Journal of neurosurgery
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Journal of neurosurgery · Oct 2023
History of neurosurgery at Howard University: the nation's only historically black academic institution that practices neurological surgery.
Howard University Hospital has been a pillar for healthcare delivery in the Black community, an underserved sector of Washington, DC, since its founding in 1862. Neurological surgery, one of the many areas of service provided, was established by trailblazer Dr. Clarence Greene Sr., who was appointed the division's first chief in 1949. ⋯ Many patients who may not have received treatment otherwise have been able to receive exemplary neurosurgical care from them. Under their tutelage, numerous African American medical students have gone on to train in neurological surgery. Future directions include developing a residency program, collaborating with other neurosurgery programs in continental Africa and the Caribbean, and establishing a fellowship for training international students.
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Journal of neurosurgery · Oct 2023
Review Meta AnalysisStroke management and outcomes in low-income and lower-middle-income countries: a meta-analysis of 8535 patients.
Strokes affect almost 13 million new people each year, and whereas the outcomes of stroke have improved over the past several decades in high-income countries, the same cannot be seen in low-income and lower-middle-income countries. This is the first study to identify the availability of diagnostic tools along with the rates of stroke mortality and other poststroke complications in low-income and lower-middle-income countries. ⋯ A severe healthcare disparity is present in low-income and lower-middle-income countries, where there is delayed diagnosis of strokes and increased rates of poor clinical outcomes for these patients.
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Journal of neurosurgery · Oct 2023
Randomized Controlled TrialCryopreserved human umbilical cord as a meningeal patch during in utero spina bifida repair in a modified ovine model.
Despite in utero spina bifida (SB) repair, more than two-thirds of patients with SB are unable to ambulate independently, and 1 in 4 children need surgery for tethered cord by school age. The objective of this study was to test the cryopreserved human umbilical cord (HUC) as an antiscarring material to reduce tethering and improve function in a modified in utero SB repair model. ⋯ In a modified ovine SB model, the HUC as a meningeal patch allows regeneration of the arachnoid layer, prevents spinal cord tethering, and improves spinal cord function after in utero SB repair.
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Journal of neurosurgery · Oct 2023
Multicenter Study Observational StudyEndovascular treatment as first-line therapy in Spetzler-Martin grade III brain arteriovenous malformations: a multicenter retrospective study.
The management of Spetzler-Martin grade (SMG) III brain arteriovenous malformations (bAVMs) may be challenging, whatever the exclusion treatment modality chosen. The purpose of this study was to evaluate the safety and effectiveness of endovascular treatment (EVT) as a first-line treatment of SMG III bAVMs. ⋯ EVT of SMG III bAVMs provides encouraging results but needs further improvement. When the embolization procedure performed with intent to cure appears difficult and/or risky, a combined technique (with microsurgery or radiosurgery) may be a safer and more effective strategy. In terms of safety and effectiveness, the benefit of EVT (alone or included in a multimodal management strategy) for SMG III bAVMs needs to be confirmed by randomized controlled trials.