Journal of neurosurgery
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Journal of neurosurgery · Sep 2012
Increased population density of neurosurgeons associated with decreased risk of death from motor vehicle accidents in the United States.
Motor vehicle accidents (MVAs) are a leading cause of death and disability in young people. Given that a major cause of death from MVAs is traumatic brain injury, and neurosurgeons hold special expertise in this area relative to other members of a trauma team, the authors hypothesized that neurosurgeon population density would be related to reduced mortality from MVAs across US counties. ⋯ A higher population density of neurosurgeons is associated with a significant reduction in deaths from MVAs, a major cause of death nationally. This suggests that the availability of local neurosurgeons is an important factor in the overall likelihood of survival from an MVA, and therefore indicates the importance of promoting neurosurgical education and practice throughout the country.
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Journal of neurosurgery · Sep 2012
Intraoperative subcortical electrical mapping of optic radiations in awake surgery for glioma involving visual pathways.
Preservation of the visual field in glioma surgery, especially avoidance of hemianopia, is crucial for patients' quality of life, particularly for driving. Recent studies used tractography or cortical occipital stimulation to try to avoid visual deficit. However, optic radiations have not been directly mapped intraoperatively. The authors present, for the first time to their knowledge, a consecutive series of awake surgeries for cerebral glioma with intrasurgical identification and preservation of visual pathways using subcortical electrical mapping. ⋯ Online identification of optic radiations by direct subcortical electrostimulation is a reliable and effective method to avoid permanent hemianopia in surgery for gliomas involving visual pathways.
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Journal of neurosurgery · Sep 2012
Comparative StudyA novel tissue engineering approach using an endothelial progenitor cell-seeded biopolymer to treat intracranial saccular aneurysms.
Recurrence after endovascular coiling of intracranial aneurysms is reported in up to 42% of cases and is attributed to the lack of endothelialization across the neck. In this study the authors used a novel tissue engineering approach to promote endothelialization by seeding endothelial progenitor cells (EPCs) within a fibrin polymer injected endovascularly into the aneurysm. ⋯ This novel technique may address reasons for the limited durability of standard coil embolization and provides further avenues for the development of improved devices for the care of patients with aneurysms.
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Journal of neurosurgery · Sep 2012
Historical ArticleNeurosurgery and consciousness: historical sketch and future possibilities.
Neurosurgery has played an important role in the development of neuroscience and the science of consciousness. In this paper, the authors reflect on some of the historical contributions of neurosurgeons to the science of consciousness and discuss the ways in which clinical neurosurgery can contribute to the science of consciousness in the 21st century. An approach to the "hard problem" is proposed based on the principles of psychophysics, and the opportunities offered by intracranial recording and stimulation in patients capable of reporting changes in subjective experience are discussed. Such an approach will allow the systematic study and description of the bridging relationships between neurobiology and conscious experience.