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Neurosurgical Review

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https://www.readbyqxmd.com/read/28220369/severe-head-injury-in-very-old-patients-to-treat-or-not-to-treat-results-of-an-online-questionnaire-for-neurosurgeons
#1
Claudia Unterhofer, Sebastian Hartmann, Christian F Freyschlag, Claudius Thomé, Martin Ortler
Due to the aging population, neurosurgeons are confronted with an increasing number of very old patients suffering from traumatic brain injury. Many of these patients present with an acute subdural hematoma. There is a lack of data on neurosurgical decision-making in elderly people. We investigated the importance of imaging criteria, patients' wishes, their surrogates' wishes, and patient demographics on treatment decisions chosen by neurosurgeons. An online questionnaire was sent to all German neurosurgical units via the German Society of Neurosurgery (DGNC)...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28220368/embolization-of-ruptured-arteriovenous-malformations-in-the-cerebellopontine-angle-cistern
#2
Hidenori Endo, Shin-Ichiro Osawa, Yasushi Matsumoto, Toshiki Endo, Kenichi Sato, Kuniyasu Niizuma, Miki Fujimura, Teiji Tominaga
Among brainstem arteriovenous malformations (AVMs), there exist small AVMs predominantly located in the cerebellopontine angle cistern (CPAC) with minimal extension into the pial surface of the brainstem. However, previous studies of CPAC AVMs did not particularly discuss the role of embolization in the treatment of these lesions. This study was conducted to clarify the effectiveness and validity of embolization in the treatment of CPAC AVMs. We retrospectively reviewed five patients with CPAC AVMs who underwent endovascular treatment...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28220367/routine-placement-of-subdural-drain-after-burr-hole-evacuation-of-chronic-and-subacute-subdural-hematoma-a-contrarian-evidence-based-approach
#3
Laxminadh Sivaraju, Ranjith K Moorthy, Visalakshi Jeyaseelan, Vedantam Rajshekhar
The objective of this paper was to evaluate whether available evidence supporting placement of subdural drain placement after evacuation of chronic subdural haematoma (CSDH) is applicable to a cohort of patients managed by us. In this observational cohort study, clinical follow-up was obtained in 166 patients who underwent burr hole evacuation of CSDH without placement of subdural drain followed by 3 days of bed rest. The primary outcome studied was recurrence requiring reoperation. Factors predicting recurrence were also analysed...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28215029/an-introduction-to-the-pathophysiology-of-aneurysmal-subarachnoid-hemorrhage
#4
REVIEW
Jasper H van Lieshout, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Toni Schneider, Tanja Restin, Hieronymus D Boogaarts, Hans-Jakob Steiger, Athanasios K Petridis, Marcel A Kamp
Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH...
February 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28204997/predicting-surgical-outcome-in-patients-with-glioblastoma-multiforme-using-pre-operative-magnetic-resonance-imaging-development-and-preliminary-validation-of-a-grading-system
#5
Hani J Marcus, Sophie Williams, Archie Hughes-Hallett, Sophie J Camp, Dipankar Nandi, Lewis Thorne
The lack of a simple, objective and reproducible system to describe glioblastoma multiforme (GBM) represents a major limitation in comparative effectiveness research. The objectives of this study were therefore to develop such a grading system and to validate it on patients who underwent surgical resection. A systematic review of the literature was performed to identify features on pre-operative magnetic resonance imaging (MRI) that predict the surgical outcome of patients with GBM. In all, the five most important features of GBM on pre-operative MRI were as follows: periventricular or deep location, corpus callosum or bilateral location, eloquent location, size and associated oedema...
February 15, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28185018/efficacy-and-safety-of-durotomy-after-decompressive-hemicraniectomy-in-traumatic-brain-injury
#6
R B Moringlane, N Keric, F B Freimann, D Mielke, R Burger, D Duncker, V Rohde, K L V Eckardstein
Decompressive hemicraniectomy (DH) plus duroplasty was demonstrated to be effective for treating critically elevated intracranial pressure (ICP). In order to shorten operation time and to avoid the use of autologous or heterologous material, durotomy has been introduced as an alternative to duroplasty. Only limited data is available on the effect of DH and durotomy on the increased ICP in traumatic brain injury (TBI). Therefore, we collected consecutive intraoperative ICP readings during the different steps of DH and durotomy in TBI patients...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28185017/intradiploic-pseudomeningocele-and-ossified-occipitocervical-pseudomeningocele-after-decompressive-surgery-for-chiari-i-malformation-report-of-two-cases-and-literature-review
#7
Arthur R Kurzbuch, Shailendra Magdum, Jayaratnam Jayamohan
Intradiploic cerebrospinal fluid (CSF) collections are rare findings. The authors describe two pediatric patients with iatrogenically induced occipital CSF collections after decompressive surgery for Chiari I malformation. The first patient presents a large occipital intradiploic pseudomeningocele and the second patient an intradiploic pseudomeningocele merging with an ossified occipitocervical pseudomeningocele. Though being rarities after decompression for Chiari I malformation, intradiploic fluid collection and ossified pseudomeningocele should be considered if patients represent with aggravating presurgical or new symptoms...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#8
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28168619/pure-endoscopic-management-of-epileptogenic-hypothalamic-hamartomas
#9
S Chibbaro, H Cebula, J Scholly, J Todeschi, I Ollivier, A Timofeev, M Ganau, P Di Emidio, M P Valenti, A M Staack, T Bast, B J Steinhoff, E Hirsch, P Kehrli, F Proust
Hypothalamic hamartomas (HH) are rare congenital malformations located in the region of the tuber cinereum and third ventricle. Their usual clinical presentation is characterized by gelastic/dacrystic seizures which often become pharmaco-resistant and progress to secondary focal/generalized intractable epilepsy causing mostly in children cognitive and behavioral problems (particularly in cases of progressive epileptic encephalopathy) and precocious puberty. Whereas gelastic seizures can be surgically controlled either by resection of the lesion or disconnection (tissue-destructive) procedures, aimed at functionally prevent the spreading of the epileptic burst; generalized seizures tend to respond better to HH excision rather than isolated neocortical resections, which generally fail to control them...
February 7, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28168618/the-short-and-midterm-outcomes-of-lumbar-transforaminal-epidural-injection-with-preganglionic-and-postganglionic-approach-in-lumbosacral-radiculopathy-a-systematic-review-and-meta-analysis
#10
REVIEW
Saran Pairuchvej, Alisara Arirachakaran, Gun Keorochana, Komkrich Wattanapaiboon, Surapon Atiprayoon, Phoonyathorn Phatthanathitikarn, Jatupon Kongtharvonskul
The purpose of this study was to compare clinical outcomes after preganglionic versus ganglionic epidural steroid injection (ESI) using a systematic review and network meta-analysis. A systematic review and meta-regression was performed to compare postoperative outcomes between the two difference injection techniques. Relevant randomized controlled trials were identified from Medline and Scopus up to September 24, 2016. Sixteen out of 598 studies were eligible; 3, 2, and 3 studies were included in the pooling of outcomes including effectiveness, visual analog score (VAS), and complications (nerve root, injury, dural puncture, and intraneural injection)...
February 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28168617/an-anatomical-study-of-pneumatized-crista-galli
#11
Ranko Mladina, Romano Antunović, Cemal Cingi, Nuray Bayar Muluk, Neven Skitarelić, Mislav Malić
The literature data on the incidence of pneumatization of the crista galli based on patients' computed tomography (CT) scans ranges from 3 to 37.5%. This study investigated for the first time the incidence of crista galli pneumatization based on CT scans of human skulls. The study examined 102 randomly selected human skulls (≥20 years of age; 76 males, 26 females). Skulls were scanned in a fixed position using cone beam computed tomography (CBCT) with a field of view of 145 × 130 mm and an isotropic voxel size of 0...
February 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28154997/risk-associated-with-perioperative-red-blood-cell-transfusion-in-cranial-surgery
#12
Jonathan A Cohen, Nima Alan, Andreea Seicean, Robert J Weil
We assessed the impact of intra- and postoperative RBC transfusion on postoperative morbidity and mortality in cranial surgery. A total of 8924 adult patients who underwent cranial surgery were identified in the 2006-2011 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Patients undergoing a biopsy, radiosurgery, or outpatient surgery were excluded. Propensity scores were calculated according to demographic variables, comorbidities, and preoperative laboratory values...
February 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28138804/lova-the-role-of-endoscopic-third-ventriculostomy-and-a-new-proposal-for-diagnostic-criteria
#13
Guillermo Ibáñez-Botella, Laura González-García, Antonio Carrasco-Brenes, Bienvenido Ros-López, Miguel Ángel Arráez-Sánchez
The diagnostic criteria and management of this condition continue to be a topic of debate in the literature. The term definitive symptomatic LOVA (longstanding overt ventriculomegaly in adults) is applied to patients that fulfil a series of diagnostic criteria,which are reviewed in our paper. The main subject of our study is to propose a rearrangement of the criteria for the diagnosis of this entity and adjusted treatment strategies. We present our data evaluating the role of endoscopy in this pathology. This descriptive and analytical study comprised 27 adult patients with LOVA who underwent endoscopic third ventriculostomy (ETV)...
January 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28130656/patients-characteristics-and-outcomes-depending-on-complete-or-incomplete-unilateral-spatial-neglect
#14
Junko Watanabe, Toshiyasu Ogata, Masani Nonaka, Mitsutoshi Iwaasa, Etsuji Shiota, Tooru Inoue
Unilateral spatial neglect (USN) is known to depress the activities of daily living. The purpose of this study was to clarify that categorizing the type of USN using line cancelation and line bisection tests is important when evaluating patients with acute intracerebral hemorrhage (ICH). In this study, patients with ICH were prospectively evaluated for the presence of USN using line cancelation and line bisection tests. They were classified into an incomplete USN group (iUSN = abnormal results in either test) or a complete USN group (cUSN = abnormal findings in both tests)...
January 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28130655/spinal-intradural-extramedullary-tumors-the-value-of-intraoperative-neurophysiologic-monitoring-on-surgical-outcome
#15
Ran Harel, David Schleifer, Shmuel Appel, Moshe Attia, Zvi R Cohen, Nachshon Knoller
Nerve sheath tumors and meningiomas account for most intradural extramedullary (IDEM) tumors. These tumors are benign and amenable to complete surgical resection. In recent years, these surgeries are performed with intraoperative neurophysiologic monitoring (IONM) in order to minimize neurological injury, but the evidence for the statistical efficacy of this utility is lacking. This paper evaluates IONM benefits in IDEM tumor resection. Data of patients treated surgically for spinal intradural tumors from 1998 to 2003 was previously collected and analyzed...
January 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28124176/charcot-spinal-arthropathy-in-patients-with-congenital-insensitivity-to-pain-a-report-of-two-cases-and-review-of-the-literature
#16
REVIEW
Michael D Staudt, Christopher S Bailey, Fawaz Siddiqi
Charcot spine, or neuropathic spinal arthropathy, involves the progressive destruction of the spinal joint due to the lack of normal protective sensations and proprioception. A rare cause of Charcot spine is congenital insensitivity to pain, which is an absent or abnormal response to painful stimuli. There are few case reports describing this condition, and long-term follow-up data are limited. The presentation and treatment of two patients with Charcot spine secondary to congenital insensitivity to pain are described...
January 26, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28124175/preoperative-simulation-of-the-running-course-of-the-abducens-nerve-in-a-large-petroclival-meningioma-a-case-report-and-literature-review
#17
Kaichuang Yang, Fusao Ikawa, Shumpei Onishi, Manish Kolakshyapati, Masaaki Takeda, Satoshi Yamaguchi, Minoru Ishifuro, Yuji Akiyama, Mizuki Morishige, Kaoru Kurisu
One of the most important and useful pieces of information in the preoperative evaluation of a large petroclival meningioma is the running course of the abducens nerve. The abducens nerve is small and has a long intracranial course, making it prone to compression by the tumor at various anatomical points. In relatively large tumors, it is difficult to confirm the entire course of the abducens nerve, even by heavy T2-thin slice imaging. We report a case of successful preoperative estimation of the course of the abducens nerve that aided in its complete preservation during the resection of a large petroclival tumor...
January 25, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28111715/atypical-pituitary-adenomas-clinical-characteristics-and-role-of-ki-67-and-p53-in-prognostic-and-therapeutic-evaluation-a-series-of-50-patients
#18
LETTER
Luciano Mastronardi
No abstract text is available yet for this article.
January 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28091827/microvascular-decompression-is-an-effective-therapy-for-trigeminal-neuralgia-due-to-dolichoectatic-basilar-artery-compression-case-reports-and-literature-review
#19
REVIEW
Caroline Apra, Jean-Pascal Lefaucheur, Caroline Le Guérinel
No abstract text is available yet for this article.
January 14, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28091826/paradigms-for-single-patient-multimodality-treatment-for-cerebral-aneurysms-single-center-eleven-year-experience
#20
Abdullah Alobaid, Erez Nossek, Katherine Wagner, Avi Setton, Amir R Dehdashti, David Langer, David Chalif
Endovascular and surgical techniques are conventional options for treating intracranial aneurysms, but criteria for selecting an optimal approach for individual patients remain variable across practitioners and institutions. While endovascular and surgical approaches are generally used alone, both modalities combined in single patients can produce efficacious outcomes. The aim of this study was to evaluate outcomes of combined, concomitant endovascular and surgical modalities in the treatment of multiple and/or complex aneurysms in single patients...
January 14, 2017: Neurosurgical Review
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