Background: Cervical degenerative disease is a common condition associated with significant morbidity, often presenting as neck pain, radiculopathy, or myelopathy. Its growing incidence, particularly in the aging population, has led to an increased demand for surgical interventions aimed at relieving neural compression and restoring spinal stability. Objective: This study aims to evaluate surgical outcomes in patients with degenerative cervical conditions, with a particular focus on the role of intraoperative neurophysiological monitoring (IONM) in preventing adverse neurological events both immediately postoperatively and at long-term follow-up. Methods: A retrospective analysis was performed on patients who underwent cervical spine surgery for degenerative conditions between January 2021 and June 2024. Data collected included demographics, comorbidities, surgical details, and intraoperative neurophysiological monitoring. Surgical outcomes were assessed using the modified Rankin Scale (mRS), Odom’s Criteria, and the modified Japanese Association (mJOA) score. Results: Key findings demonstrated that advanced age and the presence of preoperative myelopathy were significantly associated with poorer postoperative outcomes across all evaluated measures. Conversely, factors such as gender, surgical approach, and the number of treated levels did not significantly influence recovery. Although intraoperative neurophysiological monitoring (IONM) did not show an immediate effect on postoperative outcomes, it was linked to prognostic value for long-term neurological status, suggesting a potential protective role in preserving neurological function. Conclusions: This study identifies age, preoperative functional status, and myelopathy as crucial predictors of postoperative recovery in cervical spine surgery for degenerative disease. These findings underscore the importance of early intervention in patients with myelopathy and highlight the complex role of IONM in improving long-term neurological outcomes. IONM changes may help identify patients at higher risk of poor recovery who could benefit from intensive postoperative rehabilitation. Further prospective studies are warranted to elucidate the complex interactions between patient characteristics and surgical factors in optimizing postoperative recovery.

Background: The management of large (≥10 mm) and giant (≥25 mm) intracranial aneurysms remains clinically challenging due to their elevated rupture risk, morbidity, and procedural complications, which pose a dilemma for both intervention and conservative management. Flow diversion (FD) has emerged as a promising endovascular approach, although its comparative safety and efficacy versus Coiling remain unclear. Methods: Following PRISMA guidelines, studies published between January 2000 and March 2025 were identified across PubMed, EMBASE, Scopus, and Web of Science. Outcomes assessed included aneurysm recurrence, complete occlusion, favorable clinical outcomes, procedure-related complications and mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and heterogeneity and publication bias were assessed. Results: A total of 1893 patients (1256 FD, 637 Coiling) and 1915 aneurysms across 33 studies were included. FD significantly reduced recurrence compared to Coiling (8% vs. 27%; p = 0.0001) and showed a trend toward a higher rate of complete occlusion (p = 0.0571). However, FD had a modestly increased rate of hemorrhagic complications (p = 0.0495). No other significant differences were found in clinical outcomes, major complications, ischemic events, delayed rupture, or mortality. Conclusions: Both FD and Coiling are effective and generally safe for large and giant intracranial aneurysms. FD is associated with lower recurrence and a trend toward a higher rate of complete occlusion, with similar overall safety but slightly higher hemorrhagic risk. FD is emerging as a preferred first-line option for large and giant unruptured aneurysms, while coiling remains important for ruptured aneurysms or when anatomical constraints limit the use of FD.

Introduction: Fluorescence Lifetime Imaging Microscopy (FLIM) is an imaging technique that allows for the visualization of the cellular microenvironment by measuring the decay time of endogenous fluorescent molecules. Its advent has allowed the acquisition of information on previously undetectable aspects of the tissue environment, which also includes some mechanisms involving immune checkpoints. Understanding the level of interaction with their ligands is of paramount importance when stratifying patients for immunotherapy, as traditional methods such as immunohistochemistry (IHC) were found to be ineffective in predicting responders. Methods: This review analyzes the current literature on FLIM as a means of predicting targets’ responsiveness to ICIs by examining the most relevant databases. Following PRISMA guidelines, we identified the relevant literature. The predefined objective of this review was to evaluate the potential of FLIM as a predictive biomarker of responsiveness to immune checkpoint inhibitors (ICIs). Eligibility criteria included original studies (clinical or preclinical) reporting on the use of FLIM to assess tumor or immune microenvironment in the context of ICI therapy. Reviews, case reports, editorials, and abstracts without full text were excluded. Results: Research suggests that interaction, not expression, is positively correlated with the effectiveness of ICI treatment. FLIM, in combination with FRET, allows for the quantification of the interactions within the tumor microenvironment. Discussion: The scope of the review is to assist researchers in further exploring this technology for possible applications and for future drug interaction studies.

OBJECTIVE: Unmet global neurosurgical needs pose a significant challenge, as do unequal opportunities for neurosurgical education and training across the globe. Mission:BRAIN is a nonprofit organization working to provide neurosurgical expertise and resources to both patients and healthcare providers in underserved areas. It operates globally, with local chapters involving primarily medical students. Its presence in Europe has expanded in the last few years with initiatives that contribute to shaping an international approach to global neurosurgery challenges. The authors aim to investigate the impact of student-led organizations, such as Mission:BRAIN, on global neurosurgery, with a focus on low-income countries and low- to middle-income countries, while also assessing the changes observed within the European group during its initial 2 years. METHODS: Quantitative and qualitative analyses were employed to investigate changes in the number of chapters, members, and events. The perceived impact was evaluated using a Likert scale survey administered to European members. RESULTS: Between 2022 and 2023, the number of European chapters increased by 150% (n = 10) and memberships doubled. Of the 102 survey respondents, 56.9% were female and 42.2% were male. Similarly, the number of events grew by 240%, with a significant increase in educational events (325%, p = 0.007). Participation in events increased by 10.13%, reflecting growing interest and engagement. For most members (72.6%), the activities in the European region have increased global awareness of the importance of neurosurgical care in underserved areas; for 45.1% of them, outreach events have effectively communicated the importance of neurosurgical care to nonmedical audiences. For 67.6% of the members, European chapters have contributed to fostering collaboration and knowledge sharing among medical students and healthcare providers. Furthermore, 59% agreed that Mission:BRAIN initiatives have contributed to addressing disparities in neurosurgical care and education. CONCLUSIONS: Mission:BRAIN’s growth in Europe showcases the pivotal role of medical students. The impact of the organization’s activities demonstrates the students’ potential to contribute to the overarching effort of bridging worldwide gaps in healthcare and education and calls for their active participation and recognition.

Introduction: The Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire can be used to measure quality of life in persons with haemophilia (PWH) and is integrated in the Canadian Bleeding Disorders Registry (CBDR). This offers the opportunity to compare the same data inputted by patients in PROBE and their treating team in CBDR. Aim: Our objectives were to assess the feasibility of collecting PROBE data through CBDR and to compare the data collected from these two sources. Methods: We conducted a prospective observational study among PWH using MyCBDR. Participants were invited to digitally complete the PROBE questionnaire at baseline and to repeat it at 6 and 12 months. Additional data were passively collected through CBDR. Data from PROBE and CBDR were compared using Kappa agreement, intraclass correlation (ICC) and Pearson correlation. Results: A total of 142 PWH participated. Recruitment ratios were 21.1% and 12.0% for the two phases. Retention rates were 40.8% at 6 months and 32.4% at 12 months. Three hundred thirteen subjects were involved in the comparison between PROBE and CBDR data. The agreement was good to very good ( κ > 0.75) or the correlation very strong, with the exception of the history of inhibitor ( κ = 0.57), recent bleeds ( κ = 0.48) and current treatment regimen ( κ = 0.57). Conclusion: The integration of PROBE with CBDR is feasible and PROBE is a reliable tool for routine PRO data collection. Its use in clinical practice may improve data quality and personalized and patient‐centred care.