Neurosurgery Watch

Stay up to date with the latest clinical findings in Neurosurgery Watch. Each month, our panel identifies and summarizes key points of selected significant papers from over 50 journals. We emphasize the most significant findings that potentially change clinical management or treatment of neurological diseases.

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John S. Kuo, MD PhD FACS
Austin, Texas
Co-Editor

Robert Starke, MD MSc
Miami, Florida
Co-Editor

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Comparison of General Anesthesia vs. Conscious Sedation during Endovascular Therapy on Infarct Growth and Clinical Outcomes in Acute Ischemic Stroke

August 2, 2018

Cerebrovascular

By:

Stephen Grupke, MD

Source:

Neurosurgery

Previous studies have yielded conflicting results regarding patient outcomes after endovascular therapy for acute ischemic stroke depending on whether general anesthesia (GA) or conscious sedation (CS) was administered. The GOLIATH trial (General or Local Anesthesia in Intra Arterial Therapy) is...

Bupivacaine Field Block with Clonidine for Postoperative Pain Control in Posterior Spine Approaches: A Randomized Double-Blind Trial

August 2, 2018

Pain, Spine

By:

Kelsey Hundley, MD

Erika Petersen, MD

Source:

Neurosurgery

This double-blind study of 225 patients at a single center undergoing posterior cervical or lumbar surgery by the same surgeon demonstrated improved postoperative pain control when 150 ug clonidine was added to 20mL of bupivacaine for pre-incisional field block compared...

Tenectaplase versus Alteplase before Thrombectomy for Ischemic Stroke: EXTEND-IA TNK Trial

July 5, 2018

Cerebrovascular

By:

Andrew W. Grande, MD

Shailesh Male, MD

Source:

NEJM

EXTEND-IA TNK is a multicenter, randomized, open-label, blinded-outcomes, non-inferiority trial of acute ischemic stroke patients with internal carotid, middle cerebral, or basilar artery occlusion eligible for both intravenous thrombolysis. Patients were randomized 1:1 to receive IV tenecteplase (0.25mg/kg; max dose...

Restenosis & risk of stroke after stenting or endarterectomy for symptomatic carotid stenosis in the International Carotid Stenting Study: secondary analysis of a RCT

July 5, 2018

Cerebrovascular

By:

Stephen Grupke, MD

Source:

Lancet Neurology

The International Carotid Stenting Study examined 1713 patients across 50 centers with symptomatic carotid stenosis (50% or greater) who were randomized to angioplasty and stenting vs endarterectomy in a 1:1 ratio. Patients were followed at 30 days, 6 months, and...

Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial

July 5, 2018

Cerebrovascular

By:

Vincent Y. Wang, MD PhD

Source:

Lancet

Spontaneous intracerebral hemorrhage (ICH) is a common cause of mortality and disability. Tranexamic acid (TXA) is an antifibrinolytic agent that has been shown to reduce mortality in patients with traumatic injury and postpartum hemorrhage. The Tranexamic acid for hyperacute primary...

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