C ovid- 19 has become a global public health problem in recent months, and its impact on surgery, including neurosurgical procedures, has been detailed in several articles. 1 , 2 The deferral of elective surgery has been advocated by the majority of surgical or neurosurgical associations as well as governmental bodies. 3 , 4 Such cancellations were intended to create more room for COVID-19 patients and to concentrate the hospital’s limited resources (e.g., personal protective equipment [PPE] and healthcare workers) to manage the fast-growing number of COVID-19
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Handoyo Pramusinto, Daniel Agriva Tamba, Yoyok Subagio, Tommy J. Numberi, Bangun Pramujo, Franklin L. Sinanu, Gheanita Ariasthapuri, Haryo Bismantara, and Andreasta Meliala
Raymond Choi, Robert H. Andres, Gary K. Steinberg, and Raphael Guzman
studies on the mechanisms by which mild (33–36°C) and moderate (28–32°C) hypothermia protects the brain from ischemic damage. Here we review the scientific evidence behind the use of hypothermia as a method of attenuating ischemic damage, and the available clinical evidence for the use of intraoperative hypothermia in vascular neurosurgical procedures. We also suggest future studies for this controversial clinical modality. Scientific Evidence A better understanding of the mechanisms of cell death following cerebral ischemia has been necessary to appreciate the
Andrew P. Carlson, C. William Shuttleworth, Brittany Mead, Brittany Burlbaw, Mark Krasberg, and Howard Yonas
stroke with repeated CSD, 14 association with delayed cerebral ischemia (DCI) after subarachnoid hemorrhage, 7 progressive metabolic dysfunction with repeated events, 3 and association with worse clinical outcomes. 8 We recently hypothesized that CSD may occur during elective neurosurgical procedures based on physiological plausibility and an animal model of neurosurgical procedures. 4 Based on the observed deleterious effect of CSD after brain injury, we hypothesize that this may be a factor contributing to otherwise poorly explained surgery-related brain injury
Corinna C. Zygourakis, Seungwon Yoon, Victoria Valencia, Christy Boscardin, Christopher Moriates, Ralph Gonzales, and Michael T. Lawton
costs associated with opened but unused items (i.e., “waste”) across a range of neurosurgical procedures at our institution. Methods Data Collection We collected data from 58 adult neurosurgical cases at the University of California, San Francisco (UCSF), in August 2015. Cases were not consecutive, but rather reflected all cases that a single observer (S.Y.) could attend with nonoverlapping end times. For each case, patient demographics, procedure type, and case length (in minutes) were recorded. Surgeon name and years of training postresidency were also
Juergen Piek, Joachim Oertel, and Michael Robert Gaab
dissection in combination with conventional neurosurgical procedures. The intensity and quality of the waterjet dissection, as well as the instrument's usefulness, handling aspects, and ability to preserve blood vessels were noted directly after each procedure, along with the pressures used and complications encountered. Intraoperative blood loss and tendency toward edema formation were monitored. Follow-up review included clinical examination and postoperative MR studies. In six patients who were admitted for surgery to treat TLE, early postoperative MR imaging (within 8
Jack M. Haglin, Kent R. Richter, and Naresh P. Patel
and spinal neurosurgery for the year 2016 were determined ( Table 1 ). The Physician Fee Schedule Look-Up Tool from the CMS was queried for each of these CPT codes, as they are representative of the most commonly performed neurosurgical procedures ( https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PFSLookup/index.html?redirect=/PFSLookup ). The coinciding monetary data include Medicare reimbursement fees for more than 100 different centers across the United States from each year between 2000 and 2018. Pricing information for individual CPT codes was
D. W. Nitzan, B. Azaz, and S. Constantini
in all patients upon mouth opening, was demonstrated on protrusive movements in three (Cases 7, 10, and 11). The combination of limited maximum mouth opening and normal radiographic appearance of the temporomandibular joint following a transtemporal neurosurgical procedure is strongly suggestive of temporalis muscle shortening which prevents the free rotation of the coronoid process ( Fig. 1 ). Such shortening typically preserves the normal protrusive joint sliding movements since it does not require stretching of the temporalis muscle. In the two patients (Cases
Richard E. Balch
infections that developed in clean operative wounds. The nature of the various factors which may lead to infection were examined, and the incidence of infection was related to specific neurosurgical procedures. There are ample reports concerning the general surgical experience with this problem; however, neurosurgical reports are less abundant. Woodhall, et al. , 12 reported their experience with 42 infections in 3,019 operations over a 10-year period. In addition, they summarized the reported experience of Cairns, 3 Pennybacker, 10 and Penfield. 9 These rates
Nicolas W. Villelli, Rohit Das, Hong Yan, Wei Huff, Jian Zou, and Nicholas M. Barbaro
measured racial disparities of patients who undergo MIS; and an increase in discretionary surgeries compared with nondiscretionary operations. 4 , 6 , 8 Although 1 study included spinal surgery among all inpatient procedures, 4 to our knowledge, no study has analyzed the effect of this policy change on neurosurgical procedures as a whole. We compared data from Massachusetts before and after enactment of the Massachusetts reform to analyze changes in the number of neurosurgical procedures performed and the percentage performed on uninsured patients. Our goal is to
Benjamin J. Kuo, Joao Ricardo N. Vissoci, Joseph R. Egger, Emily R. Smith, Gerald A. Grant, Michael M. Haglund, and Henry E. Rice
Although NSQIP-Peds has numerous challenges unique to pediatric surgical outcomes, such as low mortality rates, differential clinical weighting of AEs, and the low volume of high-risk procedures, it provides an understanding of expected perioperative outcomes in children. 12 To date, analysis of pediatric surgical subspecialty outcomes has been limited. 16 Given the high morbidity following pediatric neurosurgical procedures, 2 a critical analysis in this field at the procedural class level may identify contributors to AEs and identify opportunities for neurosurgical
