Background The treatment of brain arteriovenous malformations (AVMs) has been studied extensively. With the use of the Spetzler-Martin (S-M) grading system, patients can be informed appropriately about their possible surgical risks. This does not hold true for their neuropsychological sequelae, which have not been studied widely. We evaluated the neuropsychological outcome of our patients treated for brain AVMs. Methods Of 113 patients treated for a brain AVM between 2001 and 2009, 66 patients were enrolled in the study. All patients underwent treatment at our institution and neuropsychological testing 2 years later using a test battery constructed specifically for this study. A control group consisted of 10 subjects without any neurologic disease. Results When the whole cohort was analyzed, no significant differences were found between the groups distinguished by hemorrhage, gender, or hemispheric dominance. Patients with S-M IV and V scores fared significantly worse than patients with S-M I to III. Patients who presented with epilepsy scored lower than patients presenting with other symptomatology, but the difference had only borderline significance. When we analyzed patients according to the presence or absence of obliteration after treatment and compared these with the control group, we found no significant differences. When the patients with an obliterated AVM after treatment were subdivided according to treatment modality, there were no significant differences in their S-M groups compared with the control group. Similarly, those patients with nonobliterated AVMs analyzed according to their S-M grade showed a borderline significant difference, with S-M IV and V having a worse neuropsychological outcome compared with the other groups. Conclusions Patients harboring nonobliterated high-grade AVMs (S-M IV and V) scored worse than patients with nonobliterated AVM S-M grades I to III. This could be explained by the steal phenomenon. No differences in neuropsychological testing were found when comparing results according to nidus location. This study lends support to an active treatment policy for cerebral AVMs. Those patients in whom complete obliteration was achieved with treatment scored similarly to the background population, implying active AVM treatment does not cause deterioration in neuropsychological performance. This, together with a > 90% AVM obliteration rate, favors microsurgery as the treatment modality of choice whenever the AVM can be safely resected.

• MeSH
• dospělí MeSH
• intrakraniální arteriovenózní malformace komplikace   chirurgie   MeSH
• kognitivní poruchy diagnóza   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikrochirurgie škodlivé účinky   MeSH
• mladý dospělý MeSH
• neuropsychologické testy * MeSH
• retrospektivní studie MeSH
• terapeutická embolizace škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The proportion of women among neurosurgeons appears to be growing worldwide with time. Official data concerning the current situation across Europe have not yet been published. Thus, there are still concerns about gender inequality. The European Women in Neurosurgery Project 2016 was designed to recognize the current situation across Europe. METHODS: The office holders of the national neurosurgical societies of 39 countries forming the European Association of Neurosurgical Societies were contacted to provide data stating the proportion of women in neurosurgery. Obtained data were supplied with the results of an online survey. RESULTS: The response rate of national office holders was 90%. The number of reported neurosurgeons was 12,985, and overall proportion of women represented was 12%. Two hundred thirty-seven responses to online questionnaire were taken into account. The overall proportion of female respondents was 30%. There was no intergender variability in responses regarding amount of working time per week, exposure to surgeries, or administrative work. Male respondents reported dedicating significantly more time to scientific work and feeling more confident dictating own career direction. Female respondents reported being less often married, having fewer children, a stronger perception of gender significance level, and a higher appreciation of personal qualities. CONCLUSIONS: Neurosurgery is a challenging field of medicine. The results of our survey did not imply an overall feeling of gender inequality among European respondents, although women believe that the gender issue to be more important than men do and that they have to sacrifice more of their personal lives.

• MeSH
• dospělí MeSH
• lékařky statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• manželský stav statistika a číselné údaje   MeSH
• neurochirurgie pracovní síly   MeSH
• neurochirurgové statistika a číselné údaje   MeSH
• postoj zdravotnického personálu * MeSH
• rozložení podle pohlaví MeSH
• sexismus statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

INTRODUCTION: Frameless stereotactic brain biopsy systems are widely used today. VarioGuide (VG) is a relatively novel frameless system. Its accuracy was studied in a laboratory setting but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based (FB) stereotaxy. MATERIAL AND METHODS: Overall, 53 patients (33 males and 20 females, 60 ± 15 years old) were enrolled into this prospective, randomized, single-center study. Twenty-six patients were randomized into the FB group and 27 patients into the VG group. Real trajectory was pointed on intraoperative magnetic resonance. The distance of the targets and angle deviation between the planned and real trajectories were computed. The overall discomfort of the patient was subjectively assessed by the visual analog scale score. RESULTS: The median lesion volume was 5 mL (interquartile range [IQR]: 2-16 mL) (FB) and 16 mL (IQR: 2-27 mL) (VG), P = 0.133. The mean distance of the targets was 2.7 ± 1.1 mm (FB) and 2.9 ± 1.3 mm (VG), P = 0.456. Mean angle deviation was 2.6 ± 1.3 deg (FB) and 3.5 ± 2.1 deg (VG), P = 0.074. Diagnostic yield was 93% (25/27) in VG and 96% (25/26) in FB, P = 1.000. Mean operating time was 47 ± 26 minutes (FB) and 59 ± 31 minutes (VG), P = 0.140. One minor bleeding was encountered in the VG group. Overall patient discomfort was significantly higher in the FB group (visual analog scale score 2.5 ± 2.1 vs. 1.2 ± 0.6, P = 0,004). CONCLUSIONS: The VG system proved to be comparable in terms of the trajectory accuracy, rate of complications and diagnostic yield compared with the "gold standard" represented by the traditional FB stereotaxy for patients undergoing brain biopsy. VG is also better accepted by patients.

• MeSH
• biopsie přístrojové vybavení   MeSH
• design vybavení MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• interpretace obrazu počítačem přístrojové vybavení   MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie přístrojové vybavení   MeSH
• mozek patologie   MeSH
• nádory mozku patologie   sekundární   chirurgie   MeSH
• neuronavigace přístrojové vybavení   MeSH
• odchylka pozorovatele MeSH
• počítačová rentgenová tomografie MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH