Using a Hybrid Approach to Increase the Impact of Medical Response to Natural Disasters.

The United Nations (UN) established an umbrella of organizations to manage distinct clusters of humanitarian aid. The World Health Organization (WHO) oversees the health cluster, giving it responsibility for global, national, and local medical responses to natural disasters. However, this centralized structure insufficiently engages local players, impeding robust local implementation.

Three-Dimensional Modeling of Complex Pediatric Intracranial Aneurysmal Malformations With a Virtual Reality System.

Introduction: Surgical simulation is valuable in neurovascular surgery given the progressive rarity of these cases and their technical complexity, but its use has not been well described for pediatric vascular pathologies. We herein review the use of surgical simulation at our institution for complex pediatric aneurysmal malformations.

Methods: A retrospective review of patients treated for middle cerebral artery aneurysmal malformations with surgical simulation assistance (SuRgical Planner [SRP]; Surgical Theater, Mayfield Village, OH) during a 2-year period at Rady Children's Hospital of San Diego was performed.

Middle fossa approach for a pediatric facial nerve meningioma.

Pediatric cerebellopontine angle (CPA) meningiomas are extremely rare and are usually treated with a retrosigmoid surgical approach or radiation. The authors present the use of a middle fossa approach for the treatment of a symptomatic CPA meningioma in a 22-month-old female. The patient initially presented at 17 months with isolated progressive, long-standing right-sided facial weakness.

Keyhole Microsurgical Middle Fossa Arachnoid Cyst Fenestration: 2-Dimensional Operative Video.

Surgical options for symptomatic intracranial arachnoid cysts include cyst shunting and microscopic or endoscopic fenestration. We advocate a microsurgical keyhole approach for the durable fenestration of middle fossa arachnoid cysts, taking advantage of the superior magnification, depth perception, and illumination of the operating microscope, as well as the ability to use bimanual surgical technique and variable suction to ensure safe manipulation of arachnoid membranes and fenestration of these lesions into the deep cisterns. Key technical aspects of this approach demonstrated in this video (Video 1) include performance of a dime-sized temporal craniotomy; strict microsurgical technique with sharp dissection via a No.

Astrocyte-induced Reelin expression drives proliferation of Her2 breast cancer metastases.

Breast cancer metastasis to the brain develops after a clinical latency of years to even decades, suggesting that colonization of the brain is the most challenging step of the metastatic cascade. However, the underlying mechanisms used by breast cancer cells to successfully colonize the brain's microenvironment remain elusive. Reelin is an archetypal extracellular glycoprotein that regulates migration, proliferation, and lamination of neurons.