World Neurosurg
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In the past, women in neurosurgery were deemed "less than a minority." Pioneering women entered neurosurgical residency programs alone, facing large obstacles to become surgical experts. Recent data suggest a stark increase in the number of women neurosurgical residents. As the field of neurosurgery attempts to increase numbers of women surgeons, it must also adjust workplace culture to embrace a new group of trainees. Here, we share an account of historical numbers, as well as evidence of a changing landscape within neurosurgery and suggestions of ways to modify workplace culture based on examples set in other career paths.
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The endoscopic approach increasingly is used to treat third ventricular colloid cysts. Our objective was to assess the results of endoscopic resection of colloid cysts of the third ventricle. ⋯ High rates of complete resection of third ventricular colloid cysts, with low morbidity and mortality, are possible with an endoscopic approach. The results of this study support the role of endoscopic resection in the treatment of patients with third ventricular colloid cysts as a safe and effective modality and show how endoscopic resection of third ventricular colloid cysts can produce favorable results.
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Diffuse idiopathic hyperostosis (DISH) is characterized by calcifications affecting mainly the spinal anterior longitudinal ligament. This disease is mainly asymptomatic but cervical osteophytes can sometimes cause dysphagia (DISHphagia), hoarseness, and even dyspnea. ⋯ A thorough literature review didn't yield any article reporting on bilateral vocal cord paralysis caused by DISH. Management of this condition is typically multidisciplinary, and treatment of cervical osteophyte-associated dysphagia or respiratory compromise is primarily medical, after performing necessary tests to rule out other causes of dysphagia. Surgical intervention is warranted when medical treatment fails, when there is weight loss, a significant airway compromise or sleeping alterations. A treatment algorithm is proposed in the end of this review for symptomatic anterior osteophytes caused by DISH in the mobile cervical spine.
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Tuberculous meningitis (TBM) is an endemic infectious disease in developing countries, and it can become a serious illness in children. Treatment of TBM is more difficult and prone to failure than treatment of pulmonary tuberculosis. TBM causes hydrocephalus, cerebral edema, increased intracranial pressure, global ischemia, and neurologic deficits, which disturb cellular metabolism and increase lactate levels. A reliable, widely available clinical indicator of TBM severity is needed. Successful treatment of TBM is assessed using the Glasgow Outcome Scale (GOS). ⋯ Examination of plasma and CSF lactate levels should be included in routine examinations to determine extent of cellular damage and GOS score in patients with TBM and acute hydrocephalus who have undergone fluid diversions.