Neurosurgery
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Detection of procedural thromboembolism by diffusion-weighted magnetic resonance imaging (MR-DWI+) can help identify and mitigate endovascular risk factors. Data remain scant on procedural MR-DWI+ following the use of the Neuroform open-cell design stent in aneurysm embolization. ⋯ The Neuroform stent carries a very low risk of MR-DWI+ compared with its closed-cell design counterpart. Subarachnoid hemorrhage and deployment of multiple stents in the same anatomical region in configurations such as the Y-stent construct did not increase the risk of acute procedural thromboembolism.
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Virtual reality (VR) simulation-based technologies play an important role in neurosurgical resident training. The Congress of Neurological Surgeons (CNS) Simulation Committee developed a simulation-based curriculum incorporating VR simulators to train residents in the management of common neurosurgical disorders. ⋯ VR ventriculostomy placement as part of the CNS simulation trauma module complements standard training techniques for residents in the management of neurosurgical trauma. Improvement in didactic and hands-on knowledge by course participants demonstrates the usefulness of the VR simulator as a training tool.
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The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. ⋯ Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.
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Carotid endarterectomy (CEA) might improve cognitive function. Fractional anisotropy (FA) values in the cerebral white matter derived from diffusion tensor magnetic resonance imaging (DTI) correlate with cognitive function in patients with various central nervous system diseases. ⋯ Postoperative increase in cerebral white matter FA on DTI is associated with cognitive improvement after uncomplicated CEA.
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Postoperative displacement of deep brain stimulation electrodes related to lead-anchoring technique.
Displacement of deep brain stimulation (DBS) electrodes may occur after surgery, especially due to large subdural air collections, but other factors might contribute. ⋯ The commercially available plastic cap system is more efficient in preventing postoperative DBS electrode displacement than titanium microplates. A reliability analysis of the electrode fixation is warranted when alternative anchoring methods are used.