Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study.

Background: Meningitis and meningoencephalitis (MME) are potential medical emergencies. Mandatory reporting of all MME cases in the Israel Defense Force (IDF) allows accurate characterization of MME incidence and course. In the present study, we described the epidemiology of MME in soldiers.

Superficial Temporal Artery-Middle Cerebral Artery Microvascular Bypass: Its Role in Treatment of Patients with Moyamoya Disease, Cerebral Aneurysms, and Vascular Occlusive Disease.

Background: Superficial temporal artery-middle cerebral artery microvascular bypass (STA-MCA MVB) is an important strategy for the management of selected patients

Objectives: To present our 19-year experience with STA-MCA MVB

Methods: Data for consecutive patients who underwent STA-MCA MVB from 2000–2019 due to moyamoya/moyamoya-like disease, complex intracranial aneurysms, or intractable brain ischemia due to internal carotid artery or MCA occlusive disease with repeated ischemic events were retrospectively analyzed under a waiver of informed consent. Key surgical steps and the important role of neuroendovascular interventions are presented. Surgical results and late outcomes were analyzed

Results: The study included 32 patients (17 women [53%], 15 men [47%]), mean age 42.

Prevalence of polyps ≥6 mm on follow-up CT colonography in a cohort with no significant colon polyps at baseline.

Aim: Assess the prevalence of neoplasia ≥6 mm at repeat CT colonoscopy (CTC) in individuals with no significant lesions at baseline.

Methods: Individuals aged ≥18 years, with/without CRC risk factors, with no polyps ≥6 mm on baseline CTC (negative baseline) who underwent repeat CTC in a large HMO from 2001 to 2011 were retrospectively identified. Studies were reviewed by board-certified radiologists with experience interpreting CTC.

Ambulation and survival following surgery in elderly patients with metastatic epidural spinal cord compression.

Background And Context: Metastatic epidural spinal cord compression (MESCC) is a disabling consequence of disease progression. Surgery can restore or preserve physical function, improving access to treatments that increase duration of survival; however, advanced patient age may deter oncologists and surgeons from considering surgical management.

Purpose: Evaluate the duration of ambulation and survival in elderly patients following surgical decompression of MESCC.

Spinal epidural abscess with a rapid course in young healthy infantry recruits with multiple skin lacerations.

In recent years, there has been high prevalence of Staphylococcus aureus (S. aureus) infection among soldiers in the Israeli military, with devastating sequelae in several cases. Emergency department physicians have developed a high level of suspicion for spinal epidural abscess (SEA) in patients presenting known risk factors; however, SEA is a particularly elusive diagnosis in young healthy adults with no history of drug abuse.

Comparison of outcomes following complex posterior fossa surgery performed in the sitting versus lateral position.

The sitting position during surgery is thought to provide important advantages, yet it remains controversial. We compared surgical and neurological outcomes for patients operated on in the sitting versus lateral position. Technically difficult procedures performed from the years 2001-2008 for complex lesions in the posterior fossa (vestibular schwannomas, other cerebellopontine angle tumors, foramen magnum meningiomas, brainstem cavernomas, pineal region tumors) were included.

Spontaneous spinal epidural hematoma: the importance of preoperative neurological status and rapid intervention.

We describe the presentation, management, and outcome of spontaneous spinal epidural hematoma (SSEH) in two tertiary academic centers. We retrospectively reviewed clinical and imaging files in patients diagnosed with SSEH from 2002-2011. Neurologic status was assessed using the American Spinal Injury Association (ASIA) Impairment Scale (AIS).

Efficacy and safety of vertebral stenting for painful vertebral compression fractures in patients with metastatic disease.

Background And Purpose: Painful vertebral compression fractures in cancer patients reduce quality of life and may limit survival. We assessed pain relief, vertebral height restoration, and kyphosis correction following vertebral augmentation using a novel expandable titanium stent implant in cancer patients with painful vertebral compression fractures.

Materials And Methods: Patients >18 years of age with metastatic disease who presented symptomatic compression fractures of vertebral bodies T5-L5, with or without a history of osteoporosis, were included in the study.

Timing of stereotactic radiosurgery and surgery and wound healing in patients with spinal tumors: a systematic review and expert opinions.

Background And Purpose: Stereotactic radiosurgery (SRS) and surgery may be used in combination to manage cord compression due to spinal tumors. Procedure sequence and interval affect wound healing. We aimed to review the evidence on effects of timing and sequence of surgery and SRS on wound healing and bone fusion in patients with spine tumors.

Are they too old? Surgical treatment for metastatic epidural spinal cord compression in patients aged 65 years and older.

Objectives: We aimed to assess the efficacy of surgical decompression of metastatic epidural spinal cord compression (MESCC) in patients ≧65 years and review our multidisciplinary surgical decision-making process.

Methods: We identified all patients operated for MESCC from August 2008 to June 2012. Patients ≧65 years, with a single area of cord compression, back/radicular pain, neurological signs of cord compression, surgery within 48 hours after onset of MESCC-related paraplegia, and follow-up for ≧1 year or until death were included.

Cost-effectiveness of baseline low-dose computed tomography screening for lung cancer: the Israeli experience.

Objective: Reduced mortality with low-dose computed tomography (LDCT) lung cancer screening was demonstrated in a large randomized controlled study of high-risk individuals. Cost-effectiveness must be assessed before routine LDCT screening is considered. We aimed to evaluate the cost-effectiveness of LDCT lung cancer screening in Israel.

Parasellar meningiomas in pregnancy: surgical results and visual outcomes.

Background: Rapid visual deterioration may occur as the result of the quick growth of parasellar meningiomas in the high-hormone/increased fluid retention milieu of pregnancy; however, surgery before delivery entails increased maternal-fetal risk. We present our experience in the management of parasellar meningiomas that compress the optic apparatus during pregnancy, with a focus on decisions regarding the timing of surgery.

Methods: Serial visual examinations and other clinical data for 11 women presenting from 2002 to 2012 with visual deterioration during pregnancy or delivery as the result of parasellar meningiomas involving the optic apparatus were reviewed.

Superficial siderosis of the central nervous system due to chronic hemorrhage from a giant invasive prolactinoma.

Superficial siderosis of the central nervous system (CNS) is a rare disorder caused by deposition of hemosiderin in neuronal tissue in the subpial layer of the CNS due to slow subarachnoid or intraventricular hemorrhage. The most common neurologic manifestations include progressive gait ataxia, sensorineural hearing loss, and corticospinal tract signs. We present a case of superficial siderosis in a 43-year-old man who presented to the Emergency Department with sudden onset bilateral visual deterioration and a loss of consciousness.

Clinical relevance of negative initial angiogram in spontaneous subarachnoid hemorrhage.

Background: We aimed to compare the presentation, management, and clinical course in patients with perimesencephalic and nonperimesencephalic (aneurysmal) bleeding patterns on noncontrast CT, but negative initial 4-vessel digital subtraction angiography (DSA).

Methods: We retrospectively reviewed clinical and imaging data for 280 patients presenting with spontaneous SAH admitted between 2005 and 2011. We identified 56 patients (20%) with SAH diagnosed on high resolution head CT performed within 48 hours of admission, and negative initial DSA, and divided them into perimesencephalic and non-perimesencephalic groups based on hemorrhage patterns.

Blind spots at oncological CT: lessons learned from PET/CT.

Improved accuracy in oncological computed tomography (CT) could lead to a decrease in morbidity and improved survival for oncology patients. Visualization of metabolic activity using the glucose analogue [(18)F]fluorodeoxyglucose (FDG) in combination with the high anatomic resolution of CT in an integrated positron emission tomography (PET)/CT examination has the highest sensitivity and specificity for the detection of primary and metastatic lesions. However, PET/CT costs are high and patient access is limited; thus CT remains the primary imaging modality in oncology patients.

Vertebral augmentation in the treatment of vertebral compression fractures: review and new insights from recent studies.

Vertebral compression fractures (VCF) due to osteoporotic degeneration and metastatic disease represent an increasingly significant public health problem. Percutaneous vertebroplasty (VP) began as a simple, low-cost procedure that aimed to provide pain relief for patients with VCF. Balloon kyphoplasty (KP) was introduced later, and was presented not only as a "pain killer," but also as a deformity correction procedure.

Statement of Ethics in Neurosurgery of the World Federation of Neurosurgical Societies.

This Statement of Ethics in Neurosurgery was developed by the Committee for Ethics and Medico-Legal Affairs of the World Federation of Neurosurgical Societies to help neurosurgeons resolve problems in the treatment of individual patients and meet obligations to the larger society. This document is intended as a framework rather than a set of rules. It cannot cover every situation and should be used with flexibility.

State-of-the-art reperfusion strategies for acute ischemic stroke.

Timely recanalization of the occluded artery is the only effective treatment for acute ischemic stroke. Intravenous tissue plasminogen activator (i.v.

Healthy aging and preclinical dementia: the United States-Israel Longitudinal Database project.

This article proposes the establishment of a United States-Israel Longitudinal Database for Healthy Aging and Preclinical Dementia as a prototype model for the eventual creation of an international database. It is envisioned that such a comprehensive international database, as a shared research resource, will provide the foundation for a systems approach to solve the dual public health problems of: (1) Early detection of individuals at an elevated risk of developing Alzheimer's disease, and (2) Developing interventions to delay onset of, or prevent, chronic brain disorders later in life.

Dual-energy derived virtual nonenhanced computed tomography imaging: current status and applications.

Radiation exposure is a growing concern, and computed tomography is a main contributor to overall radiation dose in American patients. Dual-energy computed tomography, by allowing virtual nonenhanced (VNE) imaging, may obviate the need for image acquisition during a true nonenhanced phase when multiphase studies are needed, thereby reducing radiation exposure. Various groups have reported on the technical feasibility and clinical applicability of VNE imaging in the kidney, liver, lung, brain, and aorta.

Diagnosis and management of Rosai-Dorfman disease involving the central nervous system.

Introduction: Rosai-Dorfman disease is a benign non-neoplastic proliferative disorder of histiocytes originally described in the cervical lymph nodes. Extranodal sites were later recognized, and by 1990, they were shown to represent over 40% of cases; however, central nervous system involvement is still considered rare. We review the literature, which shows a steady increase in reports of Rosai-Dorfman disease involving the brain and/or spine.

CT colonography with decreased purgation: balancing preparation, performance, and patient acceptance.

Objective: Reduction or elimination of catharsis with fecal tagging enhances the tolerability of CT colonography (CTC) and may increase compliance with colorectal cancer (CRC) screening recommendations. We systematically reviewed studies that prospectively evaluated performance and patient satisfaction with decreased-purgation CTC and with optical colonoscopy.

Conclusion: The nine studies reviewed showed moderate-to-good performance for decreased-purgation CTC; however, data are limited, and study design and data presentation are inconsistent.

Results of endovascular treatment of traumatic intracranial aneurysms.

Objective: To present results of early angiographic diagnosis and endovascular treatment of traumatic intracranial aneurysms (TICA).

Methods: From June 2002 to December 2006, diagnostic angiography was performed on patients with moderate to severe traumatic brain injury that involved a cranial base fracture or a penetrating brain injury with a tract from the penetrating agent that entered at the pterional area, went through the middle cerebral artery candelabra, and crossed the midline. TICAs were treated by various endovascular techniques during the same angiographic procedure.

Radiation-induced meningioma.

The long-term or delayed side effects of irradiation on neural tissue are now known to include the induction of new central nervous system neoplasms. However, during the first half of the 20th century, human neural tissue was generally considered relatively resistant to the carcinogenic and other ill effects of ionizing radiation. As a result, exposure to relatively high doses of x-rays from diagnostic examinations and therapeutic treatment was common.

Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography.

Objective: The purpose of our study was to perform a meta-analysis comparing the performance of double-contrast barium enema (DCBE) with CT colonography (CTC) for the detection of colorectal polyps > or = 6 mm using endoscopy as the gold standard.

Materials And Methods: Prospective DCBE and CTC studies were identified. Percentages of polyps and of patients with polyps > or = 10 mm and 6-9 mm were abstracted.