Anil Mahavadi's research while affiliated with University of Alabama at Birmingham and other places

Publications (27)

Article
Background: While general anesthesia (GA) is the most commonly used anesthetic method during lumbar microendoscopic discectomy (MED), local ± epidural anesthesia (LA) has been gaining popularity as an alternate method. Theoretical advantages of LA include reduced morbidity of anesthesia and improved surgeon-patient communication facilitating less n...
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OBJECTIVE Supramaximal resection (SMR) has arisen as a possible surrogate to gross-total resection (GTR) to improve survival in newly diagnosed glioblastoma (nGBM). However, SMR has traditionally been limited to noneloquent regions and its feasibility in eloquent nGBM remains unclear. The authors conducted a retrospective multivariate propensity-ma...
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OBJECTIVE Carotid webs (CWs) are an increasingly recognized source of recurrent stroke among young patients without conventional vascular risk factors. There have been no previous studies demonstrating that specific web morphological characteristics correlate with a higher stroke risk. The authors aim to report distinct morphological features of sy...
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Background Anterior capsulotomy is a well-established treatment for refractory obsessive–compulsive disorder (OCD). MRI-guided laser interstitial thermal therapy (LITT) allows creation of large, sharply demarcated lesions with the safeguard of real-time imaging. Objective To characterise the outcomes of laser anterior capsulotomy, including radiog...
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Background: Minimizing time-to-external ventricular drain (EVD) placement in the emergency department (ED) is critical. We sought to understand factors affecting time-to-EVD placement through a quality improvement initiative. Methods: The use of process mapping, root cause analyses, and interviews with staff revealed decentralized supply storage...
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Objective Sellar xanthogranulomas (XGAs) are a rare pathological subtype of hypophysitis reflecting a degenerative process of Rathke's cleft cyst with predilection in young adults. While the histological features have been described, there is limited discussion on the technical expectations in surgical management. We present the clinical, radiograp...
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Glioblastoma multiforme (GBM) represents one of the most challenging malignancies due to many factors including invasiveness, heterogeneity, and an immunosuppressive microenvironment. Current treatment modalities have resulted in only modest effect on outcomes. The development of viral vectors for oncolytic immunovirotherapy and targeted drug deliv...
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Background Rathke’s cleft cysts (RCCs) are benign, typically asymptomatic sellar lesions found incidentally in adults, with a dramatically lower incidence in pediatric patients (<18 years). We present a case of RCC with xanthogranulomatous change (XGC) – an even less common subtype of RCC – treated by endoscopic endonasal surgical resection. This i...
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PurposeExtent of resection remains a paramount prognostic factor for long-term outcomes for glioblastoma. As such, supramaximal resection or anatomic lobectomy have been offered for non-eloquent glioblastoma in an attempt to improve overall survival. Here, we conduct a propensity-matched analysis of patients with non-eloquent glioblastoma who under...
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Background Rosette-forming glioneuronal tumors (RGNT) are slow-growing WHO Grade I tumors that are characterized by mixed histology and rosette formation. Although typically located in the posterior fossa, these tumors can rarely originate elsewhere. Here, we describe the fourth case in literature where an RGNT was localized to the lateral ventricl...
Article
Background Deep Brain Stimulation (DBS) of the ventral intermediate nucleus (VIM) or caudal Zona Incerta (cZI) is effective for refractory essential tremor (ET). To refine stereotactic planning for lead placement, we developed a unique individualized anatomy-based planning protocol that targets both the VIM and the cZI in patients with ET. Methods...
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Traumatic brain injury (TBI) is a major public health concern. TBI has two phases: a primary injury due to direct damage from a mechanical force applied to the head and a secondary injury due to cellular and molecular responses to the injury. Despite its significant burden on societies, decades of clinical trials have not yielded any FDA‐approved t...
Article
Background: Central Neurocytomas (CNCs) are rare intraventricular lesions comprising <1% of primary brain tumors. As such, their surgical and adjuvant management is unclear. Objective: Our goal was to update Rades et al.'s 2006 systematic review to assess the outcome differences between three fundamental therapies for CNC: Gross Total Resection...
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Purpose Reducing the time from surgery to adjuvant chemoradiation, by decreasing unnecessary readmissions, is paramount for patients undergoing glioma surgery. The effects of intraoperative risk factors on 30-day readmission rates for such patients is currently unclear. We utilized a predictive model-driven approach to assess the impact of intraope...
Article
Study objective: We consider the effect of the number of previous interactions between the anesthesia provider and a single neurosurgeon during neurosurgical procedures ("familiarity") and occurrence of an interval ≥15 min from the end of surgery (i.e., dressings applied) to tracheal extubation ("prolonged extubation") during subsequent glioma pro...
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Background: Penetrating traumatic brain injury (PTBI) induced chronic inflammation that drives persistent tissue loss long after injury. Absence of endogenous reparative neurogenesis and effective neuroprotective therapies render injury-induced disability an unmet need. Cell replacement via neural stem cell transplantation could potentially rebuil...
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INTRODUCTION Selective intra-arterial delivery of chemotherapy (IAC) via microcatheter infusion into the ophthalmic artery has become an increasingly popular treatment modality to accomplish globe salvage in children with retinoblastoma. While previously limited to highly specialized centers, interest in and popularity of this treatment are growing...
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INTRODUCTION Laser interstitial thermal therapy (LITT) yields precise lesions under magnetic resonance imaging (MRI) thermometry guidance and is revolutionizing brain tumor management. However, one limitation is the inability to preoperatively predict how tumors will respond to thermal energy. Our study assessed whether preoperative variables corre...
Article
INTRODUCTION Current neurosurgical treatment of refractory severe Obsessive Compulsive Disorder either using radiosurgery, deep brain stimulation or lately focused ultrasound results in moderate and/or delayed responses. We describe the first case series in the literature applying high energy interstitial laser ablation (LITT) to successfully treat...
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Full-text available
Introduction Laser interstitial thermal therapy (LITT) is a novel MR thermometry-guided thermoablative tool revolutionizing the clinical management of brain tumors. A limitation of LITT is our inability to estimate a priori how tissues will respond to thermal energy, which hinders treatment planning and delivery. The aim of this study was to determ...
Article
Background The incidence of symptomatic radiation necrosis (RN) has risen as radiotherapy is increasingly used to control brain tumor progression. Traditionally managed with steroids, symptomatic RN can remain refractory to medical treatment, requiring surgical intervention for control. The purpose of our study was to assess a single institution’s...
Article
Background Laser Interstitial Thermal Therapy (LITT) presents an important new minimally invasive tool in the management of drug resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. Objective To evaluate the post-surgical seizure outcome following LITT after a...
Article
Full-text available
Traumatic brain injury (TBI) is the largest cause of death and disability of persons under 45 years old, worldwide. Independent of the distribution, outcomes such as disability are associated with huge societal costs. The heterogeneity of TBI and its complicated biological response have helped clarify the limitations of current pharmacological appr...

Citations

... primary central nervous system lymphoma [2]) to supramaximal resections (e.g. diffuse gliomas [3]). A major obstacle to the precision care of brain tumor patients is that the pathologic diagnosis is usually unknown at the time of surgery. ...
... Patients prior to January 2018 were excluded because we launched a centralized EVD supply cart in January 2018 and, therefore, sought to eliminate this as a confounder in our analysis. 11 For the intervention group, for which an EVD alert protocol was initiated, data were collected for patients who underwent EVD placement from December 2019 to April 2021. Patients were excluded if EVD placement was delayed due to causes unrelated to the standard EVD placement protocol, including delays due to the administration of blood products or a delay in the decision to place the EVD. ...
... These present and behave much like gliomas in humans with similar radiographic, histopathologic, and genetic features. In the dog, high-grade oligodendrogliomas have been shown to be more similar to human glioblastoma multiforme than to human high-grade oligodendroglioma, typically lacking the favorable IDH mutation and 1p19q co-deletion [20] . They also respond to therapies much like their human counterparts [20] . ...
... Extent of resection is a well-documented prognosticator for both primary and secondary malignant brain tumors. [1][2][3][4][5][6][7] Recent technological advances such as intraoperative neuronavigation and brain mapping have facilitated maximum safe resection of brain tumors while preserving neurological function. 8,9 Although intraoperative neuronavigation is one of the most extensively used neurosurgical tools, its reliance on preoperative imaging remains a major limitation because intraoperative brain shift degrades accuracy and precision. ...
... and preliminary evidence indicates improved control of tremor with cZI/PSA compared with VIM DBS [126]. In a more recent study, the implant target was implemented to traverse both VIM and cZI, and monopolar review predicated on the Bain and Findley Clinical Tremor Rating Scale was used to identify the optimal contact [133]. From this single center study, following reconstruction of 45 active contacts, 71% (n = 32) were localized above the inferior border of VIM and 29% (n = 13) were located below (i.e., putative cZI/PSA). ...
... The mainstay treatment of CN is a total resection which can be performed directly via transcortical, transcallosal, or via endoscopic neurosurgery [24,25]. Total resection was achieved only in 30-50% of the cases [2,8,13] probably due to the tumor vascularity and its adherence to nearby structures [2]. ...
... p < 0.0001). Another study also found prolonged tracheal extubation if there are less than five previous interactions between the anesthesia team and primary surgeon [11]. One possible reason for the observed prolonged time increase is that different surgeons typically use different instrumentation and set up thus requiring more [12]. ...
... With the continuous development of medical technology, the treatment of glioma is improving. Surgical resection continues to be the principal treatment for glioma, but is only applicable in patients with early-stage glioma (4,5). The tumors of patients with early-stage gliomas are small, well-defined and easily removed surgically (4,5). ...
... Thus, reconstructing the injured neuron circuit through grafting neural stem cells (NSCs) has been considered aa a promising cell therapy for TBI [8,9]. In a rodent TBI model, NSC transplantation has shown an improvement of cognitive and motor functions [10][11][12]. Recent studies also applied various growth factors, e.g., BDNF, GDNF, and bFGF, to promote the viability of grafted NSCs under TBI conditions [13][14][15]. ...
... Prior analysis of the first four cases in this series revealed strong relationships between ablation volume, energy deposition and Y-BOCS change. 24 This finding led to the use of large ablation volumes in subsequent cases. While the correlation between ablation volume and clinical improvement persisted, no relationship between energy deposition and outcome was observed. ...