Lateralization in visualization among neurosurgeons.

Background: Handedness is an epiphenomenon of brain lateralization which has been researched in the context of surgical performance, yet the same does not hold true for lateralization at a more fundamental level. We aimed to investigate whether neurosurgeons are biased in visualizing and depicting anatomy and pathology.

Methods: This was a two part study consisting of an online survey and image analysis. An online questionnaire was used to collect basic sociodemographic data and prompt subjects to visualize surgical approaches and pathological entities and report on the side of the visualized topics. Prominent neurosurgical literature was screened for depictions of the same entities and approaches and the depicted side was noted.

Results: There were 49 responses, most from Croatia (n = 26), men (n = 38), right-handed (n = 42), of average age 37 years, and with 9 years of neurosurgical experience. Ambidexterity was more prevalent than in the general population. The respondents imagined the right side more commonly in all cranial-related questions, and the left side in spine-related questions. Images in neurosurgical literature showed correspondingly biased laterality.

Conclusion: There is a significant bias among neurosurgeons in laterality in processing topographical information on anatomy and pathology. Research is warranted to investigate the causes and real life implications of this phenomenon.