Vagal nerve stimulation (VNS) is a well-tolerated procedure for patients with medication-resistant and non-focal epilepsy. It does, however, have potential complications (e.g., hoarseness and cough) thought to be from vagus nerve irritation. These arise postoperatively and generally improve without intervention. If these symptoms present later or do not improve, it suggests a more insidious etiology. Herein we report the case of a patient in their 50s with medication-resistant epilepsy, who subsequently underwent VNS electrode array and pulse generator implantation to aid seizure management. Three years after the initial implantation, the patient experienced vocal cord paralysis and neck pain following a syncopal fall. The pain radiated to their jaw and chest and was eliminated when their VNS was turned off. The patient was taken to the OR for removal and replacement of their entire VNS system. Their original electrodes were unable to be removed secondary to being scarred in place. The patient’s preoperative pain symptoms completely resolved after the removal of their old VNS and implantable pulse generator (IPG) and replacement with a new system 14 days postoperatively. While short-term postoperative sequelae and lead fractures/displacements have been reported in the literature, this is the first case to our knowledge of a patient experiencing a likely symptomatic traction injury without displacement of the VNS coils or obvious vagus nerve injury. Furthermore, the removal and replacement of the entire VNS system led to complete relief of their presenting symptoms.

Northwestern Medicine scientists have identified how one gene connects glioblastoma stem cell self-renewal to microglia immunosuppression in glioblastoma, according to a new study published in Nature Immunology.

Northwestern Medicine identified a novel therapeutic agent that is effective in treating metastatic breast cancer and brain metastases with minimal side effects.

Northwestern Medicine investigators led by Amy Heimberger, MD, PhD, have discovered a new mechanism in which cancer-associated fibroblasts are associated with tumor grade and mediate immune suppression in glioma tumors.

Scientists have recently found a highly accurate way to predict the best treatment for patients with meningioma based on patterns of gene expression in their tumors. In this Better Edge podcast episode, Stephen T. Magill, MD, PhD, of Northwestern Medicine Neurological Surgery, discusses an innovativ

MGMT promoter methylation testing is required for prognosis and predicting temozolomide response in gliomas. Accurate results depend on sufficient tumor cellularity, but histologic estimates of cellularity are subjective. We sought to determine whether driver mutation variant allelic frequency (VAF) could serve as a more objective metric for cellularity and identify possible false-negative MGMT samples. Among 691 adult-type diffuse gliomas, MGMT promoter methylation was assessed by pyrosequencing (N = 445) or DNA methylation array (N = 246); VAFs of TERT and IDH driver mutations were assessed by next generation sequencing. MGMT results were analyzed in relation to VAF. By pyrosequencing, 56% of all gliomas with driver mutation VAF ≥ 0.325 had MGMT promoter methylation, versus only 37% with VAF < 0.325 (p < 0.0001). The mean MGMT promoter pyrosequencing score was 19.3% for samples with VAF VAF ≥ 0.325, versus 12.7% for samples with VAF < 0.325 (p < 0.0001). Optimal VAF cutoffs differed among glioma subtypes (IDH wildtype glioblastoma: 0.12–0.18, IDH mutant astrocytoma: ~0.33, IDH mutant and 1p/19q co-deleted oligodendroglioma: 0.3–0.4). Methylation array was more sensitive for MGMT promoter methylation at lower VAFs than pyrosequencing. Microscopic examination tended to overestimate tumor cellularity when VAF was low. Re-testing low-VAF cases with methylation array and droplet digital PCR (ddPCR) confirmed that a subset of them had originally been false-negative. We conclude that driver mutation VAF is a useful quality assurance metric when evaluating MGMT promoter methylation tests, as it can help identify possible false-negative cases.

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Northwestern Medicine McHenry Hospital now offers pituitary tumor resection surgery - going through the nose and nasal cavity to remove pituitary tumors.

Northwestern Medicine identified a novel therapeutic agent that is effective in treating metastatic breast cancer and brain metastases with minimal side effects.

Supratentorial non-skull base meningiomas are the most common primary central nervous system tumor subtype. An understanding of their pathophysiology, imaging characteristics, and clinical management options will prove of substantial value to the multi-disciplinary team which may be involved in their care. Extensive review of the broad literature on the topic is conducted. Narrowing the scope to meningiomas located in the supratentorial non-skull base anatomic location highlights nuances specific to this tumor subtype. Advances in our understanding of the natural history of the disease and how findings from both molecular pathology and neuroimaging have impacted our understanding are discussed. Clinical management and the rationale underlying specific approaches including observation, surgery, radiation, and investigational systemic therapies is covered in detail. Future directions for probable advances in the near and intermediate term are reviewed.

Supratentorial non-skull base meningiomas are the most common primary central nervous system tumor subtype. An understanding of their pathophysiology, imaging characteristics, and clinical management options will prove of substantial value to the multi-disciplinary team which may be involved in their care. Extensive review of the broad literature on the topic is conducted. Narrowing the scope to meningiomas located in the supratentorial non-skull base anatomic location highlights nuances specific to this tumor subtype. Advances in our understanding of the natural history of the disease and how findings from both molecular pathology and neuroimaging have impacted our understanding are discussed. Clinical management and the rationale underlying specific approaches including observation, surgery, radiation, and investigational systemic therapies is covered in detail. Future directions for probable advances in the near and intermediate term are reviewed.

Explore Northwestern Medicine's groundbreaking achievements in neurology and neurosurgery, from research breakthroughs to exemplary patient care and prestigious awards.

Study design: A retrospective cohort study. Objective: To calculate the magnitude of any inc

Nature Medicine - A risk score based on a 34-gene signature for outcome prediction in meningioma was developed and validated in large multi-institutional cohorts and showed better performance in...

Sandi Lam, MD, MBA, shares her expertise in minimally invasive and endoscopic techniques and how her research and expertise is transforming pediatric epilepsy care around the world.  

Four Feinberg faculty have been inducted into the American Society for Clinical Investigation (ASCI) and three additional Feinberg faculty have been honored with the ASCI Young Physician-Scientist Award.

A new study reveals a shocking disparity: Black and Hispanic children and those on Medicaid are less likely to receive potentially life-altering epilepsy surgery, even though it can be more effective than medication alone. Read more here.

In this video, a patient of the Northwestern Medicine Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital (MBTI) named Courtney shares her story. Watch as Courtney's journey with the MBTI's co-located center

In this video, MBTI Co-Director James Chandler, MD tells us about the Northwestern Skull Base Lab he directs, how it was conceived, and the benefits it provides to Northwestern as a whole. To learn more about the Nortwestern Skull Base Lab, click here: https://www.nmskullbase.org/ For details on

Intraoperative brain mapping (awake brain surgery) is a procedure performed during brain tumor surgery while the patient is awake but sedated. In this video, neurosurgeon Matthew Tate, MD, PhD gives an overview of awake brain surgery as it is one of his clinical specialties. He discusses what brain

Dr. Zhang was first author on the study "STING agonist-loaded, CD47/PD-L1-targeting nanoparticles potentiate antitumor immunity and radiotherapy for glioblastoma" published in Nature Communications recently, available at this link: https://www.nature.com/articles/s41467-023-37328-9. Learn more abo

In this video, Director of Clinical Research Chris Amidei APN, PhD, IAAN explains what clinical trials are, how they are managed ethically, and where brain tumor patients can get more information on their clinical trial options. To learn more about clinical trials offered by the Northwestern Medic

Jessica W. Templer, MD, Karan S. Dixit, MD and Matthew Tate, MD, PhD, discuss management strategies for patients with low grade glioma.

Sandi Lam, MD, MBA, shares her expertise in minimally invasive and endoscopic techniques and how her research and expertise is transforming pediatric epilepsy care around the world.  

Northwestern Medicine identified a novel therapeutic agent that is effective in treating metastatic breast cancer and brain metastases with minimal side effects.

There is a good reason why medical facilities are held to the highest standards. They are literally the difference between life and death for many. That's why the new ranking of the 10 hospitals in Illinois that are the absolute best is important.

Find the best surgeons and hospitals, based on their hospital surgeries and published Spine research. Featuring the All-Stars in Spine.

A recent Northwestern Medicine study has discovered a previously unknown molecular mechanism that supports antitumor responses and cell survival in cytotoxic immune cells, according to findings published in the Journal of Clinical Investigation.

There is a good reason why medical facilities are held to the highest standards. They are literally the difference between life and death for many. That's why the new ranking of the 10 hospitals in Illinois that are the absolute best is important.

Vagal nerve stimulation (VNS) is a well-tolerated procedure for patients with medication-resistant and non-focal epilepsy. It does, however, have potential complications (e.g., hoarseness and cough) thought to be from vagus nerve irritation. These arise postoperatively and generally improve without intervention. If these symptoms present later or do not improve, it suggests a more insidious etiology. Herein we report the case of a patient in their 50s with medication-resistant epilepsy, who subsequently underwent VNS electrode array and pulse generator implantation to aid seizure management. Three years after the initial implantation, the patient experienced vocal cord paralysis and neck pain following a syncopal fall. The pain radiated to their jaw and chest and was eliminated when their VNS was turned off. The patient was taken to the OR for removal and replacement of their entire VNS system. Their original electrodes were unable to be removed secondary to being scarred in place. The patient’s preoperative pain symptoms completely resolved after the removal of their old VNS and implantable pulse generator (IPG) and replacement with a new system 14 days postoperatively. While short-term postoperative sequelae and lead fractures/displacements have been reported in the literature, this is the first case to our knowledge of a patient experiencing a likely symptomatic traction injury without displacement of the VNS coils or obvious vagus nerve injury. Furthermore, the removal and replacement of the entire VNS system led to complete relief of their presenting symptoms.

Vagal nerve stimulation (VNS) is a well-tolerated procedure for patients with medication-resistant and non-focal epilepsy. It does, however, have potential complications (e.g., hoarseness and cough) thought to be from vagus nerve irritation. These arise postoperatively and generally improve without intervention. If these symptoms present later or do not improve, it suggests a more insidious etiology. Herein we report the case of a patient in their 50s with medication-resistant epilepsy, who subsequently underwent VNS electrode array and pulse generator implantation to aid seizure management. Three years after the initial implantation, the patient experienced vocal cord paralysis and neck pain following a syncopal fall. The pain radiated to their jaw and chest and was eliminated when their VNS was turned off. The patient was taken to the OR for removal and replacement of their entire VNS system. Their original electrodes were unable to be removed secondary to being scarred in place. The patient’s preoperative pain symptoms completely resolved after the removal of their old VNS and implantable pulse generator (IPG) and replacement with a new system 14 days postoperatively. While short-term postoperative sequelae and lead fractures/displacements have been reported in the literature, this is the first case to our knowledge of a patient experiencing a likely symptomatic traction injury without displacement of the VNS coils or obvious vagus nerve injury. Furthermore, the removal and replacement of the entire VNS system led to complete relief of their presenting symptoms.

In this article, we will be taking a look at the 15 best hospitals for cancer treatment in the US. If you are not interested in reading about the global cancer care market, head straight to the 5 Best Hospitals For Cancer Treatment In The US. When battling cancer, choosing the right hospital for treatment […]

Nature Medicine - A risk score based on a 34-gene signature for outcome prediction in meningioma was developed and validated in large multi-institutional cohorts and showed better performance in...

Northwestern Medicine investigators have discovered that specialized immune cells within the glioblastoma tumor microenvironment use a unique “feeding” mechanism that promotes tumor growth and treatment resistance, according to findings published in the journal Cell Metabolism.