UW Neurological Surgery Recent PubMed Publications

Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms that present with diverse clinical manifestations depending on their secretory activity. Paraneoplastic hypercalcemia due to parathyroid hormone-related peptide (PTHrP) secretion by pNETs is an uncommon but serious complication. We describe the case of a 67-year-old female with a past medical history of multiple sclerosis and uveitis presenting with acute metabolic encephalopathy due to profound hypercalcemia. Laboratory workup revealed...

PURPOSE OF REVIEW: Traumatic spinal cord injury (tSCI) is a devastating neurological emergency with high morbidity and no proven therapies that reliably improve recovery. While early decompression and hemodynamic optimization are standard, clinicians lack imaging tools to stratify injury severity or monitor physiological responses in real time. Advances in high-resolution B-mode, contrast-enhanced ultrasound, and multiparametric approaches offer a unique opportunity to close this gap and improve...

At the 42nd Annual Meeting of the American Association of Clinical Anatomists (AACA) in Bellevue, Washington, June 2025, two inaugural events-the Clinical Anatomy Fireside Chat (CAFC) and the Clinical Anatomy Symposium: Head and Neck 2025 (CAS)-fostered rich dialogue on the evolving role and operational definition of clinical anatomy. Experts from various clinical and anatomical disciplines explored the meaning of clinical anatomy, highlighting the absence of a universal definition despite its...

CONCLUSION: Patients with elevated BACs scored approximately 1 point lower on the GCS than patients with BACs under 0.08. BAC's effect on the GCS persisted even after controlling for other covariates by multivariable regression analysis. Providers should be aware of this when initially evaluating intoxicated patients with TBI as it can affect their clinical management.

Background Arteriovenous malformations (AVMs) in eloquent brain regions pose significant challenges due to the increased risk of neurologic deficits associated with treatment. Although stereotactic radiosurgery (SRS) and endovascular embolization are used as standalone approaches, their comparative outcomes in eloquent brain AVMs remain unclear. Purpose To directly compare the outcomes of standalone endovascular embolization versus SRS for patients with AVMs in the eloquent brain. Materials and...

Fentanyl is widely used perioperatively and illicitly as a drug of abuse. As a potent μ-opioid receptor agonist, fentanyl canonically inhibits excitability through Gα(i/o) intracellular signalling pathways resulting in analgesia and respiratory depression. However, fentanyl also paradoxically activates respiratory muscles causing a potentially lethal effect termed wooden chest syndrome. Here we show that fentanyl, but not morphine, causes a persistent tonic component of diaphragmatic muscle...

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CONCLUSIONS: Persons with chronic TBI can use smartphone technology for self-reporting mood multiple times per week, which shows some promise for improving emotional QoL. Large variation in outcomes suggests that further research is needed to determine who is most likely to benefit from this type of intervention and what additional intervention components are needed to maximize effects.

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The effects of global climate change on biodiversity and ecosystem functioning are unevenly distributed in the geographic space. Identifying sites more suitable to sustain biodiversity in a changing climate is essential to both species conservation and restoration strategies at different scales. Here, we map terrestrial climate-resilient sites for biodiversity across Brazil to identify sites with greater chances of providing suitable conditions for species to persist under regional climate...

CONCLUSIONS AND RELEVANCE: In this cohort study, early EC surgery was associated with adverse function, cognition, and disability after TBI rated as moderate-severe or with radiographic abnormalities on CT scan regardless of GCS at index admission but not after orthopedic trauma or CT- TBI. Further studies may help determine whether surgical timing or other interventions can improve the observed long-term deficits.

INTRODUCTION: Developing robust predictive models from multi-omics data is challenging because sample sizes are typically small (often fewer than 100) while the feature space is vast (over 20,000 molecular features such as genes, transcripts, and proteins), which increases the risk of overfitting and limits generalizability. To address this challenge, this study introduces the Magnitude-Altitude Score Analysis for Tracking Infection and Time-Dependent Genes (MASIT), a novel method adept at...

Chronic pain is a complex clinical problem comprising multiple conditions that may share a common genetic profile. Genome-wide association studies (GWAS) have identified many risk loci whose cell-type context remains unclear. Here, we integrated GWAS data on chronic pain (N = 1,235,695) with single-cell RNA sequencing (scRNA-seq) data from human brain and dorsal root ganglia (hDRG), and single-cell chromatin accessibility data from human brain and mouse dorsal horn. Pain-associated variants were...

Cystic fibrosis (CF), a life-shortening genetic disease, is hallmarked by mucus obstruction, respiratory deficiency, and chronic bacterial infections. Pseudomonas aeruginosa is the most common virulent respiratory pathogen that is detrimental to the overall survival of CF patients. Here we evaluate the efficacy of farnesol emulsion, a broad-spectrum agent recently used to combat P. aeruginosa biofilm infections, for reducing P. aeruginosa infections in CF using a three-dimensional (3D) airway...

CONCLUSIONS AND RELEVANCE: In this comparative effectiveness study, similar patients with traumatic ASDH were treated differently due to center-specific treatment preferences. Outcomes were similar in centers preferring surgical evacuation and those preferring initial conservative treatment. This study suggests that, for a patient with ASDH for whom a neurosurgeon experiences clinical equipoise between acute surgery vs (initial) conservative treatment, conservative treatment may be considered.

Breathing is a fundamental motor rhythm necessary to sustain life. The rhythm and pattern of breathing arises from the coordination of a bilaterally symmetric, rostro-caudally extended column of heterogeneous neural populations in the medulla called the Ventral Respiratory Column (VRC). By recording from the extent of the VRC using Neuropixels during optogenetic and physiological manipulations, and projecting the population activity into a dynamical latent space, we find that GABAergic...

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CONCLUSIONS: This study suggests that operative reports simplified by AI can facilitate patient understanding. However, preferences varied according to patient demographics, indicating the need for individualized approaches to simplification. Further research is necessary to optimize the use of AI for personalized patient education and to evaluate the long-term impact on healthcare outcomes.

Neurons in the dorsal root ganglion (DRG) receive and transmit sensory information from the tissues they innervate and from the external environment. Upper cervical (C1-C2) DRGs are functionally unique as they receive input from the neck, head, and occipital cranial dura, the latter two of which are also innervated by the trigeminal ganglion (TG). The C2 DRG also plays an important role in neck pain, a common and disabling disorder that is poorly understood. Advanced transcriptomic approaches...

CONCLUSIONS: Single-session MMAE plus surgical evacuation appears to be safe and shortens LOS compared with a staged approach. The rates of functional outcomes, re-evacuation, and mortality did not differ significantly from those observed in patients who underwent staged procedures.