World Neurosurg
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Stereotactic radiosurgery (SRS) has evolved to become an established, well-studied treatment modality for intracranial pathologies traditionally treated with more invasive neurosurgical management. As the field expands, among neurosurgeons and across multiple disciplines, resident training will become increasingly crucial. ⋯ SRS is a rapidly expanding field that requires a unique skill set and current neurosurgical resident training often does not fully prepare trainees for its use in clinical practice. Focused resident training is necessary to ensure trainees are proficient in this specialty and well equipped to become leaders in the field.
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Neurenteric cysts (NECs) are uncommonly encountered lesions of the central nervous system with heterogeneous imaging characteristics. The object of this study was to review the preoperative imaging findings represented among a cohort of surgically treated posterior fossa NECs. These findings are considered in the context of surgical technique, and inform an understanding of aberrant neuroembryological development associated with NECs. ⋯ Posterior fossa NECs display variable patterns of MRI signal and are commonly considered as part of a broad differential of cystic posterior fossa masses. We identified tumor insinuation between the ventral brainstem and vertebrobasilar system as a highly sensitive and specific radiographic sign for NECs. This finding was not observed among a large cohort of posterior fossa masses representative of other multiple pathologies.
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Lipomatosis of nerve (LN) is a condition of massive peripheral nerve enlargement due to proliferation of fibrous and adipose tissue within the nerve, the natural history of which is currently unknown. We measured the pattern of growth in individuals with long-term radiologic follow-up. ⋯ Serial MRI reveals progressive enlargement of LN. The rate of growth was more profound in youth, but also occurred in early adulthood.
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Neurosurgical simulation training is becoming increasingly popular. Attitudes toward simulation among residents can contribute to the effectiveness of simulation training, but such attitudes remain poorly explored in neurosurgery with no psychometrically proven measure in the literature. The aim of the present study was to evaluate prospectively a newly developed tool for this purpose: the Neurosurgical Evaluation of Attitudes towards simulation Training (NEAT). ⋯ NEAT is the first psychometrically evaluated tool for evaluating attitudes toward simulation in neurosurgery. Further implementation of NEAT is required in wider neurosurgical populations to establish whether specific population groups differ. Use of NEAT in studies of neurosurgical simulation could offer an additional outcome measure to performance metrics, permitting evaluation of the impact of neurosurgical simulation on attitudes toward simulation both between participants and within the same participants over time.
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To present a case of a cavernous malformation presenting with a subdural hematoma. ⋯ The clinical course, radiologic, and intraoperative findings suggest that the subdural hemorrhage was caused by extralesional hemorrhage of the cavernous malformation.