World Neurosurg
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We describe a novel yet simple training exercise for residents who are being introduced to endoscopic spine surgery. ⋯ One of the lessons learned with this exercise that we will consider in future courses would be to place a radiodense "lesion" that could be visualized on fluoroscopy and serve as a radiologic target to find. This can help guide the trainee in knowing where to search if the "lesion" is more difficult to find.
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Glioblastoma is the most common aggressive primary brain tumor in adults. Changes in cognition, personality, and behavior of patients as well as side effects of treatments cause unique challenges for providing care and may impact caregiver burden in different ways. ⋯ The end-of-life phases of patients with glioblastoma represent a critical factor that significantly affects not only the patient but also the caregiver's burden, caregiving tasks, and time. A multidisciplinary support program is needed to address and improve caregivers' burden.
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Severe traumatic brain injury (TBI) is a condition burdened by high morbidity and mortality. Prevention of secondary insults is 1 of the main goals of management and intracranial pressure (ICP) monitoring is a cornerstone in management of TBI. The relationship between ICP and optic nerve sheath is known from the literature. Optic nerve sheath ultrasonography could represent a method added to our armamentarium for monitoring ICP. ⋯ We propose the use of ONSD ultrasound as a screening investigation for post-traumatic intracranial hypertension in the context of an emergency department, especially in contexts where there is limited availability of ICP monitors.
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The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. ⋯ Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation among the tumor, parent nerve, and surrounding soft tissue. However, multicenter randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.
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The modified Brain Injury Guidelines (mBIG) were developed to improve care of patients with traumatic brain injury (TBI). This study aimed to assess if utilization of mBIG by neurosurgeons would improve TBI patient throughput at a Level I trauma center, particularly for patients meeting mBIG 1 criteria. ⋯ The mBIG 1 criteria were safe and improved low-risk TBI patient throughput at a Level I trauma center. Neurosurgical involvement may be beneficial to the mBIG while still facilitating significant resource savings.