Background Ossifying fibroma (OF) is a benign tumor commonly occurring in the mandible and maxilla. Spinal involvement of OF is of great rarity. To the best of our knowledge, only three cases in the thoracic and lumbar spine had been reported. Methods We present a 22-year-old female with an OF of the atlas, which is the firstly described OF in cervical spine. The related literature was also reviewed. Results Only three spinal OFs involving the thoracic spine to sacrum have been reported. Here we present the first OF of the cervical spine. Conclusions Spinal involvement of OF is seldom. We report the first OF involving the cervical spine. Target Protein Ligand chemical Differential diagnosis of it from the primary spinal tumors should be included. OF occupies locally aggressive behaviors and high risk for recurrence. Complete resection, followed by regular follow up should be the ideal choice for treatment.Objective Surgical skills are generally acquired by watching the "hand movements" of experts. "Eye movements" are now attracting attention in skill-learning fields. Eye-tracking technology was introduced preliminarily to develop a better skill-learning system for neuroendovascular treatments. Methods During a task to place a detachable coil into a silastic cerebral aneurysm model under biplane X-ray fluoroscopy, gaze points were recorded using a head-mount eye-tracking device. Results During the task, 91% of fixations were allocated to the monitor displaying fluoroscopic images, and the others to the hands of operators or unspecified visual targets. More than 80% of fixations were located in frontal or lateral fluoroscopic images. Fixations were placed more frequently around the aneurysm than the microcatheter. One operator failed to recognize the timing when the proximal marker of the coil overlapped that of the microcatheter. The subject allocated most fixations to the frontal fluoroscopic image, whereas other subjects placed most fixations to the lateral fluoroscopic image. Furthermore, that operator put no fixations to the proximal marker of the microcatheter. Conclusions The results of this preliminary study imply the feasibility of the eye tracking-based learning system for neuroendovascular treatments. The eye-tracking analysis has potential in investigating or preventing procedural failures in neuroendovascular treatments.Background Numerous randomized controlled trials (RCTs) relevant to the cerebrovascular field have been performed. The fragility index was recently developed to complement the P value and measure the robustness and reproducibility of clinical findings of RCTs. Objective In this study, we evaluate the fragility index for key surgical and endovascular cerebrovascular RCTs and propose a novel RCT classification system based on the fragility index. Methods Cerebrovascular RCTs reported between 2000 and 2018 were reviewed. Six key areas were specifically targeted in relation to stroke, carotid stenosis, cerebral aneurysms, and subarachnoid hemorrhage. The correlation between fragility index, number of patients lost to follow-up, and fragility quotient were evaluated to propose a classification system for the robustness of the studies. Results A total of 20 RCTs that reported significant differences between both study groups in terms of the primary outcome were included. The median fragility index for the trials was 5.5. An additional 30 randomly selected RCTs were added to propose a classification system with high reliability. The difference between the number of patients lost to follow-up and fragility index inversely correlated with the fragility quotient and was used to divide the robustness of the RCTs into 3 classes reflecting the reproducibility of the trial. Conclusions Neurosurgeons and neurointerventionalists should exercise caution with interpreting the results of cerebrovascular RCTs, especially when the sample size and events numbers are small and there is a high number of patients who were lost to follow-up, as quantitatively identified using the proposed classification system.Background Hirayama disease (HD) is a rare focal amyotrophy, commonly reported in adolescent Asian males and characterized by unilateral or asymmetric distal upper extremity weakness. This disease exhibits an indolent course of progression over the initial 3-4 years, followed by a stage of stabilization. The diagnosis is confirmed by demonstration of enhanced posterior epidural space and dynamic spinal cord compression on cervical flexion magnetic resonance imaging. Diffusion tensor imaging (DTI) is a functional imaging modality, which can potentially be utilized in the diagnosis of HD. Case description We hereby report 2 young male patients who had presented to us with bilateral asymmetric upper extremity weakness. In both patients, magnetic resonance imaging of cervical spine revealed spinal cord atrophy or myelomalacia, anterior displacement of posterior thecal sac, and T2 hyperintense posterior epidural space, all of which were more evident in flexed position. On DTI, we could observe reduced fractional anisotropy in cervical flexion, as compared with neutral. Conclusions DTI tractography and reduced fractional anisotropy in cervical flexion can serve as potential indicators for the diagnosis of HD. Large-scale studies in the future are necessary to identify the potential role of this modality in surgical decision-making and in the assessment of prognosis in patients with HD.Background The Coronavirus disease 2019 (COVID-19) outbreak has left a lasting mark on medicine globally. Methods Here we outline the steps that the Lenox Hill Hospital/Northwell Health Neurosurgery Department-located within the epicenter of the pandemic in New York City-is currently taking to recover our neurosurgical efforts in the age of COVID-19. Results We outline measurable milestones to identify the transition to the recovery period and hope these recommendations may serve as a framework for an effective path forward. Conclusions We believe that recovery following the COVID-19 pandemic offers unique opportunities to disrupt and rebuild the historical patient and office experience as we evolve with modern medicine in a post-COVID-19 world.