World Neurosurg
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Review Multicenter Study Comparative Study
C1-C2 Fusion Versus Occipito-Cervical Fusion for High Cervical Fractures: A Multi-Institutional Database Analysis and Review of the Literature.
Type II odontoid fractures of the axis (C2) account for more than 20% of all cervical fractures. If an odontoid screw is contraindicated, the treatment approach for type II C2 fractures typically involves C1-C2 posterior fusion or occipito-cervical (O-C) fusion, each of which has distinct advantages and disadvantages. In this study, postoperative outcomes of C1-C2 fusion and O-C fusion for high cervical fractures were compared. ⋯ This study provides a snapshot of the risk profiles of C1-C2 and O-C fusion for C2 fracture, demonstrating a statistically higher risk of reoperation in O-C fusion versus C1-C2 fusion. Future randomized trials are needed to identify the preferred technique to improve patient outcomes.
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Review Historical Article
The surgeon in action: representations of neurosurgery in movies from the frères lumière to today.
In this review, we examine the portrayal of neurosurgery and neurosurgeons in 61 movies produced from the beginnings of cinema from the Lumière brothers (1895) to 2017, across 4 continents and covering 10 cinematic genres. We find that these movies tend to shape most beliefs and stereotypes about neurosurgery. However, we notice that there is a trend to describe neurosurgery and neurosurgical disorders with more accuracy as we progress in time. Although it is not for the medical profession to dictate or censor fictional content, a keen eye on these depictions will help us to understand, and perhaps combat, some of the stereotypes and myths that continue to surround neurosurgery in the twenty-first century.
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Comparative Study
Assessment of Costs in Open Microsurgery and Stereotactic Radiosurgery for Intracranial Meningiomas.
Understanding costs of microsurgical or radiosurgical treatment of intracranial meningioma may offer direction in reducing health care costs and establishing cost-effective algorithms. We used the Value Driven Outcomes database, which identifies cost drivers and tracks changes over time, to evaluate cost drivers for management of intracranial meningioma. ⋯ Implementing protocols to reduce facility usage and imaging would mitigate total costs and improve resource utilization while maintaining high-quality patient care. Additional cost-effectiveness studies evaluating patients with true therapeutic equipoise will provide further guidance in these efforts.
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Review Case Reports
Candida parapsilosis Infection of Ventriculoperitoneal Shunt in Adult: Case Report and Literature Review.
Candida parapsilosis is an incredibly rare cause of ventriculoperitoneal (VP) shunt infections, with only 1 adult case reported in the literature to date. ⋯ In our report, we describe the clinical course of our patient and offer a review and analysis of the most up-to-date literature concerning C. parapsilosis shunt infections, as well as treatment guidelines for central nervous system candidiasis.
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Review Case Reports
Scalp Cirsoid Aneurysm: An Updated Systematic Literature Review and an Illustrative Case Report.
Scalp cirsoid aneurysm is an arteriovenous fistula of the scalp that is unconnected by intracranial or cerebral vessels. Variceal dilatation of draining veins can produce cosmetic concerns, masses, local pain, palpable thrills, and audible bruits, headache, tinnitus, and hemorrhage. Its etiopathogenesis is not well understood. ⋯ An updated systematic review of the last 10 years publications was performed. Also, we report an illustrative case of a young boy with posttraumatic cirsoid aneurysm and good documentation on head vascular examinations, treated by multiple routes (percutaneous embolization with coils and endovascular embolization with cyanoacrylate) with a decrease of the pulsatile mass. A plastic surgery team performed gross total resection, and the final esthetic result was extremely satisfactory.