A5073674679- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac Arrest and Resuscitation
- Optical Imaging and Spectroscopy Techniques
- Meningioma and schwannoma management
- Thermal Regulation in Medicine
- Congenital Heart Disease Studies
- Head and Neck Surgical Oncology
- Hemodynamic Monitoring and Therapy
- Neuroscience and Neural Engineering
- Anesthesia and Neurotoxicity Research
- Cardiac Ischemia and Reperfusion
- Neonatal and fetal brain pathology
- Spinal Fractures and Fixation Techniques
- Neurological disorders and treatments
- Mechanical Circulatory Support Devices
- Neurosurgical Procedures and Complications
- Non-Invasive Vital Sign Monitoring
- Cardiac, Anesthesia and Surgical Outcomes
- Glioma Diagnosis and Treatment
- Laser Applications in Dentistry and Medicine
- Facial Nerve Paralysis Treatment and Research
- Infectious Diseases and Tuberculosis
- Nerve injury and regeneration
- Spectroscopy and Chemometric Analyses
- Cerebrospinal fluid and hydrocephalus
Mayo Clinic in Arizona
2024
Children's Hospital of Philadelphia
2016-2023
University of Pennsylvania
2017-2023
Penn Presbyterian Medical Center
2020-2022
University of Pennsylvania Health System
2020-2022
California University of Pennsylvania
2021-2022
Neurological Surgery
2020
Background Infants with congenital heart disease (CHD) are at risk for white matter injury (WMI) before neonatal surgery. Better knowledge of the causes preoperative WMI may provide insights into interventions that improve neurodevelopmental outcomes in these patients. Methods and Results A prospective single-center study neonates CHD recorded data on primary cardiac diagnosis, maternal-fetal environment (MFE), delivery type, subject anthropometrics, care. Total maturation score were...
Abstract Background Surgical resection is a mainstay in the treatment of pediatric brain tumors to achieve tissue diagnosis and tumor debulking. While maximal safe desired, it can be challenging differentiate normal from neoplastic using only microscopic visualization, intraoperative navigation, tactile feedback. Here, we investigate potential for Raman spectroscopy (RS) accurately diagnose intraoperatively. Methods Using rapid acquisition RS device, intraoperatively imaged fresh ex vivo...
Management of deep hypothermic (DH) cardiopulmonary bypass (CPB), a critical neuroprotective strategy, currently relies on non-invasive temperature to guide cerebral metabolic suppression during complex cardiac surgery in neonates. Considerable inter-subject variability response and residual metabolism may contribute the persisting risk for postoperative neurological injury. To characterize mitigate this variability, we assess sufficiency conventional nasopharyngeal (NPT) guidance, process,...
Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations cerebral mitochondrial bioenergetics are thought to contribute ischaemia-reperfusion injury DHCA. The purpose this study was compare for DHCA with continuous perfusion using a swine model.Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling 18°C, 40 min and remained at hypothermia min; animals...
Objective. Holographic mixed reality (HMR) allows for the superimposition of computer-generated virtual objects onto operator's view world. Innovative solutions can be developed to enable use this technology during surgery. The authors and iteratively optimized a pipeline construct, visualize, register intraoperative holographic models patient landmarks spinal fusion Methods. study was carried out in two phases. In phase 1, custom generate patient-specific over 7 patients. 2, registration...
Background Meningiomas are the second most common primary tumors of central nervous system. However, there is a paucity literature examining how healthcare, demographic, and socioeconomic factors impact patient outcomes. Methods We conducted retrospective study 65,812 patients from National Cancer Database (NCDB; 2004-2012) who received treatment for their meningioma. Univariate multivariate analyses were performed with overall five-year survival as outcome, following factors: facility type,...
Abstract Neurologic injury is a leading cause of morbidity and mortality following pediatric cardiac arrest. In this study, we assess the feasibility quantitative, non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) neuromonitoring during cardiopulmonary resuscitation (CPR), its predictive utility for return spontaneous circulation (ROSC) in an established swine model Cerebral tissue properties, oxy- deoxy-hemoglobin concentration ([HbO 2 ], [Hb]), oxygen saturation (StO )...
Axon regeneration is negligible in the adult mammalian brain, and thus, white matter damage often leads to permanent neurological deficits. A novel approach for axon repair generation of tracts laboratory setting followed by transplantation these constructs. This article details a human substrate this strategy. Using technique stretch growth, functional cortical are generated from pluripotent stem cells at rates up 1 mm/day. These results form basis potential patient-specific protocol...
Anterior lumbar interbody fusion (ALIF) with posterior percutaneous stabilization is a desirable surgical approach in the treatment of patients degenerative conditions lower spine but it associated increased risk certain complications including damage to sympathetic chain causing changes temperature and perspiration an affected limb. These symptoms are generally subjectively reported that not commonly assessed using objective measures. A 28-year-old female 3-year history back pain refractory...
Abstract Background Cerebral autoregulation mechanisms help maintain adequate cerebral blood flow (CBF) despite changes in perfusion pressure. Impairment of autoregulation, during and after cardiopulmonary bypass (CPB), may increase risk neurologic injury neonates undergoing surgery. In this study, alterations were assessed a neonatal swine model probing four strategies. Methods Neonatal ( n = 25) randomized to continuous deep hypothermic (DH-CPB, 7), circulatory arrest (DHCA, selective...
Recent research suggests that increased cerebral oxygen use during surgical intervention for neonates with congenital heart disease may play a role in the development of postoperative white matter injury. The objective this study is to determine whether electrical activity correlates greater decrease saturation deep hypothermic circulatory arrest.
Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is an incisionless therapy for the treatment of medication-resistant essential tremor. Although its safety and efficacy has been demonstrated, MRgFUS typically performed with patient awake, intraprocedural neurological assessments to guide lesioning.To report first case under general anesthesia in a whose medical comorbidities prohibit him from being supine position without secured airway.The dentatorubrothalamic tract was...
Neuromodulation is the alteration of neural activity in central, peripheral, or autonomic nervous systems. Consequently, this term lends itself to a variety organ systems including but not limited cardiac, nervous, and even gastrointestinal In review, we provide primer on neuromodulation, examining various technological employed neurological disorders targeted with technology. Ultimately, undergo historical analysis field's development, pivotal discoveries inventions gearing review...
Neonates undergoing cardiac surgery involving aortic arch reconstruction are at an increased risk for hypoxic-ischemic brain injury. Deep hypothermia is utilized to help mitigate this when periods of circulatory arrest needed surgical repair. Here, we investigate correlations between non-invasive optical neuromonitoring cerebral hemodynamics, which has recently shown promise the prediction postoperative white matter injury in patient population, and invasive microdialysis biomarkers. We...
Supine postures are utilized to increase cerebral blood flow following ischemic stroke. We find supine is lower than sitting in ~25% of subjects and that postural changes flow.
Continuous non-invasive quantification of cerebral hemodynamics using frequency-domain diffuse optical spectroscopy (FD-DOS) during cardiopulmonary resuscitation (CPR) provides an early prognostic indicator CPR success pediatric cardiac arrest.