Nathan A. Shlobin

• Doctor of Medicine
• Columbia University

Abstract INTRODUCTION: Traumatic brain injury (TBI) can lead to various clinical manifestations and long-term consequences. Second impact syndrome (SIS) has gained attention due to its acute and chronic symptoms. Post-traumatic headache (PTH) is a common symptom of SIS, and inflammatory mediators have been implicated in secondary brain damage. How...

Summary Background Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021. Methods Using well established Global Burden of Diseases, Injuries, and Risk Facto...

Supplement to: GBD Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Public Health 2025; published online Feb 24. https://doi.org/10.1016/ S2468-2667(24)00302-5

Supplement to: GBD Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Public Health 2025; published online Feb 24. https://doi.org/10.1016/ S2468-2667(24)00302-5

Importance The integration of palliative care in neurology, or neuropalliative care, is an emerging area of practice focused on holistically improving quality of life and reducing the burden of suffering for people living with serious neurologic disease and their care partners. Major neurology and palliative care societies have recognized the need...

Background and objectives: People with epilepsy are at risk of cardiac arrhythmias. Whether this association results from epilepsy, antiseizure medications (ASMs) such as sodium channel blockers (NABs), or other factors has not been systematically assessed. The aims of this study were to quantify the odds of cardiac conduction delays (CCDs) on ele...

Background The expanding repertoire of studies generating genome-scale omic datasets from glioma samples provides a generational opportunity to uncover mechanisms driving aggressive biology and develop new treatments. However, ensuring such studies reflect the breadth of racial groups and ethnicities affected by gliomas is critical to support equit...

Background and objectives: There is a paucity of data directly comparing the outcome of surgical techniques available for the treatment of hypothalamic hamartomas (HHs). This study aims to evaluate the safety and efficacy of commonly used surgical approaches in the treatment of HH-related epilepsy. Methods: A systematic review and individual par...

Many neurosurgical conditions are incurable, leading to disability or severe symptoms, poor quality of life, and distress for patients and families. The field of neuropalliative care addresses palliative care needs of individuals living with neurological conditions. Neurosurgeons play an important role in neuropalliative care due to neurosurgeons’...

BACKGROUND AND OBJECTIVES The most common treatment of hydrocephalus is ventriculoperitoneal (VP) shunting. Peritoneal access is commonly conducted through an open laparotomy, but laparoscopic peritoneal access is gaining popularity. Many studies have reported the benefits of minimally invasive laparoscopic peritoneal access, but there is no consen...

People with epilepsy are at risk of premature death, of which sudden unexpected death in epilepsy (SUDEP), sudden cardiac death (SCD) and sudden arrhythmic death syndrome (SADS) are the primary, partly overlapping, clinical scenarios. We discuss the epidemiologies, risk factors and pathophysiological mechanisms for these sudden death events. We rev...

Importance How epilepsy may promote cardiovascular disease remains poorly understood. Objective To estimate the odds of new-onset cardiovascular events (CVEs) over 6 years in older people with vs without epilepsy, exploring how enzyme-inducing antiseizure medications (EIASMs) and traditional cardiovascular risk factors mediate these odds. Design,...

Purpose To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years. Methods Baseline characteristics were collected from eight centers. Based on the patients’ preoperative status and comorbidit...

Advocacy, one of the five domains of global neurosurgery, represents a powerful avenue to influence public policy to expand access to safe, timely, and affordable neurosurgical care. In this manuscript, we characterize advocacy in global neurosurgery, describe specific neurosurgeon-led initiatives, and delineate how neurosurgeons can become involve...

The future of global neurosurgery should focus on addressing the unmet neurosurgical need from a health system approach should we hope to achieve sustainable and ethical change. In this article, we review the global building blocks, as defined by the World Health Organization, and use this framework to propose strategies to strengthen neurosurgical...

Since the release of the Lancet Commission on Global Surgery report in 2015, there has been an increase in the number of published papers on global neurosurgery, gaining widespread support from major neurosurgery journals. However, there remains no consensus on what may be considered part of global neurosurgery literature. Here, we propose that glo...

Education and training are essential components of global neurosurgery because they provide a sustainable solution to address the workforce deficits in the neurosurgical burden of disease. Neurosurgery training programs and opportunities exist in most areas of the world, but some countries still lack formal mechanisms to train future generations. I...

In the following article, we define the practice of global neurosurgery and review the major historical events defining this movement within the larger context of global surgery. The current state of the neurosurgical workforce, disease burden, and ongoing collaborative efforts are highlighted. Ethical practice leading the sustainability is discuss...

OBJECTIVE Patients with spina bifida (SB) were historically followed by pediatric providers throughout their entire lives. Through medical and surgical advancements, now more pediatric SB patients are living well into adulthood. Nonetheless, many patients fail to successfully transition to appropriate adult healthcare providers. The goal of this st...

Background Large vessel occlusions (LVO) are a common etiology of morbidity and mortality. The current literature lacks a synthesis of the landscape and trends in research. Objective We aimed to conduct a bibliometric analysis of the 100 most cited original articles on LVOs to assess the current state of research. Methods Scopus database was quer...

OBJECTIVE Concussions can occur at any level of ice hockey. Incidence estimates of concussions in ice hockey vary, and optimal prevention strategies and return-to-play (RTP) considerations have remained in evolution. The authors performed a mixed-methods study with the aim of elucidating the landscape of concussion in ice hockey and catalyzing init...

BACKGROUND AND OBJECTIVES Pediatric spine surgery has evolved considerably over the past century. No previous study conducted a bibliometric analysis of the corpus of pediatric spine surgery. We used big data and advanced bibliometric analyses to evaluate trends in the progression of pediatric spine surgery as a distinct field since the beginning o...

OBJECTIVE Spasticity is a challenging feature of cerebral palsy (CP) that may be managed with selective dorsal rhizotomy (SDR). Although standard work tools (SWTs) have recently been utilized to inform a standard of care for neurosurgical procedures, no SWTs for SDR have been previously described. The authors present the multidisciplinary approach...

INTRODUCTION: Invasive neuromodulation (IN), including deep brain stimulation, vagus nerve stimulation, responsive neurostimulation, and spinal cord stimulation, is an increasingly important neurosurgical modality. The state of literature on invasive neuromodulation is unknown. METHODS: Bibliometric analysis via the Scopus database. A search string...

INTRODUCTION: Deep brain stimulation (DBS) has been increasingly used to treat epilepsy. Clinical trials are currently underway to uncover novel targets and approaches for DBS for epilepsy. METHODS: ClinicalTrials.gov was queried in December 2023 with "Epilepsy", "Epilepsies", and "Epileptic" for the condition/disease and "Deep brain stimulation" f...

Background Refractory (RSE) and super-refractory status epilepticus (SRSE) are serious neurological conditions requiring aggressive management. Beyond anesthetic agents, there is a lack of evidence guiding management in these patients. This systematic review and individual participant data meta-analysis (IPDMA) seeks to evaluate and compare the cur...

OBJECTIVE A minority of pediatric patients who may benefit from epilepsy surgery receive it. The reasons for this utilization gap are complex and not completely understood. Patient and caregiver social determinants of health (SDOH) may impact which patients undergo surgery and when. The authors conducted a systematic review examining SDOH and surgi...

INTRODUCTION Odontoid fractures disproportionately affect older patients who have high surgical risk, but also high rates of fracture nonunion. METHODS We examined all patients with isolated odontoid fractures treated nonoperatively at our institution between 2010 and 2020. Multivariable regression and propensity score matching were used to quanti...

INTRODUCTION Most surgical journals are published in English, representing a challenge for individuals from non-Anglophone countries and contributing to disparities in research globally. METHODS The GCP was advertised via the journal website and social media. Applicants were selected to be a reviewer for the GCP if they demonstrated English profic...

Purpose of Review To care for patients with cerebrovascular disease (CVD), neurointerventionalists, intensivists, and other healthcare providers must be equipped to address associated ethical challenges. This review aims to delineate the applicability of fundamental bioethical approaches to CVD, highlight key ethical issues in CVD care, and delinea...

Objective Metastatic spinal tumors represent a rare but concerning complication of primary thyroid carcinoma. We identified demographics, metastatic features, outcomes, and treatment strategies for these tumors in our institutional cohort. Materials and Methods We retrospectively reviewed patients surgically treated for spinal metastases of primar...

Introduction Atlas fractures often accompany traumatic dens fractures, but existing literature on the management of simultaneous atlantoaxial fractures is limited. Methods We examined all patients with traumatic dens fractures at our institution between 2008 and 2018. We used multivariable logistic regression and ordinal logistic regression to ide...

Objective Craniopharyngiomas (CP) are rare brain tumors that often result in visual impairment due to their proximity to the optic pathway. The optimal management approach to preserve visual function in these patients remains controversial. We sought to investigate visual outcomes of children with craniopharyngiomas based on treatment modality. Me...

Study design: Scoping Review. Objective: The objective of this study was to conduct a scoping review exploring the extent to which preference sensitivity has been studied in treatment decisions for LSS, utilizing shared decision making (SDM) as a proxy. Summary of background data: Preference-sensitive care involves situations where multiple tr...

Background The Russia-Ukraine war has undeniably impacted global science and healthcare in Ukraine. Many Ukrainian researchers have had their projects disrupted by this war, either due to loss of life, displacement, or destruction of resources. Despite these challenges, these researchers have sought to make their voices heard. This scoping review h...

BACKGROUND AND OBJECTIVES Hemimegalencephaly (HME) is a rare diffuse malformation of cortical development characterized by unihemispheric hypertrophy, drug-resistant epilepsy (DRE), hemiparesis, and developmental delay. Definitive treatment for HME-related DRE is hemispheric surgery through either anatomic (AH) or functional hemispherectomy (FH). T...

BACKGROUND Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas, Objective: To evaluate outcome of supratentorial meningioma patients aged ≥80 years. This multicenter study aims to report neurofunctional status after resectio...

Pass/fail (P/F) grading has emerged as an alternative to tiered clerkship grading. Systematically evaluating existing literature and surveying program directors (PD) perspectives on these consequential changes can guide educators in addressing inequalities in academia and students aiming to improve their residency applications. In our survey, a tot...

Background and Aims: Strokes affect almost 13 million new people each year and while the outcomes of stroke have improved over the past several decades in high income countries, the same cannot be seen in low-and lower-middle-income countries. Methods: A systematic review was completed with a search of three databases in accordance with PRISMA guid...

BACKGROUND AND OBJECTIVES Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas. This multicenter study aims to report neurofunctional status after resection of patients with supratentorial meningioma aged 80 years or older, t...

Background The Russia-Ukraine war has undeniably impacted global science and healthcare in Ukraine. Many Ukrainian researchers have had their projects disrupted by this war, either due to loss of life, displacement, or destruction of resources. Despite these challenges, these researchers have sought to make their voices heard. This scoping review h...

In this systematic review, we address the status of intracortical brain-computer interfaces (iBCIs) applied to the motor cortex to improve function in patients with impaired motor ability. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Guidelines for Systematic Reviews. Risk Of Bias In Non-r...

The Lancet Commission on Global Surgery (LCoGS) estimated that 5 billion people worldwide lack access to safe, timely, and affordable surgical, obstetric, and anesthesia care. Bidirectional partnerships between institutions in high-income (HICs) and low- and middle-income countries (LMICs) have grown increasingly common. We sought to describe the c...

The antithesis between childhood cancer survival rates in low- and middle-income countries (LMIC) and high-income countries (HIC) represents one of healthcare’s most significant disparities. In HICs, the 5-year survival rate for children with cancer, including most brain tumors, exceeds 80%. Unfortunately, children in LMICs experience far worse out...

Purpose of Review Neurostimulation treatment options have become more commonly used for chronic pain conditions refractory to these options. In this review, we characterize current neurostimulation therapies for chronic pain conditions and provide an analysis of their effectiveness and clinical adoption. This manuscript will inform clinicians of tr...

OBJECTIVE Diffuse intrinsic pontine gliomas (DIPGs) are aggressive and malignant tumors of the brainstem. Stereotactic biopsy can obtain molecular and genetic information for diagnostic and potentially therapeutic purposes. However, there is no consensus on the safety of biopsy or effect on survival. The authors aimed to characterize neurological r...

Purpose The transition from pediatric to adult care can be complex and difficult to navigate for adolescents with cerebral palsy (CP). We aimed to assess the current state of transitional care for young persons with CP and delineate guidelines for best practice with opportunities for intervention. Methods A systematic review was conducted using PR...

Background Strokes affect almost 13 million new people each year and while the outcomes of stroke have improved over the past several decades in high income countries, the same cannot be seen in low- and lower-middle-income countries. Objective This is the first study to identify the availability of diagnostic tools along with the rates of stroke...

Background: Strokes affect almost 13 million new people each year and while the outcomes of stroke have improved over the past several decades in high income countries, the same cannot be seen in low- and lower-middle-income countries. Objective: This is the first study to identify the availability of diagnostic tools along with the rates of stroke...

The craniovertebral junction (CVJ) involves the atlas, axis, and occiput along with the atlanto-occipital and atlantoaxial joints. The anatomy and neural and vascular anatomy of the junction render the CVJ unique. Specialists treating disorders that affect the CVJ must appreciate its intricate anatomy and should be well versed in its biomechanics....

Objective: Traumatic spine injury (TSI) leads to significant morbidity and mortality in children. However, the global epidemiology of pediatric TSI is currently unknown. We conducted a systematic review and meta-analysis to estimate the global incidence of pediatric TSI and burden of cases. Methods: PubMed, Embase, and Scopus were searched for a...

Background: Moyamoya disease (MMD) is an occlusive arteriopathy leading to stroke. Progressive if left untreated, revascularization surgery has become the mainstay of treatment. Although clinical and radiographic outcomes of MMD after intervention are well-characterized, cognitive outcomes in pediatric patients remain unclear. We aimed to examine...

Background Hydrocephalus is a common pediatric neurosurgical pathology typically treated with a ventricular shunt, yet approximately 30% of patients experience shunt failure within the first year after surgery. Objective To validate a predictive model of pediatric shunt complications with data retrieved from the Healthcare Cost and Utilization Pro...

Objective: Odontoid fractures disproportionately affect older patients who have high surgical risk, but also high rates of fracture nonunion. To guide surgical decision-making, we quantified the effect of fracture morphology on nonunion among nonoperatively managed, traumatic, isolated odontoid fractures. Methods: We examined all patients with i...

Background: Existing literature suggests that surgical intervention for odontoid fractures is beneficial but often does not control for known confounding factors. Objective: To examine the effect of surgical fixation on myelopathy, fracture nonunion, and mortality after traumatic odontoid fractures. Methods: We analyzed all traumatic odontoid...

Magnetic resonance‐guided laser interstitial thermal therapy (MRgLITT) has emerged as a popular minimally invasive alternative to open resective surgery for drug‐resistant epilepsy (DRE). We sought to perform a systematic review and individual participant data meta‐analysis to identify independent predictors of seizure outcome and complications fol...

Introduction: War has influenced the evolution of global neurosurgery throughout the past century. Armed conflict and mass casualty disasters (MCDs), including Humanitarian Assistance Disaster Relief missions, require military surgeons to innovate to meet extreme demands. However, the military medical apparatus is seldom integrated into the civili...

Objective: Most surgical journals are published in English, representing a challenge for researchers from non-Anglophone countries. We describe the implementation, workflow, outcomes, and lessons learned from the World Neurosurgery Global Champions Program (GCP), a novel journal-specific English language editing program for articles rejected becau...

OBJECTIVE Delayed cerebral ischemia (DCI) associated with vasospasm is well described in the setting of aneurysmal subarachnoid hemorrhage (SAH). In addition, DCI is very infrequently encountered in patients who have undergone resection of a brain tumor with unclear pathophysiology. The occurrence of DCI in the pediatric population is exceedingly r...

Background: Asia has a marked shortage of neurosurgical care, with approximately 2.5 million critical cases left untreated. The Young Neurosurgeons Forum (YNF) of the World Federation of Neurosurgical Societies (WFNS) surveyed Asian neurosurgeons to identify the of research, education, and practice. Methods: A cross-sectional study using a pilot...

Background: Research is pivotal to neurosurgical training and practice. The objectives of this study were to quantify neurosurgical research output by authors from low-income countries (LICs), using author affiliation as a proxy, and to understand the patterns of collaboration between LIC authors and their international partners. Methods: PubMed...

Glutaric aciduria type 1 (GA1) is an autosomal recessive disease frequently leading to dystonia. Deep brain stimulation (DBS), intrathecal baclofen (ITB), and intraventricular baclofen (IVB) are the current interventional treatment options for refractory dystonia. We performed a scoping review, individual patient data (IPD) analysis, and clinical t...

When do we die and what happens in the brain when we die? The mystery around these questions has engaged mankind for centuries. Despite the challenges to obtain recordings of the dying brain, recent studies have contributed to better understand the processes occurring during the last moments of life. In this review, we summarize the literature on n...

Background: Barriers to neurosurgery training and practice in Latin American and Caribbean countries (LACs) have been scarcely documented. The World Federation of Neurosurgical Societies Young Neurosurgeons Forum (YNF) survey sought to identify young neurosurgeons' needs, roles, and challenges. We present the results focused on Latin America and t...

Open spina bifida (OSB) is a common neural tube defect. Medical and surgical care involves addressing the baseline orthopedic, urologic, and neurological dysfunction as well as the changes or declines that may occur as the patient ages. Given the complexity of this disease, coordinated, multidisciplinary care involving specialists in neurosurgery,...

The field of global surgery has gained attention since the publication of the Lancet Commission landmark report in 2015. The authors estimated that 5 billion people worldwide do not have access to safe, affordable surgical and anesthesia services. The paper “Global Neurosurgery: The Unmet Need,” published in 2016, launched the modern global neurosu...

In 2019, the World Federation of Neurosurgical Societies (WFNS) established an ad hoc Global Neurosurgery Committee (GNC) to coordinate its global efforts to promote equitable neurosurgical care. Medical students have been essential to the GNC since its first generation (“GNC 1.0”). We describe the integration of medical students in GNC 1.0 and pro...

Thank you for the opportunity to serve on this committee. It appears the WFNS has assembled an all-star cast of neurosurgeons interested in Global Neurosurgery. I am honored to serve as External Relations Lead. Listed below are a few examples of projects the group is working on that fit with your deliverables (specific, measurable, achievable, rele...

Objective: The onset of the COVID-19 pandemic dramatically reduced access to in-person educational activities in neurosurgery, necessitating different educational paradigms. Virtual learning, both live and on-demand, has become an essential educational paradigm in global neurosurgery in response to the pandemic. We discuss the different virtual lea...

The World Federation of Neurosurgical Societies (WFNS), the governing body for national and regional neurosurgical societies worldwide, established the ad hoc Global Neurosurgery Committee (GNC) in 2019. This international board of neurosurgeons collaborated virtually in pursuit of defined goals and targets related to neurosurgical equity. We summa...

Background: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC. Objective: To review the...

Background: Strokes affect almost 13 million new people each year and while the outcomes of stroke have improved over the past several decades in high income countries, the same cannot be seen in low- and lower-middle-income countries. Objective: This is the first study to identify the availability of diagnostic tools along with the rates of strok...

Introduction Strokes affects almost 13 million new people each year and while the outcomes of stroke have improved over the past several decades in high income countries, the same cannot be seen in low‐ and lower‐middle‐income countries. This is the first study to identify the availability of diagnostic tools along with the rates of stroke mortalit...

Background: Stereotactic body radiotherapy (SBRT) has been established as a safe and effective treatment modality for control of long-term pain and tumor growth. However, few studies have investigated the efficacy of postoperative SBRT versus conventional external beam radiation therapy (EBRT) in extending survival within the context of systemic t...