Two-Stage Pulsatile Human Placenta Model for Microvascular Anastomosis Training in Neurosurgery.

Objective: The development of microsurgical skills is crucial for neurosurgical education. The human placenta is a promising model for practicing vascular anastomosis due to its similarities with brain vessels. We propose a 2-stage model for training in extracranial-to-intracranial anastomosis using the placenta.

Evaluation of konjac noodle as a microsurgery training model: learning curve analysis.

Background: classical models of microsurgical anastomosis training are expensive and have ethical implications. Some alternatives join low cost and easiness to store. However, the translation of knowledge acquired by training in these methods into the traditional ones is not clear.

An economic study of neuro-oncological patients in a large developing country: a cost analysis.

Background: Neuro-oncological patients require specialized medical care. However, the data on the costs incurred for such specialized care in developing countries are currently lacking. These data are relevant for international cooperation.

Awake craniotomy in brain tumors - Technique systematization and the state of the art.

The anesthesia for awake craniotomy (AC) is a consecrated anesthetic technique that has been perfected over the years. Initially used to map epileptic foci, it later became the standard technique for the removal of glial neoplasms in eloquent brain areas. We present an AC anesthesia technique consisting of three primordial times, called awake-asleep-awake, and their respective particularities, as well as delve into the anesthetic medications used.

Awake craniotomy for eloquent pial arteriovenous fistula: anesthetic and surgical consideration of a rare case.

Intracranial pial Arteriovenous Fistulas (AVFs) are rare cerebral vascular lesions composed of one or more arterial connections to a single venous channel. We report a 50-year-old patient with a ruptured pial AVF located in an eloquent area. Microsurgery for pial AVF occlusion was proposed with awake craniotomy for motor function and neurological evaluation.

Safety and Efficacy of 980nm Diode Laser for Brain Tumor Microsurgery-A Pioneer Case Series.

Background: Quality of life is essential for oncologic patients. Several tools are available to improve microsurgery and reduce morbidity. Diode laser is a precise and useful technology for microsurgery.

Superficial Temporal Artery-Middle Cerebral Artery Bypass Ex Vivo Hybrid Simulator: Face, Content, Construct, and Concurrent Validity.

Background: Cerebrovascular bypass surgical procedures require highly developed dexterity and refined bimanual technical skills. To attain such a level of prowess, neurosurgeons and residents have traditionally relied on "flat" models (without depth of field), such as chicken wings, live rats, silicone vessels, and other materials that stray far from the reality of the operating room, albeit more accessible. We have explored the use of a hybrid ex vivo simulator that takes advantage of the availability of placenta vessels and retains the complexity of surgery performed on a human skull to create a more realistic method for the development of cerebrovascular bypass surgical skills.

The Use of Osirix for Surgical Planning Using Cranial Measures and Region of Interest Tools: Technical Note.

Background: During the surgery for intrinsic brain lesions, it is important to plan the proper site of the craniotomy and to identify the relations with the gyri and superficial veins. This might be a challenge, especially in small subcortical lesions and when there is a distortion of the cortical anatomy.

Materials And Methods: Using the free computer software Osirix, we have created a 3-dimensional reconstruction of the head and cerebral showing the gyri and superficial veins.

An Affordable Stereomicroscope for Microsurgery Training with Fluorescence Mode.

Background: Laboratory training is a very important step on the development of the skills necessary for a neurosurgeon. This can be achieved using animal models and surgical microscopes or stereomicroscopes. Methods, like the use of fluorescein, increase the lifelike situation and allow anyone to assess the patency of an anastomosis and improve the quality of this training.

Quality Assurance During Brain Aneurysm Microsurgery-Operative Error Teaching.

Introduction: Quality assurance (QA) is a way to prevent mistakes in advance. Although it has been previously reported for surgical setup, there is no effective approach for minimizing microsurgical technical errors before an operation is done. Neurosurgery resident operative errors during brain aneurysm surgery could be foreseen by practicing in an ex vivo hybrid simulator with microscopic fluorescein vessel flow image.

Septum Pellucidum Cavernoma: A Case Report and Anatomical Consideration of an Extremely Rare Lesion.

Cavernous angiomas (cavernomas) are vascular malformations of the brain characterized by abnormal capillaries. Ventricular cavernomas are considered rare; however, an extremely unusual topography is the septum pellucidum, with only five reported cases in the English literature. These malformations may rupture and cause very large hematomas, leading to neurological impairment.

Cryptococcoma mimicking a brain tumor in an immunocompetent patient: case report of an extremely rare presentation.

Context: Central nervous system (CNS) infectious diseases have high prevalence in developing countries and their proper diagnosis and treatment are very important for public health planning. Cryptococcus neoformans is a fungus that may cause several CNS manifestations, especially in immunocompromised patients. Cryptococcal meningitis is the most common type of involvement.

Retroauricular pain caused by Eagle syndrome: A rare presentation due to compression by styloid process elongation.

Eagle syndrome is a rare condition presenting with retroauricular pain (usually as main symptom) associated with dysphagia, headache, neck pain on rotation and, much rarelier, stroke. This occurs due to styloid process elongation. Sometimes, there is also styloid ligament calcification, which can cause compression of nerves and arteries and the symptoms above.

Low-Cost Device for Fluorescein-Guided Surgery in Malignant Brain Tumor.

Background: Gross total resection for malignant brain neoplasms is challenging owing to the heterogeneity of these lesions and infiltration in eloquent areas. Gross total resection is a very important part of treatment of these patients and is a crucial prognostic factor. Fluorescence-guided surgery is an important tool that improves the rate of total resection.

Surgical treatment of neurocysticercosis. Retrospective cohort study and an illustrative case report.

Context And Objective:: Neurocysticercosis is prevalent in developing countries and manifests with several neurological signs and symptoms that may be fatal. The cysts may be parenchymal or extraparenchymal and therefore several signs and symptoms may occur. Depending on their location, neurosurgical procedures may be required, sometimes as emergencies.