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  1. Article ; Online: Letter: Safety Considerations for Neurosurgical Procedures During the COVID-19 Pandemic.

    Daci, Rrita / Natarajan, Sabareesh K / Johnson, Mark D

    Neurosurgery

    2020  Volume 87, Issue 2, Page(s) E239–E240

    Keywords covid19
    Language English
    Publishing date 2020-05-06
    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 10.1093/neuros/nyaa196
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  2. Article ; Online: In Reply: Three-Vessel Anastomosis for Direct Bihemispheric Cerebral Revascularization.

    Sekhar, Laligam N / Zeeshan, Qazi / Natarajan, Sabareesh K

    Operative neurosurgery (Hagerstown, Md.)

    2020  Volume 19, Issue 4, Page(s) E458–E460

    MeSH term(s) Anastomosis, Surgical ; Cerebral Revascularization ; Humans ; Moyamoya Disease ; Temporal Arteries/surgery
    Language English
    Publishing date 2020-07-03
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1093/ons/opaa190
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  4. Article ; Online: Letter

    Daci, Rrita / Natarajan, Sabareesh K / Johnson, Mark D

    Neurosurgery

    Safety Considerations for Neurosurgical Procedures During the COVID-19 Pandemic

    2020  Volume 87, Issue 2, Page(s) E239–E240

    Keywords Surgery ; Clinical Neurology ; covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1093/neuros/nyaa196
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  5. Book ; Online: Letter

    Daci, Rrita / Natarajan, Sabareesh K. / Johnson, Mark D.

    COVID-19 Publications by UMMS Authors

    Safety Considerations for Neurosurgical Procedures During the COVID-19 Pandemic

    2020  

    Abstract: The highest viral load for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the lungs, nasopharynx, and oropharynx. Thus, working in close proximity to the face likely represents the greatest risk of SARS-CoV-2 exposure for ... ...

    Abstract The highest viral load for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the lungs, nasopharynx, and oropharynx. Thus, working in close proximity to the face likely represents the greatest risk of SARS-CoV-2 exposure for neurosurgeons, many of whom have contracted and/or died from COVID-19. However, sources of exposure other than the respiratory tract should also be considered. SARS-CoV-2 viremia has been reported. SARS-CoV (which is closely related to SARS-CoV-2) can invade the brain. SARS-CoV-2 ribonucleic acid has been detected in the cerebrospinal fluid (CSF) of COVID-19 patients with altered mental status, intracranial hypertension, and/or brain imaging abnormalities, raising the possibility of SARS-CoV-2 meningitis or encephalitis. Thus, blood, brain, and CSF should be treated as potentially infectious until proven otherwise.
    Keywords COVID-19 ; Coronavirus ; neurosurgery ; infection ; safety ; Health Services Administration ; Infectious Disease ; Nervous System Diseases ; Neurology ; Surgery ; Surgical Procedures ; Operative ; Virus Diseases ; covid19
    Subject code 610
    Publishing date 2020-05-07T07:00:00Z
    Publisher eScholarship@UMMS
    Publishing country us
    Document type Book ; Online
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  6. Article ; Online: Brain Bypass Surgery for Complex Middle Cerebral Artery Aneurysms: Evolving Techniques, Results, and Lessons Learned.

    Natarajan, Sabareesh K / Zeeshan, Qazi / Ghodke, Basavaraj V / Sekhar, Laligam N

    World neurosurgery

    2019  Volume 130, Page(s) e272–e293

    Abstract: Objective: To analyze a consecutive series of patients with middle cerebral artery (MCA) aneurysms who needed an adjunctive cerebral revascularization procedure to achieve aneurysm occlusion with preservation of flow through all MCA branches.: Methods! ...

    Abstract Objective: To analyze a consecutive series of patients with middle cerebral artery (MCA) aneurysms who needed an adjunctive cerebral revascularization procedure to achieve aneurysm occlusion with preservation of flow through all MCA branches.
    Methods: A total of 42 patients with 43 MCA aneurysms underwent 52 bypass procedures over 13 years. The location of the aneurysm were M1 trunk, M1 bifurcation, M2 and beyond. The bypasses performed included intracranial bypasses (resection with end to end anastomosis, end to side implantation, side to side anastomosis, and short interposition graft), extraintracranial bypasses (superficial temporal to middle cerebral artery anastomosis, and radial artery bypass graft, or saphenous vein graft), double bypasses, Y-grafts, and combined techniques.
    Results: Forty-two of 43 aneurysms (98%) had patent bypasses at long-term follow-up. All 43 aneurysms were completely occluded at last follow-up. Six patients (14%) developed strokes related to the surgical treatment. At last follow-up, 36 patients had a modified Rankin score of 0-2, 5 patients had modified Rankin score 3-5, and 1 died. In this series, 31 (73.8%) patients improved, 8 (19%) patients had same functional status, and 3 (7.2%) patients deteriorated, including 1 patient who expired due to sepsis. The mean clinical follow-up duration was 39.3 months (0.4-124 months) and the mean radiological follow-up was 37 months (0.4-134 months).
    Conclusions: Cerebral revascularization is an important adjunct for treating MCA aneurysms and can be done safely. The article provides the insights we gained by rising through the learning curve.
    MeSH term(s) Adult ; Aged ; Brain/diagnostic imaging ; Brain/surgery ; Cerebral Revascularization/methods ; Cerebral Revascularization/trends ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Middle Cerebral Artery/diagnostic imaging ; Middle Cerebral Artery/surgery ; Neurosurgical Procedures/methods ; Neurosurgical Procedures/trends ; Treatment Outcome ; Vascular Surgical Procedures/methods ; Vascular Surgical Procedures/trends
    Language English
    Publishing date 2019-06-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2019.06.059
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    Zs.A 1159: Show issues Location:
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  7. Article ; Online: Investing in neurosurgery innovations: an editorial.

    Krishna, Chandan / Natarajan, Sabareesh K / Hopkins, L Nelson

    Neurosurgery

    2014  Volume 61 Suppl 1, Page(s) 135–136

    MeSH term(s) Humans ; Inventions/economics ; Inventions/legislation & jurisprudence ; Inventions/trends ; Neurosurgery/instrumentation ; Neurosurgery/methods ; Neurosurgery/trends ; Neurosurgical Procedures/instrumentation ; Neurosurgical Procedures/methods ; Neurosurgical Procedures/trends ; Therapies, Investigational/instrumentation ; Therapies, Investigational/methods ; Therapies, Investigational/trends
    Language English
    Publishing date 2014-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/NEU.0000000000000381
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  8. Article ; Online: Response to letter to the editor.

    Mokin, Maxim / Morr, Simon / Natarajan, Sabareesh K / Lin, Ning / Snyder, Kenneth V / Hopkins, L Nelson / Siddiqui, Adnan H / Levy, Elad I

    Journal of neurointerventional surgery

    2017  Volume 9, Issue e1, Page(s) e10–e11

    Keywords covid19
    Language English
    Publishing date 2017
    Publishing country England
    Document type Letter
    ZDB-ID 2514982-9
    ISSN 1759-8486 ; 1759-8478
    ISSN (online) 1759-8486
    ISSN 1759-8478
    DOI 10.1136/neurintsurg-2015-011869
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  9. Article ; Online: Neuroimaging of headaches associated with vascular disorders.

    Natarajan, Sabareesh K / Mokin, Maxim / Sonig, Ashish / Levy, Elad I

    Current pain and headache reports

    2015  Volume 19, Issue 6, Page(s) 16

    Abstract: Headaches from vascular causes need to be differentiated from primary headaches because a misdiagnosis may lead to dire consequences for the patient. Neuroimaging is critical in identifying patients with vascular headaches and identifying the nature of ... ...

    Abstract Headaches from vascular causes need to be differentiated from primary headaches because a misdiagnosis may lead to dire consequences for the patient. Neuroimaging is critical in identifying patients with vascular headaches and identifying the nature of the pathologic disorder causing these headaches. In addition, the imaging findings guide the physician regarding the optimal treatment modality for these lesions. This review summarizes the nuances of differentiating patients with secondary headaches related to vascular disease and discusses pertinent neuroimaging studies.
    MeSH term(s) Cerebral Angiography ; Cerebrovascular Disorders/complications ; Cerebrovascular Disorders/diagnosis ; Cerebrovascular Disorders/physiopathology ; Headache Disorders, Secondary/diagnosis ; Headache Disorders, Secondary/etiology ; Headache Disorders, Secondary/physiopathology ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Predictive Value of Tests ; Tomography, X-Ray Computed
    Keywords covid19
    Language English
    Publishing date 2015-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055062-5
    ISSN 1534-3081 ; 1531-3433
    ISSN (online) 1534-3081
    ISSN 1531-3433
    DOI 10.1007/s11916-015-0489-9
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    Zs.A 5477: Show issues Location:
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  10. Article ; Online: Triple therapy versus dual-antiplatelet therapy for dolichoectatic vertebrobasilar fusiform aneurysms treated with flow diverters.

    Siddiqui, Adnan H / Monteiro, Andre / Hanel, Ricardo A / Kan, Peter / Mohanty, Alina / Cortez, Gustavo M / Rabinovich, Margarita / Matouk, Charles / Sujijantarat, Nanthiya / Romero, Charles / Stone, Jeremy / Ebersole, Koji / Fry, Lane / Natarajan, Sabareesh K / Owusu-Adjei, Brittany / Ortega-Gutierrez, Santiago / Vivanco-Suarez, Juan / Wakhloo, Ajay K / Levy, Elad I

    Journal of neurointerventional surgery

    2022  Volume 15, Issue 7, Page(s) 655–663

    Abstract: Background: Dolichoectatic vertebrobasilar fusiform aneurysms (DVBFAs) have poor natural history when left untreated and high morbimortality when treated with microsurgery. Flow diversion (FD) with dual-antiplatelet therapy (DAPT) is feasible but ... ...

    Abstract Background: Dolichoectatic vertebrobasilar fusiform aneurysms (DVBFAs) have poor natural history when left untreated and high morbimortality when treated with microsurgery. Flow diversion (FD) with dual-antiplatelet therapy (DAPT) is feasible but carries high risk of perforator occlusion and progression of brainstem compression. Elaborate antithrombotic strategies are needed to preserve perforator patency while vessel remodeling occurs. We compared triple therapy (TT (DAPT plus oral anticoagulation)) and DAPT alone in patients with DVBFAs treated with FD.
    Methods: Retrospective comparison of DAPT and TT in patients with DVBFAs treated with FD at eight US centers.
    Results: The groups (DAPT=13, TT=14) were similar in age, sex, clinical presentation, baseline disability, and aneurysm characteristics. Radial access use was significantly higher in the TT group (71.4% vs 15.3%; P=0.006). Median number of flow diverters and adjunctive coiling use were non-different between groups. Acute ischemic stroke rate during the oral anticoagulation period was lower in the TT group than the DAPT group (7.1% vs 30.8%; P=0.167). Modified Rankin Scale score decline was significantly lower in the TT group (7.1% vs 69.2%; P=0.001). Overall rates of hemorrhagic complications (TT, 28.6% vs DAPT, 7.7%; P=0.162) and complete occlusion (TT, 25% vs DAPT, 54.4%; P=0.213) were non-different between the groups. Rate of moderate-to-severe disability at last follow-up was significantly lower in the TT group (21.4% vs 76.9%; P=0.007).
    Conclusions: Patients with DVBFAs treated with FD in the TT group had fewer ischemic strokes, less symptom progression, and overall better outcomes at last follow-up than similar patients in the DAPT group.
    MeSH term(s) Humans ; Platelet Aggregation Inhibitors ; Ischemic Stroke/drug therapy ; Retrospective Studies ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/drug therapy ; Intracranial Aneurysm/surgery ; Anticoagulants ; Treatment Outcome
    Chemical Substances Platelet Aggregation Inhibitors ; Anticoagulants
    Language English
    Publishing date 2022-09-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2514982-9
    ISSN 1759-8486 ; 1759-8478
    ISSN (online) 1759-8486
    ISSN 1759-8478
    DOI 10.1136/jnis-2022-019151
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