المؤلفون: Kilgore, Collin B., So, Raymond J., Storm, Kaitlyn, Nair, Sumil K., Ran, Kathleen R., Kalluri, Anita L., Lim, Michael, Huang, Judy, Bettegowda, Chetan, Xu, Risheng

المصدر: World Neurosurgery ; volume 173, page e431-e435 ; ISSN 1878-8750

مصطلحات موضوعية: Neurology (clinical), Surgery

الإتاحة: https://doi.org/10.1016/j.wneu.2023.02.074Test
https://api.elsevier.com/content/article/PII:S1878875023002231?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1878875023002231?httpAccept=text/plainTest

المؤلفون: Douville, Christopher, Curtis, Samuel, Summers, Mahmoud, Azad, Tej D., Rincon-Torroella, Jordina, Wang, Yuxuan, Mattox, Austin, Avigdor, Bracha, Dudley, Jonathan, Materi, Joshua, Raj, Divyaansh, Nair, Sumil, Bhanja, Debarati, Tuohy, Kyle, Dobbyn, Lisa, Popoli, Maria, Ptak, Janine, Nehme, Nadine, Silliman, Natalie, Blair, Cherie, Judge, Kathy, Gallia, Gary L., Groves, Mari, Jackson, Christopher M., Jackson, Eric M., Laterra, John, Lim, Michael, Mukherjee, Debraj, Weingart, Jon, Naidoo, Jarushka, Koschmann, Carl, Smith, Natalya, Schreck, Karisa C., Pardo, Carlos A., Glantz, Michael, Holdhoff, Matthias, Kinzler, Kenneth W., Papadopoulos, Nickolas, Vogelstein, Bert, Bettegowda, Chetan

المصدر: Cell Reports Medicine ; volume 4, issue 8, page 101148 ; ISSN 2666-3791

مصطلحات موضوعية: General Biochemistry, Genetics and Molecular Biology

الإتاحة: https://doi.org/10.1016/j.xcrm.2023.101148Test
https://api.elsevier.com/content/article/PII:S2666379123003014?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2666379123003014?httpAccept=text/plainTest

المؤلفون: Nair, Sumil K.¹ (AUTHOR), Oh, Hyun Jong¹ (AUTHOR), Kalluri, Anita¹ (AUTHOR), Ejimogu, Nna-Emeka¹ (AUTHOR), Al-Khars, Hussain¹ (AUTHOR), Abdulrahim, Mostafa¹ (AUTHOR), Xia, Yuanxuan¹ (AUTHOR), Yedavalli, Vivek² (AUTHOR), Jackson, Christopher M.¹ (AUTHOR), Huang, Judy¹ (AUTHOR), Lim, Michael³ (AUTHOR), Bettegowda, Chetan¹ (AUTHOR), Xu, Risheng¹ (AUTHOR) rxu4@jhmi.edu

المصدر: Neurosurgical Review. 6/22/2024, Vol. 47 Issue 1, p1-6. 6p.

مصطلحات موضوعية: *RHIZOTOMY, *STEREOTACTIC radiosurgery, *SURGICAL complications, *GLYCERIN, *LOGISTIC regression analysis, *PAIN management, *TRIGEMINAL neuralgia, *NEURALGIA

مستخلص: Background: Both stereotactic radiosurgery (SRS) and percutaneous glycerol rhizotomy are excellent options to treat TN in patients unable to proceed with microvascular decompression. However, the influence of prior SRS on pain outcomes following rhizotomy is not well understood. Methods: We retrospectively reviewed all patients undergoing percutaneous rhizotomy at our institution from 2011 to 2022. Only patients undergoing percutaneous glycerol rhizotomy following SRS (SRS-rhizotomy) or those undergoing primary glycerol rhizotomy were considered. We collected basic demographic, clinical, and pain characteristics for each patient. Additionally, we characterized pain presentation and perioperative complications. Immediate failure of procedure was defined as presence of TN pain symptoms within 1-week of surgery, and short-term failure was defined as presence of TN pain symptoms within 3-months of surgery. A multivariate logistic regression model was used to evaluate the relationship of a history SRS and failure of procedure following percutaneous glycerol rhizotomy. Results: Of all patients reviewed, 30 had a history of SRS prior to glycerol rhizotomy whereas 371 underwent primary percutaneous glycerol rhizotomy. Patients with a history of SRS were more likely to endorse V3 pain symptoms, p = 0.01. Additionally, patients with a history of SRS demonstrated higher preoperative BNI pain scores, p = 0.01. Patients with a history of SRS were more likely to endorse preoperative numbness, p < 0.0001. A history of SRS was independently associated with immediate failure [OR = 5.44 (2.06–13.8), p < 0.001] and short-term failure of glycerol rhizotomy [OR = 2.41 (1.07–5.53), p = 0.03]. Additionally, increasing age was found to be associated with lower odds of short-term failure of glycerol rhizotomy [OR = 0.98 (0.97-1.00), p = 0.01] Conclusions: A history of SRS may increase the risk of immediate and short-term failure following percutaneous glycerol rhizotomy. These results may be of use to patients who are poor surgical candidates and require multiple noninvasive/minimally invasive options to effectively manage their pain. [ABSTRACT FROM AUTHOR]

المؤلفون: Parker, Megan, Kazemi, Foad, Ahmed, A. Karim, Kuo, Cathleen C., Nair, Sumil K., Rincon-Torroella, Jordina, Jackson, Christopher, Gallia, Gary, Bettegowda, Chetan, Weingart, Jon, Brem, Henry, Mukherjee, Debraj

المصدر: Journal of Neuro-Oncology; Jun2024, Vol. 168 Issue 2, p345-353, 9p

مستخلص: Purpose: There is limited literature describing care coordination for patients with glioblastoma (GBM). We aimed to investigate the impact of primary care and electronic health information exchange (HIE) between neurosurgeons, oncologists, and primary care providers (PCP) on GBM treatment patterns, postoperative outcomes, and survival. Methods: We identified adult GBM patients undergoing primary resection at our institution (2007–2020). HIE was defined as shared electronic medical information between PCPs, oncologists, and neurosurgeons. Multivariate logistic regression analyses were used to determine the effect of PCPs and HIE upon initiation and completion of adjuvant therapy. Kaplan-Meier and multivariate Cox regression models were used to evaluate overall survival (OS). Results: Among 374 patients (mean age ± SD: 57.7 ± 13.5, 39.0% female), 81.0% had a PCP and 62.4% had electronic HIE. In multivariate analyses, having a PCP was associated with initiation (OR: 7.9, P < 0.001) and completion (OR: 4.4, P < 0.001) of 6 weeks of concomitant chemoradiation, as well as initiation (OR: 4.0, P < 0.001) and completion (OR: 3.0, P = 0.007) of 6 cycles of maintenance temozolomide thereafter. Having a PCP (median OS [95%CI]: 14.6[13.1–16.1] vs. 10.8[8.2–13.3] months, P = 0.005) and HIE (15.40[12.82–17.98] vs. 13.80[12.51–15.09] months, P = 0.029) were associated with improved OS relative to counterparts in Kaplan-Meier analysis and in multivariate Cox regression analysis (hazard ratio [HR] = 0.7, [95% CI] 0.5-1.0, P = 0.048). In multivariate analyses, chemoradiation (HR = 0.34, [95% CI] 0.2–0.7, P = 0.002) and maintenance temozolomide (HR = 0.5, 95%CI 0.3–0.8, P = 0.002) were associated with improved OS relative to counterparts. Conclusion: Effective care coordination between neurosurgeons, oncologists, and PCPs may offer a modifiable avenue to improve GBM outcomes. [ABSTRACT FROM AUTHOR]

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المؤلفون: Nair, Sumil K., Al-Khars, Hussain, Kalluri, Anita, Ran, Kathleen, Kilgore, Collin, Budihal, Bhargavi R., Abdulrahim, Mostafa, Yedavalli, Vivek, Jackson, Christopher M., Huang, Judy, Lim, Michael, Bettegowda, Chetan, Xu, Risheng

المصدر: Neurosurgery; May2024, Vol. 94 Issue 5, p1072-1078, 7p

المؤلفون: Xie, Michael E, Halbert-Elliott, Kyra, Nair, Sumil K, Huang, Judy, Yedavalli, Vivek S, Bettegowda, Chetan, Xu, Risheng

المصدر: World Neurosurg ; ISSN:1878-8769 ; Volume:181

مصطلحات موضوعية: Microvascular decompression, Neuroradiology, Neurovascular Compression, Reconstruction, Trigeminal Neuralgia

الوصف: High-resolution magnetic resonance imaging (MRI) of the trigeminal nerve is indispensable for workup of trigeminal neuralgia (TN) before microvascular decompression; however, the evaluation is often subjective and prone to variability. We aim to develop and assess sequential thresholding-based automated reconstruction of the trigeminal nerve (STAR-TN) as an algorithm for segmenting the trigeminal nerve and contacting structures that will allow for a structured method for assessing neurovascular conflict.

العلاقة: https://doi.org/10.1016/j.wneu.2023.10.095Test; https://pubmed.ncbi.nlm.nih.gov/37890771Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055639Test/

الإتاحة: https://doi.org/10.1016/j.wneu.2023.10.095Test
https://pubmed.ncbi.nlm.nih.gov/37890771Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055639Test/

المؤلفون: Ran, Kathleen R., Nair, Sumil K., Srinivas, Tara, Xie, Michael E., Kilgore, Collin B., Ye, Xiaobu, Yedavalli, Vivek S., Sun, Lisa R., Jackson, Christopher M., Caplan, Justin M., Gonzalez, L. Fernando, Tamargo, Rafael J., Huang, Judy, Xu, Risheng

المصدر: Journal of Neurosurgical Anesthesiology ; ISSN 0898-4921

الوصف: Background: Postoperative stroke is a potentially devastating neurological complication following surgical revascularization for Moyamoya disease. We sought to evaluate whether peri-operative hemoglobin levels were associated with the risk of early post-operative stroke following revascularization surgery in adult Moyamoya patients. Methods: Adult patients having revascularization surgeries for Moyamoya disease between 1999-2022 were identified through single institutional retrospective review. Logistic regression analysis was used to test for the association between hemoglobin drop and early postoperative stroke. Results: In all, 106 revascularization surgeries were included in the study. A stroke occurred within 7 days after surgery in 9.4% of cases. There were no significant associations between the occurrence of an early postoperative stroke and patient age, gender, or race. Mean postoperative hemoglobin drop was greater in patients who suffered an early postoperative stroke compared with patients who did not (2.3±1.1 g/dL vs. 1.3±1.1 g/dL, respectively; P =0.034). Patients who experienced a hemoglobin drop post-operatively had 2.03 times greater odds (95% confidence interval, 1.06-4.23; P =0.040) of having a stroke than those whose hemoglobin levels were stable. Early postoperative stroke was also associated with an increase in length of hospital stay ( P <0.001), discharge to a rehabilitation facility ( P =0.014), and worse modified Rankin scale at 1 month ( P =0.001). Conclusion: This study found a significant association between hemoglobin drop and early postoperative stroke following revascularization surgery in adult patients with Moyamoya disease. Based on our findings, it may be prudent to avoid hemoglobin drops in Moyamoya patients undergoing surgical revascularization.

الإتاحة: https://doi.org/10.1097/ana.0000000000000972Test

المؤلفون: Nair, Sumil, Xie, Michael, Ran, Kathleen Renee, Kilgore, Collin, Kalluri, Anita, Huang, Judy, Lim, Michael, Bettegowda, Chetan, Xu, Risheng

المصدر: Neurosurgery ; volume 70, issue Supplement_1, page 104-105 ; ISSN 0148-396X 1524-4040

الوصف: INTRODUCTION: In most cases of trigeminal neuralgia (TN), the trigeminal nerve is compressed by the arterial vasculature. METHODS: We retrospectively reviewed all patients undergoing microvascular decompression at our institution, identifying patients with either sole arterial or venous compression. We dichotomized patients into arterial or venous groups and obtained demographics and postoperative complications for each case. Barrow Neurological Index (BNI) pain scores were collected preoperatively, postoperatively, and at final follow-up, as well as recurrence of pain. Differences were calculated via Chi-squared tests and t-tests. Ordinal regression was used to account for variables known to influence TN pain. Kaplan-Meier analysis was used to determine recurrence-free survival. RESULTS: Of 1044 patients, 642 (61.7%) had either sole arterial or venous compression. 472 of these cases demonstrated arterial compression, and 170 displayed sole venous compression. Patients in the venous compression group were significantly younger (p < 0.001). Patients with sole venous compression demonstrated worse preoperative (p = 0.04) and final follow-up (p < 0.001) pain scores. Patients with sole venous compression had significantly higher rate of pain recurrence (p = 0.02) and BNI score at pain recurrence (p = 0.04). On ordinal regression, venous compression was found to independently predict worse BNI pain scores (OR = 1.66, p = 0.003). Kaplan-Meier analysis demonstrated a significant relationship between sole venous compression and increased risk of pain recurrence (p = 0.03). CONCLUSIONS: TN patients with sole venous compression demonstrate worse pain outcomes following MVD compared to those with only arterial compression.

الإتاحة: https://doi.org/10.1227/neu.0000000000002809_352Test

المؤلفون: Kalluri, Anita L., Ejimogu, Emeka, Kilgore, Collin, Nair, Sumil K., Ran, Kathleen R., Abdulrahim, Mostafa, Xie, Michael E., Halbert-Elliott, Kyra, Yedavalli, Vivek, Lim, Michael, Jackson, Christopher M., Huang, Judy, Bettegowda, Chetan, Xu, Risheng

المصدر: Neurosurgery ; ISSN 0148-396X 1524-4040

الوصف: BACKGROUND AND OBJECTIVES: The prescription of opioid analgesics for trigeminal neuralgia (TN) is controversial, and their effect on postoperative outcomes for patients with TN undergoing microvascular decompression (MVD) has not been reported. We aimed to describe the relationship between preoperative opioid use and postoperative outcomes in patients with TN undergoing MVD. METHODS: We reviewed the records of 920 patients with TN at our institution who underwent an MVD between 2007 and 2020. Patients were sorted into 2 groups based on preoperative opioid usage. Demographic information, comorbidities, characteristics of TN, preoperative medications, pain and numbness outcomes, and recurrence data were recorded and compared between groups. Multivariate ordinal regression, Kaplan–Meier survival analysis, and Cox proportional hazards were used to assess differences in pain outcomes between groups. RESULTS: One hundred and forty-five (15.8%) patients in this study used opioids preoperatively. Patients who used opioids preoperatively were younger ( P = .04), were more likely to have a smoking history ( P < .001), experienced greater pain in modified Barrow Neurological Institute pain score at final follow-up ( P = .001), and were more likely to experience pain recurrence ( P = .01). In addition, patients who used opioids preoperatively were more likely to also have been prescribed TN medications including muscle relaxants and antidepressants preoperatively ( P < .001 and P < .001, respectively). On multivariate regression, opioid use was an independent risk factor for greater postoperative pain at final follow-up ( P = .006) after controlling for variables including female sex and age. Opioid use was associated with shorter time to pain recurrence on Kaplan–Meier analysis ( P = .005) and was associated with increased risk for recurrence on Cox proportional hazards regression ( P = .008). CONCLUSION: Preoperative opioid use in the setting of TN is associated with worse pain outcomes and increased risk for ...

الإتاحة: https://doi.org/10.1227/neu.0000000000002904Test

المؤلفون: Hung, Alice, Ejimogu, Emeka, Ran, Kathleen, Nair, Sumil, Yang, Wuyang, Lee, Ryan, Yedavalli, Vivek, Hillis, Argye, Gailloud, Philippe, Caplan, Justin, Gonzalez, Fernando, Xu, Risheng

المصدر: World Neurosurgery ; ISSN 1878-8750

مصطلحات موضوعية: Neurology (clinical), Surgery

الإتاحة: https://doi.org/10.1016/j.wneu.2024.03.102Test
https://api.elsevier.com/content/article/PII:S187887502400487X?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S187887502400487X?httpAccept=text/plainTest