Impact of preoperative medical management on postoperative outcomes after index percutaneous rhizotomy for trigeminal neuralgia.

Objective: Initial medical management fails in nearly half of patients with trigeminal neuralgia (TN), and patients will seek surgical management with either rhizotomy or microvascular decompression. The impact of preoperative medical management on post-rhizotomy outcomes is unclear. The authors aimed to further evaluate this relationship.

Impact of inflammation on white matter integrity and functional connectivity in chronic major depressive disorder.

Background: Inflammation is increasingly recognized as a pathophysiologic component of major depressive disorder (MDD). Concurrently, depressive episode chronicity has emerged as a significant predictor of adverse long-term outcomes.

Methods: Utilizing data from the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, our analysis included 201 participants who completed C-reactive protein (CRP) sampling and diffusion-weighted imaging scans, of whom 120 participants had usable functional magnetic resonance imaging scans.

The epigenetic mechanisms involved in the treatment resistance of glioblastoma.

Glioblastoma (GBM) is an aggressive malignant brain tumor with almost inevitable recurrence despite multimodal management with surgical resection and radio-chemotherapy. While several genetic, proteomic, cellular, and anatomic factors interplay to drive recurrence and promote treatment resistance, the epigenetic component remains among the most versatile and heterogeneous of these factors. Herein, the epigenetic landscape of GBM refers to a myriad of modifications and processes that can alter gene expression without altering the genetic code of cancer cells.

A multi-analyte blood test for acute spinal cord injury.

BACKGROUNDRapid diagnosis to facilitate urgent intervention is critical for treatment of acute spinal cord injury (SCI). We hypothesized that a multi-analyte blood biomarker would support point-of-care SCI diagnosis, correlate with injury severity, and predict long-term neurologic outcomes.METHODSDroplet digital PCR (ddPCR) assays were designed to amplify differentially hypomethylated genomic loci in spinal cord tissue.

Trends in the Management of Oligodendrogliomas: A Multinational and Multidisciplinary Survey Study.

Objective: Oligodendrogliomas present challenges in management despite their favorable prognosis. Optimal therapeutic strategies are not well-established. We aimed to characterize current practice patterns and identify areas of discordance in oligodendroglioma management.

Sleepiness in retired male boxers: daytime sleepiness and its relationship with impulsiveness and depression symptomatology in retired professional male boxers.

Background: Boxing exposes fighters to head impacts and potential traumatic brain injury (TBI). Though research has explored the neuropsychiatric consequences of contact sports, there is limited research into Excessive Daytime Sleepiness (EDS) and its relationship to other outcomes, such as impulsiveness and depression. Therefore, this study aimed to describe EDS in retired boxers using the Epworth Sleepiness Scale (ESS) and to examine how boxing and sleepiness relate to impulsiveness and depression symptomatology.

Survival Factors in 1580 Adults with Spinal Ependymoma: Insights from a Multicenter Oncology Database.

Background: Using a multi-institutional oncology database, we investigate the survival rates and the impacts of demographic, clinical, and management characteristics on overall survival among adult patients diagnosed with spinal ependymoma.

Methods: Utilizing the SEER registry, patients with histologically or radiologically confirmed ependymomas were included. Factors impacting overall survival were analyzed using Kaplan-Meier survival curves and log-rank statistical analyses.

Prior football or rugby exposure and white matter signal abnormalities in professional male mixed martial arts fighters.

Background: White matter signal abnormalities have been associated with traumatic brain injury (TBI) and repetitive head impacts (RHI) in contact sports (e.g. American football, rugby).

Subdural Extra-arachnoid Hygroma Because of Occult Distal Durotomy After Minimally Invasive Decompression: A Case Report.

Case: We present the case of a 59-year-old man who had MIS L4-5 decompression. He presented the next day with intractable back and leg pain. Magnetic resonance imaging revealed ventral displacement of the cauda equina and a subdural collection on the right L3/L4 nerve roots.

The Neurodevelopmental and Molecular Landscape of Medulloblastoma Subgroups: Current Targets and the Potential for Combined Therapies.

Medulloblastoma is the most common malignant pediatric brain tumor and is associated with significant morbidity and mortality in the pediatric population. Despite the use of multiple therapeutic approaches consisting of surgical resection, craniospinal irradiation, and multiagent chemotherapy, the prognosis of many patients with medulloblastoma remains dismal. Additionally, the high doses of radiation and the chemotherapeutic agents used are associated with significant short- and long-term complications and adverse effects, most notably neurocognitive delay.

Patient Safety Indicator 04 Does Not Consistently Identify Failure to Rescue in the Neurosurgical Population.

Background: Improving neurosurgical quality metrics necessitates the analysis of patient safety indicator (PSI) 04, a measure of failure to rescue (FTR).

Objective: To demonstrate that PSI 04 is not an appropriate measure for capturing FTR within neurosurgery.

Methods: We conducted a single-center retrospective cohort study.

Predictors of Blunt Cerebrovascular Injury, Stroke, and Mortality in Patients with Cervical Spine Trauma.

Background: Blunt cerebrovascular injury (BCVI), defined as blunt traumatic injury to the carotid or vertebral arteries, is associated with significant risk of stroke and mortality. Cervical spine trauma is a recognized risk factor for BCVI.

Objective: The objective of this study was to identify significant predictors of BCVI and its sequelae in patients with known cervical spine injury.

The Role of Preoperative Magnetic Resonance Imaging in Assessing Neurovascular Compression Before Microvascular Decompression in Trigeminal Neuralgia.

Background: Preoperative magnetic resonance imaging (MRI) is a standard component of the preoperative clinical workup for patients before microvascular decompression (MVD). However, its ability to accurately exclude neurovascular compression of the trigeminal nerve is not well understood.

Methods: We retrospectively reviewed 1020 patients with available preoperative MRI data before microvascular decompression.

Current and Future Frontiers of Molecularly Defined Oligodendrogliomas.

Oligodendrogliomas are a subtype of adult diffuse glioma characterized by their better responsiveness to systemic chemotherapy than other high-grade glial tumors. The World Health Organization (WHO) 2021 brain tumor classification highlighted defining molecular markers, including 1p19q codeletion and IDH mutations which have become key in diagnosing and treating oligodendrogliomas. The management for patients with oligodendrogliomas includes observation or surgical resection potentially followed by radiation and chemotherapy with PCV (Procarbazine, Lomustine, and Vincristine) or Temozolomide.

Safety and Cost Savings Associated with Reduced Inpatient Hospitalization for Microvascular Decompression.

Objectives: Microvascular decompression (MVD) has grown as a first-line surgical intervention for severe facial pain from trigeminal neuralgia and/or hemifacial spasm. We sought to examine the safety and cost-benefits of discharging patients with MVD within 1 day of admission.

Methods: We retrospectively reviewed patients undergoing MVD at our institution from 2008 to 2020.

Reexamining the Role of Postoperative ICU Admission for Patients Undergoing Elective Craniotomy: A Systematic Review.

Objectives: The standard-of-care for postoperative care following elective craniotomy has historically been ICU admission. However, recent literature interrogating complications and interventions during this postoperative ICU stay suggests that all patients may not require this level of care. Thus, hospitals began implementing non-ICU postoperative care pathways for elective craniotomy.

Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia.

Objective: Internal neurolysis (IN) and intraoperative glycerin rhizotomy (ioGR) are emerging surgical options for patients with trigeminal neuralgia without neurovascular contact. The objective of this study was to compare the neurological outcomes of patients who underwent IN with those of patients who underwent ioGR.

Methods: The authors retrospectively reviewed all patients who underwent IN or ioGR for trigeminal neuralgia at our institution.

Case Series in the Utility of Invasive Blood Pressure Monitoring in Microvascular Decompression.

Background: The utility of arterial lines in microvascular decompression (MVD) is not well described.

Objective: To examine the safety and costs of arterial lines compared with noninvasive blood pressure (NIBP) monitoring in MVDs.

Methods: We retrospectively reviewed patients undergoing MVD from 2012 to 2020.