Neurosurgery
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Neurosurgical emergencies are an important cause of disability and mortality. ⋯ Acute cerebrovascular disease, intracranial injury, spinal cord injury, and occlusion/stenosis of precerebral arteries requiring emergency neurosurgery carry an important nationwide burden in terms of complications, deaths, charges, and LOS. Efforts in prevention and/or treatment of these conditions should continue.
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Traumatic brain and spinal cord injuries are major public health issues causing significant death and long-term disability in the United States, with higher incidences in young and older adults. The ThinkFirst National Injury Prevention Foundation is a nonprofit organization focused on injury prevention education and awareness for people of all ages, with a particular focus on educating children, teens, and young adults. ⋯ This review discusses the efforts of a number of ThinkFirst chapters in terms of research, legislation, and public communication. It showcases the success of ThinkFirst interventions and suggests future directions which can help improve national injury prevention efforts.
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Neuroimaging plays an ever evolving role in the diagnosis, treatment planning, and post-therapy assessment of brain tumors. This review provides an overview of current magnetic resonance imaging (MRI) methods routinely employed in the care of the brain tumor patient. Specifically, we focus on advanced techniques including diffusion, perfusion, spectroscopy, tractography, and functional MRI as they pertain to noninvasive characterization of brain tumors and pretreatment evaluation. The utility of both structural and physiological MRI in the post-therapeutic brain evaluation is also reviewed with special attention to the challenges presented by pseudoprogression and pseudoresponse.
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Definitive preoperative predictors of cerebral hyperperfusion following carotid artery stenting are yet to be established. ⋯ Combined use of cerebral angiography and SPECT may obviate the need for acetazolamide challenge to predict the risk of CHP following carotid artery stenting.