2. U-King-Im JM, Fox AJ et al.    Characterization of Carotid Plaque Hemorrhage: A CT Angiography and MR Intraplaque Hemorrhage Study. Stroke 2010;41:1623-1629.  The authors did not find mean plaque density to be a useful factor for prediction of MR defined IPH. There was significant overlap between the mean plaque densities between the hemorrhagic and the nonhemorrhagic plaque groups. They did find a strong in vivo association between CTA plaque ulceration and IPH as defined by MR-IPH.

3. Raybaud C.  The corpus callosum, the other great forebrain commissures, and the septum pellucidum: anatomy, development, and malformation.  Neuroradiology (2010) 52:447–477.  This is a massive review.  I suggest a very large caffeinated drink prior to attempted reading.  Some things don’t change: the physiological role of the indusium griseum is still unknown.

4. Hassan AE, Zacharatos, H et al.  A Comparison of Computed Tomography Perfusion-Guided and Time-Guided Endovascular Treatments for Patients with Acute Ischemic Stroke. Stroke 2010; 41:1673-1678.  69 patients underwent CT-P-guided and 127 patients underwent time guided endovascular treatment.  CT-P guided endovascular treatment (compared with conventional time-guided endovascular treatment) was not associated with improved short-term outcomes.  Very interesting counterpoint to the utility of CTP, especially given the recent negative press concerning radiation dosage.

5. Ebinger M., et al. Clinical and Radiological Courses Do Not Differ Between Fluid-Attenuated Inversion Recovery-Positive and Negative Patients With Stroke After Thrombolysis.  Stroke 2010;41:1823-1825.  No significant difference was found in terms of lesion growth or neurological changes after thrombolysis between FLAIR-positive and FLAIR-negative patients. Thrombolysis should not be withheld solely based on FLAIR lesion visibility.

6. Soto-Pérez-de-Celis, E.  The Death of Leon Trotsky. Neurosurgery 67:417-423, 2010. In 1940, a Stalinist agent wounded Trotsky in the head with an ice axe in his house in Coyoacán, Mexico, where he was living in exile.  His assassin, Frank Jacson, after his release from prison, spent his time between Cuba and the Soviet Union, where he received the nation’s highest distinction, the Hero of the Soviet Union medal.  That Stalin, what  a guy.

7. Cloyd JM et al. En Bloc Resection for Primary and Metastatic Tumors of the Spine: A Systematic Review of the Literature. Neurosurgery 67:435-445, 2010. Median time to total recurrence for primary tumors was 113 months and for metastatic tumors was 24 months.  En bloc tumor excisions are highly complex and technically demanding procedure with average operating time of 12.1 hours, estimated blood loss of 3.7 L, and complication rate of 36.3%.  The comments are worth reading, and give a nice summary of current thinking regarding en bloc resection vs. lesion resection with chemo and radiation.

8. Scoccianti S., et al. Patterns of Care and Survival in a Retrospective Analysis of 1059 Patients with Glioblastoma Multiforme Treated Between 2002 and 2007.  Neurosurgery 67:446-458, 2010. Median survival was 9.5 months, and actuarial overall survival rates at 1, 2, and 5 years were 62.3%, 24.8%, and 3.9%, respectively.  Patient characteristics associated with a better prognosis included younger age at diagnosis, single lesion, absence of focal symptoms at diagnosis, and higher preoperative KPS score. One small glimmer of hope is the percentage of patients with long term survival (4-year 6.8%; 5-year 3.9%).

9. Pitt D., et al.  Imaging Cortical Lesions in Multiple Sclerosis with Ultra–High-Field Magnetic Resonance Imaging. Arch Neurol 2010; 67(7):812-818. This is a detailed assessment of the sensitivity of 3-D T2*GRE and 3-D inversion recovery WM attenuated turbo-field-echo (TFE) sequences at 7 T in formalin-fixed MS brains in three patients evaluating cortical demyelination. 46% (T2*GRE) and 42% (WHATTFE) of histologically confirmed lesions were seen on prospective scoring. These scores improved to 93% and 82%,respectively, on retrospective scoring. Lesion visibility was partially determined by size as all undetected lesions had a diameter of 1.1 mm or less.  Very impressive image quality.

10. Fisher CG, Vaccaro AR.  The Highest Level of Evidence in a High Impact Journal: Is This the Final Verdict? Spine 2010; 35 (15): E676-E677.  More fodder for the vertebroplasty debate.  They do make an interesting comparison to femur fractures: The natural history of femur fractures is healing by 6 to 12 months regardless of treatment. The goal of internal fixation is early mobilization and pain control.  The authors ask the question: Would anyone for go internal fixation of a femur fracture because of the equivocal long-term fracture healing?

11. Thompson PM, Martin MG, Wright MJ. Imaging genomics. Current Opinion in Neurology 2010, 23:368–373.  Nice reference list for an area of research to which I pay little (or no) attention.

12. Mirzayan MJ et al. Extended Long-Term (>5 Years) Outcome of  Cerebrospinal Fluid Shunting in Idiopathic Normal Pressure Hydrocephalus. Neurosurgery 67:295-301, 2010. Fifty-one patients (mean age of 70) were included after confirmation of the diagnosis by extensive clinical and diagnostic investigations. Surgery included ventriculoatrial or ventriculoperitoneal shunting with differential pressure valves. Shunt-related mortality was negligible and the main cause of death was vascular comorbidity. Nice table summarizing the literature regarding long-term follow-up studies after shunting in iNPH.

13. Langner S et al. Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts. J Neurosurg July 9, 2010. Perfusion CT allows monitoring of hemodynamic changes after bypass surgery. The combination of both modalities enables noninvasive anatomical and functional analysis of superficial temporal artery–middle cerebral artery anastomoses using a single CT protocol.  Didn’t we know this already? We use both all the time in our by-pass population.

14. Barkovich AJ.  Current concepts of polymicrogyria.  Neuroradiology 52: 479-487, 2010.  Everything you need to know in one place….’nuff said.

15. Tubbs RS et al.  Retroclival Epidural Hematomas: A Clinical Series. Neurosurgery 67:404-407, 2010. As Dr. Heger noted in the comments section, 25% of their patients experience occipital cervical dissociation and required stabilization surgery underscores the need for a high index of suspicion for spinal instability in all cases of REDH. 5 of the 6 surviving patients had minimal to no neurologic deficit on long term follow-up indicates that the prognosis from this lesion may be good.

16. Rutherford MA, et al. Magnetic resonance imaging of white matter diseases of prematurity. Neuroradiology (2010) 52:505–521.  Excellent review article with loads of images.  Highly recommended.

2. Manfredi AA, Rovere-Querini P. The Mitochondrion — A Trojan Horse That Kicks Off Inflammation? N Engl J Med 362;22 June 3, 2010. Oh, that’s what the Zhang paper is talking about!

3. Severino M, Schwartz ES et al.  Congenital tumors of the central nervous system.  Neuroradiology 2010;52:531–548.  Very nice review article with excellent image quality.  The infantile GBM appearance was new to me.

4. Hanley EN, Herkowitz HN et al.  Debating the Value of Spine Surgery.  J Bone Joint Surg Am. 2010;92:1293-304.  Pro and con viewpoints on two questions: 1) Did the NIH get its $15 million worth in the SPORT study? 2) Does spine surgery for low back pain work?  One interesting factoid is that the SPORT web site shows 27 articles published (May 2009), indicating an expense of >$500,000 per article…ouch.

5. Hyung Lee J, Durand R et al.  Global and local fMRI signals driven by neurons defined optogenetically by type and wiring.  Nature (letters) Vol 465, 10 June 2010.  I’ll admit that the Wikipedia article on “optogenetics” helped me a lot in semi-understanding this paper.  Seems like neurons really are the source of the BOLD signal.

6. Berry MR, Peterson BG, Alander DH.  A Granulomatous Mass Surrounding a Maverick Total Disc Replacement Causing Iliac Vein Occlusion and Spinal Stenosis.  J Bone Joint Surg Am. 2010; 92:1242-5.  Nasty looking mass centered on the TDR with thecal sac compression and iliac thrombosis requiring IVC filter and lumbar decompressive laminectomy.

7. Schotanus M, van Middendorp JJ et al. Isolated Transverse Process Fractures of the Subaxial Cervical Spine: A Clinically Insignificant Injury or Not?: A Prospective, Longitudinal Analysis in a Consecutive High-Energy Blunt Trauma Population. Spine 2010 May 14. [Epub ahead of print].  Incidence of isolated transverse process fractures in blunt trauma patients was 2.4%. There were no clinical signs of vertebral artery involvement in this group and none of the patients had spinal cord injury. Isolated transverse process fractures of the subaxial cervical spine can be considered as clinically insignificant.

8. Ohtori S, Yamashita M et al. Low Back Pain After Lumbar Discectomy in Patients Showing Endplate Modic Type 1 Change. Spine Vol 35, Number 13, E596–E600. Low back pain in patients with disc herniation appears to mainly originate from disc or nerve root compression, and decompression surgery without fusion is an option for these patients, even those with Modic type 1 changes.

9. Bartels RHMA, Donk R et al.  No Justification for Cervical Disk Prostheses in Clinical Practice: A Meta-Analysis of Randomized Controlled Trials.  Neurosurgery 66:1153-1160, 2010.  Nine articles with 1533 patients analyzed with the conclusion: “Therefore, these costly devices should not be used in daily clinical practice.”

10. Garrett MP, Kakarla U et al.  Formation of Painful Seroma and Edema After the Use of Recombinant Human Bone Morphogenetic Protein-2 in Posterolateral Lumbar Spine Fusions. Neurosurgery 66:1044-1049, 2010.  4.6% of 130 patients who had lumbar fusion with rhBMP returned to the OR for exploration of sterile seroma.  The authors recommend not using BMP for routine posterolateral lumbar fusions.

11. Kakarla U, Beres EJ et al.  Microsurgical Treatment of Pediatric Intracranial Aneurysms: Long-term Angiographic and Clinical Outcomes.  Neurosurgery 67: 1-13, 2010.  Follow up of 72 aneurysms treated in 48 patients.  Annual recurrence rate was 2.6% and rate of de novo formation or growth was 7.8%.

12. Zuccoli G, Siddiqui N et al.  Neuroimaging findings in pediatric Wernicke encephalopathy: a review.  Neuroradiology 2010;52:523–529.  Particularly informative section at the end on the differential diagnostic considerations.

13. Memtsoudis SG, Vougioukas VI et al.   Perioperative Morbidity and Mortality After Anterior (ASF), Posterior (PSF), and Anterior/Posterior Spine Fusion Surgery (APSF). Spine 2010, May 5 [Epub ahead of print].  Evaluation of over 1 million hospitalizations for primary spine fusion (noncervical) found that procedure-related complications was 18.68% among ASF, 15.72% in PSF, and 23.81% in APSF patients. In-hospital mortality rates after APSF were approximately twice those of PSF.

14. Sakai T, Sairyo K et al. Significance of Magnetic Resonance Imaging Signal Change in the Pedicle in the Management of Pediatric Lumbar Spondylolysis. Spine Vol 35, Number 14, E641–E645. Increased T2 signal disappeared in most pedicles on the 3-month follow-up MRI. In patients who did not comply with treatment, the signal change tended to last longer.  3 month MR will indicate whether or not conservative treatment is successful.

2. Columbano L et al. Anatomic Study of the Quadrigeminal Cistern in Patients With 3-Dimensional Magnetic Resonance Cisternography. Neurosurgery 66:991-998, 2010.  Seems like a lot of work for not much useful information.

3A. Durieux V, Alain Gevenois P.  Bibliometric Indicators: Quality Measurements of Scientific Publication. Radiology 255 (2), May 2010.

3B. Spearman CM, Quigley MJ et al. Survey of the h index for all of academic neurosurgery: another power-law phenomenon? J Neurosurg, May 14, 2010.

3C. Castillo M. Measuring Academic Output: The H-Index. AJNR Am J Neuroradiol 31:783– 86, May 2010.

These three publications tie together nicely as a primer on using the h-index.  The easiest way seems to be using the free Harzing Publish or perish software  (http://www.harzing.com/pop.htm), or with much more effort, using Google Scholar.  Kinda scary have your whole life defined by one number.  Also interesting to be an  academic voyeur by looking up other peoples number.

4. Hemingway H, Philipson P et al. Evaluating the Quality of Research into a Single Prognostic Biomarker: A Systematic Review and Metaanalysis of 83 Studies of C-Reactive Protein in Stable Coronary Artery Disease. PLoS Med 7(6): e1000286. doi:10.1371/ journal.pmed.1000286.  I know, a little off the beaten track.  This is something I file away as a good template for how to do a metaanalysis.

5. Dessaud E, Ribes V et al. Dynamic Assignment and Maintenance of Positional Identity in the Ventral Neural Tube by the Morphogen Sonic Hedgehog. PLoS Biol 8(6): e1000382. doi:10.1371/journal.pbio.1000382.  Dynamic and sustained signalling by Shh is required for the patterning of the ventral neural tube, challenging conventional models of morphogen action (that rely solely on the concentration of signal perceived by cells at specific positions in the morphogen gradient).  While I understood about 1 word in 10, the images are impressive. BTW…Osamu Shimomura won the Nobel prize for the development of Luciferins.

6. Kelly MP, Mok JM, Berven S. Dynamic Constructs for Spinal Fusion: An Evidence-Based Review. Orthop Clin N Am 41 (2010) 203–215.  A nice review on a very dry topic, but one that is often misunderstood.  One example: In the cervical spine, with an optimally size graft, the dynamic plating system is bearing only 9% of the load (I suspect most people incorrectly think that the plating system is the thing taking the compressive load).

7. Klineberg E. Cervical. Spondylotic Myelopathy: A Review of the Evidence. Orthop Clin N Am 41 (2010) 193–202.  In a nutshell, not much evidence for all this surgery.

8. Bakker NA et al. Special commentary. International Subarachnoid Aneurysm Trial 2009: Endovascular Coiling of Ruptured Intracranial Aneurysms Has No Significant Advantage Over Neurosurgical Clipping. Neurosurgery 66:961-962, 2010. ISAT has demonstrated that endovascular coiling of ruptured intracranial aneurysms has a significant advantage over neurosurgical clipping in the first year after treatment. After 5 years, the benefit seems to have vanished, and no significant difference in either disability or mortality remains between the 2 treatment modalities. Therefore, for everyday clinical practice and decision making, coiling and clipping are to be considered equivalent in the long term (these are neurosurgeons, after all).

9. Hahne AJ, Ford JJ, McMeeken JM. Conservative Management of Lumbar Disc Herniation With Associated Radiculopathy. Spine 2010;35: E488–E504.  Doing nothing is not a bad thing.

10. Clarke JL et al. Leptomeningeal metastases in the MRI era. Neurology 2010;74:1449–1454.  No real change compared to the pre-MRI era….dismal prognosis.

11. Yoshikawa T et al. Disc Regeneration Therapy Using Marrow Mesenchymal Cell Transplantation. Spine 2010;35:E475–E480. Autologous cultured mesenchymal cells placed percutaneously in collagen sponge pieces into degenerated lumbar discs in two patients. No harm, no foul I suppose (although they were hospitalized for 1 month each after the procedure).

12. Ketelslegers IA, et al. A comparison of MRI criteria for diagnosing pediatric ADEM and MS. Neurology 2010;74:1412–1415. 49 children who had had a demyelinating event evaluated with the following MR criteria: Barkhof, KIDMUS, Callen MS-ADEM criteria, and Callen diagnostic MS criteria. Callen MS-ADEM criteria had the best combination of sensitivity (75%) and specificity (95%).  Properties of this criteria are: absence of diffuse bilateral lesion pattern, presence of black holes, 2 or more periventricular lesions.

13. Cortnum S et al. Determining the Sensitivity of Computed Tomography Scanning in Early Detection of Subarachnoid Hemorrhage. Neurosurgery 66:900-903, 2010. Retrospective study of 499 patients. CT scanning is excellent for diagnosing SAH. The authors suggest leaving out lumbar puncture in the first 3 days after ictus if the results of the CT scan are negative. We see a fair number of patients who are CT neg, LP positive for blood; who then go on to have a negative CTA, in whom neurosurgery still wants a conventional angio performed.  Invariably the angio is also negative.

14. Caron T et al. Spine Fractures in Patients With Ankylosing Spinal Disorders. Spine 2010;35:E458–E464. 122 spine fractures in 112 consecutive patients with ASD showed that the majority were transdiscal extension injuries, most commonly affecting C6–C7. 58 cord injuries, 26 complete.  Mortality was 32%!! The authors advocate early CT and MR imaging and I whole heartedly concur.  These lesions scare me.  They are usually severely osteopenic and defining subtle fractures even by the best quality CT is very difficult.  I recommend MR in nearly everybody with AS if they have had significant trauma.

15. Swanson EW et al. Patient Transport and Brain Oxygen in Comatose Patients. Neurosurgery 66:925-932, 2010. 45 patients with continuous PbtO2 monitoring during the 3 hours before and after 100 head CTs that required intrahospital transport (IHT). They found that (1) ICP and CPP remain stable; (2) mean, minimum, and maximum PbtO2 are reduced; (3) brain hypoxia (PbtO2 <15 mm Hg) is more frequent after IHT; (4) the duration of compromised brain oxygen (PbtO2 <25 mm Hg) or brain hypoxia is significantly longer after IHT (they relied on Ambu bag hand ventilation).

2. Kim KH et al.  Adjacent Segment Disease After Interbody Fusion and Pedicle Screw Fixations for Isolated L4–L5 Spondylolisthesis. Spine 2010;35:625–634. A low postoperative segmental lordotic angle, especially less than 20°, at index level was related with development of clinical ASD in both isthmic and degenerative spondylolisthesis patients.

3. Ribas GC .The cerebral sulci and gyri. Neurosurg Focus 28 (2):E2, 2010.  Very detailed review of the literature regarding the historical, evolutionary, embryological, and anatomical aspects of the cerebral sulci and gyri to establish detailed descriptions of these structures, as well as their groupings in the brain lobes, for microneurosurgical purposes.

4. Diaz FL et al.  Cervical External Immobilization Devices: Evaluation of Magnetic Resonance Imaging Issues at 3.0 Tesla. Spine 2010;35:411–415. Generation 80 and V1 Halo devices exhibited substantial temperature rises with “sparking” evident for the Generation 80 during the MRI procedure. Artifacts were problematic for these devices. The 2 Resolve Ring-based cervical external immobilization devices showed little or no heating and the artifacts were acceptable.

5. Harrop JS et al.  Cervical Myelopathy: A Clinical and Radiographic Evaluation and Correlation to Cervical Spondylotic Myelopathy. Spine 2010;35:620–624.  Nice review of clinical signs.  No patients without cord compression showed myelopathy.  The likelihood of myelopathy increases with the presence of T2 cord signal hyperintensity.

6. Monti MM et al. Willful Modulation of Brain Activity in Disorders of Consciousness. N Engl J Med 2010;362:579-89. Of the 54 patients enrolled in the study, 5 were able to willfully modulate their brain activity demonstrated by fMRI.

7. Ropper AH. Cogito Ergo Sum by MRI. N Engl J Med 2010; Feb 18, 362;7. Editorial accompanying the N Engl J Med article above. (I think, therefore I am).The author reminds us of three important concepts: First, in this study, brain activation was detected in very few patients. Second, activation was found only in some patients with traumatic brain injury, not in patients with global ischemia and anoxia. Third, cortical activation does not provide evidence of an internal “stream of thought”, memory, self-awareness, reflection, synthesis of experience, symbolic representations, anxiety, despair, or awareness of one’s predicament.

8. Kase CS, Nguen TN.  The clinical conundrum of convexal subarachnoid hemorrhage. Neurology 2010;74:874–875.  Editorial. “Convexal” SAH is frequently encountered in clinical practice, and presents at times with acute headache suggestive of SAH, but often it is an unexpected finding on imaging in patients evaluated for a variety of symptoms, including change in mental status, transient focal neurologic deficits, or partial seizures.

9. Kumar S, Goddeau RP et al. Atraumatic convexal subarachnoid hemorrhage:  Clinical presentation, imaging patterns, and etiologies.  Neurology 2010;74:893–899. Reversible vasoconstriction syndrome appears to be a common cause in patients 60 years or younger whereas amyloid angiopathy is frequent in patients over 60.

10. Lovblad K, Baird AE.  Computed tomography in acute ischemic stroke. Neuroradiology (2010) 52:175–187.  Comprehensive review of use of CT imaging and perfusion.

11. Kleiser R, Staempfli P et al.  Impact of fMRI-guided advanced DTI fiber tracking techniques on their clinical applications in patients with brain tumors. Neuroradiology (2010) 52:37–46.  DTI scan can be acquired in a few more scan minutes in the same scan session in which all the other necessary images for the surgery are acquired (anatomical and fMRI data). The data processing is performed offline with dedicated software packages without involvement of the patient.

12. Bello L et al. Intraoperative use of diffusion tensor imaging fiber tractography and subcortical mapping for resection of gliomas: technical considerations. Neurosurg Focus 28 (2):E6, 2010.  Shows the potential usefulness of the routine combined use of DT imaging–FT and subcortical mapping, particularly in patients with low-grade gliomas. These tumors display an infiltrative modality of growth, along short and long connecting fibers, and visualizing the trajectory of the tracts is important for planning and performing surgery.

13. Verhoeven JS et al.  Neuroimaging of autism. Neuroradiology (2010) 52:3–14.  This is an area I have not paid much attention too, so it is convenient to have an all encompassing review available.

14. Chhabra V, Sung E et al.  Safety of magnetic resonance imaging of deep brain stimulator systems: a serial imaging and clinical retrospective study.  J Neurosurg 112:497–502, 2010.  This retrospective MR imaging–based study supports the safety of MR imaging in patients with implanted DBS systems.  Because the indications for DBS continue to expand, it is likely that postoperative MR imaging will remain an important clinical tool.

15. Richards PJ, George J et al. Spine Computed Tomography Doses and Cancer Induction. Spine Volume 35, Number 4, pp 430–433.  Risk ratio for inducing a cancer when CT scanning the whole lumbar spine was about 1 in 3200, which was much less than the risk of CTing the whole dorsal spine (about 1 in 1800) due to the longer coverage required and the anatomic implications of scanning in the region of the cervical dorsal junction.

16. Karppinen J, Solovieva S et al. Modic changes and interleukin 1 gene locus polymorphisms in occupational cohort of middle-aged men. Eur Spine J (2009) 18:1963–1970.  The pathomechanism of LBP due to Modic changes (MC) remains poorly understood. It has been hypothesized that MC is a result of a biomechanically induced inflammation around the intervertebral disc.  This inflammatory etiology is also supported by the finding of an increased number of tumor necrosis factor immunoreactive nerve cells and fibers in endplates with MC, especially in type I changes [30].   This paper shows an association between IL1A gene variation and type II MC replicates a previous finding from a different Finnish geographic area,  confirming the importance of the ILA gene in the pathophysiology of MC.

17. Kim D, Wadley R. Variability in Techniques and Patient Safety Protocols in Discography. Journal of Spinal Disorders & Techniques, 27 January 2010. To improve diagnostic validity and patient safety, the International Spine Intervention Society (ISIS) has published practice guidelines for performing discography (Bogduk N, ed. Practice Guidelines for Spinal Diagnostic and Treatment Procedures. San Francisco: International Spine Intervention Society; 2004:20–46).  The overall compliance with ISIS guidelines is fair to poor with the specialty rank order of compliance greatest to least as follows: Anesthesiology, PMR, and Radiology.

18. Kim HS, Chong HS et al. Vascular Injury in Thoracolumbar Spinal Surgeries and Role of Angiography in Early Diagnosis and Management. Journal of Spinal Disorders & Techniques, 27 January 2010. Of the total 8 arterial injury cases, only 1 of them occurred in the thoracic region and the rest all were seen in the lumbar spine.  Pseudoaneurysm formation in thoracic aorta was seen in 1 case of multiple vertebral fractures, segmental artery was found to be injured in 3 cases of osteotomy for deformities, 2 cases of aortic injury and 1 case of inferior mesenteric artery injury was seen in posterior lumbar interbody fusion. Common iliac artery and vein both were seen to be injured simultaneously in 1 case of lumbar discectomy.

Ebner FL, et al. Intramedullary lesions of the conus medullaris: differential diagnosis and surgical management. Neurosurg Rev (2009) 32:287–301.  Straight forward and all inclusive review of lesions that affect the conus (or any other part of the spinal cord, for that matter).  117 references.

Sharma GK et al. Spontaneous intramedullary hemorrhage of spinal hemangioblastoma: case report.  Neurosurgery 65:627–628, 2009.  15th reported case of spinal hemorrhage from hemangioblastoma.  The number I take away is Velthoven (Neurosurgery 57:71–76, 2005) reporting a risk of spontaneous hemorrhage in patients with a hemangioblastoma involving the central nervous system of 0.0024 per person per year.

Testai FD, Gorelick PB. Inherited Metabolic Disorders and Stroke Part 1. Arch Neurol. 2010;67(1):19-24. This portion of the review focuses on Fabry disease and MELAS.  Seriously detailed, with something that looks suspiciously like a diagram of the Krebs cycle.

Franzini A, et al. Spontaneous intracranial hypotension syndrome: a novel speculative physiopathological hypothesis and a novel patch method in a series of 28 consecutive patients. J Neurosurg 112:300–306, 2010. Blood patch with fibrin glue in the lumbar spine.  Check out the degree of thecal sac compression in figure 2.

Sheerin F et al.  Magnetic resonance imaging of acute intramedullary myelopathy: radiological differential diagnosis for the on-call radiologist. Clinical Radiology (2009) 64, 84-94.  Nice comprehensive review of a myriad of cord abnormalities with good image quality.

Vermeulen RJ et al. Microcephaly with simplified gyral pattern: MRI classification. Neurology 2010;74:386–391. Visual grading scale that can distinguish normal children from abnormal children with MSGP.  Why do I need this?

Ponce FA, Lozano AM. Highly cited works in neurosurgery. Part I: the 100 top-cited papers in neurosurgical journals. J Neurosurg 112:223–232, 2010.  Number 1? Hunt and Hess 1968.

Ponce FA, Lozano AM. Highly cited works in neurosurgery. Part II: the citation classics. J Neurosurg 112:233–246, 2010. More inclusive citations not just directly published in neurosurgical journals. I liked #32b.

Very nice review article with histopathology, imaging and helpful graphics

2.  Neuro-Behçet’s disease: epidemiology, clinical characteristics, and management.  Lancet Neurol 2009; 8: 192–204.

Behcet’s disease is a multisystem relapsing inflammatory disorder of unknown cause.  This review covers CNS parenchymal and nonparenchymal manifestations, as well as peripheral and uncommon variants.

3.  The protective status of subtotal obliteration of arteriovenous malformations after radiosurgery: significance and risk of hemorrhage.  Neurosurgery 65:709–718, 2009

Important paper evaluating the risk of AVM’s which show only early draining vein but no nidus following radiosurgery.  These “subtotally” obliterated AVM’s showed 0% rebleed rate.

4.  Microsurgical and endoscopic anatomy of the supratentorial arachnoidal membranes and cisterns.  Neurosurgery 65:644–665, 2009

More than I want to know about this topic, but nice to have as a reference.

5.  Hemispherotomy: efficacy and analysis of seizure recurrence.  J Neurosurg Pediatrics 4:000–000, 2009

Review of 49 patients who underwent functional hemispherotomy, with resultant freedom from seizures in 78%.

6.  Long term outcomes following surgical resection of myxopapillary ependymomas.  Neurosurg Rev (2009) 32:321–334

Retrospective review of 52 cases of spinal myxopapillary ependymomas.  Pediatric patients had much more aggressive tumors with recurrence and dissemination in 64%, vs. 32% in adults.  The role of radiotherapy and chemo is discussed.

7.  Neurosurgical implications of achondroplasia.  J Neurosurg Pediatrics 4:000–000, 2009

Review of treatment of pediatric patients with achondroplasia from Hospital for Sick Children, with focus on hydrocephalus and CV junction abnormalities.

8.  Occipital condyle fractures: clinical decision rule and surgical management.  J Neurosurg Spine 11:388–395, 2009

This is the kind of classification I like: presence or absence of craniocervical malalignment is the one important imaging parameter.  Malalignment was defined as C0-C1 interval on CT of >2mm.

9.  Comparison of clinical, familial, and MRI features of CADASIL and NOTCH3-negative patients.  Neurology  2010;74:57–63

Genetic analysis of 81 probands because CADASIL was suspected show no phenotypical differences between those with and without the mutation.

10.  Noninvasive testing, early surgery, and seizure freedom in tuberous sclerosis complex.  Neurology 2010;74:392–398

Evaluation of magnetic source imaing and PET/MRI coregistration techniques in 18 patients who underwent surgery.  Largest hypometabolic focus relative to the MR size seemed an important variable.

1.  Mitochondrial Neurogastrointestinal Encephalopathy Due to Mutations in RRM2B. Arch Neurol. 2009;66(8):1028-1032.  Just read the intro section and look at the images.  I had never head of MNGIE before.  The FLAIR images provided at least sort-of point to the diagnosis of “mitochondrial disease”.

2.  Depletion of B Lymphocytes From Cerebral Perivascular Spaces by Rituximab.  Arch Neurol. 2009;66(8):1016-1020.  Rituximab not only reduces the number of B cells in the peripheral blood and CSF in patients with MS, is also seems to decrease brain perivascular space B cells.

3.  Toxic and Acquired Metabolic Encephalopathies: MRI Appearance.  AJR 2009; 193:879–886.  A few examples of the classic toxic lesions in a pictorial essay.  Not an exhaustive categorization.  A classic “chasing the dragon” is not shown, nor is delayed posthypoxic leukoencephalopathy (such as seen with carbon monoxide poisoning).

4.  Window anatomy for neurosurgical approaches.  J Neurosurg 111:365–370, 2009.  Interesting for the elegant dissections and the review of craniometric points that I had forgotten (bregma, stephanion, pterion, lambda, asterion).

5.  Screening for blunt cerebrovascular injury: selection criteria for use of angiography.  J Neurosurg / July 31, 2009.  A high frequency of BCI occurred in patients with fractures of the cervical spine, midface, and cranial base after high-velocity trauma.  Isolated thoracic injuries and soft tissue injuries to the neck were only associated with BCI in 3/30 angiographic studies.

6.  Systematic Characterization of the Computed Tomography Angiography Spot Sign in Primary Intracerebral Hemorrhage Identifies Patients at Highest Risk for Hematoma Expansion. Stroke 2009;40:2994-3000.  An important predictor of significant hematoma expansion in primary ICH, independent of time from ictus to MDCTA evaluation, admission INR, mean arterial blood pressure, blood glucose level, and initial ICH volume.

7.  Transcorporeal Approach for Disc Herniation at the C2-C3 Level.  J Spinal Disord Tech 2009;22:459–462.  A drill hole of 5mm diameter was made at the middle of the C3 vertebral body and extended cranioposteriorly to the superoposterior border of the C3 endplate with disk removal.

8.  Long-Term Outcome After Suboccipital Decompressive Craniectomy for Malignant Cerebellar Infarction.  Stroke 2009;40:3045-3050.  Only neuroradiological evidence of brain stem infarction was associated with poor outcome. Other factors such as age, gender, GCS before surgery, co-morbidity, time to surgery, and bilateral versus unilateral cerebellar infarction showed no significant association with poor outcome.

9.  Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders.  J Neurosurg / August 7, 2009.  Nothing too fancy on the technical side, with STIR in everybody, and selected addition of axial volumetric 3D DESS sequences.

10. Large-Cohort Comparison Between Three-Dimensional Time-of-Flight Magnetic Resonance and Rotational Digital Subtraction Angiographies in Intracranial Aneurysm Detection.  Stroke 2009;40:3127-3129.  As the childhood rhyme goes: When it is good, it is very, very good.

11.  Comparative Reliability of 3 Thoracolumbar Fracture Classification Systems.  J Spinal Disord Tech 2009;22:422–427.  Denis, Association for Osteosynthesis (AO), and Thoracolumbar Injury Severity Score (TLISS) systems evaluated by spine surgeons, spine fellows, nonspine orthopedists, and orthopedic residents.  TLISS is acceptably reliable system compared with simple versions of Denis and AO systems.

12.  Reversing Stroke in the 2010s Lessons From Desmoteplase In Acute ischemic Stroke-2 (DIAS-2).  Stroke 2009;40:3156-3158.  Interesting editorial given the negative results of the DIAS 2 trial (Lancet Neurol 2009; 8: 141–50).  Is advanced stroke imaging superfluous?

13.  Anterior Transvertebral Herniotomy for Cervical Disc Herniation A Long-term Follow-up Study.  J Spinal Disord Tech 2009;22:408–412.  20 patients with follow up of more than 10 years showed good clinical outcome. Degenerative changes at the adjacent levels were not enhanced.

14. Multiinstitutional validation of the University of California at San Francisco Low-Grade Glioma Prognostic Scoring System.  J Neurosurg 111:203–210, 2009.  Four variables were confirmed to be predictive of survival in a multivariate analysis—1) location of tumor in eloquent cortex, 2) KPS score ≤ 80, 3) age > 50 years, and 4) maximum tumor diameter > 4 cm—and were applied to a set of 256 patients at 3 external institutions and analyzed for survival.

15.  Emerging Viral Infections of the Central Nervous System.  Arch Neurol 2009;66(8):939-948.  Nice review.  This first part discusses West Nile virus (WNV), Japanese encephalitis (JE) virus, Toscana virus, and enterovirus 71 (EV71).

16.  Neuromyelitis Optica IgG Serostatus in Fulminant Central Nervous System Inflammatory Demyelinating Disease.  Arch Neurol 2009;66(8):964-966.  NMO IgG is a specific biomarker for NMO and is not seen with other severe inflammatory CSN demyelinating disease, even if fulminant.

Clinical Usefulness of CT-myelogram Comparing With the MRI in Degenerative Cervical Spinal Disorders.  Is CTM Still Useful for Primary Diagnostic Tool?  J Spinal Disord Tech 2009;22:353–357  No surprise here, the answer is yes.

Cavernous malformations of the basal ganglia and thalamus, Neurosurgery 65:7–19, 2009.  Nice review of the literature, showing a 2.8-4.1% annual bleed rate.  10% of patients show long term morbidity from surgery for these lesions.

Developmental venous anomalies: current concepts and implications for management, Neurosurgery 65:20–30, 2009.  Very thorough review of DVA’s and there associations.

Clinical Significance and Prognosis of Idiopathic Syringomyelia. J Spinal Disord Tech 2009;22:372–375  Localized type is less than 3 vertebral segments and typically benign course.  Extended syrinx involved 4 or more segments in length and went to surgery.

Removal of the Charite Lumbar Artificial Disc Prosthesis.  J Spinal Disord Tech 2009; 22: 334-339.  29 Charite prostheses removed.  Operative morbidity included 4 major vessel lesions, colon and ureter “lesions”.

Retrieval Analysis of a ProDisc-L Total Disc Replacement.  J Spinal Disord Tech 2009; 22: 290-296.  Removal of a posteriorly malpositioned L5-S1 implant with PEEK anterior interbody fusion.

Prevalence of Degenerative Imaging Findings in Lumbar Magnetic Resonance Imaging Among Young Adults. Spine 2009; 34:1716–1721  Almost ½ young Finnish adults have one degenerated disc, although degenerative endplate changes are very uncommon.

Intra-Arterial Injection in the Rat Brain: Evaluation of Steroids Used for Transforaminal Epidurals.  Spine 2009;34:1638–1643   The depo stuff gives BBB injury, while Decadron does not.  I thought the whole point of the injection was to give the depo version.  This just makes me worry more about something I can’t change.  We don’t do cervical selective roots anyway, and I don’t think I’m going to change practice on lumbar transformational injections based on this.  I probably will fret more on left L1 transforaminals.

Vertical mobile and reducible atlantoaxial dislocation.  J Neurosurg Spine 11:9–14, 2009  8 patients with congenital CVJ abnormality, with several exacerbated by more recent trauma.  Main thing is reducibility with extension, and dynamic flex-ext CT was recommended.

Prevalence and clinical features of intraspinal facet cysts after decompression surgery for lumbar spinal stenosis. J Neurosurg Spine 10:000–000, 2009   Instablity, either preop or postop leads to cysts.  However, a large percentage show spontaneous regression.

Deep Brain Stimulation, Neuroethics, and the minimally conscious state.  Arch Neurol 2009; 66(6): 697-702.   Case study of one patient who had bilateral thalamic electrodes, outlining the challenges and ethical implications.

Case 17-2009: A 30-year-old man with progressive neurological deficits.  NEJM 2009; 360:2341-51.  I will not give this one away, but I am adding this entity to my list of pathologies which can mimic anything (lymphoma, TB, sarcoid).  Come on admit it, you go to the end and look at the answer first!

Primary angiitis of the central nervous system.  Arch Neurol 2009; 66(6): 704-709.  Good review with distinguishing features between it and reversible vasoconstriction syndrome.  Regarding RVCS, see Ann Intern Med 2007; 146:34-44 for this excellent review.

Direct imaging of the distal dural ring and paraclinoid internal carotid artery aneurysms with high-resolution T2 turbo-spin echo technique at 3T magnetic resonance imaging.  Neurosurgery 64:1059-1064, 2009.  Nice to have another way to define the cave aneurysm, besides relation to ophthalmic artery and relation to optic strut.

Minimally invasive operative management for lumbar spinal stenosis: overview of early and long-term outcomes.  Orthop Clin N Am 2007; 38: 387-399.  More than you really want to know about this procedure, but useful to get an overview of endoscopic approaches for lumbar stenosis.  Figure 9 summarized the whole article for me.

beta Amyloid, Blood vessels, and Brain Function.  Stoke 2009; 40:2601-2606.  Nice review of the cross-linking (pun intended) between cerebral amyloid angiopathy and Alzheimer’s.  CAA is the most frequent vascular abnormality in Alzheimer’s.

CT angiography for intracerebral hemorrhage does not increase risk of acute nephropathy.  Stroke 2009; 40:2393-2397.  Large series where more patients got acute nephropathy who did NOT get CTA compared to those who did get CTA.

Brain lesions are more often reversible in acute thrombotic thrombocytopenic purpura. Neurology 2009; 73:66-70.  Show interesting involvement of basal ganglia, which is apparently not just bilateral infarcts.  They postulate as variant of PRES.

Occurrence of Basal ganglia germ cell tumors without a mass.  Arch Neurol  2009; 66(6): 789-792.  Kinda scary.  BG germ cell tumors, biopsy proven, presenting with volume loss and even wallerian degeneration.  Also hypometabolism on PET.

The timing and influence of MRI on the management of patients with cervical facet dislocations remains highly variable.  J Spinal Disord Tech 2009; 22(2): 96-99.  Title says it all.  No rhyme or reason to timing and use of MR.

Complications in the use of rhBMP-2 in PEEK cages for interbody spinal fusions.  J Spinal Disord Tech 2008; 21(8): 557-562.  Endplate resorption with BMP very common.  More likely to have graft migration with use of BMP in TLIF or PLIF without plate barrier.  See also letter response in volume 22, number 4, June 2009.

Interspinous process devices for the treatment of lumbar degenerative disease.  Current Orthopaedic Practice, 2009 ; 20(3): 232-237.  Nothing earth shattering, but a nice review.

Overdoseage of intrathecal gadolinium and neurolgical response.  Clinical Radiology  2008; 63: 1063-1068.  Why the heck would gadolinium be anywhere near the myelography room?  See also Journal of Neurology, 2007, Gadolinium encephalopathy due to accidental intrathecal administration of gadopentetate dimeglumine.  Always, always check the bottle of whatever you are injecting.  My first rule for all fellows and residents on myelography rotation.

MRI lesion profiles in sporadic Creutzfeldt-Jakob disease.  Neurology 2009; 72: 1994-2001.   Nice table showing the different diffusion appearances between the six molecular subtypes.    See also Ann Neurol 2000; 48:323-329 which kinda explains what the six molecular subtypes are.

Bilaterally symmetric form of Hirayama disease.  Neurology 2009; 72:2083-2089.  Anyone have a nice case of this?  Either a spinal muscle atrophy of unknown etiology, or related to cord compression from the posterior dura with flexion.  Still uncertain.  See also The Neurologist 2009; 15: 156-160  Familial Asymmetric distal upper limb amyotrophy (Hirayama Disease) : report of a Greek Family.