Multimedia computer database for neurosurgery

OBJECTIVE: There is a need for an efficient mechanism of storing and analyzing neurosurgical clinical, imaging, and operative data to facilitate clinical audit, research, education, and preparation of scientific presentations. METHODS: A computer database was developed to meet this need. The recorded data include diagnoses, digitized neuroimaging studies, operative details (with intraoperative video clips), transcranial Doppler studies, outcomes, complications, admissions, and clinic visits. The anatomy, pathology, and clinical presentation are recorded for each diagnosis. RESULTS: The database provides an audit of neurosurgery cases, which includes admission Glasgow Coma Scale score, length of intensive care and hospital stays, Glasgow Outcome Scale score, and complications. Clinical research is facilitated by flexible search strategies based on the anatomy, pathology, or clinical presentation of diseases, or any of the recorded intraoperative or outcome factors. The system can be used to assess the influence on outcome of factors, such as transcranial Doppler velocity, intraoperative blood pressure, and the use of ventricular drainage, intraoperative angiography, or temporary clipping. The database can be used to track patients with untreated or partially treated conditions, such as incidental or incompletely coiled aneurysms. The recorded images and video clips are used for teaching and producing multimedia presentations and reports. The database is designed to enable secure Internet connections among institutions so that outcomes and complications can be compared among surgeons and institutions. CONCLUSION: This multimedia computer database facilitates clinical audit, research, teaching, and presentation activities.