SNI Digital Podcast

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• Exposure to Neurosurgery Among Undergraduate Medical Students in Europe: A Scoping Review; Tejas A. Sawant; 07.06.2026 24min

  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
• Exposure to Neurosurgery Among Undergraduate Medical Students in Europe: A Scoping Review; Tejas A. Sawant; 07.06.2026 23min

  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
• CP Angle: Extracranial Approaches; Dr. Dennis Malkasian; Part 1 07.06.2026 1h 25min

  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)
• Cauda Equina Neuroendocrine Tumour of the Filum Terminale: A Case Report and Summary of the Literature; Glasgow Neuro Meeting Video Abstracts; Theoklis Kouyialis; Christophoros Christophorou, Christina Oxinou, Demetris Fkiaras. 07.06.2026 24min

  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.
• Natural History of Pineal Cysts: A Retrospective Cohort Study; Yihui Cheng; Glasgow Neuro Meeting Video Abstracts; 2025-2026; Xin Y. Yap, Zahraa Dashti, Steven Tominey, Kevin Owusu-Agyemang, Edward J. St George. 07.06.2026 28min

  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
• The Impact of a Webinar Series on Student Perspectives to Neuroscience Research Barriers; Emilia Parsi, Alsadeg Bilal, Selnan Wuyep, Chandru Kaliaperumal; Glasgow Neuro Meeting Video Abstracts; 07.06.2026 23min

  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.
• Young Neurosurgeons Discussions with the Experts; EC-IC Bypass Surgery 1980-2025 25.05.2026 1h 14min

  SUMMARY: Drs. Nussbaum and Ausman discuss with Dr. Rennert the  years of experience with EC -IC Bypass surgery. For Ischemia the major issue was the 1985 EC-IC Bypass Study, a RCT that was scientifically corrupted and for which no valid data exists. Other studies either had major deficiencies such as too short a follow up, and too high a bypass mortality surgery. The high early mortality of these studies made it too much to overcome in the long-term followup of the patients with ischemia. With an expected 1% morbidity, recent studies show a signifiant value in EC-IC bypass surgery over medical therapy. The elimination of that mortality and morbidity is addressed by all surgeons. Dr. Rennert discusses three recent cases he has done in his center with different compromised anterior circulation patterns. One case with cerebral ischemia presenting with Memory loss and interrupted Speech was cured with successful EC-IC bypass surgery. Cerebral ischemia as a cause of memory loss was discussed.  The importance of the understanding of the collateral circulation and the vascular supply to the cranial circulation was emphasized as was 4 -vessel angiography. The deficiency in CT Angiography in evaluation of CV circulation is discussed as was CBF flow studies.   The discussion develops an Interesting interactive exchange of experience  covering 55 years of literature and clinical experience with many tips for surgical successes. This experience is not available in journals or most meetings. This is Interesting learning experience not available in journals or most meetings but on SNI Digital®.   Opportunities for other young neurosurgeons to participate in this new SNI Digital® series are proposed.  (60 minutes Discussion).  JIA . 
• How we built a Stroke Center program in a LMIC for 160 million people? Qasim Bashir; Asif Bashir 25.05.2026 1h 10min

  SUMMARY: Dr. Qasim Bashir, a Board certified Neurologist, Intensivist, Interventionist returned to Pakistan, a LMIC, after studying outside his country for 16 years to help develop healthcare in Punjab Province with 160 million people. As a neurologist he started with a Stroke Center and expanded it to multiple locations throughout the province developing emergency care transport; Treatment on site, Hospital ER teams, all to treat stroke under the paradigm of "Time is Brain". An incredibly challenging task showing how he and his neurosurgeon brother and family worked with private care and the government to develop services for all. An outstanding story to be duplicated by others worldwide.  60 minutes with discussion.  Recommend you see both videos. (JIA)  
• How we built a Neuroscience Center in Punjab Pakistan serving 160 million people; Drs Asif Bashir, Qasim Bashir, Ghaus Malik 25.05.2026 1h 6min

  SUMMARY: Dr. Asif Bashir, from Pakistan, had his neurosurgical residency in the Medical School in NJ,   He returned to Pakistan to fulfill his neurosurgeon father's life long dream of establishing a Neuroscience Center in Pakistan. With his brother and family members, both bothers, on their return to Pakistan, worked on building first rate Neuroscience Care in the private sector and then the public sectors to serve 160 million people who had no such care previously. With dedication and much hard work they have achieved their goals. Asif describes how they were able to work with government leaders to utilize government support with a high success rate helping to save the people from the devastating neurological diseases.  Hear and see  how they did it. Inspirational achievements.  Should be duplicated worldwide. The Viewer should see the first video on establishing a Stroke Center Program.  Excellent for Video on SNI Digital® and Podcasts, also SNI Digital® on Apple,  Amazon, and Spotify.  60 minutes with provocative Discussion.  (JIA)
• How we built a Neuroscience and Stroke Center in Punjab Pakistan; Drs. Asif Bashir, Qasim Bashir; and Ghaus Malik 25.05.2026 2h 13min

  SUMMARY: Drs Asif and Qasim Bashir with the mentoring of Dr Ghaus Malik, describe how they built a First Rate Stroke Center and Neuroscience Center in Punjab, Pakistan for 160 million people. Combining the needs of  of the private sector with those of the large public population and using government and private funds, they have developed a leading  practice, research and educational program that is a model for those in the LMIC. 85% of the world's population and 85% of global disease occurs in the LMIC. This program is an example of why the centers of disease management will shift from the HIC to the LMIC where billions of the world's population reside. It also describes how to attract and use public and private funds to address the health needs of the country. Both centers are being used as training grounds for those in the HIC, who do not have access to large volumes of clinical experience or for less costly but quality care medicine. (2 hours of Presentations and Discussions). Videos and Podcasts are also available in separate sections for independent viewing and listening.  A must see and hear for those worldwide as an example of the future in Healthcare. Excellent for video or Podcast  (JIA)
• Let's Talk: Mediocrity in Medicine; YNSS series; Resident Education: What to do. 25.05.2026 1h 8min

  SUMMARY: This program is the second in the SNI DIgital® "Let's Talk" series developed for the YNSS by Mohammad Ashraf and Hassan Ismael of the Glasgow University School of Medicine for the purpose of addressing controversial medically related issues of concern to the YNSS generation.  The topics are developed by the YNSS and Glasgow Neuro for all of their colleagues worldwide. Mediocrity in Medicine is a major concern for these young people as they strive to reach their life's goals seeing their desire for excellence compromised by socialistic systems, and people who are not incentivized to be their best. In addition, the government programs  reflecting this goal of equity for all, they feel has blunted their incentives to be the best that they can be. Why be excellent when mediocrity is rewarded?   The audience and the intergenerational panel discuss the reasons for this mediocrity and the personal actions one can take to achieve their life's goals.  This is a first rate open discussion of a major effect of Socialism on people and the achievement of excellence in Medicine with implications for the future and the choices one makes personally to solve this issue.  (JIA)
• Omniwar Part 2. Dr. David Hughes; New Authoritarian Government; What it means to you. 25.05.2026 58min

  SUMMARY Part 2: of this interview on Omniwar with Dr. David Hughes, describes how this Transnational Deep State has destroyed the principles of Democracy, which has as its goal, basically a war against the people. Although the Deep State existed in the USA in 1940s, by 2020, it emerged into public view with the Covid-19 false pandemic in which 5 billion people were injected with a “vaccine” and all other competing drugs (Ivermectin, steroids and others) were banned from use, for, now proven, false reasons to allow the Emergency Use of the Vaccine as the only treatment for this (benign) infection. The vaccines were under preparation before the “pandemic” and were developed by US pharmaceutical companies which had worked with the Wuhan Laboratory in the previous years. Interestingly, the Wuhan laboratory was run by the Chinese Communist Party (CCP). These events occurred at the time the US Congress inappropriately impeached President Donald Trump twice, falsely accused him of collusion with the Russian government, and the imminent implementation of a trade policy which threatened the stature of the CCP and Chinese government.   (Also read “Covid-19 What is the Truth?” by Drs. Ausman and Blaylock from amazon.com for further factual verification) Were these events an Accident, Circumstantial, Coincidental, or Planned, has never been revealed. Why? Connect the Dots. Using “fear” propaganda in violation of individual rights and the Nuremberg Code, people lost their rights to privacy, informed consent, choices as individuals and were coerced to accept the injections. All these changes were willingly accepted by the “anointed” science community, which included Medicine, the Science community, as well as the public health agencies. Hospitals were paid large sums of money for providing a fake Covid diagnosis. And no autopsies were performed to study the disease which is highly unusual scientifically. The public surrendered their privacy rights through manufactured, propagandized fear. These rights were turned over to world governments that, in turn, controlled the public with unproven restrictions on its freedoms for unproven “scientific” reasons. Eventually the pandemic was recognized by many as fraudulent. Furthermore, it was revealed that the vaccines contained graphene, a conductive metal, for no explained reason, but disclosed by authorities in the field as suspicious of an injected metal responsive to external microwave signaling. This established link remains denied by the media and government agencies but has not been discussed as to its properties and why it was added to the injection.  Attempts to force digital IDs on the people were resisted in the UK. The corruption of the Justice system, by its politicization and targeting of its enemies of the Deep State, as occurred in the USA, is a prelude to the loss of Justice and full disclosure under a Technocracy. In a Technocracy, as in China, all freedoms are eliminated by the totalitarian state. Dr. Hughes gives examples of how these goals are being achieved transnationally. Dr. Hughes provides the background data on those who make up this Transnational Deep State as the ultra-rich, occupying positions of influence within major banks, hedge funds, the UN, NATO, World Economic Forum, and in particular Global Public /Private partnerships. Also included are Gates, Soros, and other individuals, major USA Foundations (Ford and Rockefeller and others), the Trilateral Commission inner circle, the Bilderberger’s steering committee and others in positions of power. All are all working to achieve central control in a unified self-appointed government of technocracy over the people. Further details are in his books.  Dr. Hughes states that this conflict among the people and the Deep State can be resolved by 1) fighting and Chaos, 2) by resisting submission to the Deep State, or by 3) by the public uniting to reject the proposals of the Deep State for dominance. He outlines 19 points of how these actions can be achieved which are described in the Video and Podcast versions of this two-part program and are listed in his e-book These actions by the technocrats cannot be forced by the Deep State upon an unwilling, informed public. So far, the Deep State controlled the media and has not provided any of this information to the public. Are these events happening? The references will provide data supporting these statements.  It is obvious that all these above descriptions and statements can be discarded as “Conspiracy Theory” but as you will read and see, the shocking reality is that these are events and plans that are occurring for us to see worldwide. This information is not reported in the Press or Media. You are not being told the Truth. “Connect the Dots”. SNI Digital® is bringing this information to you so that you can make your own decision about “What is the Truth?”  You decide.  In our view, the recorded actions of this Transnational Deep State, seen in these videos, and in Dr. Hughes’ research, disclose a secretive, malevolent plan to control the world by a self-selected few people, using technology for evil. What is happening in the world around you? Why?  We are facing serious challenges. The people behind these plans believe that wealth, money, and power give them the right to decide what the Creator has given all mankind. It is an incredible seizure of freedoms of each person, a violation of human rights, the USA Constitution, and the desires of mankind who fought and died to gain independence that these misguided people grew to enjoy and now wish to deprive others from having. Bluntly, these are “Crimes against Humanity” and are treasonous and deserve no less than the exclusion from the humanity they seek to destroy and surrender of all their assets to the People from whom their wealth and power were taken. (54 Minutes Discussion)You will not read or hear about these things elsewhere.   James I. Ausman and Russell L. Blaylock 
• Richard Ellenbogen, MD; Neurosurgeon, Life and Interview 25.05.2026 1h 5min

  SUMMARY. Another interview with a successful Neurosurgeon-scientist you would never see or hear elsewhere.  Dr Richard Ellenbogen is interviewed by Dr. James Ausman about how he got into Medicine, Neurosurgery, his time as Chair at Walter Reed Hospital, in the armed services. He now is Head of a large successful Department of Neurosurgery at the University of Washington, Seattle, that is highly ranked with outstanding people on faculty.  Listen to what he considers important for success in Medicine and Life; How to work with people successfully; What he thinks about the future of Neurosurgery; and  how important Soul is to a physician.  The interview will grab your attention. Good tips for everyone. Well worth 60 minutes.  Excellent for Podcasts and Video (JIA)
• BLAYLOCProper DIet, Nutritional Supplements, Vitamins and Minerals and Healthful Longevity; The Scientific Basis; Dr. Russell Blaylock; Part 1K SHORTS NUTRITION 1 25.05.2026 34min

  PSUMMARY: PROPER DIET, NUTRITIONAL SUPPLEMENTS, VITAMINS AND MINERALS AND HEALTHFUL LONGEVITY; THE SCIENTIFIC BASIS; DR. RUSSELL BLAYLOCK; PART 2In Part 2, Dr. Blaylock explains how surgery triggers a major metabolic crisis in the body and leads to post-operative complications. Your Medical consultant may not be aware of these essential deficiencies, so it is up to you to know about it for your patients. He discusses why we do not know about these concerns, the part the pharmaceutical indicatory plays in keeping this information from you so you stay in a chronic disease state, dependent on their drugs. Yes, it sounds evil but those are the facts. There are other causes also. I just read that the Pharmaceutical Industries are contributing millions of dollars to keep the government shut down so that Medicare is not changed to diminish the governments purchases from drug companies. You are trying to do what is best for your patient while others are more interested in profits and not the patient welfare. The Covid-19 scandal is another example of this same attitude. Learn from Dr. Blaylock what are the Facts. This piece below is an excerpt from an article published in Breitbart News this week:          “Health insurers have never had it so good. Their stocks are up more than 1,000 percent since Obamacare passed, and they now receive roughly a trillion dollars per year in federal subsidies …. With that much taxpayer money at stake, politics inevitably follows the cash—and lately the industry has taken a hard-left turn…. Newsom’s Prop. 50 won last week, increasing the chances of Democrats retaking the House and enacting their radical agenda, which includes impeaching President Donald Trump…. The strategy appears to be paying off. Democrats in Congress are repaying the favor by shutting down the government to keep $400 billion in Obamacare subsidies flowing from the American taxpayer to the insurance companies—and thus back to Democrats.” (Breitbart November 8, 2025; “Obamacare Insurers bet $400 Billion on Shutdown Democrats” from American Resolve.) What is the Truth?See and hear SNI Digital’s programs which bring you the Facts for you to decide the truth. All without leaving your home to attend expensive meetings where Drug companies promote their products to you. And all of this is Free Education to you from snidigital.org. Copy and send it to your friends. (See how to share these programs or send this Blast on to others.)  (29 minutes)  
• Dr. Juan Torres; Guatemala; Myositis Ossificans and Hydrocephalus 25.05.2026 15min

  SUMMARY: Dr. Torres, Head of Neurosurgery in the Bautista Children's Hospital in Managua Nicaragua, reports on a young patient with a previous diagnosis of Myositis Ossificans, who developed hydrocephalus, that was complicated to treat. Myositis Ossificans is a rare genetic form of the disease which consists of calcification being deposited in tissues during the healing process. He describes the genetic defect. Dr. Torres' patient developed acute hydrocephalus, had an ETV placed and recovered only to return in 3 months with raised ICP. A VP shunt was placed which failed in 2 days for non absorption of CSF and a new ETV was planned but her ventricle size returned to normal and the procedure was not done. 4 months later the patient returned with Hydrocephalus and a new ETV was done.  Only three cases are reported with hydrocephalus in a literature search with little detail. Dr. Torres proposes from this experience that an ETV would be the treatment of choice in these rare cases. The discussion was about the treatment of complicated hydrocephalus. Is the hydrocephalus a manifestation of Myosisits  Ossiifiicans  or independent of the disease?                                                           (JIA)
• Let's Talk: Women in Neurosurgery; Part 2; Glasgow Neuro: Drs. Epstein, Whitehouse, Jadoon, Nussbaum, Ausman 25.05.2026 1h

  SUMMARY; See Part 1 summary
• Roman BOSNJAK: Extended endonasal approach to cavernous sinus compartments in parasellar adenoma - with a peek into the normal lateral compartment 25.05.2026 2h 20min

  This educational video provides a comprehensive endoscopic overview of the parasellar region, focusing on the cavernous sinus compartments, especially to the most difficult to explore - the lateral cavernous sinus compartment. It is designed for neurosurgeons and medical professionals seeking to enhance their understanding of the complex anatomical structures involved in this area. The presentation includes detailed visual aids and expert commentary to facilitate learning. Key topics covered in this video include the endoscopic neurovascular anatomy of the parasellar region, the significance of the lateral cavernous sinus compartment in neurosurgical interventions, and relevant surgical techniques for navigating this intricate area. Viewers will gain valuable insights into the implications of anatomical variations and their impact on surgical approaches, aiming to improve patient outcomes in neurosurgical procedures involving this critical region. Original technique of prof. Bosnjak (2011) to resect proximal dural ring to unlock lateral cavernous sinus by medialisation of intracavernous ICA is presented. Bosnjak R, Benedicic M. Endoscopic endonasal approach to pituitary adenoma with invasion to the cavernous sinus. Endosk rev [Internet]; Endoskopska revija /Endoscopic review. 2011;16(33):3–11. ISSN 1318-8941. Available online: http://www.dlib.si/details/URN:NBN:SI:doc-AXH0BGUN
• Pediatric Neurosurgery; Drs. Verdier, Petre; Argentina; AVM Removal: Posterior Inferior Mesial Temporal AVM from Posterior circulation 25.05.2026 20min

  SUMMARY: Drs Verdier and Petre, from Buenos Aires Argentina (FLENI) present a patient with a posterior mesial temporal occipital AVM supplied by the posterior cerebral vessels. It was not amenable to embolization. Their surgical approach described was with the operated side down occipital approach to the operative site. The AVM was removed and the feeding vessels were occluded with a complete functional recovery of the patient. They suggest that this approach be used in lesions in this area of the brain as retraction of the hemisphere is not necessary as it falls by gravity from the operative site, with limited retraction if needed. A ventricular drain done at surgery can also all for more fallaway of the hemisphere.  (JIA)
• Pediatric Neurosurgery; Drs. Verdier&Petre; Argentina; Epilepsy: Rasmussens' Encephalitis; Hemispherectomy; Epilepsy 25.05.2026 28min

  SUMMARY: Drs. Verdier and Petre from the Hospital de Ninos Ricardo Guttierrez in Buenos Aires, Argentina describe a case of a young boy with intractable seizures who was diagnosed with Rasmussen's Encephalitis. After detailed studies they performed a hemispherectomy, which they show in videos, with an excellent outcome for the patient. Their group at the Childrens Hospital  in Buenos has a large experience in Epilepsy. This is an excellent addition to the SNI Digital® Series on Epilepsy. Put Epilepsy in SEARCH to find a very complete number of videos from basic to complex on Epilepsy for neurosurgeons everywhere.  (JIA)
• Roman BOSNJAK: Endoscopic MVD in Trigeminal Neuralgia 25.05.2026 8min

  This video is about pure endoscopic microvascular decompression of trigeminal nerve.Short attacks of lancinating electric like pain, triggers and evidence of neurovascular conflict in MRA imaging constitute basics for MVD indication.Endoscope enables close, side and angled view and enhances identification of neurovascular conflict.The patient is operated on in supine position, the head rotated to the contralateral side and slightly elevated. The endoscope was held by an assistant. The 12-15 mm burrhole is drilled with a diamond ball exactly in the corner between transversus and sigmoid sinus. The blue lines at superior and lateral margins in the hole should be visible when dura is exposed. Two small triangular flaps are flipped up and lateral to expose cerebellar cortex in the angle between Transversus and Sigmoid sinus. With the use of cottonoid strip, the the cerebellum is gently pushed down and medially, exposing tentorium up and the corner between tentorium and posterior pyramidal wall. Once CSF is released, everything becomes easier and more spacious. Normal anatomy is then presented: internal auditory canal with seventh and eight nerve (and labyrinthine artery), sixth nerve entering Dorello’s canal, the petrous vein, trigeminal nerve from brainstem to the dural entrance (ostium) into cavum Meckeli. The fourth nerve floats along the tentorial margin. The axilla of the trigeminal nerve is explored first from inferior and superior aspect for any arterial, venous or arachnoid band contact with the nerve.  The whole length of the nerve should be checked.In this case, the conflict was found in the superior aspect of the nerve in a form of two parallel arteries, most probably from superior cerebellar artery. These were relocated and secured in new position away from the nerve  with Tachosil and Teflon patch (not shown in this video).  Enjoy the anatomy.Leave a comment!You may also see Neurosurgery: Trigeminal neuralgia - endoscope-assisted microvascular decompression - Dr. Bosnjak (April 2013)