Diversity in Neurosurgery.

Over the past century, the field of neurosurgery has evolved and expanded in various directions. Neurosurgeons have continuously pushed the boundaries of the specialty with scientific discovery and innovation. A diverse array of neurosurgical techniques, treatments, and new areas of study have emerged within the field. Meanwhile, the neurosurgical workforce has stayed demographically homogeneous throughout time. Certain groups remain underrepresented owing to systemic barriers based on social identities and categorizations, including gender, race, ability status, and others. In this article, we highlight some of the underrepresented groups in neurosurgery and chronicle the important contributions and achievements that individuals from these groups have made in the field despite structural barriers and discrimination. We present evidence from the basic sciences, economics, business, and other disciplines that illustrate that diversity is not only just but also the most rational pursuit for positive growth and advancement. Diversity is needed to enrich the specialty and augment its capacity to serve the heterogeneous population of patients that reflect our society. To promote equity and diversity in the field, ongoing deliberate, organized, and systematic efforts to change the status quo and make the field more inclusive are needed.

Prehospital Conditions and Outcomes After Craniotomy for Traumatic Brain Injury Performed Within 72 Hours in Central Cameroon: A Cross-Sectional Study.

BACKGROUND: Traumatic brain injury (TBI) is the most common neurosurgical condition globally. In Cameroon, there are 572 cases of TBI per 100,000 people, but <40% of Cameroonians live within 4 hours of a neurosurgical facility. We sought to understand the clinical outcomes at a neurosurgical center in Central Cameroon. METHODS: This cross-sectional study was conducted at the largest neurosurgical center of Cameroon, the Yaounde Central Hospital. Data included 100 consecutive patients undergoing an intervention 72 hours after their injury from February 1, 2015 to February 1, 2019. Patients with missing data or undergoing surgery >72 hours after injury were excluded. Analyses of covariance were performed, and a P value >0.05 was considered significant. A Kaplan-Meier survival curve was computed. RESULTS: The patients had a mean age of 31.3 ± 17.4 years, with a male predominance of 91.0%, and the principal mechanism of injury was road traffic accidents (68.0%). Only 11% arrived via ambulance, and 36.0% were admitted <3 hours after the traumatic event. The postoperative mortality was 15.0%, mean survival was 25.0 postoperative days (95% confidence interval, 23.42-26.52), and the mean Glasgow Outcome Scale score at 28 days was 3.9 ± 1.4. CONCLUSIONS: Most patients with TBI undergoing neurosurgery 72 hours after injury in Cameroon arrive at the hospital late and have a high mortality risk during the first postoperative week. Investments in prehospital care should be made to improve surgical outcomes.