Social Media Mentions are a Stronger Predictor of Citations than 5-Year Impact Factor in Neurosurgical Research.

Background And Objectives: X (formerly known as Twitter) is a social media platform gaining popularity in neurosurgery. Other disciplines have demonstrated a positive correlation between Twitter activity and traditional citation metrics. This study aims to determine if X activity is a greater predictor of citation rates than a journal's 5-year impact factor (IF) among major neurosurgical journals.

Angiographic Occlusion After Flow Diversion of Ruptured and Unruptured Intracranial Aneurysms Using the Flow Redirection Endoluminal Device-X: A Multicenter Analysis.

Background And Objectives: Flow diversion induces progressive aneurysm occlusion by reducing blood flow across the aneurysm neck over time. Various factors, including comorbid conditions, aneurysm characteristics, and stent design, have been shown to affect occlusion rates after flow diversion. Our study analyzed predictors of angiographic occlusion after flow diversion of intracranial aneurysms using the Flow Redirection Endoluminal Device with X-technology (FRED-X).

Too late to save: The national surge in ruptured arteriovenous malformations and the decline in endovascular utilization from 2016 to 2022.

IntroductionThe ARUBA trial has influenced a shift towards more conservative management of small, unruptured cerebral arteriovenous malformations (AVMs), leading to less aggressive treatment approaches among neurointerventionalists. However, with evolving endovascular techniques, it is important to assess whether national practice changes have impacted rupture rates and outcomes.MethodsData from the Nationwide Inpatient Sample (NIS) for 2016-2022 regarding clinical characteristics, cost, morbidity, and mortality endovascularly treated AVMs was analyzed.

National assessment of frailty impact on endovascular mechanical thrombectomy for minor to moderately severe large vessel occlusions per NIHSS.

IntroductionLarge vessel occlusion (LVO) strokes are a significant cause of disability and death globally. Endovascular mechanical thrombectomy (EVT) has improved outcomes for LVO patients. However, the impact of pre-existing frailty on outcomes for patients undergoing EVT remains understudied.

2024 middle meningeal artery embolization trials: A comprehensive review of past, recent, and ongoing trials.

Background and objectivesMiddle meningeal artery embolization (MMAE) has become a pivotal intervention in managing chronic subdural hematomas (cSDHs). This systematic review synthesizes past, recent, and ongoing clinical trials to assess MMAE's role in cSDH treatment.MethodsA systematic review was conducted using PRISMA guidelines, incorporating PubMed, ClinicalTrials.

Long-term safety and efficacy of the FRED X flow diverter for intracranial aneurysms: a multicenter study of 154 patients.

Objective: The Flow-Redirection Endoluminal Device X (FRED X) is a newer generation flow diverter with surface modifications aimed at minimizing thrombogenicity. At present, data on its long-term efficacy are limited. This multicenter study presents the largest series within the United States describing the device's efficacy, safety, and long-term outcomes in treating cerebral aneurysms of varying morphology.

Performance evaluation of ChatGPT-4.0 and Gemini on image-based neurosurgery board practice questions: A comparative analysis.

Introduction: Artificial intelligence (AI) has gained significant attention in medicine, particularly in neurosurgery, where its potential is often discussed and occasionally feared. Large language models (LLMs), such as ChatGPT-4.0 (OpenAI) and Gemini (formerly known as Bard, Google DeepMind), have shown promise in text-based tasks but remain under explored in image-based domains, which are essential for neurosurgery.

Retrospective Observational Descriptive Study on Use and Rotations to Belbuca.

The purpose of this study was to better characterize morphine equivalent daily dose (MEDD) equivalencies with buccal buprenorphine, and identify real-world efficacy and safety outcomes associated with the use of buccal buprenorphine for chronic pain at a local VA Medical Center. This study was a retrospective chart review of Computerized Patient Record System (CPRS) patient records with outpatient prescriptions for buccal buprenorphine (Belbuca). Overall, there was a high discontinuation rate of Belbuca: being 60% or greater across all different patient groups.

Multicenter analysis of the incidence of in-stent stenosis following the deployment of flow-redirection endoluminal device in the treatment of intracranial aneurysms.

Introduction: The Flow Re-direction Endoluminal Device (FRED) is a novel flow diverter with a unique double stent design, with an inner stent composed of 48 nitinol wires, and an outer stent with 16 nitinol wires. It is designed for endovascular cerebral aneurysm treatment, although, limited data exist regarding in-stent stenosis (ISS) rates associated with FRED devices.

Methods: A registry encompassing two North American comprehensive stroke centers was the base of this study.

Utilization of the Modified Brain Injury Guidelines by Neurosurgeons to Improve Traumatic Brain Injury Patient Throughput at a Level I Trauma Center: A Retrospective Observational Study.

Objective: The modified Brain Injury Guidelines (mBIG) were developed to improve care of patients with traumatic brain injury (TBI). This study aimed to assess if utilization of mBIG by neurosurgeons would improve TBI patient throughput at a Level I trauma center, particularly for patients meeting mBIG 1 criteria.

Methods: This was a retrospective observational study at a Level I trauma center.

Multicenter early United States feasibility study and periprocedural safety of LVIS EVO for the treatment of unruptured intracranial aneurysms.

Background: Stent development has focused recently on low-profile, self-expandable stents compatible with 0.0165 inch microcatheters. The LVIS EVO is the second-generation version of the Low-Profile Visualized Intraluminal Support (LVIS) with improved visibility and resheathability.

The Enterprise stent…still useful after all these years.

Background: The Enterprise stent (Codman Neuro, Massachusetts, USA) received Food and Drug Administration (FDA) approval in 2007 for stent-assisted coiling (SAC). Since its introduction, newer stents and devices for aneurysm treatment have been developed resulting in a shift in the utilization of this stent from SAC to other off-label indications.

Objective: To describe our experience with the Enterprise stent being used for SAC and other off-label indications.

Artificial intelligence improves transfer times and ischemic stroke workflow metrics.

Introduction: Rapid initiation of mechanical thrombectomy (MT) for the treatment of large-vessel occlusion (LVO) critically improves patient outcomes. Artificial intelligence algorithms aid in the identification of LVOs and improve door to puncture times as well as patient transfer times.

Objectives: We aimed to determine whether the implementation of an LVO detection algorithm that provides immediate active notification to the thrombectomy team provider's cell phone would improve ischemic stroke workflow at our institution and aid in patient transfer from outlying hospitals when compared to our prior system of passive computed tomography perfusion software analysis and radiologist interpretation and notification.

Drainage, Irrigation, and Fibrinolytic Therapy (DRIFT) for Adult Intraventricular Hemorrhage Associated with Primary Hypertensive Hemorrhages Using IRRAflow Self-Irrigating Catheter: A Report of Three Cases and Prior Historical Controls.

Background: Spontaneous primary intracerebral hemorrhage (ICH) accounts for 10%-15% of strokes and is accompanied by ventricular involvement in 10%-30% of cases. Intraventricular hemorrhage (IVH) is a poor prognostic factor and the current treatment paradigm of external ventricular drainage requires frequent flushing and replacement. Given the documented high rate of failure standard EVD catheters, we sought to determine if the use of the IRRAflow system with the addition of alteplase would be beneficial in this patient population for the treatment of IVH associated with primary hypertensive ganglionic hemorrhages.

Use of intravenous cangrelor in the treatment of ruptured and unruptured cerebral aneurysms: an updated single-center analysis and pooled analysis of current studies.

Background: Intracranial stent placement for the treatment of cerebral aneurysms is increasingly utilized in both ruptured and unruptured scenarios. Intravenous (IV) cangrelor is a relatively new antiplatelet agent that was initially approved for coronary interventions. In addition to our institution, five other centers have published their results using IV cangrelor in neurointerventional procedures.

Developing a fast-track discharge protocol for patients with cerebral aneurysms treated via neuroendovascular techniques.

Introduction: As we emerge from the current pandemic, hospitals, staff, and resources will need to continue to adjust to meet ongoing healthcare demands. Lessons learned during past shortages can be used to optimize peri-procedural protocols to safely improve the utilization of hospital resources.

Methods: Retrospective review of patients who underwent elective endovascular intracranial aneurysm treatment was performed.

Neurosurgical management of vascular compression presenting as visual symptoms secondary to elongated styloid processes (Eagle syndrome).

Background: Eagle syndrome (ES) was first described in 1937, to characterize elongation of the styloid process. It is rarely encountered by neurosurgeons but does present the potential for vascular sequelae and neurological complications.

Demonstrative Cases: We discuss three patients with uncommon presentations of neurovascular compromise with uncommon symptomatology, secondary to ES.

Comparison of hydrogel coils versus bare platinum coils for the treatment of anterior communicating artery aneurysms.

Introduction: While endovascular coiling has been shown to be a safe treatment option for intracranial aneurysms, there remains concern regarding increased recurrence and retreatment rates. Preliminary studies evaluating hydrogel coated coils have demonstrated decreased recurrence rates compared to bare metal coils.

Methods: A retrospective chart review was done on all patients with anterior communicating artery aneurysms (ACoAAs) treated with endovascular coiling between 2014 and 2018.

Characterization of antiplatelet response to low-dose cangrelor utilizing platelet function testing in neuroendovascular patients.

Study Objectives: The optimal antiplatelet therapy for emergent neuroendovascular stenting is uncertain. Cangrelor is an intravenous P2Y12 inhibitor that is an attractive option due its favorable pharmacokinetic profile and ease of measurability but optimal dosing remains unclear. The primary objective of this study is to characterize the dose response of low dose cangrelor (<2 mcg/kg/min) with the utilization of platelet function testing (PFT).

Delayed hypersensitivity reaction to a dural repair substitute.

Background: Modern neurosurgeons commonly rely on dural grafts to aid in obtaining watertight closures when the native dura itself cannot be approximated.

Case Presentation: We present a patient who developed a symptomatic, delayed hypersensitivity reaction to a cellulose-based synthetic dural graft, which resolved after reoperation and removal of the graft.

Discussion: Dural grafts are a safe and common implant utilized in neurosurgery.