Journal of neurosurgery
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Journal of neurosurgery · Dec 2024
Factors influencing disparities in epilepsy surgery: analysis of the National Inpatient Sample and Kids' Inpatient Database.
Despite the proven efficacy of surgical intervention for achieving seizure freedom and improved quality of life for many epilepsy patients, this treatment remains underutilized. In this study, the authors assessed sociodemographic trends in epilepsy surgery in the National Inpatient Sample (NIS) and the Kids' Inpatient Database (KID) and sought to determine whether disparities in surgical intervention for epilepsy may be attributed to insurance and comorbidity status. ⋯ This study demonstrates that marginalized patients and those with Medicaid had decreased odds of neurosurgical intervention for epilepsy. Results of this research support the need for increased attention toward epilepsy patients from marginalized groups. Further investigation into the root cause of socioeconomic inequities in epilepsy surgery is necessary.
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Journal of neurosurgery · Dec 2024
Surgical treatment of brain arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia: a single-center experience.
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal-dominant disorder characterized by multiple vascular malformations. Brain arteriovenous malformations (bAVMs) are a significant manifestation of HHT. The surgical management of these lesions in patients with HHT remains debated, with limited literature on postoperative outcomes. The goal of this study was to evaluate the safety and efficacy of surgical treatment for bAVMs in patients with HHT and propose a treatment rationale based on a single-center experience. ⋯ In this most extensive surgical series published to date, resection of bAVMs in patients with HHT showed favorable outcomes with a low complication rate, suggesting that the benefits of surgery outweigh the risks, especially considering the potential cumulative lifetime risk of hemorrhage. MR arterial spin labeling was found to be the most sensitive noninvasive measure of detecting bAVMs in patients with HHT.
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Journal of neurosurgery · Dec 2024
Characteristics of radiation-induced brain tumors: case series and systematic review.
Radiation therapy (RT) improves the outcome of patients with cancer but introduces the risk of radiation-induced neoplasms in cancer survivors. The most common radiation-induced brain tumors (RIBTs) are gliomas (RIGs), meningiomas (RIMs), and sarcomas (RISs). To investigate the characteristics of these RIBTs, the authors conducted a comprehensive review and analysis of their case series and relevant cases from the literature. ⋯ The prognosis was poor and worse for patients with RIGs and RISs than for those with RIMs, and patients with RIBTs who underwent higher-dose irradiation for primary disease had poor prognoses. Because RIBTs develop more than a decade after cranial irradiation, long-term follow-up is crucial.
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Journal of neurosurgery · Dec 2024
Initial United States experience with Medtronic Stealth Autoguide cranial robotic guidance platform.
Stereotactic techniques play an important role in neurosurgery. The development of a miniaturized cranial robot with an efficient workflow and accurate surgical execution is an important step in a broader application of these techniques. Herein, the authors describe their experience with the Medtronic Stealth Autoguide miniaturized cranial robot. ⋯ The Medtronic Stealth Autoguide robot system is versatile across biopsy, SEEG, and laser ablation indications. Setup and surgical execution are efficient with a high degree of accuracy and consistency.