Browsing by Author "Adelson, P. David"

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    Editorial. Pediatric neurosurgery along with Children's Hospitals' innovations are rapid and uniform in response to the COVID-19 pandemic
    (American Association of Neurological Surgeons, 2020-04) Weiner, Howard L.; Adelson, P. David; Brockmeyer, Douglas L.; Maher, Cormac O.; Gupta, Nalin; Smyth, Matthew D.; Jea, Andrew; Blount, Jeffrey P.; Riva-Cambrin, Jay; Lam, Sandi K.; Ahn, Edward S.; Albert, Gregory W.; Leonard, Jeffrey R.; Neurological Surgery, School of Medicine
    The COVID-19 pandemic is an unprecedented international crisis, with enormous health, economic, and social consequences, the likes of which have not been experienced in recent human history. The global medical community is facing historic practical and ethical challenges that require an urgent response. This situation has necessitated swift decision-making in the neurosurgery community. An inspiring and consistent message emerged from the resultant conversation, demonstrating our discipline’s response to this tragedy, which was strikingly rapid, uniform, and thoughtful across the many centers represented. Not surprisingly, pediatric neurosurgeons are able to lead their teams through this unprecedented time with creative decision-making and a razor-sharp focus on the health of both patients and colleagues. At the time of this writing, each center reported either no or only a small number of COVID-19–positive cases at their pediatric hospital, among either patients or staff, and a range of documented coronavirus community transmissions. Several notably consistent themes emerged from this exchange among the 13 members of the Journal of Neurosurgery: Pediatrics Editorial Board, the common concept being that decision-making remains dynamic and is modified as needed on a daily basis.
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    Network-Targeted Approach and Postoperative Resting-State Functional Magnetic Resonance Imaging Are Associated with Seizure Outcome
    (Wiley, 2019-09) Boerwinkle, Varina L.; Cediel, Emilio G.; Mirea, Lucia; Williams, Korwyn; Kerrigan, John F.; Lam, Sandi; Raskin, Jeffrey S.; Desai, Virendra R.; Wilfong, Angus A.; Adelson, P. David; Curry, Daniel J.; Surgery, School of Medicine
    Objective Postoperative resting‐state functional magnetic resonance imaging (MRI) in children with intractable epilepsy has not been quantified in relation to seizure outcome. Therefore, its value as a biomarker for epileptogenic pathology is not well understood. Methods In a sample of children with intractable epilepsy who underwent prospective resting‐state seizure onset zone (SOZ)‐targeted epilepsy surgery, postoperative resting‐state functional MRI (rs‐fMRI) was performed 6 to 12 months later. Graded normalization of the postoperative resting‐state SOZ was compared to seizure outcomes, patient, surgery, and anatomical MRI characteristics. Results A total of 64 cases were evaluated. Network‐targeted surgery, followed by postoperative rs‐fMRI normalization was significantly (p < 0.001) correlated with seizure reduction, with a Spearman rank correlation coefficient of 0.83. Of 39 cases with postoperative rs‐fMRI SOZ normalization, 38 (97%) became completely seizure free. In contrast, of the 25 cases without complete rs‐fMRI SOZ normalization, only 3 (5%) became seizure free. The accuracy of rs‐fMRI as a biomarker predicting seizure freedom is 94%, with 96% sensitivity and 93% specificity. Interpretation Among seizure localization techniques in pediatric epilepsy, network‐targeted surgery, followed by postoperative rs‐fMRI normalization, has high correlation with seizure freedom. This study shows that rs‐fMRI SOZ can be used as a biomarker of the epileptogenic zone, and postoperative rs‐fMRI normalization is a biomarker for SOZ quiescence.
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    Occipital-Cervical Fusion and Ventral Decompression in the Surgical Management of Chiari-1 Malformation and Syringomyelia: Analysis of Data From the Park-Reeves Syringomyelia Research Consortium
    (Wolters Kluwer, 2021-01-13) CreveCoeur, Travis S.; Yahanda, Alexander T.; Maher, Cormac O.; Johnson, Gabrielle W.; Ackerman, Laurie L.; Adelson, P. David; Ahmed, Raheel; Albert, Gregory W.; Aldana, Phillipp R.; Alden, Tord D.; Anderson, Richard C.E.; Baird, Lissa; Bauer, David F.; Bierbrauer, Karin S.; Brockmeyer, Douglas L.; Chern, Joshua J.; Couture, Daniel E.; Daniels, David J.; Dauser, Robert C.; Durham, Susan R.; Ellenbogen, Richard G.; Eskandari, Ramin; Fuchs, Herbert E.; George, Timothy M.; Grant, Gerald A.; Graupman, Patrick C.; Greene, Stephanie; Greenfield, Jeffrey P.; Gross, Naina L.; Guillaume, Daniel J.; Haller, Gabe; Hankinson, Todd C.; Heuer, Gregory G.; Iantosca, Mark; Iskandar, Bermans J.; Jackson, Eric M.; Jea, Andrew H.; Johnston, James M.; Keating, Robert F.; Kelly, Michael P.; Khan, Nickalus; Krieger, Mark D.; Leonard, Jeffrey R.; Mangano, Francesco T.; Mapstone, Timothy B.; McComb, J. Gordon; Menezes, Arnold H.; Muhlbauer, Michael; Oakes, W. Jerry; Olavarria, Greg; O’Neill, Brent R.; Park, Tae Sung; Ragheb, John; Selden, Nathan R.; Shah, Manish N.; Shannon, Chevis; Shimony, Joshua S.; Smith, Jodi; Smyth, Matthew D.; Stone, Scellig S.D.; Strahle, Jennifer M.; Tamber, Mandeep S.; Torner, James C.; Tuite, Gerald F.; Wait, Scott D.; Wellons, John C., III.; Whitehead, William E.; Limbrick, David D., Jr.; Neurological Surgery, School of Medicine
    Background: Occipital-cervical fusion (OCF) and ventral decompression (VD) may be used in the treatment of pediatric Chiari-1 malformation (CM-1) with syringomyelia (SM) as adjuncts to posterior fossa decompression (PFD) for complex craniovertebral junction pathology. Objective: To examine factors influencing the use of OCF and OCF/VD in a multicenter cohort of pediatric CM-1 and SM subjects treated with PFD. Methods: The Park-Reeves Syringomyelia Research Consortium registry was used to examine 637 subjects with cerebellar tonsillar ectopia ≥ 5 mm, syrinx diameter ≥ 3 mm, and at least 1 yr of follow-up after their index PFD. Comparisons were made between subjects who received PFD alone and those with PFD + OCF or PFD + OCF/VD. Results: All 637 patients underwent PFD, 505 (79.2%) with and 132 (20.8%) without duraplasty. A total of 12 subjects went on to have OCF at some point in their management (PFD + OCF), whereas 4 had OCF and VD (PFD + OCF/VD). Of those with complete data, a history of platybasia (3/10, P = .011), Klippel-Feil (2/10, P = .015), and basilar invagination (3/12, P < .001) were increased within the OCF group, whereas only basilar invagination (1/4, P < .001) was increased in the OCF/VD group. Clivo-axial angle (CXA) was significantly lower for both OCF (128.8 ± 15.3°, P = .008) and OCF/VD (115.0 ± 11.6°, P = .025) groups when compared to PFD-only group (145.3 ± 12.7°). pB-C2 did not differ among groups. Conclusion: Although PFD alone is adequate for treating the vast majority of CM-1/SM patients, OCF or OCF/VD may be occasionally utilized. Cranial base and spine pathologies and CXA may provide insight into the need for OCF and/or OCF/VD.
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    Pediatric neurosurgery along with children’s hospitals’ innovations are rapid and uniform in response to the COVID-19 pandemic
    (AANS, 2020) Weiner, Howard L.; Adelson, P. David; Brockmeyer, Douglas L.; Maher, Cormac O.; Gupta, Nalin; Smyth, Matthew D.; Jea, Andrew; Blount, Jeffrey P.; Riva-Cambrin, Jay; Lam, Sandi K.; Ahn, Edward S.; Albert, Gregory W.; Leonard, Jeffrey R.; Neurological Surgery, School of Medicine