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Introduction: In recent times, there has been an increased number of published materials related to artificial intelligence (AI) in both the medical field, and specifically, in the domain of neurosurgery. Studies integrating AI into neurosurgical practice suggest an ongoing shift towards a greater dependence on AI-assisted tools for diagnostics, image analysis, and decision-making. Material and methods: The study evaluated the performance of ChatGPT-3.5 and ChatGPT-4 on a neurosurgery exam from Autumn 2017, which was the latest exam with officially provided answers on the Medical Examinations Center in Łódź, Poland (Centrum Egzaminów Medycznych – CEM) website. The passing score for the National Specialization Exam (Państwowy Egzamin Specjalizacyjny – PES) in Poland, as administered by CEM, is 56% of the valid questions. This exam, chosen from CEM, comprised 116 single-choice questions after eliminating four outdated questions. These questions were categorized into ten thematic groups based on the subjects they address. For data collection, both ChatGPT versions were briefed on the exam rules and asked to rate their confidence in each answer on a scale from 1 (definitely not sure) to 5 (definitely sure). All the interactions were conducted in Polish and were recorded. Results: ChatGPT-4 significantly outperformed ChatGPT-3.5, showing a notable improvement with a 29.4% margin (p < 0.001). Unlike ChatGPT-3.5, ChatGPT-4 successfully reached the passing threshold for the PES. ChatGPT-3.5 and ChatGPT-4 had the same answers in 61 questions (52.58%), both were correct in 28 questions (24.14%), and were incorrect in 33 questions (28.45%). Conclusions: ChatGPT-4 shows improved accuracy over ChatGPT-3.5, likely due to advanced algorithms and a broader training dataset, highlighting its better grasp of complex neurosurgical concepts.

Background and Objectives: As brain lesions present complex diagnostic challenges, accurate tissue sampling via biopsy is critical for effective treatment planning. Traditional frame-based stereotactic biopsy has been complemented by navigated biopsy techniques, leveraging advancements in imaging and navigation technology. This study aims to compare the navigated and frame-based stereotactic biopsy methods in a clinical setting, evaluating their efficacy, safety, and diagnostic outcomes to determine the optimal approach for precise brain lesion targeting. Materials and Methods: retrospective analysis was conducted on patients who underwent brain biopsies between January 2017 and August 2023 at an academic medical center. Data on patient demographics, clinical characteristics, biopsy technique (navigated vs. frame-based), and outcomes including accuracy, complications, and hospital stay duration were analyzed. Results: The cohort comprised 112 patients, with no significant age or gender differences between groups. Symptoms leading to biopsy were predominantly diminished muscle strength (42.0%), cognitive issues (28.6%), and aphasia (24.1%). Tumors were most common in the deep hemisphere (24.1%). The median hospital stay was 5 days, with a rehospitalization rate of 27.7%. Complications occurred in 4.47% of patients, showing no significant difference between biopsy methods. However, navigated biopsies resulted in fewer samples (p < 0.001) but with comparable diagnostic accuracy as frame-based biopsies. Conclusions: Navigated and frame-based stereotactic biopsies are both effective and safe, with comparable accuracy and complication rates. The choice of technique should consider lesion specifics, surgeon preference, and technological availability. The findings highlight the importance of advanced neurosurgical techniques in enhancing patient care and outcomes.

Embolization is the preferred method for treating intracranial aneurysms due to its less invasive nature. However, recent findings suggest that even uncomplicated embolization may cause structural damage to the brain through ischemic or inflammatory mechanisms. This study aimed to find possible biomarkers of brain injury and inflammation in patients suffering from intracranial aneurysms who underwent endovascular treatment by measuring serological markers indicating brain damage. The study involved 26 patients who underwent uncomplicated intravascular stenting for unruptured intracranial aneurysms between January 2020 and December 2021. Blood samples were collected before the procedure, at 6–12 h, and at 24 h after the procedure. The following protein biomarkers levels were tested with ELISA: S100B, hNSE, TNF, hsCRP, FABP7, NFL, and GP39. Statistical analysis of the results revealed significant increases in serum levels for the four biomarkers: FABP7—before 0.25 (ng/mL) vs. 6–12 h 0.26 (p = 0.012) and vs. 24 h 0.27 (p < 0.001); GP39—before 0.03 (pg/mL) vs. 6–12 h 0.64 (p = 0.011) and vs. 24 h 0.57 (p = 0.001); hsCRP—before 1.65 (μg/mL) vs. 24 h 4.17 (p = 0.037); NFL—before 0.01 (pg/mL) vs. 6–12 h 3.99 (p = 0.004) and vs. 24 h 1.86 (p = 0.033). These biomarkers are recognized as potential indicators of neurovascular damage and should be monitored in clinical settings. Consequently, serum levels of NFL, GP39, hsCRP, and FABP7 measured before and 24 h after endovascular procedures can serve as important markers for assessing brain damage and indicate avenues for further research on biomarkers of neurovascular injury.