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Artikel: Management of Atlantoaxial Instability Due to a Pathological Fracture of the Axis.

Thirunavu, Vineeth / Dahdaleh, Nader S

2020 Band 12, Heft 7, Seite(n) e8951

Abstract: Metastases to the upper cervical spine are uncommon, and subsequent instability is rare. We report the details of a patient with metastatic breast cancer to the axis manifesting as a pathologic fracture and C1/C2 instability. This was treated by ... ...

Abstract	Metastases to the upper cervical spine are uncommon, and subsequent instability is rare. We report the details of a patient with metastatic breast cancer to the axis manifesting as a pathologic fracture and C1/C2 instability. This was treated by preoperative reduction to appropriate alignment with use of crown halo traction, followed by posterior occipitocervical fusion and postoperative radiation therapy.
Sprache	Englisch
Erscheinungsdatum	2020-07-01
Erscheinungsland	United States
Dokumenttyp	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.8951
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Blistering skin reaction with Mastisol in a patient with spina bifida: illustrative case.

Bowman, Robin M / Thirunavu, Vineeth / Lam, Sandi

Journal of neurosurgery. Case lessons

2021 Band 1, Heft 13, Seite(n) CASE2011

Abstract: Background: Patients with spina bifida have repeated interactions with the healthcare system and often require multiple surgeries throughout their lifetime. Latex precautions are often indicated owing to the high risk of anaphylactic reactions. The ... ...

Abstract	Background: Patients with spina bifida have repeated interactions with the healthcare system and often require multiple surgeries throughout their lifetime. Latex precautions are often indicated owing to the high risk of anaphylactic reactions. The choice of dressing for these patients represents an opportunity for learning and standardization if appropriate. The authors discuss the various cases of skin reactions to Mastisol in the literature in comparison with their case and explore the possible mechanisms underlying this skin reaction given the high prevalence of latex allergy in patients with spina bifida. Observations: The authors present the case of a 17-year-old girl with a history of spina bifida and shunted hydrocephalus who underwent a shunt externalization operation and subsequently developed an allergic contact dermatitis reaction to Mastisol liquid adhesive. Topical steroid cream was then administered, and signs and symptoms resolved over the next 3 days. Lessons: The choice of dressing should be considered carefully in patients with spina bifida given their repeated exposures and possible sensitivities. The authors aim to increase the awareness of the possibility of Mastisol-induced skin reactions in patients with spina bifida and set a foundation for future studies to investigate the relationship between latex allergy and sensitization to Mastisol.
Sprache	Englisch
Erscheinungsdatum	2021-03-29
Erscheinungsland	United States
Dokumenttyp	Case Reports
ISSN	2694-1902
ISSN (online)	2694-1902
DOI	10.3171/CASE2011
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: The demographic, clinical, and management differences between traumatic dens fracture patients with and without simultaneous atlas fractures.

Cloney, Michael Brendan / Texakalidis, Pavlos / Roumeliotis, Anastasios G / Thirunavu, Vineeth / Shlobin, Nathan A / Swong, Kevin / El Tecle, Najib / Dahdaleh, Nader S

Journal of craniovertebral junction & spine

2024 Band 15, Heft 1, Seite(n) 21–29

Abstract: Introduction: Atlas fractures often accompany traumatic dens fractures, but existing literature on the management of simultaneous atlantoaxial fractures is limited.: Methods: We examined all patients with traumatic dens fractures at our institution ... ...

Abstract	Introduction: Atlas fractures often accompany traumatic dens fractures, but existing literature on the management of simultaneous atlantoaxial fractures is limited. Methods: We examined all patients with traumatic dens fractures at our institution between 2008 and 2018. We used multivariable logistic regression and ordinal logistic regression to identify factors independently associated with presentation with a simultaneous atlas fracture, as well myelopathy severity, fracture nonunion, and selection for surgery. Results: Two hundred and eighty-two patients with traumatic dens fractures without subaxial fractures were identified, including 65 (22.8%) with simultaneous atlas fractures. The distribution of injury mechanisms differed between groups (χ Conclusions: Among patients with traumatic dens, patients who have simultaneous atlas fractures are a distinct subpopulation with respect to age, mechanism of injury, fracture morphology, and management. Traumatic dens fractures with simultaneous atlas fractures are independently associated with selection for OCF rather than posterior cervical fusion alone.
Sprache	Englisch
Erscheinungsdatum	2024-03-13
Erscheinungsland	India
Dokumenttyp	Journal Article
ZDB-ID	2573344-8
ISSN	0976-9285 ; 0974-8237
ISSN (online)	0976-9285
ISSN	0974-8237
DOI	10.4103/jcvjs.jcvjs_147_23
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Pre-operative predictors of post-operative seizure control in low-grade glioma: a systematic review and meta-analysis.

Nandoliya, Khizar R / Thirunavu, Vineeth / Ellis, Erin / Dixit, Karan / Tate, Matthew C / Drumm, Michael R / Templer, Jessica W

Neurosurgical review

2024 Band 47, Heft 1, Seite(n) 94

Abstract: As many as 80% of low-grade gliomas (LGGs) present with seizures, negatively impacting quality of life. While seizures are associated with gliomas regardless of grade, the importance of minimizing impact of seizures for patients with low grade tumors ... ...

Abstract	As many as 80% of low-grade gliomas (LGGs) present with seizures, negatively impacting quality of life. While seizures are associated with gliomas regardless of grade, the importance of minimizing impact of seizures for patients with low grade tumors cannot be understated given the prolonged survival period in this population. The objective of this systematic review and meta-analysis was to summarize existing literature and identify factors associated with post-operative seizure control (defined as Engel I classification) in patients with LGGs, with a focus on pre-operative factors. Patient data extracted include tumor location and histology, pre-operative anti-seizure medication use, extent of resection (EOR), adjuvant treatment, pre-operative seizure type, duration, and frequency, and post-operative Engel classification. A random-effects model was used to calculate the effects of EOR, pre-operative seizure duration, adjuvant radiation, and adjuvant chemotherapy on post-operative seizure control. The effect of tumor location and histology on post-operative Engel I classification was determined using contingency analyses. Thirteen studies including 1628 patients with seizures were included in the systematic review. On meta-analyses, Engel I classification was associated with pre-operative seizure type (OR = 0.79 (0.63-0.99), p = 0.0385, focal versus generalized), frontal lobe LGGs (OR = 1.5 (1.1-2.0), p = 0.0195), and EOR (OR (95% CI) = 4.5 (2.3-6.7), p < 0.0001 gross-total versus subtotal). Pre-operative seizure duration less than one year, adjuvant radiation, adjuvant chemotherapy, and tumor histology were not associated with achieving Engel I classification. In addition to the known effects of EOR, Engel I classification is less likely to be achieved in patients with focal pre-operative seizures and more likely to be achieved in patients with frontal lobe LGGs.
Mesh-Begriff(e)	Humans ; Quality of Life ; Glioma/surgery ; Frontal Lobe ; Postoperative Period ; Radiotherapy, Adjuvant
Sprache	Englisch
Erscheinungsdatum	2024-02-27
Erscheinungsland	Germany
Dokumenttyp	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-024-02329-9
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Konferenzbeitrag: Surgical Resection for Trigeminal Schwannomas: An Institutional Experience

Nandoliya, Khizar R. / Karras, Constantine L. / Thirunavu, Vineeth / Chandler, James P. / Magill, Stephen T.

Journal of Neurological Surgery Part B: Skull Base

2024 Band 85, Heft S 01

Veranstaltung/Kongress	33rd Annual Meeting North American Skull Base Society, Atlanta Marriott Marquis Atlanta, Georgia, United States, 2024-02-16
Sprache	Englisch
Erscheinungsdatum	2024-02-01
Verlag	Georg Thieme Verlag KG
Erscheinungsort	Stuttgart ; New York
Dokumenttyp	Artikel ; Konferenzbeitrag
ZDB-ID	2654269-9
ISSN	2193-634X ; 2193-6331
ISSN (online)	2193-634X
ISSN	2193-6331
DOI	10.1055/s-0044-1780264
Datenquelle	Thieme Verlag

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Artikel ; Online: Surgery Decreases Nonunion, Myelopathy, and Mortality for Patients With Traumatic Odontoid Fractures: A Propensity Score Matched Analysis.

Cloney, Michael / Thirunavu, Vineeth / Roumeliotis, Anastasios / Azad, Hooman / Shlobin, Nathan A / Swong, Kevin / El Tecle, Najib / Dahdaleh, Nader S

Neurosurgery

2023 Band 93, Heft 3, Seite(n) 546–554

Abstract: Background: Existing literature suggests that surgical intervention for odontoid fractures is beneficial but often does not control for known confounding factors.: Objective: To examine the effect of surgical fixation on myelopathy, fracture nonunion, ...

Abstract	Background: Existing literature suggests that surgical intervention for odontoid fractures is beneficial but often does not control for known confounding factors. Objective: To examine the effect of surgical fixation on myelopathy, fracture nonunion, and mortality after traumatic odontoid fractures. Methods: We analyzed all traumatic odontoid fractures managed at our institution between 2010 and 2020. Ordinal multivariable logistic regression was used to identify factors associated with myelopathy severity at follow-up. Propensity score analysis was used to test the treatment effect of surgery on nonunion and mortality. Results: Three hundred and three patients with traumatic odontoid fracture were identified, of whom 21.6% underwent surgical stabilization. After propensity score matching, populations were well balanced across all analyses (Rubin's B < 25.0, 0.5 < Rubin's R < 2.0). Controlling for age and fracture angulation, type, comminution, and displacement, the overall rate of nonunion was lower in the surgical group (39.7% vs 57.3%, average treatment effect [ATE] = -0.153 [-0.279, -0.028], P = .017). Controlling for age, sex, Nurick score, Charlson Comorbidity Index, Injury Severity Score, and selection for intensive care unit admission, the mortality rate was lower for the surgical group at 30 days (1.7% vs 13.8%, ATE = -0.101 [-0.172, -0.030], P = .005) and at 1 year was 7.0% vs 23.7%, ATE = -0.099 [-0.181, -0.017], P = .018. Cox proportional hazards analysis also demonstrated a mortality benefit for surgery (hazard ratio = 0.587 [0.426, 0.799], P = .0009). Patients who underwent surgery were less likely to have worse myelopathy scores at follow-up (odds ratio = 0.48 [0.25, 0.93], P = .029). Conclusion: Surgical stabilization is associated with better myelopathy scores at follow-up and causes lower rates of fracture nonunion, 30-day mortality, and 1-year mortality.
Mesh-Begriff(e)	Humans ; Infant ; Spinal Fractures/complications ; Odontoid Process/surgery ; Odontoid Process/injuries ; Propensity Score ; Retrospective Studies ; Fractures, Ununited/complications ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2023-06-12
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002557
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Traumatic Dens Fracture Patients Comprise Distinct Subpopulations Distinguished by Differences in Age, Sex, Injury Mechanism and Severity, and Outcome.

Cloney, Michael B / Thirunavu, Vineeth / Roumeliotis, Anastasios / Texakalidis, Pavlos / Swong, Kevin / El Tecle, Najib / Dahdaleh, Nader S

World neurosurgery

2023 Band 178, Seite(n) e128–e134

Abstract: Background: Dens fractures are an increasingly common injury, yet their epidemiology and its implications remain underexamined.: Methods: We retrospectively analyzed all traumatic dens fracture patients managed at our institution over a 10-year ... ...

Abstract	Background: Dens fractures are an increasingly common injury, yet their epidemiology and its implications remain underexamined. Methods: We retrospectively analyzed all traumatic dens fracture patients managed at our institution over a 10-year period, examining demographic, clinical, and outcomes data. Patient subsets were compared across these parameters. Results: Among 303 traumatic dens fracture patients, we observed a bimodal age distribution with a strong goodness of fit centered at age 22.3 ± 5.7 (R = 0.8781) and at 77.7 ± 13.9 (R = 0.9686). A population pyramid demonstrated a bimodal distribution among male patients, but not female patients, which was confirmed with a strong goodness of fit for male patient subpopulations age <35 (R = 0.9791) and age ≥35 (R = 0.8843), but a weaker fit for a second female subpopulation age <35. Both age groups were equally likely to undergo surgery. Patients younger than age 35 were more likely to be male (82.4% vs. 46.9%, odds ratio [OR] = 5.29 [1.54, 17.57], P = 0.0052), have motor vehicle collision as their mechanism of injury (64.7% vs. 14.1%, OR = 11.18 [3.77, 31.77], P < 0.0001), and to have a severe trauma injury severity score (17.6% vs. 2.9%, OR = 7.23 [1.88, 28.88], P = 0.0198). Nevertheless, patients age <35 were less likely to have fracture nonunion at follow (18.2% vs. 53.7%, OR = 0.19 [0.041, 0.76], P = 0.0288). Conclusions: The dens fracture patient population comprises 2 subpopulations, distinguished by differences in age, sex, injury mechanism and severity, and outcome, with male dens fracture patients demonstrating a bimodal age distribution. Young, male patients were more likely to have high-energy injury mechanisms leading to severe trauma, yet were less likely to have fracture nonunion at follow-up.
Mesh-Begriff(e)	Humans ; Male ; Female ; Adolescent ; Young Adult ; Adult ; Spinal Fractures/surgery ; Retrospective Studies ; Odontoid Process/surgery ; Fractures, Ununited ; Age Distribution
Sprache	Englisch
Erscheinungsdatum	2023-07-08
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.07.007
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Outcomes following surgical resection of trigeminal schwannomas: a systematic review and meta-analysis.

Karras, Constantine L / Texakalidis, Pavlos / Thirunavu, Vineeth M / Nandoliya, Khizar R / Khazanchi, Rushmin / Byrne, Kayla / Chandler, James P / Magill, Stephen T

Neurosurgical review

2023 Band 46, Heft 1, Seite(n) 215

Abstract: Although typically benign, trigeminal schwannomas (TS) may require surgical resection when large or symptomatic and can cause significant morbidity. This study aims to summarize the literature and synthesize outcomes following surgical resection of TS. A ...

Abstract	Although typically benign, trigeminal schwannomas (TS) may require surgical resection when large or symptomatic and can cause significant morbidity. This study aims to summarize the literature and synthesize outcomes following surgical resection of TS. A systematic review was performed according to PRISMA guidelines. Data extracted included patient and tumor characteristics, surgical approaches, and postoperative outcomes. Odds ratios (OR) with corresponding 95% confidence intervals (CI) were used for outcome analysis. The initial search yielded 1838 results, of which 26 studies with 974 patients undergoing surgical resection of TS were included. The mean age was 42.9 years and 58.0% were female. The mean tumor diameter was 4.7 cm, with Samii type A, B, C, and D tumors corresponding to 33.4%, 15.8%, 37.2%, and 13.6%, respectively. Over a mean symptom duration of 29 months, patients presented with trigeminal hypesthesia (58.7%), headache (32.8%), trigeminal motor weakness (22.8%), facial pain (21.3%), ataxia (19.4%), diplopia (18.7%), and visual impairment (12.0%). Surgical approaches included supratentorial (61.4%), infratentorial (15.0%), endoscopic (8.6%), combined/staged (5.3%), and anterior (5.7%) or posterior (4.0%) petrosectomy. Postoperative improvement of facial pain (83.9%) was significantly greater than trigeminal motor weakness (33.0%) or hypesthesia (29.4%). The extent of resection (EOR) was reported as gross total (GTR), near total, and subtotal in 77.7%, 7.7%, and 14.6% of cases, respectively. Over a mean follow-up time of 62.6 months, recurrence/progression was noted in 7.4% of patients at a mean time to recurrence of 44.9 months. Patients with GTR had statistically significantly lower odds of recurrence/progression (OR: 0.07; 95% CI: 0.04-0.15) compared to patients with non-GTR. This systematic review and meta-analysis report patient outcomes following surgical resection of TS. EOR was found to be an important predictor of the risk of recurrence. Facial pain was more likely to improve postoperatively than facial hypesthesia. This work reports baseline rates of post-operative complications across studies, establishing benchmarks for neurosurgeons innovating and working to improve surgical outcomes for TS patients.
Mesh-Begriff(e)	Humans ; Female ; Adult ; Male ; Hypesthesia ; Neurilemmoma/surgery ; Cranial Nerve Neoplasms/surgery ; Postoperative Complications ; Facial Pain
Sprache	Englisch
Erscheinungsdatum	2023-08-30
Erscheinungsland	Germany
Dokumenttyp	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-023-02121-1
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Odontoid fracture type and angulation affect nonunion risk, but comminution and displacement do not: A propensity score matched analysis of fracture morphology.

Cloney, Michael / Thirunavu, Vineeth / Roumeliotis, Anastasios / Azad, Hooman / Shlobin, Nathan / Swong, Kevin / El Tecle, Najib / Dahdaleh, Nader S

Clinical neurology and neurosurgery

2023 Band 231, Seite(n) 107855

Abstract: Objective: Odontoid fractures disproportionately affect older patients who have high surgical risk, but also high rates of fracture nonunion. To guide surgical decision-making, we quantified the effect of fracture morphology on nonunion among ... ...

Abstract	Objective: Odontoid fractures disproportionately affect older patients who have high surgical risk, but also high rates of fracture nonunion. To guide surgical decision-making, we quantified the effect of fracture morphology on nonunion among nonoperatively managed, traumatic, isolated odontoid fractures. Methods: We examined all patients with isolated odontoid fractures treated nonoperatively at our institution between 2010 and 2019. Multivariable regression and propensity score matching were used to quantify the effect of fracture type, angulation, comminution, and displacement on bony healing by 26 weeks from injury. Results: 303 consecutive traumatic odontoid fracture patients were identified, of whom 163 (53.8 %) had isolated fractures that were managed nonoperatively. Selection for nonoperative management was more likely with older age (OR=1.31 [1.09, 1.58], p = 0.004), and less likely with higher fracture angle (OR=0.70 [0.55, 0.89], p = 0.004), or higher presenting Nurick scores (OR=0.77 [0.62, 0.94], p = 0.011). Factors associated with nonunion at 26 weeks were fracture angle (OR=5.11 [1.43, 18.26], p = 0.012) and Anderson-D'Alonzo Type II morphology (OR=5.79 [1.88, 17.83], p = 0.002). Propensity score matching to assess the effect of type II fracture, fracture angulation> 10 Conclusion: Type II fracture morphology and fracture angle > 10
Mesh-Begriff(e)	Humans ; Odontoid Process/surgery ; Spinal Fractures/therapy ; Spinal Fractures/surgery ; Propensity Score ; Fractures, Bone ; Fractures, Ununited/diagnostic imaging ; Fractures, Ununited/epidemiology ; Retrospective Studies ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2023-06-28
Erscheinungsland	Netherlands
Dokumenttyp	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107855
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Evaluating outcome associations with race after mechanical thrombectomy: an analysis of the NVQI-QOD acute ischemic stroke registry.

Fuentes, Angelica / Thirunavu, Vineeth / Hasib Akhter Faruqui, Syed / Zhou, Chaochao / McGuire, Laura Stone / Du, Xinjian / Pandey, Dilip / Cantrell, Donald / Ansari, Sameer A / Amin-Hanjani, Sepideh

Journal of neurointerventional surgery

2024

Abstract: Background: Mechanical thrombectomy has become the standard of care for acute ischemic stroke due to large vessel occlusions. Racial differences in outcomes after mechanical thrombectomy for acute ischemic stroke have not been extensively studied. We ... ...

Abstract	Background: Mechanical thrombectomy has become the standard of care for acute ischemic stroke due to large vessel occlusions. Racial differences in outcomes after mechanical thrombectomy for acute ischemic stroke have not been extensively studied. We evaluate the real-world evidence for differences between races in the outcomes of thrombectomy for large vessel occlusions using the NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD). Methods: Data from the NVQI-QOD acute ischemic stroke registry were analyzed and compared for racial differences in outcomes after mechanical thrombectomy in 4507 patients from 28 US centers (17 states) between January 2014 and April 2021. Race was dichotomized into non-Hispanic White (NHW, n=3649) and non-Hispanic Black (NHB, n=858). We performed 1:1 propensity score matching resulting in a subsample of matched groups (n=761 each for NHB and NHW) to compare study endpoints using Welch's two-sided t-tests and Χ Results: Prior to matching, NHW and NHB patients significantly differed in age, comorbidities, medication use, smoking status, and presenting stroke severity. No significant difference in functional outcomes or mortality, at discharge or follow-up, were revealed. NHB patients had higher average postprocedure length of stay than NHW patients, which persisted following matching (11.2 vs 9.1 days, P=0.004). Conclusion: Evidence from the NVQI-QOD acute ischemic stroke registry showed that outcome metrics, such as modified Rankin Scale score and mortality, did not differ significantly between racial groups; however, disparity between NHW and NHB patients in postprocedure length of stay following mechanical thrombectomy was revealed.
Sprache	Englisch
Erscheinungsdatum	2024-01-03
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	2514982-9
ISSN	1759-8486 ; 1759-8478
ISSN (online)	1759-8486
ISSN	1759-8478
DOI	10.1136/jnis-2023-021208
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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