World Neurosurg
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Bibliometric analyses based on total citation count come with many limitations, which investigators in other fields have overcome using the average number of citations per year since publication. ⋯ These results suggest that ranking articles based on relevancy rather than historical popularity results in a list of more recently published articles and includes more studies addressing topics of surgical management and outcomes. The ability to appraise the literature in this fashion is worthwhile to those seeking a better understanding of the science underlying modern clinical practice and is thus a highly valuable tool for neurosurgical residents, program directors, and neuroscientists as they acquire an understanding of modern neurosurgery and its scientific foundation.
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Case Reports
Intracranial Blood Flow Changes in Patients with High-grade Severe Carotid Artery Stenosis after Stenting.
We investigated whether the cerebral hemodynamic changes of pre- and poststenting in patients with severe carotid stenosis differ by stenosis grades. ⋯ The improvement of brain perfusion combined with the normalization of collateral flow through the circle of Willis after CAS was observed only in patients with HGSS.
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Combined hyperactive dysfunction syndrome (HDS) is defined as the combination symptoms arising from overactivity in cranial nerves, specifically, trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN), without an obvious explanatory structural lesion. This study retrospectively analyzes the clinical characteristics of combined HDS treated with microvascular decompression (MVD) in a single institution. ⋯ Combined HDS is a rarely occurring syndrome usually observed in older females, and the most common types are combined TN-GPN and combined TN-HFS. Age and gender seemed to be causes for developing combined HDS, and MVD shows potential as a favorable treatment choice.
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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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Lateral approaches to the spine are increasing in popularity. However, details of the innervation pattern of the abdominal oblique muscles with the initial dissection have not been well studied. ⋯ Knowledge of the innervation and nerve dominance patterns might help decrease postoperative complications such as sensory deficits or abdominal wall hernias. The subcostal nerve is the dominant nerve in both size and innervation of the oblique muscles in the lateral position, transpsoas approach.