A5021778953- Cerebrospinal fluid and hydrocephalus
- Epilepsy research and treatment
- Glioma Diagnosis and Treatment
- Spinal Fractures and Fixation Techniques
- Spinal Dysraphism and Malformations
- Neurosurgical Procedures and Complications
- Neurological disorders and treatments
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracranial Aneurysms: Treatment and Complications
- EEG and Brain-Computer Interfaces
- Vascular Malformations Diagnosis and Treatment
- Fetal and Pediatric Neurological Disorders
- Neuroblastoma Research and Treatments
- CAR-T cell therapy research
- Craniofacial Disorders and Treatments
- Intraoperative Neuromonitoring and Anesthetic Effects
- Spine and Intervertebral Disc Pathology
- Hip and Femur Fractures
- Cancer-related molecular mechanisms research
- Tuberous Sclerosis Complex Research
- Anesthesia and Pain Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Neurobiology of Language and Bilingualism
- Neonatal and fetal brain pathology
- Nerve Injury and Rehabilitation
Neurological Surgery
2013-2025
University of Washington
2021-2025
Seattle Children's Hospital
2021-2025
Center for Neurosciences
2024
Seattle University
2022
Neurosciences Institute
2021
Columbia University Irving Medical Center
2012-2019
Columbia University
2011-2019
Texas Health Dallas
2018-2019
NewYork–Presbyterian Hospital
2013-2018
Phosphatase and tensin homolog on chromosome ten (PTEN) is a tumor suppressor an antagonist of the phosphoinositide-3 kinase (PI3K) pathway. We identified 576-amino acid translational variant PTEN, termed PTEN-Long, that arises from alternative translation start site 519 base pairs upstream ATG initiation sequence, adding 173 N-terminal amino acids to normal PTEN open reading frame. PTEN-Long membrane-permeable lipid phosphatase secreted cells can enter other cells. As exogenous agent,...
Significance Molecular analysis of surgically resected glioblastomas (GBM) samples has uncovered phenotypically and clinically distinct tumor subtypes. However, little is known about the molecular features glioma margins that are left behind after surgery. To address this key issue, we performed RNA-sequencing (RNA-seq) histological on MRI-guided biopsies from contrast-enhancing core nonenhancing GBM. Computational deconvolution RNA-seq data revealed cellular composition, including...
Abstract Diffuse intrinsic pontine glioma (DIPG) is a fatal central nervous system (CNS) tumor that confers median survival of 11 months. As B7-H3 expressed on pediatric CNS tumors, we conducted BrainChild-03, single-center, dose-escalation phase 1 clinical trial repetitive intracerebroventricular (ICV) dosing B7-H3-targeting chimeric antigen receptor T cells (B7-H3 CAR cells) for children with recurrent or refractory tumors and DIPG. Here report results from Arm C, restricted to patients...
Craniopharyngioma is a rare primary central nervous system neoplasm. Our objective was to determine factors associated with incidence, treatment, and survival of craniopharyngiomas in the United States. We used surveillance, epidemiology end results program (SEER) database identify patients who received diagnosis craniopharyngioma during 2004–2008. analyzed clinical demographic information, including age, race, sex, tumor histology, treatment. Age-adjusted incidence rates race-adjusted...
Central nervous system (CNS) tumors are the most common solid malignancy in pediatric population. Based on adoptive cellular therapy's clinical success against childhood leukemia and preclinical efficacy CNS tumors, chimeric antigen receptor (CAR) T cells offer hope of improving outcomes for recurrent universally fatal diseases such as diffuse intrinsic pontine glioma (DIPG). However, a major obstacle brain spine is ineffective cell chemotaxis to disease sites. Locoregional CAR delivery via...
Central nervous system (CNS) hemangiopericytomas are relatively uncommon and unique among CNS tumors as they can originate from or develop metastases outside of the CNS. Significant difference opinion exists in management these lesions, current treatment paradigms based on limited clinical experience single-institution series. Given limitations absence prospective trials within literature, nationwide registries have potential to provide insight into efficacy various therapies.The authors...
Reducing the rate of 30-day hospital readmission has become a priority in healthcare quality improvement policy, with focus on better characterizing reasons for unplanned readmission. In neurosurgery, however, peer-reviewed analyses describing patterns have been limited their number and generalizability.To determine incidence, timing, causes after neurosurgical procedures.We conducted retrospective longitudinal study from 2009 to 2012 using Statewide Planning And Research Cooperative System,...
Patients with medically refractory localization-related epilepsy (LRE) may be candidates for surgical intervention if the seizure onset zone (SOZ) can well localized. Stereoelectroencephalography (SEEG) offers an attractive alternative to subdural grid and strip electrode implantation lateralization localization; yet there are few series reporting safety efficacy of SEEG in pediatric patients.The authors review their initial 3-year consecutive experience patients LRE. coverage, SOZ...
Abstract Background Indomethacin‐responsive headaches occur in youth and include primary headache syndromes such as hemicrania continua paroxysmal hemicrania. Both are trigeminal autonomic cephalalgias (TACs). In pediatrics TACs rare. Moreover, they may differ their phenotypes response to indomethacin compared adults. Secondary causes for side‐locked can have vascular, neoplastic, inflammatory etiologies, emphasizing the importance of imaging evaluation these types. Post‐craniotomy...
Neuronal ceroid lipofuscinosis type 2 (CLN2) is a genetic disease caused by deficiency of the enzyme tripeptidyl peptidase 1 (TPP1), resulting in seizures, vision/cognitive decline, and early death. Cerliponase alfa an replacement therapy approved as treatment for CLN2 disease, administered intracerebroventricular infusion via surgically implanted device. Maintaining sterility prolonged scalp-based infusions can be difficult children damage devices. We report development technique connecting...
Which children with fetal ventriculomegaly, or enlargement of the cerebral ventricles in utero, will develop hydrocephalus requiring treatment after birth is unclear.To determine whether extraction multiple imaging features from magnetic resonance (MRI) and integration using machine learning techniques can predict which patients require postnatal cerebrospinal fluid (CSF) diversion birth.This retrospective case-control study used an institutional database 253 ventriculomegaly January 1,...
Subependymal giant cell astrocytoma (SEGA) is the most common CNS tumor in patients with tuberous sclerosis complex (TSC). Although these are benign, their proximity to foramen of Monroe frequently causes obstructive hydrocephalus, a potentially fatal complication. Open surgical resection has been mainstay treatment; however, this can cause significant morbidity. The development mTOR inhibitors changed treatment landscape, but there limitations use. Laser interstitial thermal therapy (LITT)...
Tethered cord syndrome refers to a constellation of symptoms characterized by neurological, musculoskeletal, and urinary symptoms, caused traction on the spinal cord, which can be secondary various etiologies. Surgical management simple tethered etiologies (e.g., fatty filum) typically consists single-level lumbar laminectomy, intradural exploration, coagulation sectioning filum. More complex such as lipomyelomeningoceles or scar formation after myelomeningocele repair involve dissection...
OBJECTIVE Spina bifida represents one of the most common birth defects, occurring in approximately 1–2 children per 1000 live births worldwide. The functional level patients with spina is highly variable and believed to be correlated anatomical lesion. clinical picture well established, but correlation intraoperative neuromonitoring (IONM) data has not been investigated. Furthermore, potential for preserving function beyond apparent also objective this research was determine presence...
Liquid biopsy assays that detect cell-free DNA (cfDNA) in cerebrospinal fluid (CSF) are a promising tool for disease monitoring pediatric patients with primary central nervous system (CNS) tumors. As compliment to tissue-derived molecular analyses, CSF liquid has the potential transform risk stratification, prognostication, and precision medicine approaches.
OBJECTIVE The long-term effects of surgical fusion on the growing subaxial cervical spine are largely unknown. Recent cross-sectional studies have demonstrated that there is continued growth through teenage years. purpose this multicenter study was to determine rigid instrumentation and by investigating vertical growth, alignment, curvature, adjacent-segment instability over time. METHODS A total 15 centers participated in multi-institutional retrospective study. Cases involving children...
Patients with medically refractory epilepsy often undergo intracranial electroencephalography (iEEG) monitoring to identify a seizure focus and determine their candidacy for surgical intervention. This clinically necessary period provides an increasingly utilized research opportunity study human neurophysiology, however ethical concerns demand thorough appreciation of the associated risks. We measured incidence stimulation-associated seizures in large multi-institutional dataset order...
OBJECTIVES: Multimodal analgesia (MMA) may reduce opioid use among children who are hospitalized, and contribute toward enhanced recovery after selective dorsal rhizotomy (SDR) for patients with spasticity in pediatric cerebral palsy. In this retrospective cohort study, we assess an MMA protocol consisting of scheduled nonsteroidal antiinflammatory drug doses (ketorolac or ibuprofen), alternating acetaminophen diazepam doses, as-needed opioids. It was hypothesized that would be associated...