Contact

  • Academic
    mksokol@stanford.edu
    University - Student Department: School of Medicine Position: Graduate, Medicine

Additional Info

  • Mail Code: 5151

All Publications

  • Early Cost Analysis of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Treatment: A National Claims Database Analysis (MarketScan, 2007-2023). Cureus Zhang, Y., Levinson, S., Sokol, M., Theodros, D., Skirboll, S. 2026; 18 (9): e115599

    Abstract

    Middle meningeal artery (MMA) embolization has emerged as a promising, minimally invasive treatment for chronic subdural hematoma (cSDH), with randomized controlled trials demonstrating reduced recurrence compared with surgery alone. However, real-world data comparing standalone MMA embolization, surgical evacuation alone (burr hole drainage or craniotomy), and combined MMA embolization with surgical evacuation remain limited, particularly regarding comparative safety, short-term outcomes, and healthcare costs.We conducted a retrospective analysis of MarketScan Commercial Claims and Encounters (2007-2023) identifying patients with nontraumatic SDH undergoing burr hole evacuation, craniotomy, or MMA embolization. Demographics, comorbidities, in-hospital and 30- and 90-day outcomes, costs, and reinterventions were compared across cohorts.A total of 16,291 patients were identified (7,147 burr holes, 8,757 craniotomies, 387 MMA embolizations). MMA embolization increased from 2% of cases in 2018 to 30% by 2023. MMA embolization patients had more comorbidities, including double the rate of coagulopathy (22% vs. 11-12%; p < 0.001). While index hospitalization cost for MMA embolization was the highest (median $69,383), driven by multistep interventional billing, 90-day postoperative cost was intermediate ($10,343) compared to craniotomy ($12,714) and burr hole ($6,877; p < 0.001). In-hospital mortality was lowest for MMA embolization (2%) versus burr holes (3%) and craniotomy (11%; p < 0.001). Patients undergoing combined MMA embolization and open surgery had substantially higher 90-day costs ($24,496) and stroke/transient ischemic attack (TIA) rates (40%).MMA embolization has been rapidly adopted for cSDH treatment, offering favorable short-term outcomes and an intermediate cost profile to higher-risk patients. Poor outcomes with combined surgical and embolization procedures warrant further investigation. These findings support MMA embolization as practice-changing technology while highlighting the need for long-term prospective studies to optimize patient selection and cost-effectiveness.

    View details for DOI 10.7759/cureus.115599

    View details for PubMedID 42824879

    View details for PubMedCentralID PMC13629742

  • A review of targeted therapies for NF2-related vestibular schwannoma: molecular pathogenesis, emerging therapeutics, and future clinical horizons. Journal of neuro-oncology Sokol, M. K., Ha, J. H., Li, G., Kim, L. H. 2026; 178 (1)

    Abstract

    Neurofibromatosis type 2 (NF2) is a hereditary tumor syndrome driven by mutations in the NF2 gene. The mutation leads to aberrant proliferation of Schwann cells along the vestibular division of cranial nerve VIII, resulting in bilateral vestibular schwannomas (VS) that cause progressive hearing loss and neurological dysfunction. Loss of the tumor suppressor merlin results in dysregulation of multiple oncogenic pathways, including VEGF, MAPK/ERK, PI3K/AKT/mTOR, EGFR/ErbB, PDGFR, and Hippo-YAP. The inability of conventional management modalities to address the multifocal and progressive nature of NF2-associated tumors has driven investigation into targeted therapies.This review summarizes the evolving landscape of targeted therapies in NF2-associated vestibular schwannomas. Management of NF2-VS is individualized, with active surveillance favored for stable or smaller tumors, surgical resection pursued for symptomatic or enlarging lesions, and bevacizumab increasingly utilized as either a primary or adjunctive systemic option. Radiation therapy, by contrast, is employed selectively given its potential to compromise auditory function and its association with malignant transformation. Targeted agents such as bevacizumab (anti-VEGF), MEK inhibitors (selumetinib, trametinib), EGFR inhibitors (lapatinib, erlotinib), and mTOR inhibitors (everolimus) are examined across preclinical models and clinical trials. Emerging approaches including dual pathway inhibition and immunologic strategies such as VEGF receptor vaccination are also discussed. Importantly, NF2-VS exhibits molecular and clinical heterogeneity, with differing responses observed across pediatric and adult populations.Therapeutic limitations of current targeted therapies include resistance, toxicity, and the modest efficacy of monotherapies. As such, future investigations must refine endpoints (e.g., hearing stabilization vs. tumor regression), optimize dosing strategies, and personalize therapy based on age, tumor biology, and clinical trajectory. This review highlights the translational challenges and opportunities that lie ahead in delivering clinically efficacious therapies specific to each patient.

    View details for DOI 10.1007/s11060-026-05599-z

    View details for PubMedID 42142209

    View details for PubMedCentralID 9424169