World Neurosurg
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Isocitrate dehydrogenase 1 (IDH1) mutation status is an independent favorable prognostic factor for glioblastoma (GBM) and is usually determined by sequencing or immunohistochemistry. An accurate prediction of IDH1 mutation status via noninvasive methods helps establish the appropriate treatment strategy. We aimed to predict IDH1 mutation status using quantitative radiomic data in patients with GBM. ⋯ We demonstrate that machine learning algorithms can predict IDH1 mutation status in GBM using preoperative multiparametric magnetic resonance images.
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Historical Article
Great Hospitals in North America: The Medical College of Wisconsin Neurological Surgery.
The Medical College of Wisconsin Department of Neurosurgery delivers subspecialty adult and pediatric neurosurgical care that is patient-centered, evidence-informed, and value-based. Medical College of Wisconsin research advances the science of neurological disease with the goal of a positive translational effect on clinical care. ⋯ The journey to become a neurosurgical center of excellence was accomplished with the leadership and foresight of the men and women who turned their dreams into reality. The establishment and rise of the department as a national force for neurosurgery and spine is an elegant example of the combination of individual leadership and foresight with synergistic institutional support.
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Vascular injury complications during lumbar discectomy are rare but potentially life-threatening. Therefore, an early diagnosis and effective treatment management is required for these complications. ⋯ Although lumbar discectomy is one of the most commonly performed neurosurgical procedures, the routine rules of discectomy should not be neglected. Early detection and a multidisciplinary approach can help prevent mortality in the event of vascular injury.
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Case Reports
Dasatinib Re-initiation after Post-stroke Thrombolysis Associated with Symptomatic Intracerebral Hemorrhage.
Dasatinib, a tyrosine kinase inhibitor commonly used in treatment of acute lymphoblastic leukemia and chronic myelogenous leukemia, is often associated with hemorrhagic complications. Safety of dasatinib after thrombolytic therapy in acute ischemic stroke is unknown. ⋯ It is advisable to withhold dasatinib during the poststroke period owing to its associated risk of symptomatic intracerebral hemorrhage.
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Despite increasing use of direct oral anticoagulants (DOACs), guidelines for their perioperative use in spine surgery are still lacking. The main goal of our study was to analyze the occurrence of postoperative bleeding events and possible confounders in patients treated with DOACs who undergo spine surgery. ⋯ Short preoperative discontinuation time of DOACs, even <24 hours, may be justified, considering an increased risk of perioperative packed red blood cell substitution. Care should be taken with patients treated with concomitant blood thinners and patients with pre-existing kidney disease. Postoperative DOAC resumption >72 hours may increase risk of thromboembolic events.