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2. Comparative efficacy and safety of sodium fluorescein-guided surgery versus standard white light for resection of brain metastases: a systematic review and meta-analysis

Author

Ferreira, Marcio Yuri, Antônia O. M. Pereira, Maria, Hemais, Matheus, Bocanegra-Becerra, Jhon E., Cheidde, Lidia, de Oliveira Almeida, Gustavo, Santos, Ana B., Hong, Anthony, Rocha, Igor Menezes, Palavani, Lucca B, Polverini, Allan Dias, Bertani, Raphael, Singha, Souvik, Ferreira, Christian, and Boockvar, John A

Published
2024
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7. Surgical clipping and endovascular treatments for small or very small anterior communicating artery aneurysms: A comparative pooled analysis

Author

Batista, Sávio, Ferreira, Márcio Yuri, B. Oliveira, Leonardo, Semione, Gabriel, Bocanegra-Becerra, Jhon E., Bertani, Raphael, Palavani, Lucca B., de Macêdo Filho, Leonardo José Monteiro, Bertoli, Edmundo Damiani, Rabelo, Nicollas Nunes, Welling, Leonardo Christiaan, Figueiredo, Eberval G., and Lawton, Michael T.

Published
2024
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20. Toward a Frontierless Collaboration in Neurosurgery: A Systematic Review of Remote Augmented and Virtual Reality Technologies

Author

Bocanegra-Becerra, Jhon E., primary, Sánchez, José Luis Acha, additional, Castilla-Encinas, Adriam M., additional, Rios-Garcia, Wagner, additional, Mendieta, Cristian D., additional, Quiroz-Marcelo, Diego A., additional, Alhwaishel, Khaled, additional, Aguilar-Zegarra, Luis, additional, and Lopez-Gonzalez, Miguel Angel, additional

Published
2024
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21. When Microsurgery Becomes the Only Lifesaving Resource: An Institutional Experience Treating Patients from Low-Income Backgrounds Affected by Posterior Circulation Brain Aneurysms

Author

Sánchez, José Luis Acha, primary, Montenegro, Luis Contreras, additional, Bocanegra-Becerra, Jhon E., additional, Cueva, Manuel, additional, Bellido, Adriana, additional, Contreras, Shamir, additional, Santos, Oscar, additional, Oliveira, Leonardo de Barros, additional, Batista, Sávio, additional, and Colán, Jhair Alejandro, additional

Published
2024
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25. First-generation bypass surgery for a giant fusiform aneurysm of the middle cerebral artery: an illustrative case and surgical video.

Author

Bocanegra-Becerra, Jhon E and Sánchez, José Luis Acha

Subjects
*CEREBRAL arteries, *INTRACRANIAL aneurysms, *TRANSIENT ischemic attack, *SURGERY, *CEREBRAL angiography, *TEMPORAL arteries
Abstract

Giant fusiform aneurysms of the middle cerebral artery (MCA) are complex and rare vascular lesions with a poor natural history and challenging treatment decision-making. We report the case of a 46-year-old male with a history of chronic hypertension and a transient ischemic attack who presented with left-sided hemiparesis. A cerebral angiotomography revealed an unruptured giant fusiform aneurysm in the M2 segment of the right MCA. After carefully evaluating the procedure's risks and benefits with the patient, he underwent a low-flow bypass surgery. An anastomosis between the superficial temporal artery and the M3 segment was performed with proximal clipping of the M2 segment. The postoperative course was uneventful, with preserved bypass patency. At follow-up, the patient was neurologically intact. This report illustrates the nuances and operative techniques for treating a giant fusiform aneurysm of the M2 segment that accounted for a preserved bypass patency and optimal patient neurological recovery. [ABSTRACT FROM AUTHOR]

Published
2024
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27. In reply to the Letter to the Editor regarding "Awake surgery for glioma resection during pregnancy: a systematic review".

Author

Bocanegra-Becerra, Jhon E., Batista, Sávio, Costa Vieitas, Fernando, Takahashi, Rafael, Oliveira, Leonardo de Barros, Castillo-Huerta, Nicole M., Ludeña-Esquivel, Alonso, and Bertani, Raphael

Subjects
*SURGICAL excision, *PREGNANCY, *PUBLISHED articles, *CRANIOTOMY
Abstract

The article is a response to a letter regarding a systematic review titled "Awake surgery for glioma resection during pregnancy." The authors address concerns raised about the lack of nuanced appraisal and familiarity in conducting and evaluating systematic reviews of case reports and case series. They explain the reasons for not registering their study in the PROSPERO registry and discuss the limitations of existing tools for assessing the risk of bias in case reports and case series. The authors also clarify the scope of their review and compare their findings with another recently published article on the same topic. They emphasize the need for careful interpretation of evidence from systematic reviews of case reports and case series and suggest that they serve as a base for achieving higher levels of evidence. [Extracted from the article]

Published
2023
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29. Adenosine-Assisted Clipping of Intracranial Aneurysms

Author

Bauman, Megan M. J., primary, Bocanegra-Becerra, Jhon E., additional, Turcotte, Evelyn, additional, Patra, Devi P., additional, Turkmani, Ali, additional, Krishna, Chandan, additional, Bolton, Patrick B., additional, Koht, Antoun H., additional, Hunt Batjer, H., additional, and Bendok, Bernard R., additional

Published
2022
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37. The humanitarian aid of neurosurgical missions in Peru: A chronicle and future perspectives

Author

Bocanegra-Becerra, Jhon E., Castillo-Huerta, Nicole M., Ludeña-Esquivel, Alonso, Torres-García, O. Nicole, Vilca-Salas, Martha I., and Bermudez-Pelaez, Milagros F.

Subjects
Medical missions, Peru, Global neurosurgery, Altruism
Abstract

BACKGROUND: The unmet neurosurgical need has remained patent in developing countries, including Peru. However, continuous efforts to overcome the lack of affordable care have been achieved, being neurosurgical missions one of the main strategies. We chronicle the humanitarian labor of organizations from high-income countries during their visit to Peru, the contributions to local trainees' education, and the treatment of underserved patients. Furthermore, we discuss the embedded challenges from these missions and the future perspective on long-term partnerships and sustainability. METHODS: This is a narrative review. We searched the literature in PubMed and Google Scholar about neurosurgical missions conducted in Peru. RESULTS: Since 1962, twelve organizations from high-income countries have delivered humanitarian help in Peru by training local neurosurgeons, treating low-income patients, and providing surgical instrumentation. Out of the three main regions of Peru, cities on the coast and highlands have hosted most of these missions, with no reported outreach in the amazon area. About 75% of the organizations are headquartered in the United States, followed by Canada, Luxembourg, and Spain. In addition, 50% of the organizations have an active partnership. The predominant focus of these missions has been pediatrics, neuro-oncology, and spine surgery. CONCLUSION: Neurosurgical missions have represented a strategy to close the disparity in education and treatment in Peru. However, additional efforts must be conducted to improve long-term partnership and sustainability, such as adopting standardized indicators for progress tracking, incorporating remote technologies for continuous training and communication, and expanding partnerships in less attended areas.

Published
2022

38. Internal Carotid Artery Classification Systems: An Illustrative Review

Author

Bocanegra-Becerra, Jhon E., Canaz, Gokhan, Vatcheva, Cvetina, and Wellington, Jack

Subjects
Neuroanatomy, Nomenclature, cardiovascular system, ICA, Classification systems, Internal carotid artery
Abstract

The internal carotid artery (ICA) course has been discussed extensively. Several classification systems have attempted to delineate an accurate and helpful trajectory for microsurgical and endoscopic guidance, thus allowing a better neurosurgical performance while avoiding intraoperative complications. Also, the practicality of the classification systems has been emphasized for scholarly communication among disciplines. Nevertheless, the nomenclature of the ICA remains heterogeneous and confusing for health care professionals, trainees, and students. We present an illustrative review of 8 notable ICA classification systems using lateral and anterior views as a rapid tool for neuroanatomic consultation. The appraisal of the vessel anatomy from different perspectives while recognizing their usefulness and limitations might provide a comprehensive understanding of the ICA, optimize the intraoperative performance, and facilitate communication.

Published
2022

39. Surgical management of giant cell tumor invading the occipital bone: A case report and literature review

Author

Bocanegra-Becerra, Jhon E., Showing, M.G.-P., and Huamán Tanta, L.A.

Subjects
Occipital bone, Case report, Surgical management, Skull tumor, Giant cell tumor of bone
Abstract

Background: Giant cell tumor of bone (GCTB) rarely originates in the skull, particularly in the occipital bone. Although benign, it can severely destroy the surrounding tissue and undergo an unpredictable clinical course. We report the successful resection of a GCTB invading the occipital bone in a Hispanic adult woman and present a comprehensive review of the literature on this rare pathology by focusing on the occipital area. Case Description: A 40-year-old Hispanic woman presented with a 3-month history of neck pain and a bulging lesion on the retromastoid area. Brain magnetic resonance imaging (MRI) revealed an extradural, expansive, and contrast-enhancing lesion in the right occipital bone with multiple thin septa and evidence of bleeding. The patient underwent an uneventful gross total resection (GTR) of the lesion. The histopathological examination findings included numerous scattered osteoclast-type giant multinucleated cells. At a 10-month follow-up, the patient has not developed any neurological deficits, impairment of life functioning, or signs of recurrence in MRI. Conclusion: GCTB rarely originates in the skull, being the occipital bone the most infrequent site of presentation. When feasible, total surgical resection effectively reduces the risk of recurrence. Nonetheless, radiation and adjuvant therapies have been employed when GTR could not be achieved. A close follow-up with a brain MRI is advised to control recurrence. © 2022 Published by Scientific Scholar on behalf of Surgical Neurology International.

Published
2022

42. Adenosine-assisted embolization of cerebral arteriovenous malformations: a systematic review and meta-analysis.

Author

Bocanegra-Becerra JE, Andreão FF, Acha Sánchez JL, Punukollu A, Oliveira LB, Kuhar K, Rodrigues Peixoto ME, Pimenta Weba ET, Alhwaishel K, Ferreira MY, Bertani R, and Lopez-Gonzalez MA

Abstract

Background: Cerebral arteriovenous malformations (AVMs) are complex lesions that can cause hemorrhagic stroke and significant neurological disability. Adenosine induces cardiac standstill and hypotension, which are thought to be useful during cerebral AVM embolization. Herein, we conducted a systematic review and meta-analysis of the technique's safety., Methods: Following PRISMA guidelines, four databases were queried for studies describing the use of adenosine-assisted embolization of cerebral AVMs. Adenosine-related intraoperative complications, permanent neurological outcomes, morbidity, and mortality assessed the technique's safety. Single proportion analysis under a random-effects model was performed. Heterogeneity was assessed using I² statistics, and publication bias was evaluated through funnel plot analysis and Egger's regression test., Results: Ten studies were included, involving 79 patients (55.7% male) with 79 AVMs (54.4% unruptured and 70.9% Spetzler-Martin grade III-V) who underwent 123 embolizations (80.4% and 5.9% under transarterial and transvenous approaches, respectively) with n-butyl cyanoacrylate (80.4%), ethylene vinyl alcohol (14.4%), or both (5.2%). The incidence of transient adenosine-related intraoperative complications was 0% (95% CI 0% to 3%, I 2 =24%). Besides, the incidence of adenosine-related morbidity, mortality, and permanent outcomes was 0% (95% CI 0% to 3%, I 2 =0%). During follow-up, good functional outcomes were reported for 64 patients (81%)., Conclusions: Adenosine's effects on blood flow control can facilitate embolization and mitigate the risk of AVM rupture and embolic agent migration. Although current evidence stems from observational studies, the results of this meta-analysis suggest a safe drug profile due to minimal associated morbidity and mortality. Further research from larger randomized and controlled studies is warranted to attain a higher level of evidence., Prospero Registry Number: CRD42023494116., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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