Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning.

Individuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms.

Theory and evidence-base for a digital platform for the delivery of language tests during awake craniotomy and collaborative brain mapping.

Objectives: Build the theoretical and evidence-base for a digital platform (map-OR) which delivers intraoperative language tests during awake craniotomy and facilitates collaborative sharing of brain mapping data.

Design: Mixed methodology study including two scoping reviews, international survey, synthesis of development guiding principles and a risk assessment using failure modes and effects analysis.

Setting: The two scoping reviews examined the literature published in the English language.

Impact of remoteness and rurality on the treatment and survival of patients with glioblastoma in the north of Scotland.

Background: The geographical catchment area served by the Neurosurgical Unit in Aberdeen, Scotland is the largest in the United Kingdom. We examined whether a distance-decay effect on survival exists for patients diagnosed with glioblastoma, who have to travel substantial distances for neurosurgical and oncological treatment in the north of Scotland.

Methods: Electronic medical records of adult patients with glioblastoma, referred for treatment between 2007 and 2018, who underwent surgical resection were reviewed.

Theory-based implementation of an enhanced recovery protocol for cranial surgery.

Objective: There is growing evidence for the use of enhanced recovery protocols (ERPs) in cranial surgery. As they become widespread, successful implementation of these complex interventions will become a challenge for neurosurgical teams owing to the need for multidisciplinary engagement. Here, the authors describe the novel use of an implementation framework (normalization process theory [NPT]) to promote the incorporation of a cranial surgery ERP into routine neuro-oncology practice.

Cauda equina syndrome.

Aims: Patients with cauda equina syndrome (CES) require emergency imaging and surgical decompression. The severity and type of symptoms may influence the timing of imaging and surgery, and help predict the patient's prognosis. Categories of CES attempt to group patients for management and prognostication purposes.

Comparison of External Ventricular Drains with Ventricular Access Devices for the Emergency Management of Adult Hydrocephalus.

Objective: We compared external ventricular drains (EVDs) with percutaneous continuous cerebrospinal fluid (CSF) drainage via ventricular access devices (VADs) for the acute management of hydrocephalus in adults.

Methods: This was a retrospective review of all ventricular drains inserted for a new diagnosis of hydrocephalus into noninfected CSF over four years. We compared infection rates, return to theatre, and patient outcome between EVDs and VADs.

A Digital Health Intervention for Concussion: Development and Clinical Feasibility Study.

Background: Concussion is a common condition that can lead to a constellation of symptoms that affect quality of life, social integration, and return to work. There are several evidence-based behavioral and psychological interventions that have been found to improve postconcussion symptom burden. However, these are not routinely delivered, and individuals receive limited support during their concussion recovery.

Presentation, management, and outcomes of cauda equina syndrome up to one year after surgery, using clinician and participant reporting: A multi-centre prospective cohort study.

Background: Cauda equina syndrome (CES) results from nerve root compression in the lumbosacral spine, usually due to a prolapsed intervertebral disc. Evidence for management of CES is limited by its infrequent occurrence and lack of standardised clinical definitions and outcome measures.

Methods: This is a prospective multi-centre observational cohort study of adults with CES in the UK.

Demographics of Cauda Equina Syndrome: A Population-Based Incidence Study.

Introduction: Cauda equina syndrome (CES) has significant medical, social, and legal consequences. Understanding the number of people presenting with CES and their demographic features is essential for planning healthcare services to ensure timely and appropriate management. We aimed to establish the incidence of CES in a single country and stratify incidence by age, gender, and socioeconomic status.

Autonomous surgical robotic systems and the liability dilemma.

Background: Advances in machine learning and robotics have allowed the development of increasingly autonomous robotic systems which are able to make decisions and learn from experience. This distribution of decision-making away from human supervision poses a legal challenge for determining liability.

Methods: The iRobotSurgeon survey aimed to explore public opinion towards the issue of liability with robotic surgical systems.

Impact of country self citation on the ranking of the top 50 countries in clinical neurology.

Objectives: To examine the factors that influence country self-citation rate (SCR) in clinical neurology and to assess the impact of self-citation on the ranking of the top 50 countries.

Methods: SCImago Journal & Country Rank was used to collect data for the 50 most cited countries in clinical neurology during 1996-2019. Country SCR was correlated with several productivity parameters and examined statistically.

Utility of image-guided external ventriculostomy: analysis of contemporary practice in the United Kingdom and Ireland.

Objective: Freehand external ventricular drain (EVD) insertion is associated with a high rate of catheter misplacement. Image-guided EVD placement with neuronavigation or ultrasound has been proposed as a safer, more accurate alternative with potential to facilitate proper placement and reduce catheter malfunction risk. This study aimed to determine the impact of image-guided EVD placement on catheter tip position and drain functionality.

The synapse in traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide and is a risk factor for dementia later in life. Research into the pathophysiology of TBI has focused on the impact of injury on the neuron. However, recent advances have shown that TBI has a major impact on synapse structure and function through a combination of the immediate mechanical insult and the ensuing secondary injury processes, leading to synapse loss.

Attitudes of Patients and Their Relatives Toward Artificial Intelligence in Neurosurgery.

Background: Artificial intelligence (AI) may favorably support surgeons but can result in concern among patients and their relatives. The aim of this study was to evaluate attitudes of patients and their relatives regarding use of AI in neurosurgery.

Methods: In a 2-stage cross-sectional survey, a qualitative survey was administered to a focus group of former patients to investigate their perception of AI and its role in neurosurgery.

Subarachnoid haemorrhage with negative initial neurovascular imaging: a systematic review and meta-analysis.

Background: In patients with spontaneous subarachnoid haemorrhage (SAH), a vascular cause for the bleed is not always found on initial investigations. This study aimed to systematically evaluate the delayed investigation strategies and clinical outcomes in these cases, often described as "non-aneurysmal" SAH (naSAH).

Methods: A systematic review was performed in concordance with the PRISMA checklist.

Evaluation of nationwide referral pathways, investigation and treatment of suspected cauda equina syndrome in the United Kingdom.

Purpose: Cauda equina syndrome (CES) is a spinal emergency with clinical symptoms and signs that have low diagnostic accuracy. National guidelines in the United Kingdom (UK) state that all patients should undergo an MRI prior to referral to specialist spinal units and surgery should be performed at the earliest opportunity. We aimed to evaluate the current practice of investigating and treating suspected CES in the UK.

Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study.

Introduction: Cauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences.

Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland.

Objectives: External ventricular drain (EVD) insertion is a common neurosurgical procedure. EVD-related infection (ERI) is a major complication that can lead to morbidity and mortality. In this study, we aimed to establish a national ERI rate in the UK and Ireland and determine key factors influencing the infection risk.

Randomized controlled trials in neurosurgery: an observational analysis of trial discontinuation and publication outcome.

OBJECTIVE This study aimed to determine the trial discontinuation and publication rate of randomized controlled trials (RCTs) in neurosurgery. METHODS Trials registered from 2000 to 2012 were identified on the website clinicaltrials.gov using a range of key words related to neurosurgery.

A national survey of thromboprophylaxis in traumatic brain injury in the United Kingdom.

Introduction: Patients with traumatic brain injury (TBI) are at increased risk of venous thromboembolic events (VTE). In this survey, we aimed to assess current practice in the United Kingdom and identify areas of variation for further investigation.

Methods: We distributed a case-based survey to neurosurgical consultants and trainees via e-mail.

Surgical trainee research collaboratives in the UK: an observational study of research activity and publication productivity.

Objectives: To analyse the research activity and publication output of surgical trainee research collaboratives in the UK.

Setting: Surgical trainee research collaboratives in the UK.

Participants: A total of 24 collaboratives were included in this study from 33 identified organisations.

Academic Productivity of Neurosurgeons Working in the United Kingdom: Insights from the H-Index and Its Variants.

Objectives: Academic metrics can be used to compare the productivity of researchers. We aimed to use a variety of bibliometric parameters to assess the productivity of neurosurgeons working in the United Kingdom.

Methods: Neurosurgical consultants working in the United Kingdom were identified using the Society of British Neurosurgeons' Audit Programme website.