Random Sample

We invite readers to participate in our Random Sample — a single-question survey based on timely neurosurgical topics that also are tied to the current issue of AANS Neurosurgeon. Cast your vote, and then view the results below. Be sure to revisit AANS Neurosurgeon for new Random Sample surveys in the near future. Send us your comments …

Should neurosurgeons from the developed world volunteer their services in the developing world?

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In the Loupe

This soundless video of surgery for a left central area tumor demonstrates cortical mapping of the patient’s motor area prior to resection. The patient is a 72-year-old woman with a remote history of colon cancer who presented with one month of dizziness and progressive right hemiparesis. In the immediate post-operative period, she was lethargic and had worsening of her hemiparesis. Her mental status improved in the subsequent several days. She was discharged on post-operative day six to acute rehabilitation. At follow-up one week later, her right hemiparesis had improved her pre-operative baseline. Final pathology is glioblastoma multiforme, and she is undergoing chemotherapy and radiatio... Read More...

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Departments

Does Charity End at Home?

In this edition of Editorial License, Michael Schulder, MD, FAANS, discusses what it means to be a humanitarian neurosurgeon.

The neurosurgeon as humanitarian: not the image one normally associates with the stereotypical type A, egotistical, instrument-throwing lunatic. (That is you, AANS member). Of course, we all know that this caricature is far from the truth. There are times when the demands of our profession elicit behaviors that many find narcissistic, but if we do so, it is usually in the service of our patients. And the idea that our clinical work is inherently humanitarian is a little too easy to make. We were drawn to this field because we thought it would be an interesting career that pays well (which it is). But many neurosurgeons spend at least some of their time in what can be considered humanitarian pursuits, whether it is taking care of patients pro bono, working abroad or helping our communities in completely non-neurosurgical ways.

Why, then, this issue of AANS Neurosurgeon? For one thing, the good works we do are not widely known. At a time when neurosurgeons and other physicians are struggling to maintain income and freedom to practice our craft, it is especially important that we highlight our humanitarian efforts to the larger world. Read More…

Inside Neurosurgeon

The AANS’ Commitment to Neurosurgery

In AANS President’s Perspective, Mitchel S. Berger, MD, FAANS, FACS, addresses the highlights of the AANS Annual Meeting and his year as AANS president.

As it usually does at this time of the year, my attention is turned to completing arrangements and preparing for the AANS Annual Scientific Meeting, which will take place April 27-May 1, 2013, in New Orleans. It is hard to believe my year as your president is coming to an end. I again want to thank all of you for giving me this once-in-a-lifetime opportunity to lead the American Association of Neurological Surgeons. One of the highlights for me has been getting to work with the phenomenal AANS staff, led by Mr. Tom Marshall. I have learned so much from Tom, and although I knew it before, I can tell all the members of the AANS that we are incredibly fortunate to have Tom and his staff run our great organization. A special thanks to Katie Orrico, who brilliantly orchestrates our advocacy efforts within the complex legislative environment of today. Along with Tom and Katie, I was lucky enough to work alongside an insightful group of AANS leaders on the Executive Committee — namely, Bill Couldwell, Bob Harbaugh, Alex Valadka and Rick Boop. Read More…

Peer-Reviewed Research

Identifying and Controlling High Medication Costs in the Neuroscience Intensive Care Unit

Joshua Eric Medow, MD, MS; and Carin Bouchard, PharmD, BCPS— Controlling costs is a necessity for economic stability in any health-care system. Health-care costs have continued to increase annually as the population of the U.S. ages and the prevalence of chronic conditions increases. From 1980 to 1990, total health-care expenditures in the U.S. rose from $253 billion to $714 billion. In 2009, total health-care expenditures surpassed $2.5 trillion in the U.S., which amounts to an average of $8,086 per person. In the hospital setting, spending increased 5.1 percent to $759 billion in 2009. Total health-care spending accounts for approximately 17.6 percent of the U.S. gross domestic product (GDP),  which is among the highest of industrialized nations (1, 3). To put it in a global perspective, hospital costs alone in the U.S. nearly equaled Read More…