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Receive news, Theory modules and updates from neurosurgical community!

The superior approach for managing ruptured intracranial aneurysms (endovascular or clipping) has long been the subject of debate in the neurosurgical literature.

In 2012, the first results from The Barrow Ruptured Aneurysm Trial (BRAT) were published. This study was a single-centre randomized trial with 471 patients in which treatment with clipping was compared to treatment with coil embolization.

In January 2018, Dr Spetzler and his team published in Journal of Neurosurgery a scientific study, where only the outcomes from those patients with saccular aneurysms were considered. This cohort made up the majority of the original sample (362 out of 471). Authors concluded that there was no statistical difference between the two different types of treatment, showed by the modified Rankin Scale outcomes at 10 years follow-up. There was a significantly increased rate of retreatment required in the coiling group, as well as higher obliterations in the clipping arm.

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Sunday, 29 April 2018 20:35

Prague Neurosurgical Week 2018

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Date: August 29 – September 2, 2018

Location: Prague, Czech Republic

This unique event is organized by the World Academy of Neurological Surgery, the
International Conference on Cerebrovascular Surgery and the International Meningioma Society, in partnership with many renowned institutions such as the WFNS and the EANS.

The week will start with the meeting of the World Academy of Neurological Surgery. On August 30th and September 1st there will be two main conferences focusing on cerebrovascular and meningioma, while on September 2nd the main topic will be skull base surgery. The week will finish with a two-day hands-on seminar on endoscopic neurosurgery organised by the WFNS Neurosurgical Anatomy Committee.

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Aneurysms are thought to arise from weak spots on a blood vessel wall, that leads to an outward bulging, likened to a bubble or balloon. They may be a result of a hereditary condition or an acquired disease. The securing of the aneurysm (which can be endovascular or open) may be undertaken prior to or after its rupture. Nowadays, it is still not entirely clear which is the best option of treatment for unruptured aneurysms. In this review, doctors Kelly D. Flemming and Giuseppe Lanzino elegantly discuss the best therapeutic approach to this kind of aneurysms.

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Author:
S. Kobayashi

Editor:
Thieme

Publication date:
May 2005

Description:
Neurosurgery of Complex Vascular Lesions and Tumors includes two different parts, focusing first on cerebrovascular diseases and then brain tumors.
In this book, eminent neurosurgeons from around the world expose personal clinical cases met during their previous experience, discussing the difficulty of the case and techniques used to negotiate these.
A short and concise book useful for all neurosurgeons in order to acquire a greater ability to manage particularly complex clinical cases.

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Tuesday, 17 April 2018 17:53

Treatment of Arteriovenous Malformation (AVM)

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Neil Martin, MD, is famous for his contribution to the development of the arteriovenous malformation (AVM) grading system (Spetzler-Martin classification). He spent several decades as chair of the UCLA Department of Neurosurgery and co-director of the UCLA Stroke Center. Since 2016 he has been nominated responsible of the Geisinger Neuroscience Institute.
This lecture addresses the management of AVM, a cluster of abnormal blood vessels within the brain which is congenital but not necessary hereditary.
Dr. Martin exposes the clinical manifestations, the diagnostic processes and the grading systems of the AVM. In particular he focuses on the treatment choices which are represented by: microsurgical technique, embolization and radiotherapy.

 

Sunday, 08 April 2018 12:11

Cochrane Neurological Sciences

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The Cochrane Neurological Sciences Field is part of Cochrane Review Groups. Its role is to help neurological Cochrane Review Groups (CRGs) in carrying out reviews in all areas of neurology and neurosurgery. Systematic reviews have the goal of providing the best estimate in terms of all relevant trials. The purpose is to give the best summary of evidence-based medicine in order to make the most appropriate individual treatment decisions.

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The authors of this article state that the average incidence of congenital hydrocephalus approaches 46.5 in 100,000 live births, highlighting the clinical relevance of the condition. In spite of this, investigations into the underlying genetic bases for this condition are lacking. Only 4 genes have previously been identified to play a significant role in the occurrence of congenital hydrocephalus. These are L1CAM and AP1S2 (X-linked) and CCDC88C and MPDZ (autosomal recessive). The aim of the present study was to establish the genetic aetiology of this condition.

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Dr. Ulrich Thomale from Charitè describes the role of navigated neuroendoscopy in pediatric hydrocephalus, especially for cases where the patient has presented with multiloculated hydrocephalus or trapped ventricles. Endoscopy has a particular value in this condition and in many cases could be used in shunting, decreasing the number of shunts or even replacing the shunt as a treatment option. In his lecture he presents many complex cases where advances in augmented reality has a tremendous impact also. The approach to children with hydrocephalus is beautifully outlined in his presentation. Neuroendoscopy is doubtless a highly valuable component of the neurosurgical arsenal in treating hydrocephalus.

 

Monday, 02 April 2018 07:02

Skull Base Techniques for Senior Residents

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To provide an enduring educational resource for neurosurgical residents and fellows, the American Association of Neurological Surgeons (AANS) and the Neurosurgery Research and Education Foundation (NREF) present a series of online courses: the AANS/NREF Resident Education Series. Recorded in March 2014, the Skull Base Course for Senior Residents is led by Course Director Jon H. Robertson, MD, FAANS, and presented by an expert faculty. This compilation of videos gives residents an insight into approaches to anterior, middle and posterior cranial fossae. Experts in the field present many surgical cases from their practice and give advice to future surgical generations.

Viktor’s Notessm is a free online source of educational materials created primarily for neurosurgery residents by Viktoras Palys, MD. The website includes different topics: neurosurgery, neurology, ophthalmology, otology and basic sciences. Every topic is organised in different sections (anatomy, physiology, epidemiology, pathophysiology, diagnosis and treatment) and there are hyperlinks to examine a subject. It is possible to download a PDF document for each topic, too. One of the most important features is the permanent update of references which makes this website a powerful way to stay updated.

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