Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future.

Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a "female neurosurgery" and a "male neurosurgery" is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.

Spontaneous spinal epidural haematoma. A case report.

Spinal epidural haematomas are infrequent events caused mainly by trauma or are iatrogenic following invasive spinal procedures (lumbar puncture, surgery or peridural anaesthesia). Spontaneous spinal epidural haematoma is a rare entity requiring emergency intervention in most cases. The incidence is estimated at about two to six cases per year. Early recognition, accurate diagnosis and rapid treatment may result in decreased morbidity and improved outcome. Here, we describe the case of a 60-year-old man who presented sudden paraplegia. Magnetic resonance imaging of thoracolumbar spine demonstrated an epidural mass extending from T11 to L1, causing spinal cord compression. Emergent decompressive surgery was performed and the patient had a significant improvement of neurologic deficits.