World Neurosurg
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The aims of this study were to determine the efficacy and feasibility of implementation of the intraoperative component of a high risk spine (HRS) protocol for improving perioperative patient safety in complex spine fusion surgery. ⋯ The intraoperative component of the HRS protocol, based on two Do-Confirm checklists that focused on 1) organized communication between intraoperative team members and 2) active maintenance of oxygen delivery and hemostasis appears to maintain a safe intraoperative environment and was readily implemented during a 3-year period.
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Pure intraventricular craniopharyngioma is a rare subtype of craniopharyngioma that attaches frequently to the hypothalamus. The main challenge in tumor removal is protection of hypothalamic structure. The aim of our study was to set up a feasible risk-evaluation approach to help the surgeons make an individual treatment plan. ⋯ Attachment and deformation grade evaluated based on our criteria are significantly correlated with postoperative outcome. GTR of tightly attached tumor is associated with worse endocrinologic, functional, and radiologic outcomes compared with STR. Hence, we suggest that individual surgical plans should be made according to the grade of tumor attachment and hypothalamic deformation. STR should used in tumors with a high grade to achieve a good long-term outcome and avoid severe postoperative sequelae.
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Biography Historical Article
Medieval times' influencing figure Rhaze's approach to head injuries in Liber Almansoris.
To present the chapter "On wound of the head and fracture of the head bone" of Kitāb al-Manṣūrī / Liber Almansoris, which was one of the early works of Rhazes. ⋯ Galen's contemplation for the care of the dura with its integrity and as well his proposal to remove the bone fragments for preventing the dura from injury were the golden standards at the time that Rhazes also followed in the treatment of skull fractures.
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Craniopharyngiomas represent one of the major challenges of neurosurgery. Surgical management of craniopharyngiomas classically required various transcranial approaches with the transsphenoidal route reserved for very selected cases. With the widespread use of endoscopes in endonasal surgery in the past decade, the extended endoscopic endonasal transtuberculum and transplanum approaches have been proposed as an alternative surgical route for removal of different types of suprasellar tumors, including solid craniopharyngiomas in patients with normal pituitary function and small sella. ⋯ The endoscopic endonasal approach offers advantages in the management of craniopharyngiomas that historically have been approached via the transsphenoidal route (i.e., purely intrasellar or intra-suprasellar infradiaphragmatic, preferably cystic lesions in patients with panhypopituitarism). Use of the "extended" endoscopic endonasal approach overcomes the limits of the transsphenoidal route to the sella enabling the management of different purely suprasellar and retrosellar cystic/solid craniopharyngiomas, regardless of the sellar size or pituitary function.
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To develop an understanding of the availability of the formal clinical neuro-oncology educational opportunities for medical students. ⋯ Formal clinical neuro-oncology elective opportunities for medical students in the United States and Canada are limited. Additional such opportunities may be of value in the education of medical students.