Abstract:
OBJECT:There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating consequences. The authors systematically reviewed the application of simulation within neurosurgical training and explored the state of the art in simulation within this specialty. To their knowledge this is the first systematic review published on this topic to date. METHODS:The authors searched the Ovid MEDLINE, Embase, and PsycINFO databases and identified 4101 articles; 195 abstracts were screened by 2 authors for inclusion. The authors reviewed data on study population, study design and setting, outcome measures, key findings, and limitations. RESULTS:Twenty-eight articles formed the basis of this systematic review. Several different simulators are at the neurosurgeon's disposal, including those for ventriculostomy, neuroendoscopic procedures, and spinal surgery, with evidence for improved performance in a range of procedures. Feedback from participants has generally been favorable. However, study quality was found to be poor overall, with many studies hampered by nonrandomized design, presenting normal rather than abnormal anatomy, lack of control groups and long-term follow-up, poor study reporting, lack of evidence of improved simulator performance translating into clinical benefit, and poor reliability and validity evidence. The mean Medical Education Research Study Quality Instrument score of included studies was 9.21 ± 1.95 (± SD) out of a possible score of 18. CONCLUSIONS:The authors demonstrate qualitative and quantitative benefits of a range of neurosurgical simulators but find significant shortfalls in methodology and design. Future studies should seek to improve study design and reporting, and provide long-term follow-up data on simulated and ideally patient outcomes.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Kirkman MA,Ahmed M,Albert AF,Wilson MH,Nandi D,Sevdalis Ndoi
10.3171/2014.5.JNS131766subject
Has Abstractpub_date
2014-08-01 00:00:00pages
228-46issue
2eissn
0022-3085issn
1933-0693journal_volume
121pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:Direct brain compression and secondary injury due to increased intracranial pressure are believed to be the pathognomic causes of a grave outcome in acute subdural hemorrhage (aSDH). However, ischemic damage from aSDH has received limited attention. The authors hypothesized that cerebral microcirculation is a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS162579
更新日期:2018-10-01 00:00:00
abstract::Results of computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), xenon-133 measurement of cerebral blood flow (CBF), and neuropsychological assessments are described in three head-injured patients. The patients were selected because they presented with intracranial hemorrh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.5.0760
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:Endoscopic surgery is an effective treatment strategy for pituitary adenomas; however, intrinsic tumor properties such as tumor consistency can challenge or preclude gross-total resection. Preoperative characterization of tumor consistency may help to guide the surgical approach and to predict the extent of r...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2019.12.JNS192940
更新日期:2020-02-28 00:00:00
abstract::One hundred and thirty-three patients with chronic subdural hematoma were treated surgically between 1943 and 1980. The patients, aged 5 to 84 years, were graded retrospectively according to the Bender scale; 28% were in Grades 3 and 4. There were 107 unilateral and 26 bilateral hematomas. The clots were removed mostl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.61.2.0263
更新日期:1984-08-01 00:00:00
abstract::Experiments were carried out to compare the effectiveness of oncotic and osmotic therapy in dogs with experimental cerebral edema caused by a left parietal cold lesion. Animals were divided into five groups and treated for 6 hours with either crystalloid (control group), or mannitol, albumin, furosemide, or albumin/fu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.3.0481
更新日期:1984-03-01 00:00:00
abstract::Lower-extremity pain and paresthesia have multiple origins. Early recognition of the symptoms of peripheral nerve entrapment leads to timely treatment and avoids the cost of unnecessary studies. The authors report on a case of superficial peroneal nerve syndrome resulting from nerve herniation through a fascial defect...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2006.104.5.820
更新日期:2006-05-01 00:00:00
abstract::OBJECTIVE Meningioma consistency, firmness or softness as it relates to resectability, affects the difficulty of surgery and, to some degree, the extent of resection. Preoperative knowledge of tumor consistency would affect preoperative planning and instrumentation. Several methods of prediction have been proposed, bu...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.1.JNS152329
更新日期:2017-01-01 00:00:00
abstract::The authors report the successful staged stenting and coil embolization of a large vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm using the contralateral VA for access. A 67-year-old woman presented with a large ruptured VA-PICA aneurysm. Initial attempts to stent the wide-necked aneurysm fro...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/12/1214
更新日期:2007-12-01 00:00:00
abstract::The effect of concentrated conditioned medium from each of eight human malignant glioma cell lines on the growth of indicator cells (normal rat kidney fibroblasts (NRK), clone 14) was determined in monolayer and in soft agar assay systems. The conditioned medium from all cell lines was mitogenic in the monolayer assay...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.71.6.0875
更新日期:1989-12-01 00:00:00
abstract::The outcome following decompressive laminectomy and spinal irradiation has been evaluated in 104 consecutive patients with epidural metastatic neoplasia, using broad criteria for successful outcome. Of patients so treated, 33% were benefited, while 23% became worse. Both tumor histology and the preoperative neurologic...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.52.1.0047
更新日期:1980-01-01 00:00:00
abstract::The results of anterior cervical surgery for treatment of cervical spondylotic myelopathy (CSM) are assessed 1 to 7 years postoperatively in 32 patients. At follow-up review, 50% were improved after surgery and 50% were unimproved or had deteriorated in spite of surgery. The results could not be statistically linked t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.1.0012
更新日期:1980-07-01 00:00:00
abstract::The association between arteriovenous malformations (AVM's) and aneurysms is well documented in the literature. However, a specific type of aneurysm, termed a "pedicle" aneurysm, has received little attention despite its role as a primary source of hemorrhage. The authors report four recent cases of patients with cere...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.4.0631
更新日期:1994-04-01 00:00:00
abstract::The posterior spinal vein was occluded with silicone in seven rhesus monkeys, and locally resected in one. There were no neurological findings associated with acute venous obstruction of the cord. Follow-up arteriography revealed diversion of venous outflow into the anterior spinal venous system. Histology revealed gl...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.51.2.0201
更新日期:1979-08-01 00:00:00
abstract:OBJECT:The authors performed an analysis of retrospectively obtained data to compare the outcomes of pediatric patients admitted to their institution for traumatic injuries resulting from car, motorcycle, and all-terrain vehicle (ATV) accidents. METHODS:The authors conducted a retrospective review of Columbus Children...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2006.105.3.182
更新日期:2006-09-01 00:00:00
abstract::The treatment of the syndrome of chronic inappropriate antidiuretic hormone (ADH) secretion by fluid restriction is often attended by poor patient compliance. The following case report illustrates successful management of this condition by oral demeclocycline therapy in a patient who had hyponatremia in association wi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1977.47.6.0933
更新日期:1977-12-01 00:00:00
abstract:OBJECT:The authors conducted a study to determine age-related changes in expression of transforming growth factor (TGF)-beta1, -beta2, -beta3, and Type I and Type II receptors in various cells in the nucleus pulposus and anulus fibrosus. Immunolocalization of TGFbetas and Type I and II receptors was examined during the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.1.0063
更新日期:2003-01-01 00:00:00
abstract:OBJECT:It is known that the spinal cord can sustain traumatic injury without associated injury of the spinal column in some conditions, such as a flexible spinal column or preexisting narrowed spinal canal. The purpose of this study was to characterize the clinical features and to understand the mechanisms in cases of ...
journal_title:Journal of neurosurgery
pub_type: 评论,信件
doi:
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.5.JNS17642
更新日期:2018-10-01 00:00:00
abstract::Forty-seven patients with medulloblastoma were treated postoperatively with procarbazine, followed by craniospinal radiation therapy in combination with hydroxyurea. The radiation dose to the posterior fossa was 55 Gy; the spinal cord received 25 Gy and the whole brain 25 to 35 Gy (mean 33 Gy). Seventeen tumors recurr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.3.0383
更新日期:1988-03-01 00:00:00
abstract::OBJECTIVE Hyperperfusion syndrome (HPS) is a notable complication that causes various neurological symptoms after superficial temporal artery (STA)-middle cerebral artery (MCA) bypass surgery for moyamoya disease (MMD). The authors used intraoperative indocyanine green (ICG) videoangiography to measure the change in m...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.11.JNS162403
更新日期:2018-05-01 00:00:00
abstract::The syndrome of spontaneous intracranial hypotension is characterized by orthostatic headaches in conjunction with reduced cerebrospinal fluid (CSF) pressure or CSF volume, and characteristic magnetic resonance (MR) imaging findings. A 50-year-old man presented with a 1-year history of paroxysmal ataxia of gait and sh...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2003.98.4.0903
更新日期:2003-04-01 00:00:00
abstract::Cerebral blood flow (CBF) was measured at different times during the first 150 minutes following an experimental space-occupying lesion produced with a 50-microliter microballoon in rats. Local CBF was measured with the carbon-14-labeled iodoantipyrine quantitative autoradiographic technique. A region of local ischemi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1987.67.5.0732
更新日期:1987-11-01 00:00:00
abstract::W. James Gardner, a skillful neurosurgeon and inventor, is best remembered for his cervical tongs and hydrodynamic theory of syringomyelia. A pioneer of modern neurosurgery, Gardner trained under Charles Frazier in Philadelphia, and in 1929 he moved to Ohio where he became chief of neurosurgery at the Cleveland Clinic...
journal_title:Journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.3171/jns.2004.100.5.0965
更新日期:2004-05-01 00:00:00
abstract:OBJECT:Chordomas and chondrosarcomas of the skull base are aggressive and locally destructive tumors with a high tendency for local progression despite treatment. The authors evaluated the effect of stereotactic radiosurgery (SRS) on local tumor control and survival. METHODS:Twenty-eight patients with histologically c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/10/0758
更新日期:2007-10-01 00:00:00
abstract::The authors describe the first reported case of post-craniotomy wound infection due to Pseudallescheria boydii. The patient was a 24-year-old man who sustained a direct blunt injury to the calvaria, resulting in a large subdural hematoma that was surgically evacuated. Subsequently, the surgical wound became infected w...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.64.1.0153
更新日期:1986-01-01 00:00:00
abstract::OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patient...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.1.JNS161778
更新日期:2018-04-01 00:00:00
abstract::Up to now, navigated transcranial magnetic stimulation (nTMS) has been used for motor mapping in the vicinity of rolandic brain lesions. Recently, nTMS has also been suggested to be useful in mapping human language areas. The authors describe the case of a left-handed patient with a left-side glioblastoma within the...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.9.JNS121053
更新日期:2013-01-01 00:00:00
abstract::Four cases of trigeminal neurinoma are reviewed with particular attention to clinical signs and symptoms, lumbar puncture, electroencephalogram, brain scan, plain skull and tomographic radiographs, and angiographic and pneumoencephalographic findings. Pneumoencephalography, with special tomographic projections to iden...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1976.45.5.0568
更新日期:1976-11-01 00:00:00
abstract::A case of congenital ventriculocisternostomy is reported. This infant presented with occipital meningocele. Conray ventriculography demonstrated a spontaneous ventriculocisternostomy and stenosis of the aqueduct. The case is discussed and pertinent literature reviewed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.54.1.0098
更新日期:1981-01-01 00:00:00
abstract:OBJECT:The nitric oxide system has been linked to the pathogenesis of aneurysmal subarachnoid hemorrhage (SAH). The authors performed a case-control study to investigate the association between SAH and common genetic variants within the endothelial nitric oxide synthase gene (NOS3). METHODS:Three hundred thirty-three ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.5.JNS131572
更新日期:2014-09-01 00:00:00