World Neurosurg
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Historically, medical student education in neurological surgery has generally limited student involvement to assisting in research projects with minimal formal clinical exposure before starting sub-internships and application for the neurosurgery match. Consequently, students have generally had little opportunity to acquire exposure to clinical neurosurgery and attain minimal proficiency. A medical student training camp was created to improve the preparation of medical students for the involvement in neurological surgery activities and sub-internships. ⋯ The preparation of medical students for clinical neurosurgery can be improved. Single-day courses such as the described training camp are an effective method for improving knowledge and skill gaps in medical students entering neurosurgical careers. Initiatives should be developed, in addition to this annual program, to increase the clinical and research skills throughout medical student education.
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Corkscrew (CS) electrodes are usually used for transcranial electrical stimulation (TES) in the intraoperative monitoring of motor evoked potentials (MEP). Direct cranial stimulation with peg-screw (PS) electrodes can elicit MEP. The present study investigated the difference in the initial threshold between PS and CS electrodes for intraoperative MEP monitoring. ⋯ The initial threshold to elicit MEP was significantly lower with the PS electrode than with the CS electrode. A PS electrode can be used as a feasible stimulation electrode for TES-MEP.
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Primary optic apparatus involvement by lymphoma is an exceedingly rare entity, with only 3 cases previously reported in the literature. Whether this represents a distinct pathology, metastatic disease from an unidentified systemic lymphoma, or the first manifestation of evolving primary central nervous system lymphoma is not currently understood. ⋯ Primary optic nerve lymphoma is a rare disease that requires a systemic workup and a multidisciplinary approach to treatment.
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Primary melanocytic neoplasms (PMNs) are rare neoplasms, especially within the central nervous system. Meningeal melanocytomas, a subtype of PMN, are even rarer. Nevus of Ota results from the incomplete migration of melanocytes from the neural crest. Synchronous nevus of Ota and meningeal melanocytoma are infrequently encountered in clinical practice. ⋯ Our findings indicated a trend for both types of lesion to be located ipsilaterally and supratentorially. When a patient with nevus of Ota is found to harbor an intracranial neoplasm, the most likely diagnosis is PMN.
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The 2016 World Health Organization Classification of Tumours of the Central Nervous System was revised to include a new diagnostic entity, diffuse midline glioma, H3 K27M-mutant (DMG-K27M), a highly aggressive tumor with a mean survival time of 1 year after diagnosis. DMG-K27M is classified as a World Health Organization grade IV tumor regardless of histopathologic features, and there is currently no effective treatment for it despite ongoing research. ⋯ There are currently no effective therapeutic options for treatment of DMG-K27M. The slow tumor growth and prolonged survival time (≥ 3 years) in the absence of intervention in this case serve as a reminder that much is still not known about histone H3 lysine 27-to-methionine mutation and how it impacts the pathophysiology, diagnosis, treatment, and prognosis of the disease. Careful evaluation is warranted to determine if early intervention is the best approach when treating DMG-K27M.