Surgical Neurology International最新文献

{"title":"Hands-on neuroendovascular practice for nonselective undergraduate medical students increases interest and aspirations in pursuing neurosurgery as a specialization","authors":"Yuhei Michiwaki, F. Yamane, Hiroshi Itokawa, Tatsuya Tanaka, K. Shimoji, Akira Matsuno","doi":"10.25259/sni_778_2023","DOIUrl":"https://doi.org/10.25259/sni_778_2023","url":null,"abstract":"\u0000\u0000The number of medical students aspiring to become neurosurgeons has decreased worldwide, mainly due to poor work-life balance among neurosurgeons; therefore, recruiting students for neurosurgery is essential to ensure the availability and appropriate quality of neurosurgical treatment. This study aimed to evaluate the efficacy of hands-on neuroendovascular practice for nonselective undergraduate medical students to determine whether this increases their interest in neurosurgery and contributes to their aspirations of becoming neurosurgeons.\u0000\u0000\u0000\u0000Hands-on neuroendovascular practice for mechanical thrombectomy was performed by undergraduate 5th-year medical students during their 2-week clinical rotation in the Department of neurosurgery at our university hospital between April 2021 and March 2023. After the neurosurgery practice, a questionnaire about their understanding of neurosurgery and aspirations for this specialization before and after the practice was anonymously completed by all students.\u0000\u0000\u0000\u0000Overall, 153 students completed the questionnaire. Of these, 140 (91.5 %) showed increased interest in neurosurgery after participating in the hands-on practice. Through this practice, the number of students who considered neurosurgery as their first choice or one of their specialty choices increased from 8 (5.2%) to 12 (7.8%) (P = 0.3534) and from 19 (12.4%) to 52 (34.0%) (P < 0.0001), respectively. Furthermore, the number of students with no aspiration to become neurosurgeons decreased from 95 (62.1%) to 43 (28.1%) (P < 0.0001).\u0000\u0000\u0000\u0000Hands-on neuroendovascular practice for nonselective undergraduate medical students effectively increased their interest in neurosurgery specialization and their desire to become neurosurgeons. Therefore, this practice can help recruit medical students for neurosurgery specialization.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"35 3‐4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138622130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral basal ganglia hemorrhage in a 2-year-old child","authors":"M. Alrawi, Muthanna N. Abdulqader, Hayder R. Salih, Saleh Abdulkareem Saleh, Mohammedbaqer Ali Al-Ghuraibawi, Mustafa M. Altaweel, M. Ismail, Samer S. Hoz","doi":"10.25259/sni_973_2022","DOIUrl":"https://doi.org/10.25259/sni_973_2022","url":null,"abstract":"\u0000\u0000Basal ganglia hemorrhage (BGH) is an intracerebral subtype of hemorrhage located in the caudate nucleus, putamen, globus pallidus, or adjacent structures such as the thalamus or internal capsule. Bilateral involvement of both basal ganglia is exceedingly infrequent. Herein, we report a case of a 2-year-old female who was discovered to have spontaneous bilateral BGH with a unique hemorrhagic extension.\u0000\u0000\u0000\u0000A 2-year-old female child who presented with a decreased level of consciousness, seizure, and fever was discovered to have bilateral BGH during imaging evaluation that extended from the head of the caudate to involve the putamen, globus pallidus, and anterior limb of the internal capsule.\u0000\u0000\u0000\u0000Bilateral BGH is extremely rare, and to the best of our knowledge, this is the first case report in pediatric age groups.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete tibial nerve lesion secondary to postoperative popliteal pseudoaneurysm following anterior cruciate ligament arthroscopic reconstruction: A series of two patients","authors":"Luana Caroline Miantti Ghellere Bonfim, Matthias E. Sporer, Laura Poeta, Gabriela Rezende R. Carvalho, J. Bertelli","doi":"10.25259/sni_570_2023","DOIUrl":"https://doi.org/10.25259/sni_570_2023","url":null,"abstract":"\u0000\u0000Complications following arthroscopic anterior cruciate ligament reconstruction (ACLR) are rare, but injuries to the popliteal artery can occur. Popliteal pseudoaneurysms are a potential complication and can cause significant morbidity if not diagnosed and treated promptly.\u0000\u0000\u0000\u0000We describe the cases of two patients who developed nerve injuries following arthroscopic ACLR, with subsequent diagnosis of a popliteal pseudoaneurysm. The peroneal nerve recovered spontaneously in both cases, while the tibial nerve was reconstructed using autologous nerve grafting. Satisfying, functional recoveries were observed 24 months postoperatively.\u0000\u0000\u0000\u0000Prompt diagnosis and effective treatment of popliteal pseudoaneurysms are crucial to prevent further complications. However, timely diagnosis can be challenging due to inconsistent clinical presentations and a low index of suspicion. This case report highlights the need for increased awareness of this uncommon complication and provides insights into its pathophysiological mechanisms.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138614232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral posterior fossa chronic subdural hematoma as a cause of hydrocephalus","authors":"D. Dlaka, P. Marčinković, M. Raguž, D. Romić, D. Orešković, D. Chudy","doi":"10.25259/sni_178_2023","DOIUrl":"https://doi.org/10.25259/sni_178_2023","url":null,"abstract":"\u0000\u0000Infratentorial chronic subdural hematoma (cSDH) is still a rather elusive neurosurgical entity, which, due to its proximity and likely compression of the cerebellum and brainstem, can lead to devastating consequences. To establish standardized treatment, more studies and reports regarding its therapy are needed. We report a case of a simultaneous unilateral supratentorial and bilateral infratentorial cSDH, with the latter causing hydrocephalus and successfully treated with a bilateral burr-hole trepanation of occipital bone and placement of subdural drains.\u0000\u0000\u0000\u0000A 71-year-old man with gait disturbance, Glasgow Coma Scale 12, and a radiologically verified unilateral supratentorial and bilateral cSDH of the posterior fossa causing cerebellum, brainstem, and fourth ventricle compression with obstructive hydrocephalus, underwent surgical evacuation of infratentorial hematoma with a bilateral burr-hole trepanation. The postoperative course was uneventful, with a control head computed tomography scan showing the resolution of the hematoma and hydrocephalus. The patient was discharged with no newly acquired neurological deficits.\u0000\u0000\u0000\u0000Due to a limited number of reports and studies involving infratentorial cSDHs causing hydrocephalus, decision-making and optimal surgical treatment remain unclear. We recommend a timely surgical evacuation of the hematoma if the patient is symptomatic while avoiding placement of external ventricular drainage.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"3 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of certain easily available biochemical markers in prognostication in severe traumatic brain injury requiring surgery","authors":"Ryosuke Tsuchiya, H. Ooigawa, Tatsuki Kimura, Shinya Tabata, Takuma Maeda, Hiroki Sato, Kaima Suzuki, Yasuhiro Ohara, Yoshitaka Ooya, Manabu Nemoto, Hiroki Kurita","doi":"10.25259/sni_544_2023","DOIUrl":"https://doi.org/10.25259/sni_544_2023","url":null,"abstract":"\u0000\u0000This study aimed to identify easily available prognostic factors in severe traumatic brain injury (TBI) patients undergoing craniotomy.\u0000\u0000\u0000\u0000We retrospectively analyzed the clinical characteristics (age, sex, Glasgow coma scale score, cause of TBI, and oral antithrombotic drug use), laboratory parameters (hemoglobin, sodium, C-reactive protein, D-dimer, activated partial thromboplastin time, prothrombin time-international normalized ratio, and glucose-potassium [GP] ratio), and neuroradiological findings of 132 patients who underwent craniotomy for severe TBI in our hospital between January 2015 and December 2021. The patients were divided into two groups: Those with fatal clinical outcomes and those with non-fatal clinical outcomes, and compared between the two groups.\u0000\u0000\u0000\u0000The patients comprised 79 (59.8%) male and 53 (40.2%) female patients. Their mean age was 67 ± 17 years (range, 16–94 years). Computed tomography revealed acute subdural hematoma in 108 (81.8%) patients, acute epidural hematoma in 31 (23.5%), traumatic brain contusion in 39 (29.5%), and traumatic subarachnoid hemorrhage in 62 (47.0%). All 132 patients underwent craniotomy, and 41 eventually died. There were significant differences in the D-dimer, GP ratio, and optic nerve sheath diameter between the groups (all P < 0.01). Multivariate logistic regression analysis showed elevated GP ratio and D-dimer were associated with the death group (P < 0.01, P < 0.01, respectively). A GP ratio of >42 was the optimal cutoff value for the prediction of a fatal outcome of TBI (sensitivity, 85.4%; specificity, 51.1%).\u0000\u0000\u0000\u0000The GP ratio and D-dimer were significantly associated with poor outcomes of TBI. A GP ratio of >42 could be a predictor of a fatal outcome of TBI.\u0000","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: LANGMAN'S medical embryology","authors":"S. A. Khonsary","doi":"10.25259/sni_629_2023","DOIUrl":"https://doi.org/10.25259/sni_629_2023","url":null,"abstract":"","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44637418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual-evoked potential predicts the efficacy of the optical canal decompression for traumatic optic nerve neuropathy showing blindness: A case report.","authors":"Yusuke Otsu, Satoru Komaki, Nobuyuki Takeshige, Kiyohiko Sakata, Motohiro Morioka","doi":"10.25259/SNI_450_2023","DOIUrl":"10.25259/SNI_450_2023","url":null,"abstract":"<p><strong>Background: </strong>The indication for surgical optic canal decompression (OCD) for traumatic optic neuropathy (TON) remains controversial because there is no reliable predictor of a good outcome. We report the case of a blind patient with TON whose remaining visual-evoked potential (VEP) suggested recovery potential of the injured optic nerve after OCD.</p><p><strong>Case description: </strong>A 48-year-old man had fallen from a height of 7 m, striking his head. He immediately complained of right-eye blindness. He had no light perception and the direct light reflex disappeared from the right pupil, although there was no fracture or traumatic lesion on computed tomography and magnetic resonance imaging. Because the amplitude of the VEP with the right eye stimulation remained unchanged, we performed the right OCD. During surgical OCD, the amplitude and latency of VEP began to improve. Finally, the visual field improved in almost all directions, and eyesight improved to 0.2.</p><p><strong>Conclusion: </strong>The retained VEP activity in TON may suggest the recovery potential of the injured optic nerve, even in cases of blindness. It is possible that VEP is an indicator of aggressive treatment for TON such as OCD.</p>","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"14 ","pages":"245"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/cd/SNI-14-245.PMC10408612.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9974102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in medicine and neuroscience: Through the prism of history, neurobiology, and bioethics","authors":"A. Bogart","doi":"10.25259/sni_444_2023","DOIUrl":"https://doi.org/10.25259/sni_444_2023","url":null,"abstract":"","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43298739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous closure of a superior sagittal sinus dural arteriovenous fistula with an extensive angioarchitectural network: A case report and systematic review of the literature.","authors":"Jasmina Kovacevic, Michael Alexander Silva, Henry Chang, Mynor Josue Mendez Valdez, Ian Ramsay, Uche C Ezeh, Andres M Corona, Ahmed Abdelsalam, Robert M Starke","doi":"10.25259/SNI_357_2023","DOIUrl":"10.25259/SNI_357_2023","url":null,"abstract":"<p><strong>Background: </strong>Intracranial dural arteriovenous fistulas (DAVFs) have been documented to occasionally spontaneously regress. However, the mechanism responsible for this occurrence remains speculative.</p><p><strong>Methods: </strong>We present a case of a Borden II - Cognard IIa+b DAVF involving the superior sagittal sinus (SSS) with bilateral external carotid artery supply that regressed spontaneously. A systematic literature review was conducted to explore the current theories explaining the spontaneous regression of DAVFs according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>A total of 26 studies and 54 cases were included in our results. Of the included cases, 57.14% of cases were Borden I, 16.33% were Borden II, and 26.53% were Borden III. Ruptured status or intracranial hemorrhage was documented in 24.1% of all cases, the majority of which (69.2%) were in cases with aggressive lesions (Borden II or greater). The most commonly involved location was the transverse sinus (38.89% of cases, <i>n</i> = 21), and the SSS was only involved in 12.96% of all cases. 50% of included cases proposed a mechanism responsible for spontaneous regression. The most frequently proposed mechanisms were thrombosis of the involved sinus/chronic inflammatory changes or direct endothelial injury, endoluminal stasis, and thrombogenic effects of contrast medium during angiography. We present the case of a 54-year-old woman with an aggressive ruptured DAVF that likely developed following a pediatric traumatic brain injury that was left untreated before she presented to our institution after significant delay. Her DAVF regressed on repeat angiography before neurovascular intervention without a clear identifying mechanism as proposed by the current literature.</p><p><strong>Conclusion: </strong>Our results suggest that spontaneous regression is not necessarily associated with lower risk DAVFs. The present case offers a unique long-term insight into the natural history of an aggressive ruptured DAVF of the SSS that regressed without intervention. Further research into the natural history of DAVFs will be helpful in deducing key factors leading to spontaneous regression.</p>","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"14 ","pages":"239"},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/44/SNI-14-239.PMC10408637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9976259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of unruptured intracranial aneurysms in ischemic stroke patients - A global meta-analysis.","authors":"Andres Felipe Herrera Ortiz, Enrico Stefano Suriano, Yasmin Eltawil, Manraj Sekhon, Anthony Gebran, Mateo Garland, Nury Tatiana Rincón Cuenca, Tatiana Cadavid, Bassel Almarie","doi":"10.25259/SNI_190_2023","DOIUrl":"10.25259/SNI_190_2023","url":null,"abstract":"<p><strong>Background: </strong>Unruptured intracranial aneurysms (UIAs) have an estimated global prevalence of 2.8% in the adult population; however, UIA was identified among more than 10% of ischemic stroke patients. Many epidemiological studies and reviews have pointed to the presence of UIA among patients with ischemic stroke; yet, the extent of this association is not fully known. We performed a systematic review and meta-analysis to determine the prevalence of UIA in patients admitted to hospitals with ischemic stroke and transient ischemic attack (TIA) at both global and continental levels and evaluate factors associated with UIA in this population.</p><p><strong>Methods: </strong>We identified, in five databases, all studies describing UIA in ischemic stroke and TIA patients between January 1, 2000, and December 20, 2021. Included studies were of observational and experimental design.</p><p><strong>Results: </strong>Our search yielded 3581 articles of which 23 were included, with a total of 25,420 patients. The pooled prevalence of UIA was 5% (95% confidence interval [CI] = 4-6%) with stratified results showing 6% (95% CI = 4-9%), 6% (95% CI = 5-7%), and 4% (95% CI = 2-5%) in North America, Asia, and Europe, respectively. Significant risk factors were large vessel occlusion (odds ratios [OR] = 1.22, 95% CI = 1.01-1.47) and hypertension (OR = 1.45, 95% CI = 1.24-1.69), while protective factors were male sex (OR = 0.60, 95% CI = 0.53-0.68) and diabetes (OR = 0.82, 95% CI = 0.72-0.95).</p><p><strong>Conclusion: </strong>The prevalence of UIA is notably higher in ischemic stroke patients than the general population. Physicians should be aware of common risk factors in stroke and aneurysm formation for appropriate prevention.</p>","PeriodicalId":38981,"journal":{"name":"Surgical Neurology International","volume":"14 ","pages":"222"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/e7/SNI-14-222.PMC10316137.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}