Grant Sinson

Medical College of Wisconsin

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Linda J. Bagley

University of Pennsylvania

Tracy K. McIntosh

University of Auckland

Eric L. Zager

University of Pennsylvania

Robert W. Hurst

Hospital of the University of Pennsylvania

Eugene S. Flamm

Montefiore Medical Center

Robert I. Grossman

New York University

Thomas A. Gennarelli

Medical College of Wisconsin

Julie Kolinski

Medical College of Wisconsin

Mokshal H. Porwal

Allegheny Health Network

Madhu Voddi

University of Pennsylvania

Cooperative Institutions

Medical College of Wisconsin

University of Pennsylvania

Neurological Surgery

Hospital of the University of Pennsylvania

Froedtert Hospital

Indiana University – Purdue University Indianapolis

Philadelphia University

Indiana University School of Medicine

Children's Hospital of Philadelphia

Harvard University

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Cavernous Malformations of the Third Ventricle

Neurosurgery (1995)

Grant Sinson Eric L. Zager Robert I. Grossman Thomas A. Gennarelli Eugene S. Flamm

CAVERNOUS MALFORMATIONS ARE uncommon lesions that are usually present in the cerebral hemispheres. Less frequently, these malformations are seen in the brain stem, basal ganglia, or paraventricular regions. We report four cases of cavernous malformations of the third ventricle. Patients presented with symptoms of hydrocephalus, memory loss, and signs of hypothalamic dysfunction. Magnetic resonance imaging and computed tomography provided characteristic images of the three lesions preoperatively. All patients underwent direct surgical excision of the malformations. Two patients had a transcallosal, transventricular approach, the third underwent a transcortical, transventricular approach, and the fourth had an infratentorial supracerebellar approach. Postoperatively, the patient with hypothalamic dysfunction has not improved and underwent ventriculoperitoneal shunting. The second patient did well initially; however, 8 days postoperatively, she became comatose and later died. The presumed cause of her deterioration was a hypothalamic venous infarction. The third and fourth patients have returned to their normal neurological baseline. The presenting signs and symptoms, magnetic resonance imaging and computed tomography findings, and treatment options for this rare lesion are discussed and illustrated.

Cavernous malformations

Lateral ventricles

10.1227/00006123-199507000-00005

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Citations (35)

Intracranial pressure monitoring

Operative Techniques in General Surgery (2003)

Kim L. Rickert Grant Sinson

Stroke

10.1016/s1524-153x(03)70010-4

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Citations (17)

Neuroprotective and behavioral efficacy of nerve growth factor—transfected hippocampal progenitor cell transplants after experimental traumatic brain injury

Journal of neurosurgery (2001)

Matthew F. Philips Gustav Mattiasson Tadeusz Wieloch Anders Björklund Barbro B. Johansson

Object. Immortalized neural progenitor cells derived from embryonic rat hippocampus (HiB5), were transduced ex vivo with the gene for mouse nerve growth factor (NGF) to secrete NGF (NGF-HiB5) at 2 ng/hr/10 5 cells in culture. Methods. Fifty-nine male Wistar rats weighing 300 to 370 g each were anesthetized with 60 mg/kg sodium pentobarbital and subjected to lateral fluid-percussion brain injury of moderate severity (2.3–2.4 atm, 34 rats) or sham injury (25 rats). At 24 hours postinjury, 2 µl (150,000 cells/µl) of [ 3 H]thymidine-labeled NGF-HiB5 cells were transplanted stereotactically into three individual sites in the cerebral cortex adjacent to the injury site (14 rats). Separate groups of brain-injured rats received nontransfected (naive [n])-HiB5 cells (12 animals) or cell suspension vehicle (eight animals). One week postinjury, animals underwent neurological evaluation for motor function and cognition (Morris water maze) and were killed for histological, autoradiographic, and immunocytochemical analysis. Viable HiB5 cell grafts were identified in all animals, together with reactive microglia and macrophages located throughout the periinjured parenchyma and grafts (OX-42 immunohistochemistry). Brain-injured animals transplanted with either NGF-HiB5 or n-HiB5 cells displayed significantly improved neuromotor function (p < 0.05) and spatial learning behavior (p < 0.005) compared with brain-injured animals receiving microinjections of vehicle alone. A significant reduction in hippocampal CA3 cell death was observed in brain-injured animals receiving transplants of NGF-HiB5 cells compared with those receiving n-HiB5 cells or vehicle (p < 0.025). Conclusions. This study demonstrates that immortalized neural stem cells that have been retrovirally transduced to produce NGF can markedly improve cognitive and neuromotor function and rescue hippocampal CA3 neurons when transplanted into the injured brain during the acute posttraumatic period.

10.3171/jns.2001.94.5.0765

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Citations (127)

Neuropsychological and perfusion MR imaging correlates of revascularization in a case of moyamoya syndrome.

PubMed (2006)

Anne Jefferson Guila Glosser John A. Detre Grant Sinson David S. Liebeskind

Serial neurocognitive and perfusion MR imaging findings are described in the perioperative course of a 48-year-old woman with a superficial temporal artery to middle cerebral artery bypass for right hemispheric ischemia due to moyamoya syndrome. Neurocognitive testing reflected both global and focal cerebrovascular dysfunction, which suggests that perfusion augmentation following surgical revascularization may engender cognitive and neurologic improvement beyond focal regions of established ischemia.

Neurocognitive

Moyamoya Disease

Superficial temporal artery

Neuropsychological testing

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Citations (40)

Neurotrophin infusion improves cognitive deficits and decreases cholinergic neuronal cell loss after experimental brain injury.

PubMed (1996)

Grant Sinson Madhu Voddi Eugene S. Flamm Tracy K. McIntosh

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Clipping or Coiling of Ruptured Cerebral Aneurysms and Shunt-Dependent Hydrocephalus

Neurocritical Care (2006)

Panayiotis N. Varelas Ann Helms Grant Sinson Marianna V. Spanaki Lotfi Hacein‐Bey

Clipping (morphology)

External ventricular drain

10.1385/ncc:4:3:223

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Citations (82)

Pseudo-Subarachnoid Hemorrhage: Report of Three Cases and Review of the Literature

Neurocritical Care (2004)

Brett Cucchiara Grant Sinson Scott E. Kasner Julio A. Chalela

10.1385/ncc:1:3:371

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Citations (22)

Is It Time to Follow the Lawyers: Should Hospitals Extract Themselves From US News & World Report Rankings?

American Journal of Medical Quality (2023)

Grant Sinson Julie Kolinski Carrie Alme Siddhartha Singh

Sinson, Grant MD; Kolinski, Julie MD; Alme, Carrie MD; Singh, Siddhartha MD, MS, MBA Author Information

10.1097/jmq.0000000000000116

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Citations (1)

Pleuropulmonary Metastasis of Glioblastoma Multiforme

Clinical Pulmonary Medicine (2006)

H. Erhan Dincer Mamatha Chivukula Hendrikus G. J. Krouwer Vinod B. Shidham Grant Sinson

In Brief We describe a 63-year-old man with metastatic glioblastoma multiforme who presented with a large pleural effusion and lung mass. Pleuropulmonary metastasis of gliomas is very rare. Of 10 cases described in the English literature, diagnosis was made postmortem in 9 patients and 8 patients had a sarcomatous component on the pathologic evaluation. The only other case of glioblastoma multiforme with a lung mass was diagnosed by percutaneous core needle biopsy. In our case, bronchoscopic transbronchial needle aspiration was the diagnostic procedure and, to our knowledge, this has not been described in the literature. Interpretation of needle aspirates may create a diagnostic dilemma resulting from similarities of appearance of glial tumor cells with poorly differentiated nonsmall cell lung cancer on the smear. Gliomas are known occasionally to metastasize to other organs such as the liver, spleen, and bone, and in most, this occurs after surgical debulking for the primary tumor. Several case studies suggest direct infiltration of tumor cells into the extracranial vessels as the most likely mechanism of metastasis of these locally invasive tumors. Although life expectancy of patients with glioblastoma multiforme has remained poor despite new therapies, early detection and timely treatment of extracranial metastases may prolong survival, quality of life, or prevent incorrect therapy because of misdiagnosis. Pleuropulmonary involvement of glioblastoma multiforme is very rare. To our knowledge, there are only 10 such cases described in the English literature. Rare occurrence and the need for special staining of specimens may create a diagnostic dilemma or inaccurate diagnosis. This case report and review emphasizes the importance of early diagnosis of pleuropulmonary metastases of glioblastoma multiforme in terms of survival benefit.

Stereotactic biopsy

Debulking

10.1097/01.cpm.0000227599.55055.77

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Intraventricular Hemorrhage after Aneurysmal Subarachnoid Hemorrhage: Pilot Study of Treatment with Intraventricular Tissue Plasminogen Activator

Neurosurgery (2005)

Panayiotis N. Varelas Kim L. Rickert Joseph F. Cusick Lotfi Hacein‐Bey Grant Sinson

Intraventricular (IVen) hemorrhage is considered a predictor of poor outcome after subarachnoid hemorrhage (SAH). This prospective study examines the feasibility and outcome of administration of IVen tissue plasminogen activator (tPA) after aneurysmal SAH.Ten patients with SAH who received IVen tPA after the aneurysm had been secured were compared with 10 age-, sex-, and Glasgow Coma Scale score-matched control patients. The primary end point was third and fourth ventricle clot resolution. IVen blood was quantified by use of the Graeb and Le Roux scales on admission and at an additional time (equal or longer for the control group) after the injection was terminated.Six men and four women with a mean age of 52 years in each group were evaluated. On average, 3.5 mg tPA was injected 68 +/- 51 hours after admission without ensuing complications. Although the treated group had significantly more IVen blood on admission than control subjects (mean Le Roux scale +/- standard deviation, 11 +/- 3 versus 7.6 +/- 4.2, P = 0.055, and mean Graeb scale +/- standard deviation, 8.5 +/- 2.3 in tPA versus 5.3 +/- 3, P < 0.02), it also had a significant decrease in the amount of IVen blood (mean Le Roux and Graeb scale decrease +/- standard deviation, 6.7 +/- 3.3 and 4.8 +/- 2 in tPA patients versus 0.9 +/- 3.2 and 0.5 +/- 2.6 in control subjects, P = 0.002). The tPA group had a non-statistically significantly shorter length of stay, decreased mortality, and better Glasgow Outcome Scale and modified Rankin Scale scores at discharge. Treated survivors showed a decreased need for shunt placement (2 [22%] of 9 patients versus 5 [83%] of 6 control subjects, P = 0.04).This pilot study shows that IVen tPA administration is feasible without complications after SAH and may be associated with better outcomes. These results warrant a randomized clinical trial.

Glasgow Outcome Scale

10.1227/01.neu.0000147973.83688.d8

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Citations (71)