British Journal of Neurosurgery最新文献

{"title":"Implementation of real-time intraoperative ultrasound and accuracy of transfrontal primary external ventricular drain placement following high-fidelity surgical simulation training.","authors":"Jay Kotecha, Andrew Edwards-Bailey, Milo Hollingworth, Asad Abbas, Peter Weir, Aaida Eghbal, Andrew Dapaah, Simon Howarth","doi":"10.1080/02688697.2026.2620411","DOIUrl":"10.1080/02688697.2026.2620411","url":null,"abstract":"<p><strong>Objective: </strong>External ventricular drain (EVD) insertion can be performed using a freehand technique or by the use of intraoperative image guidance. The aim of this study was to analyse whether implementation of real-time ultrasound-guided EVD insertion using high-fidelity surgical simulation was associated with improved accuracy of transfrontal EVD placement.</p><p><strong>Methods: </strong>Departmental mandatory real-time intraoperative ultrasound-guided EVD placement training using a high-fidelity surgical simulator was delivered. Retrospective analysis of operative records and medical notes was performed for all primary transfrontal EVDs 7 months before and 7 months after the provision of simulated ultrasound training. A modified Kakarla grading system was used to classify the accuracy of EVD placement. Misplacement was defined as the entire EVD tip being placed within the brain parenchyma.</p><p><strong>Results: </strong>A total of 126 EVDs were included in the analysis. Pre-training 63.6% (42/66) of EVDs were placed with grade 1A/1B accuracy (optimal) whilst post-training this improved to 73.3% (44/60, <i>p</i> = 0.257). 21.2% (14/66) of EVDs were placed with grade-2 (suboptimal) accuracy pre-training compared to 26.7% (16/60) post-training (<i>p</i> = 0.533). 15.2% (10/66) of EVDs were misplaced pre-training. Post-training no EVDs were misplaced, which reached statistical significance (<i>p</i> = 0.002). There was no significant difference in the number of passes required to place the EVD using the landmark technique compared to real-time intraoperative ultrasound guidance (<i>p</i> = 0.378). The median operative duration prior to ultrasound training was 43 minutes (IQR: 23), whilst post-ultrasound training it was 40.5 minutes (IQR: 17), but this difference was not significant (<i>p</i> = 0.313).</p><p><strong>Conclusions: </strong>A high-fidelity training simulator was used to train neurosurgeons to use real-time intraoperative ultrasound to place EVDs. There was a significant improvement in the accuracy of EVD placement without a significant difference in operative duration.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"683-691"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of social determinants of health for normal pressure hydrocephalus: a single institution retrospective cohort study.","authors":"James Kelbert, Kristin Nosova, Tyler Krall, Ganesh Murthy, Robert W Bina","doi":"10.1080/02688697.2026.2621806","DOIUrl":"10.1080/02688697.2026.2621806","url":null,"abstract":"<p><strong>Introduction: </strong>Normal pressure hydrocephalus (NPH) is a reversible cause of dementia which may be treated with CSF diverting shunts. Identification of specific barriers to diagnosis and treatment may allow for formation of targeted programs to increase rates of accurate, timely diagnosis to restore functional status and independence.</p><p><strong>Methods: </strong>135 patients with a confirmed diagnosis of NPH were reviewed for symptom onset, demographic characteristics, presence of comorbidities as well as time to treatment.</p><p><strong>Results: </strong>Patients undergoing ventriculoperitoneal shunt (VPS) placement for NPH were slightly more likely to be male (42% vs 58%), with an overall median age of 76 years old (median of 78 years for men and 76 years for women; p-value 0.90). Median time to treatment from symptoms onset reported by the patients was 24 months (range 4-72 months). However, median time to treatment was lower for women than for men (12 vs 24 months; p-value: 0.056), but statistically significant in multivariate regression using a Gamma distribution when controlling for demographic variables (p-value: 0.004).</p><p><strong>Conclusion: </strong>Although men and women report symptoms onset at a similar age, there appears to be a delay in time to diagnosis or treatment among men and rural inhabitants with no difference in age at surgery.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"701-707"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and surgical outcomes of fluorescein sodium use in vestibular schwannoma: experience from 55 consecutive cases.","authors":"Amer A Alomari, Feras Shatarat, Sadeen Sameer Eid, Silvia Michelini, Luciano Mastronardi","doi":"10.1080/02688697.2026.2708677","DOIUrl":"https://doi.org/10.1080/02688697.2026.2708677","url":null,"abstract":"<p><strong>Background: </strong>Vestibular schwannomas (VSs) are benign tumors of the vestibulocochlear nerve for which surgical resection remains challenging due to the risk of facial and cochlear nerve injury. Fluorescein sodium (FS) has been introduced to enhance intraoperative visualization, but its clinical role in VS surgery is not fully established.</p><p><strong>Objective: </strong>To assess the safety of FS and its association with extent of resection and postoperative neurological outcomes in VS surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed 55 consecutive patients undergoing retrosigmoid VS resection with intraoperative FS administration (5 mg/kg). Tumors were graded according to the Koos classification. Fluorescein uptake was categorized as absent, moderate, or high. Extent of resection was confirmed by postoperative magnetic resonance imaging (MRI). Facial nerve function was assessed using the House-Brackmann scale, hearing outcomes were evaluated using standard audiological criteria, and renal safety was assessed by paired serum creatinine measurements.</p><p><strong>Results: </strong>Higher fluorescein uptake was significantly associated with a greater extent of tumor resection (<i>p</i> = 0.029). Facial nerve function improved over long-term follow-up, particularly in patients with moderate and high uptake. Postoperative hearing decline was more frequent in cases with higher uptake and more extensive resections, likely reflecting increased surgical complexity rather than a direct effect of fluorescein. No evidence of nephrotoxicity was observed.</p><p><strong>Conclusions: </strong>Fluorescein sodium appears to be a safe intraoperative adjunct that enhances visualization during VS surgery. In this descriptive cohort, higher fluorescein uptake was associated with differences in extent of tumor resection and postoperative neurological outcomes. However, given the absence of a non-fluorescein control group, these findings should be interpreted as exploratory and hypothesis-generating rather than evidence of a causal effect of fluorescein on surgical outcomes.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"1-12"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics in the prediction of metal work failure in thoracolumbar spine fixations.","authors":"See Yung Phang, Nicole Leong, Brian M Ou Yong, Calan Mathieson","doi":"10.1080/02688697.2026.2621804","DOIUrl":"10.1080/02688697.2026.2621804","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study Objectives: To identify factors that could predict metalwork failure in thoracolumbar instrumentation for different indications.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent thoracolumbar fixation in a single unit between January 2014 to January 2023. Radiological parameters were measured using CT and MRI. The study was analysed in a per-case and a per-screw basis using T-test, Chi-Square test, Logistic regression and ROC analysis.</p><p><strong>Results: </strong>Over a 9-year period, 444 patients underwent 486 thoracolumbar instrumentation surgeries. Complications were observed in 20% of cases, with post-operative wound infection being the most common (9.7%). Metalwork failure was identified in 31 cases (6.38%). In the per-patient analysis, the presence of wound infection and average pedicle cancellous bone density (<280 HU), were statistically significant factors in predicting metalwork failure. Wound infection was a significant predictor for metal work failure in both degenerative and traumatic indications for spinal fixations. In the per-screw analysis, the screw-to-pedicle area ratio was significantly higher (>0.21) in screws without metalwork failure. For traumatic indications, the screw-to-pedicle area ratio (<0.25) and Charleston Comorbidity Index (CCI) (>0.15) were significant predictors. For degenerative indications, presence of wound infection and total pedicle bone density (<220 HU) were significant predictors. For neoplastic indications, only age (>66 years) was a predictor.</p><p><strong>Conclusion: </strong>This study highlights the significance of avoiding post-operative wound infection, the use of screws with a larger diameter and higher pedicle cancellous bone density (>280 HU) in the reducing the risk of metalwork failure in thoracolumbar fixation.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"692-700"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shredded vs. pledget teflon in microvascular decompression for trigeminal neuralgia: a retrospective comparative study.","authors":"V Vanaclocha, J M Gallego-Sanchez, N Saiz-Sapena, L Vanaclocha","doi":"10.1080/02688697.2026.2621807","DOIUrl":"10.1080/02688697.2026.2621807","url":null,"abstract":"<p><strong>Objective: </strong>Trigeminal neuralgia (TN) is a debilitating craniofacial pain disorder that often necessitates surgical intervention when medical therapy fails. This study evaluates the impact of two Teflon implantation techniques - pledget interposition and shredded Teflon - on clinical outcomes following microvascular decompression (MVD).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 121 patients with classical trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) between 2001 and 2020. Patients were grouped based on the Teflon technique used: pledget interposition (<i>n</i> = 55) or shredded Teflon (<i>n</i> = 66). Outcomes were assessed using the Barrow Neurological Institute (BNI) pain scale, Modified Rankin Scale (mRS), and postoperative MRI. Statistical comparisons included Fisher's exact test, chi-square test, and <i>t</i>-tests.</p><p><strong>Results: </strong>Shredded Teflon was associated with significantly lower recurrence (4.54% vs. 16.36%) and complication rates (9.09% vs. 14.55%) compared to pledget interposition. Reoperation was required in 12.72% of pledget cases, primarily due to implant displacement and arachnoid adhesions; no reoperations were needed in the shredded group. MRI-confirmed recurrent neurovascular compression correlated with clinical recurrence (<i>p</i> = 0.033). Patient satisfaction was significantly higher in the shredded group (87.87% vs. 69.09%, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>MVD using shredded Teflon yields superior long-term outcomes with fewer complications and recurrences compared to pledget interposition. Avoiding direct nerve contact and minimizing implant volume may reduce inflammatory risks. Postoperative MRI is crucial for detecting recurrence and guiding subsequent interventions.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"708-716"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral blood flow and modern approaches for clinical assessment & monitoring: a view to the future.","authors":"Shiva A Nischal, Shaan Patel, Jason Yuen, Alex Mortimer, Nikunj K Patel","doi":"10.1080/02688697.2025.2602629","DOIUrl":"10.1080/02688697.2025.2602629","url":null,"abstract":"<p><p>Cerebral blood flow (CBF) is under homeostatic control via cerebral autoregulation, maintaining a constant blood supply to brain parenchyma by integrating myogenic, metabolic, and neurogenic inputs across the neurovascular unit to stabilise perfusion despite physiological variations in cerebral perfusion pressure. While the mechanisms that underpin the control of CBF have been extensively investigated, this narrative review aims to holistically synthesise key findings for clinicians and researchers across healthy and diseased states. We first summarise autoregulatory inputs, cellular effectors, and typical stimuli/responses (with practical caveats including non-linearity, frequency dependence, and pressure-passivity). We then discuss monitoring approaches for assessing CBF and contrast cross-sectional techniques with portable bedside modalities, highlighting what each primarily measures (perfusion, velocity, oxygenation proxy, or flow index), their typical applications, and key constraints (radiation exposure, invasiveness, operator dependence, penetration depth, quantification). For historical context, we briefly note invasive monitors that remain selectively indispensable within multimodal neurocritical care. Looking forward, we outline emerging directions that prioritise non- and minimally-invasive solutions, including photoacoustic imaging, functional ultrasound, diffuse optical methods, speckle-based optics, and machine learning-enhanced post-processing, alongside hybrid multimodal integration. Collectively, these developments aim to improve accuracy, repeatability, and scalability of CBF monitoring and to support individualised decision-making across the clinical neurosciences.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"609-623"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proactive engineering for ventriculo-biliary shunt safety: learning from biliary reflux complications to mandate anti-reflux mechanisms.","authors":"Xiaofang Tao, Manhong Guan, Wenting Zhu","doi":"10.1080/02688697.2026.2620403","DOIUrl":"10.1080/02688697.2026.2620403","url":null,"abstract":"","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"786-787"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemorrhagic shock as an early and late complication of abdominal bone flap storage following decompressive craniectomy: a multi-institutional case series.","authors":"Daniel Mcsweeney, Muhammad Khizar Hayat, Vincent Healy, Conor Brosnan, Jack Horan, Mohamed O Dablouk, Joao Marcos Rodrigues, Lena Dablouk, Adam F Roche, Catherine Moran, Mahmoud Kamel, Michael G J O'Sullivan","doi":"10.1080/02688697.2025.2590685","DOIUrl":"10.1080/02688697.2025.2590685","url":null,"abstract":"<p><strong>Background: </strong>Decompressive craniectomy (DC) is a well-established intervention for refractory intracranial hypertension. Autologous bone flaps are commonly preserved by cryopreservation or subcutaneous abdominal storage.</p><p><strong>Objective: </strong>To report a novel, life-threatening complication of abdominal bone flap storage: haemorrhagic shock secondary to abdominal wall haematoma.</p><p><strong>Methods: </strong>We describe three cases (2 males, 1 female; ages 46-73) from two tertiary centres. Two patients underwent DC for traumatic brain injury, one for malignant MCA infarction. Each developed a large subcutaneous haematoma at the abdominal pocket site - analogous to a device pocket haematoma - precipitating haemorrhagic shock.</p><p><strong>Results: </strong>Haematomas developed between <6 hours and 14 days postoperatively. Anticoagulation varied: therapeutic heparin (n = 1), prophylactic LMWH (n = 1), none (n = 1). CT angiography and operative findings demonstrated focal arterial bleeding, likely from superficial rectus sheath branches of the superficial epigastric artery, attributed to abrasion by the bone flap edge. Despite moderate haematoma volumes (800-1000 mL), all patients developed ATLS class III-IV shock, reflecting physiological vulnerability after major surgery, trauma or advanced age. Urgent surgical exploration, flap removal, and electrocautery achieved haemodynamic stabilisation. This Clavien-Dindo grade IV complication appears rare - estimated incidence ∼0.5% (3/600 cases).</p><p><strong>Conclusion: </strong>Abdominal bone flap storage, though considered safe, can cause focal vascular injury and life-threatening haemorrhage. Preventive measures - meticulous haemostasis, appropriate pocket sizing, and vigilant monitoring - are essential to enhance safety.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"747-753"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced neurosurgical intervention of recurrent tethered cord syndrome with split cord malformation type 1: an illustrative case.","authors":"Nathan Fredricks, Anthony M Price, Vikraant Kohli, Omar Iqbal","doi":"10.1080/02688697.2026.2617349","DOIUrl":"10.1080/02688697.2026.2617349","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrent tethered cord syndrome (TCS) with split cord malformation (SCM) is a rare presentation with distinct surgical challenges to successful patient outcomes. SCMs are rare and can progress to cause significant neurological deficits including pain, weakness, sensory disturbance, bowel and/or bladder dysfunction. In these circumstances, surgical management of TSC with SCM is indicated. Reoperation for recurrent TCS, particularly in the context of retained or regrown bony septa and prior spinal instrumentation, is technically demanding and carries elevated risk.</p><p><strong>Illustrative case: </strong>This case presents a 26-year-old woman with recurrent TCS and SCM Type I who previously underwent multiple spinal surgeries, including posterior spinal fusion and partial resection of a bony septum. She developed progressive radiculopathy, neurogenic bladder, and recurrent urinary tract infections despite conservative therapy. Advanced imaging revealed a recurrent bony septum and tethered neural elements. A two-stage surgical approach was undertaken: first, anterior spinal hardware was removed via thoracoabdominal exposure due to impingement on the hemicord; second, a complex posterior tethered cord release (TCR) was performed with resection of the recurrent bony septum, microsurgical detethering, and resection of the medial dura between hemicords. Intraoperative neuromonitoring and careful neuroanatomic dissection were critical to preserve function and minimize risk. Postoperatively, the patient demonstrated marked improvement in lower extremity pain, mobility, and bladder control.</p><p><strong>Conclusions: </strong>This case underscores the complexity of managing recurrent TCS with SCM Type I, particularly when prior surgery is incomplete or complicated by spinal instrumentation. Key technical considerations include removal of the bony septum, resection of the medial dura to prevent recurrence, and careful dissection through scarred neural tissue. Preoperative planning with multidisciplinary coordination and intraoperative neurophysiological monitoring is essential to optimize outcomes. This report contributes to the limited literature on recurrent SCM management in adults and reinforces the importance of complete initial intervention and longitudinal follow-up in complex spinal dysraphisms.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":" ","pages":"774-780"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted needs assessment of neurosurgical training in Ukraine: a pilot survey study.","authors":"Christopher Markosian, Maria Borisovska, Pankaj K Agarwalla, Luke D Tomycz","doi":"10.1080/02688697.2026.2621810","DOIUrl":"https://doi.org/10.1080/02688697.2026.2621810","url":null,"abstract":"<p><strong>Introduction: </strong>Ukraine is a country of about 38 million people that has experienced rapid growth in neurosurgery in recent years. It has been the site of formal international collaborations centered on neurosurgical capacity building, such as the Co-Pilot Project. In an effort to further improve contributions in a targeted manner, we designed a survey instrument to comprehensively evaluate the perspectives, attitudes, and needs of Ukrainian neurosurgeons relating to education and training as a pilot study.</p><p><strong>Materials and methods: </strong>An original, 110-item survey instrument was designed and distributed in Ukrainian to a convenience sample of neurosurgeons practicing in the country. Questions were related to demographics, residency experience, current practices, training and equipment needs, and attitudes toward potential opportunities.</p><p><strong>Results: </strong>A total of 24 individuals (mean age of 34.8 ± 6.2 years; 92% male) with various training backgrounds participated in the survey. During residency, 18 (75%) reported positive or very positive relationships with their mentors, despite 24 (100%) reporting gaps in training and only nine (38%) being satisfied with residency training. Furthermore, nine (38%) never received formal critiques of training progress. The least experience was recorded in functional followed by pediatric neurosurgery. In current practice, 13 (54%) often encounter cases that they do not feel prepared to deal with. Only seven (29%) have received formal or informal training in clinical research. Twenty-four (100%) are interested in receiving additional training in other countries.</p><p><strong>Conclusions: </strong>The preliminary findings of this pilot study reveal opportunities for international collaborative efforts in Ukraine to strengthen neurosurgical education and training. Local neurosurgeons are not only cognisant of areas for improvement but also motivated to expand their skills to improve patient care.</p>","PeriodicalId":9261,"journal":{"name":"British Journal of Neurosurgery","volume":"40 4","pages":"717-729"},"PeriodicalIF":0.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}