Journal of neurosurgery
-
Harvey Cushing is considered the father of neurosurgery, not just for his work within the United States, but also for his global influence through international visitors and trainees. Starting in 1920, the neurosurgical clinic at the Peter Bent Brigham Hospital in Boston, led by Cushing, trained surgeons from all over the globe, many of whom returned home to establish neurosurgical departments and become neurosurgical pioneers themselves. ⋯ The authors demonstrate how Cushing provided the impetus for a movement that revolutionized neurology and neurosurgery worldwide. Even today, international cooperation continues to shape the success of our delicate specialty.
-
Journal of neurosurgery · Jul 2021
Creation of a comprehensive training and career development approach to increase the number of neurosurgeons supported by National Institutes of Health funding.
To increase the number of independent National Institutes of Health (NIH)-funded neurosurgeons and to enhance neurosurgery research, the National Institute of Neurological Disorders and Stroke (NINDS) developed two national comprehensive programs (R25 [established 2009] for residents/fellows and K12 [2013] for early-career neurosurgical faculty) in consultation with neurosurgical leaders and academic departments to support in-training and early-career neurosurgeons. The authors assessed the effectiveness of these NINDS-initiated programs to increase the number of independent NIH-funded neurosurgeon-scientists and grow NIH neurosurgery research funding. ⋯ Targeted research education and career development programs initiated by the NINDS led to a rapid and dramatic increase in the number of NIH-funded neurosurgeon-scientists and total NIH neurosurgery department funding.
-
Journal of neurosurgery · Jul 2021
Fellowship, gender, and scholarly productivity: trends among academic neurosurgeons in the US.
Current data on fellowship choice and completion by neurosurgical residents are limited, especially in relation to gender, scholarly productivity, and career progression. The objective of this study was to determine gender differences in the selection of fellowship training and subsequent scholarly productivity and career progression. ⋯ Women were found to have higher rates for fellowship completion compared with their male counterparts, yet had lower scholarly productivity in every subspecialty. Fellowship choice remains unequally distributed between genders, and scholarly productivity and career progression varies between fellowship choice.
-
Journal of neurosurgery · Jul 2021
The economic value of an on-call neurosurgical resident physician.
The cost of training neurosurgical residents is especially high considering the duration of training and the technical nature of the specialty. Despite these costs, on-call residents are a source of significant economic value, through both indirectly and directly supervised activities. The authors sought to identify the economic value of on-call services provided by neurosurgical residents. ⋯ Neurosurgery residents at the authors' institution theoretically produce enough economic value exclusively from on-call activities to far exceed the cost of their education. This information could be used to more precisely estimate the true overall cost of neurosurgical training and determine future graduate medical education funding.
-
Journal of neurosurgery · Jul 2021
Direct carotid puncture for mechanical thrombectomy in acute ischemic stroke patients with prohibitive vascular access.
While the benefit of mechanical thrombectomy (MT) for patients with anterior circulation acute ischemic stroke with large-vessel occlusion (AIS-LVO) has been clearly established, difficult vascular access may make the intervention impossible or unduly prolonged. In this study, the authors evaluated safety as well as radiographic and functional outcomes in stroke patients treated with MT via direct carotid puncture (DCP) for prohibitive vascular access. ⋯ DCP for emergency MT in patients with anterior circulation AIS-LVO and prohibitive vascular access is safe and effective and is associated with higher recanalization rates, smaller infarct volumes, and improved functional outcome compared with patients with abMT after failed transfemoral access. DCP should be considered in this patient population.