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High-Value Care Outcomes of Meningiomas
High-value health care has become a widely researched topic within neurosurgery. The concept of “high-value” care involves optimizing resource expenditures relative to patient outcomes, and therefore, high-value care research within neurosurgery has involved identifying prognostic factors for outcomes such as hospital length of stay, discharge disposition, monetary charges/costs incurred d uring hospitalization, and hospital readmission. The following article will discuss the motivation of high-value health-care research for optimizing the surgical treatment of intracranial meningiomas, highlight recent research invest...
Source: Neurosurgery Clinics of North America - April 5, 2023 Category: Neurosurgery Authors: Adrian E. Jimenez, Debraj Mukherjee Source Type: research

Histopathologic and Molecular Evaluation of Meningioma
This article reviews various aspects of the pathology of these tumors, from their frozen section appearance to the various subtypes a pathologist may come across at the microscope. Special emphasis is placed on the importance of CNS World Health Organization grading by light microscopic means to predict biological behavior of these tumors. Furthermore, relevant literature concerning the potential impact that DNA methylation profiling of these tumors and the possibility that this molecular testing modality might be the next step in refinement of our analysis of meningioma is presented. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - April 4, 2023 Category: Neurosurgery Authors: Christian Davidson Source Type: research

Novel Systemic Approaches for the Management of Meningiomas
Meningiomas, the most prevalent primary intracranial tumor, arise from the arachnoid cap cells in the meninges, the membranes that surround the brain and the spinal cord. The field has long sought effective predictors of meningioma recurrence and malignant transformation, as well as therapeutic targets to guide intensified treatment such as early radiation or systemic therapy. Novel and more targeted approaches are currently being tested in numerous clinical trials for patients who have progressed after surgery and/or radiation. In this review, the authors discuss relevant molecular drivers that have therapeutic implicatio...
Source: Neurosurgery Clinics of North America - April 4, 2023 Category: Neurosurgery Authors: Nazanin Ijad, Ashish Dahal, Albert E. Kim, Hiroaki Wakimoto, Tareq A. Juratli, Priscilla K. Brastianos Source Type: research

Advanced Meningioma Imaging
Noninvasive imaging methods are used to accurately diagnose meningiomas and track their growth and location. These techniques, including computed tomography, MRI, and nuclear medicine, are also being used to gather more information about the biology of the tumors and potentially predict their grade and impact on prognosis. In this article, we will discuss the current and developing uses of these imaging techniques including additional analysis using radiomics in the diagnosis and treatment of meningiomas, including treatment planning and prediction of tumor behavior. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - April 4, 2023 Category: Neurosurgery Authors: Erik K. Loken, Raymond Y. Huang Source Type: research

Endoscopic Endonasal and Keyhole Surgery for Skull Base Meningiomas
Traditionally, resection of anterior skull base meningiomas has been achieved by transcranial approaches; however, morbidity related (ie, brain retraction, sagittal sinus damage, optic nerve manipulation, and cosmetic healing) represent a limit of the approach. Minimally invasive techniques including supraorbital and endonasal endoscopic approaches (EEA) have gained consensus as surgical corridors provide direct access to the tumor via a midline approach in carefully selected patients . The supraorbital approach requires some retraction of the rectus gyrus, but it offers minimal risk of postoperative CSF leak or sinonasal ...
Source: Neurosurgery Clinics of North America - March 27, 2023 Category: Neurosurgery Authors: Ilaria Bove, Stephanie Cheok, Jacob J. Ruzevick, Gabriel Zada Source Type: research

The Role of Radiotherapy in the Treatment of Higher-Grade Meningioma
High-grade meningiomas (atypical and anaplastic/malignant) are at increased risk of recurrence following primary treatment with maximum safe surgical resection. Evidence based on several retrospective and prospective observational studies suggests an important role of radiation therapy (RT) in both adjuvant and salvage settings. At present, adjuvant RT is recommended for incompletely resected atypical meningiomas and anaplastic meningiomas irrespective of resection extent with disease control benefit. In completely resected atypical meningiomas, the role of adjuvant RT remains debatable but should be considered given the a...
Source: Neurosurgery Clinics of North America - March 27, 2023 Category: Neurosurgery Authors: Grace Lee, Helen A. Shih Source Type: research

History of Ablation Therapies in Neurosurgery
Laser interstitial thermal therapy (LITT) and high-intensity focused ultrasound thermal ablation are treatment options with great potential to treat glioblastoma, metastasis, epilepsy, essential tremor, and chronic pain. Results from recent studies show that LITT is a viable alternative to conventional surgical techniques in select patient populations. Although many of the bases for these treatments have existed since the 1930s, the most important advancement in these techniques has occurred in the last 15  years and the coming years hold much promise for these treatments. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Kristin Nosova, Esteban Quiceno, Amna Hussein, Oliver Bozinov, Peter Nakaji Source Type: research

Learning Curve Analysis and Adverse Events After Implementation of Neurosurgical Laser Ablation Treatment
Objective and Methods: We conducted a retrospective review of the first 30 patients treated with stereotactic laser ablation (SLA) at our institution since the introduction of the technique in September 2019. We aimed to analyze our initial results and potential learning curve by investigating precision and lesion coverage and assessing the frequency and nature of adverse events according to the Landriel –Ibanez classification for neurosurgical complications. Results: Indications were de novo gliomas (23%), recurrent gliomas (57%), and epileptogenic foci (20%). There was a trend toward improvement of lesion coverage and ...
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Margret Jensdottir, Ulrika Sandvik, Asgeir S. Jakola, Michael Fagerlund, Annika Kits, Klara Gu ðmundsdóttir, Sara Tabari, Tomas Majing, Alexander Fletcher-Sandersjöö, Clark C. Chen, Jiri Bartek Source Type: research

The Evolution of Laser-Induced Thermal Therapy for the Treatment of Gliomas
Laser-induced thermal therapy (LITT) has evolved over the past two  decades to treat a number of intracranial pathologies. Although it initially emerged as a salvage treatment of surgically inoperable tumors or recurrent lesions that had exhausted more conventional treatments, it is now being used as a primary, first-line treatment in certain instances with outcom es comparable to traditional surgical resection. The authors discuss the evolution of LITT in the treatment of gliomas and future directions, which may further enhance the efficacy of this procedure. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Purvee D. Patel, Nitesh V. Patel, Shabbar F. Danish Source Type: research

Current Applications of Ablative Therapies for Trigeminal Neuralgia
This article reviews the relevant anatomy and lesioning procedures for the treatment of trigeminal neuralgia. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Arpan R. Chakraborty, Kerrin Sunshine, Jonathan P. Miller, Jennifer A. Sweet Source Type: research

Ablation Therapies in Neurosurgery
The concept of localization of function in neurology and neurosurgery is owed to a series of early thinkers, including Gall, whose discredited theory of phrenology posited that bumps on the head had specific correlations and relations to brain functions. By the time of Broca, the concept that there was regionality in the brain was growing. Edwin Boldrey ’s description of the sensorimotor homunculus in his 1936 McGill master’s degree thesis (supervised by Wilder Penfield) firmly entrenched the idea of specific localization in the neurosurgical psyche. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Peter Nakaji, Oliver Bozinov Tags: Preface Source Type: research

Ablative Therapies in Neurosurgery
NEUROSURGERY CLINICS OF NORTH AMERICA (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Authors: Peter Nakaji, Oliver Bozinov Source Type: research

Copyright
ELSEVIER (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Source Type: research

Contributors
RUSSELL R. LONSER, MD (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Source Type: research

Contents
Peter Nakaji and Oliver Bozinov (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - March 10, 2023 Category: Neurosurgery Source Type: research