The Wascher Quiz of the Day seems to be a big success that many people enjoy playing. To make it worth their time, I am adding the chance of a weekly prize.
Here are the rules:
A question will be posted daily on Facebook. You must answer the question correctly each day of the week (5 questions per week). Of those 5 questions, you need to be the first to answer correctly on two of the questions.

Winners will be sent a prize!

Good luck!

I see many of you enjoy playing games of some sort on Facebook, so I have started a new game for you…a daily quiz. I will post a question on Facebook every day for you all to try your luck…some will be medical, and some not. Hope you enjoy the challenge!

Recent studies have shown that using stereotactic radiation therapy, such as Cyberknife, has a good control rate in patients under the age of 40. Using an average dose of 13.0 Gy, a control rate of 96% was achieved. Hearing preservation was obtained 93% of the time. Facial nerve function was preserved in 98.2% of the patients.

This information supports the option of Cyberknife as a treatment of a small acoustic neuroma in young people. For more info on this study, go to Lobato-Polo J, Kondziolka D, et al. Gamma Nkife Radiosurgery in Younger Patients with Vestibular Schwannomas. Neurosurgery 2009; 65 (August): 294-300.

For more info on Cyberknife, go to www.tomwaschermd.com

A retrospective review analyzed 1858 discectomy specimens obtained over 8 years. During this period, it was regional policy to send all discectomy specimens for pathological analysis. It was noted that only 4 patients were identified with unexpected findings, 3 for pseudo gout. The other abnormality was a false positive for multiple myeloma. Based on these findings it is felt that there is no need to send discectomy specimens. For a full report on this study, go to Wu AS, Fourney DR. Incidence of Unusual and Clinically Significant Histopathological Findings in Routine Discectomy. J Neurosurg Spine 2006; 5 (November):410-413. For more on cervical discectomy, go to www.tomwaschermd.com

While surgery is always the last option for treatment, there are times when a major surgery is the best choice. One such treatment is an occipitocervical fusion. A recent study reviewed 69 patients with occipitocervical instability due to a number of different causes. Occipitocervical fusions were performed and outcomes reviewed. 87% of the patients found an improvement in their symptoms, while 13% felt they were unchanged. In this study, there was a 12% complication rate. It is felt that such a treatment is ideal for instability, with very good outcomes. A patient is best off to find a neurosurgeon with experience with this procedure, and with good outcomes. For more on this procedure and my outcomes, go to www.tomwaschermd.com

I added a short video showing a 6th cranial nerve palsy on iOR on my site www.tomwaschermd.com today. This shows then clinical findings when the abducens (6th) cranial nerve is injured.

I added video on my website www.tomwaschermd.com in iOR showing a great case I had earlier this week. This is a benign spinal canal tumor called a schwannoma. The video really shows the anatomy well.

A recent study reviewed anterior-posterior surgical treatments for cervical spine issues. The study supports that a two stage procedure should be done from the side with greatest compression first. Hardware failure was found to be rare in anterior posterior fusions. According to the authors, 360 degree surgery can have a 30% complication rate. The most common complication was dysphagia (difficulty swallowing). For more information on this study, contact Dept of Neurosurgery, USCF Spine Center, University of California at San Fransisco, 505 Parnassus Ave, M 779, Box 0122, San Fransisco, CA 94143
While there are some good points in this study, I have not seen such a high complication rate in my anterior posterior surgeries. Please review my outcomes here for more info. Www.tomwaschermd.com

A recent study shows that cervical spine injuries are are often missed on plain xray, and that a CT scan may be a useful tool in detecting injury. 20 cases of missed cervical spine injury were reviewed, and divided into three categories. Category I errors included improper testing or inadequate testing. Category II errors occurred when the right tests were ordered, but misread or not read. Category III errors occurred when the right test was ordered and was read correctly, but the tests weren’t sensitive enough to detect the injury. Commonly missed injuries included odontoid fractures and other upper cervical spine injuries and those at C7-T1. For the complete article, reference Neuroscience Publications, Barrow Neurological Institute, 350 W Thomas Rd, Phoenix, AZ 85013. For more information, go to www.tomwaschermd.com.

Here is a great story in the Post Crescent on the high school class I taught last week. What a great group of kids!

http://www.postcrescent.com/article/20100428/APC0101/4280487/1003/APC01