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Your search keyword '"Patrick Grover"' showing total 3 results
Start Over Author "Patrick Grover" Topic neurosurgery
3 results on '"Patrick Grover"'

1. Benchtop simulation of the retrosigmoid approach: Validation of a surgical simulator and development of a task-specific outcome measure score

Author

Simon C. Williams, Razna Ahmed, Joseph Darlington Davids, Jonathan P. Funnell, John Gerrard Hanrahan, Hugo Layard Horsfall, William Muirhead, Federico Nicolosi, Lewis Thorne, Hani J. Marcus, and Patrick Grover

Subjects
Neurosurgery, Education, Model validation, Simulation training, Retrosigmoid craniotomy, Microvascular decompression, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Neurosurgical training is changing globally. Reduced working hours and training opportunities, increased patient safety expectations, and the impact of COVID-19 have reduced operative exposure. Benchtop simulators enable trainees to develop surgical skills in a controlled environment. We aim to validate a high-fidelity simulator model (RetrosigmoidBox, UpSurgeOn) for the retrosigmoid approach to the cerebellopontine angle (CPA). Methods: Novice and expert Neurosurgeons and Ear, Nose, and Throat surgeons performed a surgical task using the model – identification of the trigeminal nerve. Experts completed a post-task questionnaire examining face and content validity. Construct validity was assessed through scoring of operative videos employing Objective Structured Assessment of Technical Skills (OSATS) and a novel Task-Specific Outcome Measure score. Results: Fifteen novice and five expert participants were recruited. Forty percent of experts agreed or strongly agreed that the brain tissue looked real. Experts unanimously agreed that the RetrosigmoidBox was appropriate for teaching. Statistically significant differences were noted in task performance between novices and experts, demonstrating construct validity. Median total OSATS score was 14/25 (IQR 10–19) for novices and 22/25 (IQR 20–22) for experts (p

Published
2023
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2. Surgery for cerebral cavernous malformations: a systematic review and meta-analysis

Author

Patrick Grover, Neil Kitchen, Michiel H.F. Poorthuis, Rustam Al-Shahi Salman, and Lauren Harris

Subjects
Change over time, Adult, Male, medicine.medical_specialty, Hemangioma, Cavernous, Central Nervous System, Cochrane Library, Conservative Treatment, Cerebral cavernous malformations, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Neurological deficit, Cerebral Hemorrhage, business.industry, Incidence (epidemiology), General Medicine, Surgery, Meta-analysis, Female, Neurology (clinical), Neurosurgery, business, 030217 neurology & neurosurgery, Cohort study, Brain Stem
Abstract

We sought to quantify the risks of neurosurgical excision of cerebral cavernous malformations (CCMs) in a systematic review of cohort studies. We updated our previous systematic review by searching OVID Medline, OVID EMBASE, and the Cochrane Library from 1 January 2013 to 30 April 2019. The primary outcome was a composite of death attributed to CCM or surgery, non-fatal symptomatic intracerebral haemorrhage (ICH), or new or worsened persistent non-haemorrhagic focal neurological deficit (FND). We included 70 cohorts, 67 reporting surgery alone, and three compared surgery to conservative management. A total of 5,089 patients (median age 36 years, 52% female) underwent surgery (total follow-up 19,404 patient-years). The annual rate of the composite outcome was 4.2% (95% CI 2.9 to 5.7; 46 cohorts; I2 = 93%), which was higher in cohorts reporting exclusively brainstem CCM (6.0%, 95% CI 4.1–8.3; 25 cohorts, I2 = 92%) versus predominantly supratentorial CCM (2.4%, 95% CI 1.3–3.8, 21 cohorts, I2 = 86%, phet = 0.001). The annual rate of the composite outcome was higher in cohorts with > 95% presenting with ICH (6.1%, 95% CI 4.2–8.4; 23 cohorts, I2 = 93%) versus others (2.3%, 95% CI 1.2–3.7; 23 cohorts, I2 = 83%, phet = 0.001). The incidence of the composite outcome did not change over time in cohorts of exclusively brainstem CCM (p = 0.7) or predominantly supratentorial CCM (p = 0.5). The risk of death, ICH, or FND after CCM excision is ~ 4%. This risk is higher for brainstem CCM and CCM that have caused ICH but has not changed over time. This systematic review was registered (PROSPERO CRD42019131246).

Published
2020

3. The spectrum of traumatic injuries at the craniocervical junction: a review of imaging findings and management

Author

Thomas Campion, Ashok Adams, Hegoda Levansri Makalanda, Jonathan Bull, Juveria Siddiqui, and Patrick Grover

Subjects
medicine.medical_specialty, Injury control, Accident prevention, Poison control, Magnetic Resonance Imaging, Interventional, Radiography, Interventional, Neurosurgical Procedures, 030218 nuclear medicine & medical imaging, Neck Injuries, 03 medical and health sciences, 0302 clinical medicine, Injury prevention, medicine, Humans, Radiology, Nuclear Medicine and imaging, medicine.diagnostic_test, business.industry, Craniocervical junction, Magnetic Resonance Imaging, Spinal surgery, Surgery, Atlanto-Occipital Joint, Atlanto-Axial Joint, Angiography, Emergency Medicine, Cervical Vertebrae, Neurosurgery, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

The craniocervical junction is an area with unique biomechanical properties and injuries conferred often represent high-impact trauma. The vital structures traversing this region are susceptible to injury with frequent, only subtle findings identified on unenhanced CT, with MRI and CT angiography often revealing the full extent of injuries. This article reviews the osseous and ligamentous anatomy of the region and common injury patterns. Endovascular and neurosurgical management will also be discussed.

Published
2016

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