Neurosurgery
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Controlled Clinical Trial
Functional brain abnormalities are related to clinical recovery and time to return-to-play in athletes.
The relationship between athlete reports of symptoms, neurophysiological activation, and neuropsychological functioning is investigated in a sample of high school athletes. ⋯ These results demonstrate the relationship between neurophysiological, neuropsychological, and subjective symptom data in a relatively large sample composed primarily of concussed high school athletes. fMRI represents an important evolving technology for the understanding of brain recovery after concussion and may help shape return-to-play guidelines in the future.
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Preoperative embolization in accordance with multimodal therapies for cerebral arteriovenous malformations (AVMs) is generally the first step in treatment and may result in complete obliteration. The Onyx liquid embolic system (Micro Therapeutics, Inc., Irvine, CA) may offer advantages for intranidal targeted embolization and microsurgical resection. We present our experience in the combined treatment of intracranial AVMs using Onyx embolization and neurosurgical resection. ⋯ Preoperative use of the Onyx liquid embolic system in cerebral AVM treatment allows profound occlusion by targeted embolization and provides a basis for safe neurosurgical resection.
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Impacts causing concussion in professional football were simulated in laboratory tests to determine collision mechanics. This study focuses on the biomechanics of concussion in the struck player. ⋯ This study addresses head responses causing concussion in National Football League players. Although efforts are underway to reduce impact acceleration through helmet padding, further study is needed of head kinematics after impact and their contribution to concussion, including rapid head displacement, z-axis rotation, and neck tension up to the time of maximum strain in the midbrain. Neck strength influences head deltaV and head injury criterion and may help explain different concussion risks in professional and youth athletes, women, and children.
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Using transcranial magnetic stimulation paradigms, this study investigated motor cortex integrity as a function of an athlete's prior history of concussions. ⋯ Findings from this study indicate that sports-related concussions result in long-term motor system dysfunctions that seem to be attributable to subclinical intracortical inhibitory system abnormalities. This study also shows that sustaining subsequent concussions exacerbates this deficit, and thus provides additional support for the contention that the adverse effects of sports-related concussions on intracortical inhibitory systems are cumulative.
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The journal club (JC) plays a traditional role in resident education. However, little has been written on its current role in neurosurgical training programs. Our goal was to determine resident perception of JCs, factors that make JCs successful, and identifying variables for improving JCs. ⋯ JCs have a high perceived value by neurosurgical residents and should be maintained at all neurosurgical residency training programs. Key factors to a successful JC include faculty and resident attendance. Additional studies are needed to assess optimal JC formats and the possible utilization of supplemental educational tools.