Journal of neurosurgery
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Journal of neurosurgery · Nov 2024
Surgical anatomy of the inferior hypophyseal artery and its relevance for endoscopic endonasal skull base surgery.
The inferior hypophyseal arteries (IHAs) are intimately related to pituitary and cavernous sinus (CS) lesions. There is still no anatomical study specifically analyzing the IHAs. The aim of this study was to investigate the surgical anatomy and variations of the IHA, and to translate this knowledge into surgical practice. ⋯ The IHA can be divided into proximal and distal segments. Its proximal segment is most often found crossing the CS at the level of the lower third of the PCP and entering the posterior third of the medial wall of the CS. A detailed understanding of the surgical anatomy of the IHA and its variability will help surgeons dealing with challenging lesions within the CS and when performing transcavernous approaches, interdural posterior clinoidectomies, and pituitary gland transpositions.
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Journal of neurosurgery · Nov 2024
The value of a neurosurgeon: is neurosurgical compensation proportional to value added? A systematic review of the literature and an update on a changing healthcare economy.
Determining the value of a neurosurgeon is complex. Services provided by neurosurgeons have a range of interested parties-from a patient's singular health interest to a community catchment area rendering on-call emergency services. Such complexity makes it difficult to determine and define value. As healthcare reimbursement changes continue to transition further toward value-based/bundled payments, such determinations remain difficult and confusing. Given these factors, now more than ever before, neurosurgeons need to be active participants in the evolving discussions surrounding healthcare advocacy, value, and compensation in an ever-evolving and convoluted system. The objective of this study was to review and present current trends within the evolving landscape of healthcare economics and their impacts on the perceived value of neurosurgical services. ⋯ Medical compensation continues to evolve toward more value-driven methods. Value created as a neurosurgeon is complex, but it should not be underestimated as a key driver of hospital revenue, with up to $2.6 million created annually from neurosurgical hospital admissions. Further discussion is needed to elucidate alternative innovative payment strategies to ensure physicians remain active in the evolving structure of our healthcare system.
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Journal of neurosurgery · Nov 2024
Implementation of high-definition fiber tractography for preoperative evaluation and surgical planning of brainstem cavernous malformation: long-term outcomes.
The aim of this study was to describe the role and long-term outcomes of high-definition fiber tractography (HDFT) in the surgical management of brainstem cavernomas. ⋯ HDFT provides critical anatomical information guiding an optimal surgical corridor and more importantly defining eloquent perilesional boundaries. In this preliminary experience, preoperative planning with HDFT appeared to decrease morbidity in patients who underwent microsurgical resection of their brainstem cavernoma.
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Journal of neurosurgery · Nov 2024
NeurosurGen, Inc.: an academic ancestry database for neurosurgery.
The mission of NeurosurGen, Inc., is to compile and maintain genealogical data on every neurosurgeon in the US and, eventually, the world. ⋯ NeurosurGen offers a myriad of benefits, including the preservation of the rich history of neurosurgery and the fostering of camaraderie among its practitioners.