World Neurosurg
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To date, no standard surgical procedure has been proven effective for intracerebral hemorrhage (ICH), particularly deep hematomas. This retrospective study evaluated the effectiveness and safety of endoscopic surgery, minimally invasive puncture and drainage, and craniotomy for treating moderate basal ganglia ICH. ⋯ Minimally invasive neuroendoscopic management has the advantages of direct vision, efficient hematoma evacuation, and relatively good results. Endoscopic surgery may be a more promising approach for the treatment of moderate basal ganglia ICH.
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Exposure to neurosurgery at the undergraduate level is an important factor in determining future interest in and applications to the specialty. Given the high competition for training posts, this exposure is also becoming an almost essential addition to an applicant's portfolio. We organized a neurosurgical conference aimed at undergraduate medical students. The aim of this study was to determine factors attracting and deterring students from the specialty before and after the conference. ⋯ The most notable factor deterring students from a career in neurosurgery was work-life balance. Other deterring factors were much less prevalent following the conference. Understanding how exposure to neurosurgery influences students' perceptions is important for developing future initiatives to prevent misconceptions and allow students to make informed choices as well as encourage the right candidates to apply.
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Anterior communicating artery (ACoA) complex aneurysms are challenging to treat microsurgically. The authors report their experience with microsurgical treatment of ACoA aneurysms and examine the anatomic characteristics of these aneurysms as predictors of outcome. ⋯ The aneurysm's exact location in relation to the adjacent neurovascular structures is potentially predictive of outcomes in the microsurgical treatment of ACoA aneurysms.
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Hemorrhagic complications reported from external ventricular drain (EVD) placement range from 10% to 44%. There remains limited literature investigating the incidence, risk factors, and mechanisms to prevent its occurrence, especially in the setting of antiplatelet agent use. We investigated EVD-related hemorrhagic complications after the implementation of VerifyNow platelet inhibition assays at our institution. ⋯ The incidence of hemorrhage is lower in our new cohort when compared with that of our previously published cohort. Despite the overall decreased rate of hemorrhage, there was no significant difference in hemorrhage rates between patients who did or did not undergo the assay. Platelet transfusion did not decrease the incidence of hemorrhage in patients with inhibited platelet function.
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Vertebroplasty and kyphoplasty are minimally invasive techniques used to treat vertebral compression fractures. The etiology of vertebral compression fractures varies among patients. Although osteoporosis and trauma are major etiologic factors in patients with a vertebral compression fracture, unexpected results were found in 11 patients in the present study. The aim of the present retrospective study was to determine the incidentally detected pathology results of patients with vertebral fracture treated by vertebroplasty and kyphoplasty. ⋯ Tissue examination is useful and could reveal pathologic fractures. An incidentally detected biopsy result could change the treatment of patients; however, bone biopsy should be reserved for those patients whose preoperative radiological diagnosis raises suspicion of a nonosteoporotic etiology.