World Neurosurg
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The role of laboratory dissection training in neurosurgical residency: results of a national survey.
Work hour restrictions and current quality, financial, and legal concerns have reduced resident operative volume and autonomy. Although laboratory (cadaveric or animal) dissection has a rich history in neurosurgery, its current role in resident training is unclear. Recent literature suggests educators have looked to simulation to accelerate the learning curve of acquiring neurosurgical technical skills. The purpose of this study was to determine the prevalence, characteristics, and extent of laboratory dissection in neurosurgical residency programs in the United States. ⋯ In neurosurgical resident education, laboratory dissection is widely used; however, significant variation exists. Nonetheless, program directors believe laboratory dissection plays an integral role in neurosurgical training and is currently associated with greater educational benefit than simulation.
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To investigate the clinical and pathologic characteristics of primary intradural retroclival chordoma and improve the understanding of this rare disease. ⋯ Our study suggests that a positive staining for brachyury, galectin-3, and Ki-67 would be helpful for differential diagnosis, discriminating intradural retroclival chordoma from ecchordosis physaliphora and chordoid meningioma. Our study also shows that within intradural retroclival chordoma, there are significant prognostic differences. Tumors with an abundant blood supply, flake-like cellular arrangement, and a Ki-67 labeling index greater than 5% belong to a rapid-growth type and are prone to short-term recurrence and poorer prognosis.
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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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To analyze the clip repositioning rate and the correlation between indocyanine green (ICG) videoangiography and conventional postoperative digital subtraction angiography for completeness of aneurysm occlusion and parent and branching vessel compromise. ⋯ ICG videoangiography is a very useful modality for intraoperative assessment of the adequacy of aneurysmal obliteration and patency of parent and perforating vessels. However, ICG videoangiography is not absolutely reliable as a stand-alone method during clipping of ophthalmic artery aneurysms and can be complemented with intraoperative digital subtraction angiography. ICG videoangiography can be used either as an alternative or as a complementary technique to intraoperative digital subtraction angiography during aneurysm surgery.
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To determine whether various clinical factors are related to long-term outcomes of patients with sporadic cerebellar hemangioblastomas. ⋯ The solid configuration observed on preoperative images of sporadic cerebellar hemangioblastomas is one of the most important clinical factors related to both immediate and long-term outcomes after surgery.