World Neurosurg
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Review
Recapitulating flesh with silicon and steel: advancements in upper extremity robotic prosthetics.
With the loss of function of an upper extremity because of stroke or spinal cord injury or a physical loss from amputation, an individual's life is forever changed, and activities that were once routine become a magnitude more difficult. Much research and effort have been put into developing advanced robotic prostheses to restore upper extremity function. For patients with upper extremity amputations, previously crude prostheses have evolved to become exceptionally functional. ⋯ For patients with spinal cord injury or stroke, functional electrical stimulation promises to provide the most sophisticated prosthetic limbs possible by reanimating paralyzed arms of these patients. Advances in technology and robotics continue to help patients recover vital function. This article examines the latest neurorestorative technologies for patients who have either undergone amputation or lost the use of their upper extremities secondary to stroke or spinal cord injury.
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Anticoagulated patients with intracranial hemorrhage represent a major management challenge. Our goal is to determine how patient characteristics and management decisions influence outcome. ⋯ Our results provide prognostic information that may assist management of these patients. Our results also suggest that it may be unwise to withhold anticoagulation indefinitely after an index hemorrhage. As thromboembolic or hemorrhagic complications may be associated with worse outcome, efforts to avoid them may be wise. The studies that comprise our dataset have important limitations and a prospective study will be required to confirm these results.
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To analyze the clinical characteristics, immunohistochemistry, and treatment outcomes for skull base chordomas and the correlation between extent of resection/pathology type and outcomes. ⋯ Aggressive surgical resection should be performed for skull base chordomas, considering certain postoperative functional status. Immunohistochemical study is helpful in differential diagnosis. The combination of aggressive surgical resection and gamma knife radiosurgery for skull base chordomas may obtain favorable outcomes.
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Historical Article
Supplementing the neurosurgical virtuoso: evolution of automation from mythology to operating room adjunct.
A central concept of scientific advancement in the medical and surgical fields is the incorporation of successful emerging ideas and technologies throughout the scope of human endeavors. The field of automation and robotics is a pivotal representation of this concept. ⋯ We trace the growth of this field from the seminal concepts of Homer and Aristotle to early incorporation into neurosurgical practice. Resulting changes provide drastic and welcome advances in areas of visualization, haptics, acoustics, dexterity, tremor reduction, motion scaling, and surgical precision.