Journal of neurosurgery
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Journal of neurosurgery · Feb 2008
Comparative StudySeizure characteristics and control following resection in 332 patients with low-grade gliomas.
Seizures play an important role in the clinical presentation and postoperative quality of life of patients who undergo surgical resection of low-grade gliomas (LGGs). The aim of this study was to identify factors that influenced perioperative seizure characteristics and postoperative seizure control. ⋯ The majority of patients with LGG present with seizures; in approximately half of these patients, the seizures are pharmacoresistant before surgery. Postoperatively, >90% of these patients are seizure free or have meaningful improvement. A shorter history of seizures and gross-total resection appear to be associated with a favorable prognosis for seizure control.
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Journal of neurosurgery · Feb 2008
Case ReportsVirtual reality system for planning minimally invasive neurosurgery. Technical note.
The authors report on their experience with a 3D virtual reality system for planning minimally invasive neurosurgical procedures. ⋯ The authors found the preoperative 3D model to be in high concordance with intraoperative conditions; the resulting intraoperative "déjà-vu" feeling enhanced surgical confidence. In all procedures planned with the Dextroscope, the chosen surgical strategy proved to be the correct choice. Three-dimensional virtual reality models of a patient allow quick and easy understanding of complex intracranial lesions.
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Journal of neurosurgery · Feb 2008
Robotic catheter ventriculostomy: feasibility, efficacy, and implications.
Robotic applications hold great promise for improving clinical outcomes and reducing complications of surgery. To date, however, there have been few widespread applications of robotic technology in neurosurgery. The authors hypothesized that image-guided robotic placement of a ventriculostomy catheter is safe, highly accurate, and highly reproducible. ⋯ The robotic placement of a ventriculostomy catheter using a preplanned trajectory is safe, highly accurate, and highly reliable. This makes single-pass ventriculostomy possible in all patients, even in those with very small ventricles, and may permit catheter-based therapies in patients who would otherwise be deemed poor surgical candidates because of ventricle size. Robotic placement also permits careful preoperative study and optimization of the catheter trajectory, which may help minimize the risks to bridging veins and sulcal vessels.
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Journal of neurosurgery · Feb 2008
Neurosurgery patients' feelings about the role of residents in their care: a qualitative case study.
The role of residents in surgery is not clearly explained to patients. The authors undertook a study to explore the level of knowledge and anxiety in patients regarding residents' involvement in their surgery. ⋯ Patients appear to be unaware of the role of residents in their surgical care but do not seem anxious about it. Trust in the medical system helps patients proceed with risky operations. Surgeons could be more forthcoming with patients about the role of residents.