World Neurosurg
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Myelomeningocele (MMC) disproportionately affects low-resource areas and regions without mandatory folic acid fortification. No specific literature exists on the distribution of research output regarding neurosurgical management of myelomeningocele worldwide in relation to regional disease burden. We aimed to examine the country of origin and patient population of published papers on MMC and topics related to neurosurgical management of MMC, to determine whether these were proportionate to disease burden. ⋯ The global literature concerning neurosurgical management of myelomeningocele originates predominantly from HICs. Published experiences of myelomeningocele patients from LICs/LMICs are scarce, even though they constitute the majority of the affected population. Neurosurgeons and other health professionals must address this mismatch between disease burden and publication volume in order to inform practice, policy, and advocacy for MMC care worldwide.
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Segmental arterial mediolysis (SAM) is a nonatherosclerotic, noninflammatory vascular disease, initially reported in 1976 by Slavin and Gonzalez-Vitale. SAM-associated cerebral aneurysms have been reported in limited cases, and the disease entity is not fully understood. Therefore, we propose a diagnostic and treatment strategy with a systematic review of previously reported cases and our cases. ⋯ SAM-associated cerebral aneurysms can be life-threatening because of the risk of rupture and can lead to successive IAH after SAH. However, the prognosis is relatively good if an operation is successful. Therefore, precise diagnosis is required for suspected cases at first, and appropriate surgical treatment is required. Moreover, appropriate management of successive IAH is required among patients with SAH.
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We assessed the accuracy of pedicle screws placed during awake minimally invasive surgery (MIS) transforaminal lumbar interbody fusion (TLIF) under spinal anesthesia and analyzed outcomes at the 1-year follow-up. ⋯ Our study shows a high accuracy (99%) of pedicle screw placement in patients undergoing awake MIS-TLIF under spinal anesthesia and significant improvement of their symptoms at 1-year follow-up.
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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.