Circulating tumor DNA for malignant peripheral nerve sheath tumors in neurofibromatosis type 1.

The leading cause of early death in patients with neurofibromatosis type 1 (NF1) is malignant peripheral nerve sheath tumor (MPNST). The principles of management include early diagnosis, surgical clearance and close monitoring for tumor recurrence. Current methods for diagnosis, detection of residual disease and monitoring tumor burden are inadequate, as clinical and radiological features are non-specific for malignancy in patients with multiple tumors and lack the sensitivity to identify early evidence of malignant transformation or tumor recurrence.

Transcortical Approach to Deep-Seated Intraventricular and Intra-axial Tumors Using a Tubular Retractor System: A Technical Note and Review of the Literature.

Background:  Retraction of white matter overlying a brain lesion can be difficult without causing significant trauma especially when using traditional methods of bladed retractors. These conventional retractors can produce regions of focal pressure resulting in contusions and areas of infarct.

Methods:  In this article, we present a retrospective case series of six patients with deep-seated intraventricular and intra-axial tumors that were approached using a ViewSite Brain Access System (tubular retractor).

Cerebral aneurysms and accelerated atherosclerosis in Russell-Silver syndrome: a new subtype? Case report.

The authors describe the case of a 32-year-old woman known to have Russell-Silver syndrome who presented with repeated aneurysmal subarachnoid hemorrhage. Multiple intracranial aneurysms and advanced peripheral vascular disease were demonstrated. The authors postulate a link between these vascular features and the patient's genetic condition.

Minimally invasive neurosurgical access techniques to facilitate endovascular treatment of dural arteriovenous fistulae.

We report two cases of dural arteriovenous fistulae treated endovascularly, where percutaneous venous or arterial access was not suitable. In both cases, a different surgical access technique was used to allow transcranial cannulation of the appropriate venous sinus or of the varix to gain access and occlude the fistula.

Routine but risky: a multi-centre analysis of the outcomes of cranioplasty in the Northeast of England.

Background: Cranioplasty is undertaken as a routine secondary operation following craniectomy. At a time when decompressive craniectomy is being evaluated by several large trials, we aimed to evaluate the morbidity associated with cranioplasty and investigate its potential effect on outcome.

Methods: The outcomes of 166 patients undergoing cranioplasty at two centres in the United Kingdom between June 2006 and September 2011 were retrospectively analysed.

Has the impact of the working time regulations changed neurosurgical trainees' attitudes towards the European working time directive 5 years on?

We report the results from a survey of the British Neurosurgical Trainees' Association which aimed to assess current rota patterns and their compliance with the government's working time regulations. The survey questioned whether trainees felt that shift working, imposed as a result of the European working time directive, is continuing to impact on patient care and training opportunities in neurosurgery. The responses to this survey indicate that neurosurgical trainees remain concerned with the impact that the current working time regulations have on all facets of their work: training, work- life balance, and the provision of patient care.