Journal of neurosurgery
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Journal of neurosurgery · Mar 2022
Seventy-five years of neurosurgery residency training at The Mount Sinai Hospital.
The Department of Neurosurgery's residency program at The Mount Sinai Hospital was founded in 1946. The department has its origins in 1914 as a division of general surgery, with Charles Elsberg at the helm. Neurosurgery then became a separate department in 1932 under the leadership of Ira Cohen. ⋯ Since its inception, the residency program has graduated 120 residents. For more than 100 years, The Mount Sinai Hospital has been a site of clinical excellence, groundbreaking research, and technological innovation in neurosurgery. Currently, the Department of Neurosurgery has 39 clinical faculty members, performs more than 5300 surgeries and endovascular procedures annually, and is in the top 25 neurosurgical departments for NIH funding.
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Journal of neurosurgery · Mar 2022
Safety and effectiveness of the assessment and treatment of idiopathic normal pressure hydrocephalus in the Adult Hydrocephalus Clinical Research Network.
The aim of this study was to describe the processes and outcomes associated with patients at five sites in the Adult Hydrocephalus Clinical Research Network (AHCRN) who had undergone evaluation and treatment for suspected idiopathic normal pressure hydrocephalus (iNPH) and had 1-year postoperative follow-up. ⋯ Using criteria recommended by the international iNPH guidelines, the authors found that evaluation and treatment of iNPH are safe and effective. Testing with CSF drainage and treatment with shunt surgery are associated with a high rate of sustained improvement and a low rate of complications for iNPH in the 1st year after shunt surgery. Patients who had undergone shunt surgery for iNPH experienced improvement in gait, cognitive function, bladder symptoms, depression, and functional outcome measures. Gait velocity, which is an easily measured, objective, continuous variable, should be used as a standard outcome measure to test a patient's response to CSF drainage and shunt surgery in iNPH.
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Journal of neurosurgery · Mar 2022
Effect of comorbid Parkinson's disease and Parkinson's disease dementia on the course of idiopathic normal pressure hydrocephalus.
The objective of this study was to analyze the effect of concomitant Parkinson's disease (PD) and PD dementia (PD/PDD) on the course of idiopathic normal pressure hydrocephalus (iNPH), especially as related to the outcome of lumboperitoneal shunt (LPS) surgery. ⋯ These results revealed that comorbid PD/PDD deteriorates the clinical course of iNPH and that LPS surgery is recommended regardless of this comorbidity.
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The purpose of this study was to evaluate the clinical outcome in patients with medically refractory epilepsy who had undergone resective or ablative surgery for suspected insulo-opercular epileptogenic foci. ⋯ Surgery for medically refractory epilepsy in insulo-opercular foci is less common and remains a challenge to epilepsy surgery centers. Localization is aided significantly by a careful study of auras and semiology followed by EEG and imaging. The requirement for SEEG is generally high. Satisfactory rates of seizure freedom were achievable independent of the MRI lesional/nonlesional status. Morbidity is higher for insulo-opercular epilepsy surgery compared to other focal epilepsies; hence, the practice and development of minimally invasive strategies for this subgroup of patients undergoing epilepsy surgery is perhaps most important.
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Journal of neurosurgery · Mar 2022
Social determinants of health and the prediction of 90-day mortality among brain tumor patients.
Within the neurosurgical oncology literature, the effect of structural and socioeconomic factors on postoperative outcomes remains unclear. In this study, the authors quantified the effects of social determinant of health (SDOH) disparities on hospital complications, length of stay (LOS), nonroutine discharge, 90-day readmission, and 90-day mortality following brain tumor surgery. ⋯ SDOH disparities independently predicted a prolonged hospital LOS and 90-day mortality in brain tumor patients. Working to address these disparities offers a new avenue through which to reduce patient morbidity and mortality following brain tumor surgery.