Abstract:
:In March 2015, the Supreme Court's landmark ruling on the common law case of Montgomery vs Lanarkshire Health Board established the doctrine of informed patient consent, setting the legal standards that doctors should abide by. In this review, our primary aim has been to establish whether, despite the well-publicised implications of the ruling in the legal community, the medical profession has altered its practice. To do this, we reviewed the consenting methods applied by surgeons within our field of neurosurgery. We chose the rare, but disabling, material risk of prone spinal surgery: post-operative visual loss (POVL), as our tool for assessment. Departmental and national surveys both identified a common theme - the vast majority of doctors consenting patients for prone spinal surgery either do not consider POVL to be a serious material risk, or alternatively are not aware that current legal standards require them to ensure that patients are made aware of 'any' material risk involved in their treatment. In light of this finding, we discuss the legal implications of the Montgomery ruling, the current regulatory guidance available to support doctors, suggest some strategies to align clinical practice with the legal standards advocated by the ruling, and highlight some of the challenges surrounding the consent process given the legal framework in which we now practice.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Greenway F,Tulloch I,Laban Jdoi
10.1080/02688697.2018.1519111subject
Has Abstractpub_date
2018-12-01 00:00:00pages
604-609issue
6eissn
0268-8697issn
1360-046Xjournal_volume
32pub_type
杂志文章abstract::Twenty unselected pituitary adenomas have been examined for proliferative indices (PIs), and anterior pituitary hormone expression. All but two of the tumours were non-functional with proliferative indices from less than 0.1 to 0.5%. Two tumours were null cell adenomas with PIs less than 0.1 and 0.2%. The PIs of the t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699209002899
更新日期:1992-01-01 00:00:00
abstract::The aim of this investigation was to determine the prognostic value of coagulation abnormalities in a defined subset of patients with acute head injury. Prothrombin time, accelerated partial thromboplastin time (APTT), thrombin clotting time, fibrinogen assay, platelet count, fibrin degradation products (FDP) were ass...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699745880
更新日期:1997-10-01 00:00:00
abstract:OBJECT:To summarize our experience in treating veins during microvascular decompression (MVD) procedures for idiopathic trigeminal neuralgia (TN). METHODS:A total of 210 patients who underwent single MVD for idiopathic TN were retrospectively studied. The offending vessels were summarized. The treatment choices for ve...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1476674
更新日期:2018-10-01 00:00:00
abstract:AIM:To investigate inefficiencies during patients' stay in neurosurgical beds. METHODS:A prospective audit of neurosurgical inpatients was conducted over approximately 2 months. We recorded the causes and duration of inappropriate delays, defined as actions requiring more that 24 h from initiation until completion. R...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701649488
更新日期:2007-12-01 00:00:00
abstract:INTRODUCTION:Although neurosurgical surgical site infections (SSI) exert a devastating price on the postoperative course of patients in the developing countries, literature is sparse on the subject from these regions. METHODS:This study is an audit of post-craniotomy SSI in a sub-Sahara African academic neurosurgical ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1407746
更新日期:2018-04-01 00:00:00
abstract:AIM:The aim of this manuscript is to review the current state of knowledge regarding C-reactive protein (CRP) kinetics after standard neurosurgical procedures, and to determine the value of CRP as a screening test for early post-operative infectious complications as opposed to other more commonly used tests, and as a m...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.500408
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:The study aims to define the role and indication of surgical intervention in cases of malignant cerebral edema in consequence to cortical venous thrombosis (CVT). METHODS:A retrospective study of 13 patients who underwent decompressive craniectomies for malignant CVT is presented. All patients had supra-tent...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.578775
更新日期:2011-06-01 00:00:00
abstract::We report a large trigeminal neurinoma in an 18-month-old child involving the Gasserian ganglion and all three divisions in a plexiform pattern. The tumour in the ophthalmic division extended all the way to the supraorbital nerve. The child presented with proptosis which had been observed since she was 4 months of age...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409029629
更新日期:1994-01-01 00:00:00
abstract::Silver-Russell syndrome is a rare genetically heterogeneous disorder in which patients demonstrate intrauterine and postnatal growth retardation, triangular facies, excessive sweating during early childhood, late closure of the anterior fontanelle and skeletal asymmetry. An association with malignancy exists and only ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802044076
更新日期:2008-12-01 00:00:00
abstract::Attempts at radical excision of craniopharyngioma have been made increasingly possible by progress in neuroradiological imaging and the use of microscopic technique. Between 1977 and 1990, 50 patients of The National Hospital for Neurology and Neurosurgery, London, have undergone radical surgical excision of craniopha...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699109002877
更新日期:1991-01-01 00:00:00
abstract::There are two reported cases of ependymomas arising in the pituitary fossa; one in a human, the other in a horse. Both died during their stay in hospital. The case presented here is the first published case of a patient who is well 3 months after surgery. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/026886901750353764
更新日期:2001-06-01 00:00:00
abstract::We present a case of cervical intramedullary sarcoidosis. A 56 year old woman presented with progressive paraesthesia affecting the lower limbs. MRI revealed an intramedullar lesion from C4-C7. A laminectomy and subtotal resection was carried out for this presumed intramedullary tumour. Pathology revealed this to be a...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690400022920
更新日期:2004-12-01 00:00:00
abstract::We report our experience with five lesions exclusively involving the entire cavernous sinus in which an essentially extradural surgical approach was used. There were two cases of cavernous haemangioma, two cases of meningioma and one case of fungal granuloma. The dural cover of the superior orbital fissure, and mandib...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699746483
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:We aimed to compare quality of life (QoL) after surgical decompression of the thoracic outlet versus non-operative therapy in patients with neurogenic thoracic outlet syndrome (N-TOS). DESIGN AND METHODS:We retrospectively identified 46 patients, diagnosed with N-TOS between 1999 and 2008. Twenty-four opera...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.489656
更新日期:2010-10-01 00:00:00
abstract::Cavernous sinus meningiomas (CSM) are complex skull base lesions that, due to their particular anatomical location, render surgical management difficult. Their symptomatology is versatile, and the clinical outcome is difficult to predict. We present the case of a 57-year old female patient who experienced phantosmia -...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1834510
更新日期:2020-10-14 00:00:00
abstract::Subarachnoid hemorrhage with ruptured cerebral artery dissection caused by varicella zoster (VZ) vasculopathy is rare. We report a rare case of vertebral artery (VA) dissection induced by VZ virus, successfully treated with stent-assisted coil embolization and systemic anti viral medication, on six month follow-up cer...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2016.1187256
更新日期:2016-12-01 00:00:00
abstract::We describe the operative technique and our preliminary experience with use of the Renishaw neuromate(®) stereotactic robot to implant depth electrodes for investigation of focal epilepsy in the UK. Conventional electrocorticography involving a craniotomy and implantation of grids of electrodes directly onto the brain...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.798859
更新日期:2013-10-01 00:00:00
abstract::Objective: Mixed growth hormone (GH) and prolactin (PRL) secreting adenomas are the most common type of plurihormonal pituitary adenomas. We assessed the clinical presentations and impacts of transsphenoidal surgery (TS) on patients with mixed GH and PRL adenomas including surgical outcomes, complications, and prognos...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1713989
更新日期:2020-04-01 00:00:00
abstract::Fifty-six patients with low back pain and sciatica following radiological investigation were found to have abnormalities at multiple levels, more than one of which could be responsible for the clinical picture or at a single level, which correlated poorly with the clinical findings. Thirty-four patients had a diagnost...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699943709
更新日期:1999-06-01 00:00:00
abstract::Lymphocytic and granulocytic hypophysitis are rare pituitary masses. A series of five dealt with at a single centre is presented and discussed. Retrospective analysis of pathology records revealed the cases. Of pituitary mass lesions dealt with in this centre, 0.8% have the diagnosis. Five females presented, one pregn...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690120057664
更新日期:2001-06-01 00:00:00
abstract::The objective of the investigation was to document the clinical presentations of a group of patients with neurofibromatosis type two syndrome (NF2), and took the form of a retrospective case note review. The investigation took place in the tertiary referral skull base unit. The dominant presentation of patients with N...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690050004507
更新日期:2000-04-01 00:00:00
abstract::We present a case of recurrent vago-glossopharyngeal neuralgia after previous surgery, treated successfully with microvascular decompression using intra-operative neurophysiology monitoring. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2015.1039486
更新日期:2015-01-01 00:00:00
abstract::Despite advances in understanding, monitoring, and treatment, the outcome of patients with refractory brain oedema (RBE) remains poor. The concept of wide bone removal for treatment of RBE has been recognized since the nineteenth century. Bifrontal decompressive craniectomy (BDC) is performed as last resort treatment ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690802571094
更新日期:2009-02-01 00:00:00
abstract::Few data are available concerning the outcome of surgical removal of intracranial meningioma in elderly patients. Surgical criteria and prognostic factors are considerations in the decision as to whether neurosurgical removal should be attempted in elderly patients. The present study appears to be the first to examine...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690151127608
更新日期:2001-04-01 00:00:00
abstract::A true human tail is a rare occurrence and is defined as a caudal, vestigial, midline protrusion with skin covering connective tissue, muscle, vessels and nerves. We report a case of true human tail in a child, which is a very rare happening in humans. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688690902912933
更新日期:2009-12-01 00:00:00
abstract::Objective: Contralateral C7 nerve root transfer surgery has been successfully applied to rescue motor function of a hemiplegic upper extremity in patients with central neurological injury. This surgical technique is challenging, and limited anatomical space makes it difficult to manipulate tissues and may lead to high...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1552754
更新日期:2019-08-01 00:00:00
abstract::We describe the unique case of a 51-year-old lady who developed a contralateral lumbosacral plexopathy two days after a lumbar microdiscectomy. This is the first report to date of this complication occurring following this procedure. We review the literature regarding lumbosacral plexopathy and discuss the evidence ba...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1429568
更新日期:2020-08-01 00:00:00
abstract::In the first prospective comparison of 'scan-negative' (n=11) and 'scan-positive' (n=7) patients with cauda equina syndrome (CES) we found that Hoover's sign of functional leg weakness but not routine clinical features differentiated the two groups (p<0.02). This offers a new direction of study in this area, although ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.1003032
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Nowadays the endoscopic endonasal approach is increasingly being used to remove craniopharyngiomas, tuberculum sellae meningiomas and other presellar and parasellar lesions and its value in anterior skull base surgery is undisputed. Herein, we assess the relative advantages, disadvantages and feasibility of ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1480748
更新日期:2018-10-01 00:00:00
abstract::We report our experience with seven cases of endodermal cysts located anterior and anterolateral to the brainstem. The ages of the patients ranged from 10 to 35 years. There were three males and four females. The cysts had characteristic imaging features, and contained fluid having a 'greenish-yellow pus-like' hue and...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690500145704
更新日期:2005-04-01 00:00:00