Neurosurgery
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Reoperations account for >10% in pediatric epilepsy surgery cohorts, and they are especially relevant in young children with catastrophic epilepsy. ⋯ Reoperation is particularly beneficial for selected children with refractory epilepsy associated with cortical dysplasia that did not respond to an initial limited and/or early resection but achieved seizure freedom after extensive procedures. When indicated, reoperation should be performed at the youngest possible age to profit from higher functional plasticity in compensating for neurological deficit.
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Observational Study
Perioperative complications after carotid artery stenting: a contemporary experience from the university at buffalo neuroendovascular surgery team.
Technological advances have resulted in diminishing perioperative complications reported during carotid artery stenting (CAS) trials. Because trial experience lags behind technological advances, an understanding of the incidence of perioperative complications after CAS remains in flux. ⋯ In this retrospective analysis of consecutive patients treated with CAS, the perioperative incidence of stroke (0.9%), MI (0.6%), and death (1.1%) was favorable.
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We review our experience with lung cancer patients with newly diagnosed brain metastases treated with Gamma Knife radiosurgery (GKRS). ⋯ Histological subtype of lung cancer appears to predict outcomes. Future trials and prognostic indices should take these histology-specific patterns into account.
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Meningeal hemangiopericytoma (M-HPC) is a rare entity. ⋯ In M-HPC, both PORT and GTR independently correlate with improved LC. PORT improves LC following GTR. We recommend RT dose ≥60 Gy to optimize LC.
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Restrictions on duty hours and shift length by the Accreditation Council for Graduate Medical Education and public pressure to reduce complications and to improve outcomes in the clinical educational environment have enhanced interest in the use of procedural and surgical simulation to train neurosurgical residents. ⋯ Model-based simulation is particularly effective for early surgical learners as part of a coordinated curriculum. Almost 600 residents have used model-based simulation during the first 3 years of the Society of Neurological Surgeons boot camp courses, with ongoing modification and improvement of individual simulation models.