Journal of neurosurgery
-
Journal of neurosurgery · Nov 2024
ReviewArtificial intelligence as a modality to enhance the readability of neurosurgical literature for patients.
In this study the authors assessed the ability of Chat Generative Pretrained Transformer (ChatGPT) 3.5 and ChatGPT4 to generate readable and accurate summaries of published neurosurgical literature. ⋯ The findings demonstrate promising potential for application of the ChatGPT in patient education. GPT4 is an accessible tool that can be an immediate solution to enhancing the readability of current neurosurgical literature. Layperson summaries generated by GPT4 would be a valuable addition to a neurosurgical journal and would be likely to improve comprehension for patients using internet resources like PubMed.
-
Journal of neurosurgery · Nov 2024
Development and validation of a predictive scoring model for complications following endoscopic endonasal skull base surgery.
The endoscopic endonasal approach (EEA) has evolved into an established technique in skull base surgery. The authors previously examined 1002 EEA procedures and reported factors associated with postoperative complications. Here they report the development and validation of a scoring model based on risk factors to better predict complications following EEA. ⋯ This EEA complications scoring model accurately categorizes patients into low-, medium-, and high-risk groups with readily obtained variables. A high score in this complications model does not suggest that a patient is ineligible for surgery, but rather highlights the importance of thorough case selection, operating with caution, and appropriate preoperative counseling.
-
Journal of neurosurgery · Nov 2024
Predictors of trigeminal neuropathy in patients receiving Gamma Knife stereotactic radiosurgery for vestibular schwannoma.
The authors' objective was to validate dosimetric and clinical predictors of the development of trigeminal neuropathy (Tn) in patients treated with stereotactic radiosurgery (SRS) for a diagnosis of vestibular schwannoma (VS). ⋯ The only significant factor in the risk of development of Tn after SRS for VS was the volume of CN V that received ≥ 11 Gy. This should be routinely incorporated into dosimetric planning constraints and patients should be counseled about the risk of adverse effects if it cannot be met. For those with growing VS and a gap to the trigeminal nerve, it may be prudent to provide earlier treatment with SRS to enable application of this dosimetric constraint and reduced risk of Tn.
-
Journal of neurosurgery · Nov 2024
Management of intracavitary bleeding during ultra-early minimally invasive intracerebral hemorrhage evacuation.
Surgical evacuation of intracerebral hemorrhage (ICH) at early time points contributes to improved functional outcomes. However, ultra-early evacuation has been associated with postoperative rebleeding, a devastating complication that contributes to worse outcomes. Minimally invasive endoscopic techniques allow for intraoperative management of active bleeding, potentially allowing for safe and effective hemostasis at ultra-early time points. The authors proposed and prospectively assigned an intraoperative grading scale that quantified the severity of bleeding encountered intraoperatively. They hypothesized that ultra-early evacuation would correlate to increased intraoperative bleeding but not postoperative rebleeding or worse long-term clinical outcomes in a cohort of patients undergoing minimally invasive endoscopic evacuation. ⋯ Ultra-early evacuation within 5 hours of ictus is associated with increased intraoperative bleeding but not postoperative rebleeding or worse clinical outcomes. These findings suggest that the benefits of ultra-early evacuation can be explored without an increased risk of postoperative rebleeding when utilizing a minimally invasive endoscopic technique with good intraoperative visualization, active irrigation for targeted tamponade, and direct cauterization of bleeding vessels.
-
Journal of neurosurgery · Nov 2024
Barriers to neurosurgery for medical students: a national study focused on the intersectionality of gender and race.
Despite 51.2% of medical school graduates being female, only 29.8% of neurosurgery residency applicants are female. Furthermore, only 12.6% of neurosurgery applicants identify as underrepresented in medicine (URM). Evaluating the entry barriers for female and URM students is crucial in promoting the equity and diversity of the neurosurgical workforce. The objective of this study was to evaluate barriers to neurosurgery for medical students while considering the interaction between gender and race. ⋯ The authors highlight the implications of gender and racial diversity in the neurosurgical workforce on medical student interest and recruitment. Their findings suggest the importance of actively working to address these barriers, including 1) maternity/paternity policy reevaluation, standardization, and dissemination; and 2) actively providing resources for the creation of mentorship relationships for both women and URM students in an effort to create a workforce that aligns with the changing demographics of medical graduates to continue to improve diversity in neurosurgery.