World Neurosurg
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Lateral ventricular trigone meningioma is relatively rare and surgical resection is the main treatment strategy. It is a challenge to achieve total resection without any complication. We analyzed a series of cases using literature review. ⋯ Surgical resection, using the trans-sulcal approach with intraoperative ultrasound assistance, can achieve a high rate of total resection and a low rate of complication, promising a good prognosis. The management technique and the perioperative treatment have to be individualized.
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Cerebral revascularization has been used in treating difficult skull base tumors when the preservation of the involved native arteries is deemed challenging, and the patients are at risk of developing vascular complications. We aimed to evaluate a recent series of patients who needed high flow cerebral bypasses as part of the surgical treatment strategies for their difficult skull base tumors; to assess current indications and the results of such treatments. ⋯ High flow bypass for cerebral revascularization is a good surgical option for treating certain difficult skull base tumors. High rate of graft patency and low risk of perioperative stroke can be achieved in experienced hands with concurrent high rate of gross total resection of the tumor and good clinical outcome of the patients.
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Historical Article
A case of basilar artery aneurysm rupture from 1836: lessons in clinical observation and the natural history of the disease.
Although credit is given to Sir William Gull for highlighting the clinical picture of subarachnoid hemorrhage in 1859, we discuss a case presented by Mr. Egerton A. Jennings, Fellow of the Linnaean Society, published 23 years earlier in the 1836 edition of the Transactions of the Provincial Medical and Surgical Association. ⋯ It provides evidence of an established thought process already in progress in England in the 19th century. It is characteristic that this thought process came from a surgical practitioner. The cultivation of practical observation in British surgical culture would allow the late 19th century surgeon scientists to match the contributions of British neurologists with landmark steps in the development and establishment of neurosurgery.
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In July 2011, the UCLA Health System released its current time-out process protocol used across the Health System. Numerous interventions were performed to improve checklist completion and time-out process observance. This study assessed the impact of the current protocol for the time-out on healthcare providers' safety attitude and operating room safety climate. ⋯ The time-out process favorably impacted team members' safety attitudes and perception as well as overall safety climate in neurosurgical ORs. Survey responses identified leadership training and teamwork training as two avenues for future improvement.
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Bedside external ventricular drain (EVD) placement is less than perfect and often requires multiple passes to achieve cerebrospinal fluid flow. We conducted this prospective study to understand why multiple passes are necessary and whether this affects the incidence of hemorrhage. ⋯ Multiple passes are inherent to the bedside EVD procedure, but did not increase the rate of intracranial hemorrhage.