Enhancing Surgical Education for Medical Students Through Virtual Reality: The Digital Surgical Operating Theatre Tour.

Objective: Although the operating theatre offers unique didactic opportunities, it can be perceived as an uncomfortable environment by medical students due to the lack of theatre etiquette, time pressure and parallel work of different disciplines. We investigated whether virtual reality (VR) training can significantly reduce some of these fears and improve surgical education for medical students.

Methods: We randomly divided a group of 24 medical students and investigated the effects of a VR application (digitally recreated operating theatre tour) and compared it with currently-in-use written instructions for operational tasks in the operating theatre.

Predicting the Response of Patients Treated with Lu-DOTATATE Using Single-photon Emission Computed Tomography-Computed Tomography Image-based Radiomics and Clinical Features.

Background: In this study, we want to evaluate the response to Lutetium-177 (Lu)-DOTATATE treatment in patients with neuroendocrine tumors (NETs) using single-photon emission computed tomography (SPECT) and computed tomography (CT), based on image-based radiomics and clinical features.

Methods: The total volume of tumor areas was segmented into 61 SPECT and 41 SPECT-CT images from 22 patients with NETs. A total of 871 radiomics and clinical features were extracted from the SPECT and SPECT-CT images.

Otogenic brain abscess and concomitant acute COVID 19 infection - case report and review of the literature.

Background: COVID-19 has attracted global attention primarily because of the severe acute respiratory symptoms associated with it. However, nearly one third of the patients also present with neurologic symptoms. This report describes a case of a previously healthy woman with acute COVID-19 infection, who developed acute facial nerve palsy and rapid progression to coma due to otogenic brain abscess.

Minimal Invasive Pre-Op CT-Guided Gold-Fiducials in Local Anesthesia for Easy Level Localization in Thoracic Spine Surgery.

The accurate identification of intraoperative levels is of paramount importance in spinal surgery, particularly in cases of obesity or anatomical anomalies affecting the thoracic spine. The aim of this work was to clarify whether the preoperative percutaneous placement of fiducial markers under local anesthesia only, with minimal discomfort to the patient, can be performed safely and efficiently. Patients treated at our institution between June 2019 and June 2020 for thoracic intraspinal lesions with preoperative percutaneous gold fiducial placement were analyzed.

Radiomics Analysis for Clinical Decision Support in 177Lu-DOTATATE Therapy of Metastatic Neuroendocrine Tumors using CT Images.

Background: Radiomics is the computation of quantitative image features extracted from medical imaging modalities to help clinical decision support systems, which could ultimately meliorate personalized management based on individual characteristics.

Objective: This study aimed to create a predictive model of response to peptide receptor radionuclide therapy (PRRT) using radiomics computed tomography (CT) images to decrease the dose for patients if they are not a candidate for treatment.

Material And Methods: In the current retrospective study, 34 patients with neuroendocrine tumors whose disease is clinically confirmed participated.

Return to Work Following Anterior Lumbar Interbody Fusion with Percutaneous Posterior Pedicle Fixation: A Retrospective Analysis from Two Academic Centers in Germany.

Return to work after spinal surgery is a crucial factor in the recovery process. It can contribute not only to physical rehabilitation but also to psychological well-being. This study aims to evaluate the rate of return to work following elective lumbar spine surgery and identify predictors that predict failure of return to work.

Cranioplasty after Decompressive Craniectomy (DC) in a Patient with Intracerebral Hemorrhage after SARS-CoV-2 Vaccination-Related Vaccine-Induced Thrombotic Thrombocytopenia (VITT)-Proposal of a Management Protocol for This Rare Pathological Condition.

The COVID-19 (coronavirus disease) pandemic had a severe impact on public health worldwide. A rare but serious complication after administration of adenoviral vaccines against SARS-CoV-2 (AstraZeneca-Oxford and Johnson & Johnson) is vaccine-induced immune thrombotic thrombocytopenia and thrombosis (VITT), which can lead to serious complications such as cerebral venous sinus thrombosis (CVST). CVST itself can cause subarachnoid hemorrhage (SAH) and/or intracerebral hemorrhage (ICH), leading to high mortality due to herniation of brain parenchyma.

A Pilot and Feasibility Study to Evaluate the Effectiveness of Tofacitinib Add-On Therapy to Remdesivir in Severely Ill COVID-19 Patients.

Aim: This placebo-controlled and randomized pilot study aimed to assess the feasibility and impact of tofacitinib/remdesivir combination therapy compared to remdesivir alone on clinical and laboratory findings of severely ill COVID-19 patients for future large-scale studies.

Method: Fifty patients were included in this study. They were randomly allocated into two groups of 25 subjects each.

Investigating the diagnostic and prognostic value of anti-SARS-CoV-2 Spike IgG/IgM ELISA tests in patients infected with coronavirus Delta variant.

Aim: This study aimed to investigate the diagnostic and prognostic value of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike IgG/IgM antibodies in patients infected with coronavirus Delta variant.

Methods: This analytical observational study included 270 unvaccinated patients (aged ≥18 years) diagnosed with coronavirus disease 2019 (COVID-19) Delta variant who referred to Emergency Department of our hospital. The serum levels of anti-SARS-CoV-2 Spike IgG and IgM were measured by indirect ELISA.

Functional Outcomes in Conservatively vs Surgically Treated Cerebellar Infarcts.

Importance: According to the current American Heart Association/American Stroke Association guidelines, decompressive surgery is indicated in patients with cerebellar infarcts that demonstrate severe cerebellar swelling. However, there is no universal definition of swelling and/or infarct volume(s) available to support a decision for surgery.

Objective: To evaluate functional outcomes in surgically compared with conservatively managed patients with cerebellar infarcts.

From the Oral Cavity to the Spine: Prevalence of Oral Cavity Infections in Patients with Pyogenic Spinal Infection.

Background incidence of pyogenic spinal infections has increased in recent years. In addition to treating the spinal infection, optimal care also includes identifying the source of the pyogenic spinal infection and the presence of other infections. The aim of this study is to elucidate the prevalence of oral cavity infection (OCI) within this patient cohort.

Leveraging artificial intelligence in neurosurgery-unveiling ChatGPT for neurosurgical discharge summaries and operative reports.

Purpose: Chat generative pre-trained transformer (GPT) is a novel large pre-trained natural language processing software that can enable scientific writing amongst a litany of other features. Given this, there is a growing interest in exploring the use of ChatGPT models as a modality to facilitate/assist in the provision of clinical care.

Methods: We investigated the time taken for the composition of neurosurgical discharge summaries and operative reports at a major University hospital.

Frailty in Traumatic Brain Injury-The Significance of Temporal Muscle Thickness.

Background: Temporal muscle thickness (TMT) on cranial CT scans has recently been identified as a prognostic imaging parameter for assessing a patient's baseline frailty. Here, we analyzed whether TMT correlates with Traumatic brain injury (TBI) severity and whether it can be used to predict outcome(s) after TBI.

Methods: We analyzed the radiological and clinical data sets of 193 patients with TBI who were admitted to our institution and correlated the radiological data with clinical outcomes after stratification for TMT.

Effectiveness of outpatient parenteral antimicrobial therapy (OPAT) for patients with cranial infection.

Objective: Outpatient parenteral antimicrobial therapy (OPAT) is a well-established and cost-effective method for improving the efficient use of healthcare resources. However, only a few centres in Germany perform it. Here we analysed OPAT for the treatment of patients with cranial infections in our neurosurgical department.

Frailty in cerebellar ischemic stroke-The significance of temporal muscle thickness.

While comprising only 2% of all ischemic strokes, cerebellar strokes are responsible for substantial morbidity and mortality due to their subtle initial presentation and the morbidity of posterior fossa swelling. Furthermore, low temporal muscle thickness (TMT) has recently been identified as a prognostic imaging parameter to assess patient frailty and outcome. We analyzed radiological and clinical data sets of 282 patients with cerebellar ischemic stroke.

Blood Clots May Compromise Intracranial Pressure Measurement Using Air-Pouch Intracranial Pressure Probes.

: Air-pouch balloon-assisted probes have proven to be both simple and reliable tools for intracranial pressure (ICP) monitoring. However, we experienced reproducible falsely high ICP measurements when the ICP probe was inserted into the intracerebral hematoma cavity. Thus, the aim of the experimental and translational study was to analyze the influence of ICP probe placement with regard to measured ICP values.

Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population.

Spinal tuberculosis is due to globalization no longer a disease limited to developing nations. It remains in Germany a rarity and still a difficult diagnosis. Here we analyzed patients with spinal tuberculosis treated at our neurosurgical department.

The Beneficial Effect of Preoperative Exercise on Postoperative Clinical Outcome, Quality of Life and Return to Work after Microsurgical Resection of Spinal Meningiomas.

Objective: While outcomes of surgical treatment for spinal meningiomas are well-described within the literature, factors affecting early return to work as well as long-term health related quality of life remain unclear.

Methods: In this retrospective study, patients with spinal meningioma and surgical treatment from two university-level neurosurgical institutions between 2008 and 2021 were analyzed. Time to return to work, physical activities and long-term health related quality of life (assessed by telephone interviews using the EQ-5D-5L health status measure and visual analogue scale (EQ VAS) were analyzed.

Safety and feasibility of outpatient parenteral antimicrobial therapy for patients with spinal infection.

Outpatient parenteral antimicrobial therapy (OPAT) is a cost-effective method of administering intravenous antimicrobial therapy. Although OPAT is well established in the UK and US healthcare systems, few centres in Europe perform it. Here we analysed OPAT for the treatment of patients with spinal infections at our institution.

Reappraisal of Intracerebral Hemorrhages and Intracerebral Hemorrhage Grading Scale Score in Surgically and Medically Managed Cerebellar Intracerebral Hemorrhage.

Background: As compared with supratentorial intracerebral hemorrhages (ICH), bleeds that occur within the cerebellum require special consideration given the nature of the posterior fossa.

Objective: To validate ICH and ICH grading scale (ICH-GS) scores in patients with cerebellar hemorrhage and examine the outcomes of patients managed surgically as compared with those who underwent conservative treatment.

Methods: This observational multicenter study included 475 patients with cerebellar hemorrhage from 9 different neurosurgical departments in Germany between 2005 and 2021.

Significance of Temporal Muscle Thickness in Chronic Subdural Hematoma.

Background: Reduced temporal muscle thickness (TMT) was verified as an independent negative prognostic parameter for outcome in brain tumor patients. Independent thereof, chronic subdural hematoma (CSDH) is a neurosurgical condition with high recurrence rates and unreliable risk models for poor outcome. Since sarcopenia was associated with poor outcome, we investigated the possible role of TMT and the clinical course of CSDH patients.