Neurosurgery
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Carotid endarterectomy (CEA) might improve cognitive function. Fractional anisotropy (FA) values in the cerebral white matter derived from diffusion tensor magnetic resonance imaging (DTI) correlate with cognitive function in patients with various central nervous system diseases. ⋯ Postoperative increase in cerebral white matter FA on DTI is associated with cognitive improvement after uncomplicated CEA.
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Virtual reality (VR) simulation-based technologies play an important role in neurosurgical resident training. The Congress of Neurological Surgeons (CNS) Simulation Committee developed a simulation-based curriculum incorporating VR simulators to train residents in the management of common neurosurgical disorders. ⋯ VR ventriculostomy placement as part of the CNS simulation trauma module complements standard training techniques for residents in the management of neurosurgical trauma. Improvement in didactic and hands-on knowledge by course participants demonstrates the usefulness of the VR simulator as a training tool.
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Postoperative displacement of deep brain stimulation electrodes related to lead-anchoring technique.
Displacement of deep brain stimulation (DBS) electrodes may occur after surgery, especially due to large subdural air collections, but other factors might contribute. ⋯ The commercially available plastic cap system is more efficient in preventing postoperative DBS electrode displacement than titanium microplates. A reliability analysis of the electrode fixation is warranted when alternative anchoring methods are used.
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Stroke is a leading cause of death and disability in the United States. Despite the proven benefits of intravenous tissue plasminogen activator (IV-tPA), only a small percentage of patients who have had a stroke (3.4%-5.2%) receive this US Food and Drug Administration-approved therapy. ⋯ Implementing a telestroke system facilitates high rates of intravenous thrombolysis in patients who have had a stroke in community hospitals within a relatively short time frame. These results are higher than the national average rate (3.4%-5.2%) and support the implementation of telestroke networks for wider access to stroke expertise in underserved regions.
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Genetic risk factors for intracranial aneurysms may influence the size of aneurysms. ⋯ The 6 genetic risk loci have no major influence on the size of aneurysms at the time of rupture. Because these risk loci explain no more than 5% of the genetic risk, other genetic factors for intracranial aneurysms may influence aneurysm size and thereby proneness to rupture.