RESUMO
Forty years ago, General Professor Dr. Khalaf Al-Mouteary established the first neurosurgical department in the Kingdom of Saudi Arabia. Here, we explored various pieces of evidence on the progress and inclusion of Saudi female pioneers in the neurosurgical workforce of the Kingdom of Saudi Arabia. We gathered information data on the inclusion of women in neurological surgery retrieved from open-resource online documentation of the Ministry of Health and direct communication with Saudi Commission for Health Specialties (SCFHS) administrative services. Furthermore, regional neurosurgery program directors, four active registered consultants, were either interviewed live or through offline communications. Data on the current number of board-certified, active female neurosurgeons in either the government or private sectors, along with the number of current neurosurgery postgraduate residency program trainees, were obtained from the registered database of the SCFHS. Since 2002, 18 women (29 %) have graduated from the Saudi Neurosurgical Residency Training Program (SNRTP), in contrast,71 % of the graduates were male. The SNRTP is now training more than 34 females (30 %), who are progressing in their neurosurgical training across the country. The first Saudi woman to pursue neurosurgery was Dr Samia Abdel-Rahim Maimani, while the first woman to pass the Saudi Neurosurgery Board was Dr Aisha Al-Hajjaj in 2002. In 2021, board-certified female neurosurgeons in Saudi Arabia will represent approximately 3 % of all practicing neurosurgeons.
RESUMO
Background: Idiopathic spinal epidural arachnoid cysts (SEACs) are rare and may cause myelopathy and cord compression. They typically arise from a congenital defect in the dura that communicates with the intrathecal subarachnoid space. Although the ideal treatment of SEACs is direct dural repair and cyst excision, there is as yet no clear standard of care for the management of these lesions. Methods: A 47-year-old female presented with myelopathy attributed to an magnetic resonance imaging-documented posterior epidural T12-L2 cyst (i.e., 1.1 × 6 × 3.3 cm) lesion. The patient underwent a direct dural repair of the fistulous communication between the subarachnoid space and the cyst, along with cyst drainage/ excision through a right-sided laminotomy. Postoperatively, the patient was asymptomatic. We additionally reviewed the literature regarding the management of SEACs. Results: Our review yielded 14 articles involving 18 patients with predominantly thoracolumbar (57%) SEACs that were either communicating (61%) or not communicating (39%) with the subarachnoid space. They averaged 35.5 years of age and exhibited a male preponderance (66%). Symptoms typically included pain (78%), followed by weakness/myelopathy (42%). Surgery frequently included bilateral laminectomies (57%) followed by unilateral laminectomies (50%) that typically resulted in symptom resolution. Conclusion: SEACs are rare typically thoracolumbar lesions that may cause myelopathy which resolves following direct dural closure/subarachnoid fistulous occlusion.
RESUMO
The Middle East is known for its complex history and rich environment and culture. The region is home to a wide variety of traditions, cultures and religions, which have made the area vulnerable to political conflicts. Despite these difficulties, science and medicine have always thrived in the region, with many medical practices and principles established by physicians and scholars living in the Middle East. The first academic neurosurgical activity in the region started in the 1950s. The first women neurosurgeons in the Middle East started training in the 1970s, and were from Iran, Palestine, followed by Saudi Arabia in the 1970s. These pioneers have encountered serious challenges, yet have become role models for the next generation. These women have paved the way and facilitated neurosurgical training and practice for more women surgeons. The gradual increase in the number of women neurosurgical residents in the region leads to the expectation that women will play a more prominent role in the future as leaders in neurosurgery in the Middle East. This collaborative study, which identifies the known women neurosurgeons in the Middle East for the first time, may serve to provide background and context for further contributions of women neurosurgeons for our profession and our patients.