World Neurosurg
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Clinical Trial
Application of Rubber Band with Hooks on Both Ends for Vagus Nerve Stimulator Implantation.
Vagus nerve stimulation (VNS) is a valuable therapeutic option for many types of drug-resistant epilepsy. Muscle hooks and carotid endarterectomy rings have been used for cervical delamination preceding the implantation of stimulation electrodes. The attachment on both sides of a rubber band of Kamiyama-style hanging needles, as are used for scalp and dural retraction during craniotomy, yields a useful tool for VNS implantation. Here we report our experience with this method. ⋯ The use of hooks attached to both sides of a rubber band rendered VNS implantation safer by lifting the vagus nerve and standardizing the procedure.
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The total number of citations of a research article can be used to determine its impact on the scientific community. We aimed to identify the top-100 articles published on ischemic stroke and evaluate their characteristics. ⋯ Our list of top-100 citation classics specific to ischemic stroke provide a detailed insight into academic achievements, historical perspective and serves as a guide for the scientific progress in stroke.
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Deep brain stimulation (DBS) is an effective therapeutic modality; however, only a percentage of eligible patients undergo the procedure. ⋯ Frame placement, awake surgery, and head shaving did not appear to play a significant role in most patients' decision-making process to undergo DBS, as analyzed in this retrospective cohort. The majority of patients were satisfied with the procedure and reported being comfortable. Managing goals and expectations preoperatively played a significant role in ultimate overall satisfaction.
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Case Reports
De Novo Spinal Dural Arteriovenous Fistula in a Patient with a Lipomyelomeningocele: Case Report.
Spinal dural arteriovenous fistula (AVF), the most common type of spinal vascular malformation, tends to manifest as progressive myelopathy over several years. Spinal dural AVFs are considered an acquired lesion and, in contrast to spinal arteriovenous malformations, are not often associated with other anomalies. The presence of a spinal dural AVF in the setting of a lipomyelomeningocele and tethered cord is extremely rare. Both lesions tend to cause similar symptoms, and patients with concomitant lesions generally require surgical intervention for both. ⋯ In this case report, we present evidence of de novo development of a spinal dural AVF associated with a lipomyelomeningocele. In addition, this is the second documented patient in the literature with a lipomyelomeningocele and concomitant dural AVF who did not undergo detethering of the cord as part of treatment.
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In the past, women in neurosurgery were deemed "less than a minority." Pioneering women entered neurosurgical residency programs alone, facing large obstacles to become surgical experts. Recent data suggest a stark increase in the number of women neurosurgical residents. As the field of neurosurgery attempts to increase numbers of women surgeons, it must also adjust workplace culture to embrace a new group of trainees. Here, we share an account of historical numbers, as well as evidence of a changing landscape within neurosurgery and suggestions of ways to modify workplace culture based on examples set in other career paths.