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Article ; Online: Supratentorial, extraventricular choroid plexus carcinoma in an adult: case report.

Lozier, Alan P / Arbaje, Yamil M / Scheithauer, Bernd W

2009 Volume 65, Issue 4, Page(s) E816–7

Abstract: Objective: Choroid plexus carcinoma (CPCa) is an uncommon tumor rarely occurring in patients older than 2 years of age. The case reported herein represents the first documented example of a primary supratentorial, extraventricular CPCa in an adult. The ... ...

Abstract	Objective: Choroid plexus carcinoma (CPCa) is an uncommon tumor rarely occurring in patients older than 2 years of age. The case reported herein represents the first documented example of a primary supratentorial, extraventricular CPCa in an adult. The scant literature regarding this topic is reviewed. Clinical presentation: A 68-year-old woman presented with transient expressive aphasia. Magnetic resonance imaging demonstrated an avidly enhancing, left temporal, extra-axial mass with associated parenchymal cysts. Intervention: The tumor was gross-totally removed via a frontotemporal craniotomy. A diagnosis of CPCa was made on histological, immunohistochemical, and ultrastructural grounds. Postoperatively, the patient was treated by local radiotherapy and temozolomide. A magnetic resonance imaging scan 44 months after surgery showed no evidence of residual or recurrent tumor. Conclusion: CPCa infrequently affects adults. Only rarely does it present as a supratentorial, extraventricular mass. Resection is the mainstay of therapy. Adjuvant radiation and chemotherapy are rational treatment options.
MeSH term(s)	Aged ; Antineoplastic Agents, Alkylating/therapeutic use ; Brain/pathology ; Brain/physiopathology ; Brain/surgery ; Carcinoma/pathology ; Carcinoma/physiopathology ; Carcinoma/surgery ; Choroid Plexus/pathology ; Choroid Plexus/physiopathology ; Choroid Plexus/surgery ; Choroid Plexus Neoplasms/pathology ; Choroid Plexus Neoplasms/physiopathology ; Choroid Plexus Neoplasms/surgery ; Craniotomy ; Dacarbazine/analogs & derivatives ; Dacarbazine/therapeutic use ; Drug Administration Schedule ; Female ; Humans ; Lateral Ventricles/pathology ; Lateral Ventricles/surgery ; Magnetic Resonance Imaging ; Neurosurgical Procedures ; Radiotherapy ; Temporal Lobe/pathology ; Temporal Lobe/surgery ; Treatment Outcome
Chemical Substances	Antineoplastic Agents, Alkylating ; Dacarbazine (7GR28W0FJI) ; temozolomide (YF1K15M17Y)
Language	English
Publishing date	2009-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/01.NEU.0000348291.48810.C2
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Article: Surgical approaches to posterior third ventricular tumors.

Lozier, Alan P / Bruce, Jeffrey N

Neurosurgery clinics of North America

2004 Volume 14, Issue 4, Page(s) 527–545

Abstract: A variety of surgical approaches to the posterior third ventricle and pineal region exist. The choice of approach is influenced by the exact location of the lesion, its expected pathologic findings, and the comfort level of the operating surgeon with the ...

Abstract	A variety of surgical approaches to the posterior third ventricle and pineal region exist. The choice of approach is influenced by the exact location of the lesion, its expected pathologic findings, and the comfort level of the operating surgeon with the approach that is being considered. For most pineal region masses that are situated in the midline below the deep venous system, we favor the supracerebellar-infratentorial approach in the sitting position. For pineal region lesions that displace the deep venous system inferiorly or have significant lateral extension, we prefer the occipital-transtentorial approach in the three-quarter prone or sitting position. For lesions that are truly in the posterior third ventricle without extension posterior to the splenium, we prefer the interhemispheric-transcallosal approach in the lateral position.
MeSH term(s)	Cerebral Ventricle Neoplasms/pathology ; Cerebral Ventricle Neoplasms/surgery ; Humans ; Intraoperative Care ; Magnetic Resonance Imaging ; Neurosurgical Procedures/methods ; Postoperative Care ; Third Ventricle/anatomy & histology ; Third Ventricle/pathology ; Third Ventricle/surgery
Language	English
Publishing date	2004-03-10
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1196855-2
ISSN	1558-1349 ; 1042-3680
ISSN (online)	1558-1349
ISSN	1042-3680
DOI	10.1016/s1042-3680(03)00061-5
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Article ; Online: Meningiomas of the velum interpositum: surgical considerations.

Lozier, Alan P / Bruce, Jeffrey N

Neurosurgical focus

2003 Volume 15, Issue 1, Page(s) E11

Abstract: Meningiomas of the third ventricle are a rare subtype of pineal region tumor that arise from the posterior portion of the velum interpositum, the double layer of pia mater that forms the roof of the third ventricle. The authors review the literature ... ...

Abstract	Meningiomas of the third ventricle are a rare subtype of pineal region tumor that arise from the posterior portion of the velum interpositum, the double layer of pia mater that forms the roof of the third ventricle. The authors review the literature concerning these meningiomas and present a case in which the lesion was resected via the supracerebellar-infratentorial approach. The relationship of the tumor to the deep venous system and the splenium of the corpus callosum guides the selection of the most advantageous surgical approach. Posterior displacement of the internal cerebral veins demonstrated on preoperative imaging provides a strong rationale for use of the supracerebellar-infratentorial approach.
MeSH term(s)	Adolescent ; Adult ; Child ; Female ; Humans ; Infratentorial Neoplasms/diagnosis ; Infratentorial Neoplasms/surgery ; Male ; Meningeal Neoplasms/diagnosis ; Meningeal Neoplasms/pathology ; Meningeal Neoplasms/surgery ; Meningioma/diagnosis ; Meningioma/pathology ; Meningioma/surgery ; Middle Aged ; Pia Mater ; Preoperative Care ; Third Ventricle
Language	English
Publishing date	2003-07-15
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/foc.2003.15.1.11
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Article ; Online: Ventriculostomy-related infections: a critical review of the literature.

Lozier, Alan P / Sciacca, Robert R / Romagnoli, Mario F / Connolly, E Sander

Neurosurgery

2008 Volume 62 Suppl 2, Page(s) 688–700

Abstract: Objective: To provide a critical evaluation of the published literature describing risk factors for ventriculostomy-related infections (VRIs) and the efficacy of prophylactic catheter exchange.: Methods: A MEDLINE literature search was performed, and ...

Abstract	Objective: To provide a critical evaluation of the published literature describing risk factors for ventriculostomy-related infections (VRIs) and the efficacy of prophylactic catheter exchange. Methods: A MEDLINE literature search was performed, and data were extracted from studies published from 1941 through 2001. Results: Published criteria for diagnosing VRIs are highly variable. Intraventricular hemorrhage, subarachnoid hemorrhage, cranial fracture with cerebrospinal fluid leak, craniotomy, systemic infections, and catheter irrigation all predispose patients to the development of VRIs. Extended duration of catheterization is correlated with an increasing risk of cerebrospinal fluid infections during the first 10 days of catheterization. Prophylactic catheter exchange does not modify the risk of developing later VRIs in retrospective studies. Conclusion: Categorizing suspected cerebrospinal fluid infections as contaminants, colonization, suspected or confirmed VRIs, or ventriculitis more accurately describes the patient's clinical condition and may indicate different management strategies. A prospective, randomized clinical trial is required to further evaluate the efficacy of prophylactic catheter exchange in limiting the incidence of VRIs during prolonged catheterization. Although prophylactic catheter exchange remains a practice option, the available data suggest that this procedure is not currently justified.
Language	English
Publishing date	2008-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/01.neu.0000316273.35833.7c
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Article ; Online: The Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD): The development and reliability testing of a novel clinical outcome measurement instrument for the severity of atopic dermatitis.

Simpson, Eric / Bissonnette, Robert / Eichenfield, Lawrence F / Guttman-Yassky, Emma / King, Brett / Silverberg, Jonathan I / Beck, Lisa A / Bieber, Thomas / Reich, Kristian / Kabashima, Kenji / Seyger, Marieke / Siegfried, Elaine / Stingl, Georg / Feldman, Steven R / Menter, Alan / van de Kerkhof, Peter / Yosipovitch, Gil / Paul, Carle / Martel, Philippe /

Dubost-Brama, Ariane / Armstrong, John / Chavda, Rajeev / Frey, Steve / Joubert, Yolandi / Milutinovic, Marina / Parneix, Anne / Teixeira, Henrique D / Lin, Chen-Yen / Sun, Luna / Klekotka, Paul / Nickoloff, Brian / Dutronc, Yves / Mallbris, Lotus / Janes, Jonathan M / DeLozier, Amy M / Nunes, Fabio P / Paller, Amy S

Journal of the American Academy of Dermatology

2020 Volume 83, Issue 3, Page(s) 839–846

Abstract: Background: An Investigator Global Assessment (IGA) is recommended by health agencies for drug registration in atopic dermatitis (AD). Current IGA scales lack standardization.: Objectives: To develop an IGA scale, training module, and clinical ... ...

Abstract	Background: An Investigator Global Assessment (IGA) is recommended by health agencies for drug registration in atopic dermatitis (AD). Current IGA scales lack standardization. Objectives: To develop an IGA scale, training module, and clinical certification examination for use in AD trials; establish content validity; and assess reliability. Methods: Expert dermatologists participated in the development of the validated IGA for AD (vIGA-AD Results: Expert consensus was achieved around a 5-point IGA scale including morphologic descriptions, and content validity was established. Survey 1 showed strong interrater reliability (Kendall's coefficient of concordance W [Kendall's W], 0.809; intraclass correlation [ICC], 0.817) and excellent agreement (weighted kappa, 0.857). Survey 2, completed 5 months after training of dermatologists, showed improvements in scale reliability (Kendall's W, 0.819; ICC, 0.852; weighted kappa, 0.889). In this study, 627 investigators completed vIGA-AD training and certification. Limitations: Ratings were assessed on photographs. Conclusion: A validated IGA scale and training module were developed with the intent of harmonizing assessment of disease severity in AD trials. Strong reliability and excellent agreement between assessments were observed.
MeSH term(s)	Adult ; Child ; Consensus ; Consensus Development Conferences as Topic ; Dermatitis, Atopic/diagnosis ; Dermatitis, Atopic/therapy ; Dermatologists/standards ; Dermatologists/statistics & numerical data ; Humans ; Observer Variation ; Outcome Assessment, Health Care/standards ; Photography ; Reproducibility of Results ; Severity of Illness Index ; Skin/diagnostic imaging ; Surveys and Questionnaires/statistics & numerical data ; Telecommunications
Language	English
Publishing date	2020-04-25
Publishing country	United States
Document type	Journal Article ; Validation Study
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2020.04.104
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Article: Ventriculostomy-related infections: a critical review of the literature.

Lozier, Alan P / Sciacca, Robert R / Romagnoli, Mario F / Connolly, E Sander

Neurosurgery

2002 Volume 51, Issue 1, Page(s) 170–81; discussion 181–2

Abstract	Objective: To provide a critical evaluation of the published literature describing risk factors for ventriculostomy-related infections (VRIs) and the efficacy of prophylactic catheter exchange. Methods: A MEDLINE literature search was performed, and data were extracted from studies published from 1941 through 2001. Results: Published criteria for diagnosing VRIs are highly variable. Intraventricular hemorrhage, subarachnoid hemorrhage, cranial fracture with cerebrospinal fluid leak, craniotomy, systemic infections, and catheter irrigation all predispose patients to the development of VRIs. Extended duration of catheterization is correlated with an increasing risk of cerebrospinal fluid infections during the first 10 days of catheterization. Prophylactic catheter exchange does not modify the risk of developing later VRIs in retrospective studies. Conclusion: Categorizing suspected cerebrospinal fluid infections as contaminants, colonization, suspected or confirmed VRIs, or ventriculitis more accurately describes the patient's clinical condition and may indicate different management strategies. A prospective, randomized clinical trial is required to further evaluate the efficacy of prophylactic catheter exchange in limiting the incidence of VRIs during prolonged catheterization. Although prophylactic catheter exchange remains a practice option, the available data suggest that this procedure is not currently justified.
MeSH term(s)	Catheters, Indwelling/adverse effects ; Cerebrospinal Fluid/microbiology ; Cross Infection/etiology ; Equipment Contamination ; Humans ; Meningitis, Bacterial/etiology ; Postoperative Complications/etiology ; Reoperation ; Risk Factors ; Ventriculostomy/instrumentation
Language	English
Publishing date	2002-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1097/00006123-200207000-00024
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Article: Hypothalamic hamartoma in association with a suprasellar arachnoid cyst: a case report.

Mocco, J / Lozier, Alan P / Komotar, Ricardo J / Silver, A John / Feldstein, Neil A

Pediatric neurosurgery

2005 Volume 41, Issue 2, Page(s) 105–108

Abstract: A 5-year-old female presented with a history of precocious puberty and increased height. MRI of the brain revealed a nonenhancing hypothalamic mass and associated suprasellar arachnoid cyst. The patient underwent a right frontal craniotomy with orbital ... ...

Abstract	A 5-year-old female presented with a history of precocious puberty and increased height. MRI of the brain revealed a nonenhancing hypothalamic mass and associated suprasellar arachnoid cyst. The patient underwent a right frontal craniotomy with orbital osteotomy for wide fenestration of the cyst. Intraoperatively, it was clear the mass represented a hamartoma with a very smooth glistening surface. For this reason, no biopsy of the wall was performed. Postoperatively, the patient remains neurologically intact and without any medication dependence. This case highlights the occurrence of a suprasellar arachnoid cyst in association with a hypothalamic hamartoma.
MeSH term(s)	Arachnoid Cysts/diagnosis ; Arachnoid Cysts/surgery ; Body Height ; Child, Preschool ; Craniotomy ; Female ; Hamartoma/diagnosis ; Hamartoma/surgery ; Humans ; Hypothalamic Diseases/diagnosis ; Hypothalamic Diseases/surgery ; Puberty, Precocious/etiology
Language	English
Publishing date	2005-03
Publishing country	Switzerland
Document type	Case Reports ; Journal Article
ZDB-ID	1091757-3
ISSN	1423-0305 ; 1016-2291
ISSN (online)	1423-0305
ISSN	1016-2291
DOI	10.1159/000085166
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Article ; Online: Guglielmi detachable coil embolization of posterior circulation aneurysms: a systematic review of the literature.

Lozier, Alan P / Connolly, E Sander / Lavine, Sean D / Solomon, Robert A

Stroke

2002 Volume 33, Issue 10, Page(s) 2509–2518

Abstract: Background: Early multicenter trials of Guglielmi detachable coil embolization of posterior circulations aneurysms have been followed by the publication of numerous single-center experiences. Summary of Review- We performed a MEDLINE literature search ... ...

Abstract	Background: Early multicenter trials of Guglielmi detachable coil embolization of posterior circulations aneurysms have been followed by the publication of numerous single-center experiences. Summary of Review- We performed a MEDLINE literature search and extracted data from single-center reports containing at least 10 posterior circulation aneurysms. Twelve reports (495 aneurysms) were specific to the posterior circulation. Eighty-two percent of aneurysms arose near the basilar apex. Eighty-one percent of patients harbored unruptured aneurysms or presented in good clinical condition. Sixty-three percent of lesions were small, and 41% exhibited a narrow neck. Coil deposition was achieved in 97.6% of cases. Procedural complication and morbidity rates were 12.5% and 5.1%, respectively. Procedural and 30-day mortality rates were 1.4% and 6.7%, respectively. Complete aneurysm occlusion was achieved in 47.6%, near-complete occlusion (90% to 99%) in 43.4%, and incomplete occlusion in 9.0% of cases. There were a total of 52 recurrences (22.2%) in a subset of 234 evaluable patients. Ninety-two percent of these aneurysms exhibited wide necks. The annual risk of subarachnoid hemorrhage after embolization was 0.8%. Eighty-five percent of patients achieved functional independence, while only 5.3% lived dependent lifestyles. The overall mortality rate was 9.8%. Conclusions: The published literature approximates a large series of basilar apex aneurysms. Embolization is moderately effective in completely excluding an aneurysm from the posterior circulation. The incidence of recurrence in wide-neck aneurysms and incompletely coiled aneurysms is substantial. Coil embolization is effective in preventing early rebleeding. Its role in the treatment of unruptured aneurysms remains unclear.
MeSH term(s)	Cerebrovascular Circulation ; Clinical Trials as Topic/statistics & numerical data ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/surgery ; Recurrence ; Subarachnoid Hemorrhage/etiology ; Survival Rate ; Treatment Outcome
Language	English
Publishing date	2002-10
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	80381-9
ISSN	1524-4628 ; 0039-2499 ; 0749-7954
ISSN (online)	1524-4628
ISSN	0039-2499 ; 0749-7954
DOI	10.1161/01.str.0000031928.71695.a9
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Article: Microsurgical treatment of basilar apex aneurysms: perioperative and long-term clinical outcome.

Lozier, Alan P / Kim, Grace H / Sciacca, Robert R / Connolly, E Sander / Solomon, Robert A

Neurosurgery

2003 Volume 54, Issue 2, Page(s) 286–96; discussion 296–9

Abstract: ... a tremendous risk for poor outcome (risk ratio, 80.0; 95% confidence interval, 8.0-800.7; P < 0.01). Surviving ...

Abstract	Objective: We sought to analyze the perioperative and long-term clinical outcome data for patients with microsurgically treated basilar apex aneurysms. Methods: We identified 98 consecutively treated basilar apex aneurysms in patients prospectively enrolled in a cerebral aneurysm database. Results: Fifty patients presented with subarachnoid hemorrhage, and 19 aneurysms were giant. Eighty-four of 98 aneurysms were directly clipped. Surgical morbidity was 19.4% for the entire cohort and 8.8% for the unruptured, nongiant subgroup. The most common complication resulting in long-term morbidity was perforator injury. Sixty-seven percent of patients with clipped aneurysms were independent at discharge; this fraction increased to 79.0% at the 3-month follow-up examination. Good long-term outcomes (modified Rankin Scale score < or =2) were achieved in 56 (70%) of 80 cases. The mean Barthel Index of surviving patients was 95.8 +/- 15.0 (median = 100, n = 66). Patients with unruptured, nongiant lesions fared considerably better than patients in other cohorts. Ninety-three percent of this subgroup was independent at discharge; this fraction increased to 100% at the 3-month follow-up examination (n = 27). In univariate analyses, poor clinical grade, giant aneurysm size, major operative complications, and operations performed early in the series were associated with worse outcomes. In the multivariate analysis, unruptured giant aneurysm status was found to confer a tremendous risk for poor outcome (risk ratio, 80.0; 95% confidence interval, 8.0-800.7; P < 0.01). Surviving patients were observed for a mean clinical follow-up period of 7.4 +/- 3.7 years. The annual rate of postoperative subarachnoid hemorrhage was 0.18% for all clipped aneurysms and 0% for completely clipped lesions. Conclusion: In comparison to data from the existing literature regarding Guglielmi detachable coil embolization of basilar apex aneurysms, the data presented suggest that surgical clipping should be an important component of a multimodality approach to the treatment of patients with basilar apex aneurysms.
MeSH term(s)	Adult ; Aged ; Basilar Artery/diagnostic imaging ; Basilar Artery/surgery ; Clinical Competence ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Intraoperative Complications ; Male ; Microsurgery/adverse effects ; Middle Aged ; Postoperative Complications ; Radiography ; Severity of Illness Index ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2003-07-11
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/01.neu.0000103222.13642.00
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Article: Hypothalamic Hamartoma in Association with a Suprasellar Arachnoid Cyst: A Case Report

Mocco, J. / Lozier, Alan P. / Komotar, Ricardo J. / Silver, A.John / Feldstein, Neil A.

Pediatric Neurosurgery

2005 Volume 41, Issue 2, Page(s) 105–108

Institution	Departments of Neurological Surgery and Radiology, Columbia University, New York, N.Y., USA
Abstract	A 5-year-old female presented with a history of precocious puberty and increased height. MRI of the brain revealed a nonenhancing hypothalamic mass and associated suprasellar arachnoid cyst. The patient underwent a right frontal craniotomy with orbital osteotomy for wide fenestration of the cyst. Intraoperatively, it was clear the mass represented a hamartoma with a very smooth glistening surface. For this reason, no biopsy of the wall was performed. Postoperatively, the patient remains neurologically intact and without any medication dependence. This case highlights the occurrence of a suprasellar arachnoid cyst in association with a hypothalamic hamartoma.
Keywords	Suprasellar lesions ; Arachnoid cyst ; Hamartoma ; Hypothalamic tissue
Language	English
Publishing date	2005-05-30
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Case Report
ZDB-ID	1091757-3
ISSN	1423-0305 ; 1016-2291
ISSN (online)	1423-0305
ISSN	1016-2291
DOI	10.1159/000085166
Database	Karger publisher's database

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