World Neurosurg
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The current neurosurgical workforce is not large enough to address the significant burden of neurosurgical disease worldwide, and women are under-represented in this surgical specialty. However, trainee opportunities are particularly scarce in lower- and -middle income countries, where the burden of neurosurgical disease is high. Thus, the primary aim of this study was to assess the effects of gender and country on perceived access to neurosurgical research and mentorship opportunities. ⋯ More male than female medical trainees in the surveyed countries reported interest in neurosurgery. However, access to adequate neurosurgical research opportunities, though relatively low overall, did not vary by gender in most countries. Access to gender-concordant mentorship was less common for women than men, but women expressed that enhanced access to female neurosurgeon mentors would increase their interest in the field. These findings suggest potential avenues for intervention to augment and diversify the global neurosurgical workforce.
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This study aimed to assess the diagnostic accuracy of a novel marker, the combined lactate-to-glucose ratio (CLGR), in identifying cerebrospinal fluid (CSF) bacterial infection (CBI) in neurosurgical patients. Additionally, it seeks to establish cut-off values for CLGR and evaluate the reliability of measurement using blood gas analyzer (BGA). ⋯ CLac levels ≥6.0mmol/L and CLGR ≥20.0 accurately identified CBI in neurosurgical patients, with CLGR exhibiting superior efficacy. The potential for instant BGA measurement suggests promise for point-of-care testing.
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To compare the elastographic patterns of high-grade gliomas (HGGs) solid portions and those of adjacent healthy brain parenchyma, on intraoperative ultrasound, with magnetic resonance image (MRI) characteristics. ⋯ Three major SE patterns defined HGGs and adjacent healthy brain parenchyma. SE patterns varied accordingly to HGG histotypes and Gd-T1 MRI/FLAIR characteristics.
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This study aims to compare the diagnostic efficacy of somatosensory-evoked potentials (SEP) and transcranial Doppler sonography (TCD) for monitoring cerebral tissue ischemia during carotid endarterectomy (CEA) using network meta-analysis and retrospective analysis of clinical data. ⋯ During CEA, SEP appears to provide a slightly more reliable indication of the ischemic condition in cerebral tissues compared to TCD.
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Metastasis of WHO grade II or grade II meningiomas are rare. The aim of this study was to investigate their incidence, associated risk factors and treatment course. ⋯ The presence of metastasis contributed to poor outcomes and was related to earlier tumor relapse and major vessel compromise. Subtotal resection should be followed by adjuvant radiotherapy to reduce the risk of metastasis. Further research is warranted to identify circulating or pathologic biomarkers for the early detection of metastasis.