Scholars@Duke
Michael Martin Haglund

Michael Martin Haglund

Duke Surgery Distinguished Professor of Neurosurgery in the School of Medicine
Neurosurgery
haglu001@mc.duke.edu
Box 3807 Med Ctr, Durham, NC 27710
4508 Hosp South - Blue Zone, Durham, NC 27710

Selected Publications

Exploring the Evolution of Research Connectivity and Funding in Global Neurosurgical Publications.

Journal Article World Neurosurg · December 2024 BACKGROUND: There are critical disparities in the neurosurgical care provided around the globe due to challenges in resource allocation, training, and infrastructure. Global neurosurgical collaborations have replaced classical mission trips to address thes ... Full text Link to item Cite

Partnering in Global Health: What Is a Successful Dyad? The Duke Experience.

Journal Article Neurosurg Clin N Am · October 2024 This article explores the transformative partnership between Duke Global Neurosurgery and Neurology (DGNN) and Uganda, emphasizing the power of dyads in international collaboration. It details the partnership's focus on service, research, and training, hig ... Full text Link to item Cite

Partnering with Foundations, Philanthropy, and Universities with Programs Supported by Local Physicians and Eventually Local Physicians Taking Ownership.

Journal Article Neurosurg Clin N Am · October 2024 This article provides a thorough analysis of the evolution and current state of global neurosurgery, emphasizing the transformative power of partnerships between various stakeholders to address the stark inequities in neurosurgical care, especially in LMIC ... Full text Link to item Cite

Training the Next Generation of Academic Neurosurgeons in Global Health, Academics, and Research.

Journal Article Neurosurg Clin N Am · October 2024 This article delves into academic global neurosurgeons' role in addressing the inequities in neurosurgical care globally. It outlines a comprehensive training framework incorporating global health education, research, and leadership development into neuros ... Full text Link to item Cite

An Overview of Global Neurosurgery.

Journal Article Neurosurg Clin N Am · October 2024 Until recently, surgery had been passed over in the domain of global health, historically being described as "the neglected stepchild of global health." Knowledge of the existing global disparities in neurosurgical care has led to neurosurgery capacity-bui ... Full text Link to item Cite

Gender Differences in Operative Autonomy Using the Surgical Autonomy Program: A Multicenter Study.

Journal Article J Grad Med Educ · October 2024 Background The proportion of women surgeons is increasing, but studies show that women in surgical residency are granted less autonomy than men. Objective We utilized the Surgical Autonomy Program (SAP), an educational framework, to evaluate gender differe ... Full text Link to item Cite

The Scope, Trends, and Challenges of Neurosurgical Research in Nigeria: A Bibliometric Review.

Journal Article World Neurosurg · May 2024 OBJECTIVE: This study investigates the scope, trends, and challenges of neurosurgical research in Nigeria since inception of the specialty in 1962. METHODS: A bibliometric review of the neurosurgical literature from Nigeria was performed. Variables extract ... Full text Link to item Cite

Profile of Pediatric Neurosurgery in Nigeria from 1962 to 2021: A Systematic Review.

Journal Article World Neurosurg · May 2024 OBJECTIVE: This study aims to provide a comprehensive overview of pediatric neurosurgery in Nigeria, since 1962, by assessing epidemiological data, management strategies, and case outcomes. METHODS: A systematic bibliometric review of Nigerian neurosurgica ... Full text Link to item Cite

The Status of Specialist Neurosurgical Training in Nigeria: A Survey of Practitioners, Trainers, and Trainees.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Despite the well-known neurosurgical workforce deficit in Sub-Saharan Africa, there remains a low number of neurosurgical training programs in Nigeria. This study sought to reassess the current status of specialist neurosurgical training in the ... Full text Link to item Cite

The Role of International Collaborations in Sustainable Neurosurgical Development in Nigeria.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Despite 6 decades of existence, neurosurgery is still in the developing stages in Nigeria. In this era of collaborative health system capacity-building in low- and middle-income countries, this article reviews past efforts and future prospects f ... Full text Link to item Cite

Neurosurgical Practice, Training, and Research Capacity Assessment in Nigeria: A Methodological Approach.

Journal Article World Neurosurg · May 2024 OBJECTIVE: There has been a progressive growth of neurosurgery in Nigeria over the past 6 nulldecades. This study aims to comprehensively evaluate the state of neurosurgical practice, training, and research in the country. METHODS: We used a mixed-methods ... Full text Link to item Cite

A Geospatial Analysis of the Availability, Distribution, and Accessibility of Neurosurgical Facilities, Workforce, and Infrastructure in Nigeria; and Projection Towards 2050.

Journal Article World Neurosurg · May 2024 OBJECTIVE: There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2 decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the av ... Full text Link to item Cite

Epidemiological Burden of Neurotrauma in Nigeria: A Systematic Review and Pooled Analysis of 45,763 Patients.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Neurotrauma is a significant cause of morbidity and mortality in Nigeria. We conducted this systematic review to generate nationally generalizable reference data for the country. METHODS: Four research databases and gray literature sources were ... Full text Link to item Cite

Assessing the Neurosurgical Capacity in Nigeria Using the Modified Neuro-PIPES Tool.

Journal Article World Neurosurg · May 2024 BACKGROUND: Like many low- and-middle-income countries in Africa, documented assessment of the neurosurgical workforce, equipment, infrastructure, and scope of service delivery in Nigeria is lacking. This study aimed to assess the capacity for the delivery ... Full text Link to item Cite

Epidemiology and Management Trends of Neuro-Oncology in Nigeria: A Systematic Review and Pooled Analysis.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Access to neuro-oncologic care in Nigeria has grown exponentially since the first reported cases in the mid-1960s. In this systematic review and pooled analysis, we characterize the growth of neurosurgical oncology in Nigeria and build a referen ... Full text Link to item Cite

The Epidemiological Burden of Neurovascular Pathology in Nigeria: A Systematic Review and Pooled Patient-Level Analysis.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Vascular neurosurgery has developed significantly in Nigeria, but its burden and challenges remain unclear. This study systematically reviewed vascular neurosurgical literature from Nigeria. METHODS: Four research databases and gray literature s ... Full text Link to item Cite

The Epidemiology of Spinal Neurosurgery in Nigeria: A Systematic Review and Patient-Level Analysis.

Journal Article World Neurosurg · May 2024 OBJECTIVE: Spinal pathologies are prevalent in Nigeria, though epidemiological data remains sparse. This systematic review used pooled patient-level data from across the country to generate a standardized epidemiological reference. METHODS: Four research d ... Full text Link to item Cite

Women in Nigerian Neurosurgery: A Cross-Sectional Survey.

Journal Article World Neurosurg · May 2024 BACKGROUND: Although women have made remarkable strides in several medical specialties in Sub-Saharan Africa, their presence and contribution to the development of neurosurgery remain limited. We sought to study the gender differences within Nigerian neuro ... Full text Link to item Cite

A Mixed-Methods Assessment of the Feasibility of Conducting Neurosurgical Clinical Research in Uganda.

Journal Article World Neurosurg · March 2024 BACKGROUND: Clinical research is necessary to evaluate neurosurgical interventions, yet clinical trials are conducted less frequently in low- and middle-income countries. Because specific barriers, facilitating factors, and strategies for neurosurgical cli ... Full text Link to item Cite

Management and outcomes of pediatric traumatic brain injury in Africa: a systematic review.

Journal Article J Neurosurg Pediatr · February 1, 2024 OBJECTIVE: Traumatic brain injury (TBI) carries a major global burden of disease; however, it is well established that patients in low- and middle-income countries, such as those in Africa, have higher mortality rates. Pediatric TBI, specifically, is a doc ... Full text Link to item Cite

Long-term outcomes in patients treated with tissue-sparing posterior cervical fusion to revise a 1-level pseudarthrosis following ACDF.

Journal Article J Clin Neurosci · January 2024 STUDY DESIGN: Observational Study BACKGROUND: Symptomatic pseudarthrosis is one long-term complication in patients treated with anterior discectomy and fusion (ACDF). When revising a pseudarthrosis, a surgeon must decide to intervene posteriorly and/or ant ... Full text Link to item Cite

Exploring the feasibility of pupillometry training and perceptions of potential use for intracranial pressure monitoring in Uganda: A mixed methods study.

Journal Article PLoS One · 2024 INTRODUCTION: Traumatic brain injury (TBI) accounts for the majority of Uganda's neurosurgical disease burden; however, invasive intracranial pressure (ICP) monitoring is infrequently used. Noninvasive monitoring could change the care of patients in such a ... Full text Link to item Cite

Perioperative and safety outcomes following tissue-sparing posterior cervical fusion to revise a pseudarthrosis: A multicenter retrospective review of 150 cases.

Journal Article J Craniovertebr Junction Spine · 2024 BACKGROUND: Posterior cervical fusion (PCF) with lateral mass screws is a favorable treatment option to revise a symptomatic pseudarthrosis due to reliable rates of arthrodesis; however, this technique introduces elevated risk for wound infection and hospi ... Full text Link to item Cite

The feasibility, appropriateness, and usability of mobile neuro clinics in addressing the neurosurgical and neurological demand in Uganda.

Journal Article PLoS One · 2024 INTRODUCTION: Uganda has a high demand for neurosurgical and neurological care. 78% of the over 50 million population reside in rural and remote communities where access to neurosurgical and neurological services is lacking. This study aimed to determine t ... Full text Link to item Cite

Osteoimmunology: Interactions With the Immune System in Spinal Fusion.

Journal Article Int J Spine Surg · December 27, 2023 Spinal fusion is important for the clinical success of patients undergoing surgery, and the immune system plays an increasingly recognized role. Osteoimmunology is the study of the interactions between the immune system and bone. Inflammation impacts the o ... Full text Open Access Link to item Cite

Clinical and Radiographic Outcomes for Patients with Cervical Adjacent Segment Disease Treated with Anterior Cervical Discectomy and Fusion with Integrated Interbody Spacers.

Journal Article World Neurosurg · December 2023 INTRODUCTION: Anterior cervical discectomy and fusion (ACDF) is among the most common spine procedures. Adjacent segment disease (ASD), characterized by degenerative disease at an adjacent spinal level to a prior fusion, is a well-recognized and significan ... Full text Open Access Link to item Cite

Letter: Neurosurgical Educators.

Journal Article Neurosurgery · October 1, 2023 Full text Link to item Cite

Epilepsy among the older population of sub-Saharan Africa: Analysis of the global burden of disease database.

Journal Article Epilepsy Behav · October 2023 INTRODUCTION: Epilepsy is considered one of the most burdensome neurologic diseases by the World Health Organization due to the high risk of morbidity and mortality. Few studies have investigated the epidemiology of idiopathic epilepsy in Sub-Saharan Afric ... Full text Link to item Cite

Clinical Utility of Near-Infrared Device in Detecting Traumatic Intracranial Hemorrhage: A Pilot Study Toward Application as an Emergent Diagnostic Modality in a Low-Resource Setting.

Journal Article J Neurotrauma · August 2023 Limited computed tomography (CT) availability in low- and middle-income countries frequently impedes life-saving neurosurgical decompression for traumatic brain injury. A reliable, accessible, cost-effective solution is necessary to detect and localize ble ... Full text Link to item Cite

Demographics, referral patterns, and outcome of patients with neural tube defects in southwestern Uganda.

Journal Article J Neurosurg Pediatr · August 1, 2023 OBJECTIVE: In Uganda, the burden of neural tube defects (NTDs) poses a serious neurosurgical and public health challenge; however, published data on this patient population are lacking. The authors sought to characterize the population of patients with NTD ... Full text Link to item Cite

Quantifying the Opportunity Cost of Neurosurgical Resident Education.

Journal Article World Neurosurg · July 2023 BACKGROUND/OBJECTIVE: Education is at the core of neurosurgical residency, but little research in to the cost of neurosurgical education exists. This study aimed to quantify costs of resident education in an academic neurosurgery program using traditional ... Full text Link to item Cite

Flexible, high-resolution cortical arrays with large coverage capture microscale high-frequency oscillations in patients with epilepsy.

Journal Article Epilepsia · July 2023 OBJECTIVE: Effective surgical treatment of drug-resistant epilepsy depends on accurate localization of the epileptogenic zone (EZ). High-frequency oscillations (HFOs) are potential biomarkers of the EZ. Previous research has shown that HFOs often occur wit ... Full text Link to item Cite

Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030.

Journal Article J Neurosurg · April 1, 2023 OBJECTIVE: Africa contributes significantly to the global neurosurgical disease burden but has only 1% of the neurosurgery workforce. This study appraises the neurosurgical workforce and training capacity in Africa and projects the workforce capacity by 20 ... Full text Link to item Cite

From Their Eyes: What Constitutes Quality Formative Written Feedback for Neurosurgery Residents.

Journal Article J Surg Educ · March 2023 BACKGROUND: The characteristics of quality feedback from the neurosurgery resident's perspective are not fully elucidated. The Surgical Autonomy Program is an intraoperative assessment tool based on Vygotsky's Zone of Proximal Development (ZPD). SAP facili ... Full text Link to item Cite

"Walking the Journey Together": Creating a unique learning module in provider-patient communication for the care of epilepsy in Uganda.

Journal Article Epilepsy Behav · March 2023 OBJECTIVE: This report documents the creation of a practical communication skills module about epilepsy care, specifically targeted at first-line care providers who treat patients with epilepsy in Uganda. METHODS: Our team conducted semi-structured intervi ... Full text Link to item Cite

Evaluation of a tailored epilepsy training program for healthcare providers in Uganda.

Journal Article Epilepsy Behav · January 2023 OBJECTIVE: This study evaluated an epilepsy training program for healthcare workers that was designed to improve their knowledge of epilepsy, its treatment, and its psychosocial effects. METHODS: This single group, before and after survey was conducted in ... Full text Link to item Cite

The Scope, Growth, and Inequities of the Global Neurosurgery Literature: A Bibliometric Analysis.

Journal Article World Neurosurg · November 2022 BACKGROUND: Here, we evaluate the evolution and growth of global neurosurgery publications over time, further focusing on the contributions and impact of authors in low- and middle-income countries (LMICs). METHODS: In this systematic bibliometric analysis ... Full text Link to item Cite

Assessing the Success and Sustainability of Global Neurosurgery Collaborations: Systematic Review and Adaptation of the Framework for Assessment of InteRNational Surgical Success Criteria.

Journal Article World Neurosurg · November 2022 BACKGROUND: The high unmet neurosurgical burden in low- and middle-income countries has necessitated multiple global neurosurgical collaborations. We identified these collaborations and their peer-reviewed journal publications and evaluated them using a mo ... Full text Link to item Cite

Outcomes With a Mobile Digital Health Platform for Patients Undergoing Spine Surgery: Retrospective Analysis.

Journal Article JMIR Perioper Med · October 26, 2022 BACKGROUND: Digital health solutions have been shown to enhance outcomes for individuals with chronic medical illnesses, but few have been validated for surgical patients. The digital health platform ManageMySurgery (MMS) has been validated for spine surge ... Full text Link to item Cite

Future Directions for Global Clinical Neurosurgical Training: Challenges and Opportunities.

Journal Article World Neurosurg · October 2022 OBJECTIVE: Expanded access to training opportunities is necessary to address 5 million essential neurosurgical cases not performed annually, nearly all in low- and middle-income countries. To target this critical neurosurgical workforce issue and advance p ... Full text Link to item Cite

Optimizing the residency application process: insights from neurological surgery during the pandemic virtual application cycle.

Journal Article J Neurosurg · September 1, 2022 OBJECTIVE: In this article, the authors describe the impact of the COVID-19 virtual match cycle and discuss approaches to optimize future cycles through applicant and neurosurgical education leadership insights. METHODS: Anonymous surveys of neurosurgery p ... Full text Link to item Cite

Deep Learning to Predict Traumatic Brain Injury Outcomes in the Low-Resource Setting.

Journal Article World Neurosurg · August 2022 OBJECTIVE: Traumatic brain injury (TBI) disproportionately affects low- and middle-income countries (LMICs). In these settings, accurate patient prognostication is both difficult and essential for high-quality patient care. With the ultimate goal of enhanc ... Full text Link to item Cite

Construct validity of the Surgical Autonomy Program for the training of neurosurgical residents.

Journal Article Neurosurg Focus · August 2022 OBJECTIVE: There is no standard way in which physicians teach or evaluate surgical residents intraoperatively, and residents are proving to not be fully competent at core surgical procedures upon graduating. The Surgical Autonomy Program (SAP) is a novel e ... Full text Link to item Cite

Machine Learning for Predicting Discharge Disposition After Traumatic Brain Injury.

Journal Article Neurosurgery · June 1, 2022 BACKGROUND: Current traumatic brain injury (TBI) prognostic calculators are commonly used to predict the mortality and Glasgow Outcome Scale, but these outcomes are most relevant for severe TBI. Because mild and moderate TBI rarely reaches severe outcomes, ... Full text Link to item Cite

Machine Learning for Predicting In-Hospital Mortality After Traumatic Brain Injury in Both High-Income and Low- and Middle-Income Countries.

Journal Article Neurosurgery · May 1, 2022 BACKGROUND: Machine learning (ML) holds promise as a tool to guide clinical decision making by predicting in-hospital mortality for patients with traumatic brain injury (TBI). Previous models such as the international mission for prognosis and clinical tri ... Full text Link to item Cite

Corticosteroid Randomization after Significant Head Injury and International Mission for Prognosis and Clinical Trials in Traumatic Brain Injury Models Compared with a Machine Learning-Based Predictive Model from Tanzania.

Journal Article J Neurotrauma · January 2022 Hospitals in low- and middle-income countries (LMICs) could benefit from decision support technologies to reduce time to triage, diagnosis, and surgery for patients with traumatic brain injury (TBI). Corticosteroid Randomization after Significant Head Inju ... Full text Link to item Cite

Intraoperative microseizure detection using a high-density micro-electrocorticography electrode array.

Journal Article Brain Commun · 2022 One-third of epilepsy patients suffer from medication-resistant seizures. While surgery to remove epileptogenic tissue helps some patients, 30-70% of patients continue to experience seizures following resection. Surgical outcomes may be improved with more ... Full text Open Access Link to item Cite

The Role of Nonprofit and Academic Institutions in Global Neurosurgery

Chapter · January 1, 2022 Global neurosurgery, as a subfield of global surgery, which itself is a subfield within global health, has risen in prominence recently thanks to efforts by a multitude of nonprofit and academic institutions worldwide. In this chapter, we explore the histo ... Full text Cite

Surgical intervention and patient factors associated with poor outcomes in patients with traumatic brain injury at a tertiary care hospital in Uganda.

Journal Article J Neurosurg · November 1, 2021 OBJECTIVE: The purpose of this study was to investigate whether neurosurgical intervention for traumatic brain injury (TBI) is associated with reduced risks of death and clinical deterioration in a low-income country with a relatively high neurosurgical ca ... Full text Link to item Cite

Flexible, high-resolution thin-film electrodes for human and animal neural research.

Journal Article J Neural Eng · June 17, 2021 Objective.Brain functions such as perception, motor control, learning, and memory arise from the coordinated activity of neuronal assemblies distributed across multiple brain regions. While major progress has been made in understanding the function of indi ... Full text Link to item Cite

Long-term follow-up of neurosurgical outcomes for adult patients in Uganda with traumatic brain injury.

Journal Article J Neurosurg · June 1, 2021 OBJECTIVE: Traumatic brain injury (TBI) is a major cause of mortality and morbidity in Uganda and other low- and middle-income countries (LMICs). Due to the difficulty of long-term in-person follow-up, there is a paucity of literature on longitudinal outco ... Full text Link to item Cite

Predicting the Individual Treatment Effect of Neurosurgery for Patients with Traumatic Brain Injury in the Low-Resource Setting: A Machine Learning Approach in Uganda.

Journal Article J Neurotrauma · April 1, 2021 Traumatic brain injury (TBI) disproportionately affects low- and middle-income countries (LMICs). In these low-resource settings, effective triage of patients with TBI-including the decision of whether or not to perform neurosurgery-is critical in optimizi ... Full text Link to item Cite

The Surgical Autonomy Program: A Pilot Study of Social Learning Theory Applied to Competency-Based Neurosurgical Education.

Journal Article Neurosurgery · March 15, 2021 Over the last decade, strict duty hour policies, pressure for increased work related value units from faculty, and the apprenticeship model of education have coalesced to make opportunities for intraoperative teaching more challenging. Evidence is emerging ... Full text Link to item Cite

Estimating prognosis for traumatic brain injury patients in a low-resource setting: how do providers compare to the CRASH risk calculator?

Journal Article J Neurosurg · March 1, 2021 OBJECTIVE: Traumatic brain injury (TBI), a burgeoning global health concern, is one condition that could benefit from prognostic modeling. Risk stratification of TBI patients on presentation to a health facility can support the prudent use of limited resou ... Full text Link to item Cite

Global neurosurgery: a scoping review detailing the current state of international neurosurgical outreach.

Journal Article J Neurosurg · March 1, 2021 OBJECTIVE: Global neurosurgery is a rapidly emerging field that aims to address the worldwide shortages in neurosurgical care. Many published outreach efforts and initiatives exist to address the global disparity in neurosurgical care; however, there is no ... Full text Link to item Cite

The Legacy of Joseph A. Moylan, M.D.: "It's About Everyone Else".

Journal Article Ann Surg Open · March 2021 The history of modern American surgery is marked by larger-than-life pioneers who have made transformative contributions to our field. These extraordinary individuals have been known primarily for their technical and clinical mastery, development of novel ... Full text Link to item Cite

Sociocultural determinants and patterns of healthcare utilization for epilepsy care in Uganda.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: Epilepsy is a global public health concern, with the majority of cases occurring in lower- and middle-income countries where the treatment gap remains formidable. In this study, we simultaneously explore how beliefs about epilepsy causation, per ... Full text Link to item Cite

Epilepsy beliefs and misconceptions among patient and community samples in Uganda.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: The objective of the study was to characterize and compare the attitudes, beliefs, and perceptions about epilepsy across community and patient cohorts in Uganda. METHODS: This was a descriptive study utilizing two samples: a randomly selected, n ... Full text Link to item Cite

Healthcare provider perspectives regarding epilepsy care in Uganda.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: Epilepsy is the most common chronic neurological disorder in the world and imposes a large economic burden on global healthcare systems, especially in low-income settings and rural areas as is found in sub-Saharan Africa (SSA). Despite the high ... Full text Link to item Cite

Validity of the Personal Impact of Epilepsy Scale (PIES) in patients with epilepsy in Uganda.

Journal Article Epilepsy Behav · January 2021 PURPOSE: We sought to address the construct validity and reliability of the Personal Impact of Epilepsy Scale (PIES), an epilepsy-specific quality-of-life measure, in patients with epilepsy in Uganda. We also sought to assess the applicability of the scale ... Full text Link to item Cite

Stakeholder views of the practical and cultural barriers to epilepsy care in Uganda.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: Epilepsy is one of the most prevalent, treatable neurological diseases globally. In sub-Saharan Africa, people with epilepsy (PWE) frequently seek treatment from traditional or pastoral healers, who are more accessible than biomedical care provi ... Full text Link to item Cite

Pluralistic and singular causal attributions for epilepsy in Uganda.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: In Uganda, causal attributions for epilepsy reflect a variety of beliefs and impact care-seeking behavior, perpetuate stigma, and undermine the effectiveness of interventions to narrow the epilepsy treatment gap. The objective of this study was ... Full text Link to item Cite

Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: This study sets out to describe the current demographics of people with epilepsy (PWE) attending hospital-based care in Uganda and the epilepsy treatment practices within three of the largest Ugandan public referral hospitals. METHODS: In a six- ... Full text Link to item Cite

Leveraging the lessons learned from studies on the cultural context of epilepsy care in Uganda: Opportunities and future directions.

Journal Article Epilepsy Behav · January 2021 In this summary paper, we review the body of research contained in this special issue, The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda, and corollary recommendations for a way forward. We review key findings and conclusions for ... Full text Link to item Cite

Stigma reduction interventions for epilepsy: A systematized literature review.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: Epilepsy is a disease that is stigmatized globally. Several studies have introduced sensitization efforts to reduce stigma towards people with epilepsy (PWE) in various settings. Although sensitization efforts have shown some evidence of improve ... Full text Link to item Cite

Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study.

Journal Article Epilepsy Behav · January 2021 OBJECTIVE: Epilepsy, a neurological disorder with effective biomedical treatment, remains largely untreated in Uganda. Potential reasons for this treatment gap (TG) include limited access to trained providers and clinics, social stigmata of seizures, cultu ... Full text Link to item Cite

Understanding the cultural context of epilepsy care in Uganda: Introduction to this special issue.

Journal Article Epilepsy Behav · January 2021 This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda". ... Full text Link to item Cite

Alcohol stigma as it relates to drinking behaviors and perceptions of drink drivers: A mixed method study in Moshi, Tanzania.

Journal Article Alcohol · November 2020 BACKGROUND: Alcohol is a leading risk factor for road traffic injury in low- and middle-income countries, such as Tanzania. This research seeks to explore the drinking patterns, perceptions, and stigma of drink driving behavior of injury patients at Kilima ... Full text Link to item Cite

A Smartphone App With a Digital Care Pathway for Patients Undergoing Spine Surgery: Development and Feasibility Study.

Journal Article JMIR Perioper Med · October 16, 2020 BACKGROUND: There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before and after surgery in an efficiency-focused health care environment. OBJECTIVE: The objective of this ... Full text Open Access Link to item Cite

Influence of Caretakers' Health Literacy on Delays to Traumatic Brain Injury Care in Uganda.

Journal Article Ann Glob Health · October 6, 2020 BACKGROUND: Traumatic brain injury (TBI) is a life-altering condition, and delays to care can significantly impact outcomes. In Uganda, where nurse shortages are prevalent, patients' family members are the primary caretakers of these patients and play an i ... Full text Open Access Link to item Cite

An Attitude Survey and Assessment of the Feasibility, Acceptability, and Usability of a Traumatic Brain Injury Decision Support Tool in Uganda.

Journal Article World Neurosurg · July 2020 BACKGROUND: Traumatic brain injury (TBI) prognostic models are potential solutions to severe human and technical shortages. Although numerous TBI prognostic models have been developed, none are widely used in clinical practice, largely because of a lack of ... Full text Link to item Cite

A traumatic brain injury prognostic model to support in-hospital triage in a low-income country: a machine learning-based approach.

Journal Article J Neurosurg · June 1, 2020 OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide, with a disproportionate burden of this injury on low- and middle-income countries (LMICs). Limited access to diagnostic technologies and highly skilled providers ... Full text Link to item Cite

Global Perspectives on Task Shifting and Task Sharing in Neurosurgery.

Conference World Neurosurg X · April 2020 BACKGROUND: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controv ... Full text Link to item Cite

The College of Surgeons of East, Central, and Southern Africa: Successes and Challenges in Standardizing Neurosurgical Training.

Journal Article World Neurosurg · April 2020 BACKGROUND: The College of Surgeons of East, Central, and Southern Africa (COSECSA) is a regional accrediting body for general and specialty surgical training programs that has recently expanded to include neurosurgery. As neurosurgical services expand in ... Full text Link to item Cite

Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries.

Conference World Neurosurg X · April 2020 BACKGROUND: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical task ... Full text Link to item Cite

Boda Bodas and Road Traffic Injuries in Uganda: An Overview of Traffic Safety Trends from 2009 to 2017.

Journal Article Int J Environ Res Public Health · March 22, 2020 INTRODUCTION: Road traffic injuries (RTIs) are an important contributor to the morbidity and mortality of developing countries. In Uganda, motorcycle taxis, known as boda bodas, are responsible for a growing proportion of RTIs. This study seeks to evaluate ... Full text Open Access Link to item Cite

Demographic Factors Associated with Patient-Reported Outcome Measures in Pain Management.

Journal Article Pain Physician · January 2020 BACKGROUND: Pain control is strongly correlated with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) quality-of-care domains and overall hospital experience. Prior research implicates several factors in the variability of pati ... Link to item Cite

Injury patients' perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania.

Journal Article PLoS One · 2020 BACKGROUND: Globally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of ... Full text Link to item Cite

An evaluation of outcomes in patients with traumatic brain injury at a referral hospital in Tanzania: evidence from a survival analysis.

Journal Article Neurosurg Focus · November 1, 2019 OBJECTIVE: The purpose of this study was to determine if patients with traumatic brain injury (TBI) in low- and middle-income countries who receive surgery have better outcomes than patients with TBI who do not receive surgery, and whether this differs wit ... Full text Link to item Cite

Global neurosurgery: innovators, strategies, and the way forward.

Journal Article J Neurosurg · October 1, 2019 Around the world today, low- and middle-income countries (LMICs) have not benefited from advancements in neurosurgery; most have minimal or even no neurosurgical capacity in their entire country. In this paper, the authors examine in broad strokes the diff ... Full text Link to item Cite

Central Nervous System Tumors in Uganda: Outcomes of Surgical Treatment and Complications Assessed Through Telephone Survey.

Journal Article World Neurosurg · September 2019 BACKGROUND: Uganda has one of the largest unmet neurosurgical needs in the world, but has seen major improvements in neurosurgery-largely centered at Mulago National Referral Hospital (MNRH). This study implements the first long-term follow-up and outcomes ... Full text Link to item Cite

History of awake mapping and speech and language localization: from modules to networks.

Journal Article Neurosurg Focus · September 1, 2019 Lesion-symptom correlations shaped the early understanding of cortical localization. The classic Broca-Wernicke model of cortical speech and language organization underwent a paradigm shift in large part due to advances in brain mapping techniques. This in ... Full text Link to item Cite

Cross-cultural adaptation and psychometric properties of the MMSE and MoCA questionnaires in Tanzanian Swahili for a traumatic brain injury population.

Journal Article BMC Neurol · April 8, 2019 BACKGROUND: Traumatic Brain Injury (TBI) is the most common cause of injury-related death and disability globally, and a common sequelae is cognitive impairment. Addressing post-TBI cognitive deficits is crucial because they affect rehabilitation outcomes, ... Full text Link to item Cite

Operative and consultative proportions of neurosurgical disease worldwide: estimation from the surgeon perspective.

Journal Article J Neurosurg · April 1, 2019 OBJECTIVE: The global magnitude of neurosurgical disease is unknown. The authors sought to estimate the surgical and consultative proportion of diseases commonly encountered by neurosurgeons, as well as surgeon case volume and perceived workload. METHODS: ... Full text Link to item Cite

Optimizing Care for Ugandans with Untreated Abdominal Surgical Conditions.

Journal Article Ann Glob Health · April 1, 2019 BACKGROUND: Abdominal operations account for a majority of surgical volume in low-income countries, yet population-level prevalence data on surgically treatable abdominal conditions are scarce. OBJECTIVE: In this study, our objective was to quantify the bu ... Full text Link to item Cite

Surgical need among the ageing population of Uganda.

Journal Article Afr Health Sci · March 2019 BACKGROUND: Uganda's ageing population (age 50 years and older) will nearly double from 2015 to 2050. HIV/AIDS, diabetes, stroke among other disease processes have been studied in the elderly population. However, the burden of disease from surgically-treat ... Full text Link to item Cite

Temporal Delays Along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients at a Tertiary Care Hospital in Kampala, Uganda.

Journal Article Neurosurgery · January 1, 2019 BACKGROUND: Significant care continuum delays between acute traumatic brain injury (TBI) and definitive surgery are associated with poor outcomes. Use of the "3 delays" model to evaluate TBI outcomes in low- and middle-income countries has not been perform ... Full text Open Access Link to item Cite

Long-term follow-up of pediatric head trauma patients treated at Mulago National Referral Hospital in Uganda.

Journal Article J Neurosurg Pediatr · January 1, 2019 In Brief: This study used telephone surveys as a novel method of measuring health outcomes and tracking healthcare utilization in pediatric head trauma patients at the national referral hospital in Uganda. As the first-ever long-term follow-up of this pati ... Full text Link to item Cite

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Journal Article Clinical Neurosurgery · December 1, 2018 Cite

Trends in neurosurgical care in Western Uganda: an interrupted time series analysis.

Journal Article Neurosurg Focus · October 2018 OBJECTIVE: In addition to the rising burden of surgical disease globally, infrastructure and human resources for health remain a great challenge for low- and middle-income countries, especially in Uganda. In this study, the authors aim to explore the trend ... Full text Link to item Cite

Causes, clinical presentation, management, and outcomes of chronic subdural hematoma at Mbarara Regional Referral Hospital.

Journal Article Neurosurg Focus · October 2018 OBJECTIVE: Causes, clinical presentation, management, and outcomes of chronic subdural hematoma (CSDH) in low- and middle-income countries are not well characterized in the literature. Knowledge regarding these factors would be beneficial in the developmen ... Full text Link to item Cite

Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda.

Journal Article BMC Health Serv Res · September 20, 2018 BACKGROUND: Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and s ... Full text Open Access Link to item Cite

Cross-cultural adaptation and psychometric properties of the Kessler Scale of Psychological Distress to a traumatic brain injury population in Swahili and the Tanzanian Setting.

Journal Article Health Qual Life Outcomes · July 27, 2018 BACKGROUND: To evaluate the psychometric properties of a Swahili version of the Kessler Psychological Distress scale in an injury population in Tanzania. METHODS: Swahili version of the Kessler Psychological Distress scale was developed by translation and ... Full text Link to item Cite

Mechanism of Pediatric Traumatic Brain Injury in Southwestern Uganda: A Prospective Cohort of 100 Patients.

Journal Article World Neurosurg · June 2018 BACKGROUND: Road traffic incidents (RTIs), falls, and violence contribute to more than two thirds of pediatric traumatic brain injuries in sub-Saharan Africa. In this study, we sought to assess mechanisms of pediatric traumatic brain injury in an effort to ... Full text Link to item Cite

Life After the Neurosurgical Ward in Sub-Saharan Africa: Neurosurgical Treatment and Outpatient Outcomes in Uganda.

Journal Article World Neurosurg · May 2018 BACKGROUND: In the past decade, neurosurgery in Uganda experienced increasing surgical volume and a new residency training program. Although research has examined surgical capacity, minimal data exist on the patient population treated by neurosurgery and t ... Full text Link to item Cite

Neurosurgery in East Africa: Innovations.

Journal Article World Neurosurg · May 2018 In the last 10 years, considerable work has been done to promote and improve neurosurgical care in East Africa with the development of national training programs, expansion of hospitals and creation of new institutions, and the foundation of epidemiologic ... Full text Link to item Cite

Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries.

Journal Article Int J Surg · April 2018 INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income cou ... Full text Link to item Cite

Seizure Outcomes in Occipital Lobe and Posterior Quadrant Epilepsy Surgery: A Systematic Review and Meta-Analysis.

Journal Article Neurosurgery · March 1, 2018 BACKGROUND: Occipital lobe epilepsy (OLE) is an uncommon but debilitating focal epilepsy syndrome with seizures often refractory to medical management. While surgical resection has proven a viable treatment, previous studies examining postoperative seizure ... Full text Link to item Cite

The impact of alcohol among injury patients in Moshi, Tanzania: a nested case-crossover study.

Journal Article BMC Public Health · February 21, 2018 BACKGROUND: Globally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death ... Full text Link to item Cite

Prevalence of Surgically Untreated Face, Head, and Neck Conditions in Uganda: A Cross-Sectional Nationwide Household Survey.

Journal Article World Neurosurg · February 2018 BACKGROUND: The Surgeons OverSeas Assessment of Surgical Need tool (SOSAS) was created to evaluate the burden of surgically treatable conditions in low- and middle-income countries. The goal of our study is to describe the face, head, and neck (FHN) condit ... Full text Link to item Cite

Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda.

Journal Article J Clin Neurosci · January 2018 BACKGROUND: In Uganda, TBI constitute the majority of neurosurgical admissions and deaths specially in the pediatric population. This study aims to determine the factors associated with poor outcome among pediatric TBI cases at a major referral hospital in ... Full text Link to item Cite

A systematic review and quality analysis of pediatric traumatic brain injury clinical practice guidelines.

Journal Article PLoS One · 2018 BACKGROUND: Traumatic brain injuries (TBI) are a significant cause of mortality and morbidity for children globally. Adherence to evidence-based treatment guidelines have been shown to improve TBI outcomes. To inform the creation of a pediatric TBI managem ... Full text Link to item Cite

Rural and urban differences in treatment status among children with surgical conditions in Uganda.

Journal Article PLoS One · 2018 BACKGROUND: In low and middle-income countries, approximately 85% of children have a surgically treatable condition before the age of 15. Within these countries, the burden of pediatric surgical conditions falls heaviest on those in rural areas. The object ... Full text Link to item Cite

Injury prevalence and safety habits of boda boda drivers in Moshi, Tanzania: A mixed methods study.

Journal Article PLoS One · 2018 BACKGROUND: Traffic crashes are a major cause of global morbidity and mortality disproportionately affecting low- and middle-income countries (LMICs). Motorcycle taxi (boda boda) drivers are particularly vulnerable because they are exposed to traffic risks ... Full text Link to item Cite

Pilot Use of a Novel Tool to Assess Neurosurgical Capacity in Uganda.

Journal Article World Neurosurg · December 2017 INTRODUCTION: There is a significant burden of unmet surgical need in many low- and middle-income countries (>80% in parts of Africa). This need is even larger for specialties such as neurosurgery. Surgical capacity tools have been developed and used to as ... Full text Link to item Cite

Obituary. Robert H. Wilkins, MD, 1934-2017.

Journal Article J Neurosurg · December 2017 Full text Link to item Cite

Road traffic injury in sub-Saharan African countries: A systematic review and summary of observational studies.

Journal Article Traffic Inj Prev · October 3, 2017 OBJECTIVE: The aim of this study is to evaluate, through a systematic review of hospital-based studies, the proportion of road traffic injuries and fatalities in sub-Saharan Africa (SSA). METHODS: In accordance with Preferred Reporting Items for Systematic ... Full text Link to item Cite

Geospatial analysis of unmet pediatric surgical need in Uganda.

Journal Article J Pediatr Surg · October 2017 BACKGROUND: In low- and middle-income countries (LMICs), an estimated 85% of children do not have access to surgical care. The objective of the current study was to determine the geographic distribution of surgical conditions among children throughout Ugan ... Full text Link to item Cite

Burden of Surgical Conditions in Uganda: A Cross-sectional Nationwide Household Survey.

Journal Article Ann Surg · August 2017 OBJECTIVE: To quantify the burden of surgical conditions in Uganda. BACKGROUND: Data on the burden of disease have long served as a cornerstone to health policymaking, planning, and resource allocation. Population-based data are the gold standard, but no d ... Full text Link to item Cite

Surgical care capacity in Uganda: Government versus private sector investment

Journal Article International Surgery · July 1, 2017 Background: Uganda is a low-income country with blended, tiered government health care facilities and private/non-governmental (NGO)/mission hospitals. The population is 84% rural; 100% of referral hospitals and majority of specialist physicians are urban. ... Full text Cite

Epidemiology and Characteristics of Neurosurgical Conditions at Mbarara Regional Referral Hospital.

Journal Article World Neurosurg · June 2017 BACKGROUND: The unmet surgical need, specifically neurosurgical need, in Uganda is significant, yet only 2 public hospitals currently perform neurosurgery in the country. This study examines the epidemiology and outcomes of neurosurgical conditions present ... Full text Link to item Cite

Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis.

Journal Article World Neurosurg · May 2017 BACKGROUND: There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sect ... Full text Link to item Cite

Past, Present, and Future of Neurosurgery in Uganda.

Journal Article Neurosurgery · April 1, 2017 Neurosurgery in Uganda was virtually non-existent up until late 1960s. This changed when Dr. Jovan Kiryabwire spearheaded development of a neurosurgical unit at Mulago Hospital in Kampala. His work ethic and vision set the stage for rapid expansion of neur ... Full text Link to item Cite

Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

Journal Article J Neurosurg Pediatr · March 2017 OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quali ... Full text Link to item Cite

Geospatial Analysis of Unmet Surgical Need in Uganda: An Analysis of SOSAS Survey Data.

Journal Article World J Surg · February 2017 BACKGROUND: Globally, a staggering five billion people lack access to adequate surgical care. Sub-Saharan Africa represents one of the regions of greatest need. We sought to understand how geographic factors related to unmet surgical need (USN) in Uganda. ... Full text Link to item Cite

Quality-of-life metrics with vagus nerve stimulation for epilepsy from provider survey data.

Journal Article Epilepsy Behav · January 2017 OBJECTIVE: Drug-resistant epilepsy is a devastating disorder associated with diminished quality of life (QOL). Surgical resection leads to seizure freedom and improved QOL in many epilepsy patients, but not all individuals are candidates for resection. In ... Full text Link to item Cite

Epidemiology of pediatric surgical needs in low-income countries.

Journal Article PLoS One · 2017 OBJECTIVE: According to recent estimates, at least 11% of the total global burden of disease is attributable to surgically-treatable diseases. In children, the burden is even more striking with up to 85% of children in low-income and middle-income countrie ... Full text Link to item Cite

A prospective neurosurgical registry evaluating the clinical care of traumatic brain injury patients presenting to Mulago National Referral Hospital in Uganda.

Journal Article PLoS One · 2017 BACKGROUND: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The objectives of this study ar ... Full text Open Access Link to item Cite

Pediatric Neurosurgical Outcomes Following a Neurosurgery Health System Intervention at Mulago National Referral Hospital in Uganda.

Journal Article World Neurosurg · November 2016 OBJECTIVE: Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects ... Full text Link to item Cite

Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey.

Journal Article Pediatr Surg Int · November 2016 PURPOSE: Little is known about the prevalence of pediatric surgical conditions in low- and middle-income countries. Many children never seek medical care, thus the true prevalence of surgical conditions in children in Uganda is unknown. The objective of th ... Full text Link to item Cite

Intraoperative ECoG During MRI-Guided Laser-Interstitial Thermal Therapy for Intractable Epilepsy.

Journal Article J Clin Neurophysiol · August 2016 MRI-guided laser-interstitial thermal therapy is a new modality for epilepsy surgery. In patients with intractable localization-related seizures, it has been used to ablate epileptogenic lesions with less morbidity than conventional craniotomies, and with ... Full text Link to item Cite

Building neurosurgical capacity in low and middle income countries.

Journal Article eNeurologicalSci · June 2016 Neurosurgery capacity in low- and middle-income countries is far from adequate; yet burden of neurological diseases, especially neuro-trauma, is projected to increase exponentially. Previous efforts to build neurosurgical capacity have typically been indiv ... Full text Link to item Cite

Differential gene expression in dentate granule cells in mesial temporal lobe epilepsy with and without hippocampal sclerosis.

Journal Article Epilepsia · March 2016 OBJECTIVE: Hippocampal sclerosis is the most common neuropathologic finding in cases of medically intractable mesial temporal lobe epilepsy. In this study, we analyzed the gene expression profiles of dentate granule cells of patients with mesial temporal l ... Full text Link to item Cite

Surgeons OverSeas Assessment of Surgical Need (SOSAS) Uganda: Update for Household Survey.

Journal Article World J Surg · December 2015 INTRODUCTION: The first step in improving surgical care delivery in low- and middle-income countries (LMICs) is quantifying surgical need. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a validated household survey that has been previously im ... Full text Link to item Cite

Pilot study of a population-based survey to assess the prevalence of surgical conditions in Uganda.

Journal Article Surgery · September 2015 BACKGROUND: Noncommunicable diseases, including those requiring surgical care, are increasingly straining low- and middle-income countries. Globally, 11% of all disability-adjusted life-years lost result from conditions requiring surgery; however, little i ... Full text Link to item Cite

Distribution and characteristics of severe traumatic brain injury at Mulago National Referral Hospital in Uganda.

Journal Article World Neurosurg · March 2015 OBJECTIVE: Road traffic accidents are a leading cause of injury in low- and middle-income countries, where mortality rates are disproportionately higher. Patients with severe traumatic brain injury (TBI) tend to have very poor outcomes. To reduce the burde ... Full text Link to item Cite

Difficult conversations: a national course for neurosurgery residents in physician-patient communication.

Journal Article J Surg Educ · 2015 OBJECTIVE: To describe the design, content, implementation, and evaluation of a national curriculum for teaching practical skills in empathic communication to residents in neurosurgery. DESIGN: Based on needs assessed through a national survey of neurosurg ... Full text Link to item Cite

Commentary 2

Journal Article AMA Journal of Ethics · January 1, 2015 Cite

Duty-hour exceptions for neurosurgery residency programs

Journal Article AMA Journal of Ethics · January 1, 2015 Full text Cite

Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: Clinical article.

Journal Article J Neurosurg Spine · October 2014 Featured Publication OBJECT: The Accreditation Council for Graduate Medical Education (ACGME) implemented resident duty-hour restrictions on July 1, 2003, in concern for patient and resident safety. Whereas studies have shown that duty-hour restrictions have increased resident ... Full text Link to item Cite

Worse outcomes for patients undergoing brain tumor and cerebrovascular procedures following the ACGME resident duty-hour restrictions.

Journal Article J Neurosurg · August 2014 OBJECT: On July 1, 2003, the Accreditation Council for Graduate Medical Education (ACGME) implemented duty-hour restrictions for resident physicians due to concerns for patient and resident safety. Though duty-hour restrictions have increased resident qual ... Full text Link to item Cite

Corrigendum

Journal Article Microcirculation · February 2014 Full text Cite

Reorganization and stability for motor and language areas using cortical stimulation: case example and review of the literature.

Journal Article Brain Sci · November 26, 2013 The cerebral organization of language in epilepsy patients has been studied with invasive procedures such as Wada testing and electrical cortical stimulation mapping and more recently with noninvasive neuroimaging techniques, such as functional MRI. In the ... Full text Open Access Link to item Cite

Quantitative mapping of hemodynamics in the lung, brain, and dorsal window chamber-grown tumors using a novel, automated algorithm.

Journal Article Microcirculation · November 2013 OBJECTIVE: Hemodynamic properties of vascular beds are of great interest in a variety of clinical and laboratory settings. However, there presently exists no automated, accurate, technically simple method for generating blood velocity maps of complex micro ... Full text Link to item Cite

Comments

Journal Article Neurosurgery · 2013 Full text Cite

Comment

Journal Article Neurosurgery · August 1, 2012 Full text Cite

Optical imaging of visual cortex epileptic foci and propagation pathways.

Journal Article Epilepsia · June 2012 Precise localization of neocortical epileptic foci is a complex problem that usually requires ictal video-electroencephalography (EEG) recordings; high-resolution magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emiss ... Full text Link to item Cite

Comment

Journal Article Neurosurgery · May 1, 2012 Full text Cite

Comment

Journal Article Neurosurgery · May 1, 2012 Full text Cite

Sudden death from diffuse leptomeningeal oligodendrogliomatosis.

Journal Article J Neurosurg Spine · December 2011 In this paper the authors describe the rare disorder of diffuse leptomeningeal oligodendrogliomatosis in a patient with an oligodendroglioma of the cauda equina who died suddenly. Reviewing this uncommon pathological entity is important so that it can be r ... Full text Link to item Cite

Luminescent boron b-diketonate biomaterials: Synthesis, properties and applications

Conference ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY · August 28, 2011 Link to item Cite

Dynamic linear model analysis of optical imaging data acquired from the human neocortex.

Journal Article J Neurosci Methods · August 15, 2011 The amount of light absorbed and scattered by neocortical tissue is altered by neuronal activity. Imaging of intrinsic optical signals (ImIOS), a technique for mapping these activity-evoked optical changes with an imaging detector, has the potential to be ... Full text Link to item Cite

Surgical capacity building in Uganda through twinning, technology, and training camps.

Journal Article World J Surg · June 2011 BACKGROUND: Neurosurgical capacity is extremely deficient in East African countries where 27 neurosurgeons serve more than 250 million people. To build capacity, the Duke University Medical Center and New Mulago Hospital in Uganda applied a two-pronged twi ... Full text Link to item Cite

Comments

Journal Article Neurosurgery · May 1, 2011 Full text Cite

Impact of tumor histology on resectability and neurological outcome in primary intramedullary spinal cord tumors: a single-center experience with 102 patients.

Journal Article Neurosurgery · January 2011 BACKGROUND: Surgical outcomes for intramedullary spinal cord tumors are affected by many variables including tumor histology and preoperative neurological function. OBJECTIVE: To analyze the impact of tumor histology on neurological outcome in primary intr ... Full text Link to item Cite

Five percent CO₂ is a potent, fast-acting inhalation anticonvulsant.

Journal Article Epilepsia · January 2011 PURPOSE: CO₂ has been long recognized for its anticonvulsant properties. We aimed to determine whether inhaling 5% CO₂ can be used to suppress seizures in epilepsy patients. The effect of CO₂ on cortical epileptic activity accompanying behavioral seizures ... Full text Link to item Cite

Optical imaging techniques in pediatric neocortical epilepsy

Chapter · January 1, 2010 One of the most common forms of epilepsy affecting pediatric patients is neocortical (Obeid et al., 2009a, b). The majority of these pediatric patients require lengthy work-ups, which include grid arrays and strip electrodes, to localize the neocortical fo ... Full text Cite

Correlation of intrinsic optical signal, cerebral blood flow, and evoked potentials during activation of rat somatosensory cortex.

Journal Article J Neurosurg · October 2008 Featured Publication OBJECT: This study was undertaken to test the hypothesis that cerebral blood flow (CBF) and the intrinsic optical signal could be dissociated by altering adenosine receptor activity and to uncover the origin of the optic signal using a cranial window in th ... Full text Link to item Cite

Identification of distinct and overlapping cortical areas for bilingual naming and reading using cortical stimulation. Case report.

Journal Article J Neurosurg Pediatr · March 2008 A bilingual pediatric patient who underwent tumor resection was mapped extraoperatively using cortical stimulation to preserve English and Hebrew languages. The authors mapped both languages by using 4 tasks: 1) English visual naming, 2) Hebrew visual nami ... Full text Link to item Cite

Imaging of intrinsic optical signals in primate cortex during epileptiform activity.

Journal Article Epilepsia · 2007 Featured Publication Localized increases in neuronal activity are known to alter the distribution and oxygen content of blood within the surrounding brain tissue. In the neocortex, these activity-evoked hemodynamic changes are predominantly mediated through the dilation of the ... Full text Link to item Cite

Furosemide and mannitol suppression of epileptic activity in the human brain.

Journal Article J Neurophysiol · August 2005 Featured Publication Most research on basic mechanisms of epilepsy and the design of new antiepileptic drugs has focused on synaptic transmission or action potential generation. However, a number of laboratory studies have suggested that nonsynaptic mechanisms, such as modulat ... Full text Link to item Cite

Imaging and functional mapping of local circuits and epilepsy

Chapter · January 1, 2004 Optical imaging (OI) is a functional imaging method that measures changes in nervous tissue light reflectance or transmission. OI has been used to study brain functions in both normal and pathophysiological states. In addition to identifying brain function ... Cite

Optical imaging of epileptiform activity in human neocortex.

Journal Article Epilepsia · 2004 Featured Publication The surgical outcomes of patients suffering from neocortical epilepsy are not as successful as the surgical outcomes from resections of epilepsy patients with mesial temporal sclerosis. The main difficulty in the treatment of neocortical epilepsy is that c ... Full text Link to item Cite

Optical imaging of human epileptiform activity

Conference JOURNAL OF NEUROSURGERY · 2004 Cite

Possible role for vascular cell proliferation in cerebral vasospasm after subarachnoid hemorrhage.

Journal Article Stroke · February 2003 Featured Publication BACKGROUND AND PURPOSE: During vasospasm after subarachnoid hemorrhage (SAH), cerebral blood vessels show structural changes consistent with the actions of vascular mitogens. We measured platelet-derived vascular growth factors (PDGFs) in the cerebrospinal ... Link to item Cite

Use of vagal nerve stimulation as a treatment for refractory epilepsy in dogs.

Journal Article J Am Vet Med Assoc · October 1, 2002 Featured Publication OBJECTIVE: To evaluate safety and efficacy of vagal nerve stimulation in dogs with refractory epilepsy. DESIGN: Placebo-controlled, double-masked, crossover study. ANIMALS: 10 dogs with poorly controlled seizures. PROCEDURE: A programmable pacemaker-like d ... Full text Link to item Cite

Observer variability in assessing lumbar spinal stenosis severity on magnetic resonance imaging and its relation to cross-sectional spinal canal area.

Journal Article Spine (Phila Pa 1976) · May 15, 2002 STUDY DESIGN: Magnetic resonance image grading of lumbar spinal stenosis severity was analyzed retrospectively using a common clinical format. OBJECTIVE: To assess the interobserver and intraobserver reliability of magnetic resonance image used to grade pa ... Full text Link to item Cite

Phase II trial of carmustine plus O(6)-benzylguanine for patients with nitrosourea-resistant recurrent or progressive malignant glioma.

Journal Article J Clin Oncol · May 1, 2002 Featured Publication PURPOSE: We conducted a phase II trial of carmustine (BCNU) plus the O(6)-alkylguanine-DNA alkyltransferase inhibitor O(6)-benzylguanine (O(6)-BG) to define the activity and toxicity of this regimen in the treatment of adults with progressive or recurrent ... Full text Link to item Cite

Electrophysiological correlates to the intrinsic optical signal in the rat neocortical slice.

Journal Article Neurosci Lett · January 14, 2002 Featured Publication The study sought to further our understanding of the correlation between electrophysiological activity and the intrinsic optical signal (IOS) in neocortical slice by combining imaging of IOS with whole-cell and extracellular electrical recording. Columnar- ... Full text Link to item Cite

Phase I trial of carmustine plus O6-benzylguanine for patients with recurrent or progressive malignant glioma.

Journal Article J Clin Oncol · October 15, 2000 Featured Publication PURPOSE: The major mechanism of resistance to alkylnitrosourea therapy involves the DNA repair protein O(6)-alkylguanine-DNA alkyltransferase (AGT), which removes chloroethylation or methylation damage from the O(6) position of guanine. O(6)-benzylguanine ... Full text Link to item Cite

Asymmetry of neuronal activity during extracellular microelectrode recording from left and right human temporal lobe neocortex during rhyming and line-matching.

Journal Article J Cogn Neurosci · September 2000 Featured Publication Recordings of neuronal activity in humans have identified few correlates of the known hemispheric asymmetries of functional lateralization. Here, we examine single-unit activity recorded from both hemispheres during two delayed match-to-sample tasks that s ... Full text Link to item Cite

Intraoperative hippocampal electrocorticography to predict the extent of hippocampal resection in temporal lobe epilepsy surgery.

Journal Article J Neurosurg · July 2000 Featured Publication OBJECT: Among the variety of surgical procedures that are performed for the treatment of medically refractory mesial temporal lobe epilepsy (TLE), no consensus exists as to how much of the hippocampus should be removed. Whether all patients require a maxim ... Full text Link to item Cite

The role of spatiotemporal edges in visibility and visual masking.

Journal Article Proc Natl Acad Sci U S A · June 20, 2000 Featured Publication What parts of a visual stimulus produce the greatest neural signal? Previous studies have explored this question and found that the onset of a stimulus's edge is what excites early visual neurons most strongly. The role of inhibition at the edges of stimul ... Full text Link to item Cite

Optical images of visible and invisible percepts in the primary visual cortex of primates.

Journal Article Proc Natl Acad Sci U S A · December 21, 1999 Featured Publication We optically imaged a visual masking illusion in primary visual cortex (area V-1) of rhesus monkeys to ask whether activity in the early visual system more closely reflects the physical stimulus or the generated percept. Visual illusions can be a powerful ... Full text Link to item Cite

Optical imaging of neocortical epileptic foci and inhibitory surround

Journal Article Italian Journal of Neurological Sciences · December 1, 1999 Neocortical epileptic foci are becoming an increasingly recognized cause for medically intractable epilepsy. In order to understand the patterns of seizure propagation through the neocortex, optical imaging during visual stimulation was performed after the ... Cite

Irinotecan therapy in adults with recurrent or progressive malignant glioma.

Journal Article J Clin Oncol · May 1999 PURPOSE: To determine the activity, toxicity, and pharmacokinetics of irinotecan (CPT-11, Camptosar; Pharmacia & Upjohn, Kalamazoo, MI) in the treatment of adults with progressive, persistent, or recurrent malignant glioma. PATIENTS AND METHODS: Patients w ... Full text Link to item Cite

DNA mismatch repair and O6-alkylguanine-DNA alkyltransferase analysis and response to Temodal in newly diagnosed malignant glioma.

Journal Article J Clin Oncol · December 1998 PURPOSE: We evaluated the response to Temodal (Schering-Plough Research Institute, Kenilworth, NJ) of patients with newly diagnosed malignant glioma, as well as the predictive value of quantifying tumor DNA mismatch repair activity and O6-alkylguanine-DNA ... Full text Link to item Cite

Phase I trial of O6-benzylguanine for patients undergoing surgery for malignant glioma.

Journal Article J Clin Oncol · November 1998 PURPOSE: The major mechanism of resistance to alkylnitrosourea therapy is the DNA repair protein O6-alkylguanine-DNA alkyltransferase (AGT), which removes chlorethylation or methylation damage from the O6-position of guanine. O6-benzylguanine (O6-BG) is an ... Full text Link to item Cite

Intraoperative optical imaging of epileptiform and functional activity.

Journal Article Neurosurg Clin N Am · July 1997 Although intraoperative optical imaging is still a research tool, optical imaging has the potential to establish itself as an intraoperative tool in the future, and may be able to be used for studies into language dominance, memory, and higher cognitive fu ... Link to item Cite

Overview of functional imaging.

Journal Article Neurosurg Clin N Am · July 1997 Provides an overview of the many different modalities of imaging techniques, including positron emission tomography, single-photon emission computed tomography, functional magnetic resonance imaging, optical imaging, and magnetic source imaging. ... Link to item Cite

Functional imaging - Preface

Journal Article NEUROSURGERY CLINICS OF NORTH AMERICA · July 1, 1997 Link to item Cite

Neuropsychiatric complications after temporal lobe limbic system surgery.

Journal Article Neuroimaging Clin N Am · February 1997 Although control of seizure activity is the main goal of temporal lobectomies for complex partial epilepsy, the results of surgery must be viewed within the larger context of possible ramifications of limbic system disruption. The neuropsychiatric complica ... Link to item Cite

Cerebral lateralization of neuronal activity during naming, reading and line-matching.

Journal Article Brain Res Cogn Brain Res · November 1996 Changes in human right or left temporal cortical neuronal activity during language and visuospatial tasks were investigated during craniotomy under local anesthesia for medically intractable epilepsy in patients known to be left dominant for language based ... Full text Link to item Cite

Enhanced optical imaging of human gliomas and tumor margins.

Journal Article Neurosurgery · February 1996 One of the potential variables affecting the overall survival and quality of life of patients with intracranial gliomas is the extent of tumor resection that results in the smallest volume of residual disease. A technique involving enhanced optical imaging ... Full text Link to item Cite

Causes, prevention, and treatment of post-traumatic epilepsy.

Journal Article New Horiz · August 1995 Post-traumatic seizures often occur after severe head injury. Acutely, these seizures complicate management of the head-injured patient by increasing intracranial pressure and causing postictal decreases in level of consciousness. In the long term, epileps ... Link to item Cite

The future of pediatric epilepsy surgery. Signposts and science.

Journal Article Neurosurg Clin N Am · July 1995 Many of the advances in pediatric epilepsy surgery should reflect scientific, technical, and conceptual issues identical to those seen with adult epilepsy surgery. However, there are certainly some unique issues involving the developing brain, and these as ... Link to item Cite

In vivo models of cerebral ischemia: effects of parenterally administered NMDA receptor glycine site antagonists.

Journal Article J Cereb Blood Flow Metab · March 1995 Both in vitro and in vivo experiments have implicated extracellular glycine in the pathogenesis of ischemic brain damage. Recently, halogenated derivatives of quinoxaline-2,3-dione have been synthesized that possess bioavailability when parenterally admini ... Full text Link to item Cite

Outcome after repeat lumbar microdiscectomy.

Journal Article Br J Neurosurg · 1995 One of the standard treatments for herniation of lumbosacral disc material has become the microdiscectomy. Although multiple studies have assessed the outcome of microdiscectomy, only a few studies have evaluated the outcome of those patients who have unde ... Full text Link to item Cite

Enhanced optical imaging of rat gliomas and tumor margins.

Journal Article Neurosurgery · November 1994 Current intraoperative methods used to maximize the extent of tumor removal are limited to intraoperative biopsies, ultrasound, and stereotactic volumetric resections. A new technique involving the optical imaging of an intravenously injected dye has the p ... Full text Link to item Cite

Rapid infusion system for neurosurgical treatment of massive intraoperative hemorrhage.

Journal Article J Neurotrauma · October 1994 Using an illustrative case of severe closed head injury that resulted in a posterior fossa epidural hematoma (EDH) and supratentorial epidural/subdural hematomas (SDH), the massive blood losses associated with operative repair of the torn sigmoid sinus and ... Full text Link to item Cite

Cortical localization of temporal lobe language sites in patients with gliomas.

Journal Article Neurosurgery · April 1994 In a series of 40 patients undergoing an awake craniotomy for the removal of a glioma of the dominant hemisphere temporal lobe, cortical stimulation mapping was used to localize essential language sites. These sites were localized to distinct temporal lobe ... Full text Link to item Cite

Neuronal activity in human lateral temporal cortex during serial retrieval from short-term memory.

Journal Article J Neurosci · March 1994 Neuronal activity was recorded extracellularly from 20 populations in the lateral cortex of the left anterior temporal lobe of 11 patients undergoing awake craniotomy for epilepsy, during an input-distraction-retrieval measure of recent verbal memory that ... Full text Link to item Cite

OPTICAL IMAGING OF HUMAN COGNITIVE ACTIVITY

Journal Article JOURNAL OF NEUROSURGERY · 1994 Cite

Thoracic disc disease: experience with the transpedicular approach in twenty consecutive patients.

Journal Article Neurosurgery · July 1993 TWENTY CONSECUTIVE PATIENTS were treated for symptomatic thoracic disc herniation with the transpedicular approach. Most patients had severe, incapacitating local or radicular pain. Myelopathy was uncommon as magnetic resonance imaging allowed an early dia ... Full text Link to item Cite

Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection.

Journal Article J Neurosurg · July 1993 Adults and children with low-grade gliomas often present with medically refractory epilepsy. Currently, controversy exists regarding the need for intraoperative electrocorticography (ECoG) to identify and, separately, resect seizure foci versus tumor remov ... Full text Link to item Cite

Optical imaging of bipolar cortical stimulation.

Journal Article J Neurosurg · May 1993 In order to better understand the degree of cortical activation that occurs during bipolar surface stimulation, the authors stimulated monkey visual cortex while monitoring the degree of activation with optical imaging. Optical imaging of intrinsic signals ... Full text Link to item Cite

Extratemporal resective surgery for epilepsy.

Journal Article Neurosurg Clin N Am · April 1993 Extratemporal resections were the most common early operations for epilepsy. This area is in need of further investigations, however, as relatively little progress has been made in management of these cases. The surveys from the Palm Desert Conferences on ... Link to item Cite

Seizure outcome in patients undergoing temporal lobe resections for epilepsy.

Journal Article Neurosurg Clin N Am · April 1993 This article reviews the results of surgical treatment of temporal lobe epilepsy based on retrospective reviews: more recent surveys from 91 centers on the outcomes from the surgical treatment of epilepsy and preliminary data from the authors' institution' ... Link to item Cite

Dissociation of cortical and single unit activity in spoken and signed languages.

Journal Article Brain Lang · January 1993 Based on stroke and other lesion data, the cortical organization of sign language has been shown to be in the verbal language-dominant hemisphere. However, finer detail of the cortical organization of sign language is not readily available. Intraoperative ... Full text Link to item Cite

Intraventricular hemorrhage in blunt head trauma: an analysis of 43 cases.

Journal Article Neurosurgery · October 1992 Before the advent of computed tomography, intraventricular hemorrhage (IVH) from any source was thought rare and invariably fatal. Although intraventricular blood is readily identifiable with computed tomography, there has been little systematic study of i ... Full text Link to item Cite

Optical imaging of epileptiform and functional activity in human cerebral cortex.

Journal Article Nature · August 20, 1992 Optical imaging of animal somatosensory, olfactory and visual cortices has revealed maps of functional activity. In non-human primates, high-resolution maps of the visual cortex have been obtained using only an intrinsic reflection signal. Although the tim ... Full text Link to item Cite

Changes in gamma-aminobutyric acid and somatostatin in epileptic cortex associated with low-grade gliomas.

Journal Article J Neurosurg · August 1992 The role of specific neuronal populations in epileptic foci was studied by comparing epileptic and non-epileptic cortex removed from patients with low-grade gliomas. Epileptic and nearby (within 1 to 2 cm) non-epileptic temporal lobe neocortex was identifi ... Full text Link to item Cite

Resection of intrinsic tumors from nondominant face motor cortex using stimulation mapping: report of two cases.

Journal Article Surg Neurol · July 1991 We report two right-handed patients who underwent resection of intrinsic glial tumors from the nondominant hemisphere, face motor cortex. Both patients underwent preoperative assessment with computed tomography and magnetic resonance imaging localizing the ... Full text Link to item Cite

Symptomatic cerebral vasospasm following tumor resection: report of two cases.

Journal Article Surg Neurol · July 1991 The authors report two cases of symptomatic cerebral vasospasm following resection of an acoustic neuroma and a left sphenoid wing meningioma. Vascular spasm was documented by transcranial Doppler and angiography studies. Both patients responded to hypervo ... Full text Link to item Cite

Role of Na-K pump potassium regulation and IPSPs in seizures and spreading depression in immature rabbit hippocampal slices.

Journal Article J Neurophysiol · February 1990 1. Using the immature (8-12 days postnatal) rabbit hippocampal slice preparation, we investigated regional extracellular potassium concentration [( K+]o) changes that occur during spontaneous and evoked spreading depression (SD) episodes. We report here a ... Full text Link to item Cite

Neuronal activity in human lateral temporal cortex related to short-term verbal memory, naming and reading.

Journal Article Brain · December 1988 Extracellular microelectrode recordings were obtained from lateral temporal cortex that was subsequently resected in patients undergoing craniotomies under local anaesthesia for treatment of medically intractable epilepsy. During these recordings patients ... Full text Link to item Cite

Long-term efficacy of microvascular decompression in trigeminal neuralgia.

Journal Article J Neurosurg · July 1988 Forty patients were followed for an average period of 8 1/2 years after 44 consecutive suboccipital craniotomies for trigeminal neuralgia. Among these patients, 36 had microvascular decompression (MVD) of the nerve, four had repeat trigeminal rhizotomy aft ... Full text Link to item Cite

Spontaneous rhythmic synchronous activity in epileptic human and normal monkey temporal lobe.

Journal Article Epilepsia · 1986 Intracellular recordings were obtained from neurons in tissue taken from human epileptic temporal lobe and normal monkey hippocampus. Using the in vitro slice preparation, we confirmed that spontaneous rhythmic synchronous events (SRSEs) were predominantly ... Full text Link to item Cite

Developmental and regional differences in the localization of Na,K-ATPase activity in the rabbit hippocampus.

Journal Article Brain Res · September 16, 1985 Regional differences in Na,K-ATPase activity, and development of Na,K-ATPase activity were examined in rabbit hippocampus using a histochemical marker of enzyme activity. Stratum lucidum of CA3/CA2, corresponding to the mossy fiber terminal field, showed h ... Full text Link to item Cite

Seizure-like spreading depression in immature rabbit hippocampus in vitro.

Journal Article Brain Res · May 1984 Study of immature rabbit hippocampus, using the in vitro slice preparation, has revealed seizure-like spreading depression (SD) episodes in tissue from 8-12-day-old animals. These SDs occur both spontaneously and in response to stimulation, and are seen in ... Full text Link to item Cite