World Neurosurg
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Historical Article
Great Hospitals: The History of Neurosurgery at the University of Vermont Medical Center, A Macroscopic Examination of Microscope-Savvy Pioneers.
The University of Vermont's (UVM) Division of Neurosurgery is enshrined in a rich history of innovation and academic prowess, which have significantly contributed to making neurosurgery the field it is today. From humble beginnings, the department was started by one Raymond Madiford Peardon "Pete" Donaghy on a parenthetically watertight research budget amounting to $25 and shared space in a Quonset hut. Passion and commitment to progress, as well as an innate openness to collaboration, propelled Pete Donaghy, his colleagues, pupils, and successors to establish an exemplary center for treatment of neurosurgical disease, with multiple revolutionary accomplishments along the way. ⋯ Peardon Donaghy Microvascular and Skull Base Laboratory," is a 3-day cadaver-based teaching course for neurosurgery and ear nose and throat residents throughout New England. The course bears testament to Donaghy's everlasting influence on the UVM Division of Neurosurgery and continues to positively affect the education of countless trainees. The purpose of this historical perspective is to outline the events and accomplishments that define the UVM Division of Neurosurgery's many contributions to the field at large and the ongoing efforts to honor Donaghy's example through maintaining a culture of humility, hard work, and commitment to neurosurgical innovation and education.
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Vertebrobasilar dolichoectasia, a rare vascular anomaly, rarely presents with hydrocephalus. The traditional treatment for hydrocephalus is a ventriculoperitoneal shunt. Conventional endoscopic third ventriculostomy can avoid shunt-related complications but is considered risky due to the presence of the dolichoectatic vessel. A subfrontal extra-axial fenestration of the lamina terminalis can circumvent this anatomic constraint and establish cerebrospinal fluid communication between the third ventricle and subarachnoid space. ⋯ Extra-axial endoscopic third ventriculostomy may be a suitable treatment alternative to circumvent anatomic constraints produced by vertebrobasilar dolichoectasia in performing conventional endoscopic third ventriculostomy.
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To determine if intraoperative on-table lumbar lordosis and segmental lordosis correlate with postoperative lordosis following single-level posterolateral decompression and fusion (PLDF) or transforaminal lumbar interbody fusion (TLIF). ⋯ Subtle decreases in lumbar lordosis may be noticed in early postoperative radiographs compared with intraoperative images on Jackson operative tables. However, these changes are not present at 1-year follow-up as lumbar lordosis increases to a similar level as intraoperative fixation.
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Letter Randomized Controlled Trial
Optimization of Randomized Controlled Trial Design in Neurosurgery Using Simulation.
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The superficial temporal artery (STA)-to-middle cerebral artery (MCA) bypass requires precise preoperative planning, and 3-dimensional virtual reality (VR) models have recently been used to optimize planning of STA-MCA bypass. In the present report, we have described our experience with VR-based preoperative planning of STA-MCA bypass. ⋯ Our early experience has shown that VR can serve as a useful, interactive preoperative planning tool by enhancing visualization of the spatial relationship between the STA and MCA without compromising the surgical results.