World Neurosurg
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The posterior fossa is the site of many types of tumors, and brain metastases are the most common malignancies in that location among adults. Other brain tumors, such as ependymomas, medulloblastomas, and juvenile pilocytic astrocytomas, mostly occur during childhood and are relatively rare in adults. Most primary malignant brain tumors, such as gliomas and lymphomas, tend to be located in the supratentorial compartment. ⋯ The clinical course and surgical outcome of adult patients with intra-axial brain tumors in the posterior fossa are summarized in this review. The prognostic factors and therapeutic management of patients with these tumors are controversial because of their rarity, their heterogeneity, and the lack of sufficient data in the literature.
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To determine the rate of surgical site infection (SSI) after resection of an intracranial neoplasm using the American College of Surgeons National Surgical Quality Improvement Program data set and to identify potential risk factors associated with SSI. ⋯ This study identified patient risk factors that may assist clinical decision making regarding patient risk stratification, timing of surgery, and preoperative antibiotic prophylaxis for patients with an intracranial neoplasm undergoing craniotomy.
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Shorter working times, reduced operative exposure to complex procedures, and increased subspecialization have resulted in training constraints within most surgical fields. Simulation has been suggested as a possible means of acquiring new surgical skills without exposing patients to the surgeon's operative "learning curve." Here we review the potential impact of 3-dimensional printing on simulation and training within cranial neurosurgery and its implications for the future. ⋯ 3D printing provides a unique means of directly replicating patient-specific pathologies. It can identify anatomic variation and provide a medium in which training models can be generated rapidly, allowing the trainee and experienced neurosurgeon to practice parts of operations preoperatively. Future studies are required to validate this technology in comparison with current simulators and show improved patient outcomes.
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Multicenter Study
Use of diffusion weighted imaging in differentiating between malignant and benign meningiomas. A multicenter analysis.
Meningioma is the most frequent intracranial tumor and is often an incidental finding on imaging. Some imaging-based scores were suggested for differentiating low- and high-grade meningiomas. The purpose of this work was to compare diffusion-weighted imaging findings of different meningiomas in a large multicenter study by using apparent diffusion coefficient (ADC) values for predicting tumor grade and proliferation potential. ⋯ The estimated threshold ADC value of 0.85 can differentiate grade I meningioma from grade II and III tumors. The same ADC value is helpful for detecting tumors with high proliferation potential.
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To raise the level of awareness regarding the role of Jordan as one of the leading countries in the region in providing excellent general medical and neurosurgical care. ⋯ Jordan has placed great importance on advancing the health care sector in accordance with international benchmarks yielding performance indicators that are among the best in the region. Moreover, Jordanian women are empowered to take leading roles in nursing, medicine, and surgery.