World Neurosurg
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The management of multiple intracranial aneurysms poses a significant clinical challenge. 1 Various factors, including the patient's neurologic status, age, risk factors, aneurysm morphology, location, ruptured or unruptured status, availability of equipment, the surgeon's surgical abilities, and patient preferences, influence the choice of treatment modality . 2 It has been observed that there is a higher risk of rupture during the perioperative period when surgical intervention is performed to treat a ruptured aneurysm. 3 Additionally, it is suggested that patients with multiple aneurysms located in both the anterior and posterior circulation are less likely to be treated with a single procedure. 4 This surgical strategy should be applied in the setting of multiple aneurysms in the anterior and posterior circulation that would, on the other hand, demand multiple interventions. 5 In an experienced scenario, microsurgery could be a viable option. We present the case of a 58-year-old patient who presented with chronic headaches, a medical history of hypertension, and tobacco use. The patient had no neurological deficits. ⋯ The patient consented to the procedure and publication of her image. Institutional Review Board note: No institutional research ethics board approval was required as only intraoperative footage was shown. No identifiable data are displayed except for two photographs of the patient's head without the face, which was appropriately consented to.
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Video-assisted debriefing (VAD) is promising for medical skill training, but its effectiveness requires further exploration. The aim of this study was to investigate the effectiveness of point-of-view VAD in spinal surgery training. ⋯ VAD is more effective than traditional verbal debriefing for improving residents' surgical skills, particularly for obtaining a more comprehensive understanding of anatomical structures, imitating detailed surgical techniques as well as promoting initiative. However, in terms of mastery of surgical skills, VAD is not significantly beneficial for tactile perception of the surrounding tissue, indicating that a certain amount of practice is still necessary.
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Surgical management of blood-blister-like aneurysm(BBA) presents challenging and contentious due to high morbidity and mortality. Intraoperative neurophysiological monitoring(IONM) is a well-established tool in intracranial aneurysm surgeries while its application in BBA surgeries lacks report. This study retrospectively analyzes the utility of IONM in BBA surgeries between 2018 and 2023. ⋯ Our results demonstrate that IONM has low sensitivity (37.5%) and high specificity (100%) in detecting ischemic events during BBA surgery. The high rate of false-negative results in BBA-IONM suggests that its predictive value is limited particularly in complex maneuvers such as trapping and advanced vasoreconstruction, warranting cautious interpretation and further investigation of IONM modalities for BBA management.
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AtlasGPT represents an innovative generative pre-trained transformer (GPT), trained using neurosurgery literature. Its ability to contour its response according to the training level of the user is unique; however, whether its responses can be comprehended at each user's training level remains unknown. This study aimed to analyze the readability of responses provided by AtlasGPT. ⋯ AtlasGPT-generated content demonstrates readability variations according to the user profile selected; however, the readability of patient content still exceeds recommendations set by United States departmental agencies, necessitating a call to action.
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Ventriculoperitoneal (VP) shunt surgery is the primary treatment for patients with idiopathic normal pressure hydrocephalus (iNPH). This study compares the outcomes of VP shunt placement using electromagnetic (EM) navigation versus standard methods in iNPH patients, focusing on catheter accuracy and post-operative complication rates. ⋯ The use of EM navigation in VP shunts for iNPH patients improves catheter placement accuracy, reduces postoperative complications and shunt malfunction rates, and provides precise and individualized surgical treatment.