World Neurosurg
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Racial disparities exist in health care, frequently resulting in unfavorable outcomes for minority patients. Here, we use guided machine learning (ML) ensembles to model the impact of race on discharge disposition and length of stay (LOS) after brain tumor surgery from the Healthcare Cost and Utilization Project National Inpatient Sample. ⋯ Minority race independently increases the risk of extended LOS and black race increases the risk of non-home discharge in patients undergoing brain tumor resection, a finding not mimicked in the general inpatient or operative population. Recognition of the influence of race on discharge and LOS could generate interventions that may improve outcomes in this population.
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Case Reports
Treatment of Moyamoya Disease and Unruptured Intracranial Aneurysm in Floating-Harbor Syndrome- A case report.
This is the first report of the successful treatment of moyamoya disease and an unruptured intracranial aneurysm in a patient with Floating-Harbor syndrome. ⋯ We present the first case of diagnosis and treatment of moyamoya disease and BAA in a patient with Floating-Harbor syndrome. Due to a paucity of literature on this rare disorder, there has not been an associated link between Floating-Harbor syndrome and cerebrovascular disease. Our report and literature review suggest that these patients may be prone to cerebrovascular disorders and should be followed closely with neurovascular imaging.
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Comparative Study Observational Study
Does one size fit all? Examining the Application of Neurosurgery Residency Milestones Developed in the USA to a Taiwanese Culture.
The Milestone Project was launched in 2009, charging specialties to develop specific educational accomplishments required to establish clinical competency. The milestone assessment method was first introduced to Taiwan in 2013 and before applying milestone assessments to our medical education system, the validity and reliability of these questionnaires needed to be evaluated. ⋯ Milestone assessments have high reliability and may be a helpful assessment tool. Although milestone assessment can provide thorough feedback concerning performance and the content of the training program, they may not perfectly suit all residency-training programs, especially in different countries or different cultures. Modifications should be done before applying milestones to different areas; therefore the results can truly reflect the progress and condition of the training and learning process.
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To retrospectively review the clinicopathologic features and computed tomography (CT) and magnetic resonance imaging (MRI) findings of spinal solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) tumors. ⋯ Spinal SFT/HPC commonly appears as a well-defined solitary mass characterized by a black and white appearance that is marked with heterogeneous enhancement with or without bone destruction.
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Case Reports
Vertebrobasilar Insufficiency Due to Distal Posterior Inferior Cerebellar Artery Compression in Chiari 1.5.
Chiari malformation is characterized by radiographic evidence of herniation of cerebellar tonsils below the foramen magnum and a symptom complex of headaches; breathing, swallowing, or sleep difficulties; ataxia; restless; and motor and/or sensory deficits. ⋯ In the setting of severe Chiari malformations, particularly the Chiari 1.5 variant, assessment of the posterior fossa vasculature may be useful in defining a subset of patients with preoperative compromise in posterior fossa blood flow and postoperative expectations. Preoperative planning and exploration of midline dorsal brain stem along with the tonsilomedullary fissure could be helpful for contribution of vascular pathology among Chiari symptoms complex in these patients.