Neurosurgery 2019 Projects

Project Title: Management and Outcomes of Cerebral Vasculopathy in Children with Sickle Cell Disease: a Retrospective Registry

Faculty Mentor’s Name: Dr. Philipp Aldana
Phone: (904) 633-0991

Student’s Name: Jennifer Stein

Project Description:

Children with sickle cell disease (SCD) are at significant risk for stroke despite best medical management. Cerebral revascularization surgery (CRS) is effective in other diseases in the prevention of stroke due to cerebral vasculopathy, such as Moyamoya syndrome (MMS) – one of the types of vasculopathy seen in SCD. While preliminary studies have shown that these interventions can possibly reduce the risk of stroke in pediatric SCD, they have been mainly single center case series with small sample sizes. The patients identified to be at high risk for stroke have been managed via existing protocols to diagnose them with cerebral vasculopathy and referred for neurosurgical evaluation when appropriate. Following neurosurgical evaluation, surgical intervention may be recommended to the appropriate patient. These interventions can include CRS procedures as well as obliteration of cerebral aneurysms. However, the role of CRS in this patient population is not clearly defined. Thus, this study aims to compare the stroke outcomes in pediatric patients with SCD and MMS following best medical management alone to those additionally undergoing CRS.

As a multi-center, retrospective cohort study, the objective is to determine the role of CRS in this patient population by examining the surgical indications, techniques, outcomes and adverse events of the procedure. Patient characteristics and stroke occurrence will be compared between those who underwent CRS and those who underwent conservative treatment. Medical students would have the opportunity to analyze data and assist with data accuracy of research data between institutions.

Project Title: Neurosurgery Outcomes Calculator

Faculty Mentor’s Name: Dr. Christopher Fox

Project Description:

With the vast assortment of health treatment options and increasing complexities of patient specific variables, quantifying the risks and potential outcomes of a particular procedure is becoming increasingly difficult. This, in addition to the demand for healthcare to move closer towards personalized medicine, has increased the necessity for high-capacity prognostication tools. The generation of models and customizable calculators allows for both transparency in patient outcomes and allows for the optimization of the healthcare decision making process.

Investigators with the Department of Neurosurgery at the University of Florida have already been involved in studies interrogating the effectiveness of prognostication calculators, through comparing them with the department’s own patient outcomes data. Using this foundation, the department hopes to create a predictive calculator. This tool would implement already existing patient factors and outcome data into the design of an online prognostication tool specific to the UF Shands Hospital stakeholders. Ultimately, this work may lead to an assortment of predictive tools that could produce a more standardized and evidence based model for healthcare delivery in the neurosurgery department, and potentially throughout the Shands hospital.

The goal of this specific project is to generate a database correlating patient characteristics with their outcomes after a procedure, specifically in those patient populations that underwent an elective endovascular procedure at the Shands hospital from 2015 to 2019. This database would then be developed into a predictive model and University of Florida Shands specific calculator for neurosurgical patients.