World Neurosurg
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Quantitative estimates of surgical capacity and infrastructure and perceived care limitations in low-resource countries are essential baseline measures that can provide strategies for improving access to surgical care. Information about these barriers in Africa is scarce, particularly with respect to neurosurgery. We conducted a survey to better understand the unmet surgical need and resources available for the care of neurosurgery patients in Sub-Saharan Africa. ⋯ This large survey defines important self-perceived limitations to care within neurosurgery and highlights the importance of infrastructure and allied professions in this role. A clear understanding of areas of focus will enable a more efficient and sustainable response to the limitations in surgical care in low-resource areas.
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To determine whether fusion 3-dimensional (3D) angiography of both internal carotid arteries can better disclose vascular details in patients diagnosed with anterior communicating artery (ACoA) aneurysms by computed tomography angiography (CTA) or magnetic resonance angiography (MRA). ⋯ Fusion 3D angiography can significantly contribute to a better understanding of the complex anatomy of the anterior cerebral artery-ACoA complex, which is essential for successful treatment planning for ACoA aneurysms.
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In previous studies, multitrack trajectories in deep brain stimulation (DBS) have usually been approximated. Using a geometrically more accurate method, we compared the stereotactic accuracy of DBS with multitrack microelectrode recording and awake stimulation (function group) and MRI-guided DBS (MRI group). ⋯ Multitrack DBS using intraoperative functional evaluation resulted in worse stereotactic accuracy than did MRI-guided DBS. However, track shifts in function-guided DBS can approach MRI targets effectively.
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Paragangliomas are highly vascular and predominantly benign neoplasms that traditionally have been treated by surgery, embolization, and/or external beam radiotherapy. The aim of this study was to evaluate long-term local tumor control and the safety of radiosurgery for head and neck paragangliomas. ⋯ Both single and multisession radiosurgery were confirmed as a safe and effective treatment modality for paragangliomas. Multisession radiosurgery appears effective to treat large lesions.
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The operating microscope (OM) has become instrumental in aiding surgeons during key microdissection with greater safety and detail. An exoscope offers similar detail with improved functionality and greater implications for live teaching and improved operating room flow. ⋯ In our simulated operating room model, an exoscope is a valid alternative to the standard OM that affords the surgeon greater comfort with greater teaching potential while maintaining many of the microscope's benefits.