26
|
Jandial R, Hoshide R, Waters JD, Somlo G. Operative and Therapeutic Advancements in Breast Cancer Metastases to the Brain. Clin Breast Cancer 2017; 18:e455-e467. [PMID: 29100727 DOI: 10.1016/j.clbc.2017.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/14/2017] [Accepted: 10/01/2017] [Indexed: 12/31/2022]
Abstract
Patients with breast cancer are surviving longer as the state of the art for care advances. Because patients are surviving longer with primary breast cancer, the incidence of secondary metastatic disease has risen. Metastatic breast cancer to the brain was once thought to be universally fatal. While it is still quite lethal, its treatment after diagnosis is increasingly safe and effective. Critical progress has been made in understanding the interaction between breast metastases and the neural niche, neuroimaging of functional anatomy, minimally invasive image-guided brain surgery, characterizing subtypes of breast cancer based on molecular and genetic profiles, and individualized pharmaceuticals and immunotherapies. In this review, we discuss recent advances that have brought us to state-of-the-art management of metastatic breast cancer to the brain.
Collapse
|
27
|
Hoshide R, Jandial R. The role of the neural niche in brain metastasis. Clin Exp Metastasis 2017; 34:369-376. [DOI: 10.1007/s10585-017-9857-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/22/2017] [Indexed: 12/17/2022]
|
28
|
Waters JD, Hoshide R, Jandial R. Historical perspectives on the biology of brain metastasis. Clin Exp Metastasis 2017; 34:365-367. [DOI: 10.1007/s10585-017-9859-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 09/01/2017] [Indexed: 10/18/2022]
|
29
|
Hoshide R, Jandial R. Diffuse Midline Gliomas: Closer to a Cure? Neurosurgery 2017; 81:N19-N20. [DOI: 10.1093/neuros/nyx390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
30
|
Upadhyayula PS, Yue JK, Curtis EI, Hoshide R, Ciacci JD. A matched cohort comparison of cervical disc arthroplasty versus anterior cervical discectomy and fusion: Evaluating perioperative outcomes. J Clin Neurosci 2017; 43:235-239. [DOI: 10.1016/j.jocn.2017.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/22/2017] [Indexed: 11/17/2022]
|
31
|
Hoshide R, Teo C. Neuroendoscopy to Achieve Superior Glioma Resection Outcomes. Neurosurgery 2017; 64:139-143. [PMID: 28899051 DOI: 10.1093/neuros/nyx274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 07/28/2017] [Indexed: 11/13/2022] Open
|
32
|
Hoshide R, Calayag M, Meltzer H, Levy ML, Gonda D. Robot-assisted endoscopic third ventriculostomy: institutional experience in 9 patients. J Neurosurg Pediatr 2017; 20:125-133. [PMID: 28598265 DOI: 10.3171/2017.3.peds16636] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The endoscopic third ventriculostomy (ETV) is an established and effective treatment for obstructive hydrocephalus. In its most common application, surgeons plan their entry point and the endoscope trajectory for the procedure based on anatomical landmarks, then control the endoscope freehand. Recent studies report an incidence of neural injuries as high as 16.6% of all ETVs performed in North America. The authors have introduced the ROSA system to their ETV procedure to stereotactically optimize endoscope trajectories, to reduce risk of traction on neural structures by the endoscope, and to provide a stable mechanical holder of the endoscope. Here, they present their series in which the ROSA system was used for ETVs. METHODS At the authors' institution, they performed ETVs with the ROSA system in 9 consecutive patients within an 8-month period. Patients had to have a favorable expected response to ETV (ETV Success Score ≥ 70) with no additional endoscopic procedures (e.g., choroid plexus cauterization, septum pellucidum fenestration). The modality of image registration (CT, MRI, surface mapping, or bone fiducials) was dependent on the case. RESULTS Nine pediatric patients with an age range of 1.5 to 16 years, 4 girls and 5 boys, with ETV Success Scores ranging from 70 to 90, underwent successful ETV surgery with the ROSA system within an 8-month period. Their intracranial pathologies included tectal tumors (n = 3), communicating hydrocephalus from hemorrhage or meningeal disease (n = 2), congenital aqueductal stenosis (n = 1), compressive porencephalic cyst (n = 1), Chiari I malformation (n = 1), and pineal region mass (n = 1). Robotic assistance was limited to the ventricular access in the first 2 procedures, but was used for the entirety of the procedure for the following 7 cases. Four of these cases were combined with another procedural objective (3 stereotactic tectal mass biopsies, 1 Chiari decompression). A learning curve was observed with each subsequent surgery as registration and surgical times became shorter and more efficient. All patients had complete resolution of their preprocedural symptoms. There were no complications. CONCLUSIONS The ROSA system provides a stable, precise, and minimally invasive approach to ETVs.
Collapse
|
33
|
Jandial R, Hoshide R. Bionic-Brain: Controlling a Prosthetic Hand. World Neurosurg 2017; 105:980-982. [PMID: 28739519 DOI: 10.1016/j.wneu.2017.07.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
34
|
Hoshide R, Jandial R. Cognitive Dysfunction of Astronomical Proportions. Neurosurgery 2017; 81:N4-N5. [DOI: 10.1093/neuros/nyx261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
35
|
Hoshide R, Jandial R. Gravity of Intracranial Pressure Shifts in Outer Space. World Neurosurg 2017; 102:659-660. [DOI: 10.1016/j.wneu.2017.04.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
36
|
Hoshide R, Jandial R. A Decline in Cognitive Decline: The Brain's Modifiable Fate. Neurosurgery 2017; 80:N28. [DOI: 10.1093/neuros/nyx107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
37
|
Hoshide R, Meltzer H, Dalle-Ore C, Gonda D, Guillaume D, Chen CC. Impact of ventricular-peritoneal shunt valve design on clinical outcome of pediatric patients with hydrocephalus: Lessons learned from randomized controlled trials. Surg Neurol Int 2017; 8:49. [PMID: 28480111 PMCID: PMC5402330 DOI: 10.4103/sni.sni_11_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 01/24/2017] [Indexed: 11/05/2022] Open
Abstract
Hydrocephalus is one of the most common diseases managed by pediatric neurosurgeons. Cerebrospinal fluid (CSF) shunting has been the mainstay of durable treatment for hydrocephalus for many decades. There are two main categories of shunt designs for regulating the extent of CSF diversion: (1) Fixed-parameter valves and (2) adjustable valves. Furthermore, these valves can also function with and without an anti-siphon device. Here, we review randomized controlled trials (RCTs) that examined the impact of these valve designs on the clinical outcome of pediatric patients afflicted with hydrocephalus. All three RCTs suggested no significant differences in clinical outcome as a function of shunt design. Implications of these findings are discussed.
Collapse
|
38
|
Hoshide R, Jandial R. Cognitive Fountain of Youth. Neurosurgery 2017; 80:N11-N12. [DOI: 10.1093/neuros/nyx235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
39
|
Hoshide R, Jandial R. Human Cerebral Cortex Map 2.0. Neurosurgery 2016; 79:N16-N17. [PMID: 27861409 DOI: 10.1227/01.neu.0000508603.53941.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
40
|
Hoshide R, Cheung V, Marshall L, Kasper E, Chen CC. Do corticosteroids play a role in the management of traumatic brain injury? Surg Neurol Int 2016; 7:84. [PMID: 27656315 PMCID: PMC5025911 DOI: 10.4103/2152-7806.190439] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 08/15/2016] [Indexed: 11/09/2022] Open
Abstract
Neuroprotective strategies for the medical management of traumatic brain injury (TBI) have been elusive. While laboratory studies provide a conceptual framework for the potential efficacy of corticosteroids in this context, clinical trials testing this hypothesis have yielded no convincing evidence of clinical benefit. Here, we review the five key randomized control trials (RCTs) that have examined this issue. Based on the proposed primary endpoints of these RCTs, the five RCTs consistently showed that corticosteroids do not confer significant benefit in the TBI population.
Collapse
|
41
|
Hoshide R, Feldman E, Narayan A, Taylor W. A Novel, Minimally-Invasive Approach to Repair Degenerative Disk Disease in an Ovine Model Using Injectable Polymethyl-Methacrylate and Bovine Collagen (PMMA/BC). Cureus 2016; 8:e729. [PMID: 27630802 PMCID: PMC5016043 DOI: 10.7759/cureus.729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 08/07/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The natural, inflammatory repair processes of an injured intervertebral degenerative disc can propagate further injury and destruction. While there are many different treatment modalities of the pain related to degenerative disc disease, none are actually reparative in nature. Treatment strategies to repair a degenerative disc without inducing a destructive inflammatory milieu have been elusive. PURPOSE The purpose of this experiment is to discover the feasibility of reconstructing an injured intervertebral disc using an injected, inert polymer as the foundation for endogenous collagen growth. STUDY DESIGN In this ovine model of six subjects in total, we introduce a modality where a large inert polymer, polymethyl methacrylate (PMMA), in conjunction bovine collagen (BC) is injected into the intervertebral disc. Following six months of observation, histologic specimens were evaluated macroscopically and microscopically for evidence of a benefit of the injectable PMMA/BC. METHODS We obtained six merino sheep for this study. Concentric injuries were made to four of their lumbar intervertebral discs. Two of those levels were treated with a percutaneous injection of 0.3 cc of PMMA/BC. The remaining lumbar levels were left untreated and were our controls. After six months, all subjects were sacrificed. Their four levels were extracted and were examined macroscopically and microscopically. RESULTS All subjects tolerated the lumbar injury and percutaneous injection of PMMA/BC well. After the six month interval, all subjects have demonstrated an intact architecture of their lumbar disc height at the macroscopic and microscopic level. Microscopically, there was no evidence of external migration of the PMMA/BC microspheres, nor was there any evidence of an inflammatory response by its presence. Notably, the PMMA/BC microspheres were well-incorporated into the concentric disc tears and had undergone endogenous collagen formation in its environment. Treatment levels were revealing for maintenance of disc height without evidence of an ongoing degeneration. The controlled levels were revealing for continued disc degeneration with loss of disc height and evolving injury at the level of the concentric tear. CONCLUSIONS This ovine model demonstrates a novel and promising technique for prevention and arrest of lumbar intervertebral disc degeneration.
Collapse
|
42
|
Calayag M, Hoshide R, Gonda DD, Meltzer HS, Fukushima T, Levy ML. 309 Middle Fossa Approach to Lateralized Pontine Cavernomas in Children. Neurosurgery 2016. [DOI: 10.1227/01.neu.0000489797.26986.9c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
43
|
Hoshide R, Jandial R. Predicting Brain Metastasis Radiosensitivity From Primary Tumor Biology. Neurosurgery 2016; 79:N23-4. [DOI: 10.1227/01.neu.0000489892.55106.ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
44
|
Upadhyayula PS, Yue JK, Hoshide R, Curtis E, Ciacci JD. 345 Elective Anterior Cervical Discectomy and Fusion vs Cervical Artificial Disc Replacement. Neurosurgery 2016. [DOI: 10.1227/01.neu.0000489834.93882.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
45
|
Hoshide R, Calayag M, Meltzer HS, Levy ML, Gonda DD. 352 Robot-Assisted Endoscopic Third Ventriculostomy. Neurosurgery 2016. [DOI: 10.1227/01.neu.0000489841.88045.a3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
46
|
Hoshide R, Jandial R. 2016 World Health Organization Classification of Central Nervous System Tumors: An Era of Molecular Biology. World Neurosurg 2016; 94:561-562. [PMID: 27476688 DOI: 10.1016/j.wneu.2016.07.082] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
47
|
Hoshide R, Feldman E, Gabel BC, Taylor N, Gharib J, Lee YP, Taylor W. Novel Transabdominal Motor Action Potential (TaMAP) Neuromonitoring System for Spinal Surgery. Cureus 2016; 8:e655. [PMID: 27489748 PMCID: PMC4963228 DOI: 10.7759/cureus.655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Minimally invasive lateral lumbar interbody fusion (LLIF) approaches to the lumbar spine reduce patient morbidity compared to anterior or posterior alternatives. This approach, however, decreases direct anatomical visualization, creating the need for highly sensitive and specific neurophysiological monitoring. We seek to determine feasibility in 'transabdominal motor action potential (TaMAP)' monitoring as an assessment for the integrity of the neural elements during lateral-approach surgeries to the lumbar spine. METHODS Cathode and anode leads were placed on the posterior and anterior surfaces of two porcine subjects. Currents of varying degrees were transmitted across, from front to back. Motor responses were monitored and recorded by needle electrodes in specific distal muscle groups of the lower extremity. Lastly, the cathode and anode were placed anterior and posterior to the chest wall and stimulated to the maximum of 1500 mA to determine any effect on cardiac rhythm. RESULTS Responses were seen by measuring vertical height differences between peaks of corresponding evoked potentials. Recruitment began at 200 mA in the lower extremities. Stimulation at 450 mA recruited a reliable and distinguishable electrographic response from most muscle groups. Responses were recorded and reliably measured and increased in proportion to the graduation of transabdominal stimulation current; no responses were seen in the arms or face. 1500 mA across the chest wall failed to stimulate or induce cardiac arrhythmia on repeated stimulation, indicating safety of stimulation. CONCLUSION TaMAPs seen in the animal model provide a potential alternative to standard transcranial motor evoked potentials done in the lateral approach of LLIFs. TaMAP recordings in most muscle groups were recordable and reliable, though some muscle groups failed to stimulate. Safety of transabdominal motor evoked potentials was confirmed in this porcine study. Future studies should examine TaMAPs reliability in detecting compressive lesions of nerve roots and peripheral nerves.
Collapse
|
48
|
Calayag M, Hoshide R, Crawford J, Levy M. NS-20SURGICAL MANAGEMENT OF INTRACAVERNOUS LESIONS IN THE PEDIATRIC PATIENT: A SINGLE CENTER EXPERIENCE. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now078.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Calayag M, Hoshide R, Nation J, Crawford J, Levy M. NS-19ENDOSCOPIC TRANSPHENOIDAL SURGERY OF SELLAR AND PARASELLAR LESIONS IN THE PEDIATRIC PATIENT: A SINGLE CENTER EXPERIENCE. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now078.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
50
|
Abstract
Introduction Kambin’s Triangle is a right triangle over the dorsolateral disc. The area of this right triangle currently serves as a strategic site of posterolateral, minimally invasive access to the nerve root for delivery of epidural steroid injections. This posterolateral approach has also been considered a safe area of access to the intervertebral disc space and, thus, an effective approach in reducing complications, such as violation of the thecal sac, the nerve root, or the bony elements of the spine during minimally invasive spinal surgery. No published studies have been performed to characterize the dimensions of the Kambin's Triangle. Our aim is to characterize its dimensions at the lumbar levels and determine its efficacy and safety as a site of access for minimally invasive spinal surgery. Methods Two randomly chosen adult male cadavers were used for this study. The measurements were made bilaterally at their lumbar levels (L1–L5), which equates to 16 total measurements (eight bilateral disc spaces on two cadavers). The disc space was first accessed using a Kirschner wire in a standard oblique approach. With the assistance of fluoroscopy, a Kirschner wire was passed into the disc through the Kambin’s Triangle. The procedure was performed on the cadavers bilaterally at four levels, followed by open dissection. The calculations of the area were made by measuring the exiting nerve root, the superior border of the caudal vertebra, and the superior articulating facet—the borders of the Kambin's Triangle. Results The Kambin’s Triangle height and width respectively averaged at 12 mm and 10 mm (L1–L2), 13 mm and 11 mm (L2–L3), 17 mm and 11 mm (L3–L4), and 18 mm and 12 mm (L4–L5). Thus, the area at each level was 60 mm2 (L1–L2), 71.5 mm2 (L2–L3), 93.5 mm2 (L3–L4), and 108 mm2 (L4–L5). All dissected levels demonstrated adequate anchoring of the Kirschner wire into the disc space with no evidence of nerve injury. Following this, a retractor was placed and complete discectomies were performed. All exiting nerves were protected in this safe zone and the thecal sac remained inviolate. Conclusion Understanding the Kambin’s Triangle will assist surgeons in the minimally invasive approach to spinal surgeries, with potentially safe placement of interbody cages through this strategic space.
Collapse
|