Journal of neurosurgery
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Journal of neurosurgery · Apr 2023
Effect of embolization before stereotactic radiosurgery for brain arteriovenous malformations: a case-control study with propensity score matching.
The aim of this study was to evaluate whether endovascular embolization prior to stereotactic radiosurgery (SRS) has a negative impact on nidus obliteration for patients with arteriovenous malformations (AVMs). ⋯ Pre-SRS embolization did not affect nidus obliteration rates, cumulative hemorrhage rates, or the incidence of cyst formation or chronic encapsulated hematoma as late adverse radiation effects in patients with AVM treated with SRS.
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Journal of neurosurgery · Apr 2023
Automated detection and analysis of subdural hematomas using a machine learning algorithm.
Machine learning algorithms have shown groundbreaking results in neuroimaging. Herein, the authors evaluate the performance of a newly developed convolutional neural network (CNN) to detect and quantify the thickness, volume, and midline shift (MLS) of subdural hematoma (SDH) from noncontrast head CT (NCHCT). ⋯ The described Viz.ai SDH CNN performed exceptionally well at identifying and quantifying key features of SDHs in an independent validation imaging data set.
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Journal of neurosurgery · Apr 2023
Observational StudyNeurotrauma: a burgeoning, yet understudied disease of rural areas in developing countries.
There is a paucity of data-driven reports on neurotrauma from the rural areas of developing countries, despite a disproportionally higher and burgeoning disease burden from those areas. This study aims to define the burden of neurotrauma in a new rural neurosurgical practice of a developing sub-Saharan country in Africa (Nigeria). ⋯ Neurotrauma, mostly caused by motorcycle crashes and other road accidents, accounts for the bulk of the neurosurgical workload in this rural neurosurgical center. Although late presentation and delayed surgical interventions were prominent features of this level of care, the in-hospital outcome was fortuitously good in the majority of patients.
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Journal of neurosurgery · Apr 2023
Localizing seizure onset zones in surgical epilepsy with neurostimulation deep learning.
In drug-resistant temporal lobe epilepsy, automated tools for seizure onset zone (SOZ) localization that use brief interictal recordings could supplement presurgical evaluations and improve care. Thus, the authors sought to localize SOZs by training a multichannel convolutional neural network on stereoelectroencephalography (SEEG) cortico-cortical evoked potentials. ⋯ This was the first demonstration, to the authors' knowledge, that a deep learning framework can be used to accurately classify SOZs with single-pulse electrical stimulation-evoked responses. These findings suggest that accurate classification of SOZs relies on a complex temporal evolution of evoked responses within 350 msec of stimulation. Validation in a larger data set could provide a practical clinical tool for the presurgical evaluation of drug-resistant epilepsy.
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Journal of neurosurgery · Apr 2023
Microsurgical clipping and endovascular management of unruptured anterior circulation aneurysms: how age, frailty, and comorbidity indexes influence outcomes.
Frailty is one of the important factors in predicting the outcomes of surgery. Many surgical specialties have adopted a frailty assessment in the preoperative period for prognostication; however, there are limited data on the effects of frailty on the outcomes of cerebral aneurysms. The object of this study was to find the effect of frailty on the surgical outcomes of anterior circulation unruptured intracranial aneurysms (UIAs) and compare the frailty index with other comorbidity indexes. ⋯ Frailty affects surgical outcomes significantly and outperforms age and other comorbidity indexes in predicting outcome. It is imperative to include frailty assessment in preoperative planning.