Angela M. Bohnen

Unruptured intracranial aneurysms: risk factors and their interactions.

thors use a few exemplar tasks, taking the reader through the model’s functioning. For instance, during the A3 working memory task, Spaun is required to store a sequence of symbolic images into a visually based firing pattern, and then use the subcortical network (including the striatum to produce decoded possible actions, and the GPi for action selection) to reproduce the stored memory images. Raster plots of the network activity are shown in the Figure. The authors demonstrate similar results with all eight tasks explored with Spaun. Novel aspects of this modeling effort include the ability to solve different classes of tasks with a coordinated set of neural substrates in a fashion that can be used to form testable hypotheses. The solution for the rapid variable creation task (A6, above) implemented by Spaun, for instance, is novel and may very well differ in a measurable fashion from the human analog. In summary, Eliasmith et al have developed a computational spiking neuron model of the brain capable of supporting a series of cognitive tasks incorporating sensory inputs and motor outputs. The power of this effort, and in similar brain modeling studies, lies in the ability of the model to summarize known electrophysiology and cognitive behavior and then compare this behavior with experiment. Similar models incorporating pathologies of connectivity or abnormal neuronal firing would be very useful for designing functional neurostimulation therapies or provide clues for therapeutic targets.

The Role of Minimally Invasive Techniques in Scoliosis Correction Surgery

Objective Recently, minimally invasive surgery (MIS) has been included among the treatment modalities for scoliosis. However, literature comparing MIS to open surgery for scoliosis correction is limited. The objective of this study was to compare outcomes for scoliosis correction patients undergoing MIS versus open approach. Methods We retrospectively collected data on demographics, procedure characteristics, and outcomes for 207 consecutive scoliosis correction surgeries at our institution between 2009 and 2015. Results MIS patients had lower number of levels fused (p < 0.0001), shorter surgeries (p = 0.0023), and shorter overall lengths of stay (p < 0.0001), were less likely to be admitted to the ICU (p < 0.0001), and had shorter ICU stays (p = 0.0015). On multivariable regression, number of levels fused predicted selection for MIS procedure (p = 0.004), and multiple other variables showed trends toward significance. Age predicted ICU admission and VTE. BMI predicted any VTE, and DVT specifically. Comorbid disease burden predicted readmission, need for transfusion, and ICU admission. Number of levels fused predicted prolonged surgery, need for transfusion, and ICU admission. Conclusions Patients undergoing MIS correction had shorter surgeries, shorter lengths of stay, and shorter and fewer ICU stays, but there was a significant selection effect. Accounting for other variables, MIS did not independently predict any of the outcomes.

Neurosurgery concepts: Key perspectives on imaging characteristics of spinal metastases, surgery for low back pain, anesthesia for disc surgery, and laminectomy versus laminectomy and fusion for lumbar spondylolisthesis.

Department of Neurosurgery, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, 1Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States, 2Department of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea, 3Department of Neurosurgery, Beaumont Hospital, Grosse Pointe, MI, 4Department of Neurosurgery, Baylor College of Medicine, 5Texas Children’s Hospital, Houston, Texas, 6Department of Neurological Surgery, Loyola University Chicago, Stritch School of Medicine, Illinois, 7Department of Neurosurgery, University of California, San Diego School of Medicine, San Diego, California, United States, 8Department of Neurosurgery, Seoul National University College of Medicine and Bundang Hospital, Seongnam, Korea, 9Department of Neurosurgery, Stanford School of Medicine, Stanford, California, 10Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, 11Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington DC, 12Seton Brain and Spine Institute Neurosurgery, Kyle, Texas, 13Department of Neurosurgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States

Key perspectives on stenting of symptomatic vertebral artery stenosis, resident involvement in neurosurgery, antithrombotic therapy following sellar and parasellar tumor resection, and radiosurgery for vestibular schwannomas.

The objective of this study was to assess the safety and feasibility of stenting plus best medical treatment compared with best medical treatment alone in patients with symptomatic atherosclerotic vertebrobasilar artery stenosis of at least 50%. The patient population comprised patients from seven hospitals in the Netherlands from 2008 to 2013. Key inclusion criteria were a vertebrobasilar transient ischemic attack (TIA) or ischemic stroke in previous 6 months and intra‐ or extra‐cranial atherosclerotic vertebrobasilar artery stenosis of >50%. Primary outcomes included vascular death, myocardial infarction (MI), and ischemic stroke within 30 days. The study was a 1:1 randomization to stenting plus best medical treatment or best medical treatment alone. The outcomes were assessed by a blinded endpoint committee, but neither patients nor investigators were blinded. The stent used was at the discretion of the interventionalist, and if stent placement was not feasible, percutaneous transluminal angioplasty (PTA) alone was performed. Best medical therapy was at the discretion of treating neurologist.

Key perspectives on the learning curve of pedicle screw placement, stereotactic radiosurgery for brain metastases, growth of incidentally found meningiomas, and the Barrow Ruptured Aneurysm Trial

PSs placed by a spinal surgical fellow (SSF) without prior experience under Attending Spinal Consultant (ASC) supervision from two tertiary spinal centers in Australia were investigated. All patients had postoperative radiographic studies, X-ray (XR) and/or computed tomography (CT), which were graded by two blinded and independent observers. Screws were graded as “acceptable” (contained within the pedicle or <30% screw diameter breach of the pedicle or vertebral body) and “misplaced” (>30% screw diameter outside the pedicle/vertebral body). For XR, this was denoted as XR1 and XR2, respectively. The same was used for CT; however, CT1 was subdivided Key perspectives on the learning curve of pedicle screw placement, stereotactic radiosurgery for brain metastases, growth of incidentally found meningiomas, and the Barrow Ruptured Aneurysm Trial

Neurosurgery concepts: Key perspectives on deferoxamine and chronic hydrocephalus from intraventricular hemorrhage, laboratory dissection training in neurosurgical residency, tetanus toxoid and dendritic cell vaccines for glioblastoma, and intracranial hypertension after surgery for craniosynostosis

To explore the putative role and mechanism by which iron may mediate PHCH resultant from intraventricular hemorrhage (IVH), the authors utilized a PHCH animal model comprising rats receiving intraventricular injections of blood (IVH) or iron (Fe) either alone or in combination with DFX, an iron chelator shown to be neuroprotective in intracerebral hemorrhage. Intraventricular injections of saline were used as controls. Blood and iron injections increased rates of hydrocephalus significantly at 1 (80% and 60%) and 4 (80% and 70%) weeks compared to saline controls, which did not produce any hydrocephalus. Treatment with DFX drastically decreased rates of hydrocephalus down to 20% and 10% when given alongside IVH or Fe, respectively. DFX treatment additionally significantly decreased the severity of hydrocephalus following IVH and Fe injections. DFX treatment significant decreases in CSF iron and brain ferritin levels following blood and iron injections thereby decreases frequency and severity of hydrocephalus following IVH and iron injections. Treatment with DFX decreased elevated Wnt1/Wnt3a messenger RNA and protein levels induced by IVH. Finally, treatment with This article may be cited as: Choy W, Bohnen AM, Pelargos P, Lam S, Yang I, Smith ZA. Neurosurgery concepts: Key perspectives on deferoxamine and chronic hydrocephalus from intraventricular hemorrhage, laboratory dissection training in neurosurgical residency, tetanus toxoid and dendritic cell vaccines for glioblastoma, and intracranial hypertension after surgery for craniosynostosis. Surg Neurol Int 2015;6:139. http://surgicalneurologyint.com/Neurosurgery-concepts:-Key-perspectives-on-deferoxamine-and-chronic-hydrocephalus-from-intraventricular-hemorrhage,-laboratorydissection-training-in-neurosurgical-residency,-tetanus-toxoid-and-dendritic-cell-vaccines-for-glioblastoma,-and-intracranial-hypertension-after-surgery-for-craniosynostosis/