Martin E Weinand

Interests

Teaching

Neurosurgery

Research

Epilepsy,Neurosurgical Genomics,Pain,Neurotrauma

Courses

Scholarly Contributions

Books

• Weinand, M. E., & Alan, A. (2023). Marcus Aurelius Meditations: Adapted for the Contemporary Physician.. https://www.amazon.com/dp/B0C9S7RNGR/ref=sr_1_1?crid=26RHFFSUNESSD&keywords=martin+weinand&qid=1689601487&sprefix=martin+weinand%2Caps%2C159&sr=8-1: Amazon.

Chapters

• Fiala, A. M., Gan, X., Newton, T. F., Chiappelli, F., Shapshak, P., Kermani, V., Kung, M. A., Diagne, A., Martinez, O., Way, D., Weinand, M. E., Witte, M. H., & Graves, M. C. (1996). Divergent Effects of Cocaine on Cytokine Production by Lymphocytes and Monocyte/Macroophages. In AIDS, Drugs of Abuse, and the Neuroimmune Axis(pp 145-156). Springer, Boston, MA. doi:10.1007/978-1-4613-0407-4_20
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  Cocaine-related immunosuppression is asumed to have serious consequences, but its evaluation in drug-addicted subjects is lacking. In this study performed with materials from addicted subjects receiving intravenous cocaine and normal control subjects, acute cocaine effects on cytokine production in vivo and in mononuclear cells in vitro were determined. Acute intravenous cocaine administration resulted in (a) increased white blood cell and lymphocyte counts, (b) decreased tumor necrosis factor-α (TNF-α) and interleukin (IL)-10 serum levels; (c) depressed TNF-α, IL-10 and IL-12 production by unstimulated or LPSstimulated mononuclear cells; (d) increased TNF-a production by PHA-stimulated mononuclear cells. These observations suggest that cocaine has stimulatory effect on TNF-α production by lymphocytes but inhibitory action on TNF-α production by monocyte/macrophages. In vitro cocaine treatment of monocyte-enriched preparations of mononuclear cells from normal donors resulted in suppression of cytokine production. A blood-brain barrier model was constructed using human brain microvascular endothelial cells. In this model mononuclear cell transmigration was correctly regulated by Thl and Th2 cytokines and preferential migration of “memory” T cells was inhibited by cocaethylene. TNF-α and cocaethylene increased HIV-1 titers in the brain-side of the model.

Journals/Publications

• Weinand, M. E. (2024). Leukocyte Differential Gene Expression Prognostic Value for High versus Low Seizure Frequency in Temporal Lobe Epilepsy.. BMC Neurology, 24(16), 1-21. doi:10.1186/s12883-023-03459-1
• Weinand, M. E. (2024). Neuroprotection strategies in traumatic brain injury:Studying the effectiveness of different clinical approaches. Surgical Neurology International, 15(29), 1-13. doi:10.25259/SNI_773_2023
• Weinand, M. E. (2024). Neuroprotection: Surgical approaches in traumatic braininjury. Surgical Neurology International, 15(23), 1-11. doi:10.25259/SNI_774_2023
• Weinand, M. E. (2024). The importance of behavioral interventions in traumaticbrain injury. Surgical Neurology International, 15(22), 1-13. doi:10.25259/SNI_776_2023
• Weinand, M. E. (2023). Emotional intelligence in neurosurgery: Mitigating burnout and enhancing performance. Surgical Neurology International, 14(326), 1-7. doi:10.25259/SNI_624_2023
• Weinand, M. E. (2023). Outcomes following therapeutic intervention of post-traumatic vasospasm: a systematic review and meta-analysis.  . Clinical Neurology and Neurosurgery, 232, 107877. doi:10.1016/j.clineuro.2023.107877
• Weinand, M. E. (2023). Predictors of revision surgery after bedside subdural drain placement for chronic subdural hematomas.  . Clinical Neurology and Neurosurgery, 231, 107836. doi:10.1016/j.clineuro.2023.107836
• Weinand, M. E. (2023). Subdural hematoma, retinal hemorrhage, and fracture triad as a clinical predictor for the diagnosis of pediatric nonaccidental trauma.. Journal of Neurosurgery - Pediatrics, 1-7. doi:10.3171/2023. 11.PEDS23212
• Blohm, J. E., Salinas, P. A., Avila, M. J., Barber, S. R., Weinand, M. E., & Dumont, T. M. (2022). Three-Dimensional Printing in Neurosurgery Residency Training: A Systematic Review of the Literature. World neurosurgery, 161, 111-122.
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  The use of three-dimensional (3D) printing in neurosurgery has become more prominent in recent years for surgical training, preoperative planning, and patient education. Several smaller studies are available using 3D printing; however, there is a lack of a concise review. This article provides a systematic review of 3D models in use by neurosurgical residents, with emphasis on training, learning, and simulation.
• Weinand, M. E. (2022). Spinal cord stimulation for medically refractory sphincter of Oddi dysfunction: a case report.. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management, 28, 101487. doi:https://doi.org/10.1016/j.inat.2022.101487
• Weinand, M. E. (2020). Acoustoelectric Imaging of Deep Dipoles in a Human Head Phantom for Guiding Treatment of Epilepsy.. Journal of Neural Engineering, 17(5), 056040. doi:10.1088/1741-2552/abb63a
• Weinand, M. E. (2021). Expression levels of RAD51 inversely correlate with survival of Glioblastoma patients.. Cancers, 13(21), 5358. doi:10.3390/cancers13215358
• Barragan, A., Preston, C., Alvarez, A., Bera, T., Qin, Y., Weinand, M., Kasoff, W., & Witte, R. S. (2020). Acoustoelectric imaging of deep dipoles in a human head phantom for guiding treatment of epilepsy. Journal of neural engineering, 17(5), 056040.
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  This study employs a human head model with real skull to demonstrate the feasibility of transcranial acoustoelectric brain imaging (tABI) as a new modality for electrical mapping of deep dipole sources during treatment of epilepsy with much better resolution and accuracy than conventional mapping methods.
• Bina, R. W., Palsma, R. S., Weinand, M. E., & Kasoff, W. S. (2020). Peripheral Nerve Stimulation for Refractory Trigeminal Pain: Recent Single-Institution Case Series With Long-Term Follow-Up and Review of the Literature. Neuromodulation : journal of the International Neuromodulation Society, 23(6), 796-804.
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  Peripheral neurostimulation (PNS) for medically refractory trigeminal pain is an emerging alternative to traditional surgical approaches, with safety and efficacy demonstrated in several retrospective series and a prospective trial currently in progress. Many existing studies suffer from relatively small numbers and short or inconsistent follow-up, making balanced treatment assessment difficult.
• Hammer, M. F., Sprissler, R., Bina, R. W., Lau, B., Johnstone, L., Walter, C. M., Labiner, D. M., & Weinand, M. E. (2019). Altered expression of signaling pathways regulating neuronal excitability in hippocampal tissue of temporal lobe epilepsy patients with low and high seizure frequency. Epilepsy research, 155, 106145.
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  Despite recent advances in our understanding of synaptic transmission associated with epileptogenesis, the molecular mechanisms that control seizure frequency in patients with temporal lobe epilepsy (TLE) remain obscure. RNA-Seq was performed on hippocampal tissue resected from 12 medically intractable TLE patients with pre-surgery seizure frequencies ranging from 0.33 to 120 seizures per month. Differential expression (DE) analysis of individuals with low (LSF, mean = 4 seizure/month) versus high (HSF, mean = 60 seizures/month) seizure frequency identified 979 genes with ≥2-fold change in transcript abundance (FDR-adjusted p-value ö0.05). Comparisons with post-mortem controls revealed a large number of downregulated genes in the HSF (1676) versus LSF (399) groups. More than 50 signaling pathways were inferred to be deactivated or activated, with Signal Transduction as the central hub in the pathway network. While neuroinflammation pathways were activated in both groups, key neuronal system pathways were systematically deactivated in the HSF group, including calcium, CREB and Opioid signaling. We also infer that enhanced expression of a signaling cascade promoting synaptic downscaling may have played a key role in maintaining a higher seizure threshold in the LSF cohort. These results suggest that therapeutic approaches targeting synaptic scaling pathways may aid in the treatment of seizures in TLE.
• Nisson, P. L., James, W. S., Gaub, M. B., Borgstrom, M., Weinand, M., & Anton, R. (2019). Peripheral white blood cell count as a screening tool for ventriculostomy-related infections. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia.
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  One of the most common complications following external ventricular drain (EVD) placement is infection. Routine cultures of cerebrospinal fluid (CSF) are often used to screen for infection, however several days may pass before infection is discovered. In this study, we compared the predictive value of daily recorded vital sign parameters and peripheral white blood count (WBC) in identifying ventriculostomy-related infections. Patients with EVDs who had CSF cultures for microorganisms performed between January 2011 and July 2017 were assigned to either an infected and/or uninfected study group. Clinical parameters were then compared using t-test, chi squared and multiple logistic regression analyses. Patients of any age and gender were included. One hundred seventy uninfected and 10 infected subjects were included in the study. Nine of the 10 infected patients had an elevated WBC (>10.4 × 10/μL), with a significantly greater WBC (15.9 × 10/μL) than the uninfected group (10.4 × 10/μL) (p-value ≤ 0.0001). Using logistic regression, we found no association between patient vital signs and CSF infection except for WBC (p = .003). As a diagnostic marker for CSF infection, the sensitivity and specificity of WBC elevation greater than 15 × 10/μL was 70% (7/10) and 90.2% (147/163), respectively. This study serves as a 'proof of concept' that WBC could be useful as potential screening tool for early detection of CSF infection post-EVD placement. Future investigation using a large, multicenter prospective study is needed to further assess the applicability of this parameter.
• Weinand, M. E., Hammer, M., Lau, B., Labiner, D. M., Walter, C. M., Bernas, M. J., Witte, M. H., Kasoff, W., Bina, R., & Sprissler, R. (2019). Leukocyte expression profiles reveal gene sets with prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy. Nature Scientific Reports.
• Bina, R. W., Weinand, M. E., Hammer, M., Kasoff, W., Labiner, D. M., Sprissler, R. S., Walter, C. M., Witte, M. H., Bernas, M. J., Bernas, M. J., Witte, M. H., Walter, C. M., Sprissler, R. S., Labiner, D. M., Kasoff, W., Hammer, M., Bina, R. W., & Weinand, M. E. (2018). Leukocyte RNA expression: Prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy. Neurosurgery, 65(1), 94.
• Gallek, M. J., Skoch, J., Ansay, T., Behbahani, M., Mount, D., Manziello, A., Witte, M., Bernas, M., Labiner, D. M., & Weinand, M. E. (2016). Cortical gene expression: prognostic value for seizure outcome following temporal lobectomy and amygdalohippocampectomy. Neurogenetics, 17(4), 211-218.
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  Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between epilepsy patients rendered seizure-free versus non-seizure-free following anterior temporal lobectomy with amygdalohippocampectomy (ATL/AH). Twenty four patients underwent ATL/AH to treat medically intractable seizures of temporal lobe origin (mean age 35.5 years, mean follow-up 42.2 months); they were then dichotomized into seizure-free and non-seizure-free groups. Tissue RNA was isolated from the lateral temporal cortex and gene expression analysis was performed. Whole genome data were analyzed for prognostic value for seizure-free outcome following ATL/AH by logistic regression. Genes that could distinguish seizure outcome groups were identified based on providing an accuracy of >0.90 judging by area under the receiver operating characteristic curve, AUC, with a P value of the slope coefficient of
• McCallum, A. P., Gallek, M. J., Ramey, W., Manziello, A., Witte, M. H., Bernas, M. J., Labiner, D. M., & Weinand, M. E. (2016). Cortical gene expression correlates of temporal lobe epileptogenicity. Pathophysiology : the official journal of the International Society for Pathophysiology, 23(3), 181-90.
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  Despite being one of the most common neurological diseases, it is unknown whether there may be a genetic basis to temporal lobe epilepsy (TLE). Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between TLE patients with high vs. low baseline seizure frequency.
• Weinand, M. E. (2016). Cortical Gene Expression Correlates of Temporal Lobe Epileptogenicity. Pathophysiology, 2016 May 28, [Epub ahead of print]. doi:doi: 10.1016/j.pathophys.2016.05.006
• Weinand, M. E. (2016). Cortical Gene Expression: Prognostic Value for Seizure Outcome Following Temporal Lobectomy and Amygdalohippocampectomy. Neurogenetics, 2016 Jun 2, [Epub ahead of print]. doi:10.1007/s10048-016-0484-2
• Huang, M., Harvey, R. L., Stoykov, M. E., Ruland, S., Weinand, M., Lowry, D., & Levy, R. (2015). Cortical stimulation for upper limb recovery following ischemic stroke: a small phase II pilot study of a fully implanted stimulator. Topics in stroke rehabilitation, 15(2), 160-72.
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  To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke.
• Sprissler, R., Bina, R., Kasoff, W., Witte, M. H., Bernas, M. J., Walter, C. M., Labiner, D. M., Lau, B., Hammer, M., & Weinand, M. E. (2018). Leukocyte expression profiles reveal gene sets with prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy. Scientific Reports, 9(1), 1086. doi:10.1038/s41598-018-37763-5
• Stidd, D. A., Wuollet, A. L., Bowden, K., Price, T., Patwardhan, A., Barker, S., Weinand, M. E., Annabi, J., & Annabi, E. (2015). Peripheral nerve stimulation for trigeminal neuropathic pain. Pain physician, 15(1), 27-33.
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  Facial pain is a complex disease with a number of possible etiologies. Trigeminal neuropathic pain (TNP) is defined as pain caused by a lesion or disease of the trigeminal branch of the peripheral nervous system resulting in chronic facial pain over the distribution of the injured nerve. First line treatment of TNP includes management with anticonvulsant medication (carbamazepine, phenytoin, gabapentin, etc.), baclofen, and analgesics. TNP, however, can be a condition difficult to adequately treat with medical management alone. Patients with TNP can suffer from significant morbidity as a result of inadequate treatment or the side effects of pharmacologic therapy. TNP refractory to medical management can be considered for treatment with a growing number of invasive procedures. Peripheral nerve stimulation (PNS) is a minimally invasive option that has been shown to effectively treat medically intractable TNP. We present a case series of common causes of TNP successfully treated with PNS with up to a 2 year follow-up. Only one patient required implantation of new electrode leads secondary to electrode migration. The patients in this case series continue to have significant symptomatic relief, demonstrating PNS as an effective treatment option for intractable TNP. Though there are no randomized trials, peripheral neuromodulation has been shown to be an effective means of treating TNP refractory to medical management in a growing number of case series. PNS is a safe procedure that can be performed even on patients that are not optimal surgical candidates and should be considered for patients suffering from TNP that have failed medical management.
• Valdivia, J. M., Dellon, A. L., Weinand, M. E., & Maloney, C. T. (2015). Surgical treatment of peripheral neuropathy: outcomes from 100 consecutive decompressions. Journal of the American Podiatric Medical Association, 95(5), 451-4.
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  Since 1992 it has been reported that patients with diabetes mellitus recover sensibility and obtain relief of pain from neuropathy symptoms by decompression of lower-extremity peripheral nerves. None of these reports included a series with more than 36 diabetic patients with lower-extremity nerves decompressed, and only recently has a single report appeared of the results of this approach in patients with nondiabetic neuropathy. No previous report has described a change in balance related to restoration of sensibility. A prospective study was conducted of 100 consecutive patients (60 with diabetes and 40 with idiopathic neuropathy) operated on by a single surgeon, other than the originator of this approach, and with the postoperative results reviewed by someone other than these two surgeons. Each patient had neurolysis of the peroneal nerve at the knee and the dorsum of the foot, and the tibial nerve released in the four medial ankle tunnels. After at least 1 year of follow-up, 87% of patients with preoperative numbness reported improved sensation, 92% with preoperative balance problems reported improved balance, and 86% whose pain level was 5 or greater on a visual analog scale from 0 (no pain) to 10 (the most severe pain) before surgery reported an improvement in pain. Decompression of compressed lower-extremity nerves improves sensation and decreases pain, and should be recommended for patients with neuropathy who have failed to improve with traditional medical treatment.
• Weinand, M. E. (2015). Stereotactic laser ablation is a potentially curative procedure after unsuccessful vns or RNS for mesial temporal lobe epilepsy. Epilepsy Currents, 15 SUPPL. 1, 164-165.
• Weinand, M. E. (2015). Stereotactic laser ablation: How much hippocampal atrophy optimizes seizure freedom?. Epilepsy Currents, 15 SUPPL. 1, 345.
• Weinand, M. E. (2015). Stereotactic laser ablation: How much hippocampus and amygdala ablation volume optimizes seizure freedom?. Epilepsy Currents, 15 SUPPL. 1, 304-305.
• Weinand, M. E. (2015). Stereotactic laser amygdalo-hippocampotomy for mesial temporal lobe epilepsy: Collective experience from seven single-center, prospective, investigator-initiated studies objectives. Epilepsy Currents, 15 SUPPL. 1, 346.
• Gross, R. E., Willie, J. T., Sharan, A. D., Sperling, M., Shih, J. J., Wharen, R. E., Tatum, W., Popli, G., Couture, D. E., Laxton, A. W., Labiner, D. M., Weinand, M. E., Marsh, W. R., Cascino, G., Worrell, G. A., Wilfong, A. A., & Curry, D. (2014). Stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy: collective experience from 7 single-center, prospective, investigator-initiated studies. Neurosurgery, 61(Suppl 1:192). doi:10.1227/01.neu.0000452377.10458.80
• Nielsen, V. G., Lemole, G. M., Matika, R. W., Weinand, M. E., Hussaini, S., Baaj, A. A., & Steinbrenner, E. B. (2014). Brain tumors enhance plasmatic coagulation: the role of hemeoxygenase-1. Anesthesia and analgesia, 118(5), 919-24.
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  Patients with brain tumors suffer significant thrombotic morbidity and mortality. In addition to increased thrombin generation via tumor release of tissue factor-bearing microparticles and hyperfibrinogenemia, brain tumors and surrounding normal brain likely generate endogenous carbon monoxide (CO) via the hemeoxygenase-1 (HO-1) system. CO has been shown to enhance plasmatic coagulation via formation of carboxyhemefibrinogen (COHF). Thus, our goals in this study were to determine whether patients with brain tumors had increased HO-1 upregulation/CO production, plasmatic hypercoagulability, and formation of COHF.
• Palejwala, S. K., Stidd, D. A., Skoch, J. M., Gupta, P., Lemole, G. M., & Weinand, M. E. (2014). Use of a stop-flow programmable shunt valve to maximize CNS chemotherapy delivery in a pediatric patient with acute lymphoblastic leukemia. Surgical neurology international, 5(Suppl 4), S273-7.
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  The requirement for frequent intraventricular drug delivery in the setting of shunt dependence is particularly challenging in the treatment of central nervous system infection, neoplastic disease, and hemorrhage. This is especially relevant in the pediatric population where both hematogenous malignancy requiring intrathecal drug delivery and shunt-dependent hydrocephalus are more prevalent. Intrathecal and intraventricular chemotherapy agents can be prematurely diverted in these shunt-dependent patients.
• Stidd, D. A., Rivero, S., & Weinand, M. E. (2014). Spinal cord stimulation with implanted epidural paddle lead relieves chronic axial low back pain. Journal of pain research, 7, 465-70.
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  Spinal cord stimulation (SCS) provides significant relief for lumbosacral radiculopathy refractory to both medical and surgical treatment, but historically only offers limited relief for axial low back pain (LBP). We aim to evaluate the response of chronic axial LBP treated with SCS using a surgically implanted epidural paddle lead.
• Weinand, M. E. (2014). Stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy: Results of multicenter experience at 6 months and 1 year. Epilepsy Currents, 14(SUPPL. 1), 241-242.
• Weinand, M. E. (2014). Stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy: collective experience from 7 single-center, prospective, investigator-initiated studies.. Neurosurgery, 61(Suppl 1), 192.
• Fiala, M., Avagyan, H., Merino, J. J., Bernas, M., Valdivia, J., Espinosa-Jeffrey, A., Witte, M., & Weinand, M. (2013). Chemotactic and mitogenic stimuli of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy. Pathophysiology : the official journal of the International Society for Pathophysiology / ISP, 20(1), 59-69.
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  To identify the upstream signals of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy (TLE), we evaluated by immunohistochemistry and confocal microscopy brain tissues of 13 TLE patients and 5 control patients regarding expression of chemokines and cell-cycle proteins. The chemokine RANTES (CCR5) and other CC-chemokines and apoptotic markers (caspase-3, -8, -9) were expressed in lateral temporal cortical and hippocampal neurons of TLE patients, but not in neurons of control cases. The chemokine RANTES is usually found in cytoplasmic and extracellular locations. However, in TLE neurons, RANTES was displayed in an unusual location, the neuronal nuclei. In addition, the cell-cycle regulatory transcription factor E2F1 was found in an abnormal location in neuronal cytoplasm. The pro-inflammatory enzyme cyclooxygenase-2 and cytokine interleukin-1β were expressed both in neurons of patients suffering from temporal lobe epilepsy and from cerebral trauma. The vessels showed fibrin leakage, perivascular macrophages and expression of IL-6 on endothelial cells. In conclusion, the cytoplasmic effects of E2F1 and nuclear effects of RANTES might have novel roles in neuronal apoptosis of TLE neurons and indicate a need to develop new medical and/or surgical neuroprotective strategies against apoptotic signaling by these molecules. Both RANTES and E2F1 signaling are upstream from caspase activation, thus the antagonists of RANTES and/or E2F1 blockade might be neuroprotective for patients with medically intractable temporal lobe epilepsy. The results have implications for the development of new medical and surgical therapies based on inhibition of chemotactic and mitogenic stimuli of neuronal apoptosis in patients with medically intractable temporal lobe epilepsy.
• Funk, J. L., Frye, J. B., Davis-Gorman, G., Spera, A. L., Bernas, M. J., Witte, M. H., Weinand, M. E., Timmermann, B. N., McDonagh, P. F., & Ritter, L. (2013). Curcuminoids limit neutrophil-mediated reperfusion injury in experimental stroke by targeting the endothelium. Microcirculation (New York, N.Y. : 1994), 20(6), 544-54.
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  We sought to test the hypothesis that turmeric-derived curcuminoids limit reperfusion brain injury in an experimental model of stroke via blockade of early microvascular inflammation during reperfusion.
• McDonagh, P. F., Weinand, M. E., Witte, M. H., Funk, J. L., Frye, J. B., Davis-Gorman, G., Spera, A. L., Bernas, M. J., Timmermann, B. N., & Ritter, L. (2013). Curcuminoids Limit Neutrophil-Mediated Reperfusion Injury in Experimental Stroke by Targeting the Endothelium. Microcirculation, 20(6), 544-554. doi:10.1111/micc.12054
• Ramey, W. L., Martirosyan, N. L., Lieu, C. M., Hasham, H. A., Lemole, G. M., & Weinand, M. E. (2013). Current management and surgical outcomes of medically intractable epilepsy. Clinical neurology and neurosurgery, 115(12), 2411-8.
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  Epilepsy is one of the most common neurologic disorders in the world. While anti-epileptic drugs (AEDs) are the mainstay of treatment in most cases, as many as one-third of patients will have a refractory form of disease indicating the need for a neurosurgical evaluation. Ever since the first half of the twentieth century, surgery has been a major treatment option for epilepsy, but the last 10-15 years in particular has seen several major advances. As shown in relatively recent studies, resection is more effective for medically intractable epilepsy (MIE) than AED treatment alone, which is why most clinicians now endorse a neurosurgical consultation after approximately two failed regimens of AEDs, ultimately leading to decreased healthcare costs and increased quality of life. Temporal lobe epilepsy (TLE) is the most common form of MIE and comprises about 80% of epilepsy surgeries with the majority of patients gaining complete seizure-freedom. As the number of procedures and different approaches continues to grow, temporal lobectomy remains consistently focused on resection of mesial structures such as the amygdala, hippocampus, and parahippocampal gyrus while preserving as much of the neocortex as possible resulting in optimum seizure control with minimal neurological deficits. MIE originating outside the temporal lobe is also effectively treated with resection. Though not as successful as TLE surgery because of their frequent proximity to eloquent brain structures and more diffuse pathology, epileptogenic foci located extratemporally also benefit from resection. Favorable seizure outcome in each of these procedures has heavily relied on pre-operative imaging, especially since the massive surge in MRI technology just over 20 years ago. However, in the absence of visible lesions on MRI, recent improvements in secondary imaging modalities such as fluorodeoxyglucose positron emission computed tomography (FDG-PET) and single-photon emission computed tomography (SPECT) have lead to progressively better long-term seizure outcomes by increasing the neurosurgeon's visualization of supposed non-lesional foci. Additionally, being historically viewed as a drastic surgical intervention for MIE, hemispherectomy has been extensively used quite successfully for diffuse epilepsies often found in pediatric patients. Although total anatomic hemispherectomy is not utilized as commonly today, it has given rise to current disconnective techniques such as hemispherotomy. Therefore, severe forms of hemispheric developmental epilepsy can now be surgically treated while substantially decreasing the amount of potential long-term complications resulting from cavitation of the brain following anatomical hemispherectomy. Despite the rapid pace at which we are gaining further knowledge about epilepsy and its surgical treatment, there remains a sizeable underutilization of such procedures. By reviewing the recent literature on resective treatment of MIE, we provide a recent up-date on epilepsy surgery while focusing on historical perspectives, techniques, prognostic indicators, outcomes, and complications associated with several different types of procedures.
• Slavin, K. V., Vaisman, J., Pollack, K. L., Simopoulos, T. T., Kowlowitz, E., Weinand, M. E., & Norregaard, T. V. (2013). Treatment of chronic, intractable pain with a conventional implantable pulse generator: a meta-analysis of 4 clinical studies. The Clinical journal of pain, 29(1), 78-85.
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  To provide further short-term (6 mo) and long-term (1 y) evidence for the use of spinal cord stimulation (SCS) with a conventional implantable pulse generator in the management of chronic, intractable pain.
• Valdivia Valdivia, J. M., Weinand, M., Maloney, C. T., Blount, A. L., & Dellon, A. L. (2013). Surgical treatment of superimposed, lower extremity, peripheral nerve entrapments with diabetic and idiopathic neuropathy. Annals of plastic surgery, 70(6), 675-9.
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  Although it is recognized that people with peripheral neuropathy have an increased prevalence of chronic nerve entrapment, controversy still exists over their management. The present report details the evaluation, surgical approach, and outcome of a large cohort of people with diabetic and with idiopathic neuropathy.
• Weinand, M. E. (2013). Multicenter experience with minimally invasive stereotactic laser thermal amygdalohippocampotomy for mesial temporal lobe epilepsy. Epilepsia, 54(SUPPL. 3), 290.
• Weinand, M. E. (2013). Stereotactic laser thermal amygdalohippocampotomy for mesial temporal lobe epilepsy: Preliminary outcomes of multicenter experience. Journal of Neurosurgery, 119:2, A542-A543.
• Weinand, M. E. (2013). Treatment of chronic, intractable pain with a conventional implantable pulse generator: A meta-analysis of four clinical studies.. Clinical Journal of Pain, 29(1), 78-85. doi:10.1097/AJP.0b013e318247309a
• Osbun, J. W., Ellenbogen, R. G., Chesnut, R. M., Chin, L. S., Connolly, P. J., Cosgrove, G. R., Delashaw, J. B., Golfinos, J. G., Greenlee, J. D., Haines, S. J., Jallo, J., Muizelaar, J. P., Nanda, A., Shaffrey, M., Shah, M. V., Tew, J. M., van Loveren, H. R., Weinand, M. E., White, J. A., & Wilberger, J. E. (2012). A multicenter, single-blind, prospective randomized trial to evaluate the safety of a polyethylene glycol hydrogel (Duraseal Dural Sealant System) as a dural sealant in cranial surgery. World neurosurgery, 78(5), 498-504.
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  Incisional cerebrospinal fluid (CSF) leakage after cranial surgery is a significant cause of morbidity due to poor wound healing and infection, meningitis, and pseudomeningocele formation. Many common dural closure techniques, such as sutures, autologous grafts, gelatin or collagen sponges, and fibrin glues, are used to achieve watertight closure, although none are US Food and Drug Administration approved for this use. DuraSeal Dural Sealant System is a polyethylene glycol (PEG) hydrogel approved by the U.S. Food and Drug Administration for obtaining watertight dural closure when applied after standard dural suturing. This multicenter, prospective randomized study further evaluated the safety of a PEG hydrogel compared with common dural sealing techniques.
• Patwardhan, A. M., Wuollet, A. L., Weinand, M. E., Stidd, D. A., Price, T. J., Patwardhan, A. M., Bowden, K., Barker, S., Annabi, J., & Annabi, E. (2012). Peripheral nerve stimulation for trigeminal neuropathic pain.. Pain physician, 15(1), 27-33.
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  Facial pain is a complex disease with a number of possible etiologies. Trigeminal neuropathic pain (TNP) is defined as pain caused by a lesion or disease of the trigeminal branch of the peripheral nervous system resulting in chronic facial pain over the distribution of the injured nerve. First line treatment of TNP includes management with anticonvulsant medication (carbamazepine, phenytoin, gabapentin, etc.), baclofen, and analgesics. TNP, however, can be a condition difficult to adequately treat with medical management alone. Patients with TNP can suffer from significant morbidity as a result of inadequate treatment or the side effects of pharmacologic therapy. TNP refractory to medical management can be considered for treatment with a growing number of invasive procedures. Peripheral nerve stimulation (PNS) is a minimally invasive option that has been shown to effectively treat medically intractable TNP. We present a case series of common causes of TNP successfully treated with PNS with up to a 2 year follow-up. Only one patient required implantation of new electrode leads secondary to electrode migration. The patients in this case series continue to have significant symptomatic relief, demonstrating PNS as an effective treatment option for intractable TNP. Though there are no randomized trials, peripheral neuromodulation has been shown to be an effective means of treating TNP refractory to medical management in a growing number of case series. PNS is a safe procedure that can be performed even on patients that are not optimal surgical candidates and should be considered for patients suffering from TNP that have failed medical management.
• Stidd, D. A., Root, B., Weinand, M. E., & Anton, R. (2012). Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent girl. World neurosurgery, 78(6), 715.e7-12.
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  Balamuthia mandrillaris is a recently recognized cause of a rare, devastating infection, granulomatous amoebic encephalitis (GAE). Presenting symptoms of GAE are nonspecific and can last for months before becoming clinically significant. Once the infection involves the central nervous system, death often results within days to weeks. A high degree of clinical suspicion is needed to correctly diagnose this infection because definitive diagnostic tests are presently limited, and even then there are only sparse data concerning effective treatment. The importance of early diagnosis is emphasized because delay likely contributes to the extremely high mortality with this infection.
• Bernas, M. J., Cardoso, F. L., Daley, S. K., Weinand, M. E., Campos, A. R., Ferreira, A. J., Hoying, J. B., Witte, M. H., Brites, D., Persidsky, Y., Ramirez, S. H., & Brito, M. A. (2010). Establishment of primary cultures of human brain microvascular endothelial cells to provide an in vitro cellular model of the blood-brain barrier. Nature protocols, 5(7), 1265-72.
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  We describe a method for generating primary cultures of human brain microvascular endothelial cells (HBMVECs). HBMVECs are derived from microvessels isolated from temporal tissue removed during operative treatment of epilepsy. The tissue is mechanically fragmented and size filtered using polyester meshes. The resulting microvessel fragments are placed onto type I collagen-coated flasks to allow HBMVECs to migrate and proliferate. The overall process takes less than 3 h and does not require specialized equipment or enzymatic processes. HBMVECs are typically cultured for approximately 1 month until confluent. Cultures are highly pure ( approximately 97% endothelial cells; approximately 3% pericytes), are reproducible, and show characteristic brain endothelial markers (von Willebrand factor, glucose transporter-1) and robust expression of tight and adherens junction proteins as well as caveolin-1 and efflux protein P-glycoprotein. Monolayers of HBMVECs show characteristically high transendothelial electric resistance and have proven useful in multiple functional studies for in vitro modeling of the human blood-brain barrier.
• Harvey, R. L., Winstein, C. J., & , E. T. (2009). Design for the everest randomized trial of cortical stimulation and rehabilitation for arm function following stroke. Neurorehabilitation and neural repair, 23(1), 32-44.
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  Cortical stimulation (CS) combined with rehabilitation may improve upper limb motor function after stroke.
• Thayer, J. F., Sollers, J. J., Labiner, D. M., Weinand, M., Herring, A. M., Lane, R. D., & Ahern, G. L. (2009). Age-related differences in prefrontal control of heart rate in humans: a pharmacological blockade study. International journal of psychophysiology : official journal of the International Organization of Psychophysiology, 72(1), 81-8.
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  The Neurovisceral Integration Model is based on the premise of significant central nervous system-peripheral nervous system interactions. In support of this model we have previously shown that the prefrontal cortex tonically inhibits cardioacceleratory circuits as evidenced by increased heart rate (HR) when the prefrontal cortex is inactivated by injections of sodium amobarbitol (ISA) into the internal carotid artery. In this report we re-examine these data to investigate possible age-related differences in the prefrontal control of HR in humans. Seventy-three patients were divided into three groups based on a tertile split with mean ages of 20, 34, and 47, respectively. There were significant age-related differences in cortical control of HR as evidenced by a significant three way interaction of age (young, middle, old) by side (left versus right) by time (baseline and epochs 1-10 of inactivation) [Roy's Root (10,59)=0.378, p=0.028]. Results showed significant HR increases that did not differ between hemispheres in the youngest age group, significant increases in the middle age group that were larger in the right hemisphere than in the left, and significant HR increases in the oldest group in the right hemisphere only. The findings suggest important age-related differences in cortical inhibitory control of HR that appear less lateralized in the youngest group and significantly attenuated in the oldest age group. These results have important implications for the understanding of age-related differences in cognitive, affective, behavioral, and physiological functioning. In addition they support the importance of investigating central nervous system-peripheral nervous system relationships.
• Weinand, M., Serxner, B., Labiner, D., & Ahern, G. (2009). Interhemispheric propagation time and temporal lobe epileptogenicity. Pathophysiology : the official journal of the International Society for Pathophysiology / ISP, 16(1), 39-42.
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  Long-term subdural electroencephalographic (EEG) recording was performed in a series of patients with medically intractable complex partial seizures to test the hypothesis that ictal interhemispheric propagation time (IHPT) is correlated with temporal lobe epileptogenicity. In 41 patients, the duration from initial subdural EEG seizure onset to the first appearance of subdural EEG epileptic activity in the contralateral hemisphere (IHPT) was measured in seconds and analyzed for a quantitative relationship to temporal lobe seizure interval (frequency⁻¹), in hours. A statistically significant, nonlinear correlation between IHPT and seizure interval was found (Arctan y=-0.009x²+0.598x+75.187, y=IHPT, in seconds, x=seizure interval, in hours, r=0.326, d.f.=39, t=2.15, p
• Zaghi, J., Goldenson, B., Inayathullah, M., Lossinsky, A. S., Masoumi, A., Avagyan, H., Mahanian, M., Bernas, M., Weinand, M., Rosenthal, M. J., Espinosa-Jeffrey, A., de Vellis, J., Teplow, D. B., & Fiala, M. (2009). Alzheimer disease macrophages shuttle amyloid-beta from neurons to vessels, contributing to amyloid angiopathy. Acta neuropathologica, 117(2), 111-24.
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  Neuronal accumulation of oligomeric amyloid-beta (Alphabeta) is considered the proximal cause of neuronal demise in Alzheimer disease (AD) patients. Blood-borne macrophages might reduce Abeta stress to neurons by immigration into the brain and phagocytosis of Alphabeta. We tested migration and export across a blood-brain barrier model, and phagocytosis and clearance of Alphabeta by AD and normal subjects' macrophages. Both AD and normal macrophages were inhibited in Alphabeta export across the blood-brain barrier due to adherence of Abeta-engorged macrophages to the endothelial layer. In comparison to normal subjects' macrophages, AD macrophages ingested and cleared less Alphabeta, and underwent apoptosis upon exposure to soluble, protofibrillar, or fibrillar Alphabeta. Confocal microscopy of stained AD brain sections revealed oligomeric Abeta in neurons and apoptotic macrophages, which surrounded and infiltrated congophilic microvessels, and fibrillar Abeta in plaques and microvessel walls. After incubation with AD brain sections, normal subjects' monocytes intruded into neurons and uploaded oligomeric Abeta. In conclusion, in patients with AD, macrophages appear to shuttle Abeta from neurons to vessels where their apoptosis may release fibrillar Abeta, contributing to cerebral amyloid angiopathy.
• Brown, J. A., Lutsep, H. L., Weinand, M., & Cramer, S. C. (2008). Motor cortex stimulation for the enhancement of recovery from stroke: a prospective, multicenter safety study. Neurosurgery, 62 Suppl 2, 853-62.
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  Functional magnetic resonance imaging and transcranial magnetic stimulation studies suggest that human cortex shows evidence of neuroplasticity. Preclinical studies in rats and monkeys suggest that motor cortical stimulation can enhance plasticity and improve recovery after stroke. This study assesses the safety and preliminary efficacy of targeted subthreshold epidural cortical stimulation delivered concurrently with intensive rehabilitation therapy while using an investigational device in patients with chronic hemiparetic stroke.
• Fiala, M., Singer, E. J., Commins, D., Mirzapoiazova, T., Verin, A., Espinosa, A., Ugen, K., Bernas, M., Witte, M., Weinand, M., & Lossinsky, A. S. (2008). HIV-1 Antigens in Neurons of Cocaine-Abusing Patients. The open virology journal, 2, 24-31.
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  Cocaine opens the blood-brain barrier by deregulating transcription of target genes. Here we show that cocaine at blood concentrations in drug abusers disrupts endothelial cell junctions in parallel with signaling by phosphorylation of extracellular signal-regulated kinase, myristoylated alanine-rich C kinase and myosin light chain. Cocaine effects may be important in vivo since the neurons of drug abusing patients with HIV-1 associated dementia displayed gp120, p24 and Nef.
• Levy, R., Ruland, S., Weinand, M., Lowry, D., Dafer, R., & Bakay, R. (2008). Cortical stimulation for the rehabilitation of patients with hemiparetic stroke: a multicenter feasibility study of safety and efficacy. Journal of neurosurgery, 108(4), 707-14.
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  In this prospective multicenter study the authors hypothesized that investigational epidural cortical stimulation (CS) delivered concurrently with rehabilitation therapy may enhance motor recovery following stroke.
• Lowry, D. W., Weinand, M. E., Stoykov, M. E., Ruland, S., Lowry, D., Levy, R. M., Huang, M. E., & Harvey, R. L. (2008). Cortical stimulation for upper limb recovery following ischemic stroke: a small phase II pilot study of a fully implanted stimulator.. Topics in stroke rehabilitation, 15(2), 160-72. doi:10.1310/tsr1502-160
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  To evaluate the feasibility of a fully implanted cortical stimulator for improving hand and arm function in patients following ischemic stroke..Twenty-four chronic stroke patients with hemiplegia were randomized to targeted implanted cortical electrical stimulation of the motor cortex with upper limb rehabilitation therapy or rehabilitation therapy alone..Using repeated measures regression models, we estimated and compared treatment effects between groups over the study follow-up period. The investigational group had significantly greater mean improvements in Upper Extremity Fugl-Meyer (UEFM) scores during the 6-month follow-up period (weeks 1-24 following therapy), as compared to the control group (difference in estimated means = 3.8, p = .042). Box and Block (B & B) test improvement from baseline scores were also significantly better in the investigational group across the 6-month follow-up assessments (difference in estimated means = 3.8, p = .046). There was one report of seizure after device implant but prior to cortical stimulation and rehabilitation therapy, but no reports of neurologic decline. There were no improvements seen in the other measures assessed..Evidence suggests that cortical stimulation with rehabilitation therapy produces a lasting treatment effect in upper extremity motor control and is not associated with serious neurological complications. A larger multicenter study is underway.
• Cramer, S. C., Parrish, T. B., Levy, R. M., Stebbins, G. T., Ruland, S. D., Lowry, D. W., Trouard, T. P., Squire, S. W., Weinand, M. E., Savage, C. R., Wilkinson, S. B., Juranek, J., Leu, S., & Himes, D. M. (2007). Predicting functional gains in a stroke trial. Stroke; a journal of cerebral circulation, 38(7), 2108-14.
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  A number of therapies in development for patients with central nervous system injury aim to reduce disability by improving function of surviving brain elements rather than by salvaging tissue. The current study tested the hypothesis that, after adjusting for a number of clinical assessments, a measure of brain function at baseline would improve prediction of behavioral gains after treatment.
• Lowry, D. W., Wilkinson, S. B., Weinand, M. E., Trouard, T. P., Stebbins, G. T., Squire, S., Ruland, S., Parrish, T. B., Lowry, D., Levy, R. M., Leu, S., Juranek, J., Himes, D. M., & Cramer, S. C. (2007). An assessment of brain function predicts functional gains in a clinical stroke trial. Stroke, 38(2), 520-520.
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  Author(s): Cramer, Steven C; Parrish, Todd B; Levy, Robert M; Stebbins, Glenn T; Ruland, Sean D; Lowry, David W; Trouard, Theodore P; Squire, Scott W; Weinand, Martin E; Wilkinson, Steven B; Juranek, Jenifer; Leu, Szu-Yun; Himes, David M
• Weinand, M. E., Farley, C., Hussain, N., Labiner, D. M., & Ahern, G. L. (2007). Time from ictal subdural EEG seizure onset to clinical seizure onset: an electrocorticographic time factor associated with temporal lobe epileptogenicity. Neurological research, 29(8), 862-70.
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  Long-term subdural video/electroencephalographic (EEG) monitoring was performed in a series of patients with medically intractable complex partial seizures, in a study of diagnostic accuracy, to test the hypothesis that the time from ictal subdural EEG seizure onset to clinical seizure onset (ECOT) is correlated with temporal lobe epileptogenicity and confirm measures of validity of ECOT for predicting seizure-free outcome following anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH). In 34 patients with refractory temporal lobe epilepsy, subdural EEG monitoring localized the ictal epileptogenic focus to a single temporal lobe. In each patient, ECOT was analysed for correlation with temporal lobe epileptogenicity as measured by seizure interval in hours. Patients in whom ECOT was equal to or less than the mean (i.e. subdural EEG seizure onset preceding clinical seizure onset by at least 11.7 seconds) had a significantly greater likelihood of becoming seizure-free following ATL/AH compared to patients in whom ECOT was greater than the mean (i.e. subdural EEG seizure onset preceding clinical seizure onset by less than 11.7 seconds) (x(2) = 5.78, p
• Weinand, M. E., Hussain, N. S., & Bogert, J. (2007). Improving the Selection of Temporal Lobectomy Candidates through the Use of Multiple Subdural Electroencephalographic Prognostic Parameters. Neurosurgery, 61(1), 257-257. doi:10.1227/01.neu.0000279935.97655.90
• Brown, J. A., Lutsep, H. L., Weinand, M., & Cramer, S. C. (2006). Motor cortex stimulation for the enhancement of recovery from stroke: a prospective, multicenter safety study. Neurosurgery, 58(3), 464-73.
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  Functional magnetic resonance imaging and transcranial magnetic stimulation studies suggest that human cortex shows evidence of neuroplasticity. Preclinical studies in rats and monkeys suggest that motor cortical stimulation can enhance plasticity and improve recovery after stroke. This study assesses the safety and preliminary efficacy of targeted subthreshold epidural cortical stimulation delivered concurrently with intensive rehabilitation therapy while using an investigational device in patients with chronic hemiparetic stroke.
• Weinand, M. E. (2006). Cortical Stimulation for Motor Recovery after Stroke: Impact on Neuropsychological Performance and Functional Imaging. Neurosurgery, 59(2), 480. doi:10.1227/01.NEU.0000309928.53079.E2
• Weinand, M. E., Hussain, N., Labiner, D. M., & Ahern, G. L. (2006). Correlation of electrocorticographic to clinical seizure onset and interhemispheric propagation times in temporal lobe epilepsy. Pathophysiology : the official journal of the International Society for Pathophysiology / ISP, 13(4), 233-6.
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  This study was performed to test the hypothesis that, in human temporal lobe epilepsy, electrocorticographic time factors involved in the ictal EEG to clinical ictal transition (electrocorticographic to clinical seizure onset time, ECOT) and the interhemispheric propagation of epileptic activity (interhemispheric propagation time, IHPT), which are independently correlated with temporal lobe epileptogenicity and predictive of seizure-free outcome following temporal lobectomy, are correlated with one another in a quantitative fashion. A series of 37 patients with medically intractable temporal lobe seizures was studied with long-term subdural videoelectroencephalographic monitoring. Temporal lobe seizure interhemispheric propagation time (IHPT) was found to be a negative, exponential function of electrocorticographic to clinical seizure onset time (ECOT) (f(x)=8.201x10(-0.016x), r=0.347, d.f.=35, t=2.19, p
• Weinand, M. E., Valdivia, J. M., Maloney, C. T., & Farley, C. (2006). 13 SURGICAL TREATMENT OF PERIPHERAL ENTRAPMENT NEUROPATHY OF THE LOWER EXTREMITIES: OUTCOMES FROM 158 CONSECUTIVE SURGICAL CASES.. Journal of Investigative Medicine, 54(2), S375.2-S375. doi:10.2310/6650.2005.x0015.91
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  Objective We report the outcome of 158 patients with peripheral entrapment neuropathy treated surgically by multiple nerve decompressions of the peroneal and tibial system. This is a promising approach for the treatment of pain, numbness, and balance disturbance in diabetic and nondiabetic patients with peripheral nerve entrapment syndromes in the lower extremities. Methods Records of 158 consecutive patients with diabetic and nondiabetic neuropathy, treated surgically by multiple nerve decompression, were reviewed to document changes in the visual analogue scale, sensation improvement, reduction in pain medication requirement, and balance improvement. All patients underwent tarsal tunnel release and neurolysis of lower extremity nerves of the tibial and peroneal system as a concomitant part of the procedure. Patients offered surgical intervention met specific criteria including documented sensory abnormalities using neurosensory testing by the Pressure-Specified Sensory Device (PSSD) and a positive Tinel9s sign on examination over the involved nerve. Results Eighty-eight percent of the patients with preoperative numbness reported sensation improvement. Eighty-one percent of patients with balance disturbance reported improved balance after the procedure. From those patients who underwent the procedure mainly for pain relief, 83% reported an improvement in the visual analogue scale of more than 50% and 77% improved in more than 5 points of the scale. After the procedure, patients reported a decrease in their pain medication requirement (p ≥ .001), sensation improvement (p ≥ .001), and pain relief (p ≥ .001). Conclusion Similar to experiences found in the upper extremity, nerve decompression in the lower extremity is a safe and effective procedure to improve the quality of life of patients with peripheral neuropathy secondary to nerve compression. Documentation and staging of the severity of neuropathy with neurosensory testing and the presence of Tinel9s sign facilitate successful selection of surgical candidates. Decompression and neurolysis of compressed lower extremity nerves are associated with statistically significant improvement in the visual analogue scale and sensation. The great majority of patients are very satisfied with the results.
• Weinand, M. E., Valdivia, J., Maloney, C. T., & Dellon, A. L. (2006). Surgical Treatment of Peripheral Neuropathy: Outcomes from 200 Consecutive Surgical Cases. Journal of Reconstructive Microsurgery, 22(06). doi:10.1055/s-2006-949683
• Weinand, M., Brown, J. A., Lutsep, H. L., & Cramer, S. C. (2006). Motor Cortex Stimulation for the Enhancement of Recovery from Stroke: A Prospective, Multicenter Safety Study. Neurosurgery, 58(3), 464-473. doi:10.1227/01.neu.0000197100.63931.04
• Weinand, M., Valdivia, J., Farley, C., & Maloney, C. (2006). Surgical Treatment of Peripheral Entrapment Neuropathy of the Lower Extremities: Outcomes from 158 Consecutive Surgical Cases. Journal of Investigative Medicine, 54(2_suppl), 375-375. doi:10.1177/108155890605402s92
• Cramer, S. C., Benson, R. R., Himes, D. M., Burra, V. C., Janowsky, J. S., Weinand, M. E., Brown, J. A., & Lutsep, H. L. (2005). Use of functional MRI to guide decisions in a clinical stroke trial. Stroke; a journal of cerebral circulation, 36(5), e50-2.
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  An investigational trial examined safety and efficacy of targeted subthreshold cortical stimulation in patients with chronic stroke. The anatomical location for the target, hand motor area, varies across subjects, and so was localized with functional MRI (fMRI). This report describes the experience of incorporating standardized fMRI into a multisite stroke trial.
• Weinand, M. E. (2005). A Multicenter Feasibility Study of Cortical Stimulation for the Rehabilitation of Patients with Hemiparetic Stroke: 6-Month Follow-up. Neurosurgery, 57(2), 400. doi:10.1227/01.NEU.0000129551.64651.74
• Weinand, M. E. (2005). Carotid endarterectomy without shunt: the role of cerebral metabolic protection. Neurological Research, 27(8), 850-856.
• Weinand, M. E. (2005). Cocaine increases human immunodeficiency virus type 1 neuroinvasion through remodeling brain microvascular endothelial cells. Journal of Neurovirology, 11(3), 281-291.
• Weinand, M. E. (2005). Thyrocervical trunk-external carotid artery bypass for positional cerebral ischemia due to common carotid occlusion: Technical note.. Journal of Neurosurgery, 103(1), 170-175.
• Weinand, M. E. (2005). Use of functional MRI to guide decisions in a clinical stroke trial. Stroke, 36(5), e50-52.
• Weinand, M. E., Valdivia, J. M., Maloney, C. T., & Dellon, A. L. (2005). Surgical treatment of peripheral neuropathy: outcomes from 100 consecutive decompressions.. Journal of the American Podiatric Medical Association, 95(5), 451-4. doi:10.7547/0950451
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  Since 1992 it has been reported that patients with diabetes mellitus recover sensibility and obtain relief of pain from neuropathy symptoms by decompression of lower-extremity peripheral nerves. None of these reports included a series with more than 36 diabetic patients with lower-extremity nerves decompressed, and only recently has a single report appeared of the results of this approach in patients with nondiabetic neuropathy. No previous report has described a change in balance related to restoration of sensibility. A prospective study was conducted of 100 consecutive patients (60 with diabetes and 40 with idiopathic neuropathy) operated on by a single surgeon, other than the originator of this approach, and with the postoperative results reviewed by someone other than these two surgeons. Each patient had neurolysis of the peroneal nerve at the knee and the dorsum of the foot, and the tibial nerve released in the four medial ankle tunnels. After at least 1 year of follow-up, 87% of patients with preoperative numbness reported improved sensation, 92% with preoperative balance problems reported improved balance, and 86% whose pain level was 5 or greater on a visual analog scale from 0 (no pain) to 10 (the most severe pain) before surgery reported an improvement in pain. Decompression of compressed lower-extremity nerves improves sensation and decreases pain, and should be recommended for patients with neuropathy who have failed to improve with traditional medical treatment.
• Weinand, M. E. (2004). Targeted subthreshold cortical stimulation for recovery of motor hand function after hemiparetic stroke. Neurosurgery, 55, 480.
• Weinand, M., Gonzalez-Portillo, G., Rivero, S., Ahern, G. L., Labiner, D. M., & Weinand, M. E. (2004). Normalization of periictal bihemispheric cerebral perfusion in temporal lobe epilepsy. Pathophysiology : the official journal of the International Society for Pathophysiology / ISP, 11(1).
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  Under normal circumstances, cerebral blood flow (CBF), between the two hemispheres is coupled in a direct (i.e. positive slope), linear fashion. However, in temporal lobe epilepsy, the relationship between the two temporal cortices, during the interictal and postictal periods, is the inverse of normal (i.e. correlation is with negative slope and linear). Long-term combined temporal lobe thermal diffusion flowmetry (TDF) subdural regional cerebral blood flow and electroencephalographic (EEG) recording was performed to test the hypothesis that, during the 10min periictal period (i.e. 5min before and 5min following clinical seizure onset), the cerebral perfusion relationship between epileptic and nonepileptic cortex returns to normal (i.e. becomes direct, with positive slope, and linear). A consecutive series of 13 patients with complex partial epilepsy was studied. During continuous monitoring of clinical phenomenology in time sequence with subdural CBF/EEG, the 10min periictal period was characterized by a direct, linear correlation between epileptic and nonepileptic temporal cortical blood flow ( [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] ). The fact that this pertubation in the CBF relationship between the bilateral temporal cortices begins prior to and continues for 5min following clinical and subdural EEG seizure onset raises the interesting possibility that normalization of periictal bilateral cerebral perfusion may be associated with temporal lobe epileptogenesis.
• Brown, J. A., Lutsep, H., Cramer, S. C., & Weinand, M. (2003). Motor cortex stimulation for enhancement of recovery after stroke: case report. Neurological research, 25(8), 815-8.
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  We present a case report of a 65-year-old patient who had a subcortical infarct and a right spastic hemiparesis that occurred 19 months before being treated with an investigational therapy consisting of low frequency subthreshold epidural motor cortex electrical stimulation delivered during structured occupational therapy repeated daily for three weeks. Before treatment the patient's affected arm rested in a flexion posture and he was unable to flex or extend the fingers. After three weeks of treatment, the resting tone of his arm had improved and he was able to grasp a pen and write letters. The Fugl-Meyer motor scale score improved from 36 to 46 and this improvement was sustained for four weeks after the conclusion of rehabilitation therapy. This is the first patient to be entered into a randomized clinical feasibility and safety study assessing functional improvement in stroke patients treated with epidural cortical stimulation concurrent with occupational therapy (an investigational therapy).
• Weinand, M. E. (2003). Acute versus prolonged screening for spinal cord stimulation in chronic pain.. Neuromodulation (Technology at the Neural Interface), 6(1), 15-19. doi:10.1046/j.1525-1403.2003.03002.x.
• Weinand, M. E., & Melgar, M. A. (2003). Thyrocervical trunk-external carotid artery bypass for positional cerebral ischemia due to common carotid artery occlusion. Report of three cases.. Neurosurgical focus, 14(3), e7. doi:10.3171/foc.2003.14.3.8
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  Medically refractory positional cerebral ischemia and concomitant orthostatic hypotension associated with chronic common carotid artery (CCA) occlusion are rare. The authors detail their experience with three cases treated exclusively by an extracranial bypass in which the thyrocervical trunk was used as the donor vessel. Postoperatively grafts were patent and symptoms resolved in all three patients, although orthostatic hypotension remained. Postural cerebral ischemia due to CCA occlusion can be treated by extracranial bypass surgery. The thyrocervical trunk is a suitable donor for reconstruction of the external carotid artery in these cases.
• Weinand, M. E., Madhusudan, H., Davis, B., & Melgar, M. (2003). Acute vs. Prolonged Screening for Spinal Cord Stimulation in Chronic Pain. Neuromodulation : journal of the International Neuromodulation Society, 6(1), 15-9.
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  Spinal cord stimulation (SCS) was performed to test the hypothesis that pain relief data during acute (15 minute intraoperative) and prolonged (5 day) SCS screening have equivalent predictive value for long-term successful SCS control of chronic low back pain and/or lower extremity pain. A retrospective series of patients with chronic low back and/or lower extremity pain underwent either percutaneous or open (ie, laminectomy) SCS implantation during which acute intraoperative followed by prolonged screening trials for percentage pain relief (%PR) were performed. Data were analyzed for (a) correlation between positive predictive value (PPV) of acute and prolonged SCS screening for %PR and (b) PPV of acute vs. prolonged screening %PR for long-term SCS %PR. Fifty-four patients (male/female = 38/16; mean age ± SEM = 54.2 ± 2.0 years) underwent thoracic (T) (mean level = T9.1 ± 0.4) percutaneous (n = 33) and laminectomy (n = 21) implantation of SCS for acute (15 minute intraoperative) and prolonged (5.0 ± 0.3 days) SCS screening of pain relief. Correlation between successful (> 50%PR) pain relief during acute (n = 53/54, PPV = 98%) and prolonged (n = 47/52, PPV = 90%) screening was significant (Spearman Rank Correlation Coefficient, SRCC = 0.462, p 
• Labiner, D. M., Weinand, M. E., Brainerd, C. J., Ahern, G. L., Herring, A. M., & Melgar, M. A. (2002). Prognostic value of concordant seizure focus localizing data in the selection of temporal lobectomy candidates. Neurological research, 24(8), 747-55.
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  This study was performed to test the hypotheses that (a) resection of the temporal lobe epileptic focus, amenable to noninvasive as opposed to invasive localization, is associated with superior seizure outcome and (b) that quadruple (versus lesser degrees of) concordance of seizure focus localizing data predicts superior seizure-free outcome. Eighty-three patients underwent invasive (subdural-EEG) and/or noninvasive (video/scalp-EEG, SPECT, PET, MRI, neuropsychological testing) evaluation. All patients underwent anterior temporal lobectomy and amygdalohippocampectomy (ATL/AH) and seizure outcome was assessed at minimum one-year follow-up. At 34.8 +/- 2.5 months following ATL/AH, outcome was superior for patients in whom the seizure focus was amenable to noninvasive compared to invasive localization (80% versus 40% seizure-free, X2 = 14.03, p < 0.05). Seizure outcome was superior for patients with quadruple, compared to all lesser degrees of, concordance of seizure focus localizing data (85% versus 51% seizure-free, X2 = 7.34, p < 0.05). Post-ATL/AH, seizure outcome is superior in patients (1) harboring an epileptic focus amenable to noninvasive localization and (2) with quadruple concordance of seizure focus localizing data. These findings support the development of temporal lobectomy selection criteria including up to four invasive and/or noninvasive concordant seizure focus localizing techniques.
• Weinand, M. E. (2002). Human immunodeficiency virus type I enters brain microvascular endothelia by macropinocytosis dependent upon lipid rafts and mitogen-activated protein kinase signaling pathway. Journal of Virology, 76(13), 6689-6700.
• Weinand, M. E. (2002). Vagal nerve stimulation for the treatment of epilepsy. Epilepsia, 43(8), 433.
• Weinand, M. E. (2002). Vagal nerve stimulator for the treatment of epilepsy in a series of 44 patients. Greek Journal of Neurosurgery, 9, 57-63.
• Weinand, M., Witte, M., Liu, N. Q., Lossinsky, A. S., Popik, W., Li, X., Gujuluva, C., Kriederman, B., Roberts, J., Pushkarsky, T., Bukrinsky, M., & Fiala, M. (2002). Human Immunodeficiency Virus Type 1 Enters Brain Microvascular Endothelia by Macropinocytosis Dependent on Lipid Rafts and the Mitogen-Activated Protein Kinase Signaling Pathway. Journal of Virology, 76(13), 6689-6700. doi:10.1128/jvi.76.13.6689-6700.2002
• Ahern, G. L., Sollers, J. J., Lane, R. D., Labiner, D. M., Herring, A. M., Weinand, M. E., Hutzler, R., & Thayer, J. F. (2001). Heart rate and heart rate variability changes in the intracarotid sodium amobarbital test. Epilepsia, 42(7), 912-21.
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  Changes in heart rate and heart rate variability have been found in prior studies performed during the intracarotid sodium amobarbital (ISA) test. However, these results are not entirely consistent with current models of differential cerebral involvement in the modulation of the heart. This study was designed to re-investigate this topic with a larger N than has heretofore been used.
• Weinand, M. E. (2001). A mathematical model of internal time processing in temporal lobe epilepsy. Medical hypotheses, 56(2), 134-6.
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  Based on known relationships between epileptic and nonepileptic cortical cerebral blood flow, electrocorticographic factors and epileptogenicity, a mathematical model for internal time processing is derived. The model suggests that the human brain has mechanisms for internal processing of real, reverse and imaginary time.
• Weinand, M. E. (2001). Cervical 1-2 laminectomy for spinal cord stimulation in chronic upper extremity pain. Neurosurgery, 49, 534.
• Weinand, M. E. (2001). Integration of perceptual and mnemenic dysfunction: Sensory auras are associated with left hemisphere memory dysfunction. Epilepsy & Behavior, 2(5), 423-432.
• Weinand, M. E. (2001). Results of the anterior temporal lobectomy/amygdalohippocampectomy in a series of 54 patients with medically intractable complex partial seizures. Journal of Neurology, 248(Suppl 2), 56.
• Weinand, M. E. (2001). Results of the corpus callosotomy in patients with medically intractable primarily generalized seizures. Journal of Neurology, 248(Suppl 2), 188.
• Weinand, M. E. (2001). Time from ictal subdural EEG seizure onset to clinical seizure onset: Prognostic value for selecting temporal lobectomy candidates. Neurological Research, 23, 599-604.
• Weinand, M. E. (2001). Vagal nerve stimulator for the treatment of epilepsy. Journal of Neurology, 248(Suppl 2), 57.
• Weinand, M. E., Kester, M. M., Labiner, D. M., & Ahern, G. L. (2001). Time from ictal subdural EEG seizure onset to clinical seizure onset: prognostic value for selecting temporal lobectomy candidates. Neurological research, 23(6), 599-604.
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  Long-term subdural EEG recording was performed to test the hypothesis that the duration from ictal subdural EEG seizure onset (ECOT) is prognostic for seizure-free outcome following temporal lobectomy. In 48 patients with complex partial seizures, temporal lobectomy was based on invasive localization of the ictal seizure focus. Subdural EEG data were analyzed for association with seizure-free outcome (seizure-free: yes or no) at a minimum of one year following temporal lobectomy. As the duration from ictal subdural EEG seizure onset to clinical seizure onset increased, the odds of being seizure-free postoperatively increased. The best fitting statistical model for predicting seizure-free outcome included seizure onset (unilateral vs. bilateral) and duration from ictal subdural EEG seizure onset to clinical seizure onset. While selection of temporal lobectomy candidates has increasingly emphasized noninvasive recording, some scalp-EEG monitored patients cannot be offered surgery for various reasons, one of which may include ictal EEG seizure onset following clinical seizure onset. When subdural EEG monitoring is performed for selection of temporal lobectomy candidates, analysis of the duration from subdural EEG seizure onset to clinical seizure onset should improve the prognostic value of the subdural EEG data for seizure-free outcome following temporal lobectomy.
• Weinand, M. E., Labiner, D. M., & Ahern, G. L. (2001). Integration of Perceptual and Mnemonic Dysfunction: Sensory Auras Are Associated with Left Hemispheric Memory Impairment. Epilepsy & behavior : E&B, 2(5), 423-432.
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  Memory function during the intracarotid amobarbital test was studied to test the hypothesis that left hemisphere memory impairment is associated with sensory auras. In a series of 37 patients undergoing preoperative evaluation for epilepsy surgery, the quantitative memory scores during amobarbital inactivation of right and left hemisphere were analyzed for correlation with habitual epileptic auras classified as either (a) experiential, forced emotion, or whole-body dysphoria or (b) sensory hallucinations and/or illusions or localized dysesthesias. The left hemispheric memory score impairment was significantly worse in association with auras classified as sensory hallucinations and/or illusions or localized dysesthesias compared with auras classified as experiential, forced emotion, or whole-body dysphoria (P < 0.05). This finding may assist in predicting left-sided hemispheric memory dysfunction in patients with seizures beginning as auras involving sensory material. The results suggest an integration of perceptual and mnemonic dysfunction in which sensory auras are associated with left hemispheric memory impairment.
• Weinand, M. E., Labiner, D. M., & Ahern, G. L. (2001). Temporal lobe seizure interhemispheric propagation time depends on nonepileptic cortical cerebral blood flow. Epilepsy research, 44(1), 33-9.
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  In some patients with epilepsy, activation of eloquent cortex using various forms of environmental stimulation and mental activity may induce seizures. The increased neuronal activity resulting from cortical stimulation may be associated with increased regional cerebral blood flow. The vascular steal theory of temporal lobe epilepsy suggests that as nonepileptogenic cortical cerebral blood flow (CBFn) increases, temporal lobe epileptogenicity increases as a result, in part, of decreasing interhemispheric propagation time (IHPT). Recently, IHPT has been shown to be a quantitative electrocorticographic measure of temporal lobe epileptogenicity. In the current study, long-term combined subdural-EEG and surface cortical cerebral blood flow (CBF) monitoring was performed to test the hypothesis that IHPT depends upon CBFn. The results show that IHPT is a nonlinear (negative exponential) function of nonepileptic cortical CBF (r=0.507, df=32, t=-2.204, P
• Ahern, G. L., Herring, A. M., Labiner, D. M., Weinand, M. E., & Hutzler, R. (2000). Affective self-report during the intracarotid sodium amobarbital test: group differences. Journal of the International Neuropsychological Society : JINS, 6(6), 659-67.
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  Emotional reactions are sometimes observed during the intracarotid sodium amobarbital test. For instance, euphoric/indifference reactions can be seen during right hemisphere inactivation and catastrophic reactions may accompany left hemisphere inactivation. Less dramatic changes can also be detected in affective self-report during left and right hemisphere amobarbital tests, with more negative affect reported during left hemisphere inactivation and either neutral or mildly positive affective states reported during right hemisphere inactivation. The current study not only replicated this effect, but in addition, found significant group differences. The first group (right way) showed a pattern of affective self-report during left and right amobarbital tests entirely consistent with prior findings, while a second group (wrong way) showed results that behaved in a diametrically opposite fashion. A third group (no change) showed little, if any, difference in affective self-report during left and right amobarbital tests. The major factor distinguishing the wrong way group from the other two appeared to be an asymmetrical distribution of left and right temporal lobe lesions in the former group. In contrast, the factor differentiating the right way group from the no change group appeared to be the relative degree of left hemisphere inactivation during the left hemisphere amobarbital test. The results are discussed not only in terms of their impact on theories of cerebral lateralization for emotion, but also in terms of methodological issues in this field.
• Weinand, ., Deogaonkar, ., Kester, ., Ahern, ., & Labiner, . (2000). Electrocorticographic factors associated with temporal lobe epileptogenicity. Pathophysiology : the official journal of the International Society for Pathophysiology, 7(1), 33-39.
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  Continuous subdural electrocorticographic (ECoG) monitoring was performed to test the hypothesis that human temporal lobe epileptogenicity, during long-term monitoring following antiepileptic drug (AED) withdrawal, regardless of the specific AED regimen, is dependent upon ECoG ictal onset and interhemispheric spread of epileptic activity. In 121 patients, ECoG parameters were analyzed for association with seizure frequency, a clinical measure of epileptogenicity. Significantly associated with increased seizure frequency were: ictal medial temporal lobe onset, absence of ictal frontal lobe desynchronization and short interhemispheric propagation time (IHPT). Seizure frequency during long-term ECoG monitoring was not predictive of post-operative seizure outcome. It is concluded that, following AED withdrawal, regardless of the specific AED regimen, increased seizure frequency is associated with medial temporal lobe ictal onset, short IHPT and absence of frontal lobe desynchronization. The results confirm the hypothesis that human temporal lobe epileptogenicity, after withdrawal, is dependent upon ECoG ictal onset and interhemispheric spread of epileptic activity. Future development of procedures which promote ECoG factors associated with increased seizure frequency following AED withdrawal might decrease duration of invasive long-term monitoring and improve efficiency for the pre-surgical selection of temporal lobectomy candidates. Intervention producing ictal frontal lobe desynchronization and increased IHPT might inhibit temporal lobe epileptogenicity and should be evaluated for therapeutic efficacy outside of the long-term monitoring context.
• Weinand, M. E. (2000). Age related demographic factors predictive of success for temporal lobectomy in epilepsy. Surgical Forum, 51, 449-450.
• Weinand, M. E. (2000). Corpus callosotomy in patients with medically intractable primary generalized seizures. Neurology, 9, 179-180.
• Weinand, M. E. (2000). Electrocorticographic factors associated with temporal lobe epileptogenicity. Pathophysiology, 7(1), 33-39.
• Weinand, M. E. (2000). Results of the anterior temporal lobectomy/amygdalohippocampectomy in a series of 54 patients with medically intractable seizures. Neurology, 9, 178-179.
• Weinand, M. E. (2000). Temporal lobe epileptogenicity depends on cerebral blood flow changes preceding seizure onse. Surgical Forum, 51, 448-449.
• Weinand, M. E. (2000). Vascular steal model of human temporal lobe epileptogenicity: the relationship between electrocorticographic interhemispheric propagation time and cerebral blood flow. Medical hypotheses, 54(5), 717-20.
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  Human temporal lobe epileptogenicity (i.e. seizure frequency) depends on epileptic and non-epileptic cerebral blood flow (CBF). Increasing non-epileptic cortical CBF is associated with reduction in epileptic cortical CBF. Seizure frequency increases logarithmically with non-epileptic cortical CBF increase and epileptic cortical CBF reduction. A model of human temporal lobe epileptogenicity is derived from the mathematical equivalence to the logarithmic function of seizure frequency of (a) epileptic and non-epileptic CBF differential and (b) electrocorticographic (ECoG) interhemispheric propagation time (IHPT). The vascular steal model of human temporal lobe epileptogenicity suggests that a small CBF redistribution from non-epileptic to epileptic cortex should produce substantial reduction in temporal lobe seizure frequency in association with prolongation of IHPT. The equivalence of these CBF and ECoG parameters to the logarithmic function of seizure frequency suggests that the interhemispheric temporal lobe perfusion gradient and ECoG propagation time may be involved in the fundamental perturbation responsible for human temporal lobe epileptogenicity.
• Labiner, D. M., Yan, C. C., Weinand, M. E., & Huxtable, R. J. (1999). Disturbances of amino acids from temporal lobe synaptosomes in human complex partial epilepsy. Neurochemical research, 24(11), 1379-83.
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  We have studied the levels of neuroactive amino acids in synaptosomes (P2 fraction) isolated from brain tissue of ten patients with medically intractable epilepsy who were undergoing temporal lobectomy. First, lateral temporal tissue (nonfocal) was removed followed by medial temporal tissue (focal). A synaptosomal fraction (P2) was immediately prepared from each tissue and analyzed for free amino acid concentrations. Statistically significant reductions were seen in glutamine and GABA concentrations in focal tissue compared to nonfocal tissue. The ratio of excitatory amino acids (aspartate and glutamate) to inhibitory amino acids (taurine and GABA) was significantly higher in focal tissue compared to nonfocal. The glutamine/glutamate ratio was significantly reduced. These data support the hypothesis that alterations in the balance between excitatory and inhibitory amino acids may be involved in the expression of epilepsy.
• Weinand, M. E. (1999). CXC and CC chemokine receptors on coronary and brain endothelia. Molecular Medicine, 5(12), 795-805.
• Weinand, M. E. (1999). Cocaine enhances brain endothelial adhesion molecules and leukocyte migration. Clinical Immunology, 91(1), 68-76.
• Weinand, M. E. (1999). HIV-1 neuroinvasion across brain endothelial cells. FASEB Journal, 13, 851.
• Weinand, M. E. (1999). Microglial and astrocyte chemokines regulate monocyte migration through the blood-brain barrier in human immunodeficiency virus-1 encephalitis.. American Journal of Pathology, 155(5), 1599-1611.
• Weinand, M. E. (1999). Non-invasive versus invasive focus localization in surgical decision making in epilepsy surgery. Epilepsia, 40, 83.
• Weinand, M. E. (1999). Nonepileptic Cortical Cerebral Blood Flow and Temporal Lobe Epileptogenicity. Pathophysiology, 6, 135-141.
• Weinand, M. E. (1999). Role of invasive monitoring in surgical decision making in epilepsy surgery. Neurosurgery, 45, 699.
• Weinand, M. E. (1999). Shorter pulse width of vagus nerve stimulation is as effective in reducing seizure frequency as standard stimulation and is better tolerated. Epilepsia, 40, 141.
• Ahern, G. L., Herring, A. M., Labiner, D. M., & Weinand, M. E. (1998). Quantitative analysis of hemispatial neglect in the intracarotid sodium amobarbital (ISA) test. Journal of the International Neuropsychological Society : JINS, 4(2), 99-105.
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  There are dramatic changes in the electroencephalogram of the inactivated hemisphere in the intracarotid sodium amobarbital test. One of the more profound behavioral changes during this procedure is left hemispatial neglect accompanying right hemisphere inactivation. The present study was designed to ascertain whether there was a clear relationship between the degree of hemispheric inactivation (as measured by the electroencephalogram) and the degree of left hemispatial neglect during this procedure. Sixty-nine participants undergoing right hemisphere intracarotid sodium amobarbital testing were presented with a random letter cancellation test at various points during the procedure. Neglect was quantified as significant, moderate, minimal, or none, based on how many target letters the patients missed. The simultaneous electroencephalogram from each of these testing points was spectrally analyzed and topographic maps were generated. The degree of neglect was then compared with the comparable topographic map. It was found that as the amobarbital-induced right hemispheric dysfunction regressed, the degree of neglect lessened in a systematic fashion, as did the profound electroencephalographic changes induced by the drug. Thus, there is a clear relation between the degree of hemispheric inactivation induced by the amobarbital and the degree of left hemispatial neglect. This relationship held regardless of side of hemispheric language dominance or epileptic focus. These results replicate previous findings that right hemisphere inactivation during the intracarotid sodium amobarbital test results in left hemispatial neglect. They extend these findings by clearly showing that neglect changes in a quantitative fashion (rather than being an all-or-none phenomenon) and further, show that there is a clear relationship between the severity of neglect and the degree of hemispheric dysfunction.
• Lamszus, K., Schmidt, N. O., Jin, L., Laterra, J., Zagzag, D., Way, D., Witte, M., Weinand, M., Goldberg, I. D., Westphal, M., & Rosen, E. M. (1998). Scatter factor promotes motility of human glioma and neuromicrovascular endothelial cells. International journal of cancer. Journal international du cancer, 75(1), 19-28.
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  Malignant gliomas are characterized by rapid growth, infiltration of normal brain tissue, and high levels of tumor-associated angiogenesis. The genetic and local environmental tissue factors responsible for the malignant progression from low to high grade gliomas and the highly malignant behavior of glioblastomas are not well understood. In a study of 77 human brain tissue extracts, high grade (III-IV) tumors had significantly greater scatter factor (SF) content than did low grade tumors or non-neoplastic tissue. To investigate the potential significance of SF accumulation in gliomas, we measured the effects of SF on DNA synthesis and motility of cultured human glioma cell lines. SF stimulated DNA synthesis in 7/10 glioma cell lines and in 3/3 neuromicrovascular endothelial cell (NMVEC) lines, consistent with our previous report that SF stimulated cell proliferation of a few human glioma cell lines. SF markedly stimulated the chemotactic migration of 10/10 glioma cell lines as well as 3/3 NMVEC lines. In addition, SF stimulated the 2-dimensional migration of glioma cells on culture surfaces coated with specific extracellular matrix molecules (collagen i.v., laminin, and fibronection). As expected based on these biologic responses to SF, 10/10 glioma lines and 4/4 NMVEC lines expressed mRNA for c-met, the SF receptor. To assess the possible in vivo significance of these migration assays, we compared the chemotactic response of a glioma cell line to human brain cyst fluids and tumor extracts that contained high or low SF concentrations. Fluids and extracts with high SF content tended to induce higher levels of chemotactic migration than did fluids and extracts with low SF content. Addition of anti-SF monoclonal antibody (MAb) inhibited migration induced by fluids and extracts with high SF content by about 30-50%.
• Weinand, M. E. (1998). Amyloid-Beta induces chemokine secretion and monocyte migration across a human blood-brain barrier model. Molecular Medicine, 4(7), 480-489.
• Weinand, M. E. (1998). Quantitative analysis of hemispatial neglect in the intracarotid sodium amobarbital (ISA) test.. Journal of the International Neuropsychological Society, 4(2), 99-105.
• Weinand, M. E. (1997). A model for monocyte migration through the blood-brain barrier during HIV-1 encephalitis. Journal of Immunology, 158(7), 3499-3510.
• Weinand, M. E. (1997). Cerebral blood flow and temporal lobe epileptogenicity. Journal of Neurosurgery, 86(2), 226-232.
• Weinand, M. E. (1997). Electrocorticographic determinants of epileptogenicity. Epilepsia, 38, 109.
• Weinand, M. E. (1997). Preoperative evaluation of patients with medically intractable seizures. Hellenic Neurosurgery, 4, 39-43.
• Weinand, M. E. (1997). TNF-alpha opens a paracellular route for HIV-1 invasion across the blood-brain barrier. Molecular Medicine, 3(8), 553-564.
• Weinand, M. E., Carter, L. P., el-Saadany, W. F., Sioutos, P. J., Labiner, D. M., & Oommen, K. J. (1997). Cerebral blood flow and temporal lobe epileptogenicity. Journal of neurosurgery, 86(2), 226-32.
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  Long-term surface cerebral blood flow (CBF) monitoring was performed to test the hypothesis that temporal lobe epileptogenicity is a function of epileptic cortical perfusion. Forty-three bitemporal 2-hour periictal CBF studies were performed in 13 patients. Homotopic regions of temporal cortex maintained interictal epileptic cortical hypoperfusion and nonepileptic normal cortical CBF. At 10 minutes preictus, a statistically significant, sustained increase in CBF was detected on the epileptic temporal lobe. Two minutes preictus, there was approximation of CBF in the epileptic and nonepileptic temporal lobes. Thereafter, electrocorticographic (ECoG) and clinical seizure onset occurred. The linear relationship between CBF in the two hemispheres (epileptic and nonepileptic) was the inverse of normal (y = -0.347x + 62.767, r = 0.470, df = 95, p < 0.05). The data indicated a direct linear correlation between epileptic cortical CBF and seizure interval (frequency-1), a clinical measure of epileptogenicity (r = 0.610, df = 49, p < 0.05). Epileptogenicity was also found to be a logarithmic function of the difference between nonepileptic and epileptic cortical perfusion (r = 0.564, df = 58, t = 5.20, p < 0.05). The results showed that progressive hypoperfusion of the epileptic focus correlated with a decreased seizure interval (increased epileptogenicity). Increased perfusion of the epileptic focus correlated with an increased seizure interval (decreased epileptogenicity). The fact that CBF alterations precede ECoG seizure activity suggests that vasomotor changes may produce electrical and clinical seizure onset.
• Fiala, A. M., Gan, X. H., Newton, T., Chiappelli, F., Shapshak, P., Kermani, V., Kung, M. A., Diagne, A., Martinez, O., Way, D., Weinand, M., Witte, M., & Graves, M. (1996). Divergent effects of cocaine on cytokine production by lymphocytes and monocyte/macrophages: HIV-1 enhancement by cocaine within the blood-brain barrier. Advances in experimental medicine and biology, 402, 145-56.
• Rosen, E. M., Laterra, J., Joseph, A., Jin, L., Fuchs, A., Way, D., Witte, M., Weinand, M., & Goldberg, I. D. (1996). Scatter factor expression and regulation in human glial tumors. International journal of cancer. Journal international du cancer, 67(2), 248-55.
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  Scatter factor (SF) (also known as hepatocyte growth factor [HGF]) is a cytokine that induces cell motility in vitro and angiogenesis in vivo. SF appears to be a determinant of the malignant phenotype in certain systemic cancers. We detected SF in extracts prepared from human gliomas, with the highest levels found in malignant tumors. Human glioblastoma cells expressed both SF and its receptor (c-met protein) in vivo, as demonstrated by immunohistochemistry. Consistent with these observations, we found moderate to high levels of production of immunoreactive and biologically active SF by cultured human glioblastoma cells (3 of 8 lines) and by neural microvascular endothelial cells (NMVEC) (3 of 3 lines). SF stimulated the proliferation of glioblastoma and NMVEC cell lines by paracrine or autocrine mechanisms. Conditioned medium (CM) from both glioblastoma and NMVEC cells contained SF-inducing factor (SF-IF) activity, defined by its ability to stimulate SF production in an indicator cell line (MRC5 human fibroblasts). This activity consisted of a high-molecular-weight (> 30 kDa), heat-sensitive component and a low-molecular weight (< 30 kDa), heat-stable component. Furthermore, glioblastoma CM stimulated NMVEC SF production, and NMVEC CM stimulated glioblastoma cell SF production, by 3- to 6-fold in each case. Our findings demonstrate that SF-dependent interactions between glioma cells, and between glioma cells and endothelium, can contribute to the heterogeneous proliferative and angiogenic phenotypes of malignant gliomas in vivo.
• Sioutos, P. J., Hamilton, A. J., Narotam, P. K., & Weinand, M. E. (1996). Unusual early recurrence of a cerebellar pilocytic astrocytoma following complete surgical resection. Case report and review of the literature. Journal of neuro-oncology, 30(1), 47-54.
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  Pilocytic cerebellar astrocytomas are usually benign tumors with generally an excellent prognosis following complete surgical resection. The goal of surgery is total resection to minimize the risk of recurrence. In this case report, a 5-year old boy who had undergone total resection of a posterior fossa pilocytic cerebellar astrocytoma (as documented by a contrast-enhanced computed tomography (CT) scan within 24 hours following surgery), developed a massive recurrence of the tumor within four months. Both the initial histology and the sections examined after the second resection revealed features typical for a pilocytic astrocytoma with no suspicion of malignancy. This case is unusual in that it is contrary to other reports suggesting that CT-documented complete surgical resection of pilocytic astrocytomas is without recurrence, and suggests the need for vigilant radiographic and clinical follow-up of these patients even if apparent complete resection of the tumor has been achieved.
• Weinand, M. E. (1996). Abnormal vasomotor response of human epileptogenic cortex to reversal of hyperventilation: A long-term surface cerebral blood flow monitoring study. Pathophysiology, 3, 31-45.
• Weinand, M. E. (1996). Cerebral blood flow and temporal lobe epileptogenicity. Epilepsia, 37, 109.
• Weinand, M. E. (1996). Cerebral blood flow and temporal lobe epileptogenicity. Neurosurgical Focus (Epilepsy), 1(5).
• Weinand, M. E. (1996). Intraoperative measurement of peritumoral regional cortical cerebral blood flow. Oncology Reports, 3(3), 593-6.
• Weinand, M. E. (1996). Unusual early recurrence of a pilocytic astrocytoma following complete surgical resection. Case report and review of the literature. Journal of Neuro-oncology, 30(1), 47-54.
• Weinand, M. E. (1996). [Ca2+]i and pHin Homeostasis in Kaposi sarcoma cells. Cell Physiology and Biochemistry, 6, 169-184.
• Ahern, G. L., Labiner, D. M., Talwar, D., Herring, A. M., & Weinand, M. E. (1995). Quantitative analysis of the electroencephalogram in the intracarotid amobarbital procedure: II. Coherence analysis. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, 12(3), 285-90.
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  Thirty-seven subjects underwent bilateral internal carotid artery injections of amobarbital before surgery for intractable epilepsy. The electroencephalograms (EEG) of these patients were continuously monitored during these 74 procedures and were later subjected to quantitative analysis. Analysis of interhemispheric coherence in the delta, theta, alpha, and beta 1 bands was performed. Prominent changes occurred in interhemispheric coherence, which showed a precipitous drop in the first 2 min after amobarbital injection, followed by a gradual return to near baseline levels. These results suggest that interhemispheric relationships are significantly disrupted by intracarotid amobarbital injection.
• Sioutos, P. J., Orozco, J. A., Carter, L. P., Weinand, M. E., Hamilton, A. J., & Williams, F. C. (1995). Continuous regional cerebral cortical blood flow monitoring in head-injured patients. Neurosurgery, 36(5), 943-9; discussion 949-50.
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  Continuous regional cerebral cortical blood flow (rCoBF) was monitored with thermal diffusion flowmetry in 56 severely head-injured patients. Adequate, reliable data were accumulated from 37 patients (21 acute subdural hematomas, 10 cerebral contusions, 4 epidural hematomas, and 2 intracerebral hematomas). The thermal sensor was placed at the time of either craniotomy or burr hole placement. In 15 patients, monitoring was initiated within 8 hours of injury. One-third of the comatose patients monitored within 8 hours had rCoBF measurements of 18 ml per 100 g per minute or less, consistent with previous reports of significant ischemia in the early postinjury period. Initial rCoBF measurements were similar in the patients with Glasgow Coma Scale scores of 3 to 7 and in those with scores of 8 or greater. In patients with poor outcomes, rCoBF measurements did not change significantly from initial measurements; however, in those patients who had better outcomes, final rCoBF measurements were higher than initial rCoBF measurements. The patients who had better outcomes experienced normalization of rCoBF during the period of monitoring, and patients with poor outcomes had markedly reduced final rCoBF. These changes were statistically significant. When management was based strictly upon the intracranial pressure, examples of inappropriate treatment were found. For example, hyperemia and increased intracranial pressure treated with mannitol caused further rCoBF increase, and elevated intracranial pressure with low cerebral blood flow treated with hyperventilation increased the severity of ischemia. In 3 (5%) of 56 patients, wound infections developed. Continuous rCoBF monitoring in head-injured patients offers new therapeutic and prognostic insights into their management.
• Weinand, M. E. (1995). Constitutive metalloproteinase secretion patterns in AIDS-associated Kaposi sarcoma cell lines. Journal of Investigative Medicine, 43, 311A.
• Weinand, M. E. (1995). Continuous regional cerebral cortical blood flow monitoring in head injured patients. Neurosurgery, 36(5), 943-50.
• Weinand, M. E. (1995). Continuous regional cerebral cortical blood flow monitoring in head-injured patients. Journal of Neurosurgery, 82, 375A.
• Weinand, M. E. (1995). Ictal deja vu. Epilepsia, 36, 522.
• Weinand, M. E. (1995). Long-term cortical cerebral blood flow analysis of sequential seizures. Surgical Forum, 46, 574-5.
• Weinand, M. E. (1995). Long-term ictal electrocorticographic (ECoG) monitoring with subdural strip electrodes: Prognostic significance of temporal lobe seizure onset location and propagation patterns. Epilepsia, 36(Suppl 4), 12.
• Weinand, M. E. (1995). Response of human epileptic temporal lobe cortical blood flow to hyperventilation. Epilepsia, 36(Suppl 4), 141.
• Weinand, M. E. (1995). Subdural strip electrode monitoring and surgical decision making in refractory epilepsy: Validity and prognostic value of noninvasive localizing data. Journal of Epilepsy, 131-8.
• Weinand, M. E., Carter, L. P., Oommen, K. J., Hutzler, R., Labiner, D. M., Talwar, D., el-Saadany, W., & Ahern, G. L. (1995). Response of human epileptic temporal lobe cortical blood flow to hyperventilation. Epilepsy research, 21(3), 221-6.
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  Bilateral long-term surface cortical cerebral blood flow (CBF) and electrocorticographic (ECoG) monitoring were performed in eight patients with complex partial seizures. In each patient, the epileptic temporal lobe was localized using ictal ECoG. Mean seizure interval (frequency-1) off anticonvulsant medication, a clinical measure of epileptogenicity, was 1.0 +/- 0.3 h (range: 0.4 to 2.5 h). During 13 interictal hyperventilation periods, 3.6 +/- 0.6 min in duration, the mean decrease in epileptic and nonepileptic temporal cortical CBF was 13.7 +/- 2.3 versus 6.4 +/- 1.9 ml/(100 g min) (t = 2.230, d.f. = 16, P < 0.05), representing 20.9% and 10.8% reduction from baseline CBF during hyperventilation, respectively. Seizure interval decreased (i.e. frequency increased) with increasing magnitude of seizure focus CBF reduction during hyperventilation. Seizure interval was significantly correlated with epileptic temporal lobe CBF decrease during hyperventilation (R = 0.763, d.f. = 5, P < 0.05). The data suggest that, compared to nonepileptic brain, epileptic temporal lobe is particularly prone to hypoperfusion during hyperventilation. Epileptogenicity is a function of this seizure focus susceptibility to ischemia. The finding of abnormal seizure focus autoregulation during hyperventilation has implication for epileptic focus localization with cerebral blood flow analysis.
• Ahern, G. L., Herring, A. M., Tackenberg, J. N., Schwartz, G. E., Seeger, J. F., Labiner, D. M., Weinand, M. E., & Oommen, K. J. (1994). Affective self-report during the intracarotid sodium amobarbital test. Journal of clinical and experimental neuropsychology, 16(3), 372-6.
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  Changes in internal affective state were investigated in patients undergoing the intracarotid sodium amobarbital test. It was found that when the left hemisphere was inactivated, patients rated their mood as significantly more negative than during baseline conditions. No significant change in affective state was observed during the inactivation of the right hemisphere. The findings are interpreted in terms of a differential lateralization model of emotion, in which the right hemisphere is more involved in the more powerful and salient negative affects.
• Ahern, G. L., Labiner, D. M., Hutzler, R., Osburn, C., Talwar, D., Herring, A. M., Tackenberg, J. N., Weinand, M. E., & Oommen, K. J. (1994). Quantitative analysis of the EEG in the intracarotid amobarbital procedure. I. Amplitude analysis. Electroencephalography and clinical neurophysiology, 91(1), 21-32.
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  Thirty-seven subjects underwent bilateral internal carotid artery injections of amobarbital prior to surgery for intractable epilepsy. The electroencephalogram (EEG) of these patients was continuously monitored during these 74 procedures and was later subjected to quantitative analysis. Topographic mapping of these data suggested that the areas of inactivation were largely restricted to the anterior 2/3 of the hemisphere injected, corresponding to the vascular distributions of the anterior and middle cerebral arteries. Graphical representation of the data demonstrated that delta and theta band activity peaked in the first 2 min post injection and decreased gradually thereafter, becoming stable at around 12 min post injection. Examination of the alpha, beta 1, and beta 2 bands suggested that activity increased and decreased more gradually than that for delta and theta, with perhaps a longer latency. Although EEG changes were most prominent in the anterior 2/3 of the inactivated hemisphere, similar (though smaller) changes were also observed in both ipsilateral and contralateral zones thought to be outside of the vascular distribution of the internal carotid artery.
• Weinand, M. E. (1994). Characterization of an established immortal endothelial cell line (RSE-1): Comparison to AIDS-Kaposi sarcoma cell cultures. Lymphology, 27((Suppl)), 761-2.
• Weinand, M. E. (1994). Enhancement of endothelial cell and Kaposi sarcoma migration by selective chemoattractants. Lymphology, 27((Suppl)), 755-8.
• Weinand, M. E. (1994). In vitro models of angiotumorigenesis. Journal of Cellular Biochemistry, 18A, 330.
• Weinand, M. E. (1994). In vitro models of angiotumorigenesis. Lymphology, 27((Suppl)), 136-7.
• Weinand, M. E. (1994). Neuroactive amino acids in synaptosomes from focal and nonfocal temporal lobe tissue of patients with intractable complex partial seizures. Advances in Experimental Medicine and Biology, 359, 435-443.
• Weinand, M. E. (1994). Sex steroid modulation of endothelial cell interactions. Lymphology, 27((Suppl)), 138-41.
• Weinand, M. E. (1994). Subdural strip monitoring and surgical decision making in refractory epilepsy. Epilepsia, 35(Suppl 8), 71.
• Weinand, M. E. (1994). Surface cortical cerebral blood flow monitoring and single photon emission computed tomography: Prognostic factors for selecting temporal lobectomy candidates. Seizure, 3(1), 55-9.
• Weinand, M. E. (1994). Surgical treatment of intractable symptomatic occipital epilepsy. Epilepsia, 35(Suppl 8), 69.
• Weinand, M. E., & Carter, L. P. (1994). Surface cortical cerebral blood flow monitoring and single photon emission computed tomography: prognostic factors for selecting temporal lobectomy candidates. Seizure, 3(1), 55-9.
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  A series of 23 patients with medically intractable temporal lobe epilepsy was studied with surface cortical cerebral blood flow monitoring, single photon emission computed tomography (SPECT) and subdural strip electrocorticographic (ECoG) monitoring for localization of the seizure focus. All patients underwent anterior temporal lobectomy and seizure outcome was determined after a mean of 9 months (range: 3-17 months). Invasive and non-invasive cerebral blood flow (CBF) parameters with prognostic value for seizure-free outcome were: (a) inter-ictal seizure focus with CBF < 65 ml/100 gm-min; (b) inter-ictal seizure focus CBF < or = normal temporal lobe CBF; and (c) concordance of inter-ictal and/or early post-ictal SPECT and ictal ECoG for seizure focus localization. These results should improve prognostic value of invasive and non-invasive cerebral blood flow data for selection of temporal lobectomy candidates.
• Weinand, M. E., Carter, L. P., Patton, D. D., Oommen, K. J., Labiner, D. M., & Talwar, D. (1994). Long-term surface cortical cerebral blood flow monitoring in temporal lobe epilepsy. Neurosurgery, 35(4), 657-64.
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  Long-term subdural surface cortical cerebral blood flow (CBF) and electrocorticographic monitoring was performed in 12 patients with complex partial seizures. A total of 40 seizures were analyzed. Baseline CBF values from nonepileptic and epileptic temporal lobe (mean +/- standard error) were 60.0 +/- 1.0 and 50.2 +/- 1.8 ml/100 g per minute, respectively (P < 0.05). In general, clinical seizure onset was preceded by a 20-minute preictal CBF increase from baseline in the epileptic temporal lobe. Peak early postictal CBF values of nonepileptic and epileptic temporal lobes were 57.7 +/- 13.3 and 89.0 +/- 21.7 ml/100 g per minute (P > 0.05) at 5.2 +/- 2.2 and 2.4 +/- 1.0 minutes (P > 0.05) after clinical seizure onset, respectively. Statistically significant differences between nonepileptic and epileptic temporal lobe CBF were detected at 50 minutes (74.0 +/- 14.2 and 37.5 +/- 9.2 ml/100 g per minute, respectively; P < 0.05) and 60 minutes (75.6 +/- 13.6 and 36.1 +/- 8.5 ml/100 g per minute, respectively; P < 0.05) postictal. The data suggest that the optimal times for CBF analysis to differentiate epileptic from nonepileptic temporal lobe are 1) during the interictal period and 2) late (50 to 60 minutes) postictal. The results of this study should improve the understanding of the dynamic cerebral perfusion patterns in the epileptic human brain.
• Weinand, M. E., Hermann, B., Wyler, A. R., Carter, L. P., Oommen, K. J., Labiner, D., Ahern, G., & Herring, A. (1994). Long-term subdural strip electrocorticographic monitoring of ictal déjà vu. Epilepsia, 35(5), 1054-9.
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  We report a series of 8 patients with ictal déjà vu. Subdural strip electrocorticographic (ECoG) monitoring localized the ictal epileptogenic focus as follows: right (n = 6) and left (n = 2) mesiotemporal lobe. In all 8 patients, the left hemisphere was dominant for language function based on intracarotid amytal testing. In 6 right-handed patients, ictal déjà vu was associated with a right temporal lobe focus. However, in the 2 left-handed patients, the ictal focus was left temporal lobe. Although ictal déjà vu localizes the epileptic focus to temporal lobe, this experimental phenomenon appears to lateralize to the hemisphere nondominant for handedness.
• Ahern, G. L., Herring, A. M., Tackenberg, J., Seeger, J. F., Oommen, K. J., Labiner, D. M., & Weinand, M. E. (1993). The association of multiple personality and temporolimbic epilepsy. Intracarotid amobarbital test observations. Archives of neurology, 50(10), 1020-5.
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  What is the relationship of "multiple personality disorder" in patients with temporolimbic epilepsy to certain types of hemispheric interaction?
• Carter, L. P., Weinand, M. E., & Oommen, K. J. (1993). Cerebral blood flow (CBF) monitoring in intensive care by thermal diffusion. Acta neurochirurgica. Supplementum, 59, 43-6.
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  Continuous monitoring of cortical blood flow (CoBF) in the intensive care unit is possible with thermal diffusion techniques. The normal brain flow limits have been established when electrical activity ceases and when infarction is likely to occur. With continuous monitoring of CoBF one can see immediate changes in flow and approaching these levels may be anticipated. The thermal diffusion system we have employed is based on the thermal conductivity of cortical tissue. As blood flow increases through the tissue, the conduction of energy away from the flow probe allows the sensor to detect changes in flow. This form of monitoring has been carried out in patients with subarachnoid hemorrhage, resection of cerebral mass lesions, severe craniotrauma, and intractable epilepsy. In subarachnoid hemorrhage, vasospasm can be identified and the efficacy of treatment determined with continuous monitoring of CoBF. During resection of mass lesions, increases in blood flow can be readily detected to document the recovery of brain tissue. Continuous monitoring of CoBF in epilepsy patients is now possible with the implantation of subdural electrodes. The increase in blood flow can be documented and it is apparent that a period of elevation of blood flow is quite short. Therefore, this may be helpful in determining when other forms of CBF determination, such as Single Photon Emission Computed Tomographic (SPECT) scanning should be performed. In patients with cranial trauma, different patterns of CoBF changes are apparent. Some patients may develop increased CoBF prior to elevation of intracranial pressure (ICP); other patients demonstrate a drop in CoBF as a response to increased ICP.(ABSTRACT TRUNCATED AT 250 WORDS)
• Weinand, M. E. (1993). Alterations in neuroactive amino acids in synaptosomes isolated from both focal and nonfocal temporal lobe of individuals with medically intractable epilepsy. Epilepsia, 34(Suppl 6), 126.
• Weinand, M. E. (1993). Cerebral blood flow during hyperventilation in epileptic and non-epileptic temporal cortex. Epilepsia, 34(Suppl 6), 77.
• Weinand, M. E. (1993). Cerebral blood flow over the epileptogenic temporal cortex before, during, and after seizure. Epilepsia, Suppl 6, 77.
• Weinand, M. E. (1993). Cerebral blood-flow over epileptogenic temporal cortex before, during and after seizures. Epilepsia, 34((Suppl 6)), 127-8.
• Weinand, M. E. (1993). Long-term surface cortical cerebral blood flow monitoring in temporal lobe epilepsy. Epilepsia, 34(Suppl 6), 97.
• Weinand, M. E. (1993). Lumbar cerebral spinal fluid drainage during long-term electrocorticographic monitoring with subdural strip electrodes: Elimination of cerebral spinal fluid leak. Seizure, 2(2), 133-6.
• Weinand, M. E., & Oommen, K. J. (1993). Lumbar cerebral spinal fluid drainage during long-term electrocorticographic monitoring with subdural strip electrodes: elimination of cerebral spinal fluid leak. Seizure, 2(2), 133-6.
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  We performed this study to determine the efficacy of continuous lumbar cerebral spinal fluid (CSF) drainage in controlling CSF leak during subdural strip electrode monitoring of epilepsy patients. Subdural strip electrodes were placed in 14 patients. In seven patients, a lumbar sub-arachnoid catheter was placed for continuous CSF drainage. In seven patients, no lumbar drain was placed. The duration of scalp CSF leak during strip electrode monitoring was significantly reduced in patients undergoing lumbar CSF drainage compared to those without lumbar drains (chi 2 = 40.9, P < 0.05). In one patient spinal headache developed which resolved with lumbar drain removal. Lumbar drainage eliminates scalp CSF leakage and can improve patient comfort. This technique should be further studied to determine if it reduces infection risk during long-term invasive monitoring.
• Weinand, M. E. (1992). A mathematical model for brain edema: the relationship between brain tissue water content and intracranial pressure. Medical hypotheses, 37(2), 63-4.
• Weinand, M. E. (1992). Comparison of SPECT and MRI foci in patients with complex partial seizures. Neurology, 42(SUppl 3), 159.
• Weinand, M. E. (1992). Concordance between noninvasive and invasive evaluation techniques in seizure focus localization. Epilepsia, 33(Suppl 3), 91.
• Weinand, M. E. (1992). Surface monitoring of cerebral blood flow in epilepsy. Neurology, 42(Suppl 3), 158.
• Weinand, M. E. (1992). The relationship between intracranial pressure and brain tissue water content. Medical Hypotheses, 37, 63-64.
• Weinand, M. E., Wyler, A. R., Richey, E. T., Phillips, B. B., & Somes, G. W. (1992). Long-term ictal monitoring with subdural strip electrodes: prognostic factors for selecting temporal lobectomy candidates. Journal of neurosurgery, 77(1), 20-8.
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  Long-term electrocorticographic (ECoG) monitoring data from subdural strip electrodes are analyzed to determine factors associated with seizure-free outcome from anterior temporal lobectomy. A total of 89 consecutive patients with complex partial seizures, in whom long-term ictal video/scalp electroencephalographic monitoring was insufficient to localize their epileptogenic focus, were subsequently evaluated with long-term ictal ECoG monitoring using subdural strip electrodes. Each patient underwent anterior temporal lobectomy based on the ictal ECoG data and has been followed for at least 1 year. The following parameters were found to be statistically significant in predicting a seizure-free outcome: unilateral onset, electrical onset pattern beginning as fast spike trains, absence of frontal lobe background desynchronization at onset, and an interhemispheric propagation time of greater than 8 seconds. Electrocorticographic criteria that were not associated with seizure outcome included: right- versus left-sided onset, time from electrical to clinical ictal onset, focality of onset (number of strip electrode contacts involved), and stereotypical ECoG onset. When present, the interictal focus was concordant with the ictal focus in most patients (96%), but was falsely lateralizing in 4% of cases. It is suggested that these data should improve patient selection for temporal lobectomy when subdural strip monitoring is used during preoperative evaluation.
• Weinand, M. E. (1991). Long-term ictal monitoring with subdural strip electrodes: Prognostic factors for selecting temporal lobectomy candidates. Epilepsia, 32, 92.
• Weinand, M. E. (1989). A study of serum antidiuretic hormone and atrial natriuretic peptide levels in a series of patients with intracranial disease and hyponatremia. Neurosurgery, 25(5), 781-5.
• Weinand, M. E. (1989). Intradiploic arachnoid cysts.. Journal of Neurosurgery, 70(6), 954-8.
• Weinand, M. E., O'Boynick, P. L., & Goetz, K. L. (1989). A study of serum antidiuretic hormone and atrial natriuretic peptide levels in a series of patients with intracranial disease and hyponatremia. Neurosurgery, 25(5), 781-5.
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  Patients with intracranial disease are at risk of developing clinical deterioration due to a hyponatremic syndrome associated with an inappropriate degree of natriuresis, the "syndrome of inappropriate secretion of anti-diuretic hormone (ADH)" or SIADH. To investigate the hypothesis that atrial natriuretic peptide (ANP) is related to the natriuresis in SIADH, serum samples were obtained from 8 neurosurgical patients with intracranial disease seen consecutively who fulfilled the traditional clinical and laboratory criteria for SIADH. In one patient with a hemorrhagic cerebral infarction an elevation of serum ADH (5.7 pg/ml; normal = 1 to 5 pg/ml) in association with a normal level of serum ANP (49.8 pg/ml; normal = 10 to 60 pg/ml) was seen. Six patients (2 with intracerebral hemorrhage and 1 with hemorrhagic cerebral infarction, 1 with aneurysmal subarachnoid hemorrhage, 1 with glioblastoma multiforme, and 1 with Creutz-feldt-Jakob disease) had elevated serum ANP levels (197.0, 112.0, 92.0, 432.0, 97.5, and 138.0 pg/ml, respectively) associated with either normal or low ADH levels (1.3, 2.5, 1.2, 0.7, 2.3, and 0.5 pg/ml, respectively). Another patient with an intracerebral hemorrhage had a normal serum ANP level (37.0 pg/ml) and undetectable ADH level (less than 0.5 pg/ml). In the 7 patients in whom either ADH or ANP alone was elevated, a reciprocal relationship was observed between serum ADH and ANP levels, which could be expressed in logarithmic form (correlation coefficient, r = 0.727). In the 6 patients in whom serum ANP level alone was elevated, a near linear relationship was observed between serum ANP levels and urine sodium excretion (r = 0.851).(ABSTRACT TRUNCATED AT 250 WORDS)
• Weinand, M. E., Rengachary, S. S., McGregor, D. H., & Watanabe, I. (1989). Intradiploic arachnoid cysts. Report of two cases. Journal of neurosurgery, 70(6), 954-8.
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  Two patients are presented in whom cranial arachnoid cysts developed as diverticuli of the arachnoid membrane through small defects in the dura mater, eroded through the inner table, expanded within the diploe, and eroded the outer table of the skull. Based on observations at the time of surgery and the histological examination of these lesions, it is proposed that they are congenital in origin. Previously reported cases of "traumatic arachnoid cyst without fracture," "intradiploic cerebrospinal fluid fistula," and "middle fossa pitholes" appear to represent the same pathological process as the lesions reported in this paper. It is proposed that "intradiploic arachnoid cyst" is the most appropriate term by which these lesions should be described.
• Weinand, M. E. (1988). Medical management in head injury. Kansas medicine : the journal of the Kansas Medical Society, 89(2), 43-5.
• Weinand, M. E. (1988). Neuropharmacologic control of cerebral capillary permeability: current implications for therapy of vasogenic brain edema. Medical hypotheses, 26(1), 51-3.
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  Vasogenic brain edema occurs as a result of a diverse spectrum of central nervous system pathology. The fundamental physiologic abnormality of vasogenic brain edema is an increase in cerebral capillary permeability. It is hypothesized that the recent development of new, potent, synthetic vasopressin antagonists will make it possible to impede the formation of vasogenic brain edema by the intraventricular administration of such agents with the subsequent inhibition of the neural control of brain capillary permeability by the locus ceruleus. The action of the vasopressin antagonists should be synergistic with the anti-edema effects of central alpha-adrenergic blockade produced by phentolamine. The combination of these two modes of therapy is expected to produce an increase in intracranial pressure which will require additional forms of medical therapy to control, in spite of the overall decrease of brain parenchymal water content.

Presentations

• Weinand, M. E. (2022, October). Predictors of revision surgery after bedside subdural drain placement for chronic subdural hematomas.  . Congress of Neurological Surgeons Annual Meeting. San Francisco, CA: Congress of Neurological Surgeons.
• Weinand, M. E. (2023, December). Temporal lobe epilepsy. Neurosurgery Didactic Conference, December 27, 2023. University of Arizona College of Medicine, Tucson, AZ: University of ARizona COllege of Medicine, Department of Neurosurgery.
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  Neurosurgery didactic lecture
• Weinand, M. E. (2023, March). Opening Remarks. 1st Annual Arizona Neurosurgery and Neurology Student Conference. Tucson, AZ: College of Medicine, University of Arizona, Tucson, AZ.
• Weinand, M. E. (2023, Oct/Fall). Temporal lobe epilepsy.  . Arizona Neurosurgical Society Annual Meeting. Sonntag Pavilion, BNI, Phoenix, AZ: Arizona Neurosurgical Society.
• Weinand, M. E. (2022, September). Surgery for Temporal Lobe Epilepsy. Arizona Neurosurgical Annual Meeting. Sonntag Pavilion, BNI, Phoenix, AZ: Arizona Neurosurgical Society.
• Weinand, M. E. (2021, Fall). Leukocyte Gene Expression Predicts Human Temporal Lobe Epilepsy Seizure Frequency.. 67th Annual Meeting, Western Neurosurgical Society, Tamaya Resort, Santa Ana Pueblo, New Mexico, September 12, 2021.. Tamaya Resort, Santa Ana Pueblo, New Mexico: Western Neurosurgical Society.
• Weinand, M. E. (2020, April). Hippocampal RNA expression gene sets and biological pathways with prognostic value for seizure outcome following anterior temporal lobectomy with amygdalohippocampectomy.. American Association of Neurological Surgeons 88th Annual Meeting. Boston, MA: American Association of Neurological Surgeons.
• Weinand, M. E. (2020, August). “Temporal Lobe Epilepsy: One Neurosurgeon's Journey”. Surgery Grand Rounds. University of Arizona College of Medicine, Tucson, AZ: Department of Neurology and Department of Neurosurgery, University of Arizona College of Medicine.
• Weinand, M. E. (2020, Fall). Surgery for Temporal Lobe Epilepsy. Neuroscience Grand Rounds, University of Arizona College of Medicine, Tucson, AZ, October 2, 2020. University of Arizona College of Medicine, Tucson, AZ: University of Arizona College of Medicine, Tucson, AZ.
• Weinand, M. E. (2019, November). “Epilepsy Surgery: One Neurosurgeon's Journey”. Neuroscience Grand Rounds. University of Arizona College of Medicine, Tucson, AZ: Department of Neurology and Department of Neurosurgery, University of Arizona College of Medicine.
• Weinand, M. E. (2018, June). “Temporal Lobe Epilepsy Surgery Update”. Neuroscience Grand Rounds. University of Arizona College of Medicine, Tucson, AZ: Department of Neurology and Division of Neurosurgery, Department of Surgery, University of Arizona College of Medicine.
• Weinand, M. E. (2018, November). Academic Neurosurgery in Tucson. Arizona Neurosurgical Society Annual Meeting. Dove Mountain, Marana, AZ: Arizona Neurosurgical Society.
• Weinand, M. E. (2018, October). Abstract no 140. Leukocyte RNA Expression Correlates with SeizureFree Outcome Following Stereotactic Laser Amygdalohippocampotomy.. Congress of Neurological Surgeons Annual Meeting. 2018 Oct 8. Houston, Texas: Congress of Neurological Surgeons.
• Weinand, M. E. (2018, October). Towards Tomographic Reconstruction of Current Source Densities with Multichannel Acoustoelectric Brain Imaging (mABI) Using Ellipsoidal Human Head Model.. 2018 IEEE International Ultrasonics Symposium (IUS). Portopia Hotel, Kobe, Japan: Institute of Electrical and Electronics Engineers (IEEE).
• Weinand, M. E. (2018, September). “Presidential Address. Epilepsy Surgery: One Neurosurgeon’s Journey.”. Western Neurosurgical Society 64th Annual Meeting. Fairmont Orchid Resort, Island of Hawaii, HI: Western Neurosurgical Society.
• Weinand, M. E. (2018, September). “Surgery for Temporal Lobe Epilepsy”.. Surgery Grand Rounds. University of Arizona College of Medicine, Tucson, AZ: Department of Surgery, University of Arizona College of Medicine, Tucson, AZ.
• Weinand, M. E. (2017, Spring). Hippocampal RNA Expression Varies According to Seizure Outcome and Seizure Frequency following Anterior Temporal Lobectomy with Amgydalohippocampectomy. Scientific Session III: Stereotactic and Functional Surgery, AANS Annual Meeting, Los Angeles, CA, April 24, 2017. Los Angeles, CA: American Association of Neurological Surgeons.
• Weinand, M. E., Nisson, P. L., James, W. S., Anton, R., Torabi, M., & Borgstrom, M. (2016, Fall). White Blood Cell Count is a Clinical Predictor of CSF Infection in Patients with an External Ventricular Drain. Arizona Neurosurgical Society Annual Meeting, November 19, 2016. Ritz Carlton Resort, Dove Mountain, Arizona: Arizona Neurosurgical Society.
• Weinand, M. E. (2015, November). Cortical Gene Expression Correlates of Temporal Lobe Epileptogenicity.. Arizona Neurosurgical Society Fall 2015 Annual Meeting. Dove Mountain, Marana, AZ: Arizona Neurosurgical Society.
• Weinand, M. E. (2015, September). Cortical Gene Expression Associated with Seizure Outcome Following Temporal Lobectomy with Amygdalohippocampectomy.. Western Neurosurgical Society 61st Annual Meeting. Grand Hyatt, Kaua’I, HI: Western Neurosurgical Society and American Association of Neurological Surgeons.
• Skoch, J. M., & Weinand, M. E. (2014, April). Validity of Subdural Hematoma, Retinal Hemmorhage and Non-Cranial Fracture Triad for Suspicion & Diagnosis of Child Abuse. Unknown.
• Skoch, J. M., Stidd, D., Palejwala, S., Hayat, N., & Weinand, M. E. (2014, April). Technical note: Minimally invasive selective amygdalohippocampectomy with the Visualase® laser ablation system. Unknown.
• Weinand, M. E. (2014, July). Surgical treatment of medically intractable temporal lobe epilepsy. Medical Student Research Program, University of Arizona College of Medicine.
• Weinand, M. E. (2014, July). Surgical treatment of medically intractable temporal lobe epilepsy. Neurosurgery Didactics Lecture, University of Arizona College of Medicine.
• Skoch, J., Gallek, M. J., Ansay, T. L., Behbahani, M., & Weinand, M. E. (2013, October). Prognostic value of cortical gene expression for seizure outcome following temporal lobectomy with amygdalohippocampectomy. Arizona Neurosurgical Society Fall Meeting.
• Stidd, D. A., Langevin, J. P., & Weinand, M. E. (2013, April). MR-Guided Laser-Induced Thermal Ablation of Mesial Temporal Sclerosis. 81st Annual Scientific Meeting of the American Association of Neurological Surgeons.
• Stidd, D. A., Rivero, S., & Weinand, M. E. (2013, April). Spinal Cord Stimulation with Implanted Epidural Paddle Lead Relieves Chronic Axial Low Back Pain. 81st Annual Scientific Meeting of the American Association of Neurological Surgeons.
• Weinand, M. E. (2013, August). Surgical treatment of medically intractable temporal lobe epilepsy. Surgery Grand Rounds, Department of Surgery, University of Arizona College of Medicine.
• Weinand, M. E. (2013, July). Surgery for Intractable Temporal Lobe Epilepsy. Neuroscience Grand Rounds, University of Arizona College of Medicine.
• Palejwala, S., Stidd, D. A., Skoch, J., Gupta, P., Lemole, G. M., & Weinand, M. E. (2012, November). Use of a stop-flow programmable valve to maximize CNS chemotherapy delivery in a pediatric patient with CNS leukemia. Arizona Neurosurgical Society Annual Meeting.
• Rivero, S., Stidd, D., & Weinand, M. E. (2012, December). Spinal cord stimulation with implanted epidural paddle lead relieves chronic axial low back pain. North American Neuromodulation Society 16th Annual Meeting.
• Stidd, D. A., Langevin, J. P., & Weinand, M. E. (2012, November). MR-Guided Laser-Induced Thermal Ablation of Mesial Temporal Sclerosis. Arizona Neurosurgical Society Annual Meeting.
• Weinand, M. E., Stidd, D. A., & Langevin, J. P. (2012, September). MR-guided laser-induced ablation of mesial temporal sclerosis. Western Neurosurgical Society 58th Annual Meeting.
• Stidd, D. A., & Weinand, M. E. (2011, April). Dramatic brain expansion after placement of a ventricular-peritoneal shunt. UA/UPHK Graduate Medical Education Recognition Day.
• Stidd, D. A., Wuollet, A., Bowden, K., Price, T., Patwardhan, A., Barker, S., Weinand, M. E., Annabi, J., & Annabi, E. (2011, December). Peripheral Nerve Stimulation for Trigeminal Neuropathic Pain: A Case Series. North American Neuromodulation Society 15th Annual Meeting.
• Weinand, M. E. (2011, April). Comparison of Ease of Use of Duraseal Dural Sealant System to Fibrin Glue. AANS Annual Meeting.
• Weinand, M. E. (2011, Winter). Surgery for Temporal Lobe Epilepsy (presented twice in one year). Neuroscience Grand Rounds University of Arizona College of Medicine.
• Rice, J., Stidd, D., Anton, R., & Weinand, M. E. (2010, November). Ventriculo-peritoneal shunting of patients with hydrocephalus due to coccidioidal meningitis infection: A case series. Arizona Neurosurgical Society.

Poster Presentations

• Weinand, M. E. (2023, July). Leukocyte gene expression involved in apoptosis is prognostic for high vs low frequency temporal lobe epilepsy.. SAVAHCS Collaborative Medical Student Research Showcase, Tucson, AZ. Tucson, AZ: Southern Arizona VA Health Care System (SAVAHCS) and College of Medicine, University of Arizona, Tucson, AZ.
• Weinand, M. E. (2020, April). Leukocyte Zinc Finger Protein Expression Changes With Baseline Seizure Frequency In Patients With Intractable Temporal Lobe Epilepsy.. American Association of Neurological Surgeons 88th Annual Meeting. Boston, MA: American Association of Neurological Surgeons.
• Weinand, M. E. (2015, December). Subdural Hematoma, Retinal Hemorrhage, and Non-Cranial Fracture Triad as a Predictor for the Diagnosis of Child Abuse.. 44th Annual Meeting of the AANS/CNS Section on Pediatric Neurological Surgery.. Seattle, WA: AANS/CNS Section on Pediatric Neurological Surgery.
• Weinand, M. E. (2014, December). Stereotactic laser ablation is a potentially curative procedure after unsuccessful VNS or RNS for mesial temporal lobe epilepsy. American Epilepsy Society 68th Annual Meeting.
• Weinand, M. E. (2014, December). Stereotactic laser ablation: how much hippocampal atrophy optimizes seizure freedom?. American Epilepsy Society 68th Annual Meeting.
• Weinand, M. E. (2014, December). Stereotactic laser amygdalo-hippocampotomy for mesial temporal lobe epilepsy: collective experience from seven single-center, prospective, investigator-initiated studies objectives. American Epilepsy 68th Annual Meeting.
• Skoch, J., Gallek, M., & Weinand, M. E. (2013, October). Whole Genome Analysis of Resected Temporal Cortex Identifies Predictors of Seizure-Free Outcome Following Temporal Lobectomy for Intractable Seizures. Congress of Neurological Surgeons Annual Meeting.
• Weinand, M. E. (2013, April). Stereotactic laser thermal amygdalohippocampotomy for mesial temporal lobe epilepsy: preliminary outcomes of multicenter experience. AANS 81st Annual Meeting.
• Weinand, M. E. (2013, December). STEREOTACTIC LASER AMYGDALOHIPPOCAMPOTOMY FOR MESIAL TEMPORAL LOBE EPILEPSY: RESULTS OF MULTICENTER EXPERIENCE AT 6 MONTHS AND 1 YEAR. American Epilepsy Society 67th Annual Meeting.
• Weinand, M. E. (2010, June). A new and simple method to obtain brain microvascular endothelial cells for in vitro models of the human blood-brain barrier. Gordon-Kenan Research Seminar, Colby-Sawyer College.

Others

• Weinand, M. E. (2023, Summer). Letter to the Editor: Experiences from a Virtual Neurosurgery Research Conference for Medical Students in Arizona.. World Neurosurgery.
• Weinand, M. E. (2011, January). Former Missouri man among doctors who performed life-saving surgery on AZ Rep. Gabrielle Giffords. NBC Action News.
• Weinand, M. E. (2011, July). Central graduate operated on Giffords. St. Joseph News-Press & News-Press.
• Weinand, M., Weinand, M. E., & Melgar, M. A. (2003, Mar). Thyrocervical trunk-external carotid artery bypass for positional cerebral ischemia due to common carotid artery occlusion. Report of three cases. Neurosurgical focus.
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  Medically refractory positional cerebral ischemia and concomitant orthostatic hypotension associated with chronic common carotid artery (CCA) occlusion are rare. The authors detail their experience with three cases treated exclusively by an extracranial bypass in which the thyrocervical trunk was used as the donor vessel. Postoperatively grafts were patent and symptoms resolved in all three patients, although orthostatic hypotension remained. Postural cerebral ischemia due to CCA occlusion can be treated by extracranial bypass surgery. The thyrocervical trunk is a suitable donor for reconstruction of the external carotid artery in these cases.