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British Journal of Neurosurgery

Andrew J Nelson, Rasheed Zakaria, Michael D Jenkinson, Andrew R Brodbelt
OBJECT: Pilocytic astrocytomas are rare tumours in adults. Presentation, management and prognostic factors are poorly characterised. METHODS: Retrospective single centre study from 2000 to 2016. RESULTS: 50 cases were identified (median age 29 years; range 16-76). Symptoms at presentation were neurological deficit (n = 21), headache (n = 18) and seizures (n = 6). Five were incidental findings. Five patients had hydrocephalus at presentation and required emergent management, two by endoscopic third ventriculostomy and three by external ventricular drain...
January 17, 2019: British Journal of Neurosurgery
Viraat Harsh, Sukriti Jha, Hitesh Kumar, Anil Kumar
Post-traumatic hypopituitarism has remained as an obscured cause of worsening morbidity and mortality in head injury patients. Researchers have for decades been puzzled by the mechanism of pituitary dysfunction in these cases. Amongst other causes like direct injury, vascular injury etc, an immunological basis of hypopituitarism has been suggested in some animal studies as well as human research. In this article, we have reviewed the latest articles and compiled the evidence which suggests for or against the role of autoimmunity in post-traumatic hypopituitarism or which defines the strength to which autoimmunity has been established as a cause of head-injury induced pituitary dysfunction...
January 17, 2019: British Journal of Neurosurgery
GengHuan Wang, HePing Shen, ZhengMin Chu, JianGuo Shen, YiFei Wang
This paper presents a male, immunocompetent case aged 62-year-old with cryptococcal granuloma in the basal ganglia. No cryptococcal infection occurred in other areas. The diagnosis was made by biopsy. Cryptococcal granuloma was tough and unsuitable for sterotactic biopsy. The patient died of postoperative bleeding and we suggest avoiding stereotactic biopsy of lesions suspected of being cryptococcal granulomas.
January 17, 2019: British Journal of Neurosurgery
Anna Bjornson, Ian Tapply, Eva Nabbanja, Afrodite-Despina Lalou, Marek Czosnyka, Zofia Czosnyka, Brinda Muthusamy, Matthew Garnett
PURPOSE: To determine the outcome of ventriculo-peritoneal shunts as a treatment for idiopathic intracranial hypertension (IIH) Materials and Methods: Retrospective case series of 28 patients with IIH and evidence of raised intracranial pressure (ICP) who underwent shunt insertion. Patients were identified from a prospectively updated operative database. A case-notes review was performed and data on type of shunt, pre- and post-operative symptoms, ophthalmological findings and post-operative complications were recorded...
January 17, 2019: British Journal of Neurosurgery
Hui Yang, Shuisheng Zhong, Yunxin Hu, Zeyan Bao
Basilar invagination (BI) is a congenital or acquired craniovertebral junction (CVJ) anomaly with odontoid process superiorly migrating into the foramen magnum. Compression of neural structures is the most relevant complication of BI. However BI is also a rare cause of ischemic stroke. In this case we reported a 30-year-old female with BI who developed recurrent ischemic stroke in posterior circulation. Before the onset of ischemic stroke, she didn't present neck pain or clinical signs of lower cranial nerve dysfunction, brainstem compression or transient ischemic attack...
January 17, 2019: British Journal of Neurosurgery
Nese Kurt-Ozkaya
BACKGROUND: Early closure of the meningocele, meningomyelocele, is essential to prevent complications such as hypothermia, infection in the postnatal period. But for some reasons, it is not always possible to repair early. The possibility of malign transformation should be considered in long-term due to nonhealing ulcers and cerebrospinal fluid (CSF) fistula and frequent infections in an adult patient with meningomyelocele. The possibility of conversion to malignancy in the control of an untreated meningomyelocele patient with (CSF) drainage should be especially kept in mind...
January 17, 2019: British Journal of Neurosurgery
Mitchell T Foster, Kumar Das, Paul May
BACKGROUND: The authors report a case with interesting clinical and radiological outcomes following complete anatomical hemispherectomy. METHODS: A seven-year-old female with medically refractory epilepsy secondary to Rasmussen's encephalitis was treated with a complete right-sided anatomical hemispherectomy. RESULTS: Surgical intervention provided seizure relief, and at eleven-years post-operatively she was independently mobile, with spasticity of the upper limb...
January 17, 2019: British Journal of Neurosurgery
Mohamed F Khattab, Ahmed Nageeb Mahmoud, Ahmed Saeed Younis, Youssry El-Hawary
BACKGROUND: Anterior odontoid screw fixation (AOSF) is an osteosynthetic technique used for fixation of type 2 and rostral type 3 odontoid fractures. Compared to other treatment modalities, it provides immediate stability, preservation of the majority of the remaining C1-2 motion and an achieved union rate of 80-100%. AOSF requires a stable and reduced odontoid to allow for placement of guide wire and cannulated screw. Image guidance with neuro-navigation or intraoperative fluoroscopy are used for accurate placement of instrumentation...
January 14, 2019: British Journal of Neurosurgery
Wisam Selbi, Hugh Sims-Williams, Paul Ince, Thomas A Carroll
Leiomyomas, benign neoplasms of mesenchymal origin, are common in gastrointestinal and genitourinary tracts. They are comprised of well-differentiated smooth muscle cells with few mitotic figures. Leiomyomas should not exhibit metastatic potential, though metastasis has been reported. Primary intracranial lesions remain rare. Only 4 cases have been reported in immunocompetent patients. Here we report an intracranial leiomyoma in an immunocompetent patient. A 60 year-old woman with unremarkable past medical history presented with a right sixth nerve palsy...
January 12, 2019: British Journal of Neurosurgery
Ibrahim Burak Atci, Hakan Yilmaz, Mustafa Yavuz Samanci
PURPOSE: There is an abundance of articles published on low-grade glioma. The aim of this study was to identify and review the 50 most-cited articles on low-grade glioma, and to perform a bibliometric analysis. METHODS: In June 2017, we performed a basic search of the Web of Science database using "low-grade glioma management and/or treatment" as our search terms without publication date restrictions. The top 50 most-cited articles were obtained and reviewed...
January 12, 2019: British Journal of Neurosurgery
Ratnadip Bose, Anirban Deep Banerjee
BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic neuropathic painful condition, sometimes associated with spinal myoclonus. For intractable cases spinal cord stimulation is an important modality of treatment but the response of specifically myoclonus to this treatment is not well described. CASE DESCRIPTION: A 40-year old male, had a history of trauma 12 years back since when he had intractable neuropathic pain in his both upper limbs with superimposed severely disabling myoclonic jerks...
January 12, 2019: British Journal of Neurosurgery
Arash Fattahi, Alireza Tabibkhooei
Traumatic spinal spondyloptosis is the extreme degree of spondylolisthesis and is not common. Traumatic cervical anterior spondyloptosis has been reported but we could not find reports of posterior traumatic cervical spondyloptosis. We present an 18-year-old female with this type of injury and cervical complete cord syndrome below C5 and explain our treatment approach.
January 12, 2019: British Journal of Neurosurgery
Onur Ozgural, Ihsan Dogan, Serdar Solmaz, Tugba Morali Guler, Gokmen Kahilogullari
Thalamic neuroepithelial cysts are rare, benign lesions. Thirteen cases have been published in eight articles. The most frequent symptoms are headache, hemiparesis, tremor and related signs of hydrocephalus such as gait disturbance, confusion, and Paranaud's syndrome. Surgical interventions include endoscopic fenestration, open surgery and stereotaxic biopsy or aspiration. We report a case of a 63-year-old woman who had headache and right hemiparesis for 1 week, but no hydrocephalus. We treated her with transcranial neuronavigation-guided endoscopic complete resection...
January 12, 2019: British Journal of Neurosurgery
Patrick Mitchell
No abstract text is available yet for this article.
January 2, 2019: British Journal of Neurosurgery
Alex Y Lu, Eyiyemisi C Damisah, Ethan A Winkler, Ryan A Grant, Tore Eid, Ketan R Bulsara
INTRODUCTION: Despite advancements in medical and surgical therapies, clinical outcomes of aneurysmal subarachnoid hemorrhage (aSAH) continue to be poor. Currently, aSAH pathophysiology remains poorly understood. No aSAH biomarkers are commonly used in the clinical setting. This exploratory study used metabolomics profiling to identify global metabolic changes and metabolite predictors of long-term outcome using cerebrospinal fluid (CSF) samples of aSAH patients. METHODS AND METHODS: Gas chromatography time-of-flight mass spectrometry was applied to CSF samples collected from 15 consecutive high-grade aSAH patients (modified Fisher grade 3 or 4)...
December 26, 2018: British Journal of Neurosurgery
Fay Greenway, Isabel Tulloch, James Laban
In March 2015, the Supreme Court's landmark ruling on the common law case of Montgomery vs Lanarkshire Health Board established the doctrine of informed patient consent, setting the legal standards that doctors should abide by. In this review, our primary aim has been to establish whether, despite the well-publicised implications of the ruling in the legal community, the medical profession has altered its practice. To do this, we reviewed the consenting methods applied by surgeons within our field of neurosurgery...
December 18, 2018: British Journal of Neurosurgery
Wei Shu, Yongjie Li, Jianyu Li, Yuqing Zhang
We present the effectiveness of interleaving programming in pallidal deep brain stimulation in a patient with Meige syndrome. This patient's symptoms were initially inadequately relieved by conventional programming methods. Then, we switched to the interleaving programming strategy, which produced an individual electrical density and improved her symptoms significantly.
December 11, 2018: British Journal of Neurosurgery
Ming-Xia Huang, Xiao-Hui Liu, Zeng-Jun Zhang, Chao Chen, Dong Wang, Xin Hou, Hua Chen, Kun Xia
OBJECT: Autism spectrum disorders (ASD) is characterized by stereotyped behavior, attention deficit and/or impaired sensory perception to external stimuli. Its neurobiological mechanisms remain unclear. In this study we examined the resting-state functional connectivity of the premotor area and investigated its correlation with behavioral variables to determine whether connectivity alterations can distinguish ASD from healthy controls. METHODS: 39 children with ASD and 42 healthy children with matched age, sex and intelligence were recruited...
December 11, 2018: British Journal of Neurosurgery
Cheng-Hsin Cheng, Hung-Lin Lin, Hao-Yu Chuang
Tonsillar herniation is a rare and seldom reported complication after lumboperitoneal (LP) shunting. There have been only few reports that have presented possible options for treatment with varying degrees of success. In this report, we describe a rare case of tonsillar herniation after LP shunting and review related literature. A 17-year-old girl with hydrocephalus related to a traumatic brain injury underwent implantation of an adjustable pressure shunt (valve setting2.5) and a small lumen peritoneal catheter via the L4-L5 interspinal space...
December 6, 2018: British Journal of Neurosurgery
Katie L Krause, Caitlin DeDeaux, Enjae Jung, Khoi D Than
Surgical treatment for high-grade spondylolisthesis with high sacral slope remains controversial and no definitive gold standard procedure has been identified. The Bohlman technique, in which a fibular strut is reamed posteriorly across the L5-S1 disc space in an oblique, inferior to superior trajectory, has been increasingly utilized. Recently, a Reverse Bohlman technique has been described, in which a graft is reamed anteriorly across a single disc space in a superior to inferior trajectory. Case Report A 55 year-old male with complete lumbarization of S1 (referred to as L6) and previous L5-L6-S1 posterior instrumented fusion presented, with progressively worsening low back pain and lower extremity radicular pain...
December 6, 2018: British Journal of Neurosurgery
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