World Neurosurg
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The Agency for Healthcare Research and Quality patient safety indicators (PSIs) and the Centers for Medicare and Medicaid Services hospital-acquired conditions (HACs) are used to evaluate the safety and quality of health care provided by health care systems and individual facilities. To understand better the incidence of PSIs and HACs in hospitalized patients with stroke, we determined the rates of these events among patients with a diagnosis of stroke in the Nationwide Inpatient Sample (NIS) database. ⋯ Our results estimate baseline national incidence rates of PSIs and HACs in patients with stroke. These data may be used to determine individual institutional improvements or success by comparison.
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To understand the perceived utility of a novel simulator to improve operative skill, eye-hand coordination, and depth perception. ⋯ This simulation module may be suitable for resident training, as well as for the development of career interest and skill acquisition; however, validation for this type of simulation needs to be further developed.
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The term trepanation describes the removal of sections of bone from the cranium. Although others may have made earlier reference to trepanation, in 1995, Chinese archeologists discovered a skull at the Neolithic site Fujia from approximately 3000 bc (the Dawenkou Cultural Period), Guangrao, Dongying, Shandong, China, and after careful examination of the specimen, the archeologists suggested that the procedure had been performed on a living patient who subsequently survived. Archeological evidence supports that the practice of trepanation was widespread.
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Sphenoid wing region dural arteriovenous fistulas (DAVFs) are rare lesions that are typically fed by middle meningeal artery feeders and that drain via the sphenoparietal sinus or middle cerebral vein. We describe a unique case of a medial sphenoid wing fistula draining exclusively via the basal vein of Rosenthal. ⋯ Sphenoid wing DAVFs may drain via the deep venous system and have a complex arterial feeding network. Key features of the fistula, including deep venous drainage, presence of venous varices, and retrograde leptomeningeal venous drainage, make this an aggressive lesion with a high risk of rupture based on the available natural history data.
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Geniculate neuralgia is an uncommon pain syndrome that can be severe and disabling and is difficult to diagnose. ⋯ The patient indicated complete relief of his preoperative pain after surgery. He has remained pain-free with intact hearing and balance.