World Neurosurg
-
The security of medical devices is critical to good patient care, especially when the devices are implanted. In light of recent developments in information security, there is reason to be concerned that medical implants are vulnerable to attack. The ability of attackers to exert malicious control over brain implants ("brainjacking") has unique challenges that we address in this review, with particular focus on deep brain stimulation implants. ⋯ Targeted attacks include impairment of motor function, alteration of impulse control, modification of emotions or affect, induction of pain, and modulation of the reward system. We also discuss the limitations inherent in designing implants and the trade-offs that must be made to balance device security with battery life and practicality. We conclude that researchers, clinicians, manufacturers, and regulatory bodies should cooperate to minimize the risk posed by brainjacking.
-
Review Historical Article
From Mystics to Modern Times: A History of Craniotomy & Religion.
Neurosurgical treatment of diseases dates back to prehistoric times and the trephination of skulls for various maladies. Throughout the evolution of trephination, surgery and religion have been intertwined to varying degrees, a relationship that has caused both stagnation and progress. From its mystical origins in prehistoric times to its scientific progress in ancient Egypt and its resurgence as a well-validated surgical technique in modern times, trephination has been a reflection of the cultural and religious times. Herein we present a brief history of trephination as it relates religion, culture, and the evolution of neurosurgery.
-
China is a densely populated country faced with more than 1 million cases of traumatic brain injury annually. Since the late 1930s, there has been a great improvement in the field of neurosurgery in the treatment of neurotrauma. ⋯ We present a historical vignette of the development of neurotrauma in China over almost 80 years. It is valuable to have this documentation of the growth of neurosurgery in China by authors who are familiar with the subject matter.
-
Spine surgery relies heavily on imaging, with radiography-based devices being the major operating room imaging modality. Radiation exposure is an occupational risk historically recognized shortly after the discovery of radiation itself. Exposure of both patients and operating room staff is of increasing concern as the knowledge regarding the hazards of radiation is steadily accumulating. ⋯ We discuss the methods to reduce operating room staff exposure to the minimal amount, thus reducing occupational risks. We recognize that increasing awareness to radiation exposure hazards and promoting the knowledge of methods to reduce exposure of surgeons, nurses, and technicians could result in a reduction of exposure to radiation.
-
To determine whether complications in lumbar fusion surgery could be estimated from patient factors and perioperative laboratory values. In addition, risk scores for detection of patients prone to complications were defined. ⋯ Patients with postoperative complications and extended LOS seem to show significant differences in various perioperative laboratory values and patient factors. Perioperative risk assessments using cut-off values and risk scores may help identify patients prone to complications and extended resource use.