World Neurosurg
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Vascular injury is rarely reported but can be a life-threatening complication after lumbar disc surgery. ⋯ This case reminds us of this rare but possible complication, and emphasizes the importance of early diagnosis and urgent intervention.
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Contributing to medical practice in developing countries has become increasingly prevalent. Primary care and preventative health initiatives have been most visible, although attention has recently shifted to surgical disease, which represents a large burden in resource-poor settings. Typically dominated by individual efforts, there is now a more concerted approach, with surgical care being included in the comprehensive primary health care plan set by the World Health Organization. Although ethical dilemmas in international surgery have been discussed sporadically in the context of specific missions from the visiting surgeon/team perspective, we are missing a comprehensive evaluation of these issues in the literature. Here we have chosen to systematically categorize ethical issues confronted while teaching and operating in a developing country into 2 broad categories: venue (i.e., host) and visitor related. ⋯ This article provides a discussion written from visiting and host surgeon perspectives on diverse ethical challenges for which there is limited literature, including location selection, unmet needs at home, role of sponsors, and personal gain. In addition to candid discussion and a solutions-focused approach, the reader is provided with an "ethical checklist" for international surgical education, akin to the World Health Organization surgical safety checklist, to serve as a framework for the design of surgical missions that avoid ethical pitfalls.
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Capillary hemangioma in the cranial cavity is rare. This report describes 2 additional cases presenting shortly after pregnancy and provides a systematic review summarizing clinical experience to date. ⋯ At follow-up, symptoms had resolved and magnetic resonance imaging confirmed complete removal in both patients. Intracranial capillary hemangioma is rare, and treatment is empirical. Review of limited published reports suggests that surgery is the most commonly used treatment and that complete excision seems most likely to prevent further recurrence.
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The widely accepted h-index depends on the citation analysis source and does not consider the authorship position, the journal's impact factor (IF), or the age of the paper or author. We investigated these factors in citation statistics of academic neurosurgeons. ⋯ Google Scholar tends to inflate the h-index. The m-quotient and hc-index allow comparisons of researchers across time. Although average journal IF did not differ significantly among neurosurgeons academic ranks, it should be noted for individuals who consistently publish in high-impact journals. We recommend the creation of individual bibliometric profiles to better compare the academic productivity of neurosurgeons.