Clinical Neuroscience in Practice: An Experiential Learning Course for Undergraduates Offered by Neurosurgeons and Neuroscientists.

Many pre-health students pursue extracurricular shadowing opportunities to gain clinical experience. The Virginia Tech School of Neuroscience introduced a formal course that provides a clinical experience superior to that received by many medical students. This course is composed of weekly 75-minute seminars that cover diseases affecting the nervous system, their diagnosis and treatment, complemented by weekly half-day intensive clinical experiences with unprecedented access to a team of neurosurgeons (in hospital operating rooms, Intensive Care Units, emergency room, angiographic suites, and wards). In the operating rooms, students routinely "scrub-in" for complex surgeries. On hospital rounds, students experience direct patient care and receive in-depth exposure to modern nervous system imaging. Students participate in two 24-hour "on-call" experiences with team providers. After call, students participate in cognitive and psychological studies to assess physiological and psychological effects of call-related sleep deprivation. Students prepare weekly essays on challenging socioeconomic and ethical questions, exploring subjects such as the cost of medicine and inequalities in access to health care. Towards the end of the course, students meet with the admission dean of the Virginia Tech Carilion medical school; they prepare a personal statement for medical school/graduate school applications, and attend a half-day block of mock medical school/graduate school interviews delivered by experienced clinicians. In lieu of a final exam, each student presents to the entire neurosurgery department, an in-depth clinical analysis of a case in which they participated. We provide details on implementation, challenges and outcomes based on experiences from three semesters with a total enrollment of approximately 60 students.

Sacral fracture: case presentation and review.

Sacral fractures are either transverse or longitudinal (vertical). Transverse fractures may be isolated and can be subdivided into two types. Upper transverse fractures occur in younger people and result from severe traumatic flexion of the upper body on the fixed pelvis. Lower transverse fractures result from a hard blow to the coccyx, as in a fall. Vertical fractures are essentially never isolated, always being associated with an anterior break in the pelvic ring. These result from extreme forces transmitted through the ilium. Any of these fractures can cause injury to neural elements, and surgical decompression may be indicated in certain of the transverse types.

Excision of a brain-stem epidermoid cyst. Case report.

An intra-axial epidermoid cyst of the brain stem is presented. X-ray studies revealed a mass within the brain stem; computerized tomography showed the mass to be cystic. The epidermoid cyst was successfully removed surgically. Six months after operation the patient is stable with sixth and seventh nerve palsies but resolution of right spastic hemiparesis.