Citations 3
Risk Factors for Postoperative Cerebrospinal Fluid Leak Following Endoscopic Transsphenoidal Surgery for Craniopharyngioma: A Multicenter Cohort Study with a Contemporary Surgeon Practice Survey
Celda, María Peris, Karsy, Michael, Evans, James J, Kim, Albert H, Kim, W, Bergsneider, Marvin , Pacione, Donato , Gardner, Paul A. , Mukherjee, Raj, Liu, Connor J. , Cheok, Stephanie , Zwagerman, Nathan T. , Christenson, Charles, Blackburn, Spiros, Kshettry, Varun R, Wu, Kyle C, Prevedello, Daniel, Barkhoudarian, Garni, Fernandez-Miranda, Juan C., Zada, Gabriel, Benjamin, Carolina , Catalino, Michael Paul, Mamelak, Adam N, Furlan, André Beer, Zenonos, Georgios, Mendoza, Michelle Magana, Little, Andrew S, Gompel, Jamie J., Karsy, Michael , Palit, Sandhya R. , Shinya, Yuki , Karsy, Michael , Evans, James J., Chicoine, Michael , Kim, Albert H , Patel, Bhuvic , Kim, Won Bae , Gardner, Paul, Mukherjee, Debraj , Liu, C P, Blackburn, Spiros , Kshettry, Varun R. , Rennert, Robert C , Couldwell, William T. , Morshed, Ramin A. , Barkhoudarian, Garni , Fernandez‐Miranda, Juan C. , Zada, Gabriel , BENJAMIN, CAROLINA, Mamelak, Adam N. , Zenonos, Georgios A. , Little, Andrew S. , Gompel, Jamie J. Van
No container title available | April 7, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Purpose: This multicenter, multi-surgeon retrospective study aimed to identify risk factors for postoperative cerebrospinal fluid (CSF) leak following endonasal resection of craniopharyngioma, while evaluating the "perception gap" through a surgeon survey. Methods: A retrospective review was conducted on 416 patients who underwent endoscopic transsphenoidal surgery (ETS) for craniopharyngioma from 20 institutions. Factors were compared between patients with and without postoperative CSF leak, and between Early (2007-2015) and Late (2016-2025) Epochs. Complementing the clinical data, a survey of 19 neurosurgeons captured expert perspectives on risk stratification and management strategies. Results: Overall postoperative CSF leak rate was 13.5% (56/416 patients). Univariate analysis identified predominantly cystic tumors (34% vs. 21%, p = 0.034)and intraoperative lumbar drain (LD) use ( p < 0.028) as associated with postoperative CSF leak. BMI ( p = 0.587), prior surgery ( p = 0.576), and tumor size ( p = 0.363) were not significant. In the multivariable analysis, LD use was associated with a higher postoperative CSF leak rate (OR 1.91, 95% CI 1.06–3.46; p = 0.030). Between Epochs, nasoseptal flap (NSF) utilization increased from 70.7% to 87.6% ( p <0.001). NSF was protective (OR 0.28, 95% CI 0.07–0.92; p = 0.037) in the Early Epoch; no factors were significant in the Late Epoch. The surgeons’ survey identified prior surgery and intraoperative high flow leaks as primary risks; however, their LD protocols diverged from clinical data. Conclusion: Despite increased use of NSF, CSF leak persists. The study highlights a significant divergence between expert perception and clinical data regarding lumbar drains.
Differential Presentation and Outcomes in Micro versus Macro Pituitary Adenomas in Cushing's Disease: A Multicenter Retrospective Analysis from the Rapid Registry
Hallak, Hana , Wang, Jing, Little, Andrew S., Yuen, Kevin C., Mamelak, Adam N, Evans, J. J., Gompel, Jamie J. Van, Benjamin, Carolina , Pacione, Donato , Wu, Kyle C., Barkhoudarian, Garni, Fernandez‐Miranda, Juan C. , Kim, Won, Gardner, Paul A., Zenonos, Georgios A., Abdullah, Hussein, Zada, Gabriel, Rennert, Robert C., Couldwell, William T., Catalino, Michael P. , Kshettry, V., Zwagerman, Nathan T. , Cheok, Stephanie , Blackburn, Spiros L., Mukherjee, Debraj, Beer-Furlan, Andre, Suryadevara, Carter M. , Bergsneider, M S, Karsy, Michael, Chicoine, Michael, Kim, Albert, Silverstein, Julie M., Patel, Bhuvic , Little, Andrew S. , Gompel, Jamie J. Van , Barkhoudarian, Garni , Zenonos, Georgios A. , Zada, Gabriel , Rennert, Robert C , Couldwell, William T. , Kshettry, Varun R. , Morshed, Ramin A. , Mukherjee, Debraj , Beer‐Furlan, André , Bergsneider, Marvin , Karsy, Michael , Chicoine, Michael , Silverstein, Julie
Journal of Neurological Surgery Part B: Skull Base | February 27, 2026 | Volume: 87 | Issue: No issue available | Pages: No page available
T2-Weighted-Fluid-Attenuated Inversion Recovery Hyperintensity on Magnetic Resonance Imaging Is Associated With Aggressive Symptoms in Patients With Dural Arteriovenous Fistulas
Patel, Bhuvic , Collins, Heather , Derdeyn, Colin P. , Zipfel, Gregory J. , Petr, Ondra, Chatterjee, Arindam R , Petr, Ondra , Lanzino, Giuseppe , Derdeyn, Colin P
Stroke | August 14, 2019 | Volume: 50 | Issue: 9 | Pages: 2565-2567
Background and Purpose— Several angiographic factors of dural arteriovenous fistulas (dAVFs) are associated with aggressive presentation and poor natural history. We examined the association of magnetic resonance imaging T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) hyperintensity with aggressive presentation. Methods— A cohort of dAVF patients from 2 centers was retrospectively examined. T2/FLAIR hyperintensity was determined by blinded, de-identified review and compared with angiographic grade and presenting symptoms. Results— T2/FLAIR hyperintensity was only identified in dAVF patients with cortical venous drainage (CVD). Among patients with CVD, those with T2/FLAIR hyperintensity were more likely to present with aggressive symptoms (20/23, 87.0%) than those without (6/21, 28.5%), P <0.001. All cured dAVFs with symptom resolution and available post-treatment imaging had resolution of T2/FLAIR hyperintensity. Conclusions— T2/FLAIR hyperintensity strongly correlates with aggressive presentation and CVD in dAVF patients, and may identify a subset that would benefit from early treatment.