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British Journal of Neurosurgery

Anna Solth, Nitin Mukerji, Roger Strachan
INTRODUCTION: Low dose ionising radiation such as from CT scans carries a low but cumulative risk of cancer and children are particularly sensitive. Children with VP Shunts often undergo multiple CT scans. We developed a CT protocol with reduced radiation for paediatric patients with shunts and compared it with the current practice in the other neurosurgical units in the UK and ROI by conducting a nationwide survey. METHODS: An email questionnaire was send to the superintendent radiographer in every Neurosurgical unit in the UK and the ROI...
July 18, 2018: British Journal of Neurosurgery
Shashank S Joshi, Srikanth Murali-Krishnan, Prasanna Patankar, Kishor A Choudhari
BACKGROUND: Smartphone-based clients are being increasingly used in a medical world for individual as well as group communications. The authors report the use of WhatsApp, a common social media smartphone client for neurosurgical referral service in their Institution. They extend the use of WhatsApp application from a purely intra-departmental informal communication to a formal tertiary referral service for Neurosurgical referrals. The pros and cons of deploying such system are discussed and important concerns are highlighted...
July 13, 2018: British Journal of Neurosurgery
Jung Sub Lee, Jong Ki Shin, Tae Sik Goh
OBJECTIVE: To identify relationships between spinopelvic parameters and body image perception in ankylosing spondylitis (AS). METHODS: The study and control groups comprised 107 AS patients (18 women and 89 men) and 40 controls. All underwent anteroposterior and lateral radiography of whole spine, including hip joints, and completed clinical questionnaires. The radiographic parameters examined were sagittal vertical axis, sacral slope, pelvic tilt, pelvic incidence, lumbar lordosis, thoracic kyphosis, spinosacral angle (SSA), and spinopelvic angle (SPA)...
July 10, 2018: British Journal of Neurosurgery
Chris Bell, James Hackett, Benjamin Hall, Heinke Pülhorn, Catherine McMahon, Ganesh Bavikatte
BACKGROUND: Physical, cognitive and emotional sequelae in patients with traumatic brain injury (TBI) have been identified; some as late as two years post-injury. To aid in the specialist management of such patients, a multidisciplinary neurotrauma clinic was initiated at a tertiary centre.  Aim: This study sought to describe the clinical features of patients who attended the clinic. METHODS: Patient data was collected under several categories: basic demographics, mechanism and severity of injury, initial CT findings and management, hospital stay and discharge details, symptoms in clinic and actions performed by clinic staff (medication changes, referrals to other services, etc...
July 10, 2018: British Journal of Neurosurgery
Daniel G Eichberg, Sheikh C Ali, Simon S Buttrick, Ricardo J Komotar
BACKGROUND: Primary watertight dural closure is the preferred method of postcraniotomy dural repair. However, even when ideal technique is implemented, postoperative infection, cerebrospinal fluid (CSF) leaks, pseudomeningoceles, and dural scarring are possible complications. For this reason, materials that augment the dura's ability to create a watertight seal, prevent disease transmission, and inhibit inflammatory response are sought. Dehydrated amniotic membrane (DAM) allograft appears to fulfil these requirements as it has several beneficial properties that aid wound healing, including promotion of epithelialization, scar tissue prevention, and inhibition of bacterial growth...
July 10, 2018: British Journal of Neurosurgery
Mohammad Ghorbani, Grace DeHoff, Christoph J Griessenauer, Reza Mollahoseini, Hamidreza Shojaei, Maziar Azar
INTRODUCTION: Cystoventriculostomy is a surgical treatment for arachnoid cysts. We present a case using a neuroendovascular stent to maintain ostomy patency. CASE REPORT: A 6½-year-old male with symptomatic arachnoid cyst underwent endoscopic fenestration and Wingspan stent insertion. CONCLUSION: Neuroendovascular stent placement may be an adjunct to maintain patency in cystoventriculostomy.
June 28, 2018: British Journal of Neurosurgery
Bryan D Choi, Christopher J Stapleton, Christine K Lee, Ziv Williams
No abstract text is available yet for this article.
June 26, 2018: British Journal of Neurosurgery
Mitsuru Sato, Kensuke Tateishi, Hidetoshi Murata, Taichi Kin, Jun Suenaga, Hajime Takase, Tomohiro Yoneyama, Toshiaki Nishii, Ukihide Tateishi, Tetsuya Yamamoto, Nobuhito Saito, Tomio Inoue, Nobutaka Kawahara
INTRODUCTION: The utility of surgical simulation with three-dimensional multimodality fusion imaging (3D-MFI) has been demonstrated. However, its potential in deep-seated brain lesions remains unknown. The aim of this study was to investigate the impact of 3D-MFI in deep-seated meningioma operations. MATERIAL AND METHODS: Fourteen patients with deeply located meningiomas were included in this study. We constructed 3D-MFIs by fusing high-resolution magnetic resonance (MR) and computed tomography (CT) images with a rotational digital subtraction angiogram (DSA) in all patients...
June 26, 2018: British Journal of Neurosurgery
Luis A Robles
This paper presents the case of a 68 years old male who was admitted to the hospital after being attacked by another person. The main clinical signs were confusion and severe periorbital edema, findings of gunshot injury were not evident initially. However, a CT scan showed findings compatible with an orbito-cranial perforating gunshot injury. To the best of the author's knowledge, cases like this have not been reported in the literature. This report shows us that an orbito-cranial gunshot injury should be ruled out in cases of severe periorbital edema, especially if the cause of the injury remains unidentified...
June 26, 2018: British Journal of Neurosurgery
A Dalton, G Dobson, M Prasad, N Mukerji
PURPOSE: Arteriovenous malformations (AVM) are still frequently described as congenital lesions in medical texts despite little evidence existing for their congenital nature. Increasing numbers of case reports of de novo AVMs add weight to the notion that they are dynamic lesions and that they can form postnatally. A thorough review of all reported cases of de novo AVM formation and a review of articles relating to AVM pathogenesis was planned to summarise current research on AVM pathogenesis and provide insight into the future implications for AVM research and treatment...
June 6, 2018: British Journal of Neurosurgery
Simone Peraio, Paul Chumas, Paul Nix, Nick Phillips, Atul Tyagi
BACKGROUND: Nowadays the endoscopic endonasal approach is increasingly being used to remove craniopharyngiomas, tuberculum sellae meningiomas and other presellar and parasellar lesions and its value in anterior skull base surgery is undisputed. Herein, we assess the relative advantages, disadvantages and feasibility of the keyhole eyebrow approach and the endonasal endoscopic approach in four cadaveric heads for the removal of presellar and parasellar lesions. METHODS: We used four cadaveric heads for 12 surgical dissections...
June 6, 2018: British Journal of Neurosurgery
Zhong Yao, Xin Hu, Chao You
OBJECT: Patients surviving initial decompressive craniectomy are needed to undergo cranioplasty, which is potentially complicated by postoperative seizures. The definite incidence of post-cranioplasty seizures and application of prophylactic antiepileptic drugs remain controversial. METHODS: We performed systematic review to clarify these issues. Searching through PubMed, Ovid, Web of Science and Cochrane library databases, we included publications recording the incidence of seizures after cranioplasty and prophylactic treatment...
June 6, 2018: British Journal of Neurosurgery
Sui-To Wong, Wan-Nok Ho, Zhexi He, Kwong-Yui Yam
Developing a surgical plane between the temporalis muscle and the dura is the most technically challenging step when performing cranioplasty for post-decompressive craniectomy defects. The authors report a simple technique to demarcate this surgical plane by laying a multi-slitted, microporous polyesterurethane (MPU) patch during decompressive craniectomy. Specifically, they tried to avoid creating potential spaces around the patch, which is the inherent drawback of published anti-adhesive techniques. In 21 patients undergoing decompressive craniectomy, and in 11 of them subsequently undergoing cranioplasty, there was no wound related complications...
June 4, 2018: British Journal of Neurosurgery
Elena Romana Gasenzer, Ayhan Kanat, Vacide Ozdemir, Edmund Neugebauer
AIM: Currently, neurosurgery has gone through moments of great renewal, however, in the first half of the 20th century, unwanted outcome after surgical approach had occurred. The aim of this historical overview of a picture of the musicians is to show the development of Neurosurgery in 20 century. METHODS: History of neurosurgery in the first half of the 20th century and the current was investigated through PubMed. A brief tour of some of the major landmarks of contemporary neurosurgery was also made...
May 31, 2018: British Journal of Neurosurgery
A J Soni, G Modi
PURPOSE: Post-traumatic CSF leaks are a complication in 2% of all head injuries. Majority of these patients will recover spontaneously. Whilst recent literature has predominantly centred on CSF leaks and their general investigations and management thereof, there is a paucity of information when it comes to those patients who have persistent post-traumatic CSF leaks, as well as the complication of recurrent meningitis. We present a patient with a persistent post-traumatic CSF leak who presented with recurrent bacterial meningitis thirteen times- the highest documented amount in an adult...
May 28, 2018: British Journal of Neurosurgery
Charmaine Chircop, Nicola Dingli, Annelise Aquilina, Ludvic Zrinzo, Josanne Aquilina
INTRODUCTION: Deep Brain Stimulation (DBS) requires a specialist multidisciplinary approach and lifelong follow-up. Patient access can be a challenge for small nation states. Malta is an island nation with a population of just under 450 000. The number of patients likely to benefit from DBS is around 5 to 10 per year. This study explores the outcome of a cross border collaboration between specialist services at Queen Square, London and a tertiary centre in Malta. MATERIAL AND METHODS: Between 2011 and 2015, 35 patients underwent MRI-Guided and MRI-Verified DBS with 29 receiving bilateral subthalamic nucleus (STN) DBS for Parkinson's Disease under general anaesthesia...
May 26, 2018: British Journal of Neurosurgery
Paul Nix, Seyed A Alavi, Atul Tyagi, Nick Phillips
INTRODUCTION: Endoscopic anterior skull base surgery is now established practice. For skull base teams to manage complex pathology a variety of good dural repair techniques are required. However repairing certain skull base defects can be challenging. We look to see if a learning curve is associated with different types of CSF leaks in the anterior skull base Methods: Analysis of a prospectively collected database, contain 383 cases, on all endoscopic anterior skull base operations at one UK institution looking at CSF repair...
May 25, 2018: British Journal of Neurosurgery
Xu Zhao, Shuai Hao, Minqing Wang, Chao Han, Deguang Xing, Chengwei Wang
OBJECT: To summarize our experience in treating veins during microvascular decompression (MVD) procedures for idiopathic trigeminal neuralgia (TN). METHODS: A total of 210 patients who underwent single MVD for idiopathic TN were retrospectively studied. The offending vessels were summarized. The treatment choices for veins during the operation were reviewed. Postoperative long-term outcomes were determined by follow-up. RESULTS: Veins accounted for 26...
May 24, 2018: British Journal of Neurosurgery
Cihan Isler, Ozdem Erturk Cetin, Doga Ugurlar, Cigdem Ozkara, Nil Comunoglu, Osman Kizilkilic, Buge Oz, Yasemin Kayadibi, Taner Tanriverdi, Mustafa Uzan
OBJECT: To analyse the clinical, imaging and histopathological data of patients who were diagnosed to have Dysembrioplastic Neuroepithelial Tumour (DNET) and underwent surgery between 1995-2015. MATERIALS AND METHODS: Age at seizure onset, age at surgery, gender, disease duration, seizure outcome of 44 patients were analysed together with Magnetic Resonance Imaging (MRI) of 21 patients. MRI types were classified as type 1 (cystic/polycystic-like, well-delineated, strongly hypointense T1), type 2 (nodularlike,heterogeneous), type 3 (dysplastic-like, iso/hyposignal T1, poor delineation, gray-white matter blurring)...
May 24, 2018: British Journal of Neurosurgery
Arash Fattahi, Amin Jahanbakhshi, Morteza Taheri, Akbar Mehrizi, Mehdi Chavoshinejad
PURPOSE: Surgical site infection (SSI) is a source of concern in any surgical procedure. Although studies with high numbers of patients are available, most of these studies were performed by different surgeons and the exact anti-SSI protocol is not mentioned or is not homogeneous in all patients. MATERIALS AND METHODS: We present the results of 272 cases where SSI was successfully prevented in our neurosurgical units and in this study we explain our institutional protocol for achieving this positive result...
May 24, 2018: British Journal of Neurosurgery
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