Neurosurgical training and education - General European certification is supported: Results of an EANS survey.

Introduction: Delivering high-quality Neurosurgical care is dependent on excellence in neurosurgical training. Across Europe requirements of these programs vary from state to state. This study aims to determine satisfaction with these programs and views towards a unified certifications process for Neurosurgical training.

Cartilage Defect Treatment Using High-Density Autologous Chondrocyte Implantation (HD-ACI).

Hyaline cartilage's inability to self-repair can lead to osteoarthritis and joint replacement. Various treatments, including cell therapy, have been developed for cartilage damage. Autologous chondrocyte implantation (ACI) is considered the best option for focal chondral lesions.

Patellar Tendon Structural Adaptations Occur during Pre-Season and First Competitive Cycle in Male Professional Handball Players.

Background: While there is evidence that tendon adapts to training load, structural alterations in the patellar tendon in response to training loads are still unclear. The aim of this study is to identify changes in patellar tendon structure throughout pre-season and after finalizing the first competitive cycle.

Methods: Nineteen professional handball players participated in the aforesaid cross-sectional study, in which patellar tendon scan and counter movement jump (CMJ) performance were conducted.

Clinical and radiographic characteristics of sacral arteriovenous fistulas: a multicenter experience.

Objective: Available data on management of sacral arteriovenous fistulas (sAVFs) are limited to individual case reports and small series. Management includes observation, endovascular embolization, or surgical ligation, with no clear guidelines on the optimal treatment modality. The authors' objective was to report their multiinstitutional experience with management of sAVF patients, including clinical and radiographic characteristics and postprocedural outcomes.

Coriocarcinoma de placenta metastásico en embarazo de 34 semanas. Revisión y manejo.

El coriocarcinoma es un tumor de la placenta agresivo y poco frecuente que forma parte de las denominadas enfermedades trofoblásticas gestacionales. Presentamos el caso de una mujer de 22 años nulípara que, en el transcurso del embarazo, en la semana 34, presenta metrorragia con hemoptisis de forma espontánea. Se realiza una tomografía computarizada en la que se aprecian nódulos compatibles con metástasis, catalogándose como posible coriocarcinoma metastásico.

Giant frontal sinus osteoma and its potential consequences: illustrative case.

Background: Osteomas of the paranasal sinuses are benign, slow-growing bone tumors that can cause a variety of clinical features depending on their size and location. Most osteomas are asymptomatic and located in the frontal sinus. In rare cases, they may grow to extend into the cranial or orbital cavities, resulting in atypical presentations.

Subacromial Impingment Syndrome does not alter muscle onset activation patterns during shoulder cardinal movement at different speed and load.

This study examines neuromuscular firing patterns in healthy and subjects diagnosed with SIS of the periscapular, prime-moving, and rotator cuff muscles during "clinical" cardinal plane physiological movements at different speeds and loads. EMG recordings were taken in 34 healthy and 34 subjects diagnosed with Subacromial Impingement Syndrome (SIS) of the prime movers, periscapular, and rotator cuff muscles during flexion, scaption, and abduction performed at fast, medium, and slow speeds with a loaded (3 kg) and unloaded arm. Differences in firing patterns between groups were analyzed by fitting mixed linear models with random intercepts per subject, and fixed factors for group, muscle, movement type, speed, and load.

Multiple Cranial Dural and Pial Arteriovenous Fistulas with Occlusion of All After Embolization of Primary Superior Sagittal Sinus Dural Fistula.

Background: We present a rare case of multiple intracranial arteriovenous fistulas (AVFs). A young female presented with headache and a left eyelid pulsatile swelling.

Case Description: Magnetic resonance imaging demonstrated numerous dilated cortical veins, along with a prominent left superior ophthalmic vein.

Rescue Maneuver for Dislocated Woven EndoBridge Device in Middle Cerebral Artery.

Background: Intrasaccular flow disruption has emerged as a useful modality for treatment of wide-necked saccular aneurysm at vessel bifurcations. The Woven EndoBridge (WEB) device is one such device that has been evaluated in several series with excellent safety and good midterm efficacy. Bailout techniques to retrieve or reposition a dislocated WEB device are sparse and associated with significant risks.

Minimal exposure maximal precision ventriculoperitoneal shunt: how I do it.

Background: Ventriculoperitoneal shunt is among the most frequent neurosurgical procedures, complicated by infection and obstruction. The first is influenced by number of skin incisions, catheter exposure and manipulation, and the latter by catheter position.

Method: Presenting our neuronavigated laparoscopic-assisted minimal exposure shunt technique performed on 40 consecutive adults.

High-Density Autologous Chondrocyte Implantation as Treatment for Ankle Osteochondral Defects.

Purpose: Two-year follow-up to assess efficacy and safety of high-density autologous chondrocyte implantation (HD-ACI) in patients with cartilage lesions in the ankle.

Design: Twenty-four consecutive patients with International Cartilage repair Society (ICRS) grade 3-4 cartilage lesions of the ankle were included. Five million chondrocytes per cm of lesion were implanted using a type I/III collagen membrane as a carrier and treatment effectiveness was assessed by evaluating pain with the visual analogue scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at baseline, 12-month, and 24-month follow-up, together with dorsal and plantar flexion.

Shoulder muscle onset timing during clinical assessment movements is the same in elite handball players as non-athletes: Implications for clinical assessment.

Objectives: This study examines neuromuscular firing patterns in overhead athletes and non-athletes of the periscapular, prime-moving, and rotator cuff muscles during "clinical" cardinal plane physiological movements.

Design: Cohort prospective study.

Setting: EMG recordings were taken of the periscapular, prime-moving, and rotator cuff muscles during flexion, scaption, and abduction performed at fast, medium, and slow speeds with a loaded (3 kg) and unloaded arm.

Respiratory symptoms are more common among short sleepers independent of obesity.

Introduction: Sleep length has been associated with obesity and various adverse health outcomes. The possible association of sleep length and respiratory symptoms has not been previously described. The aim of this study was to investigate the association between sleep length and respiratory symptoms and whether such an association existed independent of obesity.

Mastoid Epidermoid Tumor and Associated Dural Arteriovenous Fistula with Venous Sinus Occlusion.

Background: Dural arteriovenous fistula (DAVF) is an abnormal vascular connection between arterial and venous channels within dura mater. Although DAVFs have been linked to other types of intracranial tumors, this is the first case reporting the association between DAVF and an epidermoid tumor.

Case Description: A middle-aged patient with chronic headache presented with Borden type II DAVF draining into the right transverse sigmoid junction and was also found to have an epidermoid tumor over the right mastoid.

Measuring Cerebral Blood Flow in Moyamoya Angiopathy by Quantitative Magnetic Resonance Angiography Noninvasive Optimal Vessel Analysis.

Background: Moyamoya disease causes progressive occlusion of the supraclinoidal internal carotid artery, and middle, anterior, and less frequently the posterior cerebral arteries, carrying the risk of stroke. Blood flow is often partially reconstituted by compensatory moyamoya collaterals and sometimes the posterior circulation. Cerebral revascularization can further augment blood flow.

The Relationship Between Serum Neuron-Specific Enolase Levels and Severity of Bleeding and Functional Outcomes in Patients With Nontraumatic Subarachnoid Hemorrhage.

Background: The value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders.

Objective: To investigate the associations of serum NSE with severity of bleeding and functional outcomes in patients with subarachnoid hemorrhage (SAH).

Methods: We retrospectively reviewed the records of patients with SAH from June 2008 to June 2012.

Flow diversion for complex intracranial aneurysms in young children.

Pediatric intracranial aneurysms are exceedingly rare and account for less than 5% of all intracranial aneurysms. Open surgery to treat such aneurysms has been shown to be more durable than endovascular techniques, and durability of treatment is particularly important in the pediatric population. Over the past 2 decades, however, a marked shift in aneurysm treatment from open surgery toward endovascular procedures has occurred for adults.

Influence of body mass index and age on functional outcomes in patients with subarachnoid hemorrhage.

Background: Recent studies have highlighted the obesity paradox where patients with obesity have a greater chance of survival than patients with normal weight.

Objective: To investigate the association between body mass index (BMI) and age with severity of subarachnoid hemorrhage (SAH) and functional outcome.

Methods: We retrospectively reviewed the charts of 274 consecutive patients admitted with SAH between June 2008 and June 2012.

Retrograde trans-anterior communicating artery rescue of unopened Pipeline Embolization Device with balloon dilation: complication management.

As the use of the Pipeline Embolization Device (PED) for the treatment of complex intracranial aneurysms rises, knowledge about complications continues to accumulate amidt a paucity of reports on techniques and rescue strategies. We describe the case of a 70-year-old woman who presented with worsening reto-orbital left-sided pain and a large cavernous aneurysm. The patient underwent endovascular treatment with PED, and there was difficulty delivering the device due to significant vascular tortuosity.

Retrograde trans-anterior communicating artery rescue of unopened Pipeline Embolization Device with balloon dilation: complication management.

As the use of the Pipeline Embolization Device (PED) for the treatment of complex intracranial aneurysms rises, knowledge about complications continues to accumulate amidt a paucity of reports on techniques and rescue strategies. We describe the case of a 70-year-old woman who presented with worsening reto-orbital left-sided pain and a large cavernous aneurysm. The patient underwent endovascular treatment with PED, and there was difficulty delivering the device due to significant vascular tortuosity.

Nerve transfers from branches to the flexor carpi radialis and pronator teres to reconstruct the radial nerve.

Purpose: To present our method and results for transferring branches of the median nerve for radial nerve palsy or posterior cord lesions.

Methods: We transferred 1 branch to the pronator teres to the branch to the extensor carpi radialis longus muscle and transferred the branch to the flexor carpi radialis to the posterior interosseous nerve. We carried out these transfers in 6 patients with radial nerve palsy or posterior cord lesions.