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Genetic Dysfunction Connected to Hydrocephalus Discovered
Hidden Variations in Neural Circuits May Explain Differences in TBI Outcomes
Biomarker Predicts Effectiveness of Brain Cancer Treatment
Study Compares Structures of Huntington’s Disease Protein
Brain Exercise and Warding off Cognitive Decline
Neurons, Brain Cancer Cells Require the Same Protein for Survival
No Anti-clotting Treatment Needed for Most Kids Undergoing Spine Surgeries
Study Finds Decrease in Incidence of Stroke, Subsequent Death
In the Loupe
As we highlight icons and innovations in neurosurgery in the May 2014 issue of AANS Neurosurgeon, we must make note of the work of Albert Rhoton Jr., MD, FAANS(L). His career as an educator and anatomist has been nothing short of iconic, and the recent launch of The Rhoton Collection is a fine example of innovation in neurosurgical innovation. This issue’s edition of “In the Loupe” features a short excerpt from Dr. Rhoton’s “Navigating the Ventricles.”
To view other videos of The Rhoton Collection, follow this link.
In this edition of Editorial License, Michael Schulder, MD, FAANS, discusses the evolution of neurosurgery through invention and innovation.
Heed the words of this article’s headline and perhaps the world — or at least people from industry, and maybe some neurosurgeons — will beat a path to your door. You can still be in mid-career and appreciate how neurosurgery has changed, thanks to the advances brought about by the ingenuity and hard work of colleagues, both iconic and not. In my first year of neurosurgical training, I was told by one of the chief residents that “if we operated the way Harvey Cushing did, we would be put in jail.” And that was 30 years ago — before stereotactic biopsy, endovascular neurosurgery, spinal instrumentation, ultrasonic aspiration and surgical navigation. Stereotactic radiosurgery (SRS) was limited to about three Gamma Knives around the world. Patients with head trauma were managed with steroids and dehydration. Meningiomas could be extirpated with a finger (I saw this!).
AANS President Robert E. Harbaugh, MD, FAANS, reflects on the origin of the Bovie cautery, and the collaboration between neurosurgery and industry then and today.
Despite their proximity, serendipity had a role to play in the interaction between Cushing and Bovie. Samuel Harvey, one of Cushing’s residents, related an occurrence at a medical convention where he and another of Cushing’s trainees were watching a diathermy machine desiccate and cut a piece of beef when Cushing approached them. (3, 4) The residents told Cushing he should use the machine on the brain, expecting a very negative response. However, Cushing stood still, remaining thoughtful for some time. Subsequently, knowing that Bovie was working on the use of electricity for medical applications, Cushing contacted him regarding the possibility of using Bovie’s device for operative hemostasis. Specifically, he solicited Bovie’s help in attempting to remove a brain tumor in a patient whose previous operation had to be aborted because of hemorrhage. Bovie agreed to bring his device to the Brigham operating room.
Michael S. Turner, MD, Kathy J. Flint, RN, MSN, Kenneth E. Davis, MS— Wound infections can be costly and debilitating for any patient with surgical implants. In the neurosurgical population, removal of the implant and involvement of CSF in the proximity of the implant can increase the risk of infection. Risks associated with environment, surgical technique and improper sterilization technique can contribute to the potential for a surgical site infection. The infecting organism in surgical site infections most often originates from the patient's skin (12, 16). Exposure of the incision to skin flora can be decreased by skin preparation and occlusive drapes.