World Neurosurg
-
To focus on postoperative drawings of aneurysms, which serve as visual records and teaching tools for neurosurgeons and reinforce three-dimensional vascular configurations that are specific for different cerebral aneurysms, and examine experience with this technique, particularly in regard to the training of neurosurgical residents. ⋯ Creation and review of postoperative drawings are important adjuncts for the development of three-dimensional understanding of aneurysmal anatomy. This classic art has impact in the digital age and allows patterns of morphology, projection, and anatomy to be reinforced. Surgical atlases created from postoperative drawings function as reference and teaching tools. The creation of postoperative drawings should be a routine part of the training and methodology of vascular neurosurgeons.
-
With subspecialty surgical care often unavailable to poor patients in developing countries, short-term brigades have filled a portion of the gap. We prospectively assessed the cost effectiveness of a pediatric neurosurgical brigade to Guatemala City, Guatemala. ⋯ To our knowledge, this is the first study evaluating cost effectiveness of a short-term neurosurgical brigade. Although surgical intervention is acknowledged as playing a crucial role in global health, subspecialty surgical care is still broadly perceived as a luxury. Although providing care through local surgeons is undeniably more efficient than bringing in foreign medical teams, such care is not universally available. This study argues that volunteer neurosurgical teams can provide high complexity care with a competitive cost-effective profile.
-
The aim of the study was to examine the correlation between various morphometric factors of the posterior circulation aneurysms and the severity of neurologic status and radiologic extent of subarachnoid hemorrhage. ⋯ Inflow angle and SR were found to be correlated with grading in FRS, and WFNS scale was correlated with inflow angle.
-
Data from several centers worldwide have demonstrated that transnasal endoscopic surgery performed with or without a transcranial approach is capable of achieving radical resection of selected sinonasal malignancies. We report our experience with endoscopic management of sinonasal cancers, with emphasis on naso-ethmoidal malignancies encroaching on the anterior skull base. ⋯ Endoscopic endonasal resection performed with or without a transcranial approach, when properly planned and in expert hands, has an accepted role with precise indications in the surgeon's armamentarium for the treatment of sinonasal and skull base malignancies.
-
Given their location and slow growth, olfactory groove and planum sphenoidale meningiomas often grow to large sizes before they present with clinical symptoms and pose significant surgical challenges. The goal of our study is to identify which preoperative symptoms and findings on magnetic resonance imaging are correlated with specific postoperative outcomes in order to better counsel patients preoperatively. ⋯ We conclude that tumors larger than 3.4 cm in diameter and those whose posterior edge is within 6-8 mm of the optic chiasm should be recommended for early surgical intervention. In terms of predicting surgical complications, nasal sinus invasion and anterior cerebral artery encasement are associated with greater-risk profiles when surgery becomes necessary. Thus, it is prudent to take these specific variables into consideration when advising patients about the risks of observation and surgery for olfactory/planum meningiomas.