World Neurosurg
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The purpose of this research was to explore the processes by which pediatric neurosurgeons make intraoperative decisions when they encounter something unexpected or uncertain while they are operating. ⋯ The findings from this study contribute novel information on PNs' intraoperative decision making processes and can be used to train resident neurosurgeons about the various components involved in these processes. This research suggests that new models of decision making are needed within the medical and neurosurgical context and inspire a new set of questions about the process by which surgeons make life and death decisions in the operating room.
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To replace educational opportunities lost during the coronavirus disease 2019 (COVID-19) pandemic, the Department of Neurosurgery at Lenox Hill Hospital produced an open-access webinar series ("BRAINterns") that covered a broad range of health care topics with a focus on neurosurgery. ⋯ These data demonstrate that webinar-based education is an effective method of expanding access to careers in medicine and in particular, neurosurgery, to traditionally underrepresented populations. Social media can be a powerful tool to combat barriers to early exposure and vastly improve diversity within the field.
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Surgical resection of symptomatic pineal cysts without hydrocephalus remains controversial because patients can present with variable symptoms. Hesitancies in surgical decision-making include determining surgical candidacy and whether results would be durable. ⋯ Pineal cysts can present with variable headache symptomatology. Surgical resection of pineal cysts in carefully selected symptomatic patients after exhaustive conservative management can be performed safely and result in durable symptomatic relief.
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There is a paucity of information regarding the optimal timing of restarting antiplatelet therapy (APT) and anticoagulation therapy (ACT) after traumatic subdural hematoma (tSDH). Therefore, we sought to report our experience at a single level 1 trauma center with regard to restarting APT and/or ACT after tSDH. ⋯ Patients requiring reinitiation of APT and/or ACT after tSDH were at elevated risk of thrombotic/thromboembolic events but not unplanned hematoma evacuation. Therefore, patients should be followed closely until APT and/or ACT are restarted, and consideration for earlier reinitiation of blood thinners should be given on a case-by-case basis.
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The loss of stereopsis and the need for markedly enhanced hand-eye coordination are obstacles to overcome when performing exoscopic procedures, but both should improve with training. Our objectives were to describe an exoscopy training station and to compare time and performance of a given microsurgical technique among neurosurgery residents and junior neurosurgeons. ⋯ Using the exoscopy training station, the trainees were able to improve their time and performance of exoscopy compared with the controls.