Neurosurgery
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Endovascular neurosurgery is a discipline strongly dependent on imaging. Therefore, technology that improves how much useful information we can garner from a single image has the potential to dramatically assist decision making during endovascular procedures. ⋯ We describe the types of simulation used for endovascular procedures, including virtual reality, and discuss the relevant data on its utility in training. Finally, the benefit of augmented reality during endovascular procedures is discussed, along with future computerized image enhancement techniques.
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Recent advances in 3-dimensional (3-D) stereoscopic imaging have enabled 3-D display technologies in the operating room. We find 2 beneficial applications for the inclusion of 3-D imaging in clinical practice. The first is the real-time 3-D display in the surgical theater, which is useful for the neurosurgeon and observers. ⋯ Higher-resolution displays will be available soon, and the algorithms for depth inference from stereo can be improved. The stereoscopic and autostereoscopic systems from microscope cameras to displays were compared by the use of recorded and live content from surgery. To the best of our knowledge, this is the first report of application of autostereoscopy in neurosurgery.
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After emerging from and transforming the practice of neurosurgery, stereotactic radiosurgery is increasingly affecting all surgical disciplines. The first generation of frame-based devices limited radiosurgery treatment to lesions of the brain where the rigidity of the skull provided adequate skeletal purchase. ⋯ After almost 2 decades of existence, the technology and clinical application of image-guided robotic radiosurgery have evolved considerably, and today a range of treatments with such technology have become commonplace. Nevertheless, the timeless allure of a truly noninvasive, yet highly effective, therapy promises that further refinements in robotic radiosurgery will be forthcoming well into the future.
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Neural progenitor cells (NPCs) are undifferentiated and mitotic and can be induced to differentiate into neurons and glia, the building blocks of the nervous system. NPCs have great therapeutic potential for nervous system trauma and degenerative disorders. They have been identified in the mammalian central nervous system, but current sources are difficult to access surgically and come from regions that are critical for normal brain function. ⋯ Multipotent NPC cells from the FT are both accessible and expendable. They may allow autologous cell-based transplantation therapy that circumvents immunological rejection.