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Updated: Jun 5, 2025

Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Complications: skull base and cerebrovascular
Walter C Jean1,2, Fady T Charbel3, Aaron A Cohen-Gadol4
1Division of Neurosurgery, Lehigh Valley Fleming Neuroscience Institute, Allentown, Pennsylvania.
Abstract:
Neurosurgical complications are a rich source for learning, but they are grossly underutilized for the purpose of surgeon education. Details of the complications, which make them all the more powerful as teaching tools, are restricted to morbidity and mortality conferences behind closed doors, and open discussions of the topic are blurred by hypotheticals in order to shield the presenters from medicolegal risks. In this issue of Neurosurgical Focus, 9 neurosurgeons were invited to present complications they encountered along with the details and specific lessons they learned. The contributors were picked for their well-known track record of skill, experience, and candor, so readers can be confident in the lessons. The video and the accompanying written article present the clinical facts. The actions that led to the complications are demonstrated in the surgical video segments. In ancient Western civilization, the seven "deadly sins" categorized and conceptualized human malfeasance, and similarly, the neurosurgical correlate of this set of sins can provide a framework for discussing the errors that lead to unexpectedly poor outcomes. Although errors in judgment and planning grow rarer with experience, errors in execution can still occur, no matter the stage of one's career. Interestingly, even though skill and experience do not eliminate complications, they may affect the lesson that the neurosurgeon takes home. The lack of open discourse on complications may slow progress in the field and set the stage for repeating mistakes. The writing and production teams hope that this work opens a rich source of learning. The video can be found here: https://stream.cadmore.media/r10.3171/2024.7.FOCUS24379.
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