Clear neuroimaging margin at the brain-tumor interface is associated with gross total resection and longer survival in non-enhancing diffuse gliomas.

Background: This study aimed to determine whether the presence of distinct glioma margins on preoperative imaging is correlated with improved intraoperative identification of tumor-brain interfaces and overall improved surgical outcomes of non-enhancing gliomas.

Methods: This is a retrospective study of all primary glioma resections at our institution between 2000-2020. Tumors with contrast enhancement or with final pathology other than diffuse infiltrative glial neoplasm (WHO II or WHO III) were excluded.

Virtual Interviews During COVID-19 Changed Neurosurgery Match-for Better or Worse.

Objective: The COVID-19 pandemic forced neurosurgery residency application processes to adopt a virtual interview model. This study analyzes the trends in program and applicant residency match behavior due to virtual interviews.

Methods: National Resident Matching Program data from Main Residency Match, National Resident Matching Program Director and Applicant Survey, Electronic Residency Application Service, and Charting Outcomes in the Match were collected for neurosurgery residents for all available years, providing information on neurosurgery residency application, interview, and match outcomes.

Neurosurgery Resident Attrition Rates Defy Trends and Decrease During COVID-19 Pandemic.

Objective: We sought to determine the effects of the coronavirus disease 2019 (COVID-19) pandemic on U.S. neurosurgery resident attrition.

Evaluating Match and Attrition Rates for Women and African Americans in Neurosurgery.

Background: Previous efforts to increase diversity in neurosurgery have been aimed primarily at female inclusion while little analysis of other under-represented groups has been performed.

Objective: To evaluate match and retention rates of under-represented groups in neurosurgery, specifically Black and female applicants compared with non-Black and male applicants.

Methods: Match lists, Electronic Residency Application Service data, and National Resident Matching Program data were retrospectively reviewed along with publicly available residency program information for successful matriculants from 2017 to 2020.

Analysis of Imaging Results for Semisitting Compared with Supine Positioning in the Retrosigmoid Approach for Resection of Cerebellopontine Angle Vestibular Schwannomas.

Objective: To compare the completeness of resection of vestibular schwannomas using three-dimensional segmented volumetric analysis of pre- and postoperative magnetic resonance imaging (MRI) of patients undergoing supine and semisitting positioning for the retrosigmoid approach.

Study Design: Retrospective chart review.

Setting: Tertiary medical center.

Outcomes and Utility of Intracranial Free Tissue Transfer.

Objective: Complications associated with intracranial vault compromise can be neurologically and systemically devastating. Primary and secondary repair of these deficits require an air and watertight barrier between the intracranial and extracranial environments. This study evaluated the outcomes and utility of using intracranial free tissue transfer as both primary and salvage surgical repair of reconstruction.

Neuroendoscopic fenestration of glioependymal cysts to the ventricle: report of 3 cases.

Glioependymal cysts are rare congenital lesions of the central nervous system. Reported surgical treatments of these lesions have varied and yielded mixed results, and the optimal surgical strategy is still controversial. The authors here report the clinical and surgical outcomes for three adult patients successfully treated with neuroendoscopic fenestration into the ventricular system.

Socioeconomic Factors Affecting Discharge Status of Patients with Uncomplicated Transsphenoidal Adenohypophysectomy.

 The number of transsphenoidal adenohypophysectomies (TSAs) surgeries has grown significantly since 1993. While there has been an overall decreasing trend in length of stay (LOS), socioeconomic factors may impact hospitalization. This study explores the impact of socioeconomic factors on LOS and total charges in uncomplicated patients undergoing TSA.

Very Large Metastases to the Brain: Retrospective Study on Outcomes of Surgical Management.

Background: The incidence of brain metastases is rising. To our knowledge, no published study focuses exclusively on brain metastases larger than 4 cm. We present our surgical outcomes for patients with brain metastases larger than 4 cm.

Safety, Efficacy, and Cost-Analysis of Percutaneous Endoscopic Gastrostomy and Ventriculoperitoneal Shunt Placement in a Simultaneous Surgery.

Background: Limited historical data suggest that concomitant placement of both a ventriculoperitoneal (VP) shunt and percutaneous endoscopic gastrostomy (PEG) tube is associated with an increased risk of complications, including VP shunt infections. Here we compare the outcomes and cost difference between 2 groups of patients, one in which a VP shunt and PEG tube were placed in the same operation and the other in which separate operations were performed.

Methods: A total of 10 patients underwent simultaneous placement of a VP shunt and PEG tube.

Malignant glioma-primitive neuroectodermal tumor recurring as PNET-like only subdural collection: Case report.

Background: Histologic variants of conventional glioblastoma are rare clinical entities. In recent years, an aggressive variant termed malignant glioma with primitive neuroectodermal tumor components (MG-PNET) has been described in adults. In addition to the rarity of supratentorial primitive neuroectdoermal tumors (sPNET) in adults, MG-PNET can present with unique radiographic features.

Herniated gyrus rectus causing idiopathic compression of the optic chiasm.

Anomalies in the frontal lobe can interfere with visual function by compression of the optic chiasm and nerve. The gyrus rectus is located at the anterior cranial fossa floor superior to the intracranial optic nerves and chiasm. Compression of these structures by the gyrus rectus is often caused by neoplastic or dysplastic growth in the area.

Three-Dimensional Printed Model Used to Teach Skull Base Anatomy Through a Transsphenoidal Approach for Neurosurgery Residents.

Background: Skull base anatomy through a transsphenoidal approach is challenging for the neurosurgical resident to conquer.

Objective: To demonstrate that stereolithography, or 3-dimensional (3-D) printing, is a useful educational tool for neurosurgery residents to learn skull base anatomy.

Methods: Before any formal teaching, residents were brought into the operating room where they were asked to identify key structures seen through an endoscopic transsphenoidal approach.

Intracerebral laser interstitial thermal therapy followed by tumor resection to minimize cerebral edema.

OBJECTIVE Laser interstitial thermal therapy (LITT) is used in numerous neurosurgical applications including lesions that are difficult to resect. Its rising popularity can be attributed to its minimally invasive approach, improved accuracy with real-time MRI guidance and thermography, and enhanced control of the laser. One of its drawbacks is the possible development of significant edema, which contributes to extended hospital stays and often necessitates hyperosmolar or steroid therapy.

Meningioma consistency prediction utilizing tumor to cerebellar peduncle intensity on T2-weighted magnetic resonance imaging sequences: TCTI ratio.

OBJECTIVE Meningioma consistency, firmness or softness as it relates to resectability, affects the difficulty of surgery and, to some degree, the extent of resection. Preoperative knowledge of tumor consistency would affect preoperative planning and instrumentation. Several methods of prediction have been proposed, but the majority lack objectivity and reproducibility or generalizability to other surgeons.

Prediction of Consistency of Pituitary Adenomas by Magnetic Resonance Imaging.

Objective Pituitary adenomas are typically soft. The prevalence of fibrous adenomas is ∼ 5 to 13%. Firm tumors are difficult to remove by curettage or suction.

Predicting Consistency of Meningioma by Magnetic Resonance Imaging.

Objective Meningioma consistency is important because it affects the difficulty of surgery. To predict preoperative consistency, several methods have been proposed; however, they lack objectivity and reproducibility. We propose a new method for prediction based on tumor to cerebellar peduncle T2-weighted imaging intensity (TCTI) ratios.

Large Vestibular Schwannomas Presenting during Pregnancy: Management Strategies.

Objective Large vestibular schwannomas rarely present in pregnant women. Diagnosis and management of these tumors during pregnancy present a therapeutic challenge. Methods A 20-year-old primigravida woman at 26 weeks' gestation was transferred to our facility with gait imbalance, left facial weakness, left ear hearing loss, and recent nausea and vomiting.

Predictors of outcome in civilians with gunshot wounds to the head upon presentation.

Object: Prediction of outcome from initial presentation after a gunshot wound to the head (GSWH) is essential to further clinical decision making. The authors' goals are to report the survival and functional outcomes of these patients, to identify prognostic factors, and to propose a scoring system that can predict their outcome.

Methods: The records of 199 patients admitted with a GSWH with dural penetration between 1990 and 2008 were retrospectively reviewed.

Fusiform dilatation of the cavernous carotid artery in acromegalic patients.

Background: Surgeons undertaking transsphenoidal surgery in patients with acromegaly confront multiple unique challenges secondary to the anatomic alterations caused by growth hormone-secreting tumors. The senior author has noted a fusiform dilatation of the cavernous carotid artery in many acromegalic patients. The authors aim to quantify this dilatation and correlate it with potential contributing factors.

Intraventricular brain abscess.

Unlike an intraventricular rupture of a brain abscess, a primary intraventricular abscess is rare. While the former usually presents with acute clinical deterioration and carries a high rate of mortality, the latter tends to present in a subacute fashion. In this paper, we present a 62-year-old female with an intraventricular brain abscess.

Surgical management of cranial base metastases.

Background: Cranial base metastases (CBM) are rare and have received limited attention in the medical literature. Questions remain regarding the role of surgery, if any, in the management of these tumors.

Objective: To report surgical outcomes in a consecutive series of patients with CBM and to better define the role of surgery in their management.

Management of skull base metastases.

Skull base metastases (SBM) are rare among all tumors affecting the base of the skull. Because of their rarity, they have received limited attention in the published medical literature. Several clinical syndromes associated with SBM have been described.

Traumatic intracranial and extracranial vascular injuries in children.

Trauma continues to be the leading cause of death in children older than 1 year of age. Although vascular injuries are uncommon, they contribute significantly to the mortality and morbidity related to traumatic injuries in the pediatric age group. In a recently reported large series of children, the head and neck location constituted 19.

Endovascular stenting of traumatic extracranial carotid artery dissections in the pediatric population: a case report.

Background: Traumatic extracranial carotid artery injuries are rare in children. Treatment options include surgery, anticoagulation therapy and endovascular treatment. There have been only limited reports in the literature documenting endovascular carotid stent placement in the pediatric population.