SNI Digital Podcast

SUMMARY: Methods: The PRISMA extension for Scoping Reviews (PRISMA-ScR) was used as a reference to guide the search strategy. PubMed was the primary database used to search for articles about “Neurosurgery AND Europe AND (medical students OR undergraduate medical education)”.Results: 101 articles were returned in the PubMed search. 10 articles were identified as suitable to the scope of the review. Limited exposure to neurosurgery in the undergraduate medical curriculum was a common theme across articles. Conclusions: Exposure to neurosurgery through the undergraduate medical curriculum in Europe remains limited. Adopting a basic framework of didactic neurosurgery teaching as well as involvement in the operating theatre can boost interest and understanding. Conferences play a vital role in bridging the gap in the curriculum by improving access to neurosurgery and fostering better understanding of the field.

Some Audience Reactions

- The Irish data on clinical rotations was interesting and quite low. Would be good to see what the Scottish picture looks like alongside it.

- Conferences like this one really do make a difference. I picked neurosurgery after going to one as a third-year medical student.

- My university in the UK only has 2 weeks of neurology and neurosurgery combined

SUMMARY: Methods: The PRISMA extension for Scoping Reviews (PRISMA-ScR) was used as a reference to guide the search strategy. PubMed was the primary database used to search for articles about “Neurosurgery AND Europe AND (medical students OR undergraduate medical education)”.Results: 101 articles were returned in the PubMed search. 10 articles were identified as suitable to the scope of the review. Limited exposure to neurosurgery in the undergraduate medical curriculum was a common theme across articles. Conclusions: Exposure to neurosurgery through the undergraduate medical curriculum in Europe remains limited. Adopting a basic framework of didactic neurosurgery teaching as well as involvement in the operating theatre can boost interest and understanding. Conferences play a vital role in bridging the gap in the curriculum by improving access to neurosurgery and fostering better understanding of the field.

Some Audience Reactions

- The Irish data on clinical rotations was interesting and quite low. Would be good to see what the Scottish picture looks like alongside it.

- Conferences like this one really do make a difference. I picked neurosurgery after going to one as a third-year medical student.

- My university in the UK only has 2 weeks of neurology and neurosurgery combined

SUMMARY: Dr. Dennis Malkasian, Neurosurgeon, Anatomist and Molecular biologist reviews the Surgical Anatomy of the CP ANGLE for Neurosurgeons approaching this area for the treatment of tumors there. Approximately 10% of all brain tumors arise in that location in addition to vascular lesions, lipomas, cysts, etc. The addition of medullary and posterior fossa lesions makes this area important surgically. We have divided his total presentation, which is ~150 minutes, into three parts for easier viewing. He uses his own outstanding anatomical diagrams which you have not seen before to illustrate his total presentation.

Part 1 covers the Anatomy of the Extra-cranial approaches. (85 Minutes)

Part 2 is a detailed Discussion of the anatomy the CP Angle (56 minutes)

Part 3 is a discussion among Drs. Malkasian, Ausman, and Himstead on the Future of Neurosurgery by 2100 for the young neurosurgeon who wants to plan his future and “how to figure out how to provide value to the world and seek meaning and purpose in ones life” as Dr. Himstead says. (22 minutes ). (JIA)

SUMMARY: Cauda Equina Neuroendocrine tumours (CENETs), previously known as Cauda Equina Paragangliomas (PGLs), are extremely rare vascular tumours of the spine which are mostly benign, slow-growing and well-demarcated from the surrounding structures...We present the case of a man in his 50s with a clinical history of low back pain exacerbated at night and right-sided sciatica with an L4 radicular distribution. Magnetic Resonance Imaging (MRI) of the lumbar spine revealed an intradural mass at the upper level of L4 with strong homogeneous enhancement following gadolinium contrast administration. Conclusions: Though the rarity of these tumours prevents the establishment of strict guidelines for their diagnosis and treatment, reviewing the existing data can provide safe and effective ways of diagnosing and selecting the best treatment options for such patients. Continued reporting of new cases, given the scarcity of information, is of extreme importance to guide evidence-based medicine in the future.

Some Audience Reactions

- Genuinely interesting write-up of a rare case. Really liked the discussions generated by Professor Walters

- Important reminder that these tumours don’t always look like what you expect on imaging.

- The point about the 2022 reclassification is well made. A lot of clinicians still call these paragangliomas out of habit.

SUMMARY: " Pineal cysts (PCs) are frequently identified incidentally on neuroimaging, yet their clinical significance was thought to be benign. While most remain stable, concerns persist regarding their potential to cause obstructive hydrocephalus or other mass effects. This study aimed to describe the natural history of PCs in adults in the West of Scotland...A total of 598 patients with PCs were identified from 1,851 MRI scans (mean age: 37 years, ranged 29–49 years; 68.3% female). Follow-up imaging was available in 256 cases (42.9%, median follow-up: 38 months [8–134 months]). Most cysts remained stable; only 11.7% (30/256) showed size changes, with 56.7% decreasing...Conclusion: Pineal cysts are generally stable incidental findings. Larger cysts (>15 mm) may cause clinically significant effects, including hydrocephalus, migraines, and headache diagnoses. As there are no significant differences in maximal diameter across cyst sizes, this supports a benign natural cause.

Some Audience Reactions

- 598 patients is quite a large dataset. Probably one of the largest UK series I’ve seen on pineal cysts.

- We need to be aware that for a lot of these cysts, clinicians won’t refer or follow up

- The female predominance is interesting and matches what’s been hinted at in smaller series. Worth a follow-up paper on its own.

- Worth seeing the numbers on the correlation with headaches

SUMMARY: "Background: Research engagement amongst medical students tends to be minimal until it becomes a curricular requirement, and the specific barriers to early involvement remain unclear. The General Medical Council (GMC) highlights that new graduates should know how to contribute to research to deliver high-quality patient care. In line with this, our study aimed to identify barriers to neuroscience research engagement and evaluate the impact of a targeted webinar series on influencing student perspectives." "Methods: From September to December 2023, we delivered a four-part online webinar series to students across 20 universities worldwide" Conclusions: Following the four-part webinar series, students developed a stronger understanding of neuroscience research. These findings highlight the value of early, structured research exposure to enhance student research engagement.

Some Audience Reactions

- I’d love to bring this format to my own university. Happy to chat offline about how the structure worked.

- Good example of student-led intervention with measurable impact. Should be published as a short report in a medical education focused.

- The fact that you reached students across 20 universities is quite impressive on its own.

SUMMARY: This is Part 2 of a  2-hour, uninterrupted SNI Digital® "Investigative Report" into the Covid-19 infection in an interview with Dr. Russell Blaylock. It covers the biology and low lethality of the man-made Covid-19  coronavirus. It reports the diseases caused by the mRNA "pseudo vaccine" which was rapidly produced, widely distributed, and mandated for use in response to 'the disease'. Learn the facts about the initial cover-up of this story. Learn about the limited research investigations behind the rapid release of the pseudo vaccines to the public, the weak scientific justification for the prevention measures, and their widespread social and economic consequences. Understand the long-term consequences of the limited pre-release research testing of these pseudo-vaccines and the false justification for the mandated  use of  this "pseudo-vaccine", which are all now being reported. Why were other early treatments intentionally suppressed? Why was the truth about these man-made diseases covered up, by whom, and for what purpose? What are the scientific facts behind the wide spread requirements for masks, social distancing, and isolation at home? Why were the case rates exaggerated by the PCR testing, which has been shown to have no real clinical value of a disease that is present. What long term complications are now being seen related to the mRNA pseudo-vaccine, which is incorporated into the cellular metabolism and DNA, leading to the continuous manufacture of "Spike proteins" for the foreseeable future in humans? What are the treatments for the diseases produced? The factual answers to these questions are answered in this video and thoroughly documented by references from the literature mentioned at the end of this report. Additionally, hundreds of other scientific references are available from SNI Digital® on request. Why do physicians and the public know so little about these facts?

This is a story of the desire of a segment of the population for Money and Power to establish Central Control over Individual Liberty, fought between different classes of the population. It is a story which has occurred repeatedly in past centuries in multiple civilizations throughout the history of mankind. (read: "The Lessons of History" -Chapter 10  Government and History.  Will and Ariel  Durant; Simon and Schuster; available at amazon.com or other booksellers). 

We hope you enjoy this report. SNI Digital investigates the facts; you decide.

SUMMARY: The Technocrats believe that all humans and social problems will be solved with Technology which will also control humans genetically by transhumanism. Is this true?  Have you been confused by the following crises, recently? What does  the Global Energy Crisis, War in Ukraine, Global Food Crisis, Dutch Farmers' strike, Canada's Truckers' strike, Global Debt and Banking Crisis, Government Cryptocurrency,  Covid 19 Crisis, Control of the Media have in common?  These were all attacks on the population driven by fear to produce conformity and destroy democratic governance. The end goal was to establish Technocracy to replace governing systems with a centrally controlled technology system and eventually rule over the people (Transhumanism).  The Technocrats, using propaganda and mind control tools,  justified  these crises by fake scientism.  The Media will not report it because technocracy controls the Media. So the public is mostly unaware of the real causes of these events. Patrick Cook and David Hughes, two world experts in Technocracy and Mind Control, outline their detailed research into these subjects. They explain the false science behind all these crises. It is well worth seeing or hearing.  See the discussion with Drs. Blaylock and Ausman to learn about these events and the dangers some are plotting to control your life and future. Sound unbelievable? Yes, until you hear the progress these technocrats have made on fulfilling their agenda. Further reading of their books will prove more details. This may be the most important video you will see about the Future. It is part of SNI Digital®'s  goals to expose you to information you may not have, to find the TRUTH. Yes, there are some crazy people in the world. The problem is to keep them from taking power from the people. Hear their suggestions to counter these trends.   70 minutes (JIA)  

SUMMARY: In another video in the SNI Digital® Controversies in Spine surgery series, Dr. Nancy Epstein, Editor in Chief of SNI,  experienced spine surgeon for 40 years; author of many papers on Spine Surgery, discusses the learning curves for TLIF, XLIF, OLIF, complications, and avoiding trouble. How many cases must be done to be skilled at these procedures? Is fellowship training required? Or can this be learned out of training? Can working with colleague or orthopedic surgeon in community be helpful? ; What to do if a complication occurs? Is intra-operative monitoring necessary? What if it is not available? What to do with in limited resource environments? Are the new advanced technologies essential? What is the evidence for their use?  Compared to what?  Who can afford it? What to do in your community? Are other procedures valuable?  Lecture 20 min; Discussion 25 min 

Enter Spine Surgery in Search  and click on the red magnifying glass to see  other spine videos; 102, 105 and 178 are very good.  More coming