World Neurosurg
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Intraventricular and subarachnoid forms represent the relatively complex, albeit uncommon, manifestations of central nervous system involvement by cysticercal cysts. Cysticercal encystation inside the Blake's pouch remnant of mega cisterna magna (MCM) remains an extremely rare clinical scenario that, to the best of our knowledge, has not been reported previously. ⋯ The clinical scenario presented here has not been described previously. Endoscopic cyst removal in such a situation is an effective and low-risk procedure that obviates the further need for antihelminthic medications.
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Randomized Controlled Trial Multicenter Study
Stereotactic Radiosurgery for A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA)-Eligible Spetzler-Martin Grade I and II Arteriovenous Malformations: A Multicenter Study.
ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations) found better short-term outcomes after conservative management compared with intervention for unruptured arteriovenous malformations (AVMs). However, because Spetzler-Martin (SM) grade I-II AVMs have the lowest treatment morbidity, sufficient follow-up of these lesions may show a long-term benefit from intervention. The aim of this multicenter, retrospective cohort study is to assess the outcomes after stereotactic radiosurgery (SRS) for ARUBA-eligible SM grade I-II AVMs. ⋯ For ARUBA-eligible SM grade I-II AVMs, long-term SRS outcomes compare favorably with the natural history. SRS should be considered for adult patients harboring unruptured, previously untreated low-grade AVMs with a minimum life expectancy of a decade.
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Medicine is rapidly changing, both in the level of collective medical knowledge and in how it is being delivered. The increased presence of administrators in hospitals helps to facilitate these changes and ease administrative workloads on physicians; however, tensions sometimes form between physicians and administrators. ⋯ Physicians and administrators both need to have a well-developed personal ethic to achieve these goals. Physicians need be allowed to retain relative autonomy over their practices as they support and participate in administrator-led efforts toward distributive justice.
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More data regarding complications in neurosurgery residents' cases are needed to assess patients' safety during hands-on surgical education. ⋯ The results of the current study in addition to the literature on neurosurgery resident training support the safety of supervised early surgical education for shunt surgery.