World Neurosurg
-
There is increasing literature supporting the importance in triaging patients to teaching hospitals for complex surgical procedures. This study analyzes the effect of teaching hospital status on outcome of endovascular coiling and microsurgical clipping of ruptured and unruptured intracranial aneurysms using the Nationwide Inpatient Sample database. ⋯ Our results suggest that the teaching status of a hospital is an independent factor for favorable outcome in the treatment of ruptured aneurysms. The difference in in-hospital death is accentuated in patients who underwent microsurgical clipping.
-
Arteriovenous malformations (AVMs) of the superior vermis, superomedian cerebellum, and tectum are uncommon lesions. Various routes have enabled accessing the precentral cerebellar fissure and the posterior incisural space. ⋯ The OITT is a valuable approach for specific superior vermian, superomedian cerebellar, and tectal AVMs. Detailed assessment of angiographic features may however preclude its safety as a unique treatment plan, and complementary or alternative therapeutic options should be considered.
-
Intracranial epidermoid tumors are epithelially derived lesions that may present particular challenges to neurosurgeons, often encasing critical neurovascular structures and extending into multiple subarachnoid cisterns. We aimed to evaluate our recent experience with endoscopic assistance to craniotomy with microsurgical resection of these lesions. ⋯ The endoscope is a safe and effective adjunct to the microscope in facilitating additional inspection and further resection of epidermoid tumors. Endoscopic-assisted surgery is particularly useful for identifying and removing additional tumor located around surgical corners.
-
To delineate the learning style that best defines a successful practitioner in the field of neurosurgery by using a validated learning style inventory. ⋯ The assimilating and diverging learning styles are the preferred learning styles among neurosurgeons, neurosurgery residents, and neurology residents. The assimilating learning style typically is the primary learning style for neurosurgeons and neurology residents. Neurosurgical residents start off with a diverging learning style and progress toward an assimilating learning style as they work toward becoming practicing neurosurgeons. The field of neurosurgery has limited opportunities for active experimentation, which may explain why individuals who prefer reflective observation are more likely to succeed in this field.
-
Biography Historical Article
James L. Poppen and surgery of the "seat of the soul": a contemporary perspective.
Dr. James Leonard Poppen (1903-1978) was one of the most renowned American neurosurgeons of the 20th century. The now eponymous Poppen approach to the pineal region is still used routinely in current neurosurgical practice. ⋯ He retired from this post in 1970; however, he continued his practice of neurosurgery until his death. This historical vignette aims to highlight the work of James L. Poppen and the evolution of the surgery of the "Seat of the Soul." His work has had a lasting influence on neurosurgeons and neuroscientists over the years.