Anna R. Kimata

Grief is an under-recognized yet pervasive experience in neurosurgery, arising not only from the death of patients and loved ones but also from losses related to professional identity, health, and personal relationships. Despite its relevance, grief is often conflated with burnout or overlooked entirely within surgical culture. When personal adversity strikes, such as loss, illness, or major life upheaval, the intensity of neurosurgical practice can amplify these challenges, influencing professional identity, performance, and overall resilience. As the field continues to evolve and diversify, it is increasingly important to foster open dialogue about vulnerability, personal hardship, and life beyond the operating room. This perspective examines how neurosurgeons experience and process loss, distinguishing grief from burnout and resilience, and highlighting the need for institutional and cultural change.

Electrical stimulation of different nodes within the Circuit of Papez has been assessed in a variety of human studies with conflicting or indeterminate results. Our goal was to combine a precise psychophysical paradigm with varying stimulation protocols across two experimental settings (intra-op, post-op) to more robustly identify and characterize the interaction between fornix stimulation and memory and to isolate whether those effects are specific to memory encoding, rather than related to distinct, supporting cognitive functions.

BACKGROUND: Responsive neurostimulation (RNS) has emerged as an effective neuromodulatory intervention for patients with medically refractory epilepsy who are not candidates for resective or ablative surgery. However, in patients with multifocal seizures arising from a widely distributed network, optimizing lead placement can be challenging. OBSERVATIONS: Here, the authors present the case of a patient with drug-resistant multifocal, nonlateralizing seizures and multiple developmental brain lesions who underwent phase II monitoring with stereoelectroencephalography electrodes targeting the lesion and surrounding cortex as well as the centromedian thalamus. Neurophysiological signals observed during recorded events implicated a seizure network within the left perisylvian polymicrogyria, involving the left parietal operculum, insula, and centromedian thalamic regions rather than a single focus. LESSONS: Using a regional RNS approach to modulate this network, the patient improved from 5 seizures a day to freedom from disabling seizures shortly after lead implantation despite low stimulation parameters. This has implications for understanding the timescale of adaptive mechanisms that occur in response to stimulation and supports the use of RNS as a surgical treatment for drug-resistant epilepsy. https://thejns.org/doi/10.3171/CASE24369

Metastatic cervical cancer to the brain is a rare occurrence, representing approximately 1.5% of metastatic cases. We report a rare presentation of cervical cancer with brain metastasis to the corpus callosum. The patient was initially suspected to have a primary glioma but was diagnosed with a metastatic cervical carcinoma lesion through both stereotactic and then opens biopsy. A 53-year-old female, with Stage III adenosquamous cervical carcinoma, presented with a large heterogeneously enhancing mass in the corpus callosum body with extension in the cingulate gyrus concerning for glioma. A stereotactic biopsy revealed hypercellular and gliotic brain tissue, while an open biopsy showed an epithelioid neoplasm consistent with metastatic cervical adenosquamous carcinoma. The patient underwent a craniotomy and recovered well and was discharged in stable condition. Brain metastases from cervical cancer are uncommon. We present a rare case of metastatic cervical carcinoma which appeared on imaging to mimic a butterfly glioma. The patient's history and histopathological examination were essential in determining the correct diagnosis and receiving timely treatment.

Lag-1 sparing is a common exception to the attentional blink, where a target presented directly after T1 can be identified and reported accurately. Prior work has proposed potential mechanisms for lag 1 sparing, including the boost and bounce model and the attentional gating model. Here, we apply a rapid serial visual presentation task to investigate the temporal limitations of lag 1 sparing by testing three distinct hypotheses. We found that endogenous engagement of attention to T2 requires between 50 and 100 ms. Critically, faster presentation rates yielded lower T2 performance, whereas decreased image duration did not impair T2 detection and report. These observations were reinforced by subsequent experiments controlling for short-term learning and capacity-dependent visual processing effects. Thus, lag-1 sparing was limited by the intrinsic dynamics of attentional boost engagement rather than by earlier perceptual bottlenecks such as insufficient exposure to images in the stimulus stream or visual processing capacity limitations. Taken together, these findings support the boost and bounce theory over earlier models that focus only on attentional gating or visual short-term memory storage, informing our understanding of how the human visual system deploys attention under challenging temporal constraints.

Epilepsy is a common, often debilitating disease of hyperexcitable neural networks. While medically intractable cases may benefit from surgery, there may be no single, well-localized focus for rese...