UW Neurological Surgery Recent PubMed Publications

Background Chronic subdural hematomas (cSDHs) are associated with high recurrence risks following surgical evacuation. The EMBOLISE trial demonstrated that, compared with surgery alone, adjunctive middle meningeal artery embolization (MMAE) significantly reduced reoperation rates. However, given the limitations of the clinical end points of the trial, which may be subject to interrater variability and certain biases, the quantitative imaging metrics need to be evaluated. Purpose To evaluate the...

[This corrects the article DOI: 10.1371/journal.pone.0319867.].

CONCLUSION: Baseline BCR has high specificity but limited sensitivity for preoperative continence. Intraoperative BCR loss is a specific but insensitive predictor of postoperative urinary dysfunction. Whilst BCR monitoring aids intraoperative decision-making, further studies are needed to optimise its role in predicting long-term bladder outcomes.

PURPOSE OF REVIEW: The vast majority of severe traumatic brain injury (TBI) patients are managed in regions of low resources. Intracranial pressure (ICP) monitoring is, therefore, uncommon. There is insufficient literature to support evidence-based algorithm construction. We here explore current validated models for sTBI management in the absence of ICP monitoring.

Study DesignSystematic review.ObjectiveTo identify and classify intervertebral foraminal morphologies associated with failed indirect decompression (IND), with the goal of developing a preoperative classification system to assess candidacy for this procedure.MethodsA systematic review of PubMed, EMBASE, and Google Scholar was conducted. All reported cases of failed indirect decompression secondary to abnormal foraminal morphology were included. Imaging findings were reviewed to identify distinct...

BACKGROUND: Hypertension is a common comorbidity in patients with unruptured intracranial aneurysms, which is closely related to the instability of aneurysms. Though anti-hypertension therapy has been recommended by several guidelines, the optimal blood pressure range remains unknown. This trial aims to determine the optimal range of blood pressure by comparing standard blood pressure reduction and intensive blood pressure reduction to reduce the instability of unruptured intracranial aneurysms.

Cost-effective approaches for integrating behavioral interventions for problematic alcohol and other drug (AOD) use into HIV care is needed, as problematic AOD is a primary barrier to adherence of antiretroviral therapy (ART). Thus, we investigated the cost-effectiveness of a recently completed pilot trial in South Africa, that showed promising findings in improved adherence of antiretroviral therapy (ART). The trial compared a task-shared, peer-delivered behavioral intervention (known as...

CONCLUSIONS: An institutional experience demonstrated that functional hemispherectomy is a safe and well-tolerated procedure in infants and offers excellent seizure control outcomes in hemispheric-onset epilepsies. The surgical technique, a focus on minimizing operative blood loss, and multidisciplinary care of these patients are critical elements in ensuring the safety and success of this procedure. Future studies are needed to better characterize long-term functional and neurodevelopmental...

CONCLUSIONS: Surgical intervention for IIH achieved high rates of papilledema resolution and visual improvement, with low long-term failure rates. Each modality showed distinct strengths, limitations, and temporal failure patterns. Papilledema resolution and time to resolution may serve as meaningful clinical endpoints in future multicenter IIH studies.

The respiratory parafacial region (pFRG) contributes critically to central chemoreception, CO(2)/H^(+) homeostasis and the regulation of all major components of the respiratory rhythm. The respiratory rhythm is also modulated by the neuropeptide substance P which is released by tachykinin-1 (Tac1)- expressing neurons. However, how tachykinergic signaling modulates the pFRG region remains incompletely understood. Here we show that substance P (1 µM, 30 nL) microinjected into the ventral pFRG...

No abstract

Diffuse axonal injury (DAI) is caused by acceleration-deceleration forces during trauma that shear white matter tracts. Susceptibility-weighted MRI (SWI) identifies microbleeds that are considered the radiologic hallmark of DAI and are used in clinical prognostication. However, this assumption is limited by a lack of systematic radiologic-pathologic correlation studies. Here, we performed ex vivo SWI on three brains from patients who died after severe TBI and assessed axonal injury around SWI...

In human skin, erythema assessed 24 h after ultraviolet (UV) exposure is a non-invasive method for determining the acute UV response. Although erythema is often reported in murine models as a measure of acute UV response, the most informative timepoint after UV exposure is unclear because of variability in mouse strain, sex, and light source. Our current work addresses this critical gap by elucidating the development of erythema and edema over time after acute UV irradiation with solar-simulator...

The physiological properties of human and rodent neurons differ, yet the extent to which these differences reflect human specializations is often unclear. Compared with their rodent counterparts, human supragranular pyramidal neurons possess enriched Hyperpolarization-activated Cyclic Nucleotide-gated channel (HCN channel)-dependent intrinsic membrane properties and a related sensitivity to synaptic inputs containing delta/theta band frequencies. Here we test whether other primate species...

No abstract

CONCLUSION: Male and female patients demonstrated comparable improvements in PROs, achievement of clinically meaningful thresholds, revision rates, and rates of conversion to total hip arthroplasty after hip arthroscopy. Although men exhibited larger alpha angles and more advanced chondral damage, and women more frequently underwent capsular repair, these sex-based differences did not translate into clinically significant disparities in postoperative outcomes.

CONCLUSIONS: Primary care OUD treatment rates varied markedly. Exemplar clinics in which all primary care providers were expected to treat OUD had the highest treatment rates at baseline and follow-up, suggesting that universal prescribing is a promising approach to increasing OUD treatment in primary care.

CONCLUSIONS: Our study did not demonstrate differences in shunt survival between children <6 months of age requiring CSF diversion secondary to PHH who had NEC and those who did not. Thus, peritoneal shunt placement may be suitable for children with NEC despite having abdominal interventions.

The human neocortex underlies higher cognition and is the engine of complex thought. Yet our understanding of its neuronal diversity is limited by sparse access to tissue, inconsistent sampling across studies, and a lack of multiple modality data. Although single-cell transcriptomic taxonomies are an important framework for characterizing cell type diversity, transcriptomic information alone cannot reveal the cellular properties that define neuronal computations. To address this, we performed...

BACKGROUND: Before infecting red blood cells and causing the clinical manifestations of malaria, the hepatotropic parasite Plasmodium falciparum completes a complex liver stage. Sex-based differences in pathogenesis by hepatotropic micro-organisms are well documented but unstudied for P falciparum in humans. We aimed to evaluate the effect of sex on the time to blood-stage positivity and initial blood-stage parasite densities as indicators of liver-stage dynamics and parasite replication.