Introduction Surgical treatment of high-grade gliomas has been a challenge for neurosurgeons since the early days of our specialty with Harvey Cushing and Walter Dandy. Dandy developed the hemispherectomy to treat patients with invasive high-grade gliomas and observed they still…
Factors Influencing the Delivery of Chemotherapy to the Brain Blood-Brain Barrier Treatment of brain tumors with systemic chemotherapy poses unique challenges. Concentrations of chemotherapeutic agents within the central nervous system (CNS) depend on multiple factors, including ability of the agents…
Introduction The ultimate goal of brain surgery, especially in neuro-oncology, is to maximize the extent of resection (EoR) while preserving or even improving the patient’s quality of life (QoL)—that is, to optimize the oncofunctional balance. , Indeed, maximal safe resection…
Over the past 25 years, intraoperative neurophysiology (ION) has established itself as a clinical discipline that uses neurophysiologic methods—especially developed or modified from existing methods of clinical neurophysiology—to detect and prevent intraoperatively induced neurologic injuries. Recent developments have solidified its…
Diffusion tensor imaging (DTI) is a noninvasive technique that makes it possible to assess the integrity and location of subcortical white matter tracts in vivo. Its importance is underscored by the developing understanding that neurologic outcomes are more dependent on the…
Acknowledgments I thank all friends from Boston (The MRT crew and SPL) at Brigham and Women’s Hospital, Colleagues in Kiel from Anesthesiology, Tec and OR Team. Introduction One of the most challenging developments in neurosurgery encompasses the interdisciplinary effort to…
Primum non nocere —first do no harm. The Hippocratic statement epitomizes the importance the medical community places on avoiding iatrogenic complications. In the process of providing care, patients, physicians, and the entire clinical team join to use all available medical…
Introduction Technological innovations over the past several decades have enabled spine surgeons to steadily increase the safety and efficacy of procedures performed with a focus on improving outcomes, while minimizing the surgical footprint. Innovations in microscopic and endoscopic visualization systems,…
Introduction A large amount of literature related to spine surgery is plagued by retrospective design and small sample sizes resulting in a lack of statistical power. This is particularly true for literature regarding the validation of cutting-edge technologies, including robotic…
Introduction of Technology While investigations into incorporating machine learning (ML) and artificial intelligence (AI) into medicine have been numerous and diverse, their aggregate contributions have altered and revolutionized clinical practice. Fundamentally, ML and AI approaches seek to leverage automata for…