bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Neurological Outcomes and Timing of Physical Therapy Initiation Among Patients Treated for Aneurysmal Subarachnoid Hemorrhage: A Propensity-Adjusted Analysis
Authors: Catapano Joshua S. , Koester Stefan W. , Rumalla Kavelin , Dabrowski Stephen J. , Winkler Ethan A. , Rudy Robert F. , Cole Tyler S. , Baranoski Jacob F. , Graffeo Christopher S. , Srinivasan Visish M. , Jha Ruchira M. , Jadhav Ashutosh P. , Ducruet Andrew F. , Albuquerque Felipe C. , Lawton Michael T. 
Published: November 2024

BACKGROUND:Aneurysmal subarachnoid hemorrhage (aSAH) is a debilitating neurological disease associated with poor neurological outcomes.OBJECTIVE:To evaluate the association between timing of physical therapy (PT) initiation and neurological outcomes among patients treated for aSAH.METHODS:Patients receiving definitive aneurysm treatment at a single quaternary center (January 1, 2014-July 31, 2019) with data available on PT initiation and the number of sessions were analyzed. Patients were compared based on whether PT initiation was delayed (>24 hours after definitive aneurysm treatment) or nondelayed (≤24 hours after treatment). The primary outcome was a poor neurological outcome at last follow-up (modified Rankin Scale [mRS] score >2). A propensity-adjusted score was generated and included as a covariate in a logistic regression analysis.RESULTS:Among 382 patients, 260 (68%) had delayed and 122 (32%) had nondelayed PT initiation. A significantly greater percentage of patients in the delayed PT group had an mRS score of >2 at last follow-up (42% [n = 110] vs 20% [n = 24];P< .001). Among 298 patients with a Hunt and Hess (HH) grade <4, the percentage with an mRS score of >2 at last follow-up was significantly higher in the delayed (34% [62/184]) than nondelayed (18% [21/114]) PT group (P= .006). The logistic regression analysis showed that, among patients with an HH grade of <4, delayed PT initiation increased the risk of having an mRS score of >2 at follow-up (odds ratio = 1.90, 95% CI = 1.02-3.62,P= .047).CONCLUSION:Delayed PT initiation after definitive aneurysm treatment was associated with poor neurological outcomes regardless of patient characteristics, neurological presentation, or aneurysm characteristics.
De Novo Plasmacytoma at the Site of Previous Anterior Cervical Fusion
Authors: Burket Noah J. , Mobasser Dillon C. , Alentado Vincent J. , Mobasser Jean-Pierre 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Solitary plasmacytoma of bone (SPB) is a rare tumor that forms from monoclonal plasma cells within bone. These tumors are typically found in patients in their fifth to sixth decade of life and often progress to multiple myeloma. Previous reports have noted the formation of these tumors at the site of previous procedures or trauma, yet none have reported the development of SPB at the same site of a previous spinal surgery.

CLINICAL PRESENTATION:
The authors report on a 47-year-old woman who developed a de novo plasmacytoma 6 years after anterior cervical discectomy and fusion at the surgical site.

CONCLUSION:
Although SPB is a rare tumor primarily seen in bone that has been unaffected by surgery, it should be included in the differential after finding a tumor at the site of a previous spine surgery. Furthermore, biopsy should be considered once a lesion is identified in the area of a previous spine surgery, as SPB may progress to multiple myeloma, resulting in worse outcomes.
Parry-Romberg Syndrome and an Associated Complex Vascular Lesion Managed With Hybrid Strategies: A Case Report
Authors: Hagstrom Rory , Riina Howard A. , Britz Gavin W. , Sharashidze Vera , Chung Charlotte , Weiss Hannah , Spetzler Robert F. , Nelson Peter Kim 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Parry-Romberg syndrome (PRS) is a condition of unknown etiology, most commonly characterized by progressive facial hemi-atrophy due to breakdown of the underlying skin and soft tissues. PRS has been associated with neurologic disease such as intracranial aneurysms and vascular malformations. However, its exact role in the incidence of neurovascular disease remains unknown.

CLINICAL PRESENTATION:
We present a case of a complex fusiform aneurysm involving the A1 segment of the left anterior cerebral artery in a 21-year-old man with PRS. The patient initially presented with a left giant fusiform/dissecting internal carotid artery aneurysm initially managed with overlapping flow diverters. His post-flow diverter treatment course was confounded by progressive growth of the aneurysm with worsening mass effect on the optic chiasm leading to complete visual loss in the left eye and a right hemifield cut. To manage the aneurysm recurrence, retreatment with surgical bypass-supported carotid occlusion was performed. Thereafter, visual symptoms improved, but complete normalization of vision was not achieved. The patient remained clinically stable for several years until follow-up imaging demonstrated a novel adjacent recurrence involving the ipsilateral A1 segment, previously noted to be angiographically normal. The patient underwent superselective angiography followed by endovascular occlusion of the new fusiform lesion.

DISCUSSION:
The case presented here illustrates the hybrid roles of endovascular and surgical treatment modalities in treating complex vascular lesions. The recurrence of the lesion following initial treatment strategies introduces questions about how the nature and development of the lesion affected the success of treatment at each stage. Considerations for the efficacy of each stage of treatment in this case include the patients underlying connective tissue disorder, the pediatric etiology of the lesion, and the timing of each treatment option given these factors.

CONCLUSION:
In addition to understanding the biological behavior of flow diversion for complex intracranial aneurysms, the role of PRS in the incidence of neurovascular disease should also be considered when applicable. More research into the mechanisms of PRS in neurovascular disease is needed.
Case Report: Contralateral Progression of a Vestibular Schwannoma After Resection in a Patient with Neurofibromatosis Type 2
Authors: Rampalli Ihika , English Collin William , Lazaro Tyler , Lovin Benjamin Daniel , Lee Sungho , Huang Andrew Tsao , Jalali Ali , Gallagher Kathleen Kelly , Mandel Jacob J. , Sweeney Alex Daniel , Patel Akash J. 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Bilateral vestibular schwannomas (VS) are a distinctive feature of neurofibromatosis type 2 (NF2) that result in a serious reduction in the quality of life for patients. The growth rates of these schwannomas are variable, and the early detection of increased growth is fundamental for improving outcomes.

CLINICAL PRESENTATION:
A 17-year-old man with NF2 and bilateral VS presented with complete right facial paralysis and sudden right hearing loss less than 1 month after resection of a left VS. Imaging revealed rapid growth of the right VS with intratumoral hemorrhage, and the patient underwent urgent surgical resection with some improvement in symptoms.

DISCUSSION:
Existing literature indicates a similar phenomenon after a longer post-operative period; however, none have shown such rapid symptomatology. Multiple etiologies were explored for this presentation, including the sudden decompression from the primary resection, paracrine factors, and hypervascularity from prior radiation.

CONCLUSION:
VS resection in a patient with NF2 may be followed by rapid growth in the contralateral VS, leading to severe symptom presentation. Patients should be counseled regarding this risk to enable early detection and intervention.
A Reliable Closure Technique for Retromastoid Craniotomy to Avoid Cerebrospinal Fluid Leaks and Meningitis
Authors: Barkhoudarian Garni , Garling R. Justin , Mallari Regin Jay , Sivakumar Walavan , Kelly Daniel F. 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Postoperative cerebrospinal fluid (CSF) leaks and meningitis are well-known risks of retromastoid craniotomy. Use of abdominal fat grafts, collagen allografts, and rigid or semirigid buttresses have demonstrated efficacy in preventing CSF leaks and meningitis in endoscopic endonasal surgery. This study aims to determine the utility of a similar multilayered reconstruction technique for retromastoid craniotomy.

METHODS:
We retrospectively reviewed 212 consecutive patients who underwent retromastoid craniotomy for tumor removal or microvascular decompression from 2007 to 2022. Scalp incisions were linear or slightly curved, muscle and facia opening was performed sharply avoiding monopolar cautery; craniotomies had a maximum dimension of 3 cm. A primary water-tight dural closure was rarely achieved favoring collagen sponge overlay often augmented with autologous fat. Clinical factors including pathology, mastoid air cell entry, and reconstruction material were analyzed. Outcomes including postoperative CSF leakage and meningitis were assessed.

RESULTS:
Of 212 patients (mean age 56 ± 16 years; 60% female; 10% with prior surgery), 148 (70%) had tumor resection and 64 (30%) had microvascular decompression. Mastoid air cells were breached in 67%. Collagen sponge dural overlay was used in 201/212 (95%). A fat graft was placed in 116 (55%) cases: 69% with air cell entry, 27% without air cell entry; 158 (75%) patients had their bone flap replaced, 46 (21%) had titanium mesh cranioplasty, 8 (4%) had no bone flap or titanium mesh. There were no CSF leaks or meningitis. One patient had a lumbar drain placement preoperatively, none postoperatively. Median length of stay was 2 days.

CONCLUSION:
Retromastoid craniotomy multilayered reconstruction with liberal use of collagen sponge and abdominal fat grafts seems to reliably avoid postoperative CSF leaks and meningitis including in the setting of nonwatertight dural closure and mastoid cell entry. Use of shorter incisions, avoidance of monopolar cautery, and a relatively small craniotomy may contribute to the absence of CSF leaks in this series.
The Evolution of Pediatric Spine Surgery: A Bibliometric Analysis of Publications From 1902 to 2023
Authors: Mir Jamshaid M. , Kurland David B. , Cheung Alexander T. M. , Liu Albert , Shlobin Nathan A. , Alber Daniel , Rai Sumedha , Jain Vasvi , Rodriguez-Olaverri Juan C. , Anderson Richard C. E. , Lau Darryl , Kondziolka Douglas , Oermann Eric K. 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Pediatric spine surgery has evolved considerably over the past century. No previous study conducted a bibliometric analysis of the corpus of pediatric spine surgery. We used big data and advanced bibliometric analyses to evaluate trends in the progression of pediatric spine surgery as a distinct field since the beginning of the 20th century.

METHODS:
A Web of Science query was designed to capture the representative corpus of pediatric spine literature. Statistical and bibliometric analyses were performed using various Python packages and the Bibliometrix R package.

RESULTS:
The collection, published from 1902 to 2023, comprised a total of 11 861 articles from 61 journals and 32 715 unique authors. The overall growth rate annually for publications was 5.08%. An upsurge in publications was seen in the 1980s, after the advent of specialty and subspecialty journals. Illustratively, over 90% of all articles pertaining to pediatric spine surgery were published in the past 3 decades. International and domestic collaboration also increased exponentially over this time period. Reference publication year spectroscopy allowed us to identify 75 articles that comprise the historical roots of modern pediatric spine surgery. There was a recent lexical evolution of topics and terms toward alignment, outcomes, and patient-centric terms. Coauthorship among under-represented groups increased since 1990, but remains low, with disparities persisting across journals.

CONCLUSION:
This comprehensive bibliometric analysis on the corpus of pediatric spine surgery offers insight into the evolving landscape of research, authorship, and publication trends over the past century. Advancements in the understanding of the natural history and technology have led the field to become increasingly outcomes focused, all of which have been fueled by pioneering authors. While diversity among authors improves, under-representation of various groups continues to persist, indicating a critical role for further outreach and promotion.
Novel Delivery of Cryoablation Through Transoral Surgical Approach for Atypical Presentation of Osteoid Osteoma of the C1 Lateral Mass: Technical Case Illustration
Authors: Dharia Anand A. , Bhargav Adip G. , Kaufman Christian B. , Rivard Douglas C. , Grabb Paul A. 
Published: November 2024

BACKGROUND AND IMPORTANCE:
Neurosurgical literature rarely explores cases of osteoid osteomas of the atlas. Traditionally, neurosurgeons performed en bloc surgical resection for refractory osteoid osteomas in the subaxial and lumbar spine, but minimally invasive ablation therapies have gained favor. Complete lesioning of the nidus, either by surgical or minimally invasive therapies, produces curative results with recurrence only developing after partial lesioning.

CLINICAL PRESENTATION:
We discuss the case of a 16-year-old adolescent boy who presented with neck and occipital pain refractory to multimodal pain management. Prolonged workup demonstrated a subtle radiographic lesion of the left C1 lateral mass. Interventional radiologists attempted a posterior approach percutaneous computed tomography-guided radiofrequency ablation but aborted due to proximity of the vertebral artery. Surgeons then pursued an open transoral approach to provide a corridor for cyclical cryoablation therapy, which proceeded without complication. The patient was discharged on postoperative day one with remission of occipital pain at the 10-month follow-up. No clinical or radiographic evidence of instability appeared on postoperative cervical films.

CONCLUSION:
No reports exist in the literature of an osteoid osteoma of C1 treated by an open anterior approach and with cryoablation. The transoral approach is a safe, effective method to access ventral pathologies of C1. The transoral approach may minimize blood loss and reduce the risk of craniocervical instability, allowing for preserved cervical mobility and improved patient outcomes. Surgeons may especially consider cryoablation when the nidus is within proximity to critical neural structures.
Does an Unintended Durotomy in Metastatic Spine Surgery Lead to Shorter Survival?
Authors: Gangavarapu Lakshmi Suryateja , Chanbour Hani , Bendfeldt Gabriel A. , Younus Iyan , Jonzzon Soren , Chotai Silky , Abtahi Amir M. , Stephens Byron F. , Zuckerman Scott L. 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Whether unintended durotomy in metastatic spine surgery seeds tumor in the central nervous system (CNS) remains unknown. Our objectives were to (1) determine the rate of unintended durotomy, (2) identify the preoperative and perioperative factors that increase the risk of unintended durotomy, and (3) determine whether unintended durotomy affected local recurrence (LR), any spinal recurrence, and overall survival.

METHODS:
A single-center, retrospective cohort study of patients undergoing metastatic spine surgery between January 2010 to January 2021 was undertaken. The primary exposure variable was the occurrence of unintended durotomy. Multivariable logistic/linear regression were performed controlling for age, body mass index, tumor size, other organ metastases, and preoperative radiotherapy/chemotherapy.

RESULTS:
Of 354 patients undergoing surgery for extradural spinal metastasis, 19 patients (5.4%) had an unintended durotomy. Preoperatively: No difference was found between patients with and without unintended durotomy regarding basic demographics, comorbidities (P = .645), or tumor histology (P = .642). Preoperative chemotherapy/radiotherapy were similar between the 2 groups. Perioperatively: Although patients with unintended durotomy had more costotransversectomies (36.8% vs 12.8%, P = .010), no difference was found in tumor characteristics, operative time (337.4 vs 310.6 minutes, P = .150), blood loss (1012.8 vs 883.8 mL, P = .157), length of stay (6.4 vs 6.9 days, P = .452), or overall reoperation/readmission. Long-term: No difference was seen in CNS spread between those with unintended durotomy and no durotomy (10.5% vs 3.0%, P = .077). LR (5.3% vs 12.2%, P = .712), time to LR (388.0 vs 213.3 ± 359.8 days, log-rank; P = .709), any spinal recurrence (26.3% vs 34.0%, P = .489), overall survival (21.05% vs 34.3%, P = .233), and time to death (466.9 ± 634.7 vs 465.8 ± 665.4 days, log-rank; P = .394) were similar on multivariable Cox regressions.

CONCLUSION:
In patients undergoing surgery for extradural spinal metastases, 5% had an unintended durotomy, and costotransversectomies were associated with increased risk of an unintended durotomy. Unintended durotomies did not lead to increased LR or shorter survival. Taken together, shortened survival due to seeding tumor into the CNS after an unintended durotomy was not observed.
The Second-Set Surgeries for Multiple Unruptured Aneurysms Do Not Increase Perioperative Complications
Authors: Nounaka Yohei , Shirokane Kazutaka , Matano Fumihiro , Koketsu Kenta , Kubota Asami , Morita Akio , Murai Yasuo 
Published: November 2024

BACKGROUND AND OBJECTIVES:
Intracranial aneurysms affect 3% to 4% of the population, with 20% to 25% having multiple aneurysms. Aggressive treatment is warranted for multiple unruptured aneurysms because of their higher risk of rupture and enlargement compared with single aneurysms. However, the risks and appropriate timing of secondary clipping surgeries are underreported. We assessed the prognosis and risks of treating multiple cerebral aneurysms with a second surgery and determined the differences in prognosis based on the timing of these surgeries.

METHODS:
We retrospectively reviewed patients who underwent secondary clipping surgery for multiple unruptured cerebral aneurysms at our hospital and affiliated institutions. The number, size, and location of aneurysms, patient demographics, and antithrombotic drug history were compared between the first and second surgeries. The modified Rankin Scale score and postoperative complications, including ischemia, hemorrhage, seizures, chronic subdural hematoma requiring surgery, infection, and postoperative hospital days, were investigated.

RESULTS:
A total of 38 patients (mean age, 65 years) were included. No significant differences were observed in modified Rankin Scale score worsening, postoperative hospital stay, or complication rates between the 2 surgeries. Older patients tended to undergo the second surgery within 6 months, with no significant difference in complication rates. The first surgery targeted larger aneurysms.

CONCLUSION:
The absence of complications between surgeries and the absence of rupture or re-treatment during follow-up emphasize the importance of choosing the most appropriate approach for each aneurysm. The first and second surgeries for multiple cerebral aneurysms did not significantly affect postoperative complications. Performing 2 craniotomies may facilitate the curative and safe treatment of aneurysms.
Complete Surgical Resection of a C3 Neuroenteric Cyst With Concurrent Cervical Fusion Deformity Through Posterior Midline Approach in the Lateral Position: Case Report
Authors: Huang Jin , Chen Yuning , Chen Kefei , Ji Wei , Shao Junfei , Guan Jian 
Published: November 2024

BACKGROUND AND IMPORTANCE:Enterogenic cysts often occur along the spinal axis and are frequently associated with congenital spinal malformations. The special location of the lesion can limit the surgical resection to achieve complete removal. In this report, the authors describe a successful case of complete resection of a ventral enterogenic cyst in the cervical spinal cord using a posterior midline approach in the lateral position.CLINICAL PRESENTATION:This report discusses a case of a 36-year-old young female patient who presented with relatively short-term discomfort and pain in the left shoulder and neck area. MRI examination revealed a cystic mass located ventrally in the C3 cervical spinal cord. We performed a posterior surgical approach and, under the lateral position, the lesion was completely resected. The surgical treatment alleviated the neurological dysfunction. During the follow-up periods of 3 and 6 months, the patient recovered well, and magnetic resonance imaging scans showed no residual lesion.CONCLUSION:Complete surgical resection of the cyst wall is the only effective treatment for enterogenic cysts because partial resection or subtotal resection may lead to recurrence. For patients with concomitant spinal malformations, a posterior midline approach in the lateral position is a viable surgical option.
Bone Regrowth After Frontal Burr Hole Craniostomy: Natural History of 14-mm and 20-mm Burr Holes and Implications for Postoperative Trans-Burr Hole Ultrasound
Authors: Antar Albert , Lee Ryan P. , Sattari Shahab Aldin , Meggyesy Michael , Ahn Jheesoo , Weber-Levine Carly , Jiang Kelly , Huang Judy , Luciano Mark 
Published: November 2024

BACKGROUND AND OBJECTIVE:
Burr hole craniostomy is performed for ventriculoperitoneal shunt insertion and endoscopic third ventriculostomy in patients with cerebrospinal fluid disorders. These burr holes are increasingly being used as windows for postoperative ultrasound, an investigational alternative to computed tomography or MRI for follow-up imaging of ventricular caliber. However, bone regrowth reduces ultrasound visibility, and little is known about burr hole regrowth rates in adults. Our study evaluates burr hole regrowth patterns and implications for transcranial ultrasound imaging.

METHODS:
We retrospectively analyzed 101 consecutive patients who had frontal burr hole craniostomy for new ventriculoperitoneal shunt insertion or endoscopic third ventriculostomy over a 3-year period. A mix of standard 14-mm burr holes and expanded 20-mm burr holes were used. Burr hole bone regrowth was assessed using serial follow-up computed tomography scans. Linear and logistic regression analyses examined if bone regrowth correlated with any clinical variables.

RESULTS:
There was wide variability in rate and degree of burr hole regrowth. The average percentage closure was 25% at 6 months, with minimal additional closure over the following 18 months. The mean residual diameter for 14-mm and 20-mm burr holes stabilized around 9.4 mm and 15.4 mm, respectively. Bone regrowth was not associated with patient characteristics, including age, sex, skull thickness, or etiology of cerebrospinal fluid disorder. Rate of bone regrowth was similar between both cohorts.

CONCLUSION:
Bone regrowth after burr hole craniostomy is common, even in elderly patients, occurring rapidly within the first 6 to 12 months and subsequently stabilizing. It is frequently severe enough to restrict ultrasound visualization. Regrowth could not be predicted with any investigated variables, so uniform techniques are needed to block regrowth to allow for longitudinal ultrasound imaging, such as full-thickness cylindrical burr hole implants.