BACKGROUND: Stress in surgeons is well-known for its negative impact on neurocognition and surgical performance. Surgeons commonly use music for stress reduction, but its specific effects on neurosurgeons remain unclear. This study aims to investigate how listening to music during microsurgery affects neurocognitive functions, subjective anxiety, and stress levels in neurosurgeons.
METHODS: Conducted in two phases, the pilot phase involved 23 neurosurgeons completing a survey and rating compositions based on ragas of North Indian/Hindustani classical music for suitability during surgery. Five excerpts were selected for the main phase, which involved three neurosurgeons performing 16 surgeries, eight with and eight without music. Data collection included pre-surgery assessments of sleep, caffeine intake, subjective stress levels, perceived complexity of the surgery that was to be performed, and neurocognitive tasks. Post-surgery subjective stress levels, actual complexity, and surgeon experiences with music were recorded.
RESULTS: While there was a trend toward reduced stress and perceived complexity with music, statistical significance was not reached. Neurocognitive tasks showed non-significant improvement with music, with a significant (at p < 0.001) speed-accuracy trade-off noted in response inhibition.
CONCLUSIONS: Music appears to reduce subjective stress and task complexity, influencing neurocognition, particularly through speed-accuracy trade-offs. Further research is needed to understand its mechanisms and appropriate contexts for use before widespread recommendation.

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OBJECTIVE: Endoscopic sinus and skull base surgery has led to significant improvements in patient outcomes, yet may have come at a cost to surgeons\' musculoskeletal (MSK) health. We aimed to determine the prevalence and characteristics of work-related MSK disorders (WRMDs) in endoscopic sinus and skull base surgeons; to investigate contributing factors for WRMD in this population; and to evaluate the effectiveness of ergonomic interventions on the severity or prevalence of WRMD in this population.
METHODS: Medline, Embase, CINAHL, Web of Science, and Scopus from inception to April 2, 2024. A bibliographic examination was performed for further papers.
METHODS: Inclusion criteria included original peer-reviewed papers with work-related MSK outcomes (prevalence, contributing factors, and interventions) relating to endoscopic sinus and/or skull base surgeons in any language.
RESULTS: Of 25,772 unique citations, 37 studies met the inclusion criteria. The pooled lifetime, point, and 12-month prevalences of WRMD were 75.9% (95% confidence interval; I2, 67.2%-83.6%, I2 95.6%), 80.8% (77.0%-84.3%, I2 98.0%), and 82.0% (71.8%-90.3%, I2 60.96%) respectively. The neck, lumbar spine, and thoracic spine were the most commonly involved areas. One of 9 studies on contributing factors investigated discomfort as an outcome. The remainder focussed on surrogate outcomes (eg, posture, hand dysfunction). Two of the 13 intervention studies investigated pain or fatigue as an outcome. The remainder targeted posture, muscle activity, or workload.
CONCLUSIONS: WRMDs are highly prevalent in endoscopic sinus and skull base surgeons. Further studies focusing on the direct outcomes of WRMD such as pain are needed.

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BACKGROUND: It is important to have a diverse workforce in clinical and research environments. A cross-sectional study was conducted to examine the possible presence of gender, perceived skin colour, education, academic productivity, and career progression inequalities among neurosurgeons in the United Kingdom.
METHODS: A list of all consultant neurosurgeons working in the United Kingdom (N=384) was obtained from the Specialist Info website. Data about their education, research activity, academic productivity, impact and progression were obtained from publicly available online sources.
RESULTS: Over 90% of consultants and all full professors were men. There was a small number of black or brown consultant neurosurgeons and no black full professors. Very few black or brown consultants obtained their medical degree from a top university or had a PhD. There were no gender disparities in currently being affiliated with a university (or top university), obtaining a PhD or Master\'s degree, ranking of the university from which they obtained their medical degree, Master\'s degree or PhD, or number of pages and open access availability of their PhD thesis. Neurosurgeons who obtained their medical degree from the UK and those with a PhD had more publications, citations and a higher h-index. Male (vs female) academic neurosurgeons had more publications, non-self-citations, and a higher h-index, and white (vs brown) female neurosurgeons had more citations per paper.
CONCLUSIONS: This study identified important gender, skin colour, education, academic productivity, and career progression inequalities in the 2023 UK consultant neurosurgery workforce.

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The vein of Rolando, also known as the central sulcal vein, is a critical superficial cerebral vein located in the central sulcus, playing a pivotal role in the venous drainage of the motor and sensory cortices. Named after the Italian anatomist Luigi Rolando, this vein serves as a crucial anatomical landmark in neurosurgery, guiding surgeons to approach critical brain structures with minimal damage. This article explores the anatomy and clinical significance of the vein of Rolando, emphasizing its role in neurosurgery and neuroimaging. Advanced imaging techniques such as functional MRI (fMRI), Magnetic Resonance Venography (MRV), and CT Angiography have enhanced the ability to diagnose and preserve this vein, reducing surgical risks. The article also discusses the interconnectedness of the vein of Rolando with other cerebral veins like the vein of Trolard and underscores the importance of understanding venous variations and drainage patterns for successful surgical outcomes. Preventive measures to protect the vein during neurosurgery are essential to prevent complications such as venous congestion and intracranial pressure. This overview highlights the necessity for precise anatomical knowledge and advanced diagnostic tools in optimizing neurosurgical procedures and patient care.

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OBJECTIVE: The gold standard for diagnostics in primary central nervous system lymphoma (PCNSL) is histopathological diagnosis after stereotactic biopsy. Yet, PCNSL has a multidisciplinary diagnostic work up, which associated with diagnostic delay and could result in treatment delay. This article offers recommendations to neurosurgeons involved in clinical decision-making regarding (novel) diagnostics and care for patients with PCNSL with the aim to improve uniformity and timeliness of the diagnostic process for patients with PCNSL.
METHODS: We present a mini review to discuss the role of stereotactic biopsy in the context of novel developments in diagnostics for PCNSL, as well as the role for cytoreductive surgery.
RESULTS: Cerebrospinal fluid-based diagnostics are supplementary and cannot replace stereotactic biopsy-based diagnostics.
CONCLUSIONS: Histopathological diagnosis after stereotactic biopsy of the brain remains the gold standard for diagnosis. Additional diagnostics should not be a cause of diagnostic delay. There is currently no sufficient evidence supporting cytoreductive surgery in PCNSL, with recent studies showing contradictive data and suboptimal study designs.