Development and Internal Validation of the ARISE Prediction Models for Rebleeding After Aneurysmal Subarachnoid Hemorrhage.

Background: Aneurysmal rerupture is one of the most important determents for outcome after aneurysmal subarachnoid hemorrhage and still occurs frequently because individual risk assessment is challenging given the heterogeneity in patient characteristics and aneurysm morphology.

Objective: To develop and internally validate a practical prediction model to estimate the risk of aneurysmal rerupture before aneurysm closure.

Methods: We designed a multinational cohort study of 2 prospective hospital registries and 3 retrospective observational studies to predict the risk of computed tomography confirmed rebleeding within 24 and 72 hours after ictus.

From decompressive craniectomy to cranioplasty and beyond-a pediatric neurosurgery perspective.

Purpose: Decompressive craniectomy (DC) is an established neurosurgical emergency technique. Patient selection, optimal timing, and technical aspects related to DC and subsequent cranioplasty remain subjects of debate. For children, the overall degree of evidence is low, compared with randomized controlled trials (RCTs) in adults.

Malpractice claims in spine surgery in Germany: a 5-year analysis.

Study Design: Retrospective analysis of anonymized malpractice claims.

Summary Of Background Data: Spine surgery is considered a high-risk specialty with regards to malpractice claims. However, limited data is available for Germany.

Conservative and operative management of iatrogenic craniocerebral disproportion-a case-based review.

Introduction: Craniocerebral disproportion (CCD) can occur as a sequela after shunting in early infancy. It can be understood as a disorder closely related to slit ventricle syndrome and chronic overdrainage syndrome. Here, we present two exemplary cases and summarize the pathophysiological, diagnostic, and therapeutic approaches to CCD.

Pediatric neurosurgery malpractice claims in Germany.

Purpose: There is limited data regarding malpractice claims in pediatric neurosurgery. Aim of this study was to analyze the rate, subject, and outcome of malpractice claims faced by pediatric neurosurgeons.

Methods: We analyzed malpractice claims in pediatric neurosurgical patients assigned to the review board of North Rhine Medical Council from 2012 to 2016.

Mini Screws for Improving Accuracy in Navigation-assisted Spine Surgery.

Study Design: Presentation of a surgical technique with accompanying video (Supplemental Digital Content 1, http://links.lww.com/CLINSPINE/A67) of an illustrative case.

Is it all a matter of size? Impact of maximization of surgical resection in cerebral tumors.

The oncological impact of cytoreductive surgery for malignant glioma has been analyzed in a few prospective, randomized studies; however, the impact of different cytoreductive surgical techniques of cerebral tumors remains controversial. Despite retrospective analyses revealing an oncological impact of complete surgical resection in cerebral metastases and low-grade glioma, the oncological impact of further extension of resection to a supramarginal resection remains disputable lacking high-grade evidence: supramarginal resections have yet to be analyzed in malignant glioma. Although extension of resection towards a supramarginal resection was thought to improve outcome and prevent malignant transformation in low-grade glioma, the rate of (temporary) deficits was higher than 50% in recent retrospective studies, and the oncological impact and long-term results have to be analyzed in further (prospective and controlled) studies.

Multidimensional long-term outcome analysis after single-level lumbar microdiscectomy: a retrospective single-centre study.

Objective: To present multidimensional long-term results after mono-segmental microdiscectomy for lumbar disc herniation (LDH) in a large adult cohort treated at a tertiary care centre.

Methods: Retrospective study design with Oswestry Disability Index (ODI) questionnaire employed at follow-up. All patients undergoing surgical treatment for single-level LDH between 2003 and 2009 were identified.

High-Frequency Spinal Cord Stimulation in Surgery-Naïve Patients-A Prospective Single-Center Study.

Introduction: A multitude of evidence supporting the beneficial effects of spinal cord stimulation (SCS) in patients suffering from chronic pain syndromes following spinal surgery has been published in the last decade. Evidence is scarce, however, for the use of high frequency SCS (HF-SCS) in the treatment of surgery naïve patients suffering from lower back pain (LBP).

Methods: From June 2014 to April 2015, we prospectively enrolled patients suffering from LBP alone or in conjunction with leg pain in a trial of HF-SCS.

Early surgical occipitocervical stabilization for plasma cell neoplasms at the craniocervical junction: systematic review and proposal of a treatment algorithm.

Background Context: Plasma cell neoplasms (PCNs) of the craniocervical junction (CCJ) are rare. Because of their destructive growth, PCNs may induce spinal instability and harbor the risk of sudden death. Therefore, PCNs at the CCJ require special consideration.

Primary bone tumors of the spine revisited: A 10-year single-center experience of the management and outcome in a neurosurgical department.

Objective: To report a large clinical series of primary bone tumors of the spine (PBTS) and review the current concepts of management.

Materials And Methods: We retrospectively analyzed a clinical series of PBTS treated over the last decade (2004-2014) in the spine unit of a large European tertiary care center. Every PBTS was identified from an electronic medical-record system.

Attenuation of vesicular stomatitis virus infection of brain using antiviral drugs and an adeno-associated virus-interferon vector.

Vesicular stomatitis virus (VSV) shows promise as a vaccine-vector and oncolytic virus. However, reports of neurotoxicity of VSV remain a concern. We compared 12 antiviral compounds to control infection of VSV-CT9-M51 and VSV-rp30 using murine and human brain cultures, and in vivo mouse models.

Marking wire placement for improved accuracy in thoracic spinal surgery.

Objective: To present an innovative approach that does not rely on intraoperative X-ray imaging for identifying thoracic target levels and critically appraise its value in reducing the risk of wrong-level surgery and radiation exposure.

Methods: 96 patients admitted for surgery of the thoracic spine were prospectively enrolled, undergoing a total of 99 marking wire placements. Preoperatively a flexible marking wire derived from breast cancer surgery was inserted with computed tomography (CT) guidance at the site of interest--the wire was then used as an intraoperative guidance tool.

Scanning electron microscopic surface analysis of cryoconserved skull bone after decompressive craniectomy.

Bone flaps removed during decompressive craniectomy are commonly frozen at -80 °C and stored until cranioplasty. Histological integrity and regenerative capacity have been shown for cryoconserved bone. The effects of cryoconservation on the surface structure are unknown, although these might cause mechanical instability or facilitate bacterial adhesion.

Primary spinal marginal zone lymphoma: case report and review of the literature.

Background And Importance: Marginal zone lymphoma (MZL) describes a heterogeneous group of indolent B-cell lymphomas. The World Health Organization recognizes 3 types of MZLs: splenic MZL, nodal MZL, and extranodal MZL of mucosa-associated lymphoid tissue. There is no consensus on the optimal adjuvant treatment modalities for intracranial primary MZLs.

Spinal cord tethering following myelomeningocele repair.

Object: Symptom response to spinal cord untethering, and the impact of duraplasty and scoliosis on retethering, are poorly understood in tethering after myelomeningocele (MMC) repair. In this retrospective study, the authors examined the outcomes of children who developed first-time spinal cord tethering following MMC repair. The response of symptoms to untethering and the role of duraplasty and scoliosis in retethering are explored.

Detailed long-term outcome analysis after decompressive craniectomy for severe traumatic brain injury.

Objective: To assess detailed long-term clinical outcome at least 1 year after decompressive craniectomy (DC) in patients with severe traumatic brain injury (TBI).

Methods: One hundred and thirty-one patients with severe TBI underwent DC between September 1997 and September 2005. Outcome was measured using the Glasgow Outcome Scale (GOS).

Peripheral immunization blocks lethal actions of vesicular stomatitis virus within the brain.

Vesicular stomatitis virus (VSV) is the prototype virus for 75 or more negative-strand RNA viruses in the rhabdovirus family. Some of these viruses, including VSV, can cause neurological impairment or death upon brain infection. VSV has shown promise in the prevention and treatment of disease as a vaccine vector and an oncolytic virus, but infection of the brain remains a concern.

Intratentorial osteochondrolipoma in a 9-year-old boy.

Intracranial osteolipomas and chondromas are rare benign tumors. Forty-five chondromas, mostly supratentorial, have been reported in the literature since 1981, with origins most commonly in the sellar regions. Twenty-one osteolipomas have been described to date, usually located near the tuber cinereum or the corpus callosum.