Purpose Based on an initial hypothesis that the abdominal radiograph is rarely useful in the radiographic shunt series (SS), this study sought to determine which components of the SS are useful in identifying and diagnosing shunt dysfunction. This enquiry broadened to evaluate which modalities were most clinically useful in patients who ultimately underwent shunt revision for their suspected dysfunction. Methods Arm1: Abdominal radiographs (AXR) performed over a 2-year period were reviewed retrospectively to identify shunt abnormalities. Arm 2: Retrospective analysis of acute imaging and shunt series was performed on patients who had undergone shunt revision at the same hospital over a 10-year period. Results Arm 1: Seventy-five AXR performed were part of a formal SS. Eight reported a shunt abnormality. Two were within the abdomen; both findings were artefactual. Arm 2: One hundred seventy-nine patients are included. Ninety-six had abnormal imaging 72 h prior to revision; most were on CT (n = 67). Thirty-one demonstrated shunt leak, fracture or migration. Ninety-three patients had an SS the week before their revision; only 15% (n = 14) were abnormal. Conclusion This is a study evaluating the utility of radiographs in paediatric shunt malfunction. SS has low clinical yield; based on our findings, as well as background research, we recommend low-dose CT head (US or MRI) should be used as first line investigation, with tailored use of plain films to assist neurosurgical planning.

Background Advancements in cancer treatments have enhanced survival rates and quality of life for patients with central nervous system (CNS) tumours. There is growing recognition of the significance of fertility preservation methods. Currently, techniques, including oocyte cryopreservation and sperm cryopreservation are established. Nevertheless, oncologists may exhibit reluctance when referring patients to reproductive specialists. This review aimed to assess the best evidence for fertility preservation techniques used in patients with CNS cancers and evaluate outcomes relating to their success and complications. Methods Two reviewers performed a search of Pubmed, Embase, Medline, Cochrane and Google Scholar. Papers were included if they reported at least one fertility preservation technique in a neuro-oncology patient. Non-English studies, editorials, animal studies and guidelines were excluded. Meta-analysis was performed using the Random effects model. Results Sixteen studies containing data for 237 participants (78.8% female) were included in the systematic review and meta-analysis, of whom 110 (46.4%) underwent fertility preservation techniques. All patients (100%) successfully underwent fertility preservation with 1 participant (2.9%) returning to rewarm their oocytes, embryos or sperm. On average, 17.8 oocytes were retrieved with 78%, ultimately being cryopreserved. Five (6.0%) patients successfully conceived nine healthy term children after utilising their cryopreserved sperm, embryos, or oocytes. Moreover, six patients successfully conceived naturally or using intrauterine insemination, resulting in seven healthy term children. Conclusion Fertility preservation techniques could offer a safe and effective way for neuro-oncology patients to deliver healthy term babies following treatment. However, further studies concerning risks, long-term pregnancy outcomes and and cost-effectiveness are needed.

Introduction: Parkinson's disease is a common neurodegenerative disease. With an aging population, co-existent degenerative diseases of the spine in these patients will become more prevalent. Research question: This systematic review and meta-analysis aims to establish the incidence and risk of adverse outcomes following spinal surgery in patients with Parkinson's disease. Material and Methods A literature review was carried out in order to identify studies assessing the outcomes of adult patients with Parkinson's disease undergoing spinal surgery for degenerative conditions. Studies with less than ten subjects or those assessing surgery for spinal deformity or trauma were excluded. Results: Of 74 studies identified, seven were included for meta-analysis. In the 689,578 participants, there was a significantly higher incidence, but not higher risk, of complications (0.54 95% CI [0.19-0.85] vs 0.07 95% CI [0.01-0.41]; p = 0.048) and revision surgery (0.6 95% CI [0.25-0.88] vs 0.1 95% CI [0.05-0.19]; p = 0.003) amongst patients with Parkinson's disease compared to controls. We also demonstrated a significantly lower incidence but not lower risk of clinical improvement (0.27 95% CI [0.16-0.41] vs 0.57 95% CI [0.36-0.76]; p = 0.02) after surgery in patients with Parkinson's disease. There was no difference in the incidence or risk of death following surgery. Discussion and conclusion: Spinal surgery for concomitant degenerative diseases in patients with Parkinson's disease is associated with a lower incidence of clinical improvement and a higher incidence of complications. Medical management should be optimised before an individually tailored and well-considered surgical intervention is implemented.

Introduction: Since the past, art has been used as a tool to elaborate anatomical knowledge and guide surgeons to perform surgeries. Through the eras, art has taken role by conveying the knowledge to people in forms of illustrations and models, including neuroanatomy knowledge for neurosurgical purposes. With the advancement of technology, neurosurgical trainings and care evolve more than before. Research question: How do art and technology play role in the education and development of neurosurgery? Materials and methods: A literature search was conducted to find the role of art and technology in forms of illustrations, models, or others in neurosurgery. Results: Illustration was known as one of the tools to understand it in the past. Now, in the modern era, neurosurgical learning, training, and teaching process have integrated both art and technology throughout the process. Not only as two-dimentional drawings, art and technology have gone as far as being developed into three-dimensional models and create specific models for surgical plannings and simulations. Artificial intelligence, virtual reality, and augmented reality have also been used to achieve accurate and efficient learning process and neurosurgical care. Discussion and conclusion: Art does take significant role in the progression of neurosurgery. When combined with technology, art give greater utility and impact through the learning, teaching process, and delivery of care in neurosurgical world.