World Neurosurg
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Neurosurgery is a challenging and stressful field. Excessive stress and professional dissatisfaction can lead to medical errors, negatively impact patient care, and cause physician burnout. Our objective is to develop and critically evaluate a survey measuring professional stress and satisfaction and to obtain preliminary data on sources and degree of stress and the prevalence of burnout among American neurosurgeons. ⋯ Our survey was well received and, according to respondents, encompassed the major issues associated with career stress, satisfaction, and burnout but needs to be shortened. Respondents were generally satisfied with their career but identified several major stressors. A larger study to identify predictors of career satisfaction/dissatisfaction will help generate dialogue on improving the quality of professional life for neurosurgeons.
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Comparative Study
Identification of knowledge gaps in neurosurgery using a validated self-assessment examination: differences between general and spinal neurosurgeons.
The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS. ⋯ The SANS Spine Examination demonstrated knowledge gaps in specific categories for spinal surgeons. The knowledge areas of diminished performance differed between spinal and general neurosurgeons. Identification of specific areas of deficiency could prove useful in the design and implementation of educational programs and maintenance of certification.
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Biography Historical Article
Sofia Ionescu, the first woman neurosurgeon in the world.
The authors present the activity of Mrs. Sofia Ionescu, the one female surgeon who was nominated as the first woman neurosurgeon in the world. Sofia Ionescu worked in the field of neurosurgery for 47 years, performing all the known neurosurgical procedures of the time. ⋯ The first documented surgical intervention performed by Diana Beck dates to 1952. Sofia Ionescu operated for the first time on a human brain as early as 1944. Furthermore, Diana Beck's actions surfaced in the year 1947, long after the war had ended and Sofia Ionescu had become a neurosurgeon.
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Historical Article
Evolution and rebirth of functional stereotaxy in the subthalamus.
The first human stereotactic surgery based on intracerebral landmarks and Cartesian coordinates was performed in 1947. With this followed the publication of a number of stereotactic frames and atlases. The intercommissural line joining the anterior and posterior commissures was to define stereotactic coordinate systems used in movement disorders and other functional neurosurgical procedures. ⋯ With advances in understanding of the functional anatomy of the corticobasal ganglia circuit, advances in brain imaging, more sophisticated electrophysiologic recordings, and the use of deep brain stimulation as a reversible lesion, stereotactic surgery returned as a viable option for the treatment of movement disorders. The posterior medial part of the globus pallidus, ventral intermediate nucleus of the thalamus, and the subthalamus, its nuclei and pathways, are sites for interrupting pathophysiologic circuits. Not only has this been applied to movement disorders, but to epilepsy, chronic pain, and behavioral disorders.