Journal of neurosurgery
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Journal of neurosurgery · Jan 2024
Multicenter Study Observational StudyComputational fluid dynamics for predicting the growth of small unruptured cerebral aneurysms.
Larger cerebral aneurysms are more likely to enlarge, but even small aneurysms can grow. The aim of this study was to investigate the hemodynamic characteristics regarding the growth of small aneurysms using computational fluid dynamics (CFD). ⋯ HSCR may be a useful hemodynamic parameter to predict the growth of small unruptured cerebral aneurysms.
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Journal of neurosurgery · Jan 2024
Factors influencing geographic gender disparity in neurosurgery: a nationwide geospatial clustering analysis.
Women neurosurgeons (WNs) continue to remain a minority in the specialty despite significant initiatives to increase their representation. One domain less explored is the regional distribution of WNs, facilitated by the hiring practices of neurosurgical departments across the US. In this analysis, the authors coupled the stated practice location of WNs with regional geospatial data to identify hot spots and cold spots of prevalence and examined regional predictors of increases and decreases in WNs over time. ⋯ The authors analyzed the prevalence of WNs by using aggregated data from the NPPES and US Census Bureau. The authors also show regional hot spots of WNs and that the establishment of WNs in a region is a predictor of additional WNs entering the region. These data suggest that female neurosurgical mentorship and representation may be a major driver of acceptance and further gender diversity in a given region.
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Journal of neurosurgery · Jan 2024
Novel treatment of intracerebral hemorrhage with mechanical tissue resuscitation.
The previous laboratory and clinical experience of the authors had demonstrated that application of controlled subatmospheric pressure directly to injured soft tissue can result in increased survival of compromised tissues. Mechanical tissue resuscitation (MTR) is a new concept evolving from these discoveries. The authors' recent studies have demonstrated that traumatic brain injury tissue can also be salvaged. The aim of this study was to examine the effects of MTR application to injuries from intracerebral hemorrhages (ICHs) in a swine model. ⋯ This study demonstrates that local continuous application of controlled subatmospheric pressure to an ICH can safely remove more than half of a clot in 1 week and more than 90% in 2 weeks.
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Journal of neurosurgery · Jan 2024
ReviewComputational modeling of whole-brain dynamics: a review of neurosurgical applications.
A major goal of modern neurosurgery is the personalization of treatment to optimize or predict individual outcomes. One strategy in this regard has been to create whole-brain models of individual patients. Whole-brain modeling is a subfield of computational neuroscience that focuses on simulations of large-scale neural activity patterns across distributed brain networks. ⋯ The resulting personalized whole-brain models have translational potential in neurosurgery, allowing investigators to simulate the effects of virtual therapies (such as resections or brain stimulations), assess the effect of brain pathology on network dynamics, or discern epileptic networks and predict seizure propagation in silico. The information gained from these simulations can be used as clinical decision support, guiding patient-specific treatment plans. Here the authors provide an overview of the rapidly advancing field of whole-brain modeling and review the literature on neurosurgical applications of this technology.
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Journal of neurosurgery · Jan 2024
Multicenter StudyTiming of microsurgical resection for ruptured brain arteriovenous malformations: a propensity score-matched analysis using prospective single-center registry data.
The optimal microsurgical timing in ruptured brain arteriovenous malformations (AVMs) is not well understood and is surrounded by controversy. This study aimed to elucidate the impacts of microsurgical resection timing on clinical outcomes. ⋯ Early and delayed resection of ruptured AVMs had similar long-term neurological outcomes. Delayed resection can lead to a higher complete obliteration rate, although the risk of rerupture during the resection waiting period should be vigilantly monitored.