World Neurosurg
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Effect of Dexmedetomidine Combined Anesthesia on Motor evoked Potentials During Brain Tumor Surgery.
Dexmedetomidine (DEX) is used as an adjunct to total intravenous anesthesia. However, its effect on intraoperative neurophysiologic monitoring (IOM) during brain tumor surgery remains controversial. The aim of this study was to explore the effect of DEX on IOM during brain tumor surgery. ⋯ This study showed that DEX had significant effects on tcMEPs during IOM in brain tumor surgery. Because the high false-positive rate could decrease the accuracy of IOM, outcomes after using DEX should be cautiously interpreted.
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Spinal subdural hematoma (SDH) concomitant with cranial SDH is extremely rare. Although some theories have been proposed, the pathophysiology underlying this condition remains unclear. We present a case of traumatic subacute spinal SDH followed by symptomatic subacute cranial SDH. ⋯ This case suggests the possibility that spinal SDH can develop as a result of cranial SDH migration to the most dependent spinal subdural space. The physician should be aware of the possibility of symptomatic cranial SDH developing following spinal SDH evacuation.
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In the modern, increasingly pay-for-performance era, unplanned return to the operating room (ROR) is gaining attention as a surgical quality metric. However, large-scale data on the appropriateness and usefulness of this measure in neurosurgery are scarce. ⋯ These findings may inform stakeholders on the optimal parameters that need to be taken into account when crafting, endorsing, and implementing quality metrics for neurosurgery that aim to assess surgical performance and reward or penalize hospitals and providers.
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Gender disparity in academic and organizational settings has been the topic of numerous studies and they have tried to extract its causes using H-index as the prime metric. The primary objective of our study was to assess gender disparity in leadership positions in neurosurgical societies worldwide. A second objective was to evaluate scholarly output among neurosurgeons in neurosurgical societies worldwide, utilizing H-index as a predominant metric. ⋯ A paucity of female neurosurgeons was seen in leadership positions in neurosurgical societies worldwide. Significant disparity present in research productivity between genders is a highlighted statistic further discussed in this study, considering variables such as H-index among others. The increase in female neurosurgeons to neurosurgical organizational echelons can be achieved by enhancing institutionalized support, setting up networking platforms, and identifying mentorship opportunities for prospective leaders.
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Case Reports
Arteriovenous Fistula Inside Cervical Spinal Canal Associated with Neurofibromatosis Type 1: A Case Report.
Neurofibromatosis type 1 (NF-1) is an autosomal dominant disease caused by mutation on chromosome 17, which affects the skin, vascular system, nervous system, and skeleton system. Arteriovenous fistula (AVF) is one of the recognized complications of NF-1. ⋯ This report reminds readers of the possibility of AVF if there is a space-occupying lesion inside the cervical spinal canal and to do computed tomography angiography examination when necessary.