Journal of neurosurgery
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Journal of neurosurgery · Apr 2022
The added value of cerebrospinal fluid analysis in patients with subarachnoid hemorrhage after negative noncontrast CT.
In patients presenting within 6 hours after signs and symptoms of suspected subarachnoid hemorrhage (SAH), CSF examination is judged to be no longer necessary if a noncontrast CT (NCCT) scan rules out SAH. In this study, the authors evaluated the performance of NCCT to rule out SAH in patients with positive CSF findings. ⋯ CSF examination is still mandatory to rule out SAH as NCCT can fail to show blood, even within 6 hours after symptom onset. In addition, the diagnosis SAH was frequently missed during initial reporting.
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Journal of neurosurgery · Apr 2022
Incidence of surgery for chronic subdural hematoma in Finland during 1997-2014: a nationwide study.
The number of surgeries performed for chronic subdural hematoma (CSDH) has increased. However, these changes have been poorly reported. The authors aimed to assess the national incidence of surgeries for CSDH in Finland during an 18-year time period from 1997 to 2014. They hypothesized that the incidence of CSDH surgeries has continued to increase, particularly among the elderly. ⋯ During the past 2 decades, the age- and sex-adjusted incidence of CSDH surgery has increased in Finland, with major increases for those aged 60 years or older. This increase is likely to continue in parallel with the aging population and increased life expectancies.
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Despite the rising number of women in higher education and leadership positions, the proportional rise of female neurosurgeons still lags behind these fields. This study evaluates the gender distribution in German neurosurgical departments across all career levels, and is aimed at heightening the awareness of gender disparity and the need for improving gender equality and its related opportunities. ⋯ The number of women in leadership positions in German neurosurgical departments is dramatically low, and with increasing leadership status gender disparity increases. Mentorship, recruitment, the perception of benefits offered by diversity and programs facilitating gender equality, job sharing, parental leave policies, and onsite childcare programs are needed to turn German neurosurgical departments into modern medical departments reflecting the gender profile of the general patient population.
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Journal of neurosurgery · Apr 2022
Bicentric validation of the navigated transcranial magnetic stimulation motor risk stratification model.
The authors sought to validate the navigated transcranial magnetic stimulation (nTMS)-based risk stratification model. The postoperative motor outcome in glioma surgery may be preoperatively predicted based on data derived by nTMS. The tumor-to-tract distance (TTD) and the interhemispheric resting motor threshold (RMT) ratio (as a surrogate parameter for cortical excitability) emerged as major factors related to a new postoperative deficit. ⋯ This bicentric validation analysis further improved the model by adding the FA value of the corticospinal tract, demonstrating the relevance of nTMS/nTMS-based DTI fiber tracking for clinical decision making.
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Journal of neurosurgery · Apr 2022
Lessons from the life of Asia's first female neurosurgeon for modern neurosurgical trainees and educators worldwide.
Surgical specialties, and particularly neurosurgery, have historically had and continue to have poor representation of female trainees. This is especially true of South Asia, considering the added social and cultural expectations for women in this region. Yet it was in India, with its difficult history of gender relations, that Asia's first fully qualified female neurosurgeon, Dr. ⋯ Many of the virtues that ensured her success are attributes that continue to be critical for a neurosurgical career. Additionally, the circumstances that helped Kanaka succeed have been recounted as considerations for those working to promote diversity and inclusion. Finally, her life choices and sacrifices are described, which are underexplored but relevant concerns for women in neurosurgery.