A5040484699- Pituitary Gland Disorders and Treatments
- Head and Neck Surgical Oncology
- Meningioma and schwannoma management
- Glioma Diagnosis and Treatment
- Sinusitis and nasal conditions
- Adrenal and Paraganglionic Tumors
- Cerebrospinal fluid and hydrocephalus
- Spinal Fractures and Fixation Techniques
- Growth Hormone and Insulin-like Growth Factors
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac, Anesthesia and Surgical Outcomes
- Neurosurgical Procedures and Complications
- Spine and Intervertebral Disc Pathology
- Bone Tumor Diagnosis and Treatments
- Trigeminal Neuralgia and Treatments
- Neurofibromatosis and Schwannoma Cases
- Craniofacial Disorders and Treatments
- Vascular Malformations Diagnosis and Treatment
- Nasal Surgery and Airway Studies
- Epilepsy research and treatment
- Oral and Maxillofacial Pathology
- Intracranial Aneurysms: Treatment and Complications
- Health Systems, Economic Evaluations, Quality of Life
- Lung Cancer Diagnosis and Treatment
- Facial Trauma and Fracture Management
St. Joseph's Hospital and Medical Center
2016-2025
Neurological Surgery
2010-2025
Barrow Neurological Institute
2016-2025
Health Education North West
2022
OhioHealth
2022
Doctors Hospital
2022
AdventHealth East Orlando
2022
Alabama College of Osteopathic Medicine
2022
University of Portsmouth
2021
St. Joseph's Hospital
2020
Fifty-six male patients who had chronic low-back pain of at least 12 weeks' duration (average duration, 28.6 weeks) and failed to respond traditional medical or surgical therapy were entered into a randomized clinical trial compare the relative efficacies Clinic's standard regimen with without dry needling muscle motor points. Before entering trial, all undergone improvement eight weeks physiotherapy, remedial exercises, occupational therapy. The 29 study subjects 27 control then continued...
Many surgeons have adopted fully endoscopic over microscopic transsphenoidal surgery for nonfunctioning pituitary tumors, although no high-quality evidence demonstrates superior patient outcomes with surgery. The goal of this analysis was to compare these techniques in a prospective multicenter controlled study.
Unplanned readmission after surgical procedures is an important quality metric. Yet, rates and causes have not been evaluated for patients transsphenoidal surgery pituitary tumors.To analyze unplanned 30-day readmissions at a center to encourage the development of effective clinical pathways prevent readmission.A retrospective review adult who underwent lesions Barrow Neurological Institute (January 2011-March 2014) was performed identify within 30 days surgery. Patient demographics, tumor...
Despite the increasing application of endoscopic transsphenoidal surgery for pituitary lesions, prognostic factors that are associated with sinonasal quality life (QOL) and nasal morbidity not well understood. The authors examine predictors QOL in patients undergoing fully surgery.An exploratory post hoc analysis was conducted who underwent were enrolled a prospective multicenter study. End points study included patient-reported objective endoscopy findings. Multivariate models developed to...
The comparative efficacy of microscopic and fully endoscopic transsphenoidal surgery for pituitary adenomas has not been well studied despite the adoption by many centers. influence surgeon experience also examined in this setting. authors therefore compared extent tumor resection (EOR) endocrine outcomes 1 very experienced performing a technique with those less using nonfunctioning concurrent series patients.Post hoc analysis was conducted cohort adult patients prospectively enrolled...
Background and Purpose- The CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) demonstrated equivalent composite outcomes between carotid endarterectomy (CEA) artery stenting (CAS) for treating stenosis. We investigated nationwide trends in these procedures associated periprocedural stroke, myocardial infarction, death, cost, readmission rates since were published. Methods- queried the Nationwide Readmissions Database to identify patients undergoing CEA CAS asymptomatic...
The significance of rhythmic and periodic EEG patterns in critically ill patients is unclear. A universal terminology needed to facilitate study these patterns, consistent observer agreement should be demonstrated its use. authors evaluated inter- intraobserver using the standardized (Hirsch et al., J Clin Neurophysiol 2005;22:128-135) recently proposed by American Clinical Neurophysiology Society. Trained electroencephalographers viewed a series 10-second samples from adults (phase I), set...
Despite the widespread adoption of endoscopic transsphenoidal surgery for pituitary adenomas, sinonasal quality life (QOL) and health status in patients who have undergone this technique not been compared with these findings traditional direct uninostril microsurgical technique. In study, authors QOL patient-reported after use 2 surgical techniques.The study design was a nonblinded prospective cohort study. Adult sellar pathology planned were screened at 4 centers US between October 2011...
Microscopic and endoscopic transsphenoidal approaches to the sellar are well established. Surgical freedom is an important skull base principle that can be measured objectively used compare approaches.To surgical of 4 sella turcica aid in approach selection.Four were performed on 8 silicon-injected cadaveric heads. was determined with stereotactic image guidance using previously established techniques. The results presented as area angular (angle attack) axial sagittal planes.Mean total...
Nonconvulsive status epilepticus (NCSE) is an underrecognized and poorly understood complication of aneurysmal subarachnoid hemorrhage (SAH). The authors evaluated the risk factors, electroencephalographic (EEG) characteristics, hospital course, clinical outcomes associated with NCSE in a population SAH treated at single institution.The hospitalization outcome data were reviewed 11 patients who had received diagnosis SAH. study included individuals from cohort 389 consecutive between March...
The long-term outcome of patients treated with gamma knife radiosurgery (GKRS) for typical trigeminal neuralgia has not been fully studied. We evaluated 185 who underwent their first GKRS treatment between 1997 and 2003 at the Barrow Neurological Institute.Follow-up was obtained by surveys review medical records. Outcomes were assessed Institute Pain Intensity Score Brief Inventory. most common maximum dose 80 Gy targeted root entry zone. are presented 136 (74%) whom more than 4 years...
Object Patient-reported quality-of-life (QOL) end points are becoming increasingly important health care metrics. To date, no nasal morbidity instrument specifically designed for patients undergoing endonasal skull base surgery has been developed. In this study, the authors describe development and validation of a site-specific to assess patient-reported rhinological outcomes following surgery. Methods Eligible included those with planned transsphenoidal sellar pathology identified in...
This article introduces a classification scheme for extensive traumatic anterior skull base fracture to help stratify surgical treatment options. The authors describe their multilayer repair technique cerebrospinal fluid (CSF) leak resulting from using combination of laterally pediculated temporalis fascial-pericranial, nasoseptal-pericranial, and pericranial flaps.Retrospective chart review identified patients treated surgically between January 2004 May 2014 fractures with CSF fistulas. All...
OBJECTIVE The goal of this study was to determine the interrater and intrarater reliability Knosp grading scale for predicting pituitary adenoma cavernous sinus (CS) involvement. METHODS Six independent raters (3 neurosurgery residents, 2 surgeons, 1 neuroradiologist) participated in study. Each rater scored 50 unique MRI scans (with contrast) biopsy-proven adenoma. Reliabilities full were determined 3 ways: 1) using all scans, 2) with midrange scores versus end scores, 3) a dichotomized...
OBJECTIVE Cerebral venous pressure gradient (CVPG) from dural sinus stenosis is implicated in headache syndromes such as idiopathic intracranial hypertension (IIH). The incidence of CVPG patients has not been reported. METHODS authors reviewed all cerebral venograms with manometry performed for between January 2008 and May 2015. Patient demographics, etiology, (ICP) measurements, radiographic manometric results were recorded. was defined a difference ≥ 8 mm Hg by venographic manometry....
To develop and determine convergent validity reliability of a simple inexpensive clinical test to quantify back extensor muscle strength.Two testing sessions were conducted, 7 days apart. Each session involved three trials standing maximal isometric strength using both the novel isokinetic dynamometry. Lumbar spine bone mineral density was examined by dual-energy X-ray absorptiometry. Validation with Pearson correlations (r). Test-retest intraclass correlation coefficients limits agreement....
OBJECTIVE Effective treatments for recurrent, previously irradiated intracranial meningiomas are limited, and resection alone is not usually curative. Thus, the authors studied combination of maximum safe adjuvant radiation using permanent brachytherapy (R+BT) in patients with aggressive meningiomas. METHODS Patients were treated between June 2013 October 2016 a prospective single-arm trial R+BT. Cesium-131 (Cs-131) sources embedded modular collagen carriers positioned operative bed on...
The authors evaluated the feasibility of using first clinical-grade confocal laser endomicroscopy (CLE) system fluorescein sodium for intraoperative in vivo imaging brain tumors.A CLE cleared by FDA was used 30 prospectively enrolled patients with 31 tumors (13 gliomas, 5 meningiomas, 6 other primary tumors, 3 metastases, and 4 reactive tissue). A neuropathologist classified images as interpretable or noninterpretable. Images were compared corresponding frozen permanent histology sections,...
Abstract Context Pituitary apoplexy (PA) has been traditionally considered a neurosurgical emergency, yet retrospective single-institution studies suggest similar outcomes among patients managed medically. Objective We established multicenter, international prospective registry to compare presentation and in PA treated with surgery or medical management alone. Methods A centralized database captured demographics, comorbidities, clinical presentation, visual findings, hormonal status, imaging...
The evaluation of patients with subarachnoid hemorrhage (SAH) negative initial catheter-based angiography is a diagnostic challenge. Better strategies based on patterns are needed.We retrospectively investigated the yield focused history taking, magnetic resonance imaging brain and cervical spine, follow-up vascular imaging, laboratory investigations, craniotomy for vessel exploration in 100 SAH angiography.The most common distribution was "classic" aneurysmal pattern filling basal cisterns...