Journal of neurosurgery
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Journal of neurosurgery · Feb 2025
Academic productivity and career trajectory of international medical graduates in US neurosurgery residency programs.
The objective of this study was to review and compare the research experiences and career outcomes of international medical graduates (IMGs) with those of US medical graduates (USMGs). ⋯ The results indicate that IMGs often exhibit higher academic productivity than USMGs. Although there was no discernible difference in residency program rankings or postresidency fellowships completed, early academic appointments were more prevalent among IMGs.
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Journal of neurosurgery · Feb 2025
Optimizing indirect targeting of the centromedian nucleus for deep brain stimulation by incorporating third ventricular anatomy.
Deep brain stimulation (DBS) of the centromedian nucleus (CM) is used to treat diverse brain diseases including epilepsy, Tourette syndrome, and disorders of consciousness. However, the CM is challenging to visualize on routine MRI. Many surgeons use an indirect targeting method based on established stereotactic coordinates. The authors aimed to quantify how often a DBS electrode's contacts were positioned within the CM using this approach, and to identify alternative indirect coordinates that are more accurate. ⋯ The unavailability of advanced MRI for direct targeting limits access to CM-DBS in resource-constrained neurosurgical programs. Standard indirect coordinates do not provide optimal targeting of the CM, with most contacts laterally placed in the sensory thalamus. The proposed indirect approach may therefore increase the accuracy and availability of CM-DBS, while reducing side effects.
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Journal of neurosurgery · Feb 2025
Meta Analysis Comparative StudyAwake versus asleep deep brain stimulation for Parkinson's disease: a comprehensive systematic review and meta-analysis.
Deep brain stimulation (DBS) has become an effective and safe treatment in patients with Parkinson's disease (PD) not responding to conventional treatments. With the growing body of literature regarding the use of DBS in different movement disorders, there remain controversies regarding performing awake or asleep DBS. This systematic review provides the most comprehensive review of the literature comparing the two techniques from various aspects in detail. ⋯ These findings suggest comparable clinical outcomes between the two DBS approaches. The two methods had their salient differences in terms of lead passes and specific adverse events. The decision to perform awake or asleep DBS should be based on the patient's preference, the surgeon's experience, the availability of advanced intraoperative imaging, and the patient's tolerance for specific adverse events.
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Journal of neurosurgery · Feb 2025
ReviewGenetics and molecular pathophysiology of normal pressure hydrocephalus.
Idiopathic normal pressure hydrocephalus (iNPH) is characterized by dilation of the cerebral ventricles without increased cerebral pressure. Patients typically present with cognitive impairment, gait abnormalities, and urinary incontinence. ⋯ Familial cases and genomic studies of iNPH have recently suggested an underappreciated role of genetics in disease pathogenesis, implicating mechanisms ranging from dysregulated CSF dynamics to underlying neurodegenerative or neuroinflammatory processes. In this paper, the authors provide a brief review of genetic insights and candidate genes for iNPH, highlighting the continued importance of integrated genetic analysis and clinical studies to advance iNPH management.
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Journal of neurosurgery · Feb 2025
Multicenter StudyRisk factors for neurosurgical intervention within 48 hours of admission for patients with mild traumatic brain injury and isolated subdural hematoma.
The objective was to identify demographic, clinical, and radiographic risk factors for neurosurgical intervention within 48 hours of admission in patients with mild traumatic brain injury and isolated subdural hematoma. ⋯ In the setting of mild traumatic brain injury with isolated subdural hematoma, radiographic risk factors were shown to be stronger than demographic and clinical variables in understanding future risk of neurosurgical intervention. These final radiographic risk factors should be considered in the creation of future prediction models and used to increase the efficiency of existing management guidelines.