Concussions, classified as a type of mild traumatic brain injury (mTBI), are frequently underdiagnosed due to the subjective nature of symptoms and limitations in existing diagnostic methodologies. Current clinical evaluations, including tools such as the Sport Concussion Assessment Tool 5 (SCAT5), Balance Error Scoring System (BESS), and Vestibular Ocular Motor Screening (VOMS), demonstrate high sensitivity and specificity but often fail to capture the full complexity of concussive injuries. Emerging diagnostic approaches, such as blood biomarkers (for example, glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), S100 calcium-binding protein B (S100B), and tau) and advanced neuroimaging techniques (for example, diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI)), show promise but remain impractical for routine clinical use due to accessibility and standardization challenges. This review examines objective markers, including neuroimaging, electrophysiological measures (for example, Electroencephalography (EEG), Magnetoencephalography (MEG)), and real-time diagnostic tools, as complementary strategies to enhance traditional clinical evaluations. Findings indicate that while clinical assessments remain central to concussion diagnosis, integrating them with advanced imaging and electrophysiological tools can provide more accurate diagnostics and recovery tracking. Biomarkers, although not yet ready for widespread use, hold significant potential for future applications. Further research is required to validate these methods and establish standardized protocols to facilitate their integration into clinical practice.

This meta-analysis aimed to assess the clinical impact of preoperative hair clipping versus no clipping in cranial neurosurgery, addressing an important element of patient-centered care that balances surgical needs with patient comfort. By examining existing evidence, this study seeks to inform neurosurgical practices on preoperative preparation choices that respect both clinical safety and patient preferences. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, articles from PubMed, Google Scholar, Embase, Scopus, and ScienceDirect, and studies that included adult patients undergoing cranial surgeries were included for data extraction and analysis. Studies were selected based on the presence of preoperative hair clipping or no clipping as a variable. Only comparative studies evaluating clipping versus no clipping were included, and razor-only or noncomparative hair-removal studies were excluded. The primary outcomes compared between these groups included infection rates, reoperation rates, readmission rates, and postoperative complications. Where available, details of perioperative protocols (preoperative Hibiclens/chlorhexidine showers, intraoperative scalp prep, postoperative antibiotic regimens, wound coverage, and timing of hair washing) were extracted. The analysis of studies (n = 22) revealed a higher infection rate in the clipping group compared to the no-clipped group (3% vs. 2%; 95% confidence interval [CI] 2-5% vs. 1-3%), though this difference was not statistically significant (P = 0.10). Reoperation rates were slightly higher in the no-clipping group than the clipping group (1% vs. 0%; 95% CI 0-3% vs. 0-1%), but this difference was also not statistically significant (P = 0.35). No significant difference in readmission rates was observed between the 2 groups (0% vs. 0%; 95% CI 0-3% vs. 0-1%, P = 0.83). Postoperative complications, primarily wound dehiscence, were comparable between the clipping and no-clipping groups (1% vs. 1%; 95% CI 0-2% vs. 0-3%, P = 0.61). This meta-analysis found no statistically significant differences in infection, reoperation, readmission rates, or postoperative complications between patients undergoing cranial neurosurgery with or without hair clipping. These findings suggest that preoperative hair clipping may not be clinically necessary, allowing patient preference to be incorporated without compromising outcomes. Furthermore, variations in perioperative antiseptic, antibiotic, and wound-care practices highlight the need for standardized reporting in future studies.

Background: Endoscopic spine surgery (ESS) is an established minimally invasive approach for degenerative spinal conditions. Advances in instrumentation and visualization have expanded its application to spinal tumor resection. This review synthesizes reported clinical outcomes and technical considerations of ESS for primary spinal tumors. Methods: PubMed was queried from 2000 to 2025 for studies reporting endoscopic resection of primary spinal tumors. Studies involving metastatic disease or non-resective interventions were excluded. Data were descriptively analyzed given heterogeneity and limited sample size. Results: Eleven patients across seven studies were included (mean age = 50.3 years). Pathologies comprised schwannoma (n = 5), meningioma (n = 3), osteoid osteoma (n = 2), and Ewing sarcoma (n = 1). Seven tumors were intradural extramedullary (63.6%) and four were extradural (36.4%); no intramedullary lesions were included. Of the seven intradural cases, one was performed via uniportal full-endoscopic technique, one via biportal endoscopy, and five via tubular retractor-assisted endoscopy. Across all eleven patients, gross total resection was achieved in 90.9% of cases. Gross total resection was achieved in 100% of cases in which it was the operative intent (10/10); the remaining case was a planned biopsy of recurrent Ewing sarcoma. One transient postoperative lower extremity weakness was reported; no cerebrospinal fluid leaks, reoperations, or perioperative deaths occurred. No recurrences were observed across a mean follow-up of 21.9 months (range 4–48 months), though this duration may be insufficient to assess long-term recurrence for slow-growing tumors such as meningioma and schwannoma. Conclusions: ESS of primary spinal tumors appears feasible and safe in carefully selected cases, particularly for small, well-circumscribed lesions in favorable anatomical locations. Intradural resection introduced distinct technical challenges, including irrigation management and dural closure, which influence platform selection. These findings are limited by small sample size, short follow-up, and likely publication bias. ESS should be considered an emerging minimally invasive option rather than a replacement for established microsurgical approaches. Prospective comparative studies are needed to better define its role in spinal oncology.