World Neurosurg
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We sought to evaluate the feasibility and efficacy of spinous process screws in subaxial cervical fixation. ⋯ The spinous process screw fixation technique in the subaxial cervical spine is a viable and effective salvage option for patients in whom conventional posterior fixations were not sufficient and salvage, supplementary techniques were required.
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Intracranial aneurysms are acquired abnormal vascular dilations. The most dangerous complication of a cerebral aneurysm is its rupture, with a high rate of mortality. This study aimed to determine whether there is an association between anatomic variations in the circle of Willis and ruptured aneurysms in the anterior and posterior communicating arteries. ⋯ Our results suggest that the studied variations of the circle of Willis and nonspherical morphology, in addition to playing a role in the development of cerebral aneurysms, may contribute to their rupture.
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The "STARS - CT-MADE" Study: Advanced Rehearsal and Intraoperative Navigation for Skull Base Tumors.
Skull base meningiomas represent a challenge for neurosurgeons, and the procedures are typically performed by experienced neurosurgeons, thus limiting resident training. A new simulation and rehearsal device can be used as an aid for senior surgeons during these operations and serve as a training tool for junior surgeons. ⋯ Surgical Theater helped residents to improve their anatomic and procedural comprehension and was deemed as a useful aid to safely perform some demanding neurosurgical procedures, by both senior and junior surgeons.
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Comment
Radiological Imaging Transmission via Smartphones by Neurosurgery Residents in the United States.
Neurosurgery requires the communication of radiological imaging. Smartphones are increasingly used for this purpose because of the efficiency and convenience of integrated cameras and native Multimedia Messaging Service (MMS) functionality. There is inconsistency among hospitals regarding policies addressing this use as it relates to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. Some hospitals offer a HIPAA-compliant secure messaging application (SMA) as a substitute. The authors hypothesized that the use of smartphones for sharing radiological imaging would be commonplace among residents. We sought to characterize usage patterns, resident awareness of policies and HIPPA, and the effectiveness of SMAs as a means of avoiding HIPAA violations. ⋯ The data suggest that there is widespread resident use of MMS for image transmission, regardless of policy and the availability of alternative HIPAA-compliant applications. Knowledge of local institutional policies and HIPAA privacy rules is poor. Alternative strategies are needed to prevent HIPAA-noncompliant transmission of imaging by residents.
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Gross total resection (GTR) is not always possible in acromegalic patients, especially in patients with invasive growth hormone-secreting adenomas. We analyzed the biochemical remission outcome in relation to extent of tumor resection and effectiveness of medical treatment in cases of remnant tumor. ⋯ The more aggressive surgical resection is, the greater the chance of attaining final biochemical remission, whether or not GTR is achieved. Medical therapy effectiveness is enhanced in cases with STR. Invasive growth hormone-secreting macroadenomas that are not surgically amenable to total resection are best managed with a combination of safe STR and medical treatment.