World Neurosurg
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Review Historical Article
The History and Current Status of Neurosurgery in Iraq.
The roots of modern neurosurgery in Iraq can be traced back to the dawn of civilization, the Mesopotamian culture. Archaeological evidence has provided us with new insights regarding Mesopotamian medical practices. ⋯ In present-day Iraq, neurosurgery is facing many challenges; the specialty is limping with an inadequate number of neurosurgeons who strive to perform under conditions of political, social, and economic instability. Nevertheless, nondismissible progress has been made in recent years propelled by the efforts of our local neurosurgeons.
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Randomized Controlled Trial
Prospective randomized study on the effects of improved sleep quality after craniotomy on melatonin concentrations and inflammatory response in neurosurgical intensive-care patients2.
Sleep disorders in intensive care units after a craniotomy can decrease melatonin secretion and increase the inflammatory stress response. The aim of this study was to investigate the influence of improving sleep quality via eye patches and earplugs on melatonin secretion and inflammatory mediator release. ⋯ Melatonin secretion significantly increased as a result of improving postoperative sleep quality by noise and light isolation in neurosurgical intensive care unit patients after craniotomy.
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Tuberculosis is a common disease; however, the prevalence of calvarial tuberculosis is very rare. Most cases of calvarial tuberculosis occur in young patients. We report a rare case of calvarial tuberculosis in an elderly patient. ⋯ A careful assessment should be performed to obtain an appropriate diagnosis in cases of osteolytic lesions of the skull.
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Neurosurgery remains a specialty with one of the largest gender gaps in the United States. Neurosurgery residency programs are highly motivated to attract the best female candidates in an effort to improve their program diversity, but no studies currently exist that examine the factors of highest importance to female applicants for neurosurgery residency selection. The purpose of this study was to determine factors that female neurosurgery residents used when selecting their residency. ⋯ Efforts to increase female applicants in neurosurgery residency programs should focus on highlighting some more universal, non-gender-related factors, such as happiness and camaraderie among residents and anticipated clinical experiences, as opposed to showcasing features that would seemingly appeal to female applicants, such as maternity leave and number of current female faculty or residents.
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Review Case Reports
Surgical Sparing and Pairing Endovascular Interventions for Carotid-Cavernous Fistula: Case Series and Review of the Literature.
Carotid-cavernous fistulas (CCFs) are abnormal communications between the arterial and venous circulation within the cavernous sinus, manifesting in myriad neurological and ophthalmological sequalae. In rare circumstances patients' unique vascular anatomies preclude standard endovascular treatment for this pathology, warranting combined surgical and endovascular approaches wherein the cavernous sinus is accessed via superior ophthalmic vein (SOV) exposure, cutdown, and cannulation. ⋯ Endovascular approaches are well described as the mainstay of treatment for CCF but are not possible for all patients. In circumstances where individual vascular anatomy is not amenable to transarterial or transvenous access or embolization, a combined surgical and endovascular approach may be appropriate. We describe 3 cases that illustrate the spectrum of interventions for CCF, as well as the technical aspects of treatment for 2 patients with complex, direct CCF, using an embolization approach reliant on SOV cutdown and cannulation.