World Neurosurg
-
The aim of this study was to analyze the characteristics of alleged medical malpractice litigation involving spine surgery in Beijing between 2013 and 2018. ⋯ This study comprehensively summarized the medical alleged malpractice litigation after spine surgery in Beijing. Given the rapid growth rate of spine surgery and the burden of related alleged medical malpractice litigation, it is valuable for spine surgeons to understand the potential legal impact of spine surgery. The most common complaint addressed in this study is inadequate consent. The findings in the present study highlight that in China, spine surgeons should pay more attention to communication with patients and perform spine surgery based on abnormal imaging as opposed to what the history and physical examination dictate, which can help reduce the litigation rate and improve the patient experience.
-
Published reports regarding the tissue types that surround the internal carotid artery (ICA) as it travels through the carotid canal vary. Reports have variably defined this membrane as periosteum, loose areolar tissue, or dura mater. With such discrepancies and realizing that knowledge of this tissue might be important for skull base surgeons who expose or mobilize the ICA at this location, the present anatomical/histological study was performed. ⋯ The membrane that surrounds the petrous part of the ICA is dura mater. To our knowledge, this is the first histological investigation of this structure and thus serves to establish the true identity of this membrane and correct previous reports in the literature that have erroneously concluded that it is periosteum or loose areolar tissue.
-
To compare functional and seizure outcomes in children with vascular and dysplastic etiologies of cerebral palsy and medically intractable epilepsy following functional hemispherotomy or anatomic hemispherectomy. ⋯ Quantitative functional and seizure outcomes following functional hemispherotomy or anatomic hemispherectomy did not differ significantly between vascular and dysplastic etiologies of cerebral palsy and medically intractable epilepsy in this study. Hemispheric surgery resulted in minor functional declines from baseline following comprehensive multidisciplinary therapy.
-
The rate of complications remains significant after craniotomy for supratentorial primary malignant brain tumors despite recent advances. ⋯ Our study identifies predictors of major 30-day complications after craniotomy for this subset of patients with brain tumor.
-
Improved technology in vestibular neuroma resection and facial nerve protection has become more sophisticated, and the protection of hearing during vestibular schwannoma resection is crucial. Currently, brainstem auditory evoked potential (BAEP), cochlear electrography, and cochlear nerve compound action potential (CNAP) are frequently used. The CNAP waveform is stable; however, the recording electrode can easily affect the procedure and cannot map the auditory nerve. The purpose of the study was to explore a simple method to record the CNAP and map the auditory nerve. ⋯ The bipolar facial nerve stimulator can locate and protect the auditory nerve by recording a stable potential. The CNAP obtained rate was significantly higher than that of BAEP. The disappearance of BAEP during acoustic neuroma monitoring can be used as a standard alert for the surgeon, and decrease in CNAP is an alert for the operator.