Prognostic significance of age within the adolescent and young adult acute ischemic stroke population after mechanical thrombectomy: insights from STAR.

Objective: Although younger adults have been shown to have better functional outcomes after mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the significance of this relationship in the adolescent and young adult (AYA) population is not well defined given its undefined rarity. Correspondingly, the goal of this study was to determine the prognostic significance of age in this specific demographic following MT for large-vessel occlusions.

Methods: A prospectively maintained international multi-institutional database, STAR (Stroke Thrombectomy and Aneurysm Registry), was reviewed for all patients aged 12-18 (adolescent) and 19-25 (young adult) years.

Multicenter investigation of technical and clinical outcomes after thrombectomy for distal vessel occlusion by frontline technique.

Background: Endovascular thrombectomy (EVT) is the standard-of-care for proximal large vessel occlusion (LVO) stroke. Data on technical and clinical outcomes in distal vessel occlusions (DVOs) remain limited.

Methods: This was a retrospective study of patients undergoing EVT for stroke at 32 international centers.

Equity in neurosurgery: a worldwide survey of women neurosurgeons.

Objective: The global neurosurgery workforce does not have a defined stance on gender equity. The authors sought to study and characterize the demographic features of the international women neurosurgery community and to better understand the perceptions and reflections of their neurosurgical careers. The objective was to define and characterize the workplace inequities faced by the global women neurosurgeon community.

Carole A. Miller, MD: Matriarch of the Ohio State University's Department of Neurosurgery.

Carole A. Miller, M.D.

Bibliometric Analysis of Major Neurosurgical Publications 2011-2020, Part 2: Journal, Author, Yearly Publication Trends, and Citation Related Metrics.

Background: Scientometrics, a subfield of bibliometrics, examines scientific publications by using bibliometric methods. The aim of a scientometric study is to study the various citation-based metrics of scientific articles, such as parameters pertaining to authors (including institutions and country of origin), articles, journals, and other citation related metrics.

Objective: In this second part of our scientometric analysis of the 6 major neurosurgical journals from 2011-2020, we study journal and author trends, yearly publication trends, and citation related metrics in , , , , , and

Methods: We analyzed parameters, including article and journal metrics (total articles published per journal per year, breakdown of the Bradford's law distribution of journals, and Lotka's law, journal impact factors), author metrics (country of origin, collaborations), citation totals, and keyword counts.

Inferior Clinical Outcomes for Patients with Medicaid Insurance After Surgery for Degenerative Lumbar Spondylolisthesis: A Prospective Registry Analysis of 608 Patients.

Background: It remains unclear how type of insurance coverage affects long-term, spine-specific patient-reported outcomes (PROs). This study sought to elucidate the impact of insurance on clinical outcomes after lumbar spondylolisthesis surgery.

Methods: The prospective Quality Outcomes Database registry was queried for patients with grade 1 degenerative lumbar spondylolisthesis who underwent single-segment surgery.

Predictors of early neurologic deterioration (END) following stroke thrombectomy.

Background: Early neurologic deterioration (END) following ischemic stroke is a serious event and is associated with poor outcomes. However, the incidence and predictors of END after stroke thrombectomy for emergent large vessel occlusion are largely unknown.

Methods: The baseline characteristics of patients enrolled in the COMPASS trial (NCT02466893) were analyzed.

Comparison of transarterial n-BCA and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis.

Objective: Brain arteriovenous malformations (AVM) are commonly treated with endovascular embolization. Due to the rapid evolution of endovascular technology and lack of consistent practice guidelines regarding AVM embolization, further study of AVM embolization outcomes is warranted.

Methods: We conducted a retrospective review of AVMs embolized at a single center from 2002-2019.

Lessons learned during COVID-19 pandemic, a worldwide survey: evolution of global neurosurgical practice.

Background: During the COVID-19 pandemic, a multitude of surveys have analyzed the impact virus spreading on the everyday medical practice, including neurosurgery. However, none have examined the perceptions of neurosurgeons towards the pandemic, their life changes, and the strategies they implemented to be able to deal with their patients in such a difficult time.

Methods: From April 2021 to May 2021 a modified Delphi method was used to construct, pilot, and refine the questionnaire focused on the evolution of global neurosurgical practice during the pandemic.

Microsurgical Clip Ligation of Ruptured, Previously Coiled A2-A3 Aneurysm Through Interhemispheric Approach in a Pediatric Patient.

Previously ruptured aneurysms treated with coil occlusion are at risk of recurrence and require thoughtful strategic planning for adequate aneurysm occlusion. Alternative strategies, such as coil extraction or trapping and bypass, are options when simple clipping is not feasible. A 15-year-old boy presented with a Hunt and Hess grade 4, Fisher grade 4 subarachnoid hemorrhage from a ruptured distal anterior cerebral artery aneurysm.

Aristotle 24 microwire early experience.

Larger microcatheters are being used with increasing frequency in routine neurovascular procedures. Navigating catheters safely and effectively to the target intracranial vessels can be a challenge when using conventional 0.014″ microwires.

Common data elements reported on middle meningeal artery embolization in chronic subdural hematoma: an interactive systematic review of recent trials.

Cross study heterogeneity has limited the evidence based evaluation of middle meningeal artery embolization (MMAE) as a treatment for chronic subdural hematoma (CSDH). Ongoing trials and prospective studies suggest that heterogeneity in upcoming publications may detract from subsequent meta-analyses and systemic reviews. This study aims to describe this data heterogeneity to promote harmonization with common data elements (CDEs) in publications.

Social risk factors predicting outcomes of cervical myelopathy surgery.

Objective: Combinations of certain social risk factors of race, sex, education, socioeconomic status (SES), insurance, education, employment, and one's housing situation have been associated with poorer pain and disability outcomes after lumbar spine surgery. To date, an exploration of such factors in patients with cervical spine surgery has not been conducted. The objective of the current work was to 1) define the social risk phenotypes of individuals who have undergone cervical spine surgery for myelopathy and 2) analyze their predictive capacity toward disability, pain, quality of life, and patient satisfaction-based outcomes.

Pre- and Posttherapy Risk Factors for Vasculopathy in Pediatric Patients With Craniopharyngioma Treated With Surgery and Proton Radiation Therapy.

Purpose: Vasculopathy (VAS) is a significant complication associated with radiation therapy in patients treated for brain tumors. We studied the type, location, severity, timing, and resolution of VAS in children with craniopharyngioma treated with proton radiation therapy (PRT) and evaluated predictors of stenosis (STN) using a novel patient and imaging-based modeling approach.

Methods And Materials: Children with craniopharyngioma (n = 94) were treated with 54 Gy relative biological effectiveness PRT in a clinical trial, NCT01419067.

Simplifying the Surgical Classification and Approach to the Posterolateral Skull Base and Jugular Foramen Using Anatomical Triangles.

Introduction Lesions of the jugular foramen (JF) and postero-lateral skull base are difficult to expose and exhibit complex neurovascular relationships. Given their rarity and the increasing use of radiosurgery, neurosurgeons are becoming less experienced with their surgical management. Anatomical factors are crucial in designing the approach to achieve a maximal safe resection.

Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in the Early and Extended Window.

Importance: Limited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting with a large core infarct.

Objective: To investigate the safety and effectiveness of MT for patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 2 to 5.

Design, Setting, And Participants: This retrospective cohort study used data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which combines the prospectively maintained databases of 28 thrombectomy-capable stroke centers in the US, Europe, and Asia.

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Treatment of Pediatric Hydrocephalus: Update of the 2014 Guidelines.

Background: The Congress of Neurological Surgeons reviews its guidelines according to the Institute of Medicine's recommended best practice of reviewing guidelines every 5 yrs. The authors performed a planned 5-yr review of the medical literature used to develop the "Pediatric hydrocephalus: systematic literature review and evidence-based guidelines" and determined the need for an update to the original guideline based on new available evidence.

Objective: To perform an update to include the current medical literature for the "Pediatric hydrocephalus: systematic literature review and evidence-based guidelines", originally published in 2014.

Complications of Mechanical Thrombectomy in Acute Ischemic Stroke.

Multiple randomized clinical trials have supported the use of mechanical thrombectomy (MT) as standard of care in the treatment of large vessel occlusion acute ischemic stroke. Optimal outcomes depend not only on early reperfusion therapy but also on post thrombectomy care. Early recognition of post MT complications including reperfusion hemorrhage, cerebral edema and large space occupying infarcts, and access site complications can guide early initiation of lifesaving therapies that can improve neurologic outcomes.

Bibliometric Analysis of Publications From 2011-2020 in 6 Major Neurosurgical Journals (Part 1): Geographic, Demographic, and Article Type Trends.

Introduction: Scientometrics is a subfield of bibliometrics that statistically analyzes publications trends. The aim of this initial study was to investigate trends in the 6 major neurosurgical journals from the last 10 years.

Methods: We searched Web of Science and Scopus for articles published in Neurosurgery, Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, Operative Neurosurgery, and World Neurosurgery from January 1, 2011, to December 31, 2020.

Novel Clinical Insights into Spinal Hemangioblastoma in Adults: A Systematic Review.

Background: Hemangioblastomas (HBs) are well-vascularized, benign central nervous system tumors and the third most common primary spinal cord tumor after astrocytoma/ependymoma, occurring sporadically or as a part of autosomal dominant von Hippel-Lindau disease, in which tumors are often multiple and prone to relapse. Spinal HBs are commonly located in the cervical cord and associated with a syrinx formation. Owing to location and growth trends, they may cause significant neurological deficit, impairing quality of life.

Intravenous alteplase has different effects on the efficacy of aspiration and stent retriever thrombectomy: analysis of the COMPASS trial.

Background: There is conflicting evidence on the utility of intravenous (IV) alteplase in patients with emergent large vessel occlusion (ELVO) treated with mechanical thrombectomy (MT).

Methods: This was a post hoc analysis of the COMPASS: a trial of aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion. We compared clinical, procedural and angiographic outcomes of patients with and without prior IV alteplase administration.