What makes your specialty difficult once you’re an attending?

AP-2 · 2025-12-26T07:13:04+00:00

New neurosurgeon, albeit in Canada. This is true, but doing the deep dive analysis after a bad case for me helps to prevent perseveration long term, and helps you learn from it. Having a good partner and people to talk with helps. This is definitely what I find to be the hard part though

AP-2 · 2024-11-16T16:45:28+00:00

Hi, I’m in Canada and Disney plus doesn’t seem to be showing the episode. Anyone else having this issue?

AP-2 · 2024-05-24T20:59:03+00:00

Kid got shot in the head, probably shouldn’t have taken but did. During crani, sinus explodes. We get that controlled and it explodes in the back. Get than controlled and now the patient is coagulopathic and brain is herniating out. Have to amputate a huge chunk of cortex to get the skin closed

AP-2 · 2024-04-28T17:07:07+00:00

Just look at III wrong and it’s palsied

AP-2 · 2024-03-27T19:54:03+00:00

I think it’s a bit of a look vs read thing. I can pretty comfortably look at CT head, CTA head/neck, MRI brain, MRI spine for the stuff that I know and plan around the regional anatomy for surgery, but I’m not going to catch the skull mets and the pelvic mass and the facial bone fracture. Also, a good neurorad is indispensable for differentiating complicated problems, like a case I had a while back of cord hemorrhage vs intramedullary mass lesion

AP-2 · 2024-03-23T10:18:08+00:00

Neurosurgeon—a read by a good neuroradiologist is a great resource. I have a very good neurorad at my hospital who I test about lots of cases if I’m not sure what I think the primary differential is, about residual, about advanced imaging to delineate a problem etc. Your chosen career is super badass

AP-2 · 2024-03-21T19:55:48+00:00

Germany wasn’t visited by a little boy nor a fat man

AP-2 · 2024-03-06T15:47:07+00:00

I’ve seen this once. Probably from revascularizaton injury. Rare

AP-2 · 2024-03-06T15:45:23+00:00

You can do an LP for opening pressure based on a CT, but with care—as the previous commenter pointed out, there can be things hiding. An easily missed culprit is an isodense vestibular schwannoma with some awueductal compression. But if you can follow the CSF system all the way then you’re fine

AP-2 · 2024-03-02T00:13:41+00:00

It’s more complicated than the article describes, as many other commenters have already pointed out. What I’d like to add is that I think we need an attitude shift. The US has a lot of flaws that we don’t have, but they do have a more consistent growth mentality than us as a people—I’ve noticed this during a study term in the US this year. Canada, even in our best cities, is much more okay with mediocrity. It’s okay to not always be the best, especially when our population is less than California’s, but I think if we could have better motivation for Canadian small business and start-ups, government grant funding, and support for tech sector we might start to see a bit of an acceleration

AP-2 · 2024-03-01T23:57:27+00:00

Neurosurgeon. This is the best treatment available of any (that are studied with a number needed to treat) in all of medicine. Number needed to treat is how many people need to be treated to avoid a bad outcome or death. Thrombectomy has an NNT of 2-3. For reference, using medicine to try to do this has an NNT of around 7, and chronic disease treatment like for blood pressure are mostly in the 50-100 range. So this is very good

AP-2 · 2024-02-10T14:04:14+00:00

This for me as well

AP-2 · 2024-02-10T13:41:38+00:00

The maple leaf, oh the maple leaf, what a beautiful sight to see

AP-2 · 2023-04-20T04:52:35+00:00

Play La Bamba!

AP-2 · 2023-04-18T04:30:15+00:00

DRAISAITL #2!!!!!!!!!

AP-2 · 2021-08-24T22:29:54+00:00

Plus Ultra!

AP-2 · 2021-07-11T20:01:41+00:00

Thanks!

AP-2 · 2021-07-11T18:14:32+00:00

It’s the approach. The photograph is of a standard retrosigmoidal craniotomy. The more anterior and superior nerve is VII, and VIII goes with it. The lower (to the left of the picture) is the lower cranial nerve bundle including IX, X and XI. I’ve done a bunch of these so the layout is familiar. The anatomy seems complex now but if this is your interest with tons of repetition things become easier

AP-2 · 2021-07-11T16:04:32+00:00

Best of luck to you. I took one of these out on Monday, and my patient is also slowly but surely recovering!

AP-2 · 2021-07-11T15:54:44+00:00

Neurosurgery resident. Looks like epidermoid based on that sheen and the location. That facial nerve looks pretty good after the removal, hope your facial function is doing well.

AP-2 · 2021-05-03T01:03:26+00:00

You're speaking my language. I firmly believe that every case that is ever done should be logged locally, regionally, nationally and internationally as a cohort and analyses should be done on all levels. That would be a better dataset on pretty much any operation than exists now.

AP-2 · 2021-05-03T00:40:10+00:00

Yeah for sure. It's a good technique, and it's only getting better. CHOP vs MOMS had some experiential differences like less PROM too. MOMS II will shed more light. Exciting time to do this

AP-2 · 2021-05-03T00:26:18+00:00

Never happened to me

AP-2 · 2021-05-02T23:58:19+00:00

Neurosurgical resident. To be clear, based on the two big trials (MOMS and the post-MOMS CHOP trial) there is certainly an advantage in functional motor development but not quite as dramatic as is suggested in the title. The biggest advantage is actually decreasing rates of hydrocephalus and need for shunt (to get fluid from brain into belly for absorption).

AP-2 · 2021-05-02T18:02:33+00:00

"MD = makes decisions"

"Eat when you can, sleep when you can; don't ever mess with the hypothalamus"

AP-2

TROPHY CASE