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Congratulations to the American Association of Neurological Surgeons and Congress of Neurological Surgeons for standing on principleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
On July 14, 2009, the US House of Representatives Ways and Means Committee voted to support the greatest government expansion of health care since the passage of the Medicare bill in 1964 for those older than 62 years, providing all mature adults with health care insurance. (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: James I. Ausman Tags: Editorial Source Type: journals

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Chordomas in the high cervical region are difficult to manage from a resection point of view. The authors have correctly highlighted the need for several approaches to excise the lesion and provide for stability. The vertebral artery is always a major factor in the resection and may sometimes have to be sacrificed. (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: Arnold H. Menezes Tags: Neoplasm Source Type: journals

A combined posterior, lateral, and anterior approach to ventrolaterally situated chordoma of the upper cervical spineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: When a direct posterior approach makes it difficult or impossible to reach tumors extending to the far lateral margins of the spine and soft tissues, the posterior-lateral approach described here allows excellent visualization and safe access with minimal neural retraction for treating these laterally situated lesions. We describe the surgical technique for a combined approach as an alternative to the direct posterior or anterior retropharyngeal approach. (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: Seung-Jae Hyun, Seung-Chul Rhim, K. Daniel Riew Tags: Neoplasm Source Type: journals

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This article is very interesting and would be the first report on the use of cadaveric vein grafts for EC-IC bypass. (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: Nobutaka Kawahara Tags: Vascular Source Type: journals

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The authors describe the use of topical fluorescein dye in endoscopic endonasal repair of cerebrospinal fluid rhinorrhea in 15 cases. They note a 100% success in localizing the site of the leak with this simple technique. In their hands, this does appear to be an effective method for leak localization and is certainly safer than intrathecal fluorescein administration. I look forward to trying their technique in the future. (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: Daniel F. Kelly Tags: Endoscopy Source Type: journals

Research news and notesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study proposes a mechanistic basis for the effect of adipose stromal cells on neuronal survival and raises important questions. Could transplantation of adipose stem cells be a promising paradigm to alleviate neural tissue damage? Adipose stromal cells can be obtained from the patient with relatively low surgical risk and obviate the problem of allograft rejection. Would the omentum be a good source? I remember seeing omental transpositions performed for cerebral ischemia and anecdotal evidence for efficacy . Is it time to revisit omental grafts for cerebral ischemia? (Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: Ben Roitberg Tags: Scientific Updates Source Type: journals

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This month, there are some very innovative articles to read. A new approach to the cervical spine that avoids complications of the anterior diskectomy, long-term results of peripheral nerve stimulation for neuropathic pain, a comparison of endoscopic and traditional microscopic transsphenoidal surgery for pituitary tumors, a clever idea for determining the site of cerebrospinal fluid (CSF) leaks without the complications of intrathecal injection, an observation on the disappearance of vasospasm with high mean arterial pressures, the comparison of the cost of clipping and coiling in developing countries, the use of a cadave...
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Authors: James I. Ausman Tags: Editorial Source Type: journals

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(Source: Surgical Neurology)
Source: Surgical Neurology - September 7, 2009 Category: Neurosurgery Source Type: journals

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This article presents a unique experience with a relatively rarely used modality designed to treat chronic pain due to peripheral nerve injury—PNS. The uniqueness comes not only from the kind of PNS device that the authors used in their patients (this system has not been in production for almost 20 years) but also from an extremely long follow up which is rather unusual for most neuromodulation outcome research. (Source: Surgical Neurology)
Source: Surgical Neurology - August 9, 2009 Category: Neurosurgery Authors: Konstantin V. Slavin Tags: Pain Source Type: journals

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A well-presented study and article on the topic, albeit with a necessarily limited number of patients. It is noteworthy that these patients had persistent relief of neuropathic pain but only with peripheral nerve stimulation for so many years, when long-term relief of neuropathic pain does not occur with nerve root stimulation . In addition, it is unfortunate that no psychological investigations of the patients occurred, either initially or during this study since the presence of psychological factors and secondary gain issues are well known to play an important role in chronic pain syndromes, including those related to ne...
Source: Surgical Neurology - August 9, 2009 Category: Neurosurgery Authors: Ron Pawl Tags: Pain Source Type: journals

Long term clinical outcome of peripheral nerve stimulation in patients with chronic peripheral neuropathic painEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In selected patients with peripheral neuropathic pain PNS remains effective even after more than 20 years. (Source: Surgical Neurology)
Source: Surgical Neurology - August 9, 2009 Category: Neurosurgery Authors: Frank Van Calenbergh, Jan Gybels, Koen Van Laere, Patrick Dupont, Leon Plaghki, Bart Depreitere, Ron Kupers Tags: Pain Source Type: journals

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This study includes an assessment over a 2-year period of Bryan disc prostheses and looks at the frequency of adjacent-level disease. The frequency of adjacent-level osteophytes or ALL/disc space narrowing was 12.5%. Changes were nearly equally frequent (cephalad or caudad) to the level of the prosthesis, and heterotopic ossification was noted in 44%. Of interest, if more preoperative CT studies were performed, more patients with OPLL, OALL, and a predilection therefore for heterotopic ossification would be recognized before surgery; in these cases, the presence of HO would constitute a contraindication to performing cervi...
Source: Surgical Neurology - August 9, 2009 Category: Neurosurgery Authors: Nancy Epstein Tags: Spine Source Type: journals

Radiologically documented adjacent-segment degeneration after cervical arthroplasty: characteristics and review of casesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The rate of adjacent-segment degeneration was higher than that observed in previous studies. Adjacent-segment degeneration documented a tendency toward HO. A longer follow-up period is necessary to investigate and document the different types of degeneration seen at levels adjacent to artificial Bryan cervical disk prostheses. (Source: Surgical Neurology)
Source: Surgical Neurology - August 9, 2009 Category: Neurosurgery Authors: Seong Yi, Dong Yeob Lee, Poong Gee Ahn, Keung Nyun Kim, Do Heum Yoon, Hyun Chul Shin Tags: Spine Source Type: journals

How did we lose it—and can we ever get it back?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
My father's maiden aunt came to live with us in November of 1947. Aunt Agnes had congestive heart failure and could no longer care for herself. But aunt Ag just got sicker. Her pulmonary edema worsened in spite of the digitalis and diuretics her doctor had given her. She then contracted pneumonia. Unable to breathe properly, she was terrified. (Source: Surgical Neurology)
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Authors: Patrick J. Kelly Tags: Editorial Source Type: journals

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In this report the authors have retrospectively reviewed 16 patients with two different clinical follow-up periods at a mean of 4.5 and 9.2 years, respectively. Using the Aminoff and Logue outcome scale, the authors report a late clinical deterioration in 50% of their 16 patients when comparing the late follow-up to the earlier follow-up periods. (Source: Surgical Neurology)
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Authors: Daniel L. Barrow Tags: Spine Source Type: journals

Late deterioration of neurologic function in patients surgically treated for spinal dural arteriovenous fistulasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Our study confirms the possible occurrence of a late clinical deterioration in as many as 50% of patients surgically treated for a SDAVF. We deem that the main pathophsyologic mechanism underlining this phenomenon is a gradual and irreversible decline in spinal function related to those hemodynamic modifications induced by the fistula and to the persistence of a state of anatomofunctional deficiency of the spinal venous drainage. (Source: Surgical Neurology)
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Authors: Paolo C. Cecchi, Angelo Musumeci, Paolo Rizzo, Franco Faccioli, Albino Bricolo Tags: Spine Source Type: journals

Research news and notesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Older patients are expected to do worse after traumatic brain injury. In the Dec 2008 issue of the journal Neurotrauma, Tokutomi et al tried to improve our understanding of the causes contributing to this general correlation. They collected data on 797 patients from Japan's Neurotrauma Data Bank who were aged 6 years or older and had Glasgow Coma scale of 8 and below on admission or within 48 hours of admission. A variety of ages were represented; 25% of the patients were 69 years old or older. They confirmed the hypothesis that older patients had a higher rate of mortality and lower rates of favorable neurological outcome...
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Authors: Ben Roitberg Tags: Scientific Updates Source Type: journals

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Discussion. Yet, taken together, there does seem to be suggestive evidence of an association between cell phones and brain tumors that needs further investigation. The controversy is far from settled. Read the articles and make your own decision. What would you decide from the evidence presented? (Source: Surgical Neurology)
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Authors: James I. Ausman Tags: Editorial Source Type: journals

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(Source: Surgical Neurology)
Source: Surgical Neurology - August 6, 2009 Category: Neurosurgery Source Type: journals

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The authors, who have previously done important work on CSF shunting and volumetric cranial data, present an interesting finding in 2 children treated for arachnoid cysts with cystoperitoneal shunting. As far as I am aware, the complication of symptomatic prepontine cistern flattening has not been described before, although many complications of arachnoid cyst shunting have been described. Their finding is important and should be known by pediatric neurosurgeons worldwide. (Source: Surgical Neurology)
Source: Surgical Neurology - July 29, 2009 Category: Neurosurgery Authors: Frank Van Calenbergh Tags: Imaging Source Type: journals

Symptomatic prepontine cistern flattening after an arachnoid cyst shunting: a report of 2 casesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: These cases demonstrate that flattening of the prepontine cisterns and acquired posterior cranial fossa overcrowding may be a potential fall out in patients with cystoperitoneal shunt due to an arachnoid cyst. (Source: Surgical Neurology)
Source: Surgical Neurology - July 29, 2009 Category: Neurosurgery Authors: Ferdnand Osuagwu, Natasha Fagel, Noriko Salamon, Jorge Lazareff Tags: Imaging Source Type: journals

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This article is a well-described and well-referenced report that reviews the networks selectively involved in writing. The link between written language and oral language is clearly tight, yet they are not the same processes. Following frontal lobe resections, I have occasionally seen patients with transient dissociation between written and spoken language function, and this report provides significant understanding to the care of such patients as well as their likely rehabilitation needs. The relative lack of recovery following SMA lesions was surprising. These sorts of observations are very important for neurosurgeons to...
Source: Surgical Neurology - July 23, 2009 Category: Neurosurgery Authors: Jeffrey G. Ojemann Tags: Neoplasm Source Type: journals

Agraphia after awake surgery for brain tumor: new insights into the anatomo-functional network of writingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: On the basis of these results, and in the light of the recent literature, we discuss the relevance of each area in this anatomo-functional network as well as the clinical implications of such better knowledge of the neural basis of writing, especially for brain surgery and functional rehabilitation. (Source: Surgical Neurology)
Source: Surgical Neurology - July 23, 2009 Category: Neurosurgery Authors: Pietro Scarone, Peggy Gatignol, Sophie Guillaume, Dominique Denvil, Laurent Capelle, Hugues Duffau Tags: Neoplasm Source Type: journals

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This study describes results of cryopreserved saphenous vein grafts (CSVGs) in EC-IC bypass. Although long-term results are virtually not available, short-term results and potential problems of the CSVGs are well illustrated. (Source: Surgical Neurology)
Source: Surgical Neurology - July 22, 2009 Category: Neurosurgery Authors: Teiji Tominaga Tags: Vascular Source Type: journals

Cerebral revascularization using cadaveric vein graftsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Use of CSVG for EC-IC bypass has not previously been reported. In our series, the short-term patency rate was 100%, better than that found in cardiac and peripheral vascular series, possibly because of the higher flow in EC-IC bypasses. Our preliminary experience suggests that CSVGs may be an option in patients without available autologous conduits, although longer follow-up is needed to assess long-term patency. (Source: Surgical Neurology)
Source: Surgical Neurology - July 22, 2009 Category: Neurosurgery Authors: Francisco J. Mery, Sepideh Amin-Hanjani, Fady T. Charbel Tags: Vascular Source Type: journals

Cost-effectiveness of clipping vs coiling of intracranial aneurysms after subarachnoid hemorrhage in a developing country—a prospective studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Patients with aneurysmal SAH whom we judged to require coiling had higher charges than patients who could be treated by clipping. The benefits of apparent decrease in length of stay in the endovascular group were offset by higher procedure price and cost of consumables. There was no significant difference in clinical outcome at 6 months. We have proposed a risk scoring system to give guidelines regarding the choice of treatment considering size of aneurysm and resource allocation. (Source: Surgical Neurology)
Source: Surgical Neurology - July 20, 2009 Category: Neurosurgery Authors: Muhammad Zubair Tahir, S. Ather Enam, Rushna Pervez Ali, Atta Bhatti, Tanveer ul Haq Tags: Socioeconomic Issues Source Type: journals

The Demise of Surgical Code # 63020: why health care costs must be transformed into widgetsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Neurosurgeon [Dr Wise] rendering a second opinion after full evaluation: “Well, Ms Paine, you have a ruptured disk in your neck which is pinching a nerve. If the pain is at an intolerable level, then I agree with Dr Young that you are a candidate for surgery.” (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: Edgar N. Weaver Tags: Editorial Source Type: journals

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As surgeons, we want to provide the best care for our patients, and when possible our, decisions should be based on the best clinical evidence. Most of the time, a particular practice is empirically beneficial over another and that becomes the standard of neurosurgical care. However, in other clinical circumstances, a neurosurgeon does “something” because “well, we have always done it that way.” It is times like these where we should carefully consider our clinical decisions and practice using information from randomized trials. (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: Gary Mathern Tags: Technique Source Type: journals

Should epidural drain be recommended after supratentorial craniotomy for epileptic patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: ED cannot decrease the incidence and volume of EH and subgaleal CSF collection. ED should not be recommended after supratentorial epileptic craniotomy. (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: Zhang Guangming, Zuo Huancong, Zhou Wenjing, Chen Guoqiang, Wang Xiaosong Tags: Technique Source Type: journals

The prevalence of shunt-treated hydrocephalus: a mathematical modelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Background: The aim of the study was to create a mathematical model that reproduces the prevalence of shunt-treated hydrocephalus in the United States over the years and predicts trends in the near future.Methods: A structured search was performed of the English language literature for case series reporting rates of shunt insertion and revision, shunt removal, and patient mortality. A meta-analytic model was constructed to pool data from multiple studies and to calculate these rates at various time intervals. Separate Markov models were used to predict numbers of shunts at any one time for children ( (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: Sherman C. Stein, Wensheng Guo Tags: Genetics Source Type: journals

The relationship between preoperative cervical alignment and postoperative spinal cord drift after decompressive laminectomy and arthrodesis for cervical spondylotic myelopathyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Preoperative cervical alignment does not statistically correlate with postoperative spinal cord drift in patients undergoing multisegmental decompressive laminectomy and fusion for CSM. The observation of significant posterior shifting of the spinal cord in the context of straight or kyphotic preoperative alignment suggests that posterior decompression and arthrodesis represent a viable option in the surgical management of patients with CSM with nonlordotic preoperative alignment. (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: Vartan S. Tashjian, Emil Kohan, David L. McArthur, Langston T. Holly Tags: Spine Source Type: journals

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This article should be read by all neurosurgeons in practice and in training. The comments by Slavin at the end are also excellent. This is a first-rate article with profound implications for medicine and surgery. (Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Authors: James I. Ausman Tags: Editorial Source Type: journals

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(Source: Surgical Neurology)
Source: Surgical Neurology - July 16, 2009 Category: Neurosurgery Source Type: journals

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This report provides a basis for testing the spinocerebellar pathways. This may have a human intraoperative correlate in the future. The authors have presented several control studies to show that they indeed did record from the spinocerebellar pathway, not just a far field recording of a lemniscal sensory pathway. I expect others to explore how this may be extended and applied to monitoring the inferior cerebellar peduncle or spinal cord during surgeries that place those structures at risk. Such a human monitoring technique may require recording from subdural strip electrodes placed over the lateral cerebellum. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Marc Nuwer Tags: Technique Source Type: journals

Evoked potentials elicited on the cerebellar cortex by electrical stimulation of the rat spinocerebellar tractEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Reproducible SCEP was recorded from the rat cerebellar hemisphere by electrical stimulation of the quadriceps femoris muscle. We posit that the SCEP differs from the SSEP, which ascends via the dorsal column, and that it is conducted by the dorsal SCT located in the Inf-CPed. Our results suggest that it may be possible to detect the dysfunction of the Inf-CPed electrophysiologically by using SCEP. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Hiroyuki Muramatsu, Kyouichi Suzuki, Tatsuya Sasaki, Masato Matsumoto, Jun Sakuma, Masahiro Oinuma, Takeshi Itakura, Namio Kodama Tags: Technique Source Type: journals

Transcranial Doppler pulsatility index is not a reliable indicator of intracranial pressure in children with severe traumatic brain injuryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The absolute value of the PI is not a reliable noninvasive indicator of ICP in children with severe TBI. Further study is required to examine the relationship between PI and a CPP threshold of 50 mm Hg. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Anthony A. Figaji, Eugene Zwane, A. Graham Fieggen, Peter Siesjo, Jonathan C. Peter Tags: Technology Source Type: journals

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This is a large series of patients with FMM. Our experience tells us that a far-lateral transcondylar approach with or without shifting the vertebral artery is necessary for removing the FMM. Without (for lateroanterior tumor) or with (for anterior tumor) removing one third of the condyle, we can get a straight corridor to the lateroventral or ventral side of the foramen magnum, so that we can remove the tumor without retracting the brainstem and cervical spine. In the recent 2 years, we have used a virtual reality system to make a surgical plan before operation on the FMM. With this technique, we are able to know to what ...
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Rong Zhang, Liang-fu Zhou Tags: Neoplasm Source Type: journals

Foramen magnum meningiomas: experiences in 114 patients at a single institute over 15 yearsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Our experience suggests that most anterior and anterolateral FMMs can be completely resected by a far-lateral retrocondylar approach without resection of the occipital condyle. Complete resection of the tumor should be attempted at the first operation. Postoperative management of FMM is important for the prognosis. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Zhen Wu, Shuyu Hao, Junting Zhang, Liwei Zhang, Guijun Jia, Jie Tang, Xinru Xiao, Liang Wang, Zhongcheng Wang Tags: Neoplasm Source Type: journals

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The authors present an article comparing the cost-effectiveness of treating intracranial aneurysms by clipping or by endovascular coiling in a developing country. Even though there are many articles in the literature dealing with the same subject, and all of them clearly demonstrate that coiling is less expensive than clipping, this advantage has not been so clearly proven in developing countries. The series presented is very small (55 patients in 3 years), but it is capable of demonstrating that the average total cost for patients undergoing endovascular treatment is much higher than surgical clipping. This higher cost is...
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Atos Alves de Sousa Tags: Socioeconomic Issues Source Type: journals

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This is an interesting article with a very simple technique to help confirm and locate the site of CSF leakage in the anterior fossa. It can be used with relative ease. In difficult cases where CSF is thought to be present, yet not confirmed with standard techniques of collection and measurement of concentrated markers, this may be easier than isotope cisternography. Extensive CT and MRI imaging must be done as noted in the manuscript. Still, there are some cases where it is not definite. It is also a simple test to try intraoperatively to aid in locating the leak site. That can be a dilemma and this may aid the surgical t...
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Kalmon D. Post Tags: Endoscopy Source Type: journals

The use of topical intranasal fluorescein in endoscopic endonasal repair of cerebrospinal fluid rhinorrheaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: In the presence of a clinically diagnosed CSF leakage and location of the leakage fistula, topical fluorescein is a very easy, sensitive, safe, and highly accurate tool in the intraoperative localization of the site and extent of CSF fistulas. It should be considered as a viable noninvasive alternative to intrathecal fluorescein. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Liu Hai-sheng, Chen Ye-tao, Wang Dong, Liang Hui, Wang Yunpeng, Wang Shi-jie, Wang Yan, Chen Guo-qiang, Zuo Huan-cong Tags: Endoscopy Source Type: journals

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The authors present their clinical experience with the lateral approach for myeloradiculopathy in a large series of patients. The authors should be commended for their excellent clinical and radiographic results, as well as the long-term follow-up. Most of the complications, except for HS, appear to be less frequent than with traditionally performed midline anterior cervical approaches. However, it should be noted that this procedure has not been widely accepted by many surgeons and that there is a significant learning curve. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Langston Holly Tags: Techique Source Type: journals

Cervical spine lateral approach for myeloradiculopathy: technique and pitfallsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The cervical lateral multilevel corpectomy/foraminotomy technique allows wide anterior decompression of the spinal cord and complete unilateral nerve root decompression preserving spinal stability and physiological spinal motion. (Source: Surgical Neurology)
Source: Surgical Neurology - July 15, 2009 Category: Neurosurgery Authors: Salvatore Chibbaro, Giuseppe Mirone, Damian Bresson, Bernard George Tags: Techique Source Type: journals

Isn't it time for us to “give something back?”Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Have you ever experienced reaching that point in life where you have begun to feel that with all of the benefits that have come your way, you should “give something back”? It may not happen to many of us, but it did happen to Dr Tom Flynn, a very successful neurosurgeon from Baton Rouge, LA, and it changed his life! (Source: Surgical Neurology)
Source: Surgical Neurology - July 14, 2009 Category: Neurosurgery Authors: Mel Cheatham Tags: Editorial Source Type: journals

Complications of posterior cranial fossa surgery—an institutional experience of 500 patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Posterior fossa surgery involves greater morbidity and mortality and has a wider variety of complications than surgery in the supratentorial compartment. These complications may be avoided by careful perioperative planning, strict adherence to aseptic technique, meticulous microsurgical dissection, proper wound closure, and the judicious use of prophylactic agent. A thorough understanding of the patient's history, neurological findings, imaging studies, operative anatomy, as well as all potential adverse events associated with the procedure is also essential to minimize complications. (Source: Surgical Neurology)
Source: Surgical Neurology - July 14, 2009 Category: Neurosurgery Authors: Arvind Dubey, Wen-Shan Sung, Mark Shaya, Ravish Patwardhan, Brian Willis, Donald Smith, Anil Nanda Tags: Technique Source Type: journals

Fully endoscopic transsphenoidal surgery for functioning pituitary adenomas: A retrospective comparison with traditional transsphenoidal microsurgery in the same institutionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: In our experience, fully endoscopic transsphenoidal surgery for functioning pituitary adenomas leads to a better endocrinologic outcome for noninvasive macroadenomas compared to the traditional microsurgical technique. However, morbidity with the endoscopic technique was higher in terms of the rate of postoperative CSF leaks. (Source: Surgical Neurology)
Source: Surgical Neurology - July 14, 2009 Category: Neurosurgery Authors: Jean D'Haens, Katrijn Van Rompaey, Tadeus Stadnik, Patrick Haentjens, Kris Poppe, Brigitte Velkeniers Tags: Pituitary Source Type: journals

Self-satisfaction: the lost piece of puzzleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I read with interest your recent editorial letter in Surgical Neurology under the title “If You Do Not Take Control of Your Life, Someone Else Will” (Surg Neurol 2009; 72:263-265) Unfortunately, I feel you are not familiar with the problems of physicians outside of the United States, and especially the troubles of doctors in developing countries. (Source: Surgical Neurology)
Source: Surgical Neurology - July 14, 2009 Category: Neurosurgery Authors: Payman Vahedi Tags: Letters to the Editor Source Type: journals

Response to the editorial “Why we misunderstand the young generations” by Dr James AusmanEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Like a ringing bell, the editorial “Why we misunderstand the younger generations” by Dr. James I. Ausman, along with 2 other articles recently published on the same topic , caught my attention. Many questions have been raised, and many brilliant solutions have been proposed to satisfy the minding of the younger generations, particularly mine among them. However, in my opinion, none of these solutions definitively fulfill the young generations' needs. (Source: Surgical Neurology)
Source: Surgical Neurology - June 26, 2009 Category: Neurosurgery Authors: Domenico Solari Tags: Letters to the Editor Source Type: journals

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I could not be in more agreement with the correct statements of Dr Kao, particularly regarding the 95° temperature used for radiofrequency lesions in the gasserian ganglion. It is possible that their equipment does not make accurate readings of temperature because temperatures of 40° to 50°, as they also claim to use, do not induce any lesion in vitro. Safe temperature in our hands, as Sigfried showed decades ago, are accomplished with 65°. The reason to keep the ganglion subjected to this temperature for more than 1 minute once the lesion is consolidated is not easy to understand. I noticed they used a curved electrod...
Source: Surgical Neurology - June 26, 2009 Category: Neurosurgery Authors: Eduardo A. Karol Tags: Letters to the Editor Source Type: journals

“Validity of percutaneous controlled radiofrequency thermocoagulation in the treatment of isolated third division trigeminal neuralgia” by Fraioli et alEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I read with interest the article entitled “Validity of percutaneous controlled radiofrequency thermocoagulation in the treatment of isolated third division trigeminal neuralgia” (Surg Neurol 2009;71:181-183) by Fraioli et al. The authors reported that the radiofrequency thermocoagulation technique is easy to perform with no mortality and low morbidity. In particular, it is immediately effective. They concluded that the technique is a precious therapeutic option, in comparison to other current treatments for trigeminal neuralgia. Based on my clinical experience, I deeply agree that the procedure is safe, simple, and imm...
Source: Surgical Neurology - June 26, 2009 Category: Neurosurgery Authors: Ming-Chien Kao Tags: Letters to the Editor Source Type: journals