Acta neurochirurgica
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Acta neurochirurgica · Jul 2009
Long-term implantation of deep brain stimulation electrodes in the pontine micturition centre of the Göttingen minipig.
To implant deep brain stimulation (DBS) electrodes in the porcine pontine micturition centre (PMC) in order to establish a large animal model of PMC-DBS. ⋯ DBS electrodes can be implanted for several weeks in the identified CRF-dense area resulting in a useful large animal model for basic research on micturition and the future clinical use of this treatment modality in neurogenic supra-pontine voiding disorders.
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Acta neurochirurgica · Jun 2009
A report on neurosurgical workforce in the countries of the EU and associated states. Task Force "Workforce Planning", UEMS Section of Neurosurgery.
Aim of this report was to present recently collected data on neurosurgical workforce in the countries of the EU and associated states. ⋯ The number of Neurosurgeons (NS) per population varies considerably among these countries. The mean is one neurosurgeon per 99,152 population. The number of neurosurgical operations per population per year varies similarly with a mean of 1,642 operations per million population/year. Countries with fewer neurosurgeons per population tend to have less neurosurgical operations per population and vice versa. The average number of operations performed by one neurosurgeon per year (annual caseload) is between 56 and 300 with a mean of 154. A numerus clausus for neurosurgical training is reported in 13 countries, another 13 countries have no numerus clausus. The annual intake of new trainees is between 2.4 and 10.3% of the number of accredited neurosurgeons with a mean of approx. 5.2%. The average yearly loss rate due to retirement, sickness, other activities, etc. can only be estimated and lies in the range between 2.3 and 3.36% of the number of accredited NS. According to the figures provided by the countries, the total number of accredited NS in 2005/2006 was approx. 6,280 for a population of about 504.7 millions. These countries had an annual intake of approx. 332 new trainees.
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Acta neurochirurgica · Jun 2009
Case ReportsPenetrating ballistic-like frontal brain injury caused by a metallic rod.
Penetrating non-missile intracranial injuries caused by metallic foreign bodies are very rare among the civilian population. We present a unique instance of a severe, high-energy, penetrating orbitocranial injury caused by a solid metallic rod that corresponded to the spray valve lever handle of a kitchen sink pre-rinse spray tap, which was fractured and projected at high speed for an unknown reason. ⋯ After careful radiological evaluation of the shape and position of the foreign object, a combined right frontal craniotomy and supraorbital osteotomy was performed in order to achieve safe removal of the metal bar. Successful surgical treatment of an orbitocranial injury caused by a similar object has not previously been reported.
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Acta neurochirurgica · Jun 2009
Staged bilateral deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.
Several investigators have described the efficacy and safety of unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of Parkinson's disease (PD). Some patients who underwent unilateral STN DBS required additional surgery on the contralateral side because the unilateral treatment was insufficient. The goal of this study was to assess the efficacy and safety of staged bilateral STN DBS compared to the simultaneous bilateral procedure. ⋯ Both the staged bilateral STN DBS and the simultaneous bilateral procedure are effective and safe treatment options, but the staged bilateral procedure may be regarded as the preferred choice for the treatment of some patients.
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Acta neurochirurgica · Jun 2009
Spine surgery training and competence of European neurosurgical trainees.
Little is known about the nature of spine surgery training received by European neurosurgical trainees during their residency and the level of competence they acquire in dealing with spinal disorders. ⋯ European neurosurgical trainees possess incomplete competence in dealing with spinal disorders. EANS trainees advocate the development of a postresidency spine subspecialty training program.