2022
Cerebral venous thrombosis after COVID-19 vaccination: the role for endovascular treatment
Mahajan A, Hirsch J. Cerebral venous thrombosis after COVID-19 vaccination: the role for endovascular treatment. Journal Of NeuroInterventional Surgery 2022, 14: 849-850. PMID: 35177518, DOI: 10.1136/neurintsurg-2021-018516.Peer-Reviewed Original Research
2021
The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus
Subramanian HE, Fadel SA, Matouk CC, Zohrabian VM, Mahajan A. The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus. World Neurosurgery 2021, 149: e1-e10. PMID: 33662608, DOI: 10.1016/j.wneu.2021.02.108.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusShunt surgeryNormal pressure hydrocephalusEvans indexCognitive improvementShunt placementPressure hydrocephalusImaging featuresLong-term patient-reported outcomesLong-term clinical improvementTelephone interviewsPreoperative imaging parametersVentriculoperitoneal shunt surgeryCerebrospinal fluid drainagePatient-reported outcomesLong-term outcomesLong-term cognitive improvementMagnetic resonance imagingImaging parametersClinical improvementGait improvementMedian durationClinical outcomesShunt candidatesFluid drainage
2020
Molecular Diagnosis and Extracranial Extension in Cushing Disease
Hong CS, Murari K, Gossmann M, Mahajan A, Erson-Omay Z, Manes RP, Omay SB. Molecular Diagnosis and Extracranial Extension in Cushing Disease. JAMA Otolaryngology - Head & Neck Surgery 2020, 146: 865-867. PMID: 32644156, DOI: 10.1001/jamaoto.2020.1471.Peer-Reviewed Original ResearchEvidence-Based Risk Mitigation and Stratification During COVID-19 for Return to Interventional Pain Practice: American Society of Interventional Pain Physicians (ASIPP) Guidelines.
Shah S, Diwan S, Soin A, Rajput K, Mahajan A, Manchikanti L, Kaye A, Hirsch J, Gharibo C. Evidence-Based Risk Mitigation and Stratification During COVID-19 for Return to Interventional Pain Practice: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain Physician 2020, 23: s161-s182. PMID: 32942784, DOI: 10.36076/ppj.2020/23/s161.Peer-Reviewed Original ResearchConceptsAmerican Society of Interventional Pain PhysiciansContinuity of careChronic pain patientsPain specialistsInterventional pain physiciansPain patientsInterventional pain specialistsPain carePain physiciansRisk of COVID-19 morbidityEvidence-informed guidanceCOVID-19 pandemicRisk factorsCOVID-related morbidityEvaluate risk-benefitCare recommendationsNumerous risk factorsManaging symptomsEvidence synthesisDisclosure of conflictsInterventional Pain PracticePain practiceTelemedicine encountersRisk stratification toolGuideline preparationLack of Superiority of Epidural Injections with Lidocaine with Steroids Compared to Without Steroids in Spinal Pain: A Systematic Review and Meta-Analysis.
Knezevic N, Manchikanti L, Urits I, Orhurhu V, Vangala B, Vanaparthy R, Sanapati M, Shah S, Soin A, Mahajan A, Atluri S, Kaye A, Hirsch J. Lack of Superiority of Epidural Injections with Lidocaine with Steroids Compared to Without Steroids in Spinal Pain: A Systematic Review and Meta-Analysis. Pain Physician 2020, 23: s239-s270. PMID: 32942786, DOI: 10.36076/ppj.2020/23/s239.Peer-Reviewed Original ResearchConceptsRandomized controlled trialsSpinal painSystematic reviewInterventional Pain Management Techniques-Quality AppraisalMeta-analysisSecondary to disc herniationPost surgery syndromeEvidence synthesis principlesCochrane review criteriaEpidural injectionSystematic review of randomized controlled trialsReview of randomized controlled trialsMethodological quality assessmentLiterature searchPreferred Reporting ItemsPain reliefSecondary outcome measuresEffects of lidocaineIPM-QRBLocal anestheticsEvidence synthesisModerate evidenceMultiple randomized controlled trialsReporting ItemsDiscogenic painValue and Validity of Coronavirus Antibody Testing.
Mahajan A, Manchikanti L. Value and Validity of Coronavirus Antibody Testing. Pain Physician 2020, 23: s381-s390. PMID: 32942795, DOI: 10.36076/ppj.2020/23/s381.Peer-Reviewed Original ResearchConceptsAntibody testIgM antibodiesImmune response to SARS-CoV-2 infectionTesting health care workersInterventional proceduresElective interventional proceduresPain management communityResponse to SARS-CoV-2 infectionElective surgical proceduresDays post-symptom onsetSARS-CoV-2 infectionPost-symptom onsetInfected patientsSurgical proceduresViral infectionPatientsIgG antibodiesImmunoglobulin MRe-infectionDetect IgGInfectionSARS-CoV-2Total antibodiesAntibodiesIgG/IgM testChoice of imaging modality for pre-treatment staging of head and neck cancer impacts TNM staging
Mur T, Sambhu KM, Mahajan A, Payabvash S, Fernandez J, Edwards HA. Choice of imaging modality for pre-treatment staging of head and neck cancer impacts TNM staging. American Journal Of Otolaryngology 2020, 41: 102662. PMID: 32858370, DOI: 10.1016/j.amjoto.2020.102662.Peer-Reviewed Original ResearchConceptsPET/CTLow-dose nonenhanced CTDistant metastasisChest CTNeck cancerNonenhanced CTF-fluorodeoxyglucose positron emission tomographyF-FDG PET/CTDiagnostic chest CTDistant metastatic diseaseInitiation of therapyRetrospective cohort studyPre-treatment stagingTertiary care settingSignificant differencesPositron emission tomographyMetastatic diseaseCohort studyOncologic treatmentTNM stagingInaccurate stagingNeck radiologistsCare settingsSingle patientPatientsPET/CT radiomics signature of human papilloma virus association in oropharyngeal squamous cell carcinoma
Haider SP, Mahajan A, Zeevi T, Baumeister P, Reichel C, Sharaf K, Forghani R, Kucukkaya AS, Kann BH, Judson BL, Prasad ML, Burtness B, Payabvash S. PET/CT radiomics signature of human papilloma virus association in oropharyngeal squamous cell carcinoma. European Journal Of Nuclear Medicine And Molecular Imaging 2020, 47: 2978-2991. PMID: 32399621, DOI: 10.1007/s00259-020-04839-2.Peer-Reviewed Original ResearchConceptsOropharyngeal squamous cell carcinomaMetastatic cervical lymph nodesCervical lymph nodesLymph nodesSquamous cell carcinomaPrimary tumorPET/CTHPV associationCell carcinomaRadiomics signatureVolume of interestHuman papilloma virus associationHuman papillomavirus associationMulti-national cohortNon-contrast CTHPV statusFDG-PETExternal cohortVirus associationFinal modelTumorsRadiomic featuresCTSignificant differencesLesion featuresPembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial
Goldberg SB, Schalper KA, Gettinger SN, Mahajan A, Herbst RS, Chiang AC, Lilenbaum R, Wilson FH, Omay SB, Yu JB, Jilaveanu L, Tran T, Pavlik K, Rowen E, Gerrish H, Komlo A, Gupta R, Wyatt H, Ribeiro M, Kluger Y, Zhou G, Wei W, Chiang VL, Kluger HM. Pembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2020, 21: 655-663. PMID: 32251621, PMCID: PMC7380514, DOI: 10.1016/s1470-2045(20)30111-x.Peer-Reviewed Original ResearchConceptsBrain metastasis responseYale Cancer CenterPD-L1 expressionPhase 2 trialUntreated brain metastasesBrain metastasesAdrenal insufficiencyAdverse eventsMetastasis responseCNS diseaseCancer CenterCohort 2Cohort 1Eastern Cooperative Oncology Group performance statusTreatment-related serious adverse eventsModified Response Evaluation CriteriaStage IV NSCLCTreatment-related deathsAcute kidney injuryPD-1 blockadeSerious adverse eventsSolid Tumors criteriaPhase 2 studyProportion of patientsResponse Evaluation CriteriaDiagnosis and Management of pituitary disease with focus on the role of Magnetic Resonance Imaging
Mahajan A, Bronen RA, Mian AY, Omay SB, Spencer DD, Inzucchi SE. Diagnosis and Management of pituitary disease with focus on the role of Magnetic Resonance Imaging. Endocrine 2020, 68: 489-501. PMID: 32162185, DOI: 10.1007/s12020-020-02242-3.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2019
Multi-Institutional Validation of Deep Learning for Pretreatment Identification of Extranodal Extension in Head and Neck Squamous Cell Carcinoma.
Kann BH, Hicks DF, Payabvash S, Mahajan A, Du J, Gupta V, Park HS, Yu JB, Yarbrough WG, Burtness BA, Husain ZA, Aneja S. Multi-Institutional Validation of Deep Learning for Pretreatment Identification of Extranodal Extension in Head and Neck Squamous Cell Carcinoma. Journal Of Clinical Oncology 2019, 38: 1304-1311. PMID: 31815574, DOI: 10.1200/jco.19.02031.Peer-Reviewed Original ResearchConceptsNeck squamous cell carcinomaExtranodal extensionSquamous cell carcinomaLymph nodesCell carcinomaContrast-enhanced CT scanDiagnostic abilityBoard-certified neuroradiologistsTreatment escalationCancer Genome AtlasPathologic confirmationPretreatment identificationDiagnostic challengeExternal validation data setsPathology resultsPretreatment imagingPoor prognosticatorClinical utilityCT scanPatientsClinical decisionHNSCCDiagnostic accuracyInstitutional ValidationGenome AtlasFrequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors
Qian JM, Yu JB, Mahajan A, Goldberg SB, Kluger HM, Chiang VLS. Frequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors. International Journal Of Radiation Oncology • Biology • Physics 2019, 105: 1113-1118. PMID: 31479702, DOI: 10.1016/j.ijrobp.2019.08.053.Peer-Reviewed Original ResearchConceptsBrain metastasesLocal therapyNeurologic safetyMelanoma patientsProspective phase 2 trialProgressive brain metastasesSerial brain imagingMelanoma brain metastasesPD-1 inhibitorsPhase 2 trialRapid disease progressionManagement of patientsNeurologic symptomsMultidisciplinary careTrial enrollmentCystic changesClinical trialsDisease progressionPatientsLesion sizeMetastasisMultidisciplinary teamTumor growthTherapyClinical decisionPerilesional edema in brain metastases: potential causes and implications for treatment with immune therapy
Tran TT, Mahajan A, Chiang VL, Goldberg SB, Nguyen DX, Jilaveanu LB, Kluger HM. Perilesional edema in brain metastases: potential causes and implications for treatment with immune therapy. Journal For ImmunoTherapy Of Cancer 2019, 7: 200. PMID: 31362777, PMCID: PMC6668163, DOI: 10.1186/s40425-019-0684-z.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAntibodies, Monoclonal, HumanizedAntigens, CD34Antineoplastic Agents, ImmunologicalBlood-Brain BarrierBrain EdemaBrain NeoplasmsCarcinoma, Non-Small-Cell LungClinical Trials, Phase II as TopicDrug Administration ScheduleHumansLung NeoplasmsMelanomaRetrospective StudiesTight JunctionsTreatment OutcomeTumor Cells, CulturedConceptsMelanoma brain metastasesBrain metastasesPerilesional edemaVessel densityEdema volumeSensitive tumorsBlood-brain barrier model systemNon-small cell lungTight junction resistancePhase II clinical trialSignificant perilesional edemaUntreated brain metastasesBlood-brain barrierPre-clinical modelsDegree of edemaTumor mass effectPotential causesMelanoma brainShort-term cultureExtracranial metastasesImmune therapyMelanoma patientsSignificant morbidityCell lungLarge tumorsSlowly progressive fatal PML-IRIS following antiretroviral initiation at CD4+ nadir of 350 cells/mm3 despite CD4+ cell count rise to 900 cells/mm3
Sandhu MR, Rutledge R, Grant M, Mahajan A, Spudich S. Slowly progressive fatal PML-IRIS following antiretroviral initiation at CD4+ nadir of 350 cells/mm3 despite CD4+ cell count rise to 900 cells/mm3. International Journal Of STD & AIDS 2019, 30: 810-813. PMID: 31046614, DOI: 10.1177/0956462419835966.Peer-Reviewed Case Reports and Technical NotesMeSH KeywordsAdultAIDS-Related Opportunistic InfectionsAntiretroviral Therapy, Highly ActiveBrainCD4 Lymphocyte CountDisease ProgressionDystonic DisordersFatal OutcomeHIV InfectionsHumansImmune Reconstitution Inflammatory SyndromeJC VirusLeukoencephalopathy, Progressive MultifocalMagnetic Resonance ImagingMaleTreatment OutcomeConceptsImmune reconstitution inflammatory syndromePML-IRISAntiretroviral therapyCell countInflammatory syndromeInitiation of ARTHIV/AIDS patientsReconstitution inflammatory syndromeRobust immune reconstitutionCells/mm3Progressive multifocal leukoencephalopathyRole of CD4Blood-brain barrierCells/Antiretroviral initiationInflammatory picturePersistent positivityImmune reconstitutionMultifocal leukoencephalopathyNeurological symptomsOpportunistic infectionsAIDS patientsVirus antigenImmune responseJC virus
2018
The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus
Subramanian HE, Mahajan A, Sommaruga S, Falcone GJ, Kahle KT, Matouk CC. The Subjective Experience of Patients Undergoing Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus. World Neurosurgery 2018, 119: e46-e52. PMID: 29981467, DOI: 10.1016/j.wneu.2018.06.209.Peer-Reviewed Original ResearchConceptsIdiopathic normal pressure hydrocephalusShunt surgeryNormal pressure hydrocephalusPreoperative courseClinical responsePressure hydrocephalusPatient's clinical responseVentriculoperitoneal shunt surgeryCounseling of patientsSaturation of themesClinical courseComorbid conditionsConsecutive seriesPostoperative assessmentDefinitive diagnosisPatients' caregiversPatient outcomesChallenges patientsDiagnostic criteriaPatientsSurgeryTelephone interviewsHydrocephalusDiagnosisSubjective experienceFatal cryptococcal meningitis in an AIDS patient complicated with immune reconstitution syndrome refractory to prolonged amphotericin B treatment
Bandaranayake TD, Ogbuagu OE, Mahajan A, Vortmeyer AO, Villanueva MS. Fatal cryptococcal meningitis in an AIDS patient complicated with immune reconstitution syndrome refractory to prolonged amphotericin B treatment. International Journal Of STD & AIDS 2018, 29: 1250-1254. PMID: 29749873, DOI: 10.1177/0956462418773219.Peer-Reviewed Case Reports and Technical NotesConceptsCentral nervous system diseaseNervous system diseasesCryptococcal meningitisSystem diseasesSevere central nervous system diseaseFatal cryptococcal meningitisLiposomal amphotericin BAmphotericin B treatmentImmune recoveryPatient refractoryAntiretroviral therapyTherapeutic challengeTreatment failureAIDS patientsCystic lesionsFatal casesTreatment approachesMeningitisAmphotericin BC. neoformansMultiple coursesCryptococcus neoformansPatientsB treatmentDiseaseIncidence of radiographically occult nodal metastases in HPV+ oropharyngeal carcinoma: Implications for reducing elective nodal coverage
Loganadane G, Kelly JR, Lee NC, Kann BH, Mahajan A, Hansen JE, Belkacémi Y, Yarbrough W, Husain ZA. Incidence of radiographically occult nodal metastases in HPV+ oropharyngeal carcinoma: Implications for reducing elective nodal coverage. Practical Radiation Oncology 2018, 8: 397-403. PMID: 29730282, DOI: 10.1016/j.prro.2018.03.009.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCarcinoma, Squamous CellFemaleFollow-Up StudiesHumansImage Processing, Computer-AssistedLymphatic MetastasisMaleMiddle AgedNeoplasm StagingOropharyngeal NeoplasmsPapillomaviridaePapillomavirus InfectionsPositron Emission Tomography Computed TomographyPrognosisRadiotherapy DosageRadiotherapy Planning, Computer-AssistedRadiotherapy, Intensity-ModulatedRetrospective StudiesConceptsRadiation field designPreoperative imagingPathologic involvementN stageOropharyngeal squamous cell carcinomaElective nodal coverageLevel II diseasePercent of patientsPositive lymph nodesOccult nodal metastasisClinical N stageRadiation therapy doseRecords of patientsNodal levelPathologic N stageSquamous cell carcinomaHuman papilloma virusTreatment deescalationNeoadjuvant therapyNodal diseaseNeck dissectionNodal involvementOropharyngeal carcinomaProspective trialSystemic agents
2017
Long-term outcomes of tissue-based ACTH-antibody assay-guided transsphenoidal resection of pituitary adenomas in Cushing disease.
Erfe JM, Perry A, McClaskey J, Inzucchi SE, James WS, Eid T, Bronen RA, Mahajan A, Huttner A, Santos F, Spencer D. Long-term outcomes of tissue-based ACTH-antibody assay-guided transsphenoidal resection of pituitary adenomas in Cushing disease. Journal Of Neurosurgery 2017, 129: 629-641. PMID: 29027854, DOI: 10.3171/2017.3.jns162245.Peer-Reviewed Original ResearchConceptsTranssphenoidal resectionMRI studiesCushing's diseaseCortisol levelsLong-term corticosteroid therapyUrinary free cortisol levelsLong-term disease remissionLong-term patient outcomesResults Fourteen patientsLong-term outcomesPostoperative MRI studiesSurgical tumor samplesFree cortisol levelsPreoperative MRI studiesPrecise tumor localizationACTH antibodiesPituitary microCorticosteroid therapyStudy patientsDisease remissionFourteen patientsRemission rateRetrospective reviewTreatment failureCure rateComparing available criteria for measuring brain metastasis response to immunotherapy
Qian JM, Mahajan A, Yu JB, Tsiouris AJ, Goldberg SB, Kluger HM, Chiang VL. Comparing available criteria for measuring brain metastasis response to immunotherapy. Journal Of Neuro-Oncology 2017, 132: 479-485. PMID: 28275886, DOI: 10.1007/s11060-017-2398-8.Peer-Reviewed Original ResearchConceptsRECIST 1.1Brain lesionsBrain metastasesDurable responsesAdditional patientsNeuro-Oncology Working GroupBrain metastasis responseBrain metastasis patientsUntreated brain metastasesStandardized response criteriaBrain lesion sizeHigh-grade gliomasSimilar clinical trialsHigh-resolution MRIMetastasis patientsMetastasis responseOngoing trialsClinical trialsNovel therapiesResponse assessmentDiscordant casesLesion sizePatientsResponse rateLongest diameterAbnormal Fluid-Attenuated Inversion Recovery Signal in the Internal Capsule: A Novel Brain Magnetic Resonance Imaging Finding in a Child With Acute Flaccid Myelitis
Makhani N, Mahajan A. Abnormal Fluid-Attenuated Inversion Recovery Signal in the Internal Capsule: A Novel Brain Magnetic Resonance Imaging Finding in a Child With Acute Flaccid Myelitis. Pediatric Neurology 2017, 73: 108-109. PMID: 28262551, DOI: 10.1016/j.pediatrneurol.2017.01.031.Peer-Reviewed Original Research