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.

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: 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.

Fournier’s gangrene is a rapidly progressive necrotizing soft tissue infection of the perineum that is typically polymicrobial and is associated with substantial morbidity and mortality. Anaerococcus vaginalis is a rare anaerobic organism that has rarely been identified as a causative agent in necrotizing infections. To our knowledge, this organism has not previously been reported as the primary pathogen causing a scrotal abscess progressing to Fournier’s gangrene. A 63-year-old male with a past medical history of alcoholic dementia presented to an urgent care facility with left hemiscrotal pain and swelling, which was identified as a hemiscrotal abscess. He underwent incision and drainage on site. Four days later, positive wound cultures prompted referral to the emergency department for further evaluation and management. Persistent pain and swelling prompted repeat imaging that revealed a 2.6-cm gas-containing subdermal collection within the left hemiscrotum concerning for necrotizing infection. Emergent operative exploration confirmed Fournier’s gangrene, and debridement and excision of the scrotal wall cysts were performed. Intraoperative cultures grew A. vaginalis. The patient denied any sexual activity in the preceding 12 months. Empiric broad-spectrum antibiotics were initiated postoperatively and subsequently de-escalated to culture-directed oral therapy, which resulted in clinical improvement and discharge from the hospital. This case represents, to our knowledge, the first reported case of A. vaginalis as the primary pathogen in a scrotal abscess progressing to Fournier’s gangrene. This report highlights the importance of early recognition, maintaining a broad differential for necrotizing infections, prompt surgical intervention, and culture-guided antibiotic management to optimize patient outcomes.