Diffuse large B-cell lymphoma in the C8 root mimicking a schwannoma: illustrative case.

Background: Primary lymphomas arising in peripheral nerves are extremely rare, with just a few case reports documented in the literature.

Observations: The authors present the case of a 62-year-old female with C8 radiculopathy, initially suspected to have a schwannoma based on imaging but later diagnosed with primary C8 nerve root B-cell lymphoma. Following histopathological confirmation, the patient underwent 5 courses of chemotherapy, resulting in a decrease in the size of her lesion on magnetic resonance imaging.

Educational Limitations of ChatGPT in Neurosurgery Board Preparation.

Objective This study evaluated the potential of Chat Generative Pre-trained Transformer (ChatGPT) as an educational tool for neurosurgery residents preparing for the American Board of Neurological Surgery (ABNS) primary examination. Methods Non-imaging questions from the Congress of Neurological Surgeons (CNS) Self-Assessment in Neurological Surgery (SANS) online question bank were input into ChatGPT. Accuracy was evaluated and compared to human performance across subcategories.

Left-Handed Palming of the Needle Driver: A Technical Report for Surgical Trainees.

Left-handed surgical trainees are uniquely challenged when learning how to suture using standard needle drivers designed for right-handed individuals and often feel disadvantaged in comparison to their right-handed peers. "Palming," a suturing technique that improves suturing mechanics and efficiency, cannot be achieved in the standard manner using the left hand. This paper proposes a previously undescribed technique for palming using the left hand that provides many of the same benefits as standard palming methods using the right hand, potentially reducing a common source of inequity in surgical training.

Public health insurance, frailty, and lack of home support predict rehab discharge following elective anterior cervical discectomy and fusion.

Background Context: Anterior cervical discectomy and fusion (ACDF) is a commonly-performed and generally well-tolerated procedure used to treat cervical disc herniation. Rarely, patients require discharge to inpatient rehab, leading to inconvenience for the patient and increased healthcare expenditure for the medical system.

Purpose: The objective of this study was to create an accurate and practical predictive model for, as well as delineate associated factors with, rehab discharge following elective ACDF.

Spontaneous abscess with intraventricular rupture in an immunocompetent adult without prior neurosurgical intervention.

Previously viewed as a culture contaminant, can cause infection following neurosurgical intervention. Its role in brain abscess in the immunocompetent, surgically naïve population has been infrequently reported. Herein, we describe an immunocompetent 55-year-old man with no risk factors found to have a thalamic abscess with intraventricular rupture.

A retrospective comparison of radiographic and clinical outcomes in single-level degenerative lumbar disease undergoing anterior versus transforaminal lumbar interbody fusion.

Background: Single-level lumbar degenerative disc disease (DDD) remains a significant cause of morbidity in adulthood. Anterior lumbar interbody fusion (ALIF) and Transforaminal lumbar interbody fusion (TLIF) are surgical techniques developed to treat this condition. With limited studies on intermediate term outcomes in a single cohort, we compare radiographic and clinical outcomes in patients undergoing ALIF and TLIF.

The modified frailty index and patient outcomes following transforaminal lumbar interbody fusion surgery for single-level degenerative spine disease.

Objective: The modified frailty index (mFI) is a simple tool that measures physiological reserve based on a thorough history and physical examination. Its use has been validated in several surgical specialties, including spinal deformity surgery. Prior research has suggested no significant differences in clinical outcomes between elderly and nonelderly patients undergoing posterior lumbar interbody fusion.

MRI and CT Guided Cryoablation for Intracranial Extension of Malignancies along the Trigeminal Nerve.

 To describe the technical aspects and early clinical outcomes of patients undergoing percutaneous magnetic resonance imaging (MRI)-guided tumor cryoablation along the intracranial trigeminal nerve.  This study is a retrospective case review.  Large academic tertiary care hospital.

Benign Intradural and Paraspinal Nerve Sheath Tumors: Advanced Surgical Techniques.

Traditional surgical techniques for benign intradural and paraspinal nerve sheath tumors often consisted of open posterior approaches. However, these were limited by the morbidity of open surgery. In addition, iatrogenic instability is often required for total resection of larger or laterally located tumors, thus necessitating the use of additional hardware for spinal fusion.

MRI-guided cryoablation for metastatic spine disease: intermediate-term clinical outcomes in 14 consecutive patients.

Objective: Minimal access ablative techniques have emerged as a less invasive option for spinal metastatic disease reduction and separation from neural tissue. Compared with heat-based ablation modalities, percutaneous image-guided cryoablation allows for more distinct visualization of treatment margins. The authors report on a series of patients undergoing MRI-guided cryoablation as a feasible method for treating spinal metastatic disease.

Dorsolateral prefrontal neurons mediate subjective decisions and their variation in humans.

Subjective decisions play a vital role in human behavior because, while often grounded in fact, they are inherently based on personal beliefs that can vary broadly within and between individuals. While these properties set subjective decisions apart from many other sensorimotor processes and are of wide sociological impact, their single-neuronal basis in humans is unknown. Here we find cells in the dorsolateral prefrontal cortex (dlPFC) that reflect variations in the subjective decisions of humans when performing opinion-based tasks.

MRI-Guided Cryoablation of Epidural Malignancies in the Spinal Canal Resulting in Neural Decompression and Regrowth of Bone.

Objective: The purpose of this article is to describe the use of MRI to safely monitor cryoablation for the treatment of spinal epidural malignancies.

Conclusion: Use of MRI guidance to monitor percutaneous cryoablation allows ablation margins more distinct than those allowed by heat-based ablation modalities. MRI-guided cryoablation is a feasible option for treating epidural tumors involving the spinal canal, resulting in successful decompression of the tumor away from the spinal cord with regrowth of previously eroded bone around the spinal canal.

Direct puncture for diagnosis of intradural spinal arachnoid cyst and fenestration using 3D rotational fluoroscopy: technical note and the "jellyfish sign".

The authors report on a 47-year-old woman with a symptomatic thoracic spinal arachnoid cyst (SAC) who underwent a novel procedure that involves direct puncture of the SAC to visualize, diagnose, and potentially treat these rare spinal lesions. The method described utilizes 3D fluoroscopy to gain access to the SAC, followed by injection of myelographic contrast into the cyst. A characteristic "jellyfish sign" was observed that represents the containment of the contrast within the superior aspect of the cyst and a clear block of cranial flow of contrast, resulting in an undulating pattern of movement of contrast within the cyst.

Decoding unconstrained arm movements in primates using high-density electrocorticography signals for brain-machine interface use.

Motor deficit is among the most debilitating aspects of injury to the central nervous system. Despite ongoing progress in brain-machine interface (BMI) development and in the functional electrical stimulation of muscles and nerves, little is understood about how neural signals in the brain may be used to potentially control movement in one's own unconstrained paralyzed limb. We recorded from high-density electrocorticography (ECoG) electrode arrays in the ventral premotor cortex (PMv) of a rhesus macaque and used real-time motion tracking techniques to correlate spatial-temporal changes in neural activity with arm movements made towards objects in three-dimensional space at millisecond precision.

Intradural spinal arachnoid cyst resection: implications of duraplasty in a large case series.

OBJECTIVE Optimal diagnosis and management strategies for intradural spinal arachnoid cysts (SACs) are still unresolved given the rare nature of this entity, with few large case series and virtually no statistical analyses of patient characteristics in the literature. Here, the authors studied a large patient cohort with these lesions to determine whether pre- or postoperative attributes could be used to aid in either diagnosis or prognosis. METHODS A chart review was completed at a single institution for the period from 2002 to 2016 to determine the preoperative characteristics and postoperative outcomes of 21 patients with exclusively intradural SACs.

Recent advances in intradural spinal tumors.

Intradural spinal tumors are rare tumors of the central nervous system. Due to the eloquence of the spinal cord and its tracts, the compact architecture of the cord and nerves, and the infiltrative nature of some of these tumors, surgical resection is difficult to achieve without causing neurological deficits. Likewise, chemotherapy and radiotherapy are utilized more cautiously in the treatment of intradural spinal tumors than their cranial counterparts.

Bibliometric profile of deep brain stimulation.

Objective: We aimed to identify and analyze the characteristics of the 100 most highly-cited papers in the research field of deep brain stimulation (DBS).

Methods: The Web of Science was searched for highly-cited papers related to DBS research. The number of citations, countries, institutions of origin, year of publication, and research area were noted and analyzed.

Short-Term Adverse Outcomes After Deep Brain Stimulation Treatment in Patients with Parkinson Disease.

Background: Despite ongoing progress in our understanding of long-term outcomes after neuromodulation procedures, acute adverse outcomes shortly after deep brain stimulation (DBS) treatment have remained remarkably limited.

Objective: To identify risk factors associated with acute 30-day outcomes after DBS treatment in patients with Parkinson disease (PD).

Methods: We evaluated patients who underwent DBS treatment for PD from 2005 to 2014 through the American College of Surgeons National Surgical Quality Improvement Program database.

Direct heart shunt placement for CSF diversion: technical note.

The authors report a complex case of an 18-year-old male with a history of hydrocephalus secondary to intraventricular hemorrhage of prematurity, with more than 30 previous shunt revisions, who presented to the authors' institution with shunt malfunction. After exhausting his peritoneal cavity and pleural space as possible distal sites of shunt placement, he underwent a direct heart shunt placement when it was discovered he had thrombosis of his subclavian vein precluding a standard wire-guided atrial cannulation. His course was complicated by postoperative distal catheter migration and repeat surgery for reimplantation of the shunt directly into the atrium.