World Neurosurg
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Despite advancements in gender equality within neurosurgery, the field continues to encounter challenges related to the under-representation of women and reports of gender-based disparities. This study examines the impact of these disparities on the experiences, professional development, and well-being of female neurosurgery residents in Germany, identifying specific challenges within the neurosurgical community. ⋯ The survey highlights gender disparities affecting female neurosurgery residents in Germany, negatively influencing job satisfaction and career advancement. Tackling gender discrimination and harassment requires a multifaceted approach, and further studies are warranted to assess these methods. The neurosurgical community must ensure a supportive environment by adopting no-tolerance policies against discrimination for all residents, paving the way for a future where professional excellence and patient care are free from gender inequalities.
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Dystonia is common in Parkinson disease patients, affecting about 30% of them. Bilateral subthalamic nucleus deep brain stimulation (DBS) can sometimes lead to dystonia, but this relationship is not well understood. Our aim was to provide a better understanding of dystonia's causes and its connection to DBS. ⋯ Patients with off-dystonia before surgery tend to improve after DBS. Otherwise, DBS could have the role of "additive boost" in the process of sensitization of striato-pallidal pathways and lead to on-dystonia in particular patients.
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This study aims to evaluate the prognostic factors and survival outcomes of pediatric patients with pineal region tumors (PRTs) using a large population-based registry. ⋯ Early age at diagnosis and aggressive histological types such as pineoblastomas are associated with poorer outcomes. Future research should focus on refining therapeutic protocols that integrate the histological and molecular profiles of these tumors.
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Trigeminal neuralgia is usually associated with vascular compression of the nerve entry zone. However, a dolichoectatic basilar artery represents the cause in only up to 3% of cases.1 This is characterized by dilation, elongation, or tortuosity of the vertebrobasilar arteries.2 In 10%-30% of cases, pain relief is not achieved with medical treatment. Thus, microvascular decompression techniques have been proven the most effective. ⋯ This surgical video illustrates anatomic nuances and critical aspects of the retrosigmoid approach as a safe and adequate access for microvascular decompression in a rare case of a megadolichoectatic basilar artery (Video 1). The patient consented to the procedure and the publication of his images. Institutional review board/ethics committee approval was not required nor sought due to the nature of this paper.
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The purpose of this study was to determine the efficacy and safety of combined intravenous and topical use of tranexamic acid (TXA) in patients undergoing separation surgery for thoracolumbar spinal metastases by evaluating perioperative blood loss and complications. ⋯ The application of TXA in separation surgery of spinal metastases can obviously reduce drain days, perioperative blood loss, an dintraoperative transfusion rate. The combination of intravenous infusion and topical use of TXA is more effective than intravenous use alone, which showed a strong synergistic effect; additionally, it does not increase the risk of venous thromboembolism and wound infection.