A spinal mass was found in a woman with complete spinal cord injury 8 years after she had undergone implantation of olfactory mucosal cells to hopefully regain sensory and motor function. Authors caution that physicians should be vigilant in follow-up of patients who undergo stem cell interventions.
This supplement to the Journal of Neurosurgery covers the current knowledge of anticoagulant-associated intracerebral hemorrhage (AAICH) and methods in use for management of the condition. CME credits are available.
Researchers investigating gene expression in normal vestibular nerves and vestibular schwannomas (VSs) found 2 important findings: 1) there is negligible difference between VSs that sporadically occur and those commonly associated with neurofibromatosis Type 2 (NF2), a genetic disorder; and 2) the overexpressed PI3K/AKT/mTOR signaling pathway in these tumors may be an excellent therapeutic target.
The Journal of Neurosurgery Publishing Group and its parent organization, the American Association of Neurological Surgeons, are pleased to announce a new look for the JNSPG journals: Journal of Neurosurgery; Journal of Neurosurgery: Spine; Journal of Neurosurgery: Pediatrics; and Neurosurgical Focus
“Pediatric hydrocephalus: systematic literature review and evidence-based guidelines,” a supplement to the Journal of Neurosurgery: Pediatrics, offers a thorough evaluation of the current treatments for pediatric hydrocephalus as well as up-to-date evidence-based recommendations for their use.
A formal protocol for delivering emergency treatment to patients with subarachnoid hemorrhage (SAH) from ruptured aneurysms within the first few hours after bleeding occurs. Offered day and night, the protocol reduces the incidence of repeated hemorrhage during the hospital stay and improves clinical outcomes in patients with aneurysmal SAH.
Researchers conducted a prospective randomized controlled clinical trial to compare a laparoscopic procedure with a mini-laparotomy for insertion of a peritoneal catheter during ventriculoperitoneal shunt surgery. Although overall shunt failure rates did not differ substantially between patients in the two surgery groups, the authors identified a significant reduction in the rate of distal (abdominal) shunt failure in patients in whom laparoscopy was used. Using Laparoscopy For Ventriculoperitoneal Shunt Placement
The use of flow-diverting stents to treat intracranial aneurysms appears safe and highly successful. Ischemic complications occur in brain territories supplied by the parent artery in which the stent is placed and in brain regions fed by small arterial branches whose ostia are covered by the stent. Most of these complications are asymptomatic.
43% of surveyed female meningioma survivors aged 25–44 yrs stated they were warned that pregnancy was a risk factor for meningioma recurrence. Nevertheless, these women were more likely to want a baby (70% vs 54%) and intend to have a baby (27% vs 12%) than same-age women in the general population.
The American Association of Neurological Surgeons, the Congress of Neurological Surgeons, and the Joint AANS/CNS Cerebrovascular Section strongly endorse interventional thrombectomy in the treatment of acute ischemic stroke based on findings of the MR CLEAN study.
A surgical skills laboratory and corresponding dissection curricula were established in the Department of Neurosurgery at the Cleveland Clinic in the 2011–2012 academic year. The authors describe how this came about and what it has meant for neurosurgical resident training and assessment of residents’ surgical skills.
Researchers examined neuroimaging studies obtained in children and adolescents with sports-related concussions and found that the images appeared normal in 78% of cases. Although usually nondiagnostic, occasionally such studies can be useful in guiding decisions about return to play.
Researchers from the Canada North Concussion Network in Manitoba investigated the frequency of vestibulo-ocular dysfunction in children and adolescents with sports-related concussion and found that its presence was predictive of a prolonged recovery.
Researchers investigated mannitol use before and during transportation of patients with intracranial emergencies from peripheral hospitals to tertiary facilities that house neurosurgery departments. The authors found a 22% dosing error rate, with slightly more patients receiving a dose smaller, rather than larger, than the dose range recommended by the Brain Trauma Foundation.
Researchers at Brown University examined three magnetically programmable shunt valves to see if the magnetic field emissions of headphones can cause unintentional changes in shunt valve settings. Based on their findings, the researchers state that it is highly unlikely that commercially available headphones will interfere with programmable shunt valve settings.
Researchers from Vienna examined elderly patients and adult patients receiving antiplatelet therapy who had presented with mild head injury to see if S100B protein levels could help identify whether intracranial bleeding was present. The researchers found that patients with serum S100B levels < 0.105 µg/L were very unlikely to have intracranial hemorrhage.
French researchers used clinical examinations and magnetic resonance imaging (MRI) studies to determine whether retired professional rugby players experience more serious symptoms of cervical spine degeneration than people in the general population.
Researchers at the University of Virginia (UVa) examined the number and severity of subconcussive head impacts sustained by college football players over an entire season during practices and games. The researchers found that the number of head impacts varied depending on the intensity of the activity.
Prenatal repair of a myelomeningocele results in less need for a shunt at 12 months and reduces the need for shunt revision in those infants who do require shunt placement. Patients with extensive hydrocephalus at the time of prenatal evaluation do not have improved outcomes following prenatal surgery.
After a thorough review of medical articles describing head injuries caused by toppled television sets in children, researchers assessed the risk factors associated with these events. Based on their assessment, the researchers developed strategies to prevent these injuries.
Using data on 30-day postoperative morbidity and mortality from the American College of Surgeons National Surgical Quality Improvement Program database, the authors examined whether there is a “July Effect” in neurosurgery. Overall the findings show “no clear evidence for an increase in rates of morbidity or mortality during this transition period.”
Researchers from Memphis, Tennessee, have examined intracranial gunshot wounds (GSWs) in children and adolescents, and identified nine clinical, laboratory, and radiological factors that were predictive of these patients’ outcomes.
In the paper “Stratification of risk to the surgical team in removal of small arms ammunition implanted in the craniofacial region: case report, by Jonathan A. Forbes, MD, and colleagues, the authors discuss risk assessments that are necessary when a surgical team is required to remove embedded ordnance that may contain explosive materials.
The Journal of Neurosurgery Publishing Group is proud to announce a new feature available for select articles on our website (www.thejns.org): direct access to The Rhoton Collection® for a detailed neuroanatomical learning experience while reading articles featuring neuroanatomy in JNSPG journals.
A neural tube defect, myelomeningocele affects many systems in the human body and requires multidisciplinary medical care to ensure optimal function and quality of life as well as survival of the patient. These patients’ medical needs are best served by high-volume medical centers, according to a new article in the Journal of Neurosurgery: Spine.
April's Neurosurgical Focus offers 12 articles presenting the most up-to-date knowledge of what constitutes sports-related brain injury, the latest diagnostic assessment tools, the neuropathology underlying symptoms, complications that may arise, prevention, and case management strategies.
Researchers studied children and adolescents with myelomeningocele or lipomyelomeningocele who underwent spinal cord detethering with or without addition of the Xiao procedure to assess the procedure’s effectiveness in achieving bladder control. The procedure was ineffective in all patients.
Researchers have determined specific risk factors associated with hospital readmission following pediatric neurosurgery. Some are related to the specific surgical procedure performed (for example, cerebral spinal fluid [CSF] shunt placement or CSF shunt revision), others to postoperative complications (such as surgical site infection), and still others to patient demographics (Native American race).
Researchers examined the case files of all patients younger than 5 years of age who had been admitted to Le Bonheur Children’s Hospital between 2009 and 2014 for abusive head injury. The authors’ goal was to identify patient demographics and determine the incidence and extent of the injuries, seasonal trends associated with this abuse, required neurosurgical procedures, and costs of hospitalization. The number of cases is on the rise,
The authors recount how Dr. Robert Hubbard, a biomechanical crash engineer, and his brother-in-law, Jim Downing, a racecar driver, joined forces to create the HANS® device, which was designed to prevent the occurrence of shear injuries between the head and neck during high-impact crashes.
Researchers used biomechanical sensors to investigate exposure to head impacts during practice sessions and games in 9- to 11-year-olds engaged in a youth football program. A higher proportion of head impacts greater than 60g occurred in tackling drills than in games. The findings may influence the structure of training for youth football teams.
Graded aerobic treadmill testing is safe, tolerable, and useful in evaluating and managing cases of sports-related concussion in children and adolescents. This is the finding of a new study reported in the Journal of Neurosurgery: Pediatrics.
Researchers offer a treatment algorithm, or protocol, for identifying patients with global (flail arm) brachial plexus injuries who are likely to benefit from trading in their insensate and nonfunctional hand for a myoelectric prosthetic device.
Research conducted at the University of Virginia suggests that patients may wish to take a 1 to 3 month break from lumbar epidural steroid injections (LESIs) before undergoing lumbar spinal fusion surgery. Why? An increased risk of infection has been identified when LESIs are administered within 3 months prior to surgery.
The biomechanics of head injury in youths (5 to 18 years of age) have been poorly understood. A new study reported in the Journal of Neurosurgery: Pediatrics set out to determine what biomechanical characteristics predispose youths with concussions to experience transient or persistent postconcussion symptoms.
Using 3D printing and Hollywood-style special effects, researchers constructed a neurosurgery training simulation model whose physical and functional qualities closely mimic those of the head and brain structures of an adolescent human patient.
JFK promoted an image of himself as a young, healthy, strong-bodied man. But this image belies the truth: that Kennedy’s life was plagued by illnesses and he required strong medication to perform his tasks as president. This paper sheds light on JFK’s back problems and how they affected his life.
German researchers report preliminary findings that show a noninvasive method of monitoring intracranial pressure (ICP) that could rival the gold standards of invasive intraventricular and intraparenchymal monitoring. The device uses advanced signal analysis algorithms to evaluate properties of acoustic signals that pass through the brain in order to determine ICP values.
This is a case report about a 10-month-old infant who inadvertently ingested ketamine. The authors offer details of the pastient's clinical course as well as unexpected imaging findings.
Researchers examined differences in the number, location, and magnitude of head impacts sustained by young athletes during various youth football practice drills. Such information could lead to recommendations for football practices, including modification of some high-intensity drills in order to reduce players’ exposure to head impacts and, consequently, lessen the risks of injury.
Researchers examined exposure to high-magnitude head impacts (accelerations greater than 40g) in young athletes, 9 to 12 years of age, during football games and practice drills to determine under what circumstances these impacts occur and how representative practice activities are of game activities with respect to the impacts. This type of information can help coaches and league officials make informed decisions in structuring both practices and games to reduce risks in these young athletes.
Despite claims that helmets do not protect the cervical spine during a motorcycle crash and may even increase the risk of injury, researchers from the University of Wisconsin Hospitals and Clinics in Madison found that, during an accident, helmet use lowers the likelihood of cervical spine injury (CSI), particularly fractures of the cervical vertebrae.
A variety of neurosurgical procedures are performed with the aid of smartphone-endoscope integration. The smartphone takes the place of a camera and video monitor. It is easy to use, more cost effective, and provides the surgeon with a more intuitive and fluid method of performing neuroendoscopy.
The University of Glasgow’s Sir Graham Teasdale, co-creator of the Glasgow Coma Scale, has teamed with Paul M. Brennan and Gordon D. Murray of the University of Edinburgh to create new assessment tools that build on the Glasgow Coma Scale to provide greater information on injury severity and prognosis in patients with traumatic brain injury while still offering simplicity of use.
Patients receiving deep brain stimulation are warned that their neurostimulators may dysfunction when confronted by electromagnetic fields generated by particular electrical devices found at work, home, and in the hospital. A new and potentially dangerous source of dysfunction has been identified: nearby lightening.
Preliminary research using mcDESPOTmagnetic resonance imaging shows changes in the myelin content of white matter in the brain following mild traumatic brain injury. Myelin changes are apparent at the time of injury and 3 months afterward.
Three neurosurgeons from the Postgraduate Institute of Medical Education and Research in Chandigarh, India, set out to examine Michael Jackson's antigravity tilt, introduced in the music video “Smooth Criminal,” from a neurosurgeon’s point of view.
Researchers evaluated the usefulness of biomarker testing in determining the potential extent of brain trauma suffered from repetitive subconcussive head impacts sustained over the course of a college football season.
Covers the assassination of Robert F. Kennedy. The authors “review the eyewitness reports of the mechanism of injury, the care rendered for 3 hours prior to the emergency craniotomy, the clinical course, and, ultimately, the autopsy.” The discussion of autopsy findings is supplemented by an artist’s depiction of the extent of Senator Kennedy’s head injury.
Researchers investigated risk factors for the development of opioid dependence in patients undergoing surgery for degenerative spondylolisthesis (DS). They found that, overall, patients were more likely to have a dependency on opioid medications before surgery than afterward.
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