Mount Sinai Medical Center of Florida’s Post

Torstein R. Meling et al, I congratulate you. You have quantified what most of us have known qualitatively for years: Talk is cheap and gets cheaper all the time. The collective rat race to publish, release a device or get ahead in #aneurysm management in general - or frankly any other field of therapeutic medicine - has indeed soiled and eroded, ever so gently but relentlessly, the process of academic rigor. It reminds me of the highly misleading and frankly hypocritical terms: "minimally invasive" (when "minimal access" would have been more appropriate), "maximum safe resection" (when it should have said "the maximum resection I personally was able to achieve"), and so many other examples of ambiguous but dangerous terminology that have invaded our scientific vernacular. Conclusions that use terms not supported by the data are rampant, everywhere. What is most insidious and alarming is that there may or may not necessarily be malintent or ill will in the authors' mind. This defective method of expressing so-called scientific results has embedded itself into the expanding collection of unconscious biases we carry as researchers and clinicians. You have studied 3 of the 4 relevant factors in aneurysm management: safety, effectiveness and durability. The fourth one would have been "feasibility" of treatment. I am not surprised that these "terms of optimism" were inappropriately used and abused ad nauseum, with no basis or clear explanation whatsoever, in the majority of the studies you looked at. After all, they form convenient catch phrases for the believers of self-fulfilling prophecies and all other interested parties to use, regardless of the data presented. Boy do I yearn for mathematical rigor in our medical literature, where axioms are recognized and hypotheses do not graduate to become theorems until proven unequivocally! That would do us so much good, but would require us to remember what logic and chains of reasoning meant. It is high time for peer reviewers - unfortunately overburdened with assignments - to scrutinize those words as hard as they scrutinize the data, if not more, and question them, always. In an era where attention spans are dwindling faster than the interest rates are rising, in a world where the youth does not have time to read an entire article, but simply the part of the conclusion that fits on their phone screens, it is high time for collective academia to pay attention to the weight of words and dissociate and uncouple any unjustified language that can be seen as straddling the worlds of "science" and the world of "marketing". For the sake of all, but mostly for the sake of our patients. "Show me, rather than tell me". Or in the words of the inimitable #juhahernesniemi , it is better to walk the walk, rather than talk the talk. So let's keep walking.

Check out this case series from Dr. Behnam Rezai Jahromi and the Helsinki University Hospital, Department of Neurosurgery: Active Cerebrospinal Fluid Exchange System for Treatment of Pyogenic Ventriculitis. “This new technique allowed us to change the composition of CSF to an antibiotic-consisted fluid. This resulted in the ability to directly modify the concentration of the targeted antibiotics in the CSF, while simultaneously removing bacterial mass without harming brain tissue and controlling ICP and pH." Read the Case Report here - https://lnkd.in/g_NbeNG9. #IRRAflow #medicaldevice #healthcare #medtech #criticalcare #medicalinnovation #neurocriticalcare #ventriculitis #neurosurgery

In the #hydrocephalus market, hospitals are primary treatment hubs, providing surgical interventions, shunt placements, and long-term care. Clinics offer #diagnostics, monitoring, and follow-up care for patients with hydrocephalus. Diagnostic centers conduct imaging tests such as MRI and #CTscans for diagnosis and monitoring. Academic institutions and research organizations drive innovation through studies on new treatments, and surgical techniques, and understanding the condition's underlying mechanisms. To know more about the study, visit https://lnkd.in/gesDCwzP #DBMR #HydrocephalusAwareness #Neurosurgery #MedicalInnovation #HealthcareTechnology #BrainHealth #PatientCare #MedicalResearch #ShuntPlacement #NeurologicalDisorders #MedicalDevices #CerebrospinalFluid #BrainSurgery #HealthcareIndustry #ResearchAdvancements #InnovativeTherapies #DBMRInsights

VGAM is a congenital vascular anomaly characterized by an abnormal connection between the arterial and venous systems within the brain, particularly involving the vein of Galen—a major cerebral vein responsible for draining blood from the brain to the heart. This malformation can lead to profound neurological and cardiovascular consequences if not managed promptly. Key Insights from Ultrasound Imaging: 1. Vascular Dynamics:    - Ultrasound allows for the visualization of aberrant blood flow patterns within the fetal brain, including dilated and tortuous vessels characteristic of VGAM. Doppler ultrasound provides additional insights into the direction and velocity of blood flow, aiding in diagnosis. 2. Structural Assessment:    - Detailed ultrasound examination of the fetal head and brain reveals associated structural anomalies, such as hydrocephalus (enlargement of the brain ventricles) and intracranial hemorrhage, providing essential diagnostic clues to the presence of VGAM. #VeinOfGalenMalformation #VGAM #CongenitalAnomalies #PrenatalDiagnostics #UltrasoundImaging #FetalBrainDevelopment #NeurovascularAnomalies #DopplerUltrasound #EarlyDetection #PrenatalCare #FetalSurgery #PediatricNeurosurgery #FamilyCenteredCare #MultidisciplinaryApproach #HealthcareCollaboration #Neonatology #MaternalFetalMedicine #MedicalIntervention #HealthcareInnovation

Here, I am sharing our newly published article in the Neurosurgery Journal (The Red Journal)! ·     The systematic review and meta-analysis examined the optimal timing for microsurgical treatment (MST) of ruptured brain arteriovenous malformations. ·     The study found that performing MST more than 48 hours after rupture significantly improved patient outcomes, with higher rates of favorable outcomes and lower mortality rates compared to MST performed within 48 hours. ·     Delaying surgical intervention beyond 48 hours leads to better clinical results for patients with ruptured bAVMs, regardless of whether preoperative endovascular treatment is used. ·     These findings support a more cautious approach, allowing time for the brain to recover from the initial hemorrhage before proceeding with MST. Please check it here: [https://lnkd.in/g_b9i9Pk] Thank you Dr. Alex Spiotta #Neurosurgery #AVM #Research #International

We are pleased to share our latest paper, just published in Neurosurgery Practice. In it, we present a case of a pure arterial malformation (PAM) located on an accessory middle cerebral artery (MCA) with signs of previous rupture.  Our patient underwent a successful hybrid treatment at Klinikum Stuttgart, which involved an STA-MCA bypass procedure followed by embolization using Glubran2/Lipiodol. Main ideas:  1.- PAMs are extremely rare lesions, and their risk of rupture is unknown.  2.- To the best of our knowledge, this is the first case of a PAM located on an accessory MCA. 3.- Only a handful of cases have been published where the malformation itself has been treated, and this is the first case managed with a hybrid microsurgical/endovascular strategy. I want to thank everyone involved in treating this patient and preparing the manuscript, especially Professor Hans Henkes, for his continuous support. Link to the open-access full article:  https://lnkd.in/ezqS9jjm #neurointervention #neurosurgery Dr. med. Peter Kurucz Ali Khanafer Kamran Hajiyev, Dr. med. Prof. Hansjörg Bäzner Hans Henkes

worth reading case report about a rare vascular malformation.

🔹Intraventricular injection of drugs in cats - effects observed! Among others: hyperphagia, when hypnotics or anesthetics were injected! 🔹A great book: “A Pharmacological Approach to the Brain from its Inner & Outer Surface“ by W. Feldberg (1963, London, Edward Arnold Publishers, 128pp). 🔹Inner surface: cerebral ventricles; Outer surface: subarachnoid space 🔹#Cerebrospinalfluid (#CSF): “At present we know as little about its function as was known about blood circulation at the time of Harvey´s discovery. We know the channels of its circulation but not its function.“ Eventually an underestimated target for #neuromodulation? 🔹During #tubocurarine (a non-depolarizing neuromuscular blocking agent employed intramuscularly or intravenously as a skeletal muscle relaxant in surgical procedures without deep anesthesia) perfusion, the abnormal discharge (#Seizures) was associated with autonomic effects: pupil & blood pressure changes 👉🏼 “an episode resulted in a rise which was sustained during the period of episode activity, & as soon as it ceased, the blood pressure fell; sometimes during the period of electrical silence, the blood pressure fell below the original level; when the rhythmic discharge reappeared, it gradually rose again.“ 🔹By the way, autonomic effects could be harnessed to optimize therapies such as #Vagusnervestimulation for #drugresistantepilepsy (#DRE): at the sign of a rapid increase in heart rate (which may be associated with seizures) an extra dose of therapy is automatically delivered (AutoStim mode)! Moreover, #VNS has little effect on autonomic nervous function (📚 https://lnkd.in/eUKzaSJi). #neurosciences #neurotech #medtech #neurosurgery #functionalneurosurgery #chronicillness #neurochirurgie #funktionelleneurochirurgie #vagusnervstimulation #νευροτροποποίηση #nöromodülasyon

“Safe and effective”. Words should matter. But these terms are becoming meaningless. Often never defined. Almost epidemic (see PubMed search below). https://lnkd.in/eTbXuScP In our recent JAMA Network Open paper, we screened 12.954 studies making any kind of claims of #safety, #effectiveness, or #durability in the field of #intracranial #aneurysm treatment were screened, and 1356 studies were included, comprising a total of 410 993 treated patients, either by #endovascular or open #neurosurgery. There was no difference in the proportion of patients with poor outcome or in-hospital mortality between studies claiming a technique was safe, uncertain, or not safe! Victor Volovici Michael T. Lawton Sepideh Amin-Hanjani Guiseppe Lanzino Ruben Dammers Nikolay Velinov Joost Schouten Iris Verploegh Djaina Satoer European Association of Neurosurgical Societies (EANS) Erasmus MC Rigshospitalet European Society of Neuroradiology American Association of Neurological Surgeons (AANS) Congress of Neurological Surgeons (CNS) Asian Australasian Society of Neurological Surgeon (AASNS), WORLD FEDERATION OF NEUROSURGICAL SOCIETIES USA FLANC Neurocirugía @congress of african associations Neurosurgical societies, #CAANS,

Robocath announced promising results of 𝗰𝗮𝗿𝗼𝘁𝗶𝗱 𝘀𝘁𝗲𝗻𝘁𝗶𝗻𝗴 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲 𝗥-𝗢𝗻𝗲 𝗿𝗼𝗯𝗼𝘁𝗶𝗰 𝗽𝗹𝗮𝘁𝗳𝗼𝗿𝗺 The CARE study conducted since November 2021 in Rennes, France, aimed at assessing the feasibility of robotic carotid stenting. Neurointerventionalists Dr. Eugène and Dr. Alias performed 7 procedures with the robot that has been initially designed for cardiovascular applications. Results: 🔸100% Clinical Success Rate - 0 complications 🔸86% Technical Success Rate - 1 procedure converted to manual This is a first step of a broader program to make robotic procedures routine practice for stroke treatment. "𝘞𝘦’𝘳𝘦 𝘯𝘰𝘸 𝘰𝘯𝘦 𝘴𝘵𝘦𝘱 𝘤𝘭𝘰𝘴𝘦𝘳 𝘵𝘰 𝘢𝘤𝘩𝘪𝘦𝘷𝘪𝘯𝘨 𝘰𝘶𝘳 𝘭𝘪𝘧𝘦-𝘴𝘢𝘷𝘪𝘯𝘨 𝘨𝘰𝘢𝘭 𝘰𝘧 𝘮𝘢𝘬𝘪𝘯𝘨 𝘭𝘰𝘯𝘨-𝘥𝘪𝘴𝘵𝘢𝘯𝘤𝘦 𝘵𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵 𝘧𝘰𝘳 𝘴𝘵𝘳𝘰𝘬𝘦 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘢 𝘳𝘦𝘢𝘭𝘪𝘵𝘺” - Philippe Bencteux, president and founder Read the full press release 👉 https://lnkd.in/em5dDH4C #medtech #roboticsurgery #neurosurgery #neurovascular