In-Hospital Outcomes of Neonates with Hypoxic-Ischemic Encephalopathy Receiving Sedation-Analgesia during Therapeutic Hypothermia.

Objective:  This study aimed to compare magnetic resonance imaging (MRI) severity scores and in-hospital outcomes among neonates with perinatal hypoxic-ischemic encephalopathy (HIE) with and without exposure to sedation-analgesia (SA) during therapeutic hypothermia (TH).

Study Design:  A single-center, retrospective cohort study of neonates with perinatal HIE undergoing TH between January 2010 and December 2020. Demographics, clinical characteristics, MRI scores, and in-hospital outcomes were compared between patients without SA exposure and those with SA use.

Computational Prognostic Modeling in Traumatic Brain Injury.

Traumatic brain injury is the leading cause of death and disability worldwide. Despite this large impact, no predictive models are in widespread use due to tedious data collection requirements, lack of provider trust, and poor performance. Furthermore, these models use simple, often binary, data elements that fail to capture the complex heterogeneity of traumatic brain injury.

Artificial intelligence innovations in neurosurgical oncology: a narrative review.

Purpose: Artificial Intelligence (AI) has become increasingly integrated clinically within neurosurgical oncology. This report reviews the cutting-edge technologies impacting tumor treatment and outcomes.

Methods: A rigorous literature search was performed with the aid of a research librarian to identify key articles referencing AI and related topics (machine learning (ML), computer vision (CV), augmented reality (AR), virtual reality (VR), etc.

"It's like having a superpower": Reclaiming creativity and the intersectional experiences of trans young adults of color.

Trans young adults of color experience systemic harm that contributes to negative health outcomes and hinders their ability to live freely. The present study used a grounded theory qualitative methodology rooted in a critical-ideological paradigm to understand the intersections of racial and gender oppression. Trans young adults of color from across the United States ( = 15; ages 20-29; majority racial identities: Asian, Black, and multiracial; majority gender identities: nonbinary and transmasculine) participated in a semistructured interview.

Early Seizure Prophylaxis in Mild and Moderate Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Importance: Guidelines recommend seizure prophylaxis for early posttraumatic seizures (PTS) after severe traumatic brain injury (TBI). Use of antiseizure medications for early seizure prophylaxis after mild or moderate TBI remains controversial.

Objective: To determine the association between seizure prophylaxis and risk reduction for early PTS in mild and moderate TBI.

Insights into epileptogenesis from post-traumatic epilepsy.

Post-traumatic epilepsy (PTE) accounts for 5% of all epilepsies. The incidence of PTE after traumatic brain injury (TBI) depends on the severity of injury, approaching one in three in groups with the most severe injuries. The repeated seizures that characterize PTE impair neurological recovery and increase the risk of poor outcomes after TBI.

Development and prospective validation of an artificial intelligence-based smartphone app for rapid intraoperative pituitary adenoma identification.

Background: Intraoperative pathology consultation plays a crucial role in tumor surgery. The ability to accurately and rapidly distinguish tumor from normal tissue can greatly impact intraoperative surgical oncology management. However, this is dependent on the availability of a specialized pathologist for a reliable diagnosis.

Family rejection and LGBTQ+ Asian Americans' psychological distress and disordered eating: The role of conflicts in allegiances and family shame.

Objectives: Lesbian, gay, bisexual, trans, and queer (LGBTQ+) Asian Americans experience unique psychological health concerns at the intersection of multiple forms of marginalization. White supremacist, cisheteronormative, and colonial ideals and their structural and interpersonal manifestations may encourage family rejection of LGBTQ+ identities within Asian American family units. Family shame, conflicts in allegiances, and internalized anti-LGBTQ+ stigma were hypothesized as mediators in the association between family rejection and psychological distress and disordered eating.

Comparison of the Biomechanics of the Mouse Astrocytic Lamina Cribrosa Between Glaucoma and Optic Nerve Crush Models.

Purpose: The strain response of the mouse astrocytic lamina (AL) to an ex vivo mechanical test was compared between two protocols: eyes that underwent sustained intraocular pressure (IOP) increase and eyes after optic nerve crush.

Methods: Chronic IOP elevation was induced by microbead injection or the optic nerve was crushed in mice with widespread green fluorescence. After 3 days or 6 weeks, eyes were inflation tested by a published method of two-photon fluorescence to image the AL.

Subarachnoid Hemorrhage Outcomes in an Endovascular Right of First Refusal Neurosurgical Environment.

Background: Randomized controlled trials demonstrate that endovascular techniques yield improved outcomes compared with microsurgical approaches. However, not all patients are suitable candidates for endovascular management. This study aimed to determine if healthy patients managed microsurgically could achieve functional outcomes comparable to patients managed endovascularly.

Interaction of admission platelet count with current medications and the risk for chronic subdural recurrence.

Objective: Chronic subdural hematoma (cSDH) has a reported 10%-24% rate of recurrence after surgery, and prognostic models for recurrence have produced equivocal results. The objective of this study was to leverage a data mining algorithm, chi-square automatic interaction detection (CHAID), which can incorporate continuous, nominal, and binary data into a decision tree, to identify the most robust predictors of repeat surgery for cSDH patients.

Methods: This was a retrospective cohort study of all patients with SDH from two level 1 trauma centers at a single institution.

Automated Preoperative and Postoperative Volume Estimates Risk of Retreatment in Chronic Subdural Hematoma: A Retrospective, Multicenter Study.

Background And Objectives: Several neurosurgical pathologies, ranging from glioblastoma to hemorrhagic stroke, use volume thresholds to guide treatment decisions. For chronic subdural hematoma (cSDH), with a risk of retreatment of 10%-30%, the relationship between preoperative and postoperative cSDH volume and retreatment is not well understood. We investigated the potential link between preoperative and postoperative cSDH volumes and retreatment.

Comparison of machine learning models to predict long-term outcomes after severe traumatic brain injury.

Objective: An estimated 1.5 million people die every year worldwide from traumatic brain injury (TBI). Physicians are relatively poor at predicting long-term outcomes early in patients with severe TBI.

Applying the Sliding Scale Approach to Quantifying Functional Outcomes Up to Two Years After Severe Traumatic Brain Injury.

Outcomes after severe traumatic brain injury (TBI) can be represented by a sliding score that compares actual functional recovery to that predicted by illness severity models. This approach has been applied in clinical trials because of its statistical efficiency and interpretability but has not been used to describe change in functional recovery over time. The objective of this study was to use a sliding scoring system to describe the magnitude of change in Glasgow Outcome Scale Extended (GOSE) score at 6, 12, and 24 months after severe TBI and to compare patients who improved after 6 months to those who did not.

Outcomes and Treatment Algorithm in Glioblastoma Patients 80 Years and Older.

Objective: The current standard of care for patients with glioblastoma (GBM) is maximal safe resection followed by adjuvant radiation therapy with concurrent temozolomide chemotherapy. Previous studies that identified this treatment regimen focused on younger patients with GBM. The proportion of patients with GBM over the age of 80 years is increasing.

Impact of Racist Microaggressions and LGBTQ-Related Minority Stressors: Effects on Psychological Distress Among LGBTQ+ Young People of Color.

Background: College students situated at the nexus of racial and sexual and gender minority (SGM) identities may experience multiple identity-related oppressions. We assessed whether racist microaggressions and lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ)-related minority stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) are associated with greater psychological distress among SGM college students of color (SOC) (students who identified as Hispanic/Latinx and/or any nonwhite race).

Methods: Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study of SGM college students.

Interpretable machine learning model for imaging-based outcome prediction after cardiac arrest.

Introduction: Early identification of brain injury patterns in computerized tomography (CT) imaging is crucial for post-cardiac arrest prognostication. Lack of interpretability of machine learning prediction reduces trustworthiness by clinicians and prevents translation to clinical practice. We aimed to identify CT imaging patterns associated with prognosis with interpretable machine learning.

Advances in surgical approaches for refractory pituitary adenomas.

Refractory pituitary adenomas are difficult to control tumors that progress through optimal surgical, medical, and radiation management. Repeat surgery is a valuable tool to reduce tumor volume for more effective radiation and/or medical therapy, and to decompress critical neurovascular structures. Advances in surgical techniques and technologies, including minimally invasive cranial approaches, intraoperative MRI suites, and cranial nerve monitoring, have improved surgical outcomes and expanded indications.

Predicting posttraumatic epilepsy using admission electroencephalography after severe traumatic brain injury.

Objective: Posttraumatic epilepsy (PTE) develops in as many as one third of severe traumatic brain injury (TBI) patients, often years after injury. Analysis of early electroencephalographic (EEG) features, by both standardized visual interpretation (viEEG) and quantitative EEG (qEEG) analysis, may aid early identification of patients at high risk for PTE.

Methods: We performed a case-control study using a prospective database of severe TBI patients treated at a single center from 2011 to 2018.

Association of Posttraumatic Epilepsy With Long-term Functional Outcomes in Individuals With Severe Traumatic Brain Injury.

Background And Objective: Nearly one-third of patients with severe traumatic brain injury (TBI) develop posttraumatic epilepsy (PTE). The relationship between PTE and long-term outcomes is unknown. We tested whether, after controlling for injury severity and age, PTE is associated with worse functional outcomes after severe TBI.

Performance of CRASH and IMPACT Prognostic Models for Traumatic Brain Injury at 12 and 24 Months Post-Injury.

The Corticoid Randomization after Significant Head Injury (CRASH) and International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic models are the most reported prognostic models for traumatic brain injury (TBI) in the scientific literature. However, these models were developed and validated to predict 6-month unfavorable outcome and mortality, and growing evidence supports continuous improvements in functional outcome after severe TBI up to 2 years post-injury. The purpose of this study was to evaluate CRASH and IMPACT model performance beyond 6 months post-injury to include 12 and 24 months post-injury.

Radiosurgery outcomes in infratentorial juvenile pilocytic astrocytomas.

Purpose: To assess survival and neurological outcomes for patients who underwent primary or salvage stereotactic radiosurgery (SRS) for infratentorial juvenile pilocytic astrocytomas (JPA).

Methods: Between 1987 and 2022, 44 patients underwent SRS for infratentorial JPA. Twelve patients underwent primary SRS and 32 patients underwent salvage SRS.

Hunt-Hess Score at 48 Hours Improves Prognostication in Grade 5 Aneurysmal Subarachnoid Hemorrhage.

Background: Patients with Hunt-Hess (HH)5 aneurysmal subarachnoid hemorrhage (SAH) have high mortality rates. Despite an initial moribund exam, a subset of patients progress to favorable outcomes.

Objective: To evaluate the utility of delayed HH grading to improve prognostication.