World Neurosurg
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With subspecialty surgical care often unavailable to poor patients in developing countries, short-term brigades have filled a portion of the gap. We prospectively assessed the cost effectiveness of a pediatric neurosurgical brigade to Guatemala City, Guatemala. ⋯ To our knowledge, this is the first study evaluating cost effectiveness of a short-term neurosurgical brigade. Although surgical intervention is acknowledged as playing a crucial role in global health, subspecialty surgical care is still broadly perceived as a luxury. Although providing care through local surgeons is undeniably more efficient than bringing in foreign medical teams, such care is not universally available. This study argues that volunteer neurosurgical teams can provide high complexity care with a competitive cost-effective profile.
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The best management of patients with brain arteriovenous malformations (BAVM) is controversial. The radiosurgery-based arteriovenous malformation (AVM) score (RBAS) was developed to predict outcomes for patients with BAVM having stereotactic radiosurgery (SRS). ⋯ SRS provided a high rate of obliteration at very low risk for patients with BVAM with a RBAS ≤1. Patient outcomes after SRS are likely equivalent to resection for younger patients with small-volume BAVM who do not require a craniotomy for clot removal.