Journal Club: Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomized controlled trials

Title and Citation Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomized controlled trials Lancet Neurology 2007 Background and importance Malignant MCA infarct associated with 80% mortality. Trial design Pooled analysis of 18-60 year old patients with space occupying MCA infarction included in DECIMAL, DESTINY, or HAMLET

Journal Club: Comparative Therapeutic Effectiveness of Anticoagulation and Conservative Management in Traumatic Cerebral Venous Sinus Thrombosis

Title and Citation Comparative Therapeutic Effectiveness of Anticoagulation and Conservative Management in Traumatic Cerebral Venous Sinus Thrombosis Neurosurgery 2022 Background and importance Traumatic cerebral venous sinus thrombosis does not have a clear treatment and largely modeled off spontaneous cerebral venous sinus thrombosis Trial design Retrospective Decision to initiate AC must have stable interval CT non

Journal Club: Randomized Trial Comparing Burr Hole Craniostomy, Minicraniotomy, and Twist Drill Craniostomy for Treatment of Chronic Subdural Hematoma

Title and Citation Randomized Trial Comparing Burr Hole Craniostomy, Minicraniotomy, and Twist Drill Craniostomy for Treatment of Chronic Subdural Hematoma Neurosurgery 2022 Background and importance Unknown best surgical technique for chronic subdural hematoma Recurrence of SDH despite evacuation can occur in up to 30% of patients Trial design Multicenter prospective randomized trial Drainage system for

Journal Club: Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression

Title and Citation Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression Neurosurgery 2022 Background and importance Sagittal spinal pelvic alignment used to determine/diagnose adult spinal deformities Misdiagnosis can lead to inappropriate surgery Trial design Retrospective cohort Analyzed patients who underwent lumbar decompression via laminectomy or laminectomy with discectomy without instrumentation

Empirical targets for acute hemodynamic management of individuals with spinal cord injury

Author: Squair, Jordan PhD et al Title: Empirical targets for acute hemodynamic management of individuals with spinal cord injury Background: Ideal clinically significant BP goals and/or spinal cord perfusion pressure goals are not well defined Guidelines suggest MAP 85-90mmHg x7 days after injury Trial Design: prospective observational n=92 Intrathecal lumbar catheter placed L2-3 or L3-4

STICH II

Title: Early Surgery Versus Initial Conservative Treatment in Patients with Spontaneous Lobar Intracerebral Hematomas (STICH II): a randomized trial Authors: Mendelow et alLancet 2013 Background/Importance: Undetermined benefit of early surgical intervention for intracerebral hematoma Trial design: international multicenter randomized trialDuration: 67 monthsObjectives: Determine if early surgical intervention for intracerebral hemorrhage improves outcomesPrimary Outcome/Endpoint: prognosis based

Unruptured Intracranial Aneurysms – Risk of Rupture and Risks of Surgical Intervention

Unruptured Intracranial Aneurysms – Risk of Rupture and Risks of Surgical Intervention ISUIA investigators NEJM 1998 Objectives: Retrospective component Describe natural history of saccular unruptured intracranial aneurysms without a history of subarachnoid hemorrhage from a separate aneurysm (group 1) Describe natural history of saccular unruptured intracranial aneurysms with a history of subarachnoid hemorrhage from a

NOMS Framework

The NOMS Framework: Approach to the Treatment of Spinal Metastatic TumorsLaufer et alOncologist 2013Decision framework for metastatic spine disease developed at Memorial Sloan Kettering Cancer Center NOMS framework based on four components: Neurologic Oncologic Mechanical instability Systemic disease Neurologic Assessment Focuses on degree of spinal cord compromise by assessing MRI image Six point system (0,1a,1b,

Comparison of Warfarin and Aspirin for Symptomatic Intracranial Arterial Stenosis

Randomized Controlled Trial double blinded Inclusion criteria: TIA or non disabling stroke within 90 days before randomization attributable to angiographically verified 50 to 99% stenosis (carotid, MCA, vertebral, or basilar) mRS of 3 or less Age at least 40 Exclusion: Tandem 50-99% stenosis of extracranial carotid artery Nonatherosclerotic stenosis of intracranial artery Cardiac source of