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Neurosurgical planning

Hesham Mostafa Zakaria, Peter Joseph Massa, Richard L Smith, Tarek Hazem Moharram, John Corrigan, Ian Lee, Lonni Schultz, Jianhui Hu, Suresh Patel, Brent Griffith
Preoperative identification of the eloquent brain is important for neurosurgical planning. One common method of finding the motor cortex is by localizing "the Omega sign." No studies have tested the reliability of imaging to identify the Omega sign. We identified 40 recent and consecutive patients who had undergone preoperative functional magnetic resonance imaging for identification of the hand motor area prior to tumor resection. We recruited 11 neurosurgical residents of various levels of training and one board-certified neurosurgeon to identify the hand motor cortex Omega...
January 1, 2018: Neuroradiology Journal
Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
A V Moskalev, V S Gladkikh, A A Al'shevskaya, A P Kovalevskiy, A I Sakhanenko, K Yu Orlov, N A Konovalov, A V Krut'ko
To date, a large amount of retrospectively collected data about treatment of neurosurgical pathology have been accumulated. Modern methods of medical statistics are necessary for correct interpretation of the data. The article purpose is to demonstrate application of one of the modern methods, Propensity Score Matching (PSM), in neurosurgery. The use of PSM avoids misinterpretation of retrospectively collected data and obviates errors in planning further prospective studies. For the past 10 years, the number of published international PSM-based studies has increased more than 10-fold, with the number of articles by Russian authors accounting for less than 0...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
B A Kadashev, A N Konovalov, L I Astaf'eva, P L Kalinin, M A Kutin, I S Klochkova, D V Fomichev, O I Sharipov, D N Andreev
The pituitary stalk (PS) is a relatively thin bundle connecting the hypophyseal stalk to the pituitary gland; it consists of both axons of the hypothalamic nuclei (terminating in the neurohypophysis) and the system of portal vessels. Compression of the PS by a space-occupying lesion or its transection (forced or intended) during surgery may lead to the development of endocrine disorders: hypopituitarism, diabetes insipidus, and hyperprolactinemia. The modern literature lacks studies evaluating the severity of endocrine disorders depending on the PS condition before and after surgery...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Felix Ehret, Alexander Muacevic
Vestibular schwannomas are mostly sporadic, neuroectodermal, benign tumors of the myelin-forming cells of the vestibulocochlear nerve. Typical initial symptoms of vestibular schwannomas often include unilateral hearing loss, tinnitus, vertigo, and headaches. As schwannomas characteristically show a slow growth rate and various symptoms, different therapeutic approaches are possible, ranging from a watchful waiting strategy to radiation therapy and neurosurgical tumor removal. In addition, these treatment options should be evaluated carefully and assigned individually to the patients' needs and symptoms while respecting the feasibility and possible outcome of the chosen treatment...
January 5, 2018: Curēus
Rami A El Shafie, Angela Paul, Denise Bernhardt, Henrik Hauswald, Thomas Welzel, Tanja Sprave, Adriane Hommertgen, Johannes Krisam, Daniela Schmitt, Sebastian Klüter, Kai Schubert, Christina Klose, Meinhard Kieser, Jürgen Debus, Stefan Rieken
BACKGROUND: Neurosurgical resection is recommended for symptomatic brain metastases, in oligometastatic patients or for histology acquisition. Without adjuvant radiotherapy, roughly two-thirds of the patients relapse at the resection site within 24 mo, while the risk of new metastases in the untreated brain is around 50%. Adjuvant whole-brain radiotherapy (WBRT) can reduce the risk of both scenarios of recurrence significantly, although the associated neurocognitive toxicity is substantial, while stereotactic radiotherapy (SRT) improves local control at comparably low toxicity...
March 8, 2018: Neurosurgery
Hari S Raman, David D Limbrick, Wilson Z Ray, Dean W Coble, Sophie Church, Ralph G Dacey, Gregory J Zipfel
OBJECTIVE The challenging nature of neurosurgical residency necessitates that appropriate measures are taken by training programs to ensure that residents are properly progressing through their education. Residents who display a pattern of performance deficiencies must be identified and promptly addressed by faculty and program directors to ensure that resident training and patient care are not affected. While studies have been conducted to characterize these so-called "problem residents" in other specialties, no current data regarding the prevalence and management of such residents in neurosurgery exist...
March 2, 2018: Journal of Neurosurgery
Julien Delaunois, Géraldo Vaz, Christian Raftopoulos
BACKGROUND AND IMPORTANCE: Cavernous malformations (CMs) are vascular abnormalities with a hemorrhage risk of 0.2% to 5% per year, according to their location. Brainstem CMs seem to have a greater hemorrhagic risk and represent a neurosurgical challenge. We report here the first transsylvian transuncal (TS-TU) approach for an anteromedial mesencephalic CM resection. CLINICAL PRESENTATION: A 29-yr-old female suddenly presented a left hemiparesis and central facial paresis with a diplopia in the upward gaze...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Dimitri Laurent, Seth F Oliveria, Michael Shang, Frank Bova, Rachel Freedman, Maryam Rahman
BACKGROUND: Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia. OBJECTIVE: To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Liang Wang, Xun Ye, Qiang Hao, Li Ma, Xiaolin Chen, Hao Wang, Yuanli Zhao
To develop a realistic model of middle cerebral artery (MCA) aneurysms using three-dimensional (3D) printing for surgical planning, research, and training of neurosurgical residents. This study included eight MCA aneurysm cases. The aneurysm together with the adjacent arteries and skull base were printed based on raw computed tomography angiography (CTA) data using a 3D printer with acrylonitrile-butadiene-styrene as the model material. The aneurysm models were used for surgical planning, and craniotomy and clipping practice by neurosurgical residents...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Siddeshappa Nandish, Gopalakrishna Prabhu, Kadavigere V Rajagopal
BACKGROUND: Imaging modalities in medicine gives complementary information. Inadequacy in clinical information made single imaging modality insufficient. There is a need for computer-based system that permits rapid acquisition of digital medical images and performs multi-modality registration, segmentation and three-dimensional planning of minimally invasive neurosurgical procedures. In this regard proposed article presents multimodal brain image registration and fusion for better neurosurgical planning...
December 2017: Biomedical Journal
Roberto Herrera, Héctor Rojas, Ariel Estramian, Julieta Gómez, José Luis Ledesma, José Pablo, Julián Pastore
Background: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. Case Description: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2...
2018: Surgical Neurology International
Rimal H Dossani, Piyush Kalakoti, Anil Nanda, Bharat Guthikonda, Luis M Tumialán
BACKGROUND: The main objective of the Affordable Care Act (ACA) was to make health insurance affordable to all Americans while addressing the lack of coverage for 48 million people. In the face of rapidly increasing enrollment and rising demand for inexpensive plans, insurance providers are limiting in-network physicians. Provider networks offering plans with limited in-network physicians have become known as "narrow networks." OBJECTIVE: To assesses the adequacy of ACA marketplace plans for outpatient neurosurgery in Louisiana...
February 6, 2018: Neurosurgery
Sima Rafiei, Arman Daneshvaran, Sina Abdollahzade
CONTEXT: Shortage of physicians particularly in specialty levels is considered as an important issue in Iran health system. Thus, in an uncertain environment, long-term planning is required for health professionals as a basic priority on a national scale. AIMS: This study aimed to estimate the number of required neurosurgeons using system dynamic modeling. SETTING AND DESIGN: System dynamic modeling was applied to predict the gap between stock and number of required neurosurgeons in Iran up to 2020...
2018: Journal of Education and Health Promotion
Vito Colella, Carla Maia, André Pereira, Nuno Gonçalves, Marta Caruso, Coralie Martin, Luis Cardoso, Lenea Campino, Ivan Scandale, Domenico Otranto
The genus Onchocerca encompasses parasitic nematodes including Onchocerca volvulus, causative agent of river blindness in humans, and the zoonotic Onchocerca lupi infecting dogs and cats. In dogs, O. lupi adult worms cause ocular lesions of various degrees while humans may bear the brunt of zoonotic onchocercosis with patients requiring neurosurgical intervention because of central nervous system localization of nematodes. Though the zoonotic potential of O. lupi has been well recognized from human cases in Europe, the United States and the Middle East, a proper therapy for curing this parasitic infection in dogs is lacking...
January 29, 2018: PLoS Neglected Tropical Diseases
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
PURPOSE: The quality of physicians practicing in hospitals recognized for nursing excellence by the American Nurses Credentialing Center has not been studied before. We investigated whether Magnet hospital recognition is associated with higher quality of physicians performing neurosurgical procedures. MATERIALS AND METHODS: We performed a cohort study of patients undergoing neurosurgical procedures from 2009-2013, who were registered in the New York Statewide Planning and Research Cooperative System (SPARCS) database...
January 24, 2018: British Journal of Neurosurgery
Hye Ran Park, Sukh Que Park, Jae Hyun Kim, Jae Chan Hwang, Gwang Soo Lee, Jae-Chil Chang
Objective: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea. Methods: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas...
January 2018: Journal of Korean Neurosurgical Society
Matthias Gmeiner, Johannes Dirnberger, Wolfgang Fenz, Maria Gollwitzer, Gabriele Wurm, Johannes Trenkler, Andreas Gruber
OBJECTIVE: Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force feedback and real-time deformation of the aneurysm and vessels. METHODS: A prototype simulator was developed from 2012 to 2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software, and the prototype was evaluated by 18 neurosurgeons...
January 11, 2018: World Neurosurgery
Ryan S Youland, Deanna H Pafundi, Debra H Brinkmann, Val J Lowe, Jonathan M Morris, Bradley J Kemp, Christopher H Hunt, Caterina Giannini, Ian F Parney, Nadia N Laack
Treatment-related changes can be difficult to differentiate from progressive glioma using MRI with contrast (CE). The purpose of this study is to compare the sensitivity and specificity of 18F-DOPA-PET and MRI in patients with recurrent glioma. Thirteen patients with MRI findings suspicious for recurrent glioma were prospectively enrolled and underwent 18F-DOPA-PET and MRI for neurosurgical planning. Stereotactic biopsies were obtained from regions of concordant and discordant PET and MRI CE, all within regions of T2/FLAIR signal hyperintensity...
January 13, 2018: Journal of Neuro-oncology
Esther Bay, Andrea Sherzer, Emily Darnbrook
In response to regulators of nursing education and the Institute of Medicine, an academic-service partnership was formed between a research-intensive school of nursing and a tertiary health care facility. In that partnership, clinical experiences occurred mostly within 1 organization. This case report showcases the development, implementation, and revisions within our capstone immersion course, designed to ease the new graduates' transition into practice, including transitions to critical care nursing. Herein, we highlight our successes and challenges of implementing the clinical component within 2 critical care units focused on trauma and neurosurgical care of complex patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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