World Neurosurg
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Operative neurosurgical skills education is a vital part of neurosurgical training, and these skills are usually obtained through operating room experience and supplemented by textbooks and other resources. We aimed to determine the resources used by trainees in the Philippines, both prior to and after the onset of the coronavirus disease 2019 pandemic. ⋯ Operative experience, online academic resources, and neurosurgical textbooks were the main resources for operative neurosurgical education among trainees in the Philippines. After the onset of the pandemic, the hours spent on operative experience decreased and online academic resources increased significantly. New avenues of neurosurgical education, particularly webinars, also became available locally.
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Hemangioblastoma, especially medulla oblongata hemangioblastoma, is a great challenge for neurosurgeons due to its highly vascularized property and neighbor to the pivotal neural structures of the brainstem.1,2 Surgical resection has been recommended as the main therapeutic option for symptomatic lesions.3,4 However, how to remove the huge solid tumor en bloc, instead of the relatively small cystic counterpart, without any neurologic dysfunction still remains elusive.5 Here, we demonstrate the case of a 28-year-old female who presented with headache for 2 months. A series of images illustrated multiple hemangioblastomas including a huge (maximum diameter >3 cm) solid medulla oblongata hemangioblastoma and a cerebellum hemangioblastoma. Surgical resection via the suboccipital approach was chosen because of the increasing risks of hydrocephalus and brainstem compression. ⋯ In addition, appropriate traction assisted us in creating a detachable plane, collectively providing an opportunity to remove the tumor en bloc without uncontrollable bleeding and functional brain tissue injury. With the help of these technical nuances, a curative resection of the tumor was finally achieved and the patient preserved intact neurologic function. The patient gave informed consent for the procedure and verbal consent for the publication of her image.
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Meta Analysis
Mechanical Thrombectomy for M2 Segment Occlusion in Acute Ischemic Stroke：a systematic review and meta analysis.
The safety and benefit of mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS) patients with M2 segment middle cerebral artery occlusions remain uncertain. ⋯ Compared with M1 occlusion, patients with M2 occlusion treated by MT demonstrated similar clinical outcomes in this study. Moreover, there was no difference between stent retriever and aspiration in treating M2 occlusion in terms of functional independence at 90 days. However, aspiration exerted a conspicuously higher recanalization rate in M2 occlusion than in M1 occlusion.
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Meta Analysis
Feasibility and Safety of Transradial Aneurysm Embolization: A Systematic Review and Meta-analysis.
Use of the transradial access (TRA) approach for neuroendovascular procedures has been increasing in recent years. Our aim is to assess the feasibility, success rate, and complications associated with TRA for intracranial aneurysm embolization. ⋯ Treating intracranial aneurysms using various embolization techniques through TRA is feasible and associated with low access site and intraoperative complications.