Increased population density of neurosurgeons associated with decreased risk of death from motor vehicle accidents in the United States.

Abstract:

OBJECT:Motor vehicle accidents (MVAs) are a leading cause of death and disability in young people. Given that a major cause of death from MVAs is traumatic brain injury, and neurosurgeons hold special expertise in this area relative to other members of a trauma team, the authors hypothesized that neurosurgeon population density would be related to reduced mortality from MVAs across US counties. METHODS:The Area Resource File (2009-2010), a national health resource information database, was retrospectively analyzed. The primary outcome variable was the 3-year (2004-2006) average in MVA deaths per million population for each county. The primary independent variable was the density of neurosurgeons per million population in the year 2006. Multiple regression analysis was performed, adjusting for population density of general practitioners, urbanicity of the county, and socioeconomic status of the county. RESULTS:The median number of annual MVA deaths per million population, in the 3141 counties analyzed, was 226 (interquartile range [IQR] 151-323). The median number of neurosurgeons per million population was 0 (IQR 0-0), while the median number of general practitioners per million population was 274 (IQR 175-410). Using an unadjusted analysis, each increase of 1 neurosurgeon per million population was associated with 1.90 fewer MVA deaths per million population (p < 0.001). On multivariate adjusted analysis, each increase of 1 neurosurgeon per million population was associated with 1.01 fewer MVA deaths per million population (p < 0.001), with a respective decrease in MVA deaths of 0.03 per million population for an increase in 1 general practitioner (p = 0.007). Rural location, persistent poverty, and low educational level were all associated with significant increases in the rate of MVA deaths. CONCLUSIONS:A higher population density of neurosurgeons is associated with a significant reduction in deaths from MVAs, a major cause of death nationally. This suggests that the availability of local neurosurgeons is an important factor in the overall likelihood of survival from an MVA, and therefore indicates the importance of promoting neurosurgical education and practice throughout the country.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Desai A,Bekelis K,Zhao W,Ball PA

doi

10.3171/2012.6.JNS111281

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

599-603

issue

3

eissn

0022-3085

issn

1933-0693

journal_volume

117

pub_type

杂志文章
  • Reversible occlusion of donor vessel caused by mouth opening after superficial temporal artery-middle cerebral artery anastomosis in adult moyamoya patients.

    abstract:OBJECT:The authors experienced an intriguing phenomenon in 2 adult patients with moyamoya disease. Mouth opening caused reversible occlusion of the donor superficial temporal artery (STA), and the patients exhibited transient cerebral ischemic symptoms. The aim of this study was to assess the incidence of such occlusio...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.10.JNS141805

    authors: Katsuta T,Abe H,Miki K,Inoue T

    更新日期:2015-09-01 00:00:00

  • Dynamic telescopic craniotomy: a cadaveric study of a novel device and technique.

    abstract::OBJECT The authors assessed the feasibility of the dynamic decompressive craniotomy technique using a novel cranial fixation plate with a telescopic component. Following a craniotomy in human cadaver skulls, the telescopic plates were placed to cover the bur holes. The plates allow constrained outward movement of the ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2015.6.JNS15706

    authors: Khanna R,Ferrara L

    更新日期:2016-09-01 00:00:00

  • Removal of broken pedicle screws. Technical note.

    abstract::The authors describe a simple, new method for removing broken pedicle screws. Under microscopic visualization a straight, narrow slot is etched in the broken surface of the pedicle screw by using a power drill with a 2-mm diamond burr. A minus screwdriver is then inserted into the slot, and the broken screw is rotated...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2001.95.1.0150

    authors: Miyamoto K,Shimizu K,Kouda K,Hosoe H

    更新日期:2001-07-01 00:00:00

  • Prediction of BRAF mutation status of craniopharyngioma using magnetic resonance imaging features.

    abstract::OBJECTIVE Treatment with a BRAF mutation inhibitor might shrink otherwise refractory craniopharyngiomas and is a promising preoperative treatment to facilitate tumor resection. The aim of this study was to investigate the noninvasive diagnosis of BRAF-mutated craniopharyngiomas based on MRI characteristics. METHODS Fi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.4.JNS163113

    authors: Yue Q,Yu Y,Shi Z,Wang Y,Zhu W,Du Z,Yao Z,Chen L,Mao Y

    更新日期:2018-07-01 00:00:00

  • Prediction of tolerance to carotid artery occlusion using transcranial Doppler ultrasound.

    abstract::Surgical sacrifice of the carotid artery is a frequently anticipated event during the treatment of certain aneurysms and tumors. The ability to predict tolerance to carotid artery occlusion is therefore of benefit when planning procedures in which the carotid artery is at risk. A trial of carotid artery occlusion usin...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1994.81.1.0015

    authors: Giller CA,Mathews D,Walker B,Purdy P,Roseland AM

    更新日期:1994-07-01 00:00:00

  • Penetration of the optic chiasm by a ruptured anterior communicating artery aneurysm. Case report.

    abstract::There are few reports of anterior communicating artery aneurysms causing visual symptoms, and penetration of the optic chiasm by such aneurysms has not been reported. A 40-year-old man presented with the abrupt onset of left homonymous hemianopsia, right visual acuity disturbance (finger counting), and slight headache...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1997.87.2.0324

    authors: Date I,Akioka T,Ohmoto T

    更新日期:1997-08-01 00:00:00

  • Consistency of interictal and ictal onset localization using magnetoencephalography in patients with partial epilepsy.

    abstract:OBJECT:The aim of this study was to evaluate the spatial accuracy of interictal magnetoencephalography (MEG) in localizing the primary epileptogenic focus in comparison with alternative MEG-derived estimates such as ictal onset recording or sensory mapping of the periphery where seizures manifest. METHODS:During this ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2003.98.4.0837

    authors: Tang L,Mantle M,Ferrari P,Schiffbauer H,Rowley HA,Barbaro NM,Berger MS,Roberts TP

    更新日期:2003-04-01 00:00:00

  • Nerve graft immunogenicity as a factor determining axonal regeneration in the rat.

    abstract::Acellular basal lamina grafts have recently been reported to support axonal regeneration and have been used in peripheral nerve repair. The present study was designed to determine the immunogenicity of such basal lamina allografts (grafts that are genetically different) and their potential as bridging material for ner...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1990.72.1.0114

    authors: Gulati AK,Cole GP

    更新日期:1990-01-01 00:00:00

  • Femoral nerve palsy secondary to traumatic pseudoaneurysm and iliacus hematoma.

    abstract::The authors report a case of traumatic femoral nerve palsy caused by a pseudoaneurysm of the iliolumbar artery and a iliacus muscle hematoma. This case report details not only the classic history and physical findings seen in patients such as this one, but also illustrates an unusual source of the hematoma and a discu...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2005.102.2.0382

    authors: Rochman AS,Vitarbo E,Levi AD

    更新日期:2005-02-01 00:00:00

  • Impact test comparisons of 20th and 21st century American football helmets.

    abstract:OBJECT:Concussion is the signature American football injury of the 21st century. Modern varsity helmets, as compared with vintage leather helmets, or "leatherheads," are widely believed to universally improve protection by reducing head impact doses and head injury risk for the 3 million young football players in the U...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2011.9.JNS111059

    authors: Bartsch A,Benzel E,Miele V,Prakash V

    更新日期:2012-01-01 00:00:00

  • Microvascular decompression for superior oblique myokymia: first experience. Case report.

    abstract::Superior oblique myokymia (SOM) is a rare eye movement disorder presenting as uniocular rotatory microtremor due to intermittent contractions of the superior oblique muscle. Medical treatment usually fails to provide long-term benefit for the patient and has considerable side effects. Surgical alternatives including t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1998.89.6.1020

    authors: Samii M,Rosahl SK,Carvalho GA,Krzizok T

    更新日期:1998-12-01 00:00:00

  • Lateral supracerebellar infratentorial approach for microsurgical resection of large midline pineal region tumors: techniques to expand the operative corridor.

    abstract::Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a lateral supracerebellar infratentorial approach that was...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2015.2.JNS142088

    authors: Kulwin C,Matsushima K,Malekpour M,Cohen-Gadol AA

    更新日期:2016-01-01 00:00:00

  • Comparison of clipping and coiling in elderly patients with unruptured cerebral aneurysms.

    abstract::OBJECTIVE The comparative effectiveness of the 2 treatment options-surgical clipping and endovascular coiling-for unruptured cerebral aneurysms remains an issue of debate and has not been studied in clinical trials. The authors investigated the association between treatment method for unruptured cerebral aneurysms and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.1.JNS152028

    authors: Bekelis K,Gottlieb DJ,Su Y,O'Malley AJ,Labropoulos N,Goodney P,Lawton MT,MacKenzie TA

    更新日期:2017-03-01 00:00:00

  • Anterior thoracic myelomeningocele presenting as a retromediastinal mass. Case report.

    abstract::Myelomeningocele presenting as a retromediastinal mass originating from the midline defect through the fused T-4, T-5, and T-6 VBs is described. An 11-year-old boy with a completely normal systemic and neurological examination suffering pulmonary problems such as effort dyspnea and severe kyphosis was evaluated and an...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2005.103.1.0079

    authors: Börcek AO,Ergün E,Emmez H,Kurt G,Dogulu F,Baykaner MK

    更新日期:2005-07-01 00:00:00

  • Choroid plexus carcinoma presenting as an intraparenchymal mass.

    abstract::A 6-year-old girl with a history of a nondisplaced skull fracture diagnosed with computerized tomography (CT) scanning 3 years previously presented with a 6-week history of headaches and decreased use of her right side. On admission CT scans, a large cystic mass was identified in the left frontal lobe region of the br...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/jns.2001.95.6.1040

    authors: Carter AB,Price DL Jr,Tucci KA,Lewis GK,Mewborne J,Singh HK

    更新日期:2001-12-01 00:00:00

  • Endonasal endoscopic transsphenoidal resection of intrinsic third ventricular craniopharyngioma: surgical results.

    abstract::OBJECTIVEIntrinsic third ventricular craniopharyngiomas (IVCs) have been reported by some authors to "pose the greatest surgical challenge" of all craniopharyngiomas (CPAs). A variety of open microsurgical approaches have historically been used for resection of these tumors. Despite increased utilization of the endosc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.5.JNS18198

    authors: Forbes JA,Ordóñez-Rubiano EG,Tomasiewicz HC,Banu MA,Younus I,Dobri GA,Phillips CD,Kacker A,Cisse B,Anand VK,Schwartz TH

    更新日期:2018-11-01 00:00:00

  • Outpatient brain tumor craniotomy under general anesthesia.

    abstract::OBJECTIVE Outpatient craniotomy has many advantages to the psychological and physical well-being of patients, as well as benefits to the health care system. Its efficacy and safety have been well demonstrated, but barriers to its widespread adoption remain. Among the challenges is a perception that its application is ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2015.11.JNS152151

    authors: Au K,Bharadwaj S,Venkatraghavan L,Bernstein M

    更新日期:2016-11-01 00:00:00

  • Clinical and electroneurographic evaluation of sensory/motor-differentiated nerve repair in the hand.

    abstract::In 17 patients acetylcholinesterase activity was used to differentiate between sensory and motor fascicles in median and ulnar nerve repair of the hand. Eleven patients received follow-up evaluation 1 to 11 years after surgery, and at that time clinical and electroneurographic examinations were performed to evaluate t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1993.78.5.0709

    authors: Deutinger M,Girsch W,Burggasser G,Windisch A,Mayr N,Freilinger G

    更新日期:1993-05-01 00:00:00

  • Longitudinal evaluation of corticospinal tract in patients with resected brainstem cavernous malformations using high-definition fiber tractography and diffusion connectometry analysis: preliminary experience.

    abstract:OBJECT:Brainstem cavernous malformations (CMs) are challenging due to a higher symptomatic hemorrhage rate and potential morbidity associated with their resection. The authors aimed to preoperatively define the relationship of CMs to the perilesional corticospinal tracts (CSTs) by obtaining qualitative and quantitative...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.12.JNS142169

    authors: Faraji AH,Abhinav K,Jarbo K,Yeh FC,Shin SS,Pathak S,Hirsch BE,Schneider W,Fernandez-Miranda JC,Friedlander RM

    更新日期:2015-11-01 00:00:00

  • Exosomes as a biomarker platform for detecting epidermal growth factor receptor-positive high-grade gliomas.

    abstract::OBJECTIVE High-grade glial brain tumors are often characterized by an elevated expression of the tumorigenic epidermal growth factor receptor variant III ( EGFRvIII). The authors sought to establish a clinically adaptive protocol as a noninvasive diagnostic tool for EGFRvIII detection through serum exosomes. METHODS P...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.11.JNS161187

    authors: Manda SV,Kataria Y,Tatireddy BR,Ramakrishnan B,Ratnam BG,Lath R,Ranjan A,Ray A

    更新日期:2018-04-01 00:00:00

  • Effects of ventricular entry on patient outcome during glioblastoma resection.

    abstract:OBJECTIVE:Tumor proximity to the ventricle and ventricular entry (VE) during surgery have both been associated with worse prognoses; however, the interaction between these two factors is poorly understood. Given the benefit of maximal tumor resection, it is imperative for surgical planning and technique to know if VE h...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2020.7.JNS201362

    authors: Young JS,Gogos AJ,Pereira MP,Morshed RA,Li J,Barkovich MJ,Hervey-Jumper SL,Berger MS

    更新日期:2021-01-08 00:00:00

  • Extracorporeal membrane oxygenation combined with endovascular embolization for management of neonatal high-output cardiac failure secondary to intracranial arteriovenous fistula. Case report.

    abstract::The authors describe a novel approach to the management of high-output heart failure secondary to an intracranial high-flow dural arteriovenous fistula (DAVF) by using extracorporeal membrane oxygenation (ECMO). To the best of the authors' knowledge, this represents the first report of an embolization performed in con...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2004.100.2.0197

    authors: Burry M,Reig AS,Beierle EA,Chen MK,Mericle RA

    更新日期:2004-02-01 00:00:00

  • Failure of temporal lobe resection for epilepsy in patients with mesial temporal sclerosis: results and treatment options.

    abstract:OBJECT:The purpose of this study was to identify the causes of failed temporal lobe resection in patients with mesial temporal sclerosis (MTS) and the role of repeat surgery for seizure control. METHODS:This is a retrospective study of 105 patients who underwent temporal lobe resection for MTS with unilateral electroe...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2009.1.JNS08638

    authors: Ramos E,Benbadis S,Vale FL

    更新日期:2009-06-01 00:00:00

  • Peroneal neuropathy following successful bariatric surgery. Case report and review of the literature.

    abstract::Peroneal neuropathy has been observed in starvation, anorexia, and other situations of extreme weight loss. The authors report a case in which sequential bilateral peroneal neuropathies developed after successful bariatric surgery resulting in a weight loss of 114 lbs over 12 months. The diagnosis was confirmed using ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2006.105.4.631

    authors: Elias WJ,Pouratian N,Oskouian RJ,Schirmer B,Burns T

    更新日期:2006-10-01 00:00:00

  • Disseminated intravascular coagulation following cranial trauma. Case report.

    abstract::Cranial and spinal trauma resulted in disseminated intravascular coagulation (DIC) in a 78-year-old man, causing widespread bleeding and incoagulable blood. Traumatized brain tissue was found in the lumina of dural venous sinuses. The mechanisms of DIC are reviewed. It is suggested that intravascular release of potent...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1980.52.2.0266

    authors: Clark JA,Finelli RE,Netsky MG

    更新日期:1980-02-01 00:00:00

  • Tuberculous brain abscess. Case report.

    abstract::An abscess was removed from the left occipital region in a 73-year-old woman with no previous history of tuberculosis. The patient later died from aspiration bronchopneumonia. Autopsy revealed a basilar tuberculous meningitis and miliary tuberculosis in the peritracheal lymphatic glands, the liver, the spleen, and in ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1980.52.3.0419

    authors: González PR,Herrero CV,Joachim GF,Ocaña CR,Sevilla GC,Loyzaga PG

    更新日期:1980-03-01 00:00:00

  • Origin of somatosensory evoked responses recorded from the cervical skin surface.

    abstract::Somatosensory evoked response from the cervical skin surface over the spine (the cervical SER) was recorded, and compared with the cord dorsum potential (CDP) simultaneously recorded from the posterior epidural space at the same segment. The cervical SER evoked by segmental nerve stimulation consisted of an initially ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1978.48.6.0980

    authors: Shimoji K,Shimizu H,Maruyama Y

    更新日期:1978-06-01 00:00:00

  • Regeneration of the transected rat sciatic nerve after suturing or adhesion with cyanoacrylate glue.

    abstract:OBJECT:Traditional treatment of transected peripheral nerves has been by suturing the nerve ends to each other. Because this approach is not widely available and is technically demanding, the authors evaluated an easier method for end-to-end anastomosis using cyanoacrylate-based glue. METHODS:The authors used a rat sc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2010.7.JNS091266

    authors: Roth J,Shtokman J,Shamir MH,Nissan M,Shchetinkov L,Trejo LL,Rochkind S

    更新日期:2011-01-01 00:00:00

  • Squamous cell carcinoma as a late complication of intracerebroventricular epidermoid cyst. Case report.

    abstract::Primary intracerebral squamous cell carcinoma is a rare sequela of benign cerebral epidermoid cysts. A case of presumed malignant transformation in a lateral ventricular epidermoid cyst is described, in which squamous cell carcinoma arose 33 years after the surgical resection of a benign epidermoid cyst. Three years a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1987.66.4.0618

    authors: Goldman SA,Gandy SE

    更新日期:1987-04-01 00:00:00

  • Somatosensory evoked potentials and neurological grades as predictors of outcome in acute spinal cord injury.

    abstract::An analysis of Motor Index score, pinprick sensory score, joint position sense score, somatosensory evoked potential (SSEP) grade in the ulnar (SSEPu) and posterior tibial (SSEPt) regions, and overall SSEP grade (mean SSEPu + t) was conducted in 36 patients with cervical spinal cord injuries to determine the relations...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1990.72.4.0600

    authors: Li C,Houlden DA,Rowed DW

    更新日期:1990-04-01 00:00:00