Subcortical Surgery Group

Neurosurgeons who collaborate to empower progress with minimally invasive corridor surgery to the subcortical space

Physician members of the Subcortical Surgery Group have unique publishing opportunities, sharing their experiences, techniques and clinical outcomes using MIPS (Minimally Invasive Parafascicular Surgery).  More than 70 clinical papers, posters and abstracts have been published showing evidence of improved clinical and economic outcomes.

Tumor Clinical Data
Vascular Clinical Data
Pediatric Clinical Data
Novel Applications
Proof of Concept
White Matter Tract Recovery
Tissue Preservation
Reviews and Comparisons
Economic Analysis

Tumor Clinical Data

  1. Chen Y, Omay SB, Sathwik SR, Liang B, Almeida JP, Ruiz-Trevino AS, et al. Transtubular excisional biopsy as a rescue for a non-diagnostic stereotactic needle biopsy – case report and literature review.  Acta Neurochir.  2017; 0:1-7. Published Ahead of Print.  https://dx.doi.org/10.1007/s00701-017-3260-7.
  2. Jackson C, Gallia GL, Chaichana KL. Minimally invasive biopsies of deep-seated brain lesions using tubular retractors under exoscopic visualization.  Journal of Neurological Surgery, A.    Published Ahead of Print.  https://doi.org/10.1055/s-0037-1602698.
  3. Polster SP, Cartwright MM, Patel V, Bailes JE. Experiential summary of 1032 cases of adult brain surgery using a navigable trans-sulcal tubular retractor device for the removal of deep-seated brain lesions.  Poster presented at: 2017 Congress of Neurological Surgeons Annual Meeting; October 7-11, 2017; Boston, MA.  https://www.cns.org/education/browse-type/abstracts-and-posters
  4. Eliyas JK, Glynn R, Kulwin CG, et al. Minimally-invasive trans-sulcal resection of Intra-ventricular and Peri-ventricular lesions through a tubular retractor system: Multi-centric experience and results.  World Neurosurgery.  2016; 90: 556-564.  http://dx.doi.org/10.1016/j.wneu.2015.12.100
  5. Nagatani K, Takeuchi S, Feng D, Mori K, Day JD. High definition exoscope system for microneurosurgery: Use of an exoscope in combination with tubular retraction and frameless neuronavigation for microsurgical resection of deep brain lesions. Neurological Surgery, Japan. 2015; 43(7): 611-617. ISID:1436203086. http://medicalfinder.jp/doi/abs/10.11477/mf.1436203086
  6. Labib M, Young RL, Rovin RA, Day JD, Eliyas JK, Bailes JE. The safety and efficacy of diffusion tensor imaging (DTI)- guided Transulcal radial tubular corridors to subcortical neoplasms: A multicenter study.  Abstract presented at: 2015 Congress of Neurological Surgeons Annual Meeting; September 26-30, 2015; New Orleans, LA.  http://2015.cns.org/posterbrowser.aspx
  7. Kulwin CG, Shah MV. Minimally invasive parafascicular approach to deep cerebral lesions: initial Indiana University experience.  Presented at: 2014 Neurosurgical Society of America Annual Meeting; June 2014.
  8. Eliyas JK, Bailes J. Early experience with trans-sulcal parafascicular Exoscopic resection of supratentorial brain tumors.  Neuro Oncol (2014) 16 (suppl 5):v161.  https://dx.doi.org/1093/neuonc/nou265.13   
  9. Alzate J, Young R, Rovin R. A novel minimally invasive approach for the resection of intraventricular tumors.  Neuro Oncol (2014) 16 (suppl 5):v127.  doi: 1093/neuonc/nou260.3.
  10. Rovin R, Kassam AB. Minimally invasive surgical resection of subcortical tumors using the six pillars system.  Poster #ST-029 presented at: 18th Annual Meeting of the Society for Neuro-Oncology; November 21-24, 2013; San Francisco, CA. http://soc-neuro-onc.conference services.net/reports/template/onetextabstract.xml?xsl=template/onetextabstract.xsl&conferenceID=3676&abstractID=760212.
  11. Labib M, Ghinda D, Bafaquh M, Kumar R, Agbi C, Kassam AB. The diffusion tensor imaging (DTI) guided Transulcul Exoscopic radial corridor approach for the resection of lesions in the sensorimotor area.  Poster #1598 presented at: 2013 Congress of Neurological Surgeons Annual Meeting; October 19-23, 2013; San Francisco, CA.  http://2013.cns.org/posterbrowser.aspx.

Vascular Clinical Data

  1. Ratcliff JJ, Hall AJ, Saville BR, Phillips VL, Sekerak P, Lewis RJ, et al. Trial design, methods, and rationale for the early minimally invasive removal of intracerebral hemorrhage (ENRICH) clinical trial.  Presented at: 2017 Neurocritical Care Society Annual Meeting; Hilton Waikoloa Village, HI. 
  2. Sujijantarat N, El Tecle N, Pierson M, Urquiaga JF, Quadri NF, Ashour AM, et al. Trans-sulcal endoport-assisted evacuation of supratentorial intracerebral hemorrhage: initial single-institution experience compared to matched medically managed patients and effect on 30-day mortality.  Operative Neurosurgery.  2017; 0:1-8. Published Ahead of Print.  https://doi.org/10.1093/ons/opx161.
  3. Lang M, Witek AM, Moore NZ, Bain MD. Clinical Outcomes of Patients Undergoing BrainPath-assisted Evacuation of Intracerebral Hemorrhage.  Abstract presented at: 2017 International Stroke Conference; February 22-24, 2017; Houston, TX.  https://aha.scientificposters.com/epsAbstractAHA.cfm?id=1
  4. Polster SP, Cartwright MM, Patel V, Bailes JE. Experiential summary of 1032 cases of adult brain surgery using a navigable trans-sulcal tubular retractor device for the removal of deep-seated brain lesions.  Poster presented at: 2017 Congress of Neurological Surgeons Annual Meeting; October 7-11, 2017; Boston, MA.  https://www.cns.org/education/browse-type/abstracts-and-posters
  5. Bauer AM, Rasmussen PA, Bain MD. Initial single-center technical experience with the BrainPath system for acute intracerebral hemorrhage evacuation.  Operative Neurosurgery.  2016; 0:1-7.  Published Ahead of Print.  http://journals.lww.com/onsonline/pages/articleviewer.aspx?year=9000&issue=00000&article=99972&type=abstract
  6. Chen JW, Paff MR, Abrams-Alexandru D, Kaloostian SW. Decreasing the cerebral edema associated with traumatic intracerebral hemorrhages: use of a minimally invasive technique.  In: RL Applegate et al (eds), Brain Edema XVI: Translate Basic Science into Clinical Practice, Acta Neurochirurgica Supplement. 2016; 121:279-284.  doi: 10.1007/978-3-319-18497-5_48.  https://www.ncbi.nlm.nih.gov/pubmed/26463961
  7. Scranton RA, Fung SH, Britz GW. Transulcal parafascicular minimally invasive approach to deep and subcortical cavernomas: technical note.  Journal of Neurological Surgery. 2016; 125(6): 1360-1366.  http://dx.doi.org/10.3171/2015.12.JNS152185
  8. Przybylowski CJ, Ding D, Starke RM, Crowley RW, Liu KC. Endoport-assisted surgery for the management of spontaneous intracerebral hemorrhage. Journal of Clinical Neuroscience. 2015; 22(11): 1727-1732. http://dx.doi.org/10.1016/j.jocn.2015.05.015
  9. Ding D, Przybylowski CJ, Starke, RM, et al. A minimally invasive anterior skull base approach for evacuation of a basal ganglia hemorrhage. Journal of Clinical Neuroscience. 2015; 22(11): 1816-1819. http://dx.doi.org/10.1016/j.jocn.2015.03.052
  10. Chen J, Tran K, Dastur C, Stradling D, Yu W. The use of the BrainPath stereotactic guided surgery for the removal of spontaneous intracerebral hemorrhage: a single institutional experience.  Abstract presented at: 2015 NeuroCritical Care Society Meeting; October 7-10, 2015; Scottsdale, AZ.  http://link.springer.com/article/10.1007/s12028-015-0193-y
  11. Kulwin C, Rodgers R, Shah M. Preliminary experience with evacuation of intracerebral hemorrhage via a minimally invasive parafascicular technique.  Presented at: 2015 Neurosurgical Society of America Annual Meeting; April 2015.
  12. Britz G, Kassam AB, Labib M, Young R, Zucker L, Maioriello A, et al. Minimally invasive subcortical parafascicular access for clot evacuation: a paradigm shift.  Poster # MP120 presented at: 2015 International Stroke Conference; February 11-13, 2015; Nashville, TN.  http://stroke.ahajournals.org/content/46/Suppl_1/AWMP120.short?rss=1
  13. Chen J, Kaloostian SW. Use of minimally invasive techniques under austere circumstances for the urgent resection of subcortical intracerebral hemorrhages.  Poster #0075 presented at: 12th Annual Conference of the Society for Brain Mapping and Therapeutics; March 6-8, 2015.
  14. Kulwin CG, Shah MV. Minimally invasive parafascicular approach to deep cerebral lesions: initial Indiana University experience.  Presented at: 2014 Neurosurgical Society of America Annual Meeting; June 2014.
  15. Ghinda DC, Bafaquh M, Labib M, Kumar R, Agbi CB, Kassam AB. A Transulcul Exoscopic radial corridor approach for the management of primary intracranial hemorrhage.  Poster #1621 presented at: 2013 Congress of Neurological Surgeons Annual Meeting; October 19-23, 2013; San Francisco, CA. http://2013.cns.org/posterbrowser.aspx.
  16. Labib M, Ghinda D, Bafaquh M, Kumar R, Agbi C, Kassam AB. The diffusion tensor imaging (DTI) guided Transulcul Exoscopic radial corridor approach for the resection of lesions in the sensorimotor area.  Poster #1598 presented at: 2013 Congress of Neurological Surgeons Annual Meeting; October 19-23, 2013; San Francisco, CA.  http://2013.cns.org/posterbrowser.aspx.

Pediatric Clinical Data

  1. Young RA, Cartwright M, Kiehna EN. Minimally invasive resection of subcortical pediatric brain tumors and vascular malformations using a novel navigable tubular retractor system. Presented at: 2017 AANS/CNS Pediatric Section Meeting; November 29-December1, 2017; Houston, TX.
  2. Kiehna EN. Minimally invasive resection of rolandic cavernomas in children using a novel navigable tubular retractor system.  Presented at: 13th Annual Angioma Alliance CCM Scientific Meeting; October 26-27, 2017; Washington, DC.   
  3. Weiner HL, Placantonakis DG. Resection of a pediatric thalamic juvenile pilocytic astrocytoma with whole brain tractography.  Cureus. 2017; 9(10): e1768.  https://dx.doi.org/10.7759/cureus.1768

Novel Applications

  1. Witek AM, Moore NZ, Sebai MA, Bain MD. BrainPath-mediated resection of a ruptured subcortical arteriovenous malformation.  Operative Neurosurgery.  2017; 0:1-7. Published Ahead of Print.  http://dx.doi.org/10.1093/ons/opx186.
  2. Gonen L, Chakravarthi SS, Monroy-Sosa A, Celix JM, Kojis N, Singh M, et al. Initial experience with a robotically operated video optical telescopic-microscope in cranial neurosurgery: feasibility, safety, and clinical applications.  Neurosurgical Focus. 2017; 42(5): E9.  https://dx.doi.org/10.3171/2017.3.FOCUS1712.
  3. Somasundaram A, Evans J, Shah M, Asbari SH, Chicoine M, Kulwin C. Resection of deep-seated intrinsic brain tumors using a novel combination of a minimally invasive tubular brain retraction system, high resolution exoscope visualization, and high field intraoperative magnetic resonance imaging (iMRI).  Poster #2081 presented at: 2016 Congress of Neurological Surgeons Annual Meeting; September 24-28, 2016; San Diego, CA.  http://latebreaking16.cns.org/posterbrowser.aspx
  4. Chen CJ, Caruso J, Starke RM, et al. Endoport-assisted microsurgical treatment of a ruptured periventricular aneurysm.  Case Rep Neurol Medicine.  2016; 2016(8654262): 4 pages.  http://dx.doi.org/10.1155/2016/8654262
  5. Habboub G, Sharma M, Barnett GH, Mohammadi AM. A novel combination of two minimally invasive surgical techniques in the management of refractory radiation necrosis: Technical note.  Journal of Clinical Neuroscience. 2016; 35: 117-121.  https://dx.doi.org/10.1016/j.jocn.2016.09.020
  6. Amenta PS, Dumont AS, Medel R. Resection of a left posterolateral thalamic cavernoma with the Nico BrainPath sheath: case report, technical note, and review of the literature.  Interdisciplinary Neurosurgery: Advanced Techniques and Case Management.  2016; 5:12-17.  http://dx.doi.org/10.1016/j.inat.2016.03.006
  7. Ding D, Starke R, Crowley R, Liu K. Endoport-assisted microsurgical resection of cerebral cavernous malformations. Journal of Clinical Neuroscience. 2015; 22(6): 1025-1029. http://dx.doi.org/10.1016/j.jocn.2015.01.004

Proof of Concept

  1. Young FL, Cartwright MM. Inclusion of a minimal access surgery device system into a pilot neurosurgical enhanced recovery after surgery (ERAS) protocol.  Poster presented at: 2017 Congress of Neurological Surgeons Annual Meeting; October 7-11, 2017; Boston, MA.  https://www.cns.org/education/browse-type/abstracts-and-posters
  2. Day JD. Transsulcal parafascicular surgery using BrainPath for subcortical lesions.  Neurosurgery.  2017;64(Suppl 1): 151-156.  http://dx.doi.org/10.1093/neuros/nyx324
  3. Labib MA, Shah M, Kassam AB, Young R, Zucker L, Maioriello A, et al. The safety and feasibility of image-guided BrainPath-mediated transsulcul hematoma evacuation: a multicenter study.  Neurosurgery.  2017; 80(4): 515-524.  http://dx.doi.org/10.1227/NEU.0000000000001316
  4. Kassam AB, Labib MA, Bafaquh M, et al. Part II: an evaluation of an integrated systems approach using diffusion-weighted, image-guided, Exoscopic-assisted, transulcal radial corridors. Innovative Neurosurg. 2015; 3(1-2): 25-33.http://dx.doi.org/10.1515/ins-2014-0012
  5. Kassam AB, Labib MA, Bafaquh M, et al. Part I: the challenge of functional preservation: an integrated systems approach using diffusion-weighted, image-guided, Exoscopic-assisted, transulcal radial corridors. Innovative Neurosurgy. 2015; 3(1-2): 5-23.http://dx.doi.org/10.1515/ins-2014-0011
  6. Labib M, Britz G, Young R, Zucker L, Shah M, Kulwin CG, et al. The safety and efficacy of image-guided trans-sulcal radial corridors for hematoma evacuation: a multicenter study.  Late breaking oral presentation LB12 at: 2015 International Stroke Conference; February 11-13, 2015; Nashville, TN. http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_471665.pdf
  7. Ritsma B, Kassam AB, Dowlatshahi D, Nguyen T, Stotts G. Minimally invasive subcortical parafascicular transsulcal access for clot evacuation (Mi SPACE) for intracerebral hemorrhage. Case Rep Neurol Med. 2014;2014(102307): 4 pages.http://dx.doi.org/10.1155/2014/102307

White Matter Tract Recovery

  1. Agarwal V, Malcolm JG, Pradilla G, Barrow DL. Tractography for optic radiation preservation in transcortical approaches to intracerebral lesions.  2017; 9(9): e1722.  https://dx.doi.org/10.7759/cureus.1722
  2. Chakravarthi SS, Zbacnik A, Jennings J, et al. White matter tract recovery following medial temporal lobectomy and selective amygdalophippocampectomy for tumor resection via a ROVOT-m port-guided technique: A case report and review of literature.  Interdisciplinary Neurosurgery. 2016; 6:55-61.  http://dx.doi.org/10.1016/j.inat.2016.07.004
  3. Zucker, L. Corticospinal tract restoration post parafascicular transulcal subcortical (thalamic) ICH evacuation.  Poster #1450 presented at: 2016 Congress of Neurological Surgeons Annual Meeting; September 24-28, 2016; San Diego, CA.  http://2016.cns.org/posterbrowser.aspx

Tissue Preservation

  1. Soroceanu L, Chang J, Sidorov M, Ayala AM, Zusman EE, Dickinson LD. Tissue extraction and preservation for glioblastoma specimens used for molecular oncology and personalized therapy studies.  Presented at: 2017 Congress of Neurological Surgery Annual Meeting; October 7-11, 2017; Boston MA.  https://www.cns.org/education/browse-type/abstracts-and-posters
  2. Cartwright M. Towards the Development of Personalized Medicine: A Novel Tissue Preservation System for the Automation and Standardization of Brain Tumor Harvesting in a Surgical Setting. FASEB Journal. 2017: 31(1): supplement lb516. http://www.fasebj.org/content/31/1_Supplement/lb516.abstract?sid=94be4899-a0b2-491e-89e1-5189dbe511f5
  3. Kumar R, Gont A, Hanson JEL, Cheung AYL, Nicholas G, Woulfe J, et al. Isolating glioblastoma tumor initiating progenitor cells from the subventricular zone using a novel minimally invasive approach.  Neuro Oncol (2014) 16 (suppl 5):v200.  http://doi.org/1093/neuonc/nou275.15

Reviews and Comparisons

  1. Buttrick SS, Shah AH, Basil GW, Komotar RJ. The future of cranial neurosurgery – adapting new approaches.    2017;64(CN Suppl 1):144-150.  http://dx.doi.org/10.1093/neuros/nyx214
  2. Ziai W, Nyquist P, Hanley DF. Surgical strategies for spontaneous intracerebral hemorrhage.  Seminars in Neurology. 2016;36:261-268.  http://dx.doi.org/10.1055/s-0036-1582131
  3. Fiorella D, Arthur A, Bain M, Mocco J. Minimally invasive surgery for intracerebral and intraventricular hemorrhage.  2016;47:1399-1406.  http://dx.doi.org/10.1161/STROKEAHA.115.011415

Economic Analysis

  1. Norton SP, Dickerson EM, Kulwin CG, Shah MV. Technology that achieves the Triple Aim: an economic analysis of the BrainPath approach in neurosurgery.  ClinicoEconomics and Outcomes Research. 2017;9: 519-523.  https://doi.org/10.2147/CEOR.S133623