A5025288812- Vascular Malformations Diagnosis and Treatment
- Intracranial Aneurysms: Treatment and Complications
- Meningioma and schwannoma management
- Glioma Diagnosis and Treatment
- Cerebrospinal fluid and hydrocephalus
- Traumatic Brain Injury and Neurovascular Disturbances
- Head and Neck Surgical Oncology
- Neurosurgical Procedures and Complications
- Pituitary Gland Disorders and Treatments
- Cerebrovascular and Carotid Artery Diseases
- Spinal Dysraphism and Malformations
- Brain Metastases and Treatment
- Intracerebral and Subarachnoid Hemorrhage Research
- Lung Cancer Research Studies
- Neurofibromatosis and Schwannoma Cases
- Bone Tumor Diagnosis and Treatments
- Oral and Maxillofacial Pathology
- Aortic aneurysm repair treatments
- Moyamoya disease diagnosis and treatment
- Trauma Management and Diagnosis
- Congenital Heart Disease Studies
- Traumatic Ocular and Foreign Body Injuries
- Cerebral Venous Sinus Thrombosis
- Adrenal and Paraganglionic Tumors
- Acute Ischemic Stroke Management
St. Vincent Hospital
2022-2024
Neurological Surgery
2011-2024
St Vincent Medical Center
2022-2024
St Vincent Hospital
2024
St. Vincent Carmel Hospital
2024
Indiana Spine Group
2016-2023
St. Vincent's Medical Center
2020
Indiana University School of Medicine
2012-2018
Indiana University – Purdue University Indianapolis
2011-2018
Indiana University
2015-2016
Abstract BACKGROUND: Subcortical injury resulting from conventional surgical management of intracranial hemorrhage may counteract the potential benefits hematoma evacuation. OBJECTIVE: To evaluate safety and a novel, minimally invasive approach for clot evacuation in multicenter study. METHODS: The integrated incorporates 5 competencies: (1) image interpretation trajectory planning, (2) dynamic navigation, (3) atraumatic access system (BrainPath, NICO Corp, Indianapolis, Indiana), (4)...
Conventional approaches to deep-seated cerebral lesions range from biopsy transcortical or transcallosal resection. Although the former does not reduce tumor burden, latter are more invasive and associated with greater potential for irreparable injury normal brain. Disconnection syndrome, hemiparesis, hemianesthesia, aphasia is uncommon after such surgery, especially when lesion large. By contrast, transsulcal parafascicular approach uses naturally existing corridors a tubular retractor...
No FDA approved pharmacological therapy is available that would reduce cell death following traumatic brain injury (TBI). Dexmedetomidine (Dex) a highly selective agonist of alpha-2 adrenergic receptors and has demonstrated neuroprotective effects in hippocampal slice cultures undergoing direct impact. However, no one tested whether Dex, addition to its sedative action, an animal model TBI. Thus, the present study, we investigated Dex on Mice received different doses (1, 10, or 100 µg/kg...
The authors of this study sought to report the technique and early clinical outcomes a purely endonasal endoscopic approach for resection petroclival chondrosarcomas.Between 2010 2014, 8 patients (4 men 4 women) underwent operations resect chondrosarcomas at 2 institutions. patients' mean age was 44.8 years (range 30-64 years). One had previously undergone radiation therapy another staged craniotomy. Using volumetric software, an independent neuroradiologist assessed extent resections on MRI...
Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due obstruction by the apex of culmen. The authors describe lateral supracerebellar infratentorial approach that was successfully used treatment 10 large (> 3 cm) midline pineal tumors. patients were placed modified decubitus position. A small suboccipital craniotomy exposed transverse sinus....
Treatment of deep-seated subcortical intrinsic brain tumors remains challenging and may be improved with trans-sulcal tubular retraction techniques coupled intraoperative magnetic resonance imaging (iMRI).To conduct a preliminary assessment feasibility efficacy iMRI in retractor-guided resections tumors.Assessment this technique impact upon outcomes were assessed series tumor patients from 2 centers.Ten underwent resection retractor system iMRI. Mean age was 53.2 ± 9.0 yr (range: 37-61 yr,...
Stereotactic radiosurgery (SRS) has been shown to be efficacious for the treatment of limited brain metastasis (BM); however, effects SRS on human metastases have yet studied. We performed genomic analysis resected from patients whose lesion was previously treated with SRS. Our analyses demonstrated first time that possess a distinct signature based type failure including local failure, leptomeningeal spread, and radio-necrosis. Examination center peripheral edge tumors indicated...
A cerebral dural arteriovenous fistula (DAVF) is an acquired abnormal arterial-to-venous connection within the leaves of intracranial dura with a wide range clinical presentations and natural history. The Cognard classification correlates venous drainage patterns neurological course, identifying 5 DAVF types increasing rates symptomatic presentation. spinal occurs when radicular artery makes direct anomalous shunt vein leaflets nerve root sleeve. cervical rare entity, as most DAVFs present...
Surgical exposure of the peritrigonal or periatrial region has been challenging due to depth and overlying important functional cortices white matter tracts. The authors demonstrate operative feasibility a contralateral posterior interhemispheric transfalcine transprecuneus approach (PITTA) this present series patients treated via route.Fourteen consecutive underwent PITTA were included in study. Pre- postoperative clinical radiological data points retrospectively collected. Complications...
Cerebral arteriovenous malformations (AVMs) can be a heterogeneous pathological entity whose management requires complex decision-making process due to the risks associated with their treatment and natural history. Despite recently published conclusions of aborted Randomized Trial Brain Unruptured AVMs (ARUBA) trial, authors this article believe multimodality intervention in general microsurgical resection particular continue play major role carefully selected ruptured or unruptured AVMs.The...
Cerebral aneurysm rupture is associated with high rates of morbidity and mortality. Detecting aneurysms at risk critical in management decision making. Rupture has traditionally been size-measured as a maximum dimension. However, are morphologically dynamic, characteristic ignored by large prospective studies. Manual measurement challenging fraught error. We used an artificial intelligence (AI) tool to study that ruptured during conservative detect changes size not appreciated manual linear...
Ideal management of intracranial arteriovenous malformations (AVMs) remains poorly defined. Decisions regarding AVMs are based on the expected natural history lesion and risk prediction for peritreatment morbidity. Microsurgical resection, stereotactic radiosurgery, endovascular embolization alone or in combination all viable treatment options, each with different risks. The authors attempt to clarify existing literature's understanding AVMs, risk-assessment grading scales three...
Stereotactic radiosurgery (SRS) following surgical resection is the standard of care for patients with symptomatic oligo brain metastasis (BM), however, it associated 10-15% local failure. Targeting a cavity imprecise, thus preoperative where target well-defined may be superior, efficacy SRS has not yet been tested in clinical trial.
The surgical management of patients with symptoms tethered cord syndrome (TCS) who lack significant radiographic abnormalities is controversial. One potential MRI marker for TCS a spinal syrinx or syringomyelia. Alternatively, may be benign and incidental finding. In this report the authors evaluated highly selected cohort minimal other than They analyzed clinical outcomes after release (TCR).A retrospective review data from 16 children met study inclusion criteria was performed. All had...
Aneurysms in children are rare and potentially devastating lesions. The authors report the case of a 16-year-old girl with complicated medical history related to chiasmal glioma diagnosed at 18 months age. She had previously received multiple modalities radiation treatment, including external beam, proton therapy, Gamma Knife. presented hemorrhage centered tumor extending into ventricular space. There was no subarachnoid blood. Magnetic resonance imaging demonstrated anatomy. angiography...
The Triple Aim is defined as: improving the patient experience of care, health populations, and reducing per capita cost care. purpose this analysis was to evaluate economic value a new neurosurgical technique, BrainPath™ approach, for use in patients with subcortical tumors intracerebral hemorrhage (ICH).Inpatient length stay (LOS) data were collected ICH brain tumor surgical cases between August 2013 November 2015. Patient separated into two groups; BrainPath approach (n = 28) conventional...
OBJECTIVE Aneurysmal rebleeding before definitive obliteration of the aneurysm is a cause mortality and morbidity. There are limited data on role short-term antifibrinolytic therapy among patients undergoing endovascular intervention. METHODS All consecutive receiving for their ruptured saccular at authors' institution between 2000 2011 were included in this study. These underwent coiling within 72 hours admission. In ε-aminocaproic acid (EACA), EACA administration was continued until time...
Stereotactic radiosurgery (SRS) has emerged as a common adjuvant modality used with surgery for resectable brain metastases (BMs). However, the optimal sequence of multi-modality therapy not been established. The goal study is to evaluate 6-month local control utilizing pre-operative SRS followed by surgical resection patients 1–4 metastases. This prospective, single arm, phase II trial will recruit up 4 and at least one lesion. All lesions be treated symptomatic resected within days after...
OBJECTIVE Intraoperative angiography can be a valuable tool in the surgical management of vascular disorders CNS. This is typically accomplished via femoral artery puncture; however, this technically difficult patients prone position. The authors describe feasibility intraoperative popliteal patient. METHODS Three underwent spinal position access through artery. Standard techniques were used, along with ultrasound and micropuncture needle for initial access. Two to confirm obliteration dural...