World Neurosurg
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Review Historical Article
Cranial surgery in antiquity: the size of trepanations during the Neolithic period in France.
The trepanation, a surgical procedure performed on the skull, finds its roots in prehistoric times. This investigation delves into the analysis of the trepanned skulls housed at the Musée de l'Homme in Paris, focusing on those found in France, a region abundant in archaeological evidence of early neurosurgical techniques. With the opportunity to scrutinize these human remains, our study aimed to analyze the dimensions of Neolithic trepanations across 41 skulls. ⋯ Additionally, we successfully applied a straightforward protocol to determine the perforation area in ten Neolithic trepanations. These findings shed light on the medical practices of ancient civilizations, particularly in France during the Neolithic era. Moreover, this study underscores the significance of museum collections as valuable resources for scientific inquiry and the historical understanding of medicine.
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To highlight the neurosurgical implications of the hypoxia-inducible factor-2α- targeting agent belzutifan in the management of both von-Hippel Lindau (VHL)-associated and sporadic hemangioblastomas (HBLs). ⋯ There is limited experience regarding the use of belzutifan for CNS hemangioblastoma. While its application has been limited to a small group of clinical cases, it has exhibited significant efficacy in reducing the size and consequences of HBLs. Based on the promising outcomes observed in individual patient experiences and ongoing clinical trials, we infer that further exploration and integration of belzutifan into neurosurgical treatment plans for both sporadic and VHL-associated HBLs are warranted.
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Anterior column realignment via anterior, oblique, or lateral lumbar interbody fusion is increasingly recognized as a powerful mechanism for indirect decompression and sagittal realignment in flexible deformity. Single-position lateral surgery is a popular variation that places patients in the lateral decubitus position, allowing concomitant placement of lateral interbodies and posterior segmental instrumentation without the need for repositioning the patient. The addition of robotics to this technique can help to overcome ergonomic limitations of the placement of pedicle screws in the lateral decubitus position; however, its description in the literature is relatively lacking. In this review we aim to discuss the indications, advantages, and pitfalls of this approach.
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Neurosurgery is a field with complex ethical issues. In this article, we aim to provide an overview of key and emerging ethical issues in neurosurgery with a focus on issues relevant to practicing neurosurgeons. ⋯ We argue that bioethics can help neurosurgeons think about and address these issues, and, in turn, the field of bioethics can benefit from engagement by neurosurgeons. Several ideas for increasing engagement in bioethics are proposed.
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Health care in developing countries often lacks adequate bookkeeping and national cancer registries, means of information that have proven to impact disease research and care. The true burden of brain tumors therefore remains unchecked and so does the extent of the problem. Therefore, this study aims to explore the challenges and potential strategies related to information management of brain tumors in low- and middle-income countries (LMICs). ⋯ In LMICs, improving patient outcomes and quality of life postneurosurgical intervention for brain tumors requires coordinated efforts to enhance information systems. The support of the government and public health professionals is vital in implementing strategies to achieve this goal.