Artificial Intelligence and Neurosurgery: A Revolution in The Field

Artificial Intelligence (AI) is being used in the field of neurosurgery for improving patient outcomes, reducing the risk of complications, and increasing the efficiency of surgical procedures. AI algorithms can analyze patient data, plan surgical procedures, guide surgical instruments, monitor brain activity, and improve post-operative care. The benefits of incorporating AI into neurosurgical practice include pre-operative planning, intraoperative navigation, real-time monitoring, and post-operative care. AI is already being used in neurosurgery for image segmentation, surgical planning, intraoperative navigation, real-time monitoring, and predictive analytics. The potential applications of AI in neurosurgery include personalized medicine, virtual reality, robotic surgery, predictive analytics, and medical imaging. However, the challenges of incorporating AI into neurosurgical practice are data quality, data privacy and security, regulatory frameworks, and training and education. In short, AI has the potential to completely transform the discipline of neurosurgery, but there is a need to address the challenges associated with its incorporation into neurosurgical practice

An insight into artificial intelligence and its role in neurosurgery

To acquire a wide range of technical skills, neurosurgeons undergo extensive and drawn-out training. Additionally, neurosurgery necessitates a significant amount of preoperative, intraoperative, and postoperative clinical data collection, decision-making, care, and recovery. The significance of artificial intelligence in neurosurgery has significantly increased during the past ten years. The potential of artificial intelligence to improve diagnostic and prognostic outcomes in neurosurgery is quite promising. It is important to clinical therapy because it helps neurosurgeons make crucial decisions during surgical interventions to improve patient outcomes and it enhances their abilities to give patients the finest interventional and non-interventional care possible. Furthermore, the acquisition, processing, and storage of clinical and experimental data are all greatly influenced by artificial intelligence. Its application in neurosurgery can lower surgical care expenses and offer top-notch medical treatment to a larger population. This article examines the use of artificial intelligence in preoperative, intraoperative, and postoperative care for both interventional and non-interventional aspects of neurosurgery, including diagnosis, clinical decision-making, surgical operation, prognosis, data collection, and research in the field

Radiation exposure in spine surgeries: A review of risks, consequences, and prevention strategies

Radiation exposure is a significant concern in spine surgeries due to the extensive use of fluoroscopic imaging. This review aims to evaluate the risks, consequences, and prevention strategies associated with radiation exposure in spine surgeries. The risks of radiation exposure include potential biological damage to patients and surgical staff, such as skin burns, cataracts, and an increased risk of developing cancer. The consequences of radiation exposure can have long-term health implications and may result in substantial healthcare costs. To mitigate the risks, various prevention strategies are recommended. These include optimizing the use of fluoroscopy by adopting low-dose imaging techniques, minimizing the duration of exposure, and ensuring proper shielding of personnel. Additionally, the use of alternative imaging modalities, such as intraoperative three-dimensional (3D) navigation systems, can reduce reliance on fluoroscopy and subsequently decrease radiation exposure. Furthermore, implementing a culture of radiation safety through education, training, and awareness programs is crucial. This involves educating surgeons, nurses, and other healthcare professionals about the potential risks, proper use of equipment, and radiation protection measures. Strict adherence to radiation safety guidelines and continuous monitoring of radiation doses are essential to ensure the well-being of both patients and healthcare providers. In short, radiation exposure in spine surgeries poses significant risks and potential consequences. However, with the adoption of appropriate prevention strategies, such as optimizing imaging techniques, implementing alternative modalities, and fostering a culture of radiation safety, the potential risks can be mitigated. By prioritizing radiation safety, healthcare facilities can provide better outcomes for patients and minimize the long-term health implications associated with radiation exposure in spine surgeries

Global neurosurgery: the need of the hour for developing countries

Global neurosurgery is relatively a new sub-discipline of global surgery. It is an area of study, research, practice, and advocacy that focuses on enhancing health outcomes and promoting health equity for all individuals around the world who are afflicted by neurosurgical disorders or require neurosurgical care. Low- and middle-income countries (LMICs) around the world have not benefited from advances in neurosurgery; most have little or no neurosurgical capacity in their entire country. The need of the hour is that a global problem necessitates a global response with a common vision and objectives

Common peroneal neuroma in continuity with complete foot drop secondary to a bullet fragment injury: A case report demonstrating end-to-end nerve repair

Background. Common peroneal nerve (CPN) injuries are generally common but they are uncommon due to gunshot injuries and are associated with poor motor outcomes. Managing neuroma-in-continuity is still challenging because there are currently no accepted standards for deciding on the most effective course of treatment or estimating the time needed for repair. Treatment options for a neuroma-in-continuity include neurolysis, neuroma resection with interposition, end-to-side nerve grafting, and bypass grafting. Case presentation. A 40-year-old man presented with findings of complete right foot drop due to an 8-month-old firearm injury to his right distal thigh. Following baseline investigations, imaging, and anaesthesia fitness, he underwent surgical exploration under general anaesthesia. A neuroma-in-continuity was found in the CPN, resected, and an end-to-end nerve repair was performed. Along with the neuroma-in-continuity, a bullet fragment was also removed. The neurological status remained unchanged postoperatively. Conclusion. Regardless of the cause of the lesion, patients should be urged to seek surgical therapy if there is no spontaneous recovery within four months after the CPN injury. Sharp injuries and knee dislocations have a better chance of recovery than crush injuries and gunshot wounds

Delayed cerebrospinal fluid ascites following ventriculoperitoneal shunt: A case report with literature review

Background: Cerebrospinal fluid (CSF) ascites is an abnormal accumulation of CSF within the peritoneal cavity caused by the peritoneum's inability to absorb the CSF, following a ventriculoperitoneal (VP) shunt surgery. Excessive CSF production (e.g, choroid plexus papilloma and choroid plexus villous hypertrophy), high CSF protein secondary to chronic infection (e.g. tuberculosis), and brain tumours (e.g, optic gliomas and craniopharyngiomas) have all been suggested as contributing factors to the formation of CSF ascites. Peritoneal inflammation as a result of several shunt revisions or some non-specific inflammatory reaction to shunt material has also been explored. Case Presentation: A 3-year-old girl with lumbar myelomeningocele and delayed CSF ascites following VP shunt is reported. Therapeutic paracentesis was employed to relieve abdominal distension, although recurring accumulation was common. The VP shunt was removed and instead of a Ventriculo-atrial shunt, she underwent Endoscopic Third Ventriculostomy (ETV). CSF ascites gradually disappeared after ETV over a two-week period. Conclusions: Abdominal paracentesis to relieve ascites and conversion of a Ventriculoperitoneal shunt to a Ventriculo-atrial shunt are commonly used to treat CSF ascites, however Endoscopic Third Ventriculostomy, where feasible, is another alternative treatment that can be performed to treat this condition

Common peroneal neuroma in continuity with complete foot drop secondary to a bullet fragment injury

Background. Common peroneal nerve (CPN) injuries are generally common but they are uncommon due to gunshot injuries and are associated with poor motor outcomes. Managing neuroma-in-continuity is still challenging because there are currently no accepted standards for deciding on the most effective course of treatment or estimating the time needed for repair. Treatment options for a neuroma-in-continuity include neurolysis, neuroma resection with interposition, end-to-side nerve grafting, and bypass grafting. Case presentation. A 40-year-old man presented with findings of complete right foot drop due to an 8-month-old firearm injury to his right distal thigh. Following baseline investigations, imaging, and anaesthesia fitness, he underwent surgical exploration under general anaesthesia. A neuroma-in-continuity was found in the CPN, resected, and an end-to-end nerve repair was performed. Along with the neuroma-in-continuity, a bullet fragment was also removed. The neurological status remained unchanged postoperatively. Conclusion. Regardless of the cause of the lesion, patients should be urged to seek surgical therapy if there is no spontaneous recovery within four months after the CPN injury. Sharp injuries and knee dislocations have a better chance of recovery than crush injuries and gunshot wounds

Delayed diagnosis of hydrocephalus: Negligence of enlarging head in a child by parents

Abstract A 1‐year‐old girl presented with an overly enlarged head for 5 months. Negligence of parents regarding treatment for this enlarged head is concerning. Early treatment can avoid a lot of complications. Hydrocephalus secondary to aqueductal stenosis was diagnosed after a thorough history, examination, and investigations. Endoscopic third ventriculostomy was performed

Hyperostosis frontalis interna presenting as a forehead scar in a young male

Abstract Hyperostosis frontalis interna is a benign overgrowth of the inner table of the frontal bone. Exact etiology is unknown. The condition is often an incidental finding and requires no treatment unless there are neurological signs and symptoms

The efficacy of endoscopic endonasal duraplasty compared to transcranial duraplasty for post-traumatic CSF rhinorrhea in terms of CSF rhinorrhea recurrence and other complications

Objectives. To determine the efficacy of endoscopic endonasal dura repair versus transcranial dura repair for post-traumatic CSF rhinorrhoea in terms of CSF rhinorrhea recurrence and other complications. Materials and methods. A total of 92 patients (age 15-50 years, both genders) with an established diagnosis of CSF rhinorrhea following traumatic brain injury were enrolled in this prospective cohort study. Group A and Group B were formed from the patients. Group A received endoscopic endonasal duraplasty, while Group B received transcranial duraplasty. Recurrence of CSF rhinorrhea, as well as any other complications (meningitis, anosmia, hydrocephalus, and abscess), were noted and compared between the two groups one week, two weeks, and four weeks after the procedure. Results. In Group A, the mean age was 28.6 ± 9.9 SD years and in Group B it was 29.9 ± 8.6 SD years. In group A, there were 63% (n=29/46) patients who had age between 15-30 years and 37% (n=17/46) had age between 31-50 years. In group B, 52.2% (n=24/46) patients had age between 15-30 years and 47.8% (n=22/46) had age between 31-50 years. In group A, there were 82.6% (n=38/46) males and 17.4% (n=8/46) were females and in group B there were 87% (n=40/46) males and 13% (n=6/46) females. At one month follow-up, overall recurrence of rhinorrhea was observed in 17.4% (n=8/46) patients in Group A, while it was 41.3% (n=19/46) patients in Group B (P=0.012). On the other hand, overall complications were 8.7% (n=21/46) in Group A patients, while they were 45.7% (n=21/46) in Group B patients (P=0.001). Conclusions. During a one-month follow-up, patients who received endoscopic repair experienced fewer recurrences and other complications overall than patients who underwent transcranial duraplasty, and the difference was statistically significant. We advise conducting studies with a larger sample size and longer follow-up periods