Ryan P. Lee

Ryan P. Lee
Johns Hopkins Medicine | JHUSOM · Department of Neurosurgery

MD
Neurosurgery Resident

About

51
Publications
5,479
Reads
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2,082
Citations
Introduction
Current resident in neurosurgery at the Johns Hopkins Hospital. Clinical and academic interests are in neuro-vascular disease, CSF disorders, and neuro-oncology.
Additional affiliations
June 2012 - August 2013
St. Jude Children's Research Hospital
Position
  • Research Tech
Education
July 2013 - June 2017
July 2009 - May 2012
Vanderbilt University
Field of study
  • Neuroscience

Publications

Publications (51)
Chapter
Severe, sudden onset headache has a varied differential diagnosis. Several etiologies with this presentation require swift workup and targeted management to prevent morbidity or mortality. Aneurysmal subarachnoid hemorrhage (SAH) is one such pathology that must be identified and treated quickly. In this chapter, a patient with severe, sudden onset...
Article
Objective: Screening for cervical spine injury (CSI) after blunt trauma is common, but there remains varied practice patterns and clinical uncertainty regarding adequate radiographic evaluation. An oft-cited downside of MRI is the added risk compared to CT in the pediatric population; however, these specific risks have not yet been reported. This...
Article
OBJECTIVE In microvascular decompression (MVD) surgery through the retrosigmoid approach, the surgeon may have to sacrifice the superior petrosal vein (SPV). However, this is a controversial maneuver. To date, high-level evidence comparing the operative outcomes of patients who underwent MVD with and without SPV sacrifice is lacking. Therefore, thi...
Article
Full-text available
The immune response to ischemic stroke is an area of study that is at the forefront of stroke research and presents promising new avenues for treatment development. Upon cerebral vessel occlusion, the innate immune system is activated by danger-associated molecular signals from stressed and dying neurons. Microglia, an immune cell population within...
Chapter
Improved treatments for hydrocephalus have increased survival into adulthood. As neurosurgeons treat more patients with “transitional hydrocephalus,” understanding the cerebrospinal fluid (CSF) system becomes more relevant. The ventricles, cisterns, subarachnoid space, periarterial and foraminal passages, interstitial fluid space, and lymphatic ves...
Article
Background: Several East Asian studies have examined the role of revascularization in the context of hemorrhagic moyamoya disease (MMD) and found a decrease in postoperative rehemorrhage rates. To date, no data exist comparing revascularization with conservative management in North American patients with hemorrhagic MMD. Objective: To compare th...
Article
Introduction: Despite folate supplementation, neural tube defects (NTDs) still occur in 0.5-1.0/1,000 pregnancies, with 30-50% not preventable with folate. Twinning has increased due to artificial fertilization and in itself predisposes to NTDs at a rate of 1.6/1,000. The contributions of genetic and environmental factors to myelomeningocele devel...
Article
The lateral orbitotomy approach (LOA) was first described by Kronlein in 1888 and has since been subject to many modifications and variations. When considering orbital approaches, the location of the pathology is often more important in decision making than the type of pathology. The LOA is best suited for access to intraconal and extraconal lesion...
Article
Full-text available
Background Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include t...
Article
Full-text available
Since the initial characterization of a novel coronavirus in December 2019 (COVID-19), the globe has been gripped by a disruptive and dangerous pandemic that continues to upheave economies and test the limits of health care system capacities. The pandemic’s effect on neurosurgical practice has been detailed in timely editorials highlighting various...
Article
Objective: Coronavirus disease 2019 (COVID-19) is a disruptive pandemic that has continued to test the limits of health care system capacities. It is important to highlight the specific challenges facing US neurosurgery during these difficult circumstances. In the present study, we have described our neurosurgery department's unique experience dur...
Chapter
Most neurosurgical emergencies involve either diversion of cerebrospinal fluid, control of intracranial pressure, or decompression of brain parenchyma and cranial nerves. The goal of these interventions is to reverse or prevent progression of damage to neural structures. The pathologies that require emergent neurosurgical treatment can develop acut...
Chapter
Most neurosurgical emergencies involve either diversion of cerebrospinal fluid, control of intracranial pressure, or decompression of brain parenchyma and cranial nerves. The goal of these interventions is to reverse or prevent progression of damage to neural structures. The pathologies that require emergent neurosurgical treatment can develop acut...
Article
Objective: Many medical students find neurosurgery interesting, but few pursue it as a career. Reasons for this mismatch include lack of exposure and poor perceptions of its career demands, work-life balance, personalities, and patient outcomes. It is imperative to recruit promising students early in medical school in order to build a pipeline of...
Article
Full-text available
Purpose The liver is the most common site of uveal melanoma (UM) metastasis with approximately 50% of UM patients being affected. With no proven therapies that mitigate metastases the mortality rate is 85% within the first year after detection of the liver disease. In this study, we provide a mechanistic understanding of the de-regulation of the TP...
Article
Background: Incontrovertible predictors of shunt malfunction remain elusive. Objective: To determine predictors of shunt failure within 30 d of index surgery. Methods: This was a single-center retrospective cohort study from January 2010 through November 2016. Using a ventricular shunt surgery research database, clinical and procedural variabl...
Article
OBJECTIVE The objective of this study was to analyze the publication output of postgraduate pediatric neurosurgery fellows for a 10-year period as well as identify 25 individual highly productive pediatric neurosurgeons. The correlation between academic productivity and the site of fellowship training was studied. METHODS Programs certified by the...
Article
Full-text available
Of nine ependymoma molecular groups detected by DNA methylation profiling, the posterior fossa type A (PFA) is most prevalent. We used DNA methylation profiling to look for further molecular heterogeneity among 675 PFA ependymomas. Two major subgroups, PFA-1 and PFA-2, and nine minor subtypes were discovered. Transcriptome profiling suggested a dis...
Article
OBJECTIVE There has been an increasing interest in the quantitative analysis of publishing within the field of neurosurgery at the individual, group, and institutional levels. The authors present an updated analysis of accredited pediatric neurosurgery training programs. METHODS All 28 Accreditation Council for Pediatric Neurosurgery Fellowship pr...
Article
Full-text available
Object Primary closure of posterior fossa dura can be challenging, and postoperative cerebrospinal fluid (CSF) leaks continue to represent a common complication of the retrosigmoid approach. We describe a simple technique to allow for primary closure of the dura following retrosigmoid approaches. The incidence of CSF leaks using this method is repo...
Article
Background: Shunt infections remain a significant challenge in pediatric neurosurgery. Numerous surgical checklists have been introduced to reduce infection rates. Objective: To introduce an evidence-based shunt surgery checklist and its impact on our shunt infection rate. Methods: Between January 1, 2008 and December 31, 2015, pediatric patie...
Article
OBJECTIVE Thalamopeduncular tumors are a group of pediatric low-grade gliomas that arise at the interface of the thalamus and brainstem peduncle. They typically occur within the first 2 decades of life, presenting with progressive spastic hemiparesis. Treatment strategies, including surgical intervention, have varied significantly. The authors pres...
Article
Full-text available
Background: Retinoblastoma (Rb) is the most common primary intraocular tumor in children. Local treatment of the intraocular disease is usually effective if diagnosed early; however advanced Rb can metastasize through routes that involve invasion of the choroid, sclera and optic nerve or more broadly via the ocular vasculature. Metastatic Rb patien...
Chapter
Radiation therapy is a critical component in the treatment of children with central nervous system tumors. As the use of this modality continues to increase in complexity and sophistication, it is imperative for the neurosurgeon to understand the additional challenges that the use of radiotherapy may pose in both surgical and nonsurgical management...
Article
Full-text available
INTRODUCTION Our ability to predict brain metastasis in melanoma is poor. Gene expression profiling (GEP) of tumor samples could provide prognostic information by identifying genes that are differentially expressed between melanoma patients who do and do not develop metastasis. Since primary tumor is not always available for molecular testing, we s...
Article
Background: We recently performed a comprehensive bibliometric analysis of 103 US neurosurgical departments and found the ih(5)-index as meaningful and reproducible using public data. The present report expands this analysis by adding 14 Canadian and 1 additional US program. Methods: Departments were included if listed on the American Associatio...
Article
Full-text available
Low-grade neuroepithelial tumors (LGNTs) are diverse CNS tumors presenting in children and young adults, often with a history of epilepsy. While the genetic profiles of common LGNTs, such as the pilocytic astrocytoma and ‘adult-type’ diffuse gliomas, are largely established, those of uncommon LGNTs remain to be defined. In this study, we have used...
Article
Full-text available
Type 2 diabetes is commonly characterized by insulin deficiency and decreased sensitivity of insulin receptors, leading to a chronic state of hyperglycemia in individuals. Disease progression induces changes in the immune profile that engenders a chronic inflammatory condition. Thiazolidinedione (TDZ) drugs, such as Pioglitazone (Pio), aid in contr...
Conference Paper
Purpose: Purpose: Approximately 50% of Uveal Melanoma (UM) patients will be diagnosed with liver metastases within 5-years of diagnosis. Micro-metastases are present in the liver as early as 2-years before diagnosis of the intraocular malignancy. Recent work from our laboratory suggests that inhibiting the upregulation of cytoskeletal signaling cou...
Article
Full-text available
Members of the nuclear factor-kappaB (NF-kappaB) family of transcriptional regulators are central mediators of the cellular inflammatory response. Although constitutive NF-kappaB signalling is present in most human tumours, mutations in pathway members are rare, complicating efforts to understand and block aberrant NF-kappaB activity in cancer. Her...
Article
BACKGROUND: The nuclear factor-kB (NF-kB) family of transcriptional regulators are central mediators of the cellular inflammatory response. Although constitutive NF-kB signaling is present in most human tumours, mutations in pathway members are rare, complicating efforts to understand and block aberrant NF-kB activity in cancer. METHODS: To identif...
Article
Full-text available
Members of the nuclear factor-[kgr]B (NF-[kgr]B) family of transcriptional regulators are central mediators of the cellular inflammatory response. Although constitutive NF-[kgr]B signalling is present in most human tumours, mutations in pathway members are rare, complicating efforts to understand and block aberrant NF-[kgr]B activity in cancer. Her...
Article
A few case series in adults have described the characteristics of epithelioid glioblastoma (e-GB), one of the rarest variants of this cancer. We evaluated clinical, radiological, histological, and molecular characteristics in the largest series to date of paediatric e-GB. Review of clinical characteristics and therapy, imaging studies, and histolog...
Data
Full-text available
The most common pediatric brain tumors are low-grade gliomas (LGGs). We used whole-genome sequencing to identify multiple new genetic alterations involving BRAF, RAF1, FGFR1, MYB, MYBL1 and genes with histone-related functions, including H3F3A and ATRX, in 39 LGGs and low-grade glioneuronal tumors (LGGNTs). Only a single non-silent somatic alterati...
Article
Full-text available
LGGs arise most frequently in children and young adults and are the most common pediatric central nervous system (CNS) neoplasms 1–3 . Although LGGs grow slowly, those that cannot be surgically resected cause considerable morbidity and premature death. Current adjuvant therapies with irradiation and pharmaceuticals extend survival but contribute to...

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Projects (4)
Project
Updated contemporary bibliometric analysis and ranking of all US and Canadian neurosurgery departments with residency training programs
Project
Analyzing outcomes of transtemporal approach for gross total resection, and potential implications of molecular genetic profiles