Neurosurgery Fact of the day

One neurosurgery fact per day. Let's learn together!

[Spyros Karadimas MD PhD FRCSC FAANS @SpyrosKaradimas]

Foramen magnum-marginal sinus dural arteriovenous fistula presenting with brain stem edema and progressive myelopathy.
Skull base and cerebrovascular surgery-the inseparable twins (citing @jacquesmorcosmd). Far lateral approach provided the exposure needed for precise microsurgical disconnection of the fistula resulting in symptoms resolution. @MariaBederson @StanfordNsurg

[Colin Son, MD @txmedai]

https://t.co/A6LXLemZih

[Neurosurgery Fact of the day @NeurosurgeryOf]

@siemionowkris @MostlyMonkey This is for device innovation and not generalizable to the profession.

[Jason Sheehan @jasonpsheehan]

A wonderful read for young neurosurgeons

[Michael Galgano MD @MGalganoMD]

The literature has consistently supported that a retro odontoid pannus will regress over time with atlantoaxial fixation and fusion. On rare occasion, compressive cysts can accompany the pannus, leading to progressive myelopathy. The literature is not as clear in this setting regarding the timing of cyst regression after fusion. There are times when it is necessary to think outside the box in order to rapidly get the patient’s cord out of trouble, providing a direct & immediate decompression.

In this surgical video and manuscipt, we detail our posterior transdural approach for resecting a retro-odontoid cyst causing neurological decline.

Many thanks to Mark Shornak for his complementary illustrations.

https://t.co/egcJhB1UJq

@TheJNS
@AANSNeuro
@spinesection
@uncneuro
@unc_neurorads
@UNCneurosurgery

[Anil Makam @AnilMakam]

My latest for AAOx2

An illustrative example of a major undiscussed problem

[Lee Zhao @lee_c_zhao]

In 1980, DeBakey operated on the Shah of Iran. He declares success. Soon, the patient is dead. Reoperation is psychologically brutal: how bias delay truth & what might save us from the same trap. https://t.co/5nZdjJEcmA #MedTwitter #Surgery #MedEd

[Neurosurgery Fact of the day @NeurosurgeryOf]

@drs462 @DrDiGiorgio https://t.co/TIX2ENBy5R

[Tyler Olson, EA @olsonplanner]

I had a chance to review the reasoning and math shared by Arianna Konstantopoulous, @cchildersmd and @drdevirgilio

My thoughts below:

[Simone Peschillo, M.D., Ph.D. @S_Pesch]

And the award for the most interesting case at the Mortality Morbidity Neuroendovascular Meeting goes to…

Has anyone experienced something similar?

[Dr. Z Neurosurgery @DrZNeurosurgery]

I compiled this flow chart based on the most recent clinical guidelines for spinal trauma. It includes when to operate immediately, when it’s OK to observe, and some important ICU-level management regarding perfusion pressure and arterial pressure.

Clinical guidelines are very important for us to be able to have a uniform understanding of what’s considered a surgical emergency versus something that can be monitored. As of right now this is what the most recent data tells us.

[Michael Staudt @StaudtMD]

Great example of mesial temporal sclerosis following a temporal lobectomy. Atrophic and rubbery, but great cross sectional anatomy!

#epilepsy @CwruEpilepsy @UHCLENeurosurg @UHhospitals

[Neurosurgery Fact of the day @NeurosurgeryOf]

@STateshimaMD @S_Pesch @CarlosC74716941

[Neurosurgery Fact of the day @NeurosurgeryOf]

Recently tried the 7Fr radial balloon guide PATH catheter by Crossroads Neurovascular and encountered a radial loop. Radial loops are present in 1-2% of the population. They can be reduced, though often it is painful in the awake patient.

[Satoshi Tateshima, MD, DMSc @STateshimaMD]

SAH case with no aneurysm. The key? Not a positive finding - a negative one. After proper angling & longer injection, proximal PICA showed up. Distal portion occluded from dissection. Treated with PAO. Patient did well with partial Wallenberg. Always look for what's not there.

[Neurosurgery Fact of the day @NeurosurgeryOf]

@DutchRojas Maybe venous sinus stenting will join this trend soon

[Matt Bender @mtbendermd]

Diagnosing/localizing CSF leak is harder than treating. But transdural repair for ventral bone spur is beautiful, technical surgery

March 2025 @StrokeBern series showed no diff bw suture and patch, though I like both

@NeurosurgeryCNS PMID 39132996 @WouterSchievink @tdobrocky

[Jason Scott Hauptman MD PhD @jshauptman]

One of the hardest tumors I’ve tackled in a long time. 2 year-old male presents with vision loss and sleepiness. Biopsy shows adamantinomatous craniopharyngioma. Subfrontal approach. Encasing every major neurovascular structure of the skull base. Was able to take it back to the hypothalamus, the chiasm, and dissect off the nerves and vessels. Likely stage 2 transcallosal from the top needed. Thinking about toci/avastin. Thoughts? @PhxChildrens @BarrowNeuro

[Neurosurgery Fact of the day @NeurosurgeryOf]

@chenjared @cvsection @AANSNeuro @CNS_Update @StrokeAHA_ASA @UTHealthStroke @UTHNeuro @chenjared It would be interesting to know what the respondents did before ENRICH. ENRICH does not support evacuation of basal ganglia hemorrhages.

[Neurosurgery Fact of the day @NeurosurgeryOf]

@georgetolisjr I have been following @georgetolisjr posts for a while. Would very much enjoy listening to him on the nsgy podcSt @JPGK_MD