World Neurosurg
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The greater auricular nerve (GAN) may be used as a nerve graft during neurosurgical procedures to repair damaged nerves. There is extensive literature on localization of the GAN at the posterior triangle of the neck, but objective information on localization of the GAN at the anterior triangle of the neck close to cranial neurosurgical fields is lacking. The aim of this study was to introduce simple and reliable landmarks to localize the GAN at the anterior triangle of the neck to facilitate its harvest during neurosurgical procedures. ⋯ The AGA point and the M-A line are reliable landmarks for locating the GAN at the anterior triangle of the neck and for helping neurosurgeons expose and harvest the GAN efficiently.
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Programs that address overall wellbeing early in residency are necessary to prevent physician burnout and promote physician mental health to improve patient outcomes and ensure long and productive careers. A wellness initiative was implemented at our institution 3 years ago. We present feedback from participating residents across all levels of training. ⋯ Participating resident perceptions of the wellness program are highly favorable. The survey results, combined with the perspectives across training levels, provide insight for other programs wishing to implement program of their own.
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Nonlethal cervical spine injuries in skydiving are rare due to the associated high mortality. Here, we report an unusual pathomechanism leading to a Hangman fracture in a semiprofessional parachute athlete. ⋯ Excessive deceleration during canopy deployment may pose a risk for life-threatening cervical spine injuries in skydiving.
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This video (Video 1) demonstrates bilateral posterior communicating artery (PCoA) aneurysms that were treated through a unilateral supraorbital approach. A 53-year-old woman presented with a Hunt-Hess grade I subarachnoid hemorrhage. Computed tomography scan showed subarachnoid hemorrhage in the left sylvian fissure and basal cistern. ⋯ The patient recovered well without any complications. Postoperative angiography confirmed complete obliteration of these 2 aneurysms. For selected bilateral PCoA aneurysms with non-low-lying and posteromedial projection of the contralateral aneurysm, surgical clipping of all aneurysms via a unilateral approach is a feasible alternative.