bluuebunny/crossref_metadata_2025_split huggingface dataset:
Video-assisted thoracoscopic image-guided spine surgery: evolution of 19 years of experience, from endoscopy to fully integrated 3D navigation
Authors: Hanna George , Kim Terrence T. , Uddin Syed-Abdullah , Ross Lindsey , Johnson J. Patrick 
Published: January 2021

OBJECTIVEThe purpose of this study was to describe the evolution of thoracoscopic spine surgery from basic endoscopic procedures using fluoroscopy and anatomical localization through developmental iterations to the current technology use in which endoscopy and image-guided surgery are merged with intraoperative CT scanning.METHODSThe authors provided detailed explanations of their thoracoscopic spine surgery techniques, beginning with their early-generation endoscopy with fluoroscopic localization, which was followed with point surface matching techniques and early image guidance. The authors supplanted this with the modern era of image guidance, thoracoscopic spine surgery, and seamless integration that has reached its current level of refinement.RESULTSA retrospective review of single-institution thoracoscopic procedures performed by the senior author over the course of 19 years yielded a total of 160 patients, including 73 women and 87 men. The mean patient age was 55 years, and the range included patients 16–94 years of age. There were no patients with worsened neurological function. One hundred sixteen patients underwent surgery for thoracic disc herniation, 18 for underlying neoplasms with spinal cord compression, 14 for osteomyelitis and discitis, 12 for thoracic deformity with neurological changes, and 8 for traumatic etiologies.CONCLUSIONSMore than 19 years of experience has revealed the benefits of integrating thoracoscopic spine surgery with intraoperative CT scanning and image-guided surgery, including direct decompression without manipulation of neural elements, superior 3D spatial orientation, and localization of complex spinal anatomy. With the exponential growth of machine learning, robotics, artificial intelligence, and advances in imaging techniques and endoscopic imaging, there may be further refinements of this technique on the horizon.
Magnetic resonance imaging–based synthetic computed tomography of the lumbar spine for surgical planning: a clinical proof-of-concept
Authors: Staartjes Victor E. , Seevinck Peter R. , Vandertop W. Peter , van Stralen Marijn , Schröder Marc L. 
Published: January 2021

OBJECTIVEComputed tomography scanning of the lumbar spine incurs a radiation dose ranging from 3.5 mSv to 19.5 mSv as well as relevant costs and is commonly necessary for spinal neuronavigation. Mitigation of the need for treatment-planning CT scans in the presence of MRI facilitated by MRI-based synthetic CT (sCT) would revolutionize navigated lumbar spine surgery. The authors aim to demonstrate, as a proof of concept, the capability of deep learning–based generation of sCT scans from MRI of the lumbar spine in 3 cases and to evaluate the potential of sCT for surgical planning.METHODSSynthetic CT reconstructions were made using a prototype version of the “BoneMRI” software. This deep learning–based image synthesis method relies on a convolutional neural network trained on paired MRI-CT data. A specific but generally available 4-minute 3D radiofrequency-spoiled T1-weighted multiple gradient echo MRI sequence was supplemented to a 1.5T lumbar spine MRI acquisition protocol.RESULTSIn the 3 presented cases, the prototype sCT method allowed voxel-wise radiodensity estimation from MRI, resulting in qualitatively adequate CT images of the lumbar spine based on visual inspection. Normal as well as pathological structures were reliably visualized. In the first case, in which a spiral CT scan was available as a control, a volume CT dose index (CTDIvol) of 12.9 mGy could thus have been avoided. Pedicle screw trajectories and screw thickness were estimable based on sCT findings.CONCLUSIONSThe evaluated prototype BoneMRI method enables generation of sCT scans from MRI images with only minor changes in the acquisition protocol, with a potential to reduce workflow complexity, radiation exposure, and costs. The quality of the generated CT scans was adequate based on visual inspection and could potentially be used for surgical planning, intraoperative neuronavigation, or for diagnostic purposes in an adjunctive manner.
Transcondylar fossa approach for the large, high-flow, and diffuse arteriovenous malformation of the posterior fossa
Authors: Torihashi Koichi , Ogura Takafumi , Kadowaki Mitsutoshi , Sakamoto Makoto , Kurosaki Masamichi 
Published: January 2021

Posterior fossa high-grade arteriovenous malformations (AVMs) are challenging diseases. This video presents the treatment of a patient with a diffuse, high-flow AVM of the posterior fossa on the tonsil and cerebellopontine angle (4 cm in diameter) and deep draining veins. The patient had an intraventricular and cerebellar hemorrhage. After conservative treatment, total resection of the AVM was performed with embolization and surgery. The authors resected the nidus after the endovascular embolization, on the same day. The postoperative course was uneventful, and the patient was discharged with almost full recovery.The video can be found here: https://youtu.be/logCCn3uKUc
Microsurgical treatment of a posterior fossa arteriovenous malformation initially mistaken for a dural arteriovenous fistula: avoidance of near disaster
Authors: Howard Brian M. , Barrow Daniel L. 
Published: January 2021

Many brain arteriovenous malformations (AVMs) derive dural blood supply, while 10%–15% of dural arteriovenous fistulas (dAVFs) have pial arterial input. To differentiate between the two is critical, as treatment of these entities is diametrically opposed. To treat dAVFs, the draining vein(s) is disconnected from feeding arteries, which portends hemorrhagic complications for AVMs. The authors present an operative video of a subtle cerebellar AVM initially treated as a dAVF by attempted embolization through dural vessels. The lesion was subsequently microsurgically extirpated. The authors show a comparison case of an AVM mistaken for a dAVF and transvenous embolization that resulted in a fatal hemorrhage.The video can be found here: https://youtu.be/eDeiMrGoE0Q
Microsurgical resection of previously embolized recurrent cerebellopontine angle AVM
Authors: Dowlati Ehsan , Chesney Kelsi , Nayar Vikram V. 
Published: January 2021

This is the case of a ruptured Spetzler-Martin grade II arteriovenous malformation (AVM) located in the cerebellopontine angle and draining into the transverse sinus. The AVM was initially treated with staged embolization using Onyx (ev3 Neurovascular). However, recurrence was noted and treatment with microsurgical resection was undertaken. The authors present technical nuances of the approach and strategies for microsurgical resection of a previously embolized recurrent AVM with the aid of intraoperative indocyanine green angiography. Follow-up after endovascular treatment is critical, and curative treatment with microsurgical resection can be achieved with low morbidity in such AVMs as demonstrated by this case.The video can be found here: https://youtu.be/LMpz_YTFC0g
Suboccipital craniectomy with bilateral cerebellomedullary fissure dissection for resection of a ruptured tonsillar/vermian AVM occupying the roof of the fourth ventricle in a pregnant patient
Authors: Raper Daniel M. S. , Raygor Kunal P. , Rutledge Caleb , Dubnicoff Todd B. , Abla Adib A. 
Published: January 2021

Posterior fossa arteriovenous malformations (AVMs) in pregnant patients can present unique considerations for surgical treatment, including positioning to minimize pressure on the fetus, minimization of radiation exposure, and ethical considerations regarding emergency surgery. This video outlines surgical treatment of a ruptured tonsillar/vermian AVM performed in a staged fashion after emergent suboccipital craniotomy with posterior fossa decompression in the setting of a life-threatening infratentorial hemorrhage. Later, bilateral cerebellomedullary fissure dissection, exposure and dissection of the tela choroidea and inferior medullary velum, and disconnection of arterial feeders from the posterior inferior cerebellar artery (PICA) allowed resection of this AVM occupying the roof of the fourth ventricle.This study was approved by the UCSF Human Research Protection Program IRB no. 18-26938.The video can be found here: https://youtu.be/rTYUGanopUE
Usefulness of the middle cerebellar peduncle approach for microsurgical resection of lateral pontine arteriovenous malformation
Authors: Tominaga Shinsuke , Kugai Miyahito , Matsuda Kou , Yamazato Keisho , Inui Toshihiko , Kitano Masahiko , Hasegawa Hiroshi 
Published: January 2021

Surgical treatment of brainstem arteriovenous malformation (AVM) is challenging and associated with a higher risk of complications and a lower rate of gross-total resection. The authors present their experience with the surgical management of lateral pontine AVM using the middle cerebellar peduncle approach. All cases presented with neurological deficits that were caused by hemorrhage before surgery. In all cases, the AVM was not visualized on postoperative angiography, and there was no deterioration of neurological symptoms. In this video, the authors report the treatment results of one case and describe the technique with a review of the literature.The video can be found here: https://youtu.be/bFvEMtMnrKw
Multimodal treatment of a pediatric posterior fossa arteriovenous malformation employing endovascular and microsurgical techniques
Authors: Demartini Zeferino , Ceccato Guilherme H. W. , da Trindade Érico S. G. G. , Borba Luis A. B. 
Published: January 2021

Intracranial hemorrhage is the most common presentation of posterior fossa arteriovenous malformations (AVMs) and may have serious consequences. The authors present a case of a 7-year-old girl with headache, vomiting, dysmetria, and ataxia due to a ruptured cerebellar grade III AVM. After two sessions of embolization, the patient underwent total microsurgical resection through a suboccipital craniotomy. There were no additional postoperative deficits, and the patient improved progressively during 6 months of rehabilitation. These challenging lesions should be removed after rupture, especially in children with long-term cumulative risk of rebleeding. Multimodal treatment reduces the perioperative bleeding, allowing better outcomes for pediatric AVM.The video can be found here: https://youtu.be/HQWnjD8ENZQ
Combined treatment for a hemispheric cerebellar AVM
Authors: Loof de Amorim Bruno , Wainberg Ricardo Chmelnitsky , Paz-Archila Juan Alberto , Lessa Silvio Sarmento , Bustamante Vargas Gabriela Miroslava , Bocca Leonardo Favi , de Campos Filho José Maria , de Siqueira Campos Christiane Monteiro , Silva da Costa Marcos Devanir , Chaddad-Neto Feres 
Published: January 2021

Posterior fossa arteriovenous malformations (AVMs) can be a challenging disease, especially those large in size. AVMs can be treated with a combination of endovascular treatment and microsurgery. Here, the authors present the case of a 16-year-old female patient with progressive dizziness and episodic syncope. The workup of the patient showed a hemispheric cerebellar AVM, Spetzler-Martin grade IV. She underwent combined treatment (endovascular and microsurgery) with no complications and cure of the malformation.The video can be found here: https://youtu.be/rNw_Kyd76Mg
Microsurgical resection of unruptured cerebellar arteriovenous malformation presenting with trigeminal neuralgia
Authors: Marani Walter , Montemurro Nicola , Tsuji Shoichiro , Perrini Paolo , Noda Kosumo , Ota Nakao , Kinoshita Yu , Kamiyama Hiroyasu , Tanikawa Rokuya 
Published: January 2021

Cerebellar arteriovenous malformations (AVMs) represent 10%–15% of all intracranial AVMs and are associated with a greater risk for hemorrhagic presentation compared with supratentorial AVMs. When they reach the cerebellopontine angle cistern, neurovascular compression syndromes, including trigeminal neuralgia and hemifacial spasm, can occur. Due to the aggressive natural history of cerebellar AVM, an effective treatment strategy is required. In this video, the authors demonstrate the technical nuances of microsurgical resection of an unruptured cerebellar AVM in a 24-year-old female presenting with trigeminal neuralgia. The patient underwent right retrosigmoid craniotomy and complete resection of the AVM with resolution of trigeminal neuralgia.The video can be found here: https://youtu.be/6GmNjgFQwx8
Intraoperative application of a new-generation 3D IV-DSA technology in resection of a hemorrhagic cerebellar AVM
Authors: Ozaydin Burak , Dawkins Demi W. , Armstrong Stephanie A. , Aagaard-Kienitz Beverly , Baskaya Mustafa K. 
Published: January 2021

Although intravenous digital subtraction angiography (IV-DSA), cone-beam CT, and rotational angiography are well-established technologies, using them in a single system in the hybrid operating room to acquire high-quality noninvasive 3D images is a recent development. This video demonstrates microsurgical excision of a ruptured cerebellar arteriovenous malformation (AVM) in a 66-year-old male followed by intraoperative IV-DSA acquisition using a new-generation system (Artis Icono). IV-DSA confirmed in real time that no residual remained following excision without the need to reposition the patient. To the best of the authors’ knowledge, this is the first surgical video to demonstrate the simplified workflow and application of this technology in neurovascular surgery.The video can be found here: https://youtu.be/bo5ya9DQQPw
Lateral supracerebellar infratentorial approach for a ruptured cerebellomesencephalic fissure arteriovenous malformation resection
Authors: Pereira Livio , Vieira Eduardo 
Published: January 2021

In this surgical video, the authors present a case of a 24-year-old male patient who presented with sudden-onset headache and imbalance. On examination, he had a right-sided dysmetria and was otherwise neurologically intact. MRI showed a right cerebellar hematoma associated with multiple flow voids in the cerebellomesencephalic fissure and an enlarged lateral mesencephalic vein. Preoperative angiogram confirmed an arteriovenous malformation supplied by branches of the superior cerebellar artery. The patient underwent a lateral supracerebellar infratentorial approach for resection of the arteriovenous malformation (AVM). He recovered well from surgery and was discharged home on postoperative day 6. Postoperative angiogram confirmed complete AVM resection.The video can be found here: https://youtu.be/tY4Go2n7V80
Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience
Authors: Höhne Julius , Schebesch Karl-Michael , Zoubaa Saida , Proescholdt Martin , Riemenschneider Markus J. , Schmidt Nils Ole 
Published: January 2021

OBJECTIVEConfocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement of the technology have made this modality available for operative imaging with a handheld device. Sufficient image contrast is provided by the preoperative application of fluorescein sodium. The authors report their first experiences in a clinical case series using the new confocal laser endomicroscope.METHODSHandling, operative workflow, and visualization of the CLE were critically evaluated in 12 cases of different CNS tumors. Three different imaging positions in relation to the tumor were chosen: the tumor border (I), tumor center (II), and perilesional zone (III). Respective diagnostic sampling with H & E staining and matching intraoperative neuronavigation and microscope images are provided.RESULTSCLE was found to be beneficial in terms of high-quality visualization of fine structures and for displaying hidden anatomical details. The handling of the device was good, and the workflow was easy.CONCLUSIONSHandling ergonomics and image acquisition are intuitive. The endomicroscope allows excellent additional visualization of microstructures in the surgical field with a minimally invasive technique and could improve safety and clinical outcomes. The new confocal laser endomicroscope is an advanced tool with the potential to change intracranial tumor surgery. Imaging of these microstructures is novel, and research with comparative validation with traditional neuropathological assessments is needed.
Cauda equina syndrome secondary to portal vein thrombosis: case report of favorable outcome with conservative treatment
Authors: Campione Alberto , Agresta Gianluca , Locatelli Davide , Pozzi Fabio 
Published: January 2021

Epidural varicosis is a rare though well-known cause of cauda equina syndrome (CES). Although inferior vena cava (IVC) obstruction is the most common finding in such cases, portal vein hypertension can lead to epidural venous plexus engorgement by means of lumbar portocaval shunt activation.A 40-year-old woman presented with right-sided sciatica, which progressed to right foot drop and a 3-day history of vesical tenesmus and fecal retention. She was initially diagnosed with L4–5 lumbar disc protrusion. However, contrast-enhanced lumbar MRI scan showed the presence of epidural varices in the L3–S1 tract. Given the absence of vascular anomalies amenable to resection, etiological conservative treatment was addressed. Therefore, a complete diagnostic workup was performed and revealed deep vein thrombosis (DVT), pulmonary embolism, and portal vein thrombosis. Oral anticoagulant therapy was initiated and prompt resolution of CES was observed. To the authors’ knowledge, this is the first report of CES secondary to epidural varicosis in the setting of acute portal vein thrombosis and extrahepatic portal vein obstruction (EHPVO). In cases of epidural varicosis, conservative etiological treatment is the most appropriate choice as CES may be the epiphenomenon of underlying systemic pathophysiological processes.
Deciphering the frontostriatal circuitry through the fiber dissection technique: direct structural evidence on the morphology and axonal connectivity of the fronto-caudate tract
Authors: Komaitis Spyridon , Koutsarnakis Christos , Lani Evgenia , Kalamatianos Theodosis , Drosos Evangelos , Skandalakis Georgios P. , Liakos Faidon , Liouta Evangelia , Kalyvas Aristotelis V. , Stranjalis George 
Published: January 2021

OBJECTIVE
The authors sought to investigate the very existence and map the topography, morphology, and axonal connectivity of a thus far ill-defined subcortical pathway known as the fronto-caudate tract (FCT) since there is a paucity of direct structural evidence regarding this pathway in the relevant literature.

METHODS
Twenty normal adult cadaveric formalin-fixed cerebral hemispheres (10 left and 10 right) were explored through the fiber microdissection technique. Lateral to medial and medial to lateral dissections were carried out in a tandem manner in all hemispheres. Attention was focused on the prefrontal area and central core since previous diffusion tensor imaging studies have recorded the tract to reside in this territory.

RESULTS
In all cases, the authors readily identified the FCT as a fan-shaped pathway lying in the most medial layer of the corona radiata and traveling across the subependymal plane before terminating on the superolateral margin of the head and anterior part of the body of the caudate nucleus. The FCT could be adequately differentiated from adjacent fiber tracts and was consistently recorded to terminate in Brodmann areas 8, 9, 10, and 11 (anterior pre–supplementary motor area and the dorsolateral, frontopolar, and fronto-orbital prefrontal cortices). The authors were also able to divide the tract into a ventral and a dorsal segment according to the respective topography and connectivity observed. Hemispheric asymmetries were not observed, but instead the authors disclosed asymmetry within the FCT, with the ventral segment always being thicker and bulkier than the dorsal one.

CONCLUSIONS
By using the fiber microdissection technique, the authors provide sound structural evidence on the topography, morphology, and connectional anatomy of the FCT as a distinct part of a wider frontostriatal circuitry. The findings are in line with the tract’s putative functional implications in high-order motor and behavioral processes and can potentially inform current surgical practice in the fields of neuro-oncology and functional neurosurgery.
Stereotactic radiosurgery for treatment of radiation-induced meningiomas: a multiinstitutional study
Authors: Bunevicius Adomas , Suleiman Mohand , Patel Samir , Martínez Álvarez Roberto , Martinez Moreno Nuria E. , Liscak Roman , Hanuska Jaromir , Langlois Anne-Marie , Mathieu David , Mau Christine , Caldwell Catherine , Tuanquin Leonard C. , Zacharia Brad E. , McInerney James , Lee Cheng-Chia , Yang Huai-Che , Peterson Jennifer L. , Trifiletti Daniel M. , Ogino Akiyoshi , Kano Hideyuki , Warnick Ronald E. , Saylany Anissa , Buch Love Y. , Lee John Y. K. , Strickland Ben A. , Zada Gabriel , Chang Eric L. , Lunsford L. Dade , Sheehan Jason 
Published: January 2021

OBJECTIVE
Radiation-induced meningiomas (RIMs) are associated with aggressive clinical behavior. Stereotactic radiosurgery (SRS) is sometimes considered for selected RIMs. The authors investigated the effectiveness and safety of SRS for the management of RIMs.

METHODS
From 12 institutions participating in the International Radiosurgery Research Foundation, the authors pooled patients who had prior cranial irradiation and were subsequently clinically diagnosed with WHO grade I meningiomas that were managed with SRS.

RESULTS
Fifty-two patients underwent 60 SRS procedures for histologically confirmed or radiologically suspected WHO grade I RIMs. The median ages at initial cranial radiation therapy and SRS for RIM were 5.5 years and 39 years, respectively. The most common reasons for cranial radiation therapy were leukemia (21%) and medulloblastoma (17%). There were 39 multiple RIMs (35%), the mean target volume was 8.61 ± 7.80 cm3, and the median prescription dose was 14 Gy. The median imaging follow-up duration was 48 months (range 4–195 months). RIM progressed in 9 patients (17%) at a median duration of 30 months (range 3–45 months) after SRS. Progression-free survival at 5 years post-SRS was 83%. Treatment volume ≥ 5 cm3 predicted progression (HR 8.226, 95% CI 1.028–65.857, p = 0.047). Seven patients (14%) developed new neurological symptoms or experienced SRS-related complications or T2 signal change from 1 to 72 months after SRS.

CONCLUSIONS
SRS is associated with durable local control of RIMs in the majority of patients and has an acceptable safety profile. SRS can be considered for patients and tumors that are deemed suboptimal, poor surgical candidates, and those whose tumor again progresses after removal.