World Neurosurg
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Endoscopic third ventriculostomy (ETV) is a routinely used alternative to ventriculoperitoneal shunt in patients with obstructive hydrocephalus. We attempted to determine the usefulness of the surgeon's intraoperative impression and postoperative period intracranial pressure monitoring that may help guide clinicians in predicting the early functional outcome of ETV. ⋯ ETV is a valuable means of treating obstructive hydrocephalus. By considering the surgeon's intraoperative impression and postoperative ICP monitoring course, some of the uncertainty around its functional outcome can be overcome. The surgeon's impression and the ICP monitoring offer approximately the same predictive quality for ETV outcome.
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Fundamentals of neurosurgery: virtual reality tasks for training and evaluation of technical skills.
Technical skills training in neurosurgery is mostly done in the operating room. New educational paradigms are encouraging the development of novel training methods for surgical skills. Simulation could answer some of these needs. This article presents the development of a conceptual training framework for use on a virtual reality neurosurgical simulator. ⋯ The conceptual framework presented here, the Fundamentals of Neurosurgery, represents a first attempt to develop standardized training modules for technical skills acquisition in neurosurgical oncology. The National Research Council Canada is currently developing NeuroTouch, a virtual reality simulator for cranial microneurosurgery. The simulator presently includes the five Fundamentals of Neurosurgery modules at varying stages of completion. A first pilot study has shown that neurosurgical residents obtained higher performance scores on the simulator than medical students. Further work will validate its components and use in a training curriculum.
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Atypical meningiomas represent 20% of all meningiomas. This retrospective study analyzes the prognostic factors, the effect of different methods of treatments, and the behavior of atypical meningiomas. ⋯ Long-term survival is possible for patients with atypical meningiomas treated with surgery and postoperative RT. Multivariate analysis confirmed that age (<50 years) and total surgical excision were independent prognostic factors for survival. Adjuvant RT reduces tumor recurrence, especially after incomplete surgery.
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To estimate the incidence of central nervous system (CNS) tumors in Suriname. ⋯ The annual incidence of treated CNS tumors of 5 per 100,000 inhabitants in Suriname was in accordance with the expectation of an incidence of 3-6 per 100,000. Suriname is considered a country with a low cancer incidence. The differences found among various subgroups were too small to make definitive statements.