Vascular

This chapter explores vascular diseases. The first set of studies discusses the natural history of unruptured intracranial aneurysms, examines the clinical outcomes of surgical and endovascular treatment, and assesses the safety and efficacy of endovascular coiling and neurosurgical clipping of ruptured intracranial aneurysms. The second set of studies compares carotid endarterectomy versus carotid angioplasty and stenting for the treatment of carotid artery stenosis, determines the efficacy of endovascular therapy after intravenous tissue plasminogen activator (tPA) versus tPA alone for the treatment of acute ischemic stroke, and tests the efficacy of endovascular thrombectomy. The third set of studies identifies risk factors for hemorrhage in patients with untreated brain arteriovenous malformation (BAVM) and looks at the management of unruptured BAVM. The fourth set of studies evaluates the effect of early neurosurgical intervention in patients with superficial lobar intracerebral hemorrhage and tests the hypothesis that minimally invasive hematoma evacuation along with the use of recombinant tissue-type plasminogen activator (rtPA) could safely reduce hematoma size and perihematomal edema. Finally, the last study describes the management of giant intracranial aneurysms.

Trauma

This chapter discusses traumatic spinal cord and brain injuries. The first three studies review the background and key findings of the third National Acute Spinal Cord Injury Study (NASCIS) trial, examine the efficacy of the Canadian C-Spine Rule in the evaluation of cervical spine injuries in alert and stable trauma patients; and describe the development of the Thoracolumbar Injury Classification and Severity Score (TLICS) classification system. The next two studies assess the effect of early surgical decompression in patients with traumatic cervical spinal cord injury and delineate the role of secondary brain injury in determining patient outcome in severe traumatic brain injury. The following set of four studies evaluates the efficacy of phenytoin in preventing posttraumatic seizures, as well as the efficacy of intracranial pressure monitoring, induction of hypothermia, and decompressive craniectomy for severe traumatic brain injury. The last study, which is of historical value, identifies predictors of outcome in comatose patients with traumatic acute subdural hematoma.

Spine

This chapter explores pathologies of the spine. The first study addresses the question of adjacent segment disease in the cervical spine. The second study, which presents a critical review of cervical laminoplasty, has a historical value showing how a novel procedure can be rejected at first but subsequently commonly adopted. The next two studies compare lumbar discectomy versus nonoperative treatment for lumbar disc herniation, and determine the safety and efficacy of bone morphogenetic proterin-2 in anterior lumbar interbody fusion. The following study is also of historic value, it evaluates the effect of pedicle screw instrumentation on fusion rates in posterolateral lumbar spinal fusion. The following studies focus on the treatment of adult scoliosis, compare the National Emergency X-Radiography Utilization Study Low-Risk Criteria to the Canadian C-Spine Rule in patients with trauma, and demonstrate that direct decompressive surgery plus postoperative radiotherapy is superior to treatment with radiotherapy alone for patients with spinal cord compression caused by metastatic cancer. Finally, a historical paper from 1980 investigates anterior approaches to the cervical spine.

Tumor

This chapter focuses on neurosurgical oncology. The first set of studies explores various preoperative parameters that impact survival in patients with glioblastoma multiforme, identifies a cancer stem cell in human brain tumors, and demonstrates the importance of language mapping for glioma resection and its impact on functional outcomes. The second set of studies provides an analysis of the recurrence and progression of meningioma. The third set of studies evaluates the efficacy of surgery, whole-brain radiotherapy, and stereotactic radiosurgery in the treatment of patients with brain metastases. The last study, included for its historical value, is Dr. Simpson's paper in which he proposed a grading system for the recurrence rates of meningiomas but also the relationship between these rates and extent of resection of meningioma.

Peripheral Nerve

This chapter addresses the peripheral nerve. The first set of studies discusses the management of carpal tunnel syndrome as well as the treatment for ulnar neuropathy at the elbow, which is the second most common entrapment neuropathy after carpal tunnel syndrome, and it describes lower extremity entrapment neuropathies. The second set of studies examines solitary benign neurofibromas or neurilemomas, which are relatively rare, and considers the international consensus on malignant peripheral nerve sheath tumors in neurofibromatosis 1. The third set of studies assesses the ulnar nerve as an alternative for nerve transfer after complete avulsion of the C5–C6 brachial plexus roots in order to restore elbow function, looks at outcomes of surgery in 1,019 brachial plexus lesions treated at Louisiana State University Health Sciences Center, and evaluates the surgical treatment of brachial plexus birth palsy. The last two studies introduce the application of magnetic resonance neurography in the evaluation of patients with peripheral nerve pathology and propose a five-tiered classification of peripheral nerve injuries.

Pediatric Neurosurgery

This chapter focuses on pediatric neurosurgery. The first study compares the results of extended strip craniectomy versus subtotal calvarectomy with cranial vault remodeling for patients with sagittal craniosynostosis, while the second study tests the safety and efficacy of minimally invasive endoscopic strip craniectomy followed by helmet molding therapy in the treatment of infantile craniosynostosis. The next three studies determine the success of endoscopic third ventriculostomy (ETV) in the treatment of childhood hydrocephalus, evaluate the risk factors for cerebrospinal fluid (CSF) shunt infection following initial shunt replacement, and assess the efficacy of drainage, irrigation, and fibrinolytic therapy (DRIFT) for premature infants with posthemorrhagic ventricular dilatation. Meanwhile, the following set of studies identifies the genetic alterations related to the pathogenesis of pediatric medulloblastoma and discusses the effect of prolonged postoperative chemotherapy on the ability to delay the delivery of radiation in children younger than 3 years of age with malignant brain tumors. The following two studies investigate whether prenatal repair of myelomeningocele could result in better neurologic function compared with the standard postnatal repair and explore functional outcomes following selective posterior rhizotomy in children with cerebral palsy. The last study is of historical value and explore Cushing’s critical review of cerebellar medulloblastomas.

Functional

This chapter discusses pain, movement disorders, epilepsy, dystonia, and neuropsychiatric disorder. The first set of studies examines the efficacy of spinal cord stimulation in managing pain in patients with chronic back pain and extremity pain, chronic pain, and neuropathic pain. The second set of studies evaluates the efficacy of deep brain stimulation of the subthalamic nucleus for the management of severe motor complications of Parkinson’s disease and compares it with ablative options such as unilateral pallidotomy. The third set of studies assesses the therapeutic value of nerve stimulation for patients with refractory epilepsy as well as its impact in seizure reduction. The next study explores the safety and efficacy of bilateral globus pallidus pars interna (GPi) stimulation for cervical dystonia, a complex condition that is often refractory to multiple medical and procedural therapies. Finally, the last study determines whether daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) safely and effectively treats major depressive disorder.