Background: Empathy is a concept native to the field of medicine. However, over the course of medical school, empathy levels are expected to decline. The aim of this study was to assess the empathy levels among medical students in relation to their year of study and specialties of choice in the future. Materials and methods: A cross-sectional study was conducted to assess empathy levels among students from medical colleges in Karachi, Pakistan, using an online survey. The total duration of the study was 2 months. The authors analyzed the data using SPSS version 20. Results: A total of 463 undergraduate medical students participated in this survey. The overall mean empathy score was 101.9±16.3 with 104.6±14.1 for females, which was significantly higher than the male participants. The highest empathy levels were demonstrated in fourth-year medical students with a mean empathy score of 104.1±16.3, whereas, the lowest empathy levels were found in second-year medical students with a mean empathy score of 99.8±9.4. Study participants considering emergency medicine, neurology, obstetrics/gynecology, and oncology as their specialty of choice demonstrated the highest empathy levels followed by pediatrics and internal medicine. Conclusion: On average, there was a female preponderance in empathy levels among undergraduate medical students. Empathy levels among fourth-year students involved in clinical practice were greater as compared to students in their initial years of study. Further investigations are required to validate the findings of this study.

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) and stroke constitute 60% of the global neurosurgical case volume. Although decompressive craniectomy (DC) has been historically used for treating elevated intracranial pressures (ICP), it remains a controversial technique and is also associated with cranioplasty-related complications and additional costs. Hinge craniotomy (HC) may offer a potentially safer and, importantly, cheaper alternative to DC in low- and middle-income countries (LMICs), which bear the greatest burden of TBI cases. In this article, we aimed to provide a comprehensive meta-analysis comparing patients undergoing HC vs those undergoing DC for elevated ICP. METHODS: The MEDLINE and Cochrane databases were systematically searched from inception to May 2024. We included all studies comparing outcomes in patients with elevated ICP undergoing HC vs those undergoing DC. Random effects models were used to pool dichotomous outcomes as risk ratios and continuous outcomes as mean differences. RESULTS: Seven observational studies and one randomized controlled trial comprising 1335 patients were included in our meta-analysis. Both surgical techniques achieved comparable intracranial volume expansion (mean differences: −9.94 mm ³ ) and had similar rates of postoperative hydrocephalus (risk ratio [RR]: 0.46), wound infections (RR: 0.61), and subdural hematoma (RR: 1.37). However, patients undergoing HC showed significant improvement in functional outcomes at discharge (RR: 3.32), although long-term outcomes in this respect were similar between the 2 arms (RR: 1.12). CONCLUSION: Our meta-analysis, the first of its kind, depicts that HC offers an equally efficacious alternative to DC with the added benefit of achieving quicker functional recovery postoperatively. This is of particular clinical utility in LMICs which bear the greatest burden of TBI cases. However, in future, a cost-effectiveness analysis as well as adequately powered randomized controlled trials are needed to definitively delineate the optimal surgical approach needed to improve outcomes in our patient population.

Objective: Balloon-assisted coiling of intracranial aneurysms is considered a safe and effective practice. Complications can rarely arise from balloon-assisted endovascular procedures, including thromboembolic events and dissection.Case Presentation: We present the case of a patient with a subarachnoid hemorrhage from a ruptured 3.5 × 2.5-mm right posterior communicating artery aneurysm. After embolization, the patient developed a new right carotid artery dorsal blood blister aneurysm at the site of prior embolization, which was treated with placement of a double layer of laser cut stents.Conclusion: This case represents the first reported iatrogenic blister aneurysm that formed acutely after balloon-assisted coiling and was detected and treated promptly with endovascular embolization. Future research is needed to further elucidate the detection and management of such lesions.