Article
Oncology
Sergey A. Goryaynov, Svetlana B. Buklina, Ivan V. Khapov, Artyom I. Batalov, Alexander A. Potapov, Igor N. Pronin, Artem U. Belyaev, Andrey A. Aristov, Vadim U. Zhukov, Galina V. Pavlova, Evgenii Belykh
Summary: The simultaneous use of 5-ALA fluorescence and awake speech mapping in patients with left frontal gliomas can enhance the extent of resection for infiltrative high-grade gliomas and identify foci of anaplasia in non-enhancing gliomas, while maintaining safe limits of functional resection based on speech mapping. Positive 5-ALA fluorescence in diffuse Grade 2 gliomas may indicate a more aggressive disease course.
FRONTIERS IN ONCOLOGY
(2022)
Review
Oncology
Lasse Cramer Ahrens, Mathias Green Krabbenhoft, Rasmus Wuergler Hansen, Nikola Mikic, Christian Bonde Pedersen, Frantz Rom Poulsen, Anders Rosendal Korshoej
Summary: Surgery is crucial in treating high-grade gliomas (HGG) as gross total resection (GTR) can increase overall survival and progression-free survival. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) has shown to significantly increase GTR compared to white light surgery. Sodium fluorescein (SF), an off-label fluorophore, has gained popularity due to its cost-effectiveness, non-toxicity, and ease of administration during surgery, although its level of evidence in HGG surgery is lower than that of 5-ALA.
Article
Neurosciences
Pietro Zeppa, Raffaele De Marco, Matteo Monticelli, Armando Massara, Andrea Bianconi, Giuseppe Di Perna, Stefania Greco Crasto, Fabio Cofano, Antonio Melcarne, Michele Maria Lanotte, Diego Garbossa
Summary: This study compared the use of 5-ALA and SF in GBM patients and found no significant differences in terms of resection extent and postoperative functional status. However, the concomitant use of both fluorophores may improve overall survival.
Review
Clinical Neurology
Emily J. Smith, Kavita Gohil, Charee M. Thompson, Anant Naik, Wael Hassaneen
Summary: This meta-analysis demonstrates that fluorescein-guided surgery improves GTR rates of HGGs compared to non-fluorescence guided surgery, while showing similar GTR rates compared to reported 5-ALA-guided resection rates.
WORLD NEUROSURGERY
(2021)
Review
Oncology
Harshal A. Shah, Sandra Leskinen, Hamza Khilji, Vinayak Narayan, Netanel Ben-Shalom, Randy S. D'Amico
Summary: The current studies on 5-ALA fluorescence in brain metastases are limited and do not confirm its efficacy in improving the extent of resection or post-operative survival. Fluorescence varies greatly across and within tumor types.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Review
Oncology
Andrea Bianconi, Marta Bonada, Pietro Zeppa, Stefano Colonna, Fulvio Tartara, Antonio Melcarne, Diego Garbossa, Fabio Cofano, Andreas F. Hottinger, Nimish Mohile
Summary: This systematic review aimed to evaluate the reliability of fluorescence-guided surgery in low-grade gliomas and identify the best fluorophore for highlighting tumor boundaries. The current evidence does not support the routine use of 5-aminolevulinic acid or sodium fluorescein in low-grade glioma surgery. New molecules and techniques show promising results but require further clinical validation.
Review
Oncology
Barbara Kiesel, Julia Freund, David Reichert, Lisa Wadiura, Mikael T. Erkkilae, Adelheid Woehrer, Shawn Hervey-Jumper, Mitchel S. Berger, Georg Widhalm
Summary: 5-ALA plays a crucial role in neurosurgery by assisting in visualizing malignant transformation within suspected low-grade gliomas during surgery, and new approaches based on fluorescence technology are being introduced to overcome current limitations.
FRONTIERS IN ONCOLOGY
(2021)
Article
Clinical Neurology
Zhan Xue, Lu Kong, Shuyu Hao, Yu Wang, Guijun Jia, Zhen Wu, Wang Jia, Junting Zhang, Liwei Zhang
Summary: The combined application of sodium fluorescein and neuronavigation techniques showed satisfactory tumor visualization in brain glioma resection surgery, with higher consistency in the brainstem group compared to the supratentorial group. A half dose of sodium fluorescein was found to be sufficient for pediatric patients. Overall, this combined approach may lead to better clinical outcomes for glioma patients.
FRONTIERS IN NEUROLOGY
(2021)
Article
Biotechnology & Applied Microbiology
Elizaveta Kozlikina, Igor S. Trifonov, Mikhail Sinkin, Vladimir V. Krylov, Victor B. Loschenov
Summary: The treatment of glial brain tumors is a challenging problem in neuro-oncology. This case report demonstrates the potential of using a combination of two photosensitizers for fluorescence-guided resection and photodynamic therapy to achieve total tumor removal and additional treatment.
BIOENGINEERING-BASEL
(2022)
Review
Clinical Neurology
Anant Naik, Emily J. Smith, Ariana Barreau, Mark Nyaeme, Samuel W. Cramer, Daniel Najafali, David T. Krist, Paul M. Arnold, Wael Hassaneen
Summary: A network meta-analysis comparing 5-ALA, IMRI, and FS as intraoperative navigation methods for high-grade glioma resection showed that IMRI, FS, and 5-ALA all led to higher rates of gross total resection and improved overall survival and progression-free survival.
JOURNAL OF CLINICAL NEUROSCIENCE
(2022)
Review
Medicine, General & Internal
Alexander J. Schupper, Raymund L. Yong, Constantinos G. Hadjipanayis
Summary: Maximal safe resection is the standard of care for high-grade gliomas in neurosurgical treatment. Various advanced technologies, such as fluorescence-guided surgery, intraoperative imaging, neuromonitoring modalities, and microscopic imaging techniques, have been developed to improve intraoperative visualization of tumor tissue. These technologies aim to enhance the detection of tumor tissue beyond what conventional microsurgery allows, and future directions focus on improving intraoperative technologies.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Oncology
Tiffany A. Eatz, Daniel G. Eichberg, Victor M. Lu, Long Di, Ricardo J. Komotar, Michael E. Ivan
Summary: 5-aminolevulinic acid (5-ALA) has been shown to enhance the outcomes of high-grade glioma (HGG) surgery, including extent of resection and patient survival. However, its impact on postoperative neurological function remains inconclusive.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Review
Oncology
Linda M. Wang, Matei A. Banu, Peter Canoll, Jeffrey N. Bruce
Summary: The current standard of care for glioblastoma includes surgical resection followed by temozolomide chemotherapy and radiation. Recent studies suggest that over 95% extent of resection is associated with better outcomes. The goal of surgery is maximal safe resection, extending into the contrast-enhancing tumor margins for improved prognosis.
FRONTIERS IN ONCOLOGY
(2021)
Article
Medicine, General & Internal
Mario Mischkulnig, Thomas Roetzer-Pejrimovsky, Daniela Loetsch-Gojo, Nina Kastner, Katharina Bruckner, Romana Prihoda, Alexandra Lang, Mauricio Martinez-Moreno, Julia Furtner, Anna Berghoff, Adelheid Woehrer, Walter Berger, Georg Widhalm, Barbara Kiesel
Summary: This study compares the mRNA and protein expression of intramitochondrial heme biosynthesis enzymes/transporters in glioma tissue samples with different fluorescence behavior. The findings suggest that the activity of the heme biosynthesis pathway is enhanced in fluorescing gliomas, with upregulation of PpIX generating enzymes and decreased ABCG2 mediated PpIX efflux. The results provide insights into optimizing intraoperative 5-ALA fluorescence visualization in non-fluorescing tumors.
FRONTIERS IN MEDICINE
(2022)
Article
Clinical Neurology
Sabino Luzzi, Alice Giotta Lucifero, Andrea Martinelli, Mattia Del Maestro, Gabriele Savioli, Anna Simoncelli, Elvis Lafe, Lorenzo Preda, Renato Galzio
Summary: Augmented reality (AR) with diffusion tensor imaging (DTI)-based high-definition fiber tractography (HDFT) and sodium fluorescein (F) in high-grade glioma (HGG) surgery was found to be safe and effective, leading to lower postoperative NANO scores, higher extent of resection (EOR), and longer progression-free survival (PFS) rate for patients.
NEUROSURGICAL FOCUS
(2021)
Article
Clinical Neurology
Aaron P. Kamer, Jose M. Bonnin, Robert J. Spinner, Aaron A. Cohen-Gadol
JOURNAL OF NEUROSURGERY
(2020)
Article
Clinical Neurology
Clint M. Alfaro, Valentina Pirro, Michael F. Keating, Eyas M. Hattab, R. Graham Cooks, Aaron A. Cohen-Gadol
JOURNAL OF NEUROSURGERY
(2020)
Article
Clinical Neurology
Aaron A. Cohen-Gadol
OPERATIVE NEUROSURGERY
(2020)
Article
Clinical Neurology
Robert A. Scranton, Kushal Shah, Aaron A. Cohen-Gadol
JOURNAL OF NEUROSURGERY
(2020)
Article
Clinical Neurology
Benjamin K. Hendricks, Aaron A. Cohen-Gadol
OPERATIVE NEUROSURGERY
(2020)
Article
Clinical Neurology
Robert A. Scranton, Aaron A. Cohen-Gadol
OPERATIVE NEUROSURGERY
(2020)
Article
Clinical Neurology
Aaron Cohen-Gadol
OPERATIVE NEUROSURGERY
(2020)
Article
Health Care Sciences & Services
Joseph R. Linzey, Faith Robertson, Ali S. Haider, Christopher Salvatore Graffeo, Justin Z. Wang, Gillian Shasby, Naif M. Alotaibi, Aaron A. Cohen-Gadol, James T. Rutka
JOURNAL OF MEDICAL INTERNET RESEARCH
(2020)
Review
Engineering, Biomedical
Vitaliy L. Rayz, Aaron A. Cohen-Gadol
ANNUAL REVIEW OF BIOMEDICAL ENGINEERING, VOL 22
(2020)
Editorial Material
Clinical Neurology
Samuel B. Tomlinson, Benjamin K. Hendricks, Aaron A. Cohen-Gadol
JOURNAL OF NEUROSURGERY
(2020)
Letter
Clinical Neurology
Samuel B. Tomlinson, Benjamin K. Hendricks, Aaron Cohen-Gadol
WORLD NEUROSURGERY
(2020)
Review
Clinical Neurology
Chung Liang Chai, Jin Pyeong Jeon, Yi-Hsin Tsai, Paula Whittaker, R. Loch Macdonald, Antti E. Lindgren, Oliver G. S. Ayling, Marcus Andre Acioly, Aaron Cohen-Gadol, Yu-Hua Huang
Review
Oncology
Paolo Palmisciano, Ali S. Haider, Mohammadmahdi Sabahi, Chibueze D. Nwagwu, Othman Bin Alamer, Gianluca Scalia, Giuseppe E. Umana, Aaron A. Cohen-Gadol, Tarek Y. El Ahmadieh, Kenny Yu, Omar N. Pathmanaban
Summary: Primary skull base chondrosarcomas (SBCs) can result in significant tumor burden leading to severe cranial nerve neuropathies. Current treatment strategies mainly focus on surgical resection and radiotherapy, with a range of efficacy and safety outcomes. Surgical resection favors maximal tumor removal with acceptable complication rates, while radiotherapy protocols offer safe and effective local tumor control. Overall, prognosis for primary SBCs is favorable and comparable to benign skull base neoplasms, making them a challenging but manageable entity in clinical practice.
Review
Medicine, General & Internal
Hailey C. Budnick, Samuel Tomlinson, Jesse Savage, Aaron Cohen-Gadol
CUREUS JOURNAL OF MEDICAL SCIENCE
(2020)
Article
Medicine, General & Internal
Charles Kulwin, Aaron Cohen-Gadol
CUREUS JOURNAL OF MEDICAL SCIENCE
(2020)
Article
Clinical Neurology
Guilu He, Jianhao Lin, Jing Ye, Fobao Huang, Changzhi Yan, Zesi Liu, Xiuming Zhou, Qiao Li, Liang Zhang
Summary: This article introduces long tunneled external ventricular drain (LTEVD), which effectively avoids multiple surgeries by connecting an external shunt valve. It allows visual control of drainage flow, prolongs catheter indwelling time, and eliminates the need for multiple surgeries.
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Vinay Suresh, H. S. Suresh, Bharath Raju, Himanshu Jindal, Ahmad Ozair
Summary: This study investigated the outcomes of postoperative discitis treated with debridement and a novel technique focused on reducing outpatient antibiotic requirement in a low- and middle-income country (LMIC) setting. The results showed that patients with medically refractory postoperative discitis potentially have good outcomes after debridement plus 2-week local antibiotic instillation in LMICs.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Beatrice C. Bono, Davide Milani, Fabio Ferreli, Simone Olei, Luca Raspagliesi, Maria Pia Tropeano, Giovanni B. Lasio, Federico Pessina
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Avi A. Gajjar, Shrey Patel, Raj Swaroop Lavadi, Rida Mitha, Rohit Prem Kumar, Tavis Taylor, Galal A. Elsayed, D. Kojo Hamilton, Nitin Agarwal
Summary: Art in neurosurgery has played a crucial role in the discipline for centuries. Medical illustrations help visualize anatomy and surgical procedures, contributing to education, surgical planning, and navigation.
WORLD NEUROSURGERY
(2024)
Article
Clinical Neurology
Joaquin Perez Zabala, Yamila Basilotta Marquez, Romina Arganaraz, Beatriz Mantese
Summary: We present a low-cost and easily accessible adaptation system for stereotactic procedures in infants. By using a headband cast technique, a stereotactic biopsy was successfully performed in a 5-month-old patient, achieving precise targeting, histopathological diagnosis, and no associated complications.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Muhammad Kusdiansah, Arnau Benet, Yosuke Suzuki, Kenichi Haraguchi, Nakao Ota, Kosumo Noda, Rokuya Tanikawa
Summary: Fusiform vertebral artery aneurysms are difficult to treat, and endovascular and open microsurgical treatments are used for different situations. This report presents a case with complex anatomy and branch involvement and describes the treatment strategy used.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Victor M. Lu
Summary: This review emphasizes four essential domains that should be considered when interpreting pediatric neurosurgical SRMAs and provides examples to ensure accurate and effective interpretation of findings in this niche.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Lapo Bonosi, Angelo Torrente, Filippo Brighina, Cateno Concetto Tito Petralia, Pietro Merlino, Chiara Avallone, Vincenzo Gulino, Roberta Costanzo, Lara Brunasso, Domenico Gerardo Iacopino, Rosario Maugeri
Summary: Corticocortical evoked potentials (CCEPs) have emerged as a valuable intraoperative monitoring technique in eloquent brain tumor surgery, aiding in preserving critical functional areas. Current research shows the potential of CCEPs in guiding surgical decision making, reducing the risk of postoperative neurological deficits, and mapping functional connectivity, but further research and standardization are needed.
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Yuchen Duan, Dagang Feng, Min Zhu, Heng Qiu, Tong Li, Zhen Chen, Leiming Jiang, Yong Huang
Summary: This study aimed to compare the effect of different Modic changes (MC) grades on the cage subsidence rate after spinal interbody fusion surgery. A meta-analysis was conducted on relevant randomized controlled trials and cohort studies. The results showed that MC may be associated with a higher cage subsidence rate. With the increase in MC grades, the incidence of subsidence decreased gradually, but it was always higher than that in the non-Modic changes (NMC). Oblique lumbar interbody fusion may be a better treatment choice for lumbar degenerative disease with MC.
WORLD NEUROSURGERY
(2024)
Editorial Material
Clinical Neurology
Brian F. Saway, Conor M. Cunningham, Mustafa Ismail, Alejandro M. Spiotta
WORLD NEUROSURGERY
(2024)
Review
Clinical Neurology
Joanna M. Roy, Michael M. Covell, Carmelo Venero Jr, Christian A. Bowers
Summary: Early exposure to neurosurgery during medical school is critical for improving recruitment into the specialty. However, about 30% of medical schools in the U.S. lack a neurosurgery program, limiting students' exposure to the field. Virtual education, facilitated by webinars during the pandemic, has advantages such as global outreach and accessibility for international medical students. This review identifies and describes 16 educational resources, serving as a guide for medical students interested in neurosurgery.
WORLD NEUROSURGERY
(2024)