife (GK), and intensity modulated proton therapy (IMPT) using an SRT approach (30 Gy in 5 fractions).

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Lacrosse, a sport of increasing popularity, is played with netted sticks and a firm rubber ball propelled at speeds frequently reaching over 100 miles/hour. While lacrosse injuries have been previously described, little published literature exists on lacrosse balls causing pulmonary contusion. We present a case of a 17-year-old male lacrosse player athlete who suffered a lacrosse ball strike to the left posterolateral chest, leading to a clinical presentation of local bruising, shortness of breath, and hemoptysis.

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Introduction: This study compares four management paradigms for large brain metastasis (LMB): fractionated SRS (FSRS), staged SRS (SSRS), resection and postoperative-FSRS (postop-FSRS) or preoperative-SRS (preop-SRS).

Methods: Patients with LBM (≥ 2 cm) between July 2017 and January 2022 at a single tertiary institution were evaluated. Primary endpoints were local failure (LF), radiation necrosis (RN), leptomeningeal disease (LMD), a composite of these variables, and distant intracranial failure (DIF).

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Article Synopsis
  • - Meningiomas are the most common primary brain tumors in adults, with an increasing incidence linked to aging and better neuroimaging, and while many are benign, some are aggressive and treatment-resistant, leading to serious health impacts.
  • - Recent advancements in understanding meningioma biology have introduced molecular biomarkers for diagnosis and prognosis, but a standardized molecular classification for these tumors is still lacking.
  • - A comprehensive consensus review by the International Consortium on Meningiomas aims to guide clinicians and researchers by covering proposed classifications, novel treatment strategies, ongoing studies, and unique management approaches for different patient populations.
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  • A systematic review was conducted to analyze how outcomes of meningioma clinical trials are measured and reported, addressing the lack of agreement on these measures.
  • The study reviewed 30 published articles and 18 ongoing trials, resulting in 47 clinical trials and 659 reported outcomes, which were grouped into unique terms using a standardized classification system.
  • The findings highlight the need for a more consistent approach to outcome measurement, leading to plans for a consensus meeting to create a core outcome set to guide future trials.
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Article Synopsis
  • A systematic review was conducted to analyze how outcomes are measured in studies of patients with incidental intracranial meningioma, as inconsistent practices have hindered comparative research.
  • The review included 33 published articles, resulting in 268 reported outcomes, which were refined to 178 unique outcomes categorized into 53 standardized terms and classified into 9 outcome domains.
  • The goal is to create a Core Outcome Set through stakeholder consensus, improving the consistency of outcome measurements in future studies.
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Background: Frontal craniotomies for a medial subfrontal approach necessitate crossing the frontal sinus. Large superior extensions of the frontal sinus into frontal bone can result in mucosal retention in a free craniotomy bone flap, leading to a delayed mucocele with significant associated morbidity. The authors describe an "open-window" craniectomy technique that permits mucosal removal under direct vision and maintains the inner table on the bone flap's inferior side, helping to seal off the sinus opening with a pericranial flap.

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  • The Kaplan-Meier method can overestimate the risk of cancer coming back, especially when other events like death happen first, but the Aalen-Johansen method can give a more accurate picture by considering these events.
  • A study looked at research articles about meningiomas (a type of brain tumor) since 2020 and found that only a few used the better method.
  • It showed that not using the Aalen-Johansen method mostly led to overestimating the recurrence risk, especially in older patients with more serious tumors.
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Background: Early palliative/pre-emptive intervention improves clinical outcomes and quality of life for patients with metastatic cancer. A previous signal-seeking randomized controlled trial (RCT) demonstrated that early upfront radiotherapy to asymptomatic or minimally symptomatic high-risk osseous metastases led to reduction in skeletal-related events (SREs), a benefit driven primarily by subgroup of high-risk spine metastasis. The current RCT aims to determine whether early palliative/pre-emptive radiotherapy in patients with high-risk, asymptomatic or minimally symptomatic spine metastases will lead to fewer SREs within 1 year.

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Mechanisms specifying cancer cell states and response to therapy are incompletely understood. Here we show epigenetic reprogramming shapes the cellular landscape of schwannomas, the most common tumors of the peripheral nervous system. We find schwannomas are comprised of 2 molecular groups that are distinguished by activation of neural crest or nerve injury pathways that specify tumor cell states and the architecture of the tumor immune microenvironment.

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Background And Objectives: Meningiomas are the most common primary intracranial tumors and are among the only tumors that can form lamellar, hyperostotic bone in the tumor microenvironment. Little is known about the epidemiology or molecular features of hyperostotic meningiomas.

Methods: Using a retrospective database of 342 meningiomas treated with surgery at a single institution, we correlated clinical, tumor-related, targeted next-generation DNA sequencing (n = 39 total, 16 meningioma-induced hyperostosis [MIH]), and surgical variables with the presence of MIH using generalized linear models.

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Brain metastases (BMs) represent the most common intracranial tumors in adults, and most commonly originate from lung, followed by breast, melanoma, kidney, and colorectal cancer. Management of BM is individualized based on the size and number of brain metastases, the extent of extracranial disease, the primary tumor subtype, neurological symptoms, and prior lines of therapy. Until recently, treatment strategies were limited to local therapies, like surgical resection and radiotherapy, the latter in the form of whole-brain radiotherapy or stereotactic radiosurgery.

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Surgery is the mainstay of treatment for meningioma, the most common primary intracranial tumor, but improvements in meningioma risk stratification are needed and indications for postoperative radiotherapy are controversial. Here we develop a targeted gene expression biomarker that predicts meningioma outcomes and radiotherapy responses. Using a discovery cohort of 173 meningiomas, we developed a 34-gene expression risk score and performed clinical and analytical validation of this biomarker on independent meningiomas from 12 institutions across 3 continents (N = 1,856), including 103 meningiomas from a prospective clinical trial.

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Objective: Intraventricular meningiomas (IVMs) of the lateral ventricle are rare tumors that present surgical challenges because of their deep location. Visual field deficits (VFDs) are one risk associated with these tumors and their treatment. VFDs may be present preoperatively due to the tumor and mass effect (tumor VFDs) or may develop postoperatively due to the surgical approach (surgical VFDs).

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Purpose: This study evaluates the outcomes of recurrent brain metastasis treated with resection and brachytherapy using a novel Cesium-131 carrier, termed surgically targeted radiation therapy (STaRT), and compares them to the first course of external beam radiotherapy (EBRT).

Methods: Consecutive patients who underwent STaRT between August 2020 and June 2022 were included. All patients underwent maximal safe resection with pathologic confirmation of viable disease prior to STaRT to 60 Gy to a 5-mm depth from the surface of the resection cavity.

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