Application of virtual and mixed reality for 3D visualization in intracranial aneurysm surgery planning: a systematic review

BACKGROUND Precise preoperative anatomical visualization and understanding of an intracranial aneurysm (IA) are fundamental for surgical planning and increased intraoperative confidence. Application of virtual reality (VR) and mixed reality (MR), thus three-dimensional (3D) visualization of IAs could be significant in surgical planning. Authors provide an up-to-date overview of VR and MR applied to IA surgery, with specific focus on tailoring of the surgical treatment. METHODS A systematic analysis of the literature was performed in accordance with the PRISMA guidelines. Pubmed, and Embase were searched to identify studies reporting use of MR and VR 3D visualization in IA surgery during the last 25 years. Type and number of IAs, category of input scan, visualization techniques (screen, glasses or head set), inclusion of haptic feedback, tested population (residents, fellows, attending neurosurgeons), and aim of the study (surgical planning/rehearsal, neurosurgical training, methodological validation) were noted. RESULTS Twenty-eight studies were included. Eighteen studies (64.3%) applied VR, and 10 (35.7%) used MR. A positive impact on surgical planning was documented by 19 studies (67.9%): 17 studies (60.7%) chose the tailoring of the surgical approach as primary outcome of the analysis. A more precise anatomical visualization and understanding with VR and MR was endorsed by all included studies (100%). CONCLUSION Application of VR and MR to perioperative 3D visualization of IAs allowed an improved understanding of the patient-specific anatomy and surgical preparation. This review describes a tendency to utilize mostly VR-platforms, with the primary goals of a more accurate anatomical understanding, surgical planning and rehearsal

Myelography and the 20th Century Localization of Spinal Cord Lesions

In this article, we commemorate the centenary of myelography, a neuroradiological procedure that, despite certain disadvantages, significantly contributed to the diagnosis and localization of spinal cord lesions during the 20th century. From the start, the use of myelography was characterized by different views regarding the potential dangers associated with the prolonged exposure of a "foreign body" to the central nervous system. Such differences in attitude resulted in divergent myelography practices; its precise indications, technical performance, and adopted contrast material remaining subject to variability until the procedure were eventually replaced by MRI at the close of the 20th century

Brain Battles: Locating the History of Neurosurgery

This dissertation explores the history of neurosurgery from multiple perspectives – national and international, internalist and externalist, long-term and temporally-focused – thereby seeking to do justice to the diversity of authorial voices that characterize the historiography of this medical specialty. At a more fundamental level, the dissertation draws on the history of neurosurgery as a case study to analyze the historiographic divide between physicians and professional historians that characterizes the history of medicine more broadly. To accomplish this goal, this dissertation comprises three chronologically organized parts, each containing one chapter that conforms to the medical historiographic culture of physicians and one that conforms to the medical historiographic culture of professional historians. Together, the chapters paint a colorful picture of neurosurgery’s past while simultaneously exposing the profound historiographic schism that cleaves the history of medicine. Following the six chapters, the theme of the divergent medical historiographic cultures of physicians and professional historians will be revisited in the discussion. Here, the numerous medical-historiographic differences will be untangled based on a comparative analysis of two of the chapters of the dissertation and personal reflections on several revealing interactions with physicians and professional historians. The discussion will conclude with a series of recommendations to start bridging “the two cultures” in the history of medicine. These recommendations include the creation of common ground, fostering intellectual exchange, facilitating interdisciplinary education, and exploring innovative research methods and outreach strategies. As a whole, the dissertation seeks to address an audience of healthcare professionals and professional historians. While healthcare professionals may be naturally drawn to the technical chapters and professional historians to the more contextualized chapters, those who gravitate towards one half of the dissertation are invited to read the other half. The recommendations put forth in this dissertation are neither exhaustive nor final; others are invited to join the conversation and to contribute to a future history of medicine that is not only attentive to the greatest possible variety of voices from the past but also celebrates diversity among its own ranks in the common pursuit to reconstruct medicine’s multifaceted past to the benefit of humanity

Worth Their Salt:One Hundred Years of Hyperosmolar Therapy

In this article, we commemorate the centenary of the discovery and clinical implementation of hyperosmolar therapy for the treatment of increased intracranial pressure (ICP). Following the pioneering work of anatomists Weed and McKibben in 1919, the use of hypertonic solutions was soon adopted into clinical practice, even though the preferred hypertonic agent, route of administration, and ideas regarding the physiological mechanism by which it reduced ICP diverged. These divergent conceptions and practices have continued to surround the use of hyperosmolar therapy into present times

Recent Advances in Experimental Techniques for Flow and Mass Transfer Analyses in Thermal Separation Systems

Modelling flow and mass transfer of thermal separation equipment constitutes one of the most challenging tasks in fluids process engineering. The difficulty of this task comes from the multiscale multiphase flow phenomena in rather complex geometries. Both analysis of flow and mass transfer on different scales as well as validation of models and simulation results require advanced experimental and measurement techniques. As a follow-up to intensive discussions during the 2019 Tutzing Symposium “Separation Units 4.0” a wide set of available modern experimental technologies is presented. © 2020 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinhei