Background: Peripheral nerve surgeries require extensive practice to address anatomical variability and effectively manage neuropathy symptoms. While these procedures are increasingly performed by other surgical specialists, neurosurgeons bring unparalleled expertise in the central and peripheral nervous systems. Microscopic surgical techniques are essential for minimally invasive procedures, and cadaver-based education provides an invaluable medium for trainees to practice these techniques. However, few papers address these concepts in tandem. This study explores lesser-known peripheral nerve entrapments, highlights minimally invasive microscopic approaches, and advocates for cadaver-based training. Methods: Willed cadavers were embalmed through approved methods by the state anatomical board. For each decompression procedure, a 1–2 cm keyhole incision was made. Further methods are described in each nerve entrapment surgery below. Exploratory sessions with wider incisions were conducted either before or after the minimally invasive procedure to review anatomy or assess procedural success, respectively. Results: Neurosurgical medical education using cadavers allows trainees to practice techniques and enhance their skillset. Cadavers provide a valuable medium for exploring the relevant anatomy and visualizing the correct procedural steps after minimally invasive surgeries. Using microscopes for the procedures further facilitates detailed anatomical observation and technique refinement. Conclusions: Here, we show that cadaver-based medical education offers a realistic and controlled environment for exploring anatomical variability and refining surgical techniques. This method allows for a visual, mental, and tactile understanding, while performing minimally invasive procedures with a microscope on cadavers further enhances trainees’ proficiency, precision, and confidence, equipping them with the skills needed for improved surgical outcomes.

Background: Most epidural hematomas (EDHs) are caused by middle meningeal artery rupture, though any cranial-facial artery could be involved. Hypertension (HTN) is a major risk factor for intracerebral hemorrhages due to vascular remodeling and dysfunction. Fluid dynamics shows us that blood follows the path of least resistance, which may lead to untypical hemorrhaging patterns. To date, no cases have documented an EDH from an occipital artery bleed. Case Description: A 37-year-old male with an unremarkable medical history except for HTN presented with basal ganglia hemorrhage. Computed tomography (CT) angiography was unremarkable. He underwent decompressive craniectomy. The bone flap was not replaced. At 4-month follow-up, right ventriculomegaly prompted ventriculoperitoneal shunt placement. Within 24 h, clinical deterioration prompted CT, revealing an EDH. Reoperation identified the occipital artery as the bleeding source that caused blood to enter the burr hole. With a small dural opening occupied by the catheter, the blood could not enter the subdural space and accumulated epidurally. Conclusion: Intraoperative injury to the occipital artery would have caused immediate, visible scalp bleeding. Instead, postoperative HTN likely led to arterial rupture. Blood followed the path of least resistance through the burr hole, driven by a pressure gradient from the shunt. This hypertensive episode resulted in an occipital artery epidural hematoma localized at the burr-hole site.

Objective: Peripheral nerve surgeries require extensive practice to understand the anatomical variability amongst patients and effectively manage neuropathy symptoms. Peripheral nerve surgeries performed by neurosurgeons are on the decline, as other surgical specialists increasingly undertake these procedures. However, neurosurgeons possess an extensive understanding of the central and peripheral nervous system, undergoing rigorous surgical training in both areas. The aim of this study is to provide a comprehensive description of minimally invasive surgical techniques for uncommon peripheral entrapment neuropathies and advocate for the utilization of cadavers in medical education to explore pertinent neuroanatomy. Methods: Willed cadavers were embalmed through approved methods by the state anatomical board. For each decompression procedure, a 1–2-centimeter keyhole, linear incision was made. Further methods are described in each nerve entrapment surgery below. Either before or after the minimally invasive procedure, an exploratory session was executed with a wider incision to review anatomy or success of the procedure, respectively. Results: Neurosurgical medical education using cadavers allows trainees to learn techniques and improve their skillset. Cadavers offer the benefit of exploring relevant anatomy and visualizing correct procedural steps after the minimally invasive surgery has been performed. Conclusions: Embalmed cadavers for medical education and procedural practice for minimally invasive, decompressive nerve release procedures is a purposeful tool for trainees and continuing education. This method of practice allows for a visual, mental, and tactile experience to enhance the trainee prior to operating on a living patient.

Background: Spinal stress fractures are common among young athletes due to high-intensity training and repetitive spinal loading. Elderly individuals also exhibit high rates of spinal fractures, primarily due to age-related bone degeneration. This study aimed to compare fracture severity between pediatric patients experiencing high-energy mechanical injuries and geriatric patients sustaining low-energy injuries. Methods: This 10-year retrospective review included patients from a single center. Pediatric patients (60 years) were included if they had spinal injuries from ground-level falls. Fractures were graded using the arbeitsgemeinschaft für osteosynthesefragen (AO) thoracolumbar classification. Fisher’s test, Welch’s t -test, and the Mann–Whitney U-test were used to assess statistical differences. Results: Ninety patients were analyzed (47 pediatric, 43 geriatric). No significant difference was found in thoracolumbar grading levels between age groups ( P = 0.244), but geriatric patients had significantly higher median injury severity ( P = 0.005). All geriatric patients and 92% of pediatric patients had Type A (compression) fractures. A0 fractures were more common in pediatric (30%) than geriatric (7%) patients. A1 fractures occurred in 51% of geriatric and 49% of pediatric patients. A2 fractures were seen in 7% of geriatric patients only. A3 and A4 fractures were more prevalent in geriatric patients (23% and 12%, respectively) than in pediatric patients (16% and 5%). Conclusion: Thoracolumbar fracture patterns were similar between age groups, but elderly patients had more severe subtype injuries, likely reflecting the impact of age-related bone fragility.

Background: Hemangioblastomas (HBs) are vascular neoplasms that are most involved with the central nervous system and can be associated with Von Hippel-Lindau disease (VHL). HBs involving pediatric patients are common, but VHL-associated HBs and those that cause obstructive hydrocephalus are rare. Case Description: In this case study, a pediatric patient presented with multiple neurological deficits including headaches, ataxia, confusion, and right-sided weakness, as well as a magnetic resonance image revealing a lesion involving the 4 ^th ventricle causing obstructive hydrocephalus. An external ventricular drain was placed to treat the hydrocephalus acutely, followed by a tumor resection, resulting in some postsurgical bleeding and increased fluid accumulation. Further genetic testing revealed that the patient was positive for a VHL mutation. Conclusion: There are only a few reports of intraventricular HBs that are found in the 4 ^th ventricle in pediatric patients with less discussing solid HBs, so evaluation of this case can provide a valuable opportunity to compare and reflect on the nature of this rare presentation and contribute toward understanding the best approaches for treating these rare conditions.