World Neurosurg
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Secretory meningioma (SM) is a rare histologic subtype known to cause disproportional peritumoral brain edema. Although meningiomas are defined by slow growth and mostly manifest with benign clinical symptoms, SMs can cause life-threatening deterioration. The aim of this study was to characterize the potential pitfalls in treatment of SMs by illustrating their characteristic clinical features. ⋯ Our results illustrate the complicated clinical course of this rare histologic meningioma subtype. The increased frequency of seizures may enable raised awareness of clinicians for potential complications and treatment adjustments perioperatively early at clinical admission.
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Recent decades have seen a rapid expansion of involvement of medical students in biomedical research during medical school training. Research within medical school has been shown to influence medical students with regard to medical knowledge, career development, and residency specialty choice. The objective of this study was to evaluate the impact of neurosurgery medical student research grants on neurosurgery residency choice and provide an insight on the demographics of grant awardees. ⋯ Neurosurgery grants for medical students are highly successful in producing future neurosurgeons with >50% of grant recipients matched into neurosurgery. Women are underrepresented in neurosurgery grants and neurosurgery residency programs. This situation can be improved by providing insight about the field early in medical school, perhaps through increased use of neurosurgery medical student grants.
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The middle fossa approach (MFA) is not used as frequently as the traditional translabyrinthine and retrosigmoid approaches for accessing vestibular schwannomas (VSs). Here, MFA was used to remove primarily intracanalicular tumors in patients in whom hearing preservation is a goal of surgery. ⋯ Preliminary results from this single-center retrospective study of patients undergoing MFA for resection of VS showed that good hearing preservation and facial nerve outcomes could be achieved with few complications. These results suggest that resection via the MFA is a rational alternative to watchful waiting or stereotactic radiosurgery.
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To elucidate venous drainage patterns to avoid damage to the venous drainage route in the middle cranial fossa and superior petrosal sinus when employing the transpetrosal approach. ⋯ In cases of venous drainage impairment secondary to PCM progression, the drainage route changed to the pterygoid plexus route through the emissary foramen and/or superior sagittal sinus and to the transverse sinus route through the greater anastomosis of the superficial middle cerebral vein. In the anterior transpetrosal approach, peeling off the dura propria of the trigeminal nerve of the foramen rotundum for petrous apex exposure may be associated with the potential risk of pterygoid plexus drainage route impairment.
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The medical infrastructure of Iraqi Kurdistan, a semiautonomous region in the northern part of Iraq, lags disproportionately behind relative to the otherwise booming industrial advances of the region. Although neurosurgical training is available, the local population lacks trust in its own neurosurgeons. ⋯ Over the last 4 years, the visiting neurosurgical team has seen hundreds of patients in consultation and performed more than 50 complex cranial and spinal operations jointly with local neurosurgeons. This article discusses our experience as volunteer neurosurgeons in building neurosurgical capacity in Iraqi Kurdistan.