Early exposure to neurosurgery: promoting early specialty interest through a single-day resident-driven neurosurgical course for preclinical students.

Background And Objectives: Minimal exposure to neurosurgery in standard medical school curricula alongside a growing need for neurosurgical care necessitate early exposure programs that promote medical student retention in neurosurgery. Here, we evaluate preclinical students' perceptions on a one-day, resident-designed introductory neurosurgical course.

Methods: Course curriculum involved hands-on and discussion-based elements split into three stations: (1) suturing/general information; (2) introduction to drilling/LPs/EVDs; and (3) case/clinical skills review.

Intracranial aneurysm embolization using Penumbra fill and finish coils: 1-year results of a prospective, real-world, multicenter SURF study.

Background: SURF was a prospective, multicenter, single-arm, observational study with core lab adjudication of radiographic data, assessing embolization of intracranial aneurysms (IAs) using WAVE Extra Soft Coils as part of SMART Coil System.

Methods: Adults undergoing IA embolization with the SMART Coil System (Penumbra, Inc.) comprising 75% of implanted coils and WAVE as the final finishing coil were enrolled at 43 global centers.

Carotid Revascularization in the Modern Era: A Comparative Review of Carotid Endarterectomy, Carotid Angioplasty and Stenting, and Transcarotid Artery Revascularization.

Carotid artery stenosis is a major cause of acute ischemic stroke, accounting for approximately 15% of cases. Although optimal medical therapy remains the cornerstone of management, current guidelines recommend consideration of surgical intervention for symptomatic patients with ≥50% stenosis and asymptomatic patients with ≥70% stenosis. Extensive evidence supports carotid endarterectomy (CEA) as the gold standard procedure, whereas transfemoral carotid angioplasty and stenting (TF-CAS) and transcarotid artery revascularization (TCAR) offer safe alternatives for patients with high surgical risk.

Safety and efficacy of preoperative embolization in the treatment of brain arteriovenous malformations with perinidal aneurysms and single draining vein: a multicenter study with propensity score-weighting.

Background And Objectives: Arteriovenous malformations (AVMs) with perinidal aneurysms and single draining vein are associated with an elevated risk of rupture and increased procedural complexity. The role of preoperative embolization in this high-risk anatomical subset remains unclear. This study aimed to evaluate the safety and efficacy of microsurgery with preoperative embolization, compared with microsurgery alone in patients with such AVMs.

Safety and efficacy of the Celt arterial closure device in a femoral first neuroendovascular practice: prospective cohort study.

Objectives: To evaluate the safety and efficacy of the Celt arterial closure device (ACD), allowing immediate upright position and ambulation within 30 minutes, for femoral access closure in neuroendovascular procedures.

Methods: Single center prospective study of consecutive neuroendovascular procedures performed via transfemoral access over 6 months. The Celt ACD was preferentially used for arterial closure in eligible cases.

Angiographic perfusion outperforms large artery vasospasm for predicting the impact of rescue therapy in subarachnoid hemorrhage.

Aneurysmal subarachnoid hemorrhage (aSAH) contributes disproportionately to stroke-related disability due to its prevalence in younger patients. Large vessel vasospasm complicates aSAH and is often treated with endovascular rescue therapy (ERT). However, clinical trials have not demonstrated a clear link between vasospasm improvement and better outcomes.

Demonstration of physiologic, clinical and angiographic improvement of dural arteriovenous fistula via primary transverse sinus stenting.

A healthy, middle-aged man presented with acute on chronic progressive photophobia, headache and visual impairment. Clinical workup demonstrated advanced papilledema, tortuous optic nerves, flattened globes and intracranial pressure of >55 cm HO. Diagnostic cerebral angiogram demonstrated a Cognard IIA tentorial dural arteriovenous fistula (dAVF) associated with transverse sinus stenosis.

Neurosurgical Resident Skill Development Using a Novel Simulator-Based Anterior Cervical Discectomy and Fusion Curriculum.

Background: Simulation-based training is increasingly integrated into surgical education as a method to enhance technical skills in a safe and reproducible environment. This dual-institution pilot study - conducted within the neurosurgery residency programs at Massachusetts General Hospital and Stanford University - evaluates the feasibility and impact of integrating a three-dimensional printed anterior cervical discectomy and fusion (ACDF) simulator (UpSurgeon S.r.

Impact of smoking on occlusion rates following stereotactic radiosurgery for Spetzler Martin grade I-III brain arteriovenous malformations - A propensity score matched analysis of the MISTA consortium.

Backgroundand Objective: The authors compareocclusion rates in grade I-III AVMs in smokers and non-smokers, using propensity score matching (PSM).

Methods: The authors performed a subgroup analysis of the MISTA consortium, a multicenter registry that includes patients aged 1 to 89 years with AVMs treated between January 2010 and December 2023. Only grade I-III AVMs were included.

Ability of Head Impact Measurements to Predict Sports Concussions: A Review.

Background And Objectives: Provide a review of the current landscape of motion sensor-based analyses of mild traumatic brain injury (concussion) and shed light on avenues for further investigation.

Methods: A review of the literature on motion sensor-based concussion studies was conducted using search terms "concussion prediction sensor," "concussion prediction motion," "concussion diagnosis sensor," and "concussion diagnosis motion" in PubMed (between January 2000 and March 2024). In total, 207 publications were initially identified.

Traumatic Vertebral Artery Injury: Diagnosis, Natural History, and Key Considerations for Management.

Vertebral artery injury (VAI) is a known complication of blunt cervical spine trauma with a potential risk of stroke. Factors including cervical bony injury, spinal cord injury, and overall trauma severity have been linked to an increased risk of VAI. Despite its prevalence, there is little consensus on various aspects of this pathology, including its initial screening, diagnostic approaches, and therapeutic strategies.

International multi-center study of middle meningeal artery embolization for chronic subdural hematoma in cancer patients: Efficacy, safety, and outcomes in a high-risk population.

BackgroundMiddle meningeal artery embolization (MMAE) is a promising treatment for chronic subdural hematoma (cSDH). Cancer patients are at risk for cSDH due to thrombocytopenia. The efficacy of MMAE in this population has not been studied.

Effect of race on procedural and clinical outcomes in middle meningeal artery embolization for primary and adjunctive treatment of chronic subdural hematoma.

BackgroundWe investigated racial disparities in radiologic and clinical outcomes of patients after middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) with or without evacuation surgery.MethodsThis multicenter retrospective study includes consecutive patients who underwent MMAE across 11 institutions in North America (10 in the United States and 1 in Canada). Patients were stratified using self-reported racial data.

Triple Woven EndoBridge device strategy for recurrent basilar tip aneurysm: A case report.

Background: Coil embolization and surgical clipping are among the treatment options for acutely ruptured cerebral aneurysms. However, wide-neck aneurysms may necessitate stent placement, introducing dual antiplatelet therapy risks during subarachnoid hemorrhage (SAH). The Woven EndoBridge (WEB) intrasaccular device provides a unique solution for wide-neck aneurysms that does not require dual antiplatelet therapy.

Higher risk of recurrence in partially thrombosed cerebral aneurysms post-WEB (Woven EndoBridge) device treatment: insights from the WorldWideWEB Consortium registry.

Background: The Woven EndoBridge (WEB) device is a prevalent treatment for intracranial aneurysms. While many studies have assessed the obliteration rate post-WEB embolization, few have focused on long-term outcomes in partially thrombosed aneurysms.

Objective: To assess whether partially thrombosed aneurysms are at higher risk of recurrence or retreatment following WEB embolization compared with non-thrombosed aneurysms.

Outcomes of arteriovenous malformations with single versus multiple draining veins: A multicenter study.

Background: Cerebral arteriovenous malformations (AVMs) are complex vascular lesions that pose a risk for hemorrhagic stroke. The number of draining veins has recently emerged as a significant predictor of rupture risk. This multicenter study aimed to evaluate the outcomes in adult AVM patients with single versus multiple draining veins.

Spetzler-martin grade IV cerebral arteriovenous malformations in adult patients: a propensity-score matched analysis of resection and stereotactic radiosurgery.

Spetzler-Martin Grade IV arteriovenous malformations (AVMs) are challenging due to high risks associated with both treatment and natural progression. This study compares the outcomes of microsurgical resection and stereotactic radiosurgery (SRS) in high-grade AVMs, analyzing obliteration rates, complications, and functional outcomes. A retrospective cohort of 96 patients treated with either microsurgical resection (33 patients) or SRS (63 patients) was analyzed.

Parenchymal Hematoma After Endovascular Thrombectomy Is Associated With Pretreatment Basal Ganglia Infarct Volume.

Background And Purpose: Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preintervention, such as infarct topography, may help elucidate predisposing factors and inform more nuanced patient care intra- and postprocedurally.

Methods: Large vessel occlusion patients with pre-EVT MRI were included from a single quaternary center.

Prediction of persistent incomplete occlusion of intracranial aneurysms treated with woven EndoBridge device.

While the Woven EndoBridge (WEB) device has transformed the treatment of wide-neck intracranial aneurysms, incomplete occlusion remains a significant challenge requiring better understanding of contributing factors. A retrospective analysis was conducted on multicenter data from patients who underwent WEB device treatment for intracranial aneurysms between January 2011 and December 2022. Using machine learning models, Cox regression, and time-stratified analyses, we evaluated factors associated with persistent incomplete occlusion, defined as non-improving Raymond-Roy Occlusion Classification grade 2 or 3 at final follow-up.

Traumatic vertebral artery occlusion is associated with high rates of recanalization: insights from a systematic review and meta-analysis.

Background: Vertebral artery occlusion (VAO) is a known complication of blunt cervical injuries and can be associated with a risk of devastating strokes. VAO can spontaneously recanalize, particularly following cervical spine intervention. The aim of this study is to examine overall recanalization rates, recanalization in the context of cervical spine intervention, and the associations between VAO and stroke, spinal cord injury, and acute cervical deformity.

Spetzler-Martin grade I and II cerebral arteriovenous malformations: a propensity-score matched analysis of resection and stereotactic radiosurgery in adult patients.

Cerebral arteriovenous malformations (AVMs) are congenital vascular anomalies that can lead to severe complications, including hemorrhage and neurological deficits. This study compares the outcomes of microsurgical resection and stereotactic radiosurgery (SRS) for SM grade I and II AVMs. Out of a large multicenter registry, we identified 180 matched patients with SM grade I and II AVMs treated with either microsurgical resection or SRS between 2010 and 2023.

Incidence and predictors of Woven EndoBridge (WEB) shape modification following treatment of intracranial aneurysms in a large multicenter study.

The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment.

Seizure presentation and incidence-associated factors in treated cerebral arteriovenous malformations: a secondary analysis of the MISTA consortium.

Seizures occur in 20-45% of patients with cerebral arteriovenous malformations (AVMs) and can potentially influence their quality of life. Some studies have suggested risk factors influencing their development, but the evidence is limited to small cohorts. To analyze seizure presentation and factors influencing seizure development in patients with cerebral AVMs using a multi-institutional consortium.

Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching.

Introduction: The impact of multiple feeding arteries on clinical outcomes of cerebral arteriovenous malformations (AVMs) is not well understood. This study aims to compare outcomes between AVMs with multiple versus single feeding arteries.

Patients And Methods: Data from the Multicenter International Study for Treatment of Brain AVMs (MISTA) consortium were analyzed.