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Central nervous system (CNS) malignancies contribute significantly to the global burden of cancer. Brain tumors constitute the most common solid organ tumors in children and the second most common malignancies of childhood overall. Accounting for nearly 20% of all pediatric malignancies, these are the foremost cause of cancer-related deaths in children 0–14years of age. This book chapter provides a state-of-the-art overview of pediatric brain tumors. It discusses their morbidity and mortality and introduces the WHO 2021 classification of CNS tumors, which is critical to therapeutic decision-making. It then describes the modern understanding of tumor grading and its clinical implications, followed by the general principles of diagnosis and management. The chapter then discusses, in detail, those brain tumors which have the highest disease burden in children, including medulloblastoma, astrocytoma, ependymoma, schwannoma, meningioma, amongst others. The landscape of treatment of pediatric brain tumors has been rapidly evolving, with several effective therapies on the horizon.

Trauma is currently the leading cause of death in the age group 15 to 44 years globally, with road trauma now representing the sixth leading cause of death worldwide. We present a case of a young male, who was brought to the apex trauma centre of the province with a metallic roadside guardrail impaled in his neck up to his oral cavity, which had to be cut to transport him to the hospital. A meticulous local exploration resulted in the successful removal of the spiked guardrail, with no damage to critical structures. We discuss the paradigm changes in and the expertise required for the management of such penetrating neck injuries (PNIs). For family physicians, this case represents one of the wide variety of cases they will be called to help upon and administer prehospital care. Thus, utilization of principles of basic life support, recognition of the severity of road trauma cases, and ensuring urgency of referral by general practitioners are all critical.

Introduction Indian medical schools contribute significantly to the global pool of doctors. To strengthen the medical education system further, this study was aimed at identifying existing lacunae and proposing solutions, from perspective of medical undergraduates. Methodology Medical undergraduates participated in group discussions under mentorship of an expert in medical education. Identification and prioritisation of problems was done based on demand and impact on medical education. After critically reviewing available literature, solutions were reached by consensus. Results Six interested students participated in discussions. Classification of identified problems was done into domains of knowledge, skill training, and research. Major problems in ‘knowledge' were: inefficient utilisation of time of students and teachers, and unyielding assessments; in ‘skill training': inadequate training in skills; and in ‘research': insufficient awareness and interest in research among undergraduates. Some solutions suggested for respective domains were prioritisation of teaching and training of medical students, advocation of innovative methods of teaching and assessment like flipped classroom approach and clinical vignettes respectively; early initiation of undergraduate training in skill development following the principle of competency-based education; and sensitization of undergraduates towards research by introducing it as basic core and advanced elective subject, besides setting up research advisory cells and organising research conclaves. Conclusion Problems were classified into domains of knowledge, skill training, and research. Proposed solutions involve a radical alteration in perception of students and teachers in terms of teaching-learning principles. There is a need to highlight these points before policy makers and implementers for a more robust medical education system.

We received so many biographies of women neurosurgery leaders for this issue that only a selection could be condensed here. In all of them, the essence of a leader shines through. Many are included as “first” of their country or color or other achievement. All of them are included as outstanding—in clinical, academic, and organized neurosurgery. Two defining features are tenacity and service. When faced with shocking discrimination, or numbing indifference, they ignored it or fought valiantly. When choosing their life’s work, they chose service, often of the most neglected—those with pain, trauma, and disability. These women inspire and point the way to a time when the term “women leaders” as an exception is unnecessary.—Katharine J. Drummond, MD, on behalf of this month’s topic editors

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