World Neurosurg
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In the revised World Health Organization 2016 classification of central nervous system tumors, "diffuse midline glioma, H3 K27M-mutant" has been added as a new diagnostic entity. However, some confusion exists concerning this diagnostic entity because H3 K27M-mutant diffuse midline glioma is diagnosed with grade IV regardless of morphologic phenotype. Furthermore, the significance of H3 K27M mutation in tumors that aren't typical "diffuse midline glioma, H3 K27M-mutant," such as those with an unusual location and nontypical histology, remains unclear. ⋯ We describe here a rare case and present a short literature review of circumscribed/nondiffuse gliomas, particularly in PA with H3 K27M mutation. However, the significance of H3 K27M mutation for PA remains unclear, so further studies and clinical data are needed to elucidate the biology and optimal treatment of such tumors.
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Multicenter Study Observational Study
The new fully radiopaque Aperio Hybrid Stent-Retriever: Efficient and safe? An early multicenter experience.
To investigate the visibility, safety, and efficacy of the full-length radiopaque Aperio Hybrid stent retriever (APH) in mechanical thrombectomy of large vessel occlusions. ⋯ Mechanical thrombectomy with the APH appeared feasible, efficient, and safe. Full-length device radiopacity may facilitate thrombectomy or support to adapt the course of action during retrieval, if required.
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Comparative Study Observational Study
Preservation of Deep Cervical Extensor Muscle Volume: Comparison between Conventional Open-Door and Muscle Preserving Laminoplasty Approaches in the Same Patients.
Surgical laminoplasty techniques have been developed to reduce cervical kyphosis and postoperative axial neck pain and preserve the posterior cervical extensor muscles. We compared a unilateral conventional open approach (OA) and a contralateral muscle preserving approach (MPA) for laminoplasty in the same patients to determine differences in the preservation of the posterior cervical muscles after the 2 approaches. ⋯ MPA was effective in preserving the volume of deep cervical extensor muscles and helping minimize postoperative musculoskeletal complications. In addition, muscle preservation was more effective at the C3-4 level.
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Microsurgery is technically demanding, treacherous, venturesome, and precarious. For the best outcomes, the surgeon's confidence, prudence, comfort, and relaxed body posture are crucial for controlling operator fatigue and preventing exhaustion. Often, the most critical and demanding parts of an operation occur hours into the case when fatigue has worn away the surgeon's patience and self-control-qualities required to pursue calculated and deliberate microsurgical movements. The following paper describes philosophies and strategies to advance an operator's efficiency and minimize fatigue.
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Recent years have witnessed an increase in articles describing factors influencing medical student recruitment in neurosurgery, such as undergraduate preparation, impact of research experience, and selection into residency programs. In this study, we provide a comprehensive review of the literature addressing the relationship of medical students within neurosurgery. ⋯ Our study bridges the gap of fragmented knowledge on medical student involvement in neurosurgery with the aim of optimizing existing approaches. We suggest that medical institutions outside the United States and United Kingdom should implement university-based interest groups to stimulate student interest, with reinforced participation of faculty for leading educational initiatives and collaborative research. We advocate the creation of national and international associations to support medical students in approaching neurosurgery early in their education.