World Neurosurg
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Several differences distinguish brain functioning and behavior of women and men. This article addresses how gender features influence the way one behaves in the workplace, in particular, in neurosurgery. Women experience impostor syndrome, which is a persistent fearing of impropriety, by tending to point out their own fears and express their flaws, underrating themselves. ⋯ According to several authors, female neurosurgeons represent an important component for the future of the discipline and are essential to the field's growth. Nevertheless, young women feel a tension between the "women can have it all" movement and a realistic view of themselves as mothers, partners, employees, and leaders. As a young neurosurgeon, I think that our future is in our hands, it depends on our enthusiasm, on our energy but, above all, it will be bright, since we all are neurosurgeons.
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To define, from a series of surgically treated meningiomas of the posterior fossa with dural attachment above the dural sinuses, the best management of the sinus invasion according to the pattern of venous circulation. ⋯ In patients with posterior fossa meningiomas, we suggest to safety resect the involved sinus segment only when completely occluded. If the sinus lumen is not invaded or the tumor lies on the side of the unique or dominant transverse sinus, it should be preserved. This results in no or negligible risk of venous infarction and rather low recurrence rate.
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Posterior communicating artery segment aneurysms are one of the most frequent intracranial aneurysms. Currently, limited data have described the use of the pipeline embolization device (PED) in these aneurysms. ⋯ PED use for treatment of PComA aneurysms resulted in acceptable occlusion rates. The present study did not find that fetal PComA, its origin, or its patency during follow-up had an effect on aneurysm occlusion.
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Despite increasing use of direct oral anticoagulants (DOACs), guidelines for their perioperative use in spine surgery are still lacking. The main goal of our study was to analyze the occurrence of postoperative bleeding events and possible confounders in patients treated with DOACs who undergo spine surgery. ⋯ Short preoperative discontinuation time of DOACs, even <24 hours, may be justified, considering an increased risk of perioperative packed red blood cell substitution. Care should be taken with patients treated with concomitant blood thinners and patients with pre-existing kidney disease. Postoperative DOAC resumption >72 hours may increase risk of thromboembolic events.
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The overall survival rates for breast cancer are increasing due to controlled brain disease and improved systemic treatments. This study examined neurologic outcomes, tumor control, and survival data in breast cancer patients with multiple brain metastases and who required salvage stereotactic radiosurgery (SRS) for recurrent breast cancer brain metastases. ⋯ This report indicated that both initial and salvage SRS procedures in breast cancer patients with multiple brain metastases are effective for local control of intracranial disease while minimizing adverse radiation effects.