SNI Digital Podcast

SUMMARY: Professor Nimrod Mgwanb'ombe, challenges us with a complicated case of cranio-vertebral junction abnormalities presenting as an Chiari I problem symptomatically. However the pathology was complicated by the compaction of the brain stem through the foramen magnum and the posterior displacement of the dens impacting the brain stem and basilar invagination.  See how this case management evolves and how it is a genetically related disorder with different anatomical lesions. It is only found in certain tribes in Africa. This is another fine scholarly presentation by Dr. Mgwamb'ombe. The patient failed three operations to decompress and stabilize the craniovertebral junction.  Is th...

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...

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 cent...

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...

SUMMARY: Dr Ramsis Ghaly, with Boards in Neurosurgery, Anesthesia, Critical Care, Pain medicine presents a personal case of a patient with classic L5/S1 disc disease from a work related injury.  Microdiscectomy vs Endoscopic approaches?; Surgical tips;  Total Healthcare System failure in supporting this patient with severe disabled pain; What went wrong? Why?  Do you see these patients? Is treatment in Africa a better?  Total failure of Workman's Compensation Insurance? What would you do with such a patient when the insurance is there but the system failed?  Should you take these cases? Was Dr. Ghaly right to assume responsibility for t...

SUMMARY: This Video is likely the best interactive teaching video in SNI Digital®. This cannot be produced in any other format. "Minimally Invasive Spine Surgery (MIS) on how I do it".  Two different approaches used:  1) Interlaminar Tubular Lumbar Microdiscectomy by Dr. Wague from Senegal and 2) Full Endoscopic Approach using the "Borescope" without a Microscope by Dr. Joham Choque Velasquez from Helsinki and Peru. This program lasts 105 minutes and is full of pearls and tips from many surgeons in the audience and the speakers. Will the Interlaminar Tubular approach be replaced by the Borscope, an inexpensive endoscope with great illumination, for sur...

Dr. Ausman provides a 10 minute introduction to the 2024 updated SNI Digital website version 3.0 and how you can get most out of the more than 30 new features on the website with multiple methods of learning from Video with Closed Captions, , Audio for multi tankers, to Print outs in 10 languages. From sound bites, to Interviews with leaders in multiple areas of interest, lectures from world wide neurosurgeons, whole meetings, SNI Digital® Investigative Reports, for students to experienced neurosurgeons. Controversies Discussed, global round table discussions; Clinical Neuroscience lectures, UCLA 101 Neurosurgery Lecture series with experts, for those in LMIC to HIC.  New features of...

SUMMARY: A comprehensive review of the history of neurosurgical education in the USA in the past 124 years and a look into the future. For academic faculty  and residents. Lecture 50 minutes; Discussion 25 minutes

SUMMARY:  Dr. Russell Blaylock discusses the recent studies demonstrating the molecular basis of Aneurysm Formation.  It is basically an inflammatory reaction with macrophage infiltration of the cerebral vessel wall, the destruction of its collagen and media by agents secreted by the macrophage accumulation to the attractive forces of the signaling molecules on the endothelium. These studies, published by Dr. Aoki from Japan, demonstrate that this aneurysm formation. can be stopped and the aneurysm will regress.  Dr. Blaylock amplifies on the mechanism involved as immune-excito-toxicity, a concept he introduced over 20 years ago, which underlies many CNS degenerative diseases, atherosclerosis, adult diabetes, and...

SUMMARY: A look at the impact of Artificial Intelligence on Neurosurgery.

Lecture 41 min; Discussion 6 min  

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 t...

SUMMARY: Dr. Richard Everson provides a comprehensive review of Meningiomas. His laboratory work is on the molecular and genetic changes in meningiomas which he relates to the clinical course, newer diagnostic methods, staging, and different forms of stereotactic radiation, and their effects on outcomes of this neoplastic disease. This modern update reveals a deeper understanding of this common brain tumor for which surgical treatments have prevailed for decades and now will be further modified with this molecular understanding of meningiomas. All of this data reflects on how these lesions be managed in the future, likely on a molecular basis. References...

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...

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 w...

SUMMARY: Dr. Salamon presents  another basic neuroradiology lecture on the Anatomy and Pathology of the Cerebral Venous system.  In this lecture, the value of Closed Captions (CC) can be seen in the English translations along with the video. The AI translations really make this lecture more valuable as the viewer does not miss the many key observations Dr. Salamon makes.  Very informative for those with an interest in this area.  50 minutes lecture; 12 minutes discussion.

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...

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 ad...

SUMMARY: Dr. Epstein discusses the evidence for the diagnosis and. treatment of Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) , which is commonly seen in all branches of Medicine and by Spine Surgeons. She reviews the studies indicating the value in early recognition of this problem to prevent the serious complications that follow this disease. The value in Elastic Stockings, Mechanical Compression Stockings, which combined with chemoprophylaxis (with Low Dose Heparin or Low Molecular Weight Heparin or equivalents)  will significantly lower the risks associated with DVTs to under 1% and eliminate PEs. The risks of bleeding with chemoprophylaxis is similar to t...

SUMMARY: Dr. Ramsis Ghaly, with Board certification as a Neurosurgeon, Anesthesiologist; Critical Care Specialist and Pain Medicine Specialist presents a complicated case of a woman who had multiple spine operations and cervical and lumbar fusions for back pain without relief. She became addicted to drugs for the pain. When she was seen by Dr. Ghaly he stopped her drugs, used spinal cord stimulation for her pain and she returned to work. The case is an example of how pain medicine treatments can be abused, patients harmed, and diagnosed a failed back syndrome.  Dr. Ghaly reviews the entire spectrum of Drugs u...

SUMMARY: Dr. Epstein presents a brief lecture with discussion on the subject of Lumbar Synovial Cysts of the Spine. She discusses the origin from the facet joint as an extruded cyst formation. The detailed pathology appearance from a cyst structure to a fibrous often calcified walled vesicle that presses on the related cauda equina centrally and spinal nerve roots laterally is described. A detailed series of images shows the cyst appearance on CT, MR , and myelographic imaging. The pathology is clear indicating the difficulty in treating this lesion with needle aspiration, a procedure itself which can produce dural tears, scarring...

SUMMARY: WHAT IS YOUR FUTURE?

AN INTERVIEW WITH DR. DAVID HUGHES ON WW III, OR OMNIWAR, -

A FIGHT OF CENTRAL CONTROL VS INDIVIDUAL LIBERTY.  WHAT IT MEANS TO YOU. PART 1 

SUMMARY Part 1: At the time of the 1930s there was the Great Economic Depression and the rise of Naziism in Germany and Communism in the Soviet Union. In the 1930s, the “elitest” segment of the population, decided to create a “perfect society” to avoid what they considered the social and economic problems of that time. Concurrently, the wealthy “elite” controlled giant businesses...

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 vacc...

SUMMARY: Dr. Epstein discusses the choice of the proper surgical approach to the lumbar spine and for synovial cyst removal. Given the complicated pathology seen in Part 1 of this series, Open surgery appears to be the procedure choice for the lowest risk removal of these lesions under a wide anatomical vision.  Laminotomy,  hemilamincetomy, laminectomy are the procedures of choice depending upon the extent of the pathology and dural and root involvement. The value in using magnification for spinal surgery is stated. The limitations of minimally invasive approaches are presented. How to remove the lesion with wide exposure, preservation of a fa...

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 p...

SUMMARY: At the 17th Monthly SubSaharan International Neurosurgery Grand Rounds meeting, the subject of the Management of Giant Brain tumors was discussed. These tumors are seen all over the world, usually related to people seeking medical care late in the disease. Dr. Eric Nussbaum, who has treated a number of these patents from outside the USA describes his experience with a patient who had a Giant Osteogenic Sarcoma and a second with an ossifying fibroma and Fibrous Dysplasia. Fibrous Dysphasia is a rare bone condition that happens when abnormal fibrous (scar-like) tissue replaces healthy bone tissue. It is not h...

SUMMARY:  Professor Chika Ndubuisi, Acting Head of Neurosurgery at Memfys Hospital in Enugu, Nigeria explains his groups experience with the management of Giant pituitary tumors (Ademonas) at his hospital. There are difficulties in some of the transmission but his message comes across on how to handle these cases. An active discussion follows that is informative. 41 minutes. Ok for video but some audio troubled for Podcasts.  (JIA)

SUMMARY: Dr. Dolachee describes his approach to a patient with limited funds and a complex spinal problem with Multiple Myeloma. His second case involved a patient with a symptomatic clival lesion. Both of these cases were managed thoughtfully, with limited resources to involve the endoscopic removal of the clival lesion and subsequent posterior cervical fusion with success. Outstanding examples of what can be achieved with creativity, determination, and intelligence using what is available to achieve an excellent result for a patient. 40 minutes: case presentation and 20 minute: Discussion. Highly recommended. 

SUMMARY: 

SUMMARY: Dr. Tasa describes his diagnosis and management of  two cases of symptomatic lumbar spinal instability from his large experience in CNS Spinal Surgery. Discussion by Dr. Nancy Epstein in using available means to select and treat these patients.  Lecture 22 minutes; Discussion 23 minutes. Practical information for surgeons managing these cases.

SUMMARY: Drs Frank Hsu, Head of Neurosurgery at UC Irvine; Edward Kuan Professor of Otolaryngology and Co-director of the Comprehensive Skull Base program; Dennis Malkasian, Neurosurgeon, Molecular Biologist, and Anatomist, and Alexander Himstead, PGY 4 in Neurosurgery, moderated by Dr. Ausman, have an intergenerational discussion on the Present and Future of Skull Base surgery. The panel’s ages range from 30 to 80’s with a wide surgical experience. The field has grown from the gross removal of these tumors in complex locations to using minimal retraction, different corridors to reach the lesion, using advancing technology, and better understanding of the biology of t...

PSUMMARY: PROPER DIET, NUTRITIONAL SUPPLEMENTS, VITAMINS AND MINERALS AND HEALTHFUL LONGEVITY; THE SCIENTIFIC BASIS; DR. RUSSELL BLAYLOCK; PART 2

In 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...

SUMMARY: Dr. Nancy Epstein discusses the evidence proving that spinal epidural steroid injections have considerable short and long tern risks but no long term benefit.  She provides proof of nerve, spinal cord, cauda equina injuries, CSF leak, arachnoiditis, brain stem infarction, quadra or paraplegia and more. She reviews the anatomy and imaging to support those claims from a series of studies over the years. She analyses the studies over the past 10 years as evidence.  Have appropriate imaging studies been done before these injections are given? What are the alternatives?  Even though some insurance companies require these procedures, the patient is...

SUMMARY: Management of Clival Chordoma and giant Anterior and Middle Fossa Meningiomas: How we do it. From UC Irvine Skull Base Surgery Team; Frank Hsu, Edward Kuan, Dennis Malkasian; Alexander Himstead. CHORDOMA: history and examination; outstanding imaging, preoperative planning; Anatomical Diagrams, Choosing best approach to eliminate complications, endoscopy, microsurgery techniques, when to stop surgery, how to deal with tumor remnant; meticulous closure, post operative management. Excellent outcome. Discussion of molecular and genetic basis of chordomas and future treatments. (40 minutes with discussion). 

GIANT ANTERIOR AND MIDDLE FOSSA MENINGIOMA: Subtile clinical presentation; imaging and interpretation, preoperative planning, angiography, embolization o...

In an interview with Dr. Richard Byrne, Dr. Ausman reviews the principles of micro-neurosurgery, and implementing Operations Analysis theories to the performance of surgery with the goal to reducing the probability of error to zero. Dr. Ausman describes all the components of achieving excellent results from preplanning of the operation, research on each case, operating room organization and personnel management, breaking the surgery in to packages or steps, each to be error free. An understanding of the family and patient is crucial. The final stage of the surgery is the part with different possible outcomes once the pathology is...

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...

SUMMARY; See Part 1 summary

SUMMARY: Six presentations were given with discussion. Subjects included were Why and how to do brainstem tumor biopsies?, Intraventricular endoscopic removal of craniopharyngeoma, A new quantitive measure of hydrocephalus using a pupil sign, Myosisits ossificans and hydrocephalus; Posterior, Mesial, temporal-occipital, AVM removal, Rasmussen's encephalitis: hemispherectomy in the treatment of intractable seizures.  (JIA)

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...

SUMMARY: Drs. Laplace, Sosa, and Cervio describe their experience in brain stem tumors. Since more is becoming known about the molecular basis of these tumors, it is necessary to perform a biopsy to determine the type so that present and future molecular treatments can be used. They describe their technique of performing a brain stem biopsy using the sub- temporal route. Intra-operative monitoring is used. Multiple samples are taken with no post operative complications using available instrumentation. In their pediatric center they see about 2-3 cases a year.  The technique is described in detail. (In our experience with brainstem surgery, w...

AI will have a significant impact but in a longer time frame that we think. AI is math which deals with data and numbers. LLM (Large Language Models) are language based deals with words. AI is excellent in dealing with data. “Large Language Model (LLM) is an advanced AI trained on massive amounts of text data to understand, generate, and process human language, acting like a super-powered autocomplete that predicts the next most likely word or sequence of words in response to a prompt, enabling tasks like answering questions, summarizing, translating, and writing…” (Google search)  Clinic notes can now be summa...