INTRODUCTION: The World Federation of Neurosurgical Societies (WFNS) Young Neurosurgeons Committee conducted a global survey to identify key challenges affecting early-career neurosurgeons. These challenges ranging from restricted access to advanced training and limited research funding to insufficient mentorship, work-life imbalance, and experiences of gender and racial bias pose significant obstacles to professional growth and equitable neurosurgical development worldwide. METHODS: A cross-sectional, web-based survey comprising 49 structured and open-ended questions was disseminated through neurosurgical networks, mailing lists, and social media. The target group included neurosurgeons within 10 years of completing residency. Data were analyzed using descriptive statistics for quantitative responses and thematic analysis for qualitative insights. RESULTS: Of the 500 respondents, 56.1% reported limited access to advanced training, 50.6% highlighted insufficient funding opportunities, and 48.2% cited a lack of mentorship. Work-life balance was a major concern for 87.1% of participants. Reports of gender and racial/ethnic bias were noted by 40.5% and 22.4% of respondents, respectively. While most participants worked in public hospitals, institutional support for career development varied considerably. Key recommendations included structured mentorship, equitable resource distribution, improved training access, flexible work policies, and targeted strategies to promote diversity and inclusion. CONCLUSION: The findings underscore persistent structural and institutional barriers confronting young neurosurgeons globally. Addressing these challenges through coordinated strategies including mentorship networks, funding reforms, international collaborations, and inclusive leadership policies is essential to cultivating the next generation of neurosurgical leaders and ensuring equitable progress in the field.
- Klíčová slova
- Career advancement, Diversity, Early-career neurosurgeons, Global neurosurgery, Mentorship, Training barriers, WFNS,
- MeSH
- dospělí MeSH
- lidé MeSH
- neurochirurgie * výchova MeSH
- neurochirurgové * výchova MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- rovnováha mezi pracovním a osobním životem MeSH
- školitelé MeSH
- volba povolání * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Neurosurgical 3D visualizers and simulators are innovative devices capable of defining a surgical strategy in advance and possibly making neurosurgery safer by rehearsing the phases of the operation beforehand. The aim of this study is to evaluate Surgical Theater™ (Surgical Theater LLC, Mayfield, OH, USA), a new 3D neurosurgical planning, simulation, and navigation system, and qualitatively assess its use in the operating room. METHODS: Clinical data were collected from 30 patients harboring various types of brain tumors; Surgical Theater™ was used for the preoperative planning and intraoperative 3D navigation. Preoperative and postoperative questionnaires were completed by first and second operators to get qualitative feedback on the system's functionality. Furthermore, we measured and compared the impact of this technology on surgery duration. RESULTS: Neurosurgeons were overall satisfied when using this rehearsal and navigation tool and found it efficient and easy to use; interestingly, residents considered this device more useful as compared to their more senior colleagues (with significantly higher scores, P<0.05), possibly because of their limited anatomical experience and spatial/surgical rehearsal ability. The length of the surgical procedure was not affected by this technology (P>0.05). CONCLUSIONS: Surgical Theater™ system was found to be clinically useful in improving anatomical understanding, surgical planning, and intraoperative navigation, especially for younger and less experienced neurosurgeons.
- MeSH
- lidé MeSH
- nádory mozku * chirurgie patologie MeSH
- neurochirurgické výkony metody MeSH
- neurochirurgie * MeSH
- neurochirurgové MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: In Africa, no cerebral aneurysm treatment guidelines exist. Epidemiology, management, and outcomes after aneurysmal subarachnoid hemorrhage (aSAH) remain poorly understood, with many underdiagnosed cases. Muhimbili Orthopaedic and Neurosurgery Institute (MOI) is the only neurosurgical referral center in Tanzania. The aim of this study is to describe the current aSAH management with regional outcomes and limitations. METHODS: Patients with aSAH confirmed by computed tomography/magnetic resonance angiography between February 2019 and June 2021 were retrospectively studied. The analyzed parameters included demographics, clinical/radiologic characteristics, injury characteristics, and the modified Rankin Scale (mRS) score. RESULTS: In total, 22 patients, with a female/male ratio of 1.4 and a median age of 54 years (interquartile range [IQR], 47.2-63 years) harboring 24 aneurysms were analyzed. Thirteen patients (59.1%) paid out of pocket. The median distance traveled by patients was 537 km (IQR, 34.7-635 km). The median time between admission and treatment was 12 days (IQR, 3.2-39 days). The most common symptoms were headache (n = 20; 90.9%) and high blood pressure (n = 10; 45.4%). Nine patients (40.9%) had Fisher grade 1 and 12 (54.5%) World Federation of Neurosurgical Societies grade I. The most common aneurysms were of the middle cerebral artery (7/29.2%). Fourteen patients (63.6%) underwent clipping; of those, only 4 (28.6%) were operated on within 72 hours. Mortality was 62.5% in the nonsurgical group. Among clipped patients, 78.6% showed favorable outcomes, with no mortality. Endovascular treatment is not available in Tanzania. CONCLUSIONS: To our best knowledge, this is the first study highlighting aSAH management in Tanzania, with its assets and shortcomings. Our data show pertinent differences among international treatment guidelines, with the resultant outcomes, such as high preoperative mortality resulting from delayed/postponed treatment. Regional difficult circumstances notwithstanding, our long-term goal is to significantly improve the overall management of aSAH in Tanzania.
- Klíčová slova
- Diagnosis, Intracranial aneurysm, Management, Subarachnoid hemorrhage, Tanzania,
- MeSH
- intrakraniální aneurysma * chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neurochirurgie * MeSH
- ortopedie * MeSH
- retrospektivní studie MeSH
- subarachnoidální krvácení * diagnostické zobrazování chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Tanzanie epidemiologie MeSH
The world currently faces the novel severe acute respiratory syndrome coronavirus 2 pandemic. Little is known about the effects of a pandemic on non-elective neurosurgical practices, which have continued under modified conditions to reduce the spread of COVID-19. This knowledge might be critical for the ongoing second coronavirus wave and potential restrictions on health care. We aimed to determine the incidence and 30-day mortality rate of various non-elective neurosurgical procedures during the COVID-19 pandemic. A retrospective, multi-centre observational cohort study among neurosurgical centres within Austria, the Czech Republic, and Switzerland was performed. Incidence of neurosurgical emergencies and related 30-day mortality rates were determined for a period reflecting the peak pandemic of the first wave in all participating countries (i.e. March 16th-April 15th, 2020), and compared to the same period in prior years (2017, 2018, and 2019). A total of 4,752 emergency neurosurgical cases were reviewed over a 4-year period. In 2020, during the COVID-19 pandemic, there was a general decline in the incidence of non-elective neurosurgical cases, which was driven by a reduced number of traumatic brain injuries, spine conditions, and chronic subdural hematomas. Thirty-day mortality did not significantly increase overall or for any of the conditions examined during the peak of the pandemic. The neurosurgical community in these three European countries observed a decrease in the incidence of some neurosurgical emergencies with 30-day mortality rates comparable to previous years (2017-2019). Lower incidence of neurosurgical cases is likely related to restrictions placed on mobility within countries, but may also involve delayed patient presentation.
- MeSH
- COVID-19 mortalita MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- neurochirurgické výkony mortalita trendy MeSH
- neurochirurgie metody MeSH
- novorozenec MeSH
- pandemie statistika a číselné údaje MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: It has been previously published that the frontal branch of the middle meningeal artery (MMA) is usually embedded in a bony canal (BC). Although the incidence of the BC was over 70%, this structure is currently omitted both in anatomical nomenclature and in most of the literature. We found the same gap pertaining to the grooves for the MMA on the skull base. The aims of our study were to assess the incidence and morphometry of the MMA BC and grooves on the skull base. MATERIALS AND METHODS: Computed tomography (CT) scans of 378 patients, 172 skull bases as well as 120 sphenoidal bones and 168 temporal bones, and 12 histological specimens from 3 men and 3 women and 3 different regions of the MMA course were assessed. RESULTS: Based on CT scans, the incidence of the BC was 85.44% and was significantly higher in females than in males. Most of the canals and grooves were bilateral. The mean canal length was 17.67 mm, the mean transverse diameter 1.33 mm, and the mean distance from the superior orbital fissure (dFOS) was 26.7 mm. In the skull bases, the BC incidence was 70.07%, the mean canal length 10.74 mm, and the mean dFOS was 19.16 mm. The groove for the MMA on the temporal and sphenoidal bones was present in 99.42% and 95.35%, respectively. Histological specimens confirmed the presence of the MMA and accompanying vein/s. CONCLUSIONS: Based on our results, we suggest the addition of the BC and grooves for the middle meningeal vessels to the upcoming version of the Terminologia Anatomica.
- Klíčová slova
- Terminologia Anatomica, anatomical terminology, middle meningeal artery, skull base,
- MeSH
- arteriae meningeae * diagnostické zobrazování MeSH
- klínová kost diagnostické zobrazování MeSH
- lidé MeSH
- neurochirurgie * MeSH
- orbita MeSH
- počítačová rentgenová tomografie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- Betacoronavirus MeSH
- COVID-19 MeSH
- komunikace * MeSH
- koronavirové infekce epidemiologie MeSH
- lidé MeSH
- neurochirurgie MeSH
- neurochirurgové MeSH
- osobní ochranné prostředky * MeSH
- pandemie MeSH
- přístup k informacím * MeSH
- psychický stres * MeSH
- SARS-CoV-2 MeSH
- společnosti lékařské MeSH
- virová pneumonie epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- úvodníky MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
PURPOSE OF THE STUDY Back pain and pathologies of the spine are among the main reasons why people consult a doctor, both general practitioners and paediatricians, as well as, specifically, orthopaedists, surgeons, and neurosurgeons. This involvement of different faculties calls for a high degree of interdisciplinary co-operation. In order to mediate these aspects of spine-specific diagnostics, therapy, and research to students during their studies and to promote up-and-coming specialists, the compulsory elective subject 'Spine' was established. MATERIAL AND METHODS From the winter semester of 2013 to the winter semester of 2014, the compulsory elective subject 'Spine' was offered to interested students in the 7th semester of their studies of human medicine. The maximum number of participants per course was 16. Each course lasted four weeks. The subjects taught covered the fields of degeneration, deformities, and destruction in the specialist disciplines of orthopaedics, traumatology, neurosurgery, and rehabilitation medicine. In addition, orthopaedic technology and the local musculoskeletal and biomechanical research institute were integrated into the course. Various teaching methods were applied, including problem oriented learning, seminars, observation or consultation, and internship. At the end, the course was evaluated with regard to subjective learning success, knowledge gain, satisfaction, and interdisciplinarity. Participants were compared with all students of the semester employing an objectively structured clinical examination (OSCE). RESULTS Forty-eight students took part in the compulsory elective subject 'Spine'. The compulsory elective subject was given a positive rating in all fields. In the learning success control, all of the students had good to very good results. Students attending the elective subject performed significantly better in the objective structured clinical examination (OSCE) (p ≤ 0.001). The compulsory elective course continues to be offered in the curriculum with a slightly altered schedule. CONCLUSIONS In view of the high prevalence of patients with back pain and its associated importance in terms of healthcare policy and social relevance, our experience leads us to recommend the general integration of such a compulsory elective subject in the study of human medicine. Key words:elective subject, spine, students, spinal disorders.
- MeSH
- biomedicínský výzkum * metody organizace a řízení MeSH
- bolesti zad terapie MeSH
- kurikulum MeSH
- lidé MeSH
- mezioborová komunikace * MeSH
- nemoci páteře terapie MeSH
- neurochirurgie výchova MeSH
- ortopedie výchova MeSH
- studium lékařství * metody organizace a řízení MeSH
- stupeň vzdělání MeSH
- týmová péče o pacienty MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: A pineal cyst is a relatively common benign condition of the pineal gland. The clinical management of patients with a pineal cyst remains controversial, especially when patients present with nonspecific symptoms. METHODS: We performed a prospective study between 2000 and 2016. All patients with a pineal cyst >7 mm were included. Epidemiologic data, presenting symptoms, surgical results, and radiographic and clinical follow-up were documented. RESULTS: A total of 110 patients were enrolled in the present study. The most common presenting symptoms were tension headache (62.7%), vertigo (16.4%), migraine (12.7%), syncope (10.9%), nausea (8.2%), and diplopia (8.2%). Symptoms worsened during the follow-up period in 17 patients (15.5%), improved in 13 patients (11.8%), and remained stable in 81 patients (73.6%). The mean follow-up was 79.2 months. A pineal cyst increased in size during the follow-up in 6 patients (5.5%) and decreased in size in 9 patients (8.2%). Twenty-one patients underwent pineal cyst resection; 20 patients (95.2%) reported some improvement in their presenting symptoms, and 10 patients (47.6%) were symptom free after the surgery. CONCLUSION: We present the largest clinical series of patients with pineal cysts. Surgery, if indicated properly, is a legitimate treatment modality for symptomatic patients with satisfactory results. Relief of symptoms, even nonspecific ones, is achieved in the majority of cases. Simple growth of the cyst in the first decades of life is a part of the natural course and should not be considered as an indication for surgery.
- Klíčová slova
- Conservative treatment, Headache, Magnetic resonance imaging, Natural history, Neurosurgery, Pineal cyst, Pineal gland,
- MeSH
- cysty komplikace diagnostické zobrazování chirurgie MeSH
- dítě MeSH
- dospělí MeSH
- epifýza mozková diagnostické zobrazování chirurgie MeSH
- hydrocefalus etiologie MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory mozku diagnostické zobrazování chirurgie MeSH
- neurochirurgie metody MeSH
- tenzní bolesti hlavy etiologie MeSH
- vertigo etiologie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství 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.
- Klíčová slova
- E-WIN, EANS, Education, Gender, Neurosurgery, Survey, Women,
- MeSH
- dospělí MeSH
- lékařky statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- manželský stav statistika a číselné údaje MeSH
- neurochirurgie * MeSH
- neurochirurgové statistika a číselné údaje MeSH
- postoj zdravotnického personálu * MeSH
- pracovní síly 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
