Acta neurochirurgica
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Acta neurochirurgica · Jan 2016
Long-term outcomes after supratotal resection of diffuse low-grade gliomas: a consecutive series with 11-year follow-up.
Total or subtotal surgical resection of WHO grade II glioma (diffuse low-grade glioma, DLGG) can significantly increase survival. Moreover, a supratotal resection, i.e., an extended resection with a margin beyond MR imaging abnormalities, could decrease the risk of malignant transformation. Here, the goal is to analyze the long-term functional and oncological outcomes following supratotal resection for DLGG. ⋯ This is the first series demonstrating the prolonged impact of supratotal resection on malignant transformation of DLGG. These original data may suggest to remove a margin around the FLAIR-weighted MR imaging abnormalities in a more systematic manner for DLGG not involving eloquent structures.
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Acta neurochirurgica · Jan 2016
The teaching of neurosurgery in UK medical schools: a message from British medical students.
A great variability exists in the clinical exposure of neurosurgery across all academic years in UK medical schools, although the effects of this on knowledge level and confidence in referring cases appropriately to specialists have not been reported. ⋯ Students with exposure to an operating theatre outperformed those students exposed to just classroom teaching. Students indicated an increased preference for teaching through the operating theatre scene. One in three final-year medical students had difficulty identifying the need for a neurosurgical referral.If neurosurgical teaching were further enhanced at medical school, it could lead to increased confidence and efficiency in junior-year doctors when facing the neurosurgical referral process. Increased exposure to clinical neurosurgery may significantly improve the ability of future doctors to tackle neurosurgical scenarios.
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Acta neurochirurgica · Jan 2016
Preoperative predictive factors for surgical and functional outcomes in chronic subdural hematoma.
Chronic subdural hematoma (CSDH) is a frequently encountered neurosurgical condition, especially in the elderly. We investigated predictive factors for surgical and functional outcomes after burr-hole drainage (BHD) surgery. ⋯ Clinicians should be more aware of general conditions and medical problems, especially in elderly patients. Membranectomy should be considered in patients with a long duration of symptoms or hypo-dense hematomas to promote good brain expansion and good mRS scores.
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Acta neurochirurgica · Jan 2016
Postoperative transient neurological symptoms and chronic subdural hematoma after extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases: negative effect on cognitive performance.
The mechanisms underlying post-extracranial to intracranial (EC-IC) bypass neurocognitive changes are poorly understood. ⋯ Postoperative transient neurological symptoms and/or CSDH might play a significant role in the subtle decline in cognition following an EC-IC bypass. However, this detrimental effect was small, and based on the group rate analysis, we concluded that a successful unilateral EC-IC bypass does not adversely affect postoperative cognitive function.
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Acta neurochirurgica · Jan 2016
Neurosurgical resident education in Europe--results of a multinational survey.
Neurosurgical training aims at educating future generations of specialist neurosurgeons and at providing the highest-quality medical services to patients. Attaining and maintaining these highest standards constitutes a major responsibility of academic or other training medical centers. ⋯ Theoretical and practical aspects of neurosurgical training are highly variable throughout European countries, despite some efforts within the last two decades to harmonize this. Some countries are rated significantly above (and others significantly below) the current European average for several analyzed parameters. It is hoped that the results of this survey should provide the incentive as well as the opportunity for a critical analysis of the local conditions for all training centers, but especially those in countries scoring significantly below the European average.