Journal of neurosurgery
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Journal of neurosurgery · Jul 2023
Comment Letter Clinical TrialLetter to the Editor. Clazosentan was superior to placebo, but was the comparison appropriate?
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Journal of neurosurgery · Jul 2023
Risk prediction model for unsuccessful elbow flexion recovery after nerve transfer surgery in patients with brachial plexus injury.
Nerve transfer surgery has been a mainstay treatment of brachial plexus injury, with varying success rates. Patients undergoing unsuccessful surgery are left with a useless limb for at least 2 years. Preoperative prediction has become a topic of interest to avoid an unsuccessful nerve transfer surgery. This study aimed to find strong predictive factors and develop a prediction model for unsuccessful functional elbow flexion recovery 2 years after a nerve transfer surgery in patients with brachial plexus injury. ⋯ The prediction model for failed elbow flexion recovery after nerve transfer surgery in traumatic brachial plexus injury was developed with good predictive value and internal validity. An alternative treatment, i.e., primary free functioning muscle transfer, should be offered in preoperative counseling in cases of a very high risk of failure.
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Journal of neurosurgery · Jul 2023
Assessing opportunities for formal exposure to clinical neurosurgery within United States allopathic medical education curricula.
The objective of this study was to evaluate opportunities for early clinical exposure to neurosurgery at US allopathic medical schools and to assess associations between early exposure and recruitment into neurosurgery. ⋯ Early exposure to clinical neurosurgery is available at most US allopathic medical schools and is associated with shorter preclinical curricula and institutions with AANS medical student chapters. Medical schools with a higher proportion of medical students entering neurosurgery had a shorter preclinical curriculum length and early clinical exposure to neurosurgery. Further study is recommended to characterize the impact of early exposure on long-term pedagogical outcomes.
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Journal of neurosurgery · Jul 2023
Anatomical predictors of difficult left internal carotid artery navigation in transradial access for neurointervention.
Transradial access (TRA) has received considerable attention in the field of neurointervention owing to its advantages over transfemoral access. However, the difficulty of left internal carotid artery (ICA) navigation under certain anatomical conditions of the aortic arch and its branches is a limitation of right TRA. In this study the authors aimed to investigate the anatomical predictors that impede navigation of the left ICA in right TRA. ⋯ Successful left ICA navigation in right TRA was related to the specific vascular geometry of the aortic arch and its branches. Preprocedural evaluation of the anatomical predictors identified in this study may enhance the success rate of left ICA navigation in right TRA.