Neurosurgery
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In tetraplegics, thumb and finger motion traditionally has been reconstructed via orthopedic procedures. Although rarely used, nerve transfers are a viable method for reconstruction in tetraplegia. ⋯ Transfer of the ECRB distal branch to the FPL is a viable option to reconstruct thumb flexion.
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For neuroepithelial tumors, the surgical goal is maximum resection with preservation of neurological function. This is contributed to by intraoperative magnetic resonance imaging (iMRI) combined with multimodal navigation. ⋯ Intraoperative visualization of language-related cortical areas and the connecting pathways with DTI-based fiber tracking can be successfully performed and integrated in the navigation system. In a setting of intraoperative high-field MRI this contributes to maximum tumor resection with low postoperative morbidity.
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Chronic subdural hematoma (CSDH) is commonly seen in neurosurgical practice, and the incidence is increasing. Treatment results are highly variable with respect to recurrences and complications. ⋯ The present data suggest that in surgical treatment of CSDH with burr hole craniostomy, extended preoperative corticosteroid administration is associated with a lower recurrence rate. The use of corticosteroids does not seem to be related to a higher incidence of complications and treatment-related death compared with the current literature.
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Cranial base metastases (CBM) are rare and have received limited attention in the medical literature. Questions remain regarding the role of surgery, if any, in the management of these tumors. ⋯ The goal of surgery for CBM is to provide symptom relief and to preserve functional status in well-selected cases. Patient selection is critical because the surgery is usually palliative, and only a minority of patients are surgical candidates. Radiation therapy remains the management option of choice for the majority of patients.
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Factors during neurosurgical residency that are predictive of an academic career path and promotion have not been defined. ⋯ Defined in-training factors including number of total publications, number of first-author publications, and program size are predictive of residents choosing and succeeding in an academic career path.