Neurosurgery
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Stereoelectroencephalography (SEEG) has been shown to be a valuable tool for the anatomoelectroclinical definition of the epileptogenic zone (EZ) in patients with medically refractory epilepsy considered for surgery (RES patients). In Spain, many of those patients are not offered this diagnostic procedure. ⋯ SEEG is a cost-effective technology in RES patients when compared to no SEEG intervention.
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Physicians are poorly trained in balancing the demands of a career in medicine and maintaining personal health. Physician burnout occurs due to demanding hours and psychological conditions unique to the field. Programs that address overall well-being early in residency are necessary to prevent physician burnout and promote physician mental health. ⋯ Residency-incorporated wellness programs are achievable and can benefit resident mental health. Lack of a control group limits the interpretation of the results. Programs such as these may be implemented to promote well-being and combat physician burnout and its associated mental health abnormalities.
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Neck remnants are not uncommon after endovascular treatment of cerebral aneurysms. Critics of endovascular treatments for cerebral aneurysms cite neck remnants as evidence in favor of microsurgical clipping. However, studies have failed to evaluate the true clinical significance of aneurysm neck remnants following endovascular therapies. ⋯ We found that unruptured aneurysms with residual necks following endovascular treatment posed a very low risk of rupture (0.6%). However, patients presenting with ruptured aneurysms had a higher risk of rerupture from a neck remnant (3.4%). These results highlight the importance of achieving complete angiographic occlusion of ruptured aneurysms.
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Diffusion imaging tractography caught the attention of the scientific community by describing the white matter architecture in vivo and noninvasively, but its application to small structures such as cranial nerves remains difficult. The few attempts to track cranial nerves presented highly variable acquisition and tracking settings. ⋯ This review highlights the variability in the settings used for cranial nerve tractography. It points out challenges that originate both from cranial nerve anatomy and the tractography technology, and allows a better understanding of cranial nerve tractography.
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Comparative Study
Histopathological Findings After Reirradiation Compared to First Irradiation of Spinal Bone Metastases With Stereotactic Body Radiotherapy: A Cohort Study.
Stereotactic body radiotherapy (SBRT) of the spine provides superior tumor control, but vertebral compression fractures are increased and the pathophysiological process underneath is not well understood. Data on histopathological changes, particularly after salvage SBRT (sSBRT) following conventional irradiation, are scarce. ⋯ For both, sSBRT and pSBRT, histopathological changes were similar. Neurological symptoms were attributable to tumor progression and pathological fractures were not associated with osteonecrosis or tumor progression.