World Neurosurg
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Traditionally, neurosurgery constitutes one of the most male-dominated scientific fields owing to several factors, including social stereotypes, nonequal opportunities for higher education, and historical circumstances. Currently, with the increasing number of women in neurosurgery all over the world, this stereotype seems to be slowly but steadily disappearing. Since 1989, Women in Neurosurgery has played a vital role in introducing and promoting talented women in neurosurgery and highlighting contributions of women to academic society and medical leadership worldwide. ⋯ In this article, we present a brief history of Greek neurosurgery, with an emphasis on the first women neurosurgeons and their contribution to neurosurgery in Greece. We have outlined the role of Greek women neurosurgeons in neurosurgical leadership through their active involvement in the administration of national and international neurosurgical societies. Furthermore, we have attempted to explore the underrepresentation of women in the Greek academic neurosurgical community and to determine whether it is associated with lurking gender discrimination or deep-rooted social prejudice.
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Treatment of Chiari malformation (CM) is controversial, especially when it coexists with "stable" or Type II basilar invagination (CM + II-BI). Precise evaluation of craniovertebral junction (CVJ) stability is crucial in such patients; however, this has never been validated. This study aimed to dynamically evaluate atlanto-condyle and atlantoaxial stability by kinematic computed tomography (CT) and report its surgical treatment. ⋯ CVJ instability, especially the ultramovement of atlanto-condyle facets, commonly exists in II-BI as evaluated using kinematic CT. The surgical strategy of atlantoaxial distraction and occipitocervical fusion should be considered to treat such patients.
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We sought to compare the dosimetric accuracy of postoperative stereotactic body radiation therapy in a carbon-fiber (CF) versus titanium instrumented spine using a cadaveric model. ⋯ More accurate dosimetry and radiation therapy delivery with CF screws compared with traditional titanium screws may have implications on optimal radiation delivery, as well as complication avoidance. This may be due to reduced scatter and thus lower variability in radiation delivery with the volumetric modulated arc therapy technique.
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There are 466 cases of absent unilateral (398) and bilateral (68) internal carotid artery (ICA) published in online books, abstracts, and original articles from 2020 to 2021. Of the 398 cases of absent unilateral ICA, 95 were associated with aneurysms. The analysis of these cases includes age, nationality and gender, location of aneurysm(s), description, and scheme of carotid-vertebrobasilar angioarchitecture mode in the brain base, as well as hypothesis on the embryonic background of accompanying vascular variations and abnormalities. ⋯ The association between the posterior communicating middle cerebral anastomosis and intercavernous (trans-sellar or intercarotid) channel with the absence of both anterior cerebral and anterior communicating arteries is common. More than half of the cases with aneurysms are located at the anterior segment vessels of the cerebral arterial circle. This review is based on the description and explanation of embryology and morphology of absent unilateral ICA with aneurysms, which would be a significant contribution to published literature on this topic, especially due to the fact that nothing similar has been published since 1957.
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Suboccipital decompression with duraplasty is being increasingly accepted for treating patients with Chiari malformation type I (CM-1). To date, the optimal duraplasty for CM-I has not been delineated. This study aims to compare the clinical and radiologic effects of duraplasty performed using 2 types of grafts and 2 graft fixation methods in 3 combinations. ⋯ Autologous and nonautologous dural grafts can be performed using either sutures or sutures plus glue, as both result in similar outcomes.