Publications by authors named "Jakob V E Gerstl"

Background: Years of Life Lost (YLL) is a disease burden measure quantifying the number of years lost due to premature mortality for a given disease. The present study sought to assess YLL for primary brain and other central nervous system (CNS) tumor histopathologies in the United States.

Methods: Mortality, incidence, and life expectancy data for mortalities occurring in 2018 were obtained from the National Vital Statistics System and the National Program of Cancer Registries.

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Background And Objectives: This study evaluates the effectiveness of a transitional care program (TCP) implemented for spinal neurosurgery patients, focusing on the reduction of length of stay (LOS).

Methods: We conducted a retrospective analysis of patients treated by 5 primary surgeons at our institution from January 2023 to December 2023. The analysis included 2 distinct parts: a multivariable ordinary least squares regression to determine factors affecting LOS for all spine surgery patients and a subset analysis using multivariable logistic regression to identify factors contributing to extended LOS in extended recovery unit (ERU)-admitted patients.

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Although bone resorption has been extensively reported following craniectomy, bone resorption and fusion rates following craniotomy remains unexplored. The aim of the present study was to conduct a volumetric assessment of craniotomy resorption and fusion rates at one year following the index surgery. Adult patients who had a computed tomography scan immediately after craniotomy and at one year follow up were included in the study.

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Background: Spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of morbidity and mortality in the United States. The efficacy of early antiseizure medication (ASM) is debated. Recent literature reports seizure rates ranging from 7.

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Neuronal-glioma interactions are increasingly recognized as critical in the development and progression of central nervous system tumors. Recent research highlights that gliomas can integrate into neural circuits through various mechanisms, including the synaptogenic factor thrombospondin-1 (TSP-1). This new mechanistic understanding of cancer neuroscience allows for novel insights into target discovery.

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Background Context: The management of type II odontoid fractures in elderly patients presents significant clinical challenges. Surgical treatment may lead to operative complications, while conservative management may increase the risk of non-osseous union, potentially compromising fracture stability.

Purpose: This study aims to evaluate the safety of non-osseous union subtypes in type II odontoid fractures following conservative treatment and to identify risk factors for unstable fractures.

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The modified 5-item frailty index (mFI-5), an index of reduced physiological reserve, has risen as a predictor of complications following surgical procedures. We examined the association of mFI-5 and surgical outcomes following the management of nontraumatic subarachnoid hemorrhage (nSAH). We queried the American College of Surgeons National Surgical Quality Improvement Program database for patients who received surgical management of nSAH between 2006 and 2021.

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Background: Middle meningeal artery embolization (MMAE) is an established treatment option for chronic subdural hematoma. The aim of this systematic review and meta-analysis was to establish estimates of the pooled incidence for complications following MMAE.

Methods: PubMed, Embase, and Cochrane were searched for studies reporting complications following MMAE through January 2023.

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Methods to assess quality of life and recovery after endoscopic endonasal surgery (EES) for sellar lesions are limited and often biased by subjective patient-reported assessments. Objective in-situ assessments are lacking. Smartphone-based digital phenotyping has been increasingly studied across a variety of pathologies, utilizing built-in technologies to measure behavioral patterns pertaining to sleep, physical mobility, social interactions, and cognitive functioning, among others.

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Objective: Spinal meningioma (SM) is a pathology with an estimated incidence of nearly 1000 diagnoses per year in the United States and presents in 20% of patients with neurofibromatosis type 2 (NF2). This multi-institutional retrospective cohort study aimed to assess clinical outcomes for patients with SM who underwent surgery between 1998 and 2020 with stratification by NF2 mutation status.

Methods: Medical records were reviewed retrospectively to collect data on patient demographics, clinical presentation, tumor characteristics, treatment, and outcomes.

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The diagnosis of pituitary microprolactinomas is often obscured by relatively low levels of elevated prolactin compared to macroprolactinomas. This may lead to varying patterns of medical therapy versus observation. We sought to correlate prolactin levels in suspected microprolactinomas with tumor volumes and clinical outcomes.

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Interim results from two phase 1 trials demonstrate progress in the use of chimeric antigen receptor (CAR) T cell therapy for recurrent glioblastoma (GBM).

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Article Synopsis
  • Glioblastoma is a highly aggressive brain tumor with a median survival of only 6-9 months after progression, due to factors like molecular pathways and tumor microenvironment.
  • Current treatments like surgery, radiation, and chemotherapy can manage the primary tumor but not effectively prevent relapse, and the role of surgery for recurrent cases is debated.
  • New innovative therapies for recurrent glioblastoma are being developed, including checkpoint inhibitors and CAR T-cell therapy, aimed at improving treatment outcomes.
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  • Nearly all neurosurgeons in the U.S. will face a malpractice claim before they retire, so this study looks at trends in those lawsuits to help them understand their risks.
  • Researchers checked databases for malpractice cases involving open brain surgery from 1987 to 2023, finding out details like how much money was awarded and what went wrong.
  • Out of 1,550 cases studied, they found 252 related to surgery, with the average payout being about $2.75 million, and many claims were due to complications during or after surgery.
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Article Synopsis
  • - Digital phenotyping (DP) allows for objective tracking of patient behaviors, particularly in assessing the mobility trends of glioblastoma (GBM) patients during different treatment phases.
  • - The study tracked 15 GBM patients using the Beiwe app, collecting data on their movement and locations visited during preoperative and postoperative periods, revealing a decrease in mobility over time post-surgery.
  • - Results showed that, one month after surgery, GBM patients spent less time out and visited fewer places compared to pre-surgery, but displayed increased mobility immediately after surgery; DP proved useful for measuring these changes.
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The emerging field of cancer neuroscience reshapes our understanding of the intricate relationship between the nervous system and cancer biology; this new paradigm is likely to fundamentally change and advance neuro-oncological care. The profound interplay between cancers and the nervous system is reciprocal: Cancer growth can be induced and regulated by the nervous system; conversely, tumors can themselves alter the nervous system. Such crosstalk between cancer cells and the nervous system is evident in both the peripheral and central nervous systems.

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Background Context: Currently, there is no universally accepted method for assessing radiological fusion shortly after anterior cervical discectomy. Five-year follow-up radiological X-rays demonstrating solid fusion or absence of fusion provided a gold standard for comparison with various assessment methods.

Purpose: Establishing the most accurate diagnostic test for earlier bony fusion assessment by comparing different cut-off values for the difference in interspinous distance and the change in Cobb angle on dynamic radiological images against the established gold standard.

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Objective: Surgical intervention can be curative or palliative for drug-resistant focal epilepsy. However, if the seizure onset zone (SOZ) cannot be adequately localized via noninvasive tests, intracranial EEG (iEEG) recordings are often carried out to develop surgical plans in appropriate candidates. Stereotactic EEG (SEEG), subdural EEG (SDE), and SDE with depth electrodes (hybrid) are major tools used for investigation, but there is no class 1 or 2 evidence comparing the effectiveness of these modalities.

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Background: Traumatic subarachnoid hemorrhage (tSAH) is a common consequence of head trauma. Treatment of patients with tSAH commonly involves serial computed tomography (CT) scans to assess for expansile hemorrhage. However, growing evidence suggests that these patients rarely deteriorate or require neurosurgical intervention.

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We evaluate whether interictal spikes, epileptiform HFOs and their co-occurrence (Spike + HFO) were included in the resection area with respect to seizure outcome. We also characterise the relationship between high frequency oscillations (HFOs) and propagating spikes. We analysed intracranial EEG of 20 patients that underwent resective epilepsy surgery.

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Article Synopsis
  • Oncolytic viral (OV) therapies are a new treatment option for hard-to-treat cancers like glioblastoma in the central nervous system but face challenges in effectiveness due to delivery issues and immune responses.
  • The SUMO pathway, which regulates various physiological processes, plays a role in both CNS cancers and viral interactions, making it a target for enhancing OV treatments.
  • The authors provide an overview of the SUMO pathway's impact on CNS malignancies, the current status of OV therapies, and how the SUMO pathway interacts with the viral lifecycle and immune responses.
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Cerebral proliferative angiopathy (CPA) is an entity distinct from that of classical arteriovenous malformations. As such, few reports have considered the long-term follow-up of patients with hemorrhage in CPA. Accordingly, herein the authors present a case of recurrent hemorrhage in CPA with 32 years of follow-up and in so doing summarize the literature of hemorrhagic cases in CPA.

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Background: Meningiomas are common intracranial tumors. Machine learning (ML) algorithms are emerging to improve accuracy in 4 primary domains: classification, grading, outcome prediction, and segmentation. Such algorithms include both traditional approaches that rely on hand-crafted features and deep learning (DL) techniques that utilize automatic feature extraction.

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Background: An understanding of global, regional, and national macroeconomic losses caused by stroke is important for allocation of clinical and research resources. The authors investigated the macroeconomic consequences of stroke disease burden in the year 2019 in 173 countries.

Methods: Disability-adjusted life year data for overall stroke and its subtypes (ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage) were collected from the GBD study (Global Burden of Disease) 2019 database.

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Adult and pediatric high-grade gliomas (HGGs) are aggressive cancers of the central nervous system that confer dismal clinical prognoses. Standard radiation and chemotherapy have demonstrated only limited efficacy in HGGs, motivating the accelerated investigation of novel modalities such as oncolytic virus (OV) therapies. OV centered therapies work through a mixed mechanism centered on oncolysis and the stimulation of an antitumor immune response.

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