World Neurosurg
-
Meningiomas are the most frequently diagnosed benign intracranial tumors. However, meningioma en plaque (MEP) is a rare subset accounting for 2.5% of all meningiomas and is characterized by flat, carpet-like proliferation along the dura, typically arising in the spheno-orbital region; therefore, causes proptosis, decreased visual acuity, and orbital pain. We present a unique case of MEP presenting with cerebrospinal fluid (CSF) rhinorrhea and conduct a systematic review of literature. ⋯ MEP associated with spontaneous CSF rhinorrhea is extremely rare and poses diagnostic and therapeutic challenges. Conservative management for select cases of MEP can be a good choice, refraining the patient from surgical complications, especially for difficult-access skull base areas.
-
Decentralized federated learning (DFL) may serve as a useful framework for machine learning (ML) tasks in multicentered studies, maximizing the use of clinical data without data sharing. We aim to propose the first workflow of DFL for ML tasks in multicentered studies, which can be as powerful as those using centralized data. ⋯ We demonstrate that the DFL workflow without data sharing should be a more appropriate method in ML tasks in multicentered studies. And the DFL workflow should be further exploited in clinical researches in other departments and it can encourage and facilitate multicentered studies.
-
Virtual reality (VR) has emerged as a powerful tool for neuroanatomy education of postgraduate medical trainees. However, its use in early training in neurosurgery, such as of undergraduate, medical, and physician assistant students, has not been evaluated. We also have limited insight into how VR may be integrated with traditional teaching methods. ⋯ Integration of VR with traditional pedagogic tactics is well received by the learners and contributes to measurable learning outcomes. Our experience informs the future use of VR tools in medical education.
-
Individuals with psychiatric illnesses (PI) have increased rates of traumatic brain injury (TBI). Nonetheless, the influence of underlying PI on TBI outcomes is poorly understood. ⋯ Individuals with PI and SUD appeared to have better outcomes but more complicated hospital stays following sTBI. Future studies should investigate the mechanisms underlying these outcomes.
-
Surgical Strategy and Decision Making in Recurrent Atlanto-Axial Dislocations: The Role of Traction.
To analyse patients with recurrent atlantoaxial dislocation and give a criterion of an ideal patient who can benefit from redo surgery. ⋯ The best candidates who can benefit after re-do surgery are the ones who exhibit either clinical and/or radiological improvement on the trial of traction, as the pathological C1-C2 joints are either not fused or have undergone pseudoarthrosis. Those patients who do not exhibit significant clinical or radiological improvement post-trial of traction should not be offered subsequent surgical intervention.