Louise Eisenhardt (1891-1967): World Renowned Neuropathologist, Brain Tumor Registry Director, First Editor-In-Chief of Journal of Neurosurgery, and President of Harvey Cushing Society.

BACKGROUND: This historical account reviews the course and lasting impact of Dr. Louise Eisenhardt (1891-1967) in neurosurgery. METHOD: The writing of this project was sparked by the discovery of original scientific and bibliographical information about Eisenhardt, testimony on personal relationships, and viewpoints after comprehensive compilation of information. It is a thorough review of literature on Eisenhardt and reflects the scope and depth of these prior works. RESULTS: It begins with the decisive influence of Harvey Cushing's mentorship and academic; follows Eisenhardt's impact on the development of modern neuropathology; discusses the Eisenhardt-Percival-Bailey-Cushing collaboration on gross brain specimens and histological classification of brain tumors; recounts Cushing's creation of a neuropathologist team for the Brain Tumor Registry working asynchronously with the Pathology Department at Peter Bent Brigham Hospital; Eisenhardt's aid in the development of intraoperative analysis of brain tumors; her career as a neuropathologist; her contributions as Editor-in-Chief of the Journal of Neurosurgery; and her preservation of the Brain Tumor Registry at Yale University School of Medicine estimated the largest and most valuable databank of information in the history of medicine. Eisenhardt served as President, Historian, and Secretary-Treasurer of the Harvey Cushing Society, the professional organization now known as the American Association of Neurological Surgeons, and was senior lecturer for members of the Congress of Neurological Surgeons, constituents of NEUROSURGERY Publications. CONCLUSIONS: Our article provides glimpses into the personality of Dr. Louise Eisenhardt and her marked impact on neurosurgery and allied neurosciences.

Impact of Affective Disorders on Inpatient Opioid Consumption and Hospital Outcomes Following Open Posterior Spinal Fusion for Adult Spine Deformity.

OBJECTIVE: Affective disorders (ADs) are common and have a profound impact on surgical recovery, though few have studied the impact of ADs on inpatient narcotic consumption. The aim of this study was to assess the impact of ADs on inpatient narcotic consumption and healthcare resource utilization in patients undergoing spinal fusion for adult spinal deformity. METHODS: A retrospective cohort study was performed using the 2016-2017 Premier Healthcare Database. Adults who underwent adult spinal deformity surgery were identified using International Classification of Disease, Tenth Revision, codes. Patients were grouped based on comorbid diagnosis of an AD. Demographics, comorbidities, intraoperative variables, complications, length of stay, admission costs, and nonroutine discharge rates were assessed. Increased inpatient opioid use was categorized by morphine milligram equivalents consumption greater than the 75th percentile. Multivariate regression analysis was used to identify predictors of increased healthcare recourse utilization. RESULTS: Of the 1831 study patients, 674 (36.8%) had an AD. A smaller proportion of patients in the AD cohort were 65+ years of age (P = 0.001), while a greater proportion of patients in the AD cohort identified as non-Hispanic White (P < 0.001). A greater proportion of patients in the AD cohort had increased morphine milligram equivalents consumption (P < 0.001). The AD cohort also had a longer mean length of stay (P < 0.001). A greater proportion of patients in the AD cohort had nonroutine discharges (P = 0.039) and unplanned 30-day readmission (P = 0.041). On multivariate analysis, AD was significantly associated with increased cost (odds ratio: 1.61, P < 0.001) and nonroutine discharge (odds ratio: 1.36, P = 0.035). CONCLUSIONS: ADs may be associated with increased inpatient opioid consumption and healthcare resource utilization.

High-resolution cortical parcellation based on conserved brain landmarks for localization of multimodal data to the nearest centimeter.

Precise cortical brain localization presents an important challenge in the literature. Brain atlases provide data-guided parcellation based on functional and structural brain metrics, and each atlas has its own unique benefits for localization. We offer a parcellation guided by intracranial electroencephalography, a technique which has historically provided pioneering advances in our understanding of brain structure-function relationships. We used a consensus boundary mapping approach combining anatomical designations in Duvernoy's Atlas of the Human Brain, a widely recognized textbook of human brain anatomy, with the anatomy of the MNI152 template and the magnetic resonance imaging scans of an epilepsy surgery cohort. The Yale Brain Atlas consists of 690 one-square centimeter parcels based around conserved anatomical features and each with a unique identifier to communicate anatomically unambiguous localization. We report on the methodology we used to create the Atlas along with the findings of a neuroimaging study assessing the accuracy and clinical usefulness of cortical localization using the Atlas. We also share our vision for the Atlas as a tool in the clinical and research neurosciences, where it may facilitate precise localization of data on the cortex, accurate description of anatomical locations, and modern data science approaches using standardized brain regions.