Journal of neurosurgery
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Journal of neurosurgery · Jan 2021
For the further training of individuals in neurosurgery II: the academic legacy of the William P. Van Wagenen Fellowship.
William P. Van Wagenen pursued a research fellowship in Europe early in his career under the recommendation of Harvey Cushing. Later, Van Wagenen would be instrumental in the establishment of the William P. Van Wagenen Fellowship, a postgraduate fellowship for neurosurgeons from the AANS that requires study outside of a fellow's country of residency training with plans to return to academic practice. ⋯ The Van Wagenen Fellowship will continue to provide young neurosurgeons with opportunities to pursue novel research and network with peers internationally and to motivate young neurosurgeons to transform neurosurgery. The legacy of Cushing and Van Wagenen continues today through the Van Wagenen Fellowship, a legacy that will only continue to grow.
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Journal of neurosurgery · Jan 2021
Outcomes of stereotactic radiosurgery for pilocytic astrocytoma: an international multiinstitutional study.
The current standard initial therapy for pilocytic astrocytoma is maximal safe resection. Radiation therapy is considered for residual, recurrent, or unresectable pilocytic astrocytomas. However, the optimal radiation strategy has not yet been established. Here, the authors describe the outcomes of stereotactic radiosurgery (SRS) for pilocytic astrocytoma in a large multiinstitutional cohort. ⋯ This represents the largest study of single-session GKRS for pilocytic astrocytoma to date. Favorable long-term PFS and overall survival were observed with GKRS. Further prospective studies should be performed to evaluate appropriate radiosurgery dosing, timing, and sequencing of treatment along with their impact on toxicity and the quality of life of patients with pilocytic astrocytoma.
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Journal of neurosurgery · Jan 2021
Deep brain stimulation in the caudal zona incerta in patients with essential tremor: effects on cognition 1 year after surgery.
The ventral intermediate nucleus (VIM) of the thalamus is currently the established target in the use of deep brain stimulation (DBS) to treat essential tremor (ET). In recent years, the caudal zona incerta (cZi), a brain target commonly used during the lesional era, has been revived as the primary target in a number of DBS studies that show evidence of the efficacy of cZi targeting in DBS treatment for controlling the symptoms of ET. The authors sought to obtain comprehensive neuropsychological data and thoroughly investigate the cognitive effects of cZi targeting in patients with ET treated with DBS. ⋯ This study indicates that the cZi is a safe target from a cognitive perspective in the treatment of ET with DBS.
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Journal of neurosurgery · Jan 2021
Case ReportsMasson's tumor presenting as a left frontal intraparenchymal hemorrhage resulting in severe expressive aphasia during pregnancy: case report.
Intravascular papillary endothelial hyperplasia (IPEH), commonly known as Masson's tumor, is a benign lesion that manifests as an excessive proliferation of endothelial cells within a vessel wall. IPEH is extremely rare in the brain, with only 36 intracranial cases previously described in the literature. It is commonly mistaken for more malignant pathologies, such as angiosarcoma. ⋯ The patient underwent a left frontoparietal craniotomy for hematoma evacuation and gross-total resection (GTR) of an underlying hemorrhagic mass at 29 weeks' gestation. This case illustrates the importance of multidisciplinary patient care and the feasibility of intervention in the early third trimester with subsequent term delivery. While GTR of IPEH is typically curative, the decision to proceed with surgical treatment of any intracranial lesion in pregnancy must balance maternal stability, gestational age, and suspected pathology.
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Journal of neurosurgery · Jan 2021
Using postoperative remodeling of donor arteries on MR angiography to predict the development of surgical collaterals in moyamoya disease.
The calibers of donor arteries can change dynamically after bypass surgery in patients with moyamoya disease (MMD). The present study aimed to evaluate the cutoffs of caliber changes in donor arteries associated with good surgical revascularization and to assess the impact of clinical factors potentially related to bypass development. ⋯ Caliber changes in STAs and DTAs can be easily measured using MRA, and they could be indicators of direct and indirect bypass development. The dual development of a direct and indirect bypass was most frequently observed in the context of a combined bypass procedure in both adults and children with MMD.