World Neurosurg
-
Despite the growing number of female medical students, there remains a significant disparity between the number of female and male neurosurgeons. This study aims to determine if this trend is also evident among medical students, examine how various medical schools worldwide are addressing this issue, and propose potential solutions. ⋯ This study highlights gender-based differences in career planning, scientific and practical neurosurgery experiences, and mentoring opportunities during medical education. Initiatives such as congresses and mentoring programs could help address this imbalance by supporting female medical students from the early stages of their careers.
-
Surgical management of blood blister-like aneurysm (BBA) is challenging and contentious because of high morbidity and mortality. Intraoperative neurophysiologic monitoring (IONM) is a well-established tool in intracranial aneurysm surgery, although its application in BBA surgery lacks reports. This study retrospectively analyzes the usefulness of IONM in BBA surgery between 2018 and 2023. ⋯ Our results show that IONM has low sensitivity (37.5%) and high specificity (100%) in detecting ischemic events during BBA surgery. The high rate of false-negative results in BBA-IONM suggests that its predictive value is limited particularly in complex maneuvers such as trapping and advanced vasoreconstruction, warranting cautious interpretation and further investigation of IONM modalities for BBA management.
-
The dissection of the Sylvian fissure (SF) is a crucial technique requiring considerable expertise and skills traditionally acquired through years of experience. The continuous decline in surgical case-load necessitates the development of efficient alternative training opportunities. However, building a realistic and effective training simulator for the microsurgical dissection of the SF as an integral part of the neurosurgical curriculum remains a challenging endeavor. This work aims to develop and evaluate a high-fidelity phantom simulator for effective and transferable training of the SF dissection with a focus on middle cerebral artery aneurysm clipping. ⋯ The presented methodology demonstrates that the development and assessment of a high-fidelity hands-on simulator for the focused training of one of the most delicate neurosurgical procedures is achievable in a timely manner and without extensive investments.
-
In general, the superior cerebellar artery is the most prevalent vessel that compresses the trigeminal nerve root exit zone (TGNREZ) and is responsible for trigeminal neuralgia (TGN). Nevertheless, the surgical outcome is less efficacious when the offending vessel is a dolichoectatic vertebrobasilar vessel (DVB). In addition, the potential for postprocedural adhesion and fibrosis renders recurrent TGN after prior surgery, an extremely challenging operation. ⋯ A combined transpetrosal approach with microneurovascular transposition technique was selected to achieve all objectives. A case illustration with a surgical video is demonstrated.
-
Socioeconomic status has historically influenced traumatic brain injury (TBI) outcomes, yet pediatric TBI disparities remain understudied. We aimed to analyze the National Inpatient Sample database for socioeconomic disparities in the outcomes of pediatric TBI patients. ⋯ This study highlights significant differences based on race, sex, income, insurance type, and geographic location in pediatric TBI outcomes. Future research should focus on identifying factors contributing to inequalities and developing strategies to mitigate them.