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British Journal of Neurosurgery

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https://www.readbyqxmd.com/read/27931120/outcomes-of-csf-spectrophotometry-in-cases-of-suspected-subarachnoid-haemorrhage-with-negative-ct-two-years-retrospective-review-in-a-birmingham-hospital
#1
A Bakr, D Silva, R Cramb, G Flint, M Foroughi
AIM: The aim of this study was to evaluate the adherence to current guidelines for the investigation of suspected subarachnoid haemorrhage and the prevalence and outcome of computed tomography (CT)-negative aneurysmal subarachnoid haemorrhage. DESIGN: A retrospective review in a single large tertiary referral centre. SUBJECTS: A total of 796 patients, aged 16-90 years, who underwent lumbar puncture (LP) for suspected subarachnoid haemorrhage (SAH) following a negative or equivocal CT scan between January 2012 and November 2013 (23 months)...
December 8, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27931117/resection-planning-in-extratemporal-epilepsy-surgery-using-3d-multimodality-imaging-and-intraoperative-mri
#2
Mark Nowell, Rachel Sparks, Gergely Zombori, Anna Miserocchi, Roman Rodionov, Beate Diehl, Tim Wehner, Mark White, Sebastien Ourselin, Andrew McEvoy, John Duncan
Surgical resection in non-lesional, extratemporal epilepsy, informed by stereoEEG recordings, is challenging. There are no clear borders of resection, and the surgeon is often operating in deep areas of the brain that are difficult to access. We present a technical note where 3D multimodality image integration in EpiNav(TM) is used to build a planned resection model, based on a previous intracranial EEG evaluation. Intraoperative MRI is then used to ensure a complete resection of the planned model. As stereoEEG becomes more common in the presurgical evaluation of epilepsy, these tools will become increasingly important to facilitate targeted cortical resections...
December 8, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27927027/primary-pineal-glioblastoma-multiforme-mimicking-a-germ-cell-tumour
#3
Syed Sameer Nadvi, Kritish Timatkia
Glioblastoma multiforme (GBM) is extremely rare in the pineal region, with only 19 previously reported cases. We report a unique case of a teenage girl with a pineal tumour with markedly raised beta-human chorionic gonadotropin (BHCG) levels, thought to be a germ-cell tumour. However, the raised BHCG was due to pregnancy, and biopsy revealed a pineal GBM.
December 7, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27927019/treatment-of-a-giant-vertebral-artery-pseudoaneurysm-secondary-to-gunshot-wound-to-the-neck-using-pipeline-embolization-device
#4
Mena Kerolus, Lee A Tan, Michael Chen
No abstract text is available yet for this article.
December 7, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27927015/isolated-oculomotor-nerve-palsy-in-patients-with-mild-head-injury
#5
Tamara Tajsic, Angelos G Kolias, Tilak Das, Daniel Scoffings, Brinda Muthusamy, Matthew R Garnett, Peter J A Hutchinson
Isolated oculomotor nerve palsy following head injury is uncommon. It can only be diagnosed with confidence if it is known to have developed immediately following trauma and if adequate investigations exclude secondary causes. The recovery is only partial and this has repercussion on patients' quality of life.
December 7, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27923275/nasoethmoid-schwannoma-with-intracranial-extension-case-report-and-review-of-the-literature
#6
Christopher S Hong, I Jonathan Pomeraniec, Robert M Starke, Mark E Shaffrey
Nasoethmoid schwannomas with significant intracranial extension are rare tumours that typically present with visual and olfactory deficits. We describe a nasoethmoid schwannoma in a patient who was completely asymptomatic. Despite impressive intracranial involvement, nasoethmoid schwannomas may present asymptomatically and should be considered in the differential of contrast-enhancing anterior skull base lesions.
December 6, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27908202/intracranial-migration-of-iophendylate-four-decades-after-conventional-myelography
#7
Shao-Chung Wang, Ping-Sheng Lu, Patricia Wanping Wu, Chih-Hua Yeh, Chao-Jan Wang, Chih-Chen Chang
Iophendylate is an oil-based contrast agent used in conventional myelography before the 1980s. We report an unusual case of an 82-year-old woman with iophendylate migration into the intracranial cerebrospinal fluid space after myelography 40 years ago. The patient was treated conservatively and followed up regularly.
December 1, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27906546/persistent-hemifacial-spasm-after-microvascular-decompression-a-risk-assessment-model
#8
Aalap Shah, Michael Horowitz
OBJECTIVE: Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. METHODS: A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up...
December 1, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27905216/-epidemiology-of-surgical-site-infection-in-a-neurosurgery-department
#9
Patricia López Pereira, Cristina Díaz-Agero Pérez, Nieves López Fresneña, Julio Las Heras Mosteiro, Aurelio Palancar Cabrera, Ángela Lourdes Rincón Carlavilla, Jesús María Aranaz Andrés
OBJECTIVE: To know the rates of infection of the surgical wound in the Department of Neurosurgery between 2011 and 2014. METHODS: An observational, prospective study was conducted of the rates of surgical wound infection among patients admitted for more than 48 h to the Neurosurgery Department of a tertiary-level university hospital between July 2011 and December 2014. RESULTS: The study surveyed a total of 536 surgical procedures performed in 521 patients...
December 1, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27899031/risk-factors-for-recurrence-of-chronic-subdural-hematoma-after-burr-hole-surgery-potential-protective-role-of-dexamethasone
#10
Zhongrun Qian, Dianxu Yang, Fei Sun, Zhenguo Sun
OBJECTIVE: Chronic subdural hematomas (CSDHs) are often found in neurosurgery, and display a recurrence rate of up to 37%. This study aimed to determine potential risk factors contributing to unilateral CSDH recurrence, and evaluate the role of postoperative management with dexamethasone (DX) in reducing recurrence. METHODS: Between January 2010 and May 2015, a total of 242 consecutive patients with CSDH treated with burr-hole trephination were included in this study...
November 30, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27881024/the-use-of-atorvastatin-for-chronic-subdural-haematoma-a-retrospective-cohort-comparison-study
#11
David Yuen Chung Chan, Danny Tat Ming Chan, Tin Fung David Sun, Stephanie Chi Ping Ng, George Kwok Chu Wong, Wai Sang Poon
Chronic subdural haematoma (CSDH) is a common neurosurgical condition. Burr-hole for drainage is an effective treatment. However, recurrence can be up to 8-33% and is associated with morbidities and mortalities. The underlying pathogenesis was postulated to be localised inflammation and pathological aberrant vessels formation. Atorvastatin, an HMG-CoA reductase inhibitor, is a type of lipid-lowering medication. In animal studies and a preliminary clinical trial, Atorvastatin was shown to be effective in the treatment of CSDH...
November 23, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27848263/joint-arthropathy-at-the-cranio-vertebral-junction-scintigraphic-patterns-on-bone-spect-ct
#12
Vittorio M Russo, Anneli Duits, Ranju T Dhawan, Adrian T H Casey
Osteoarthritic degeneration at the cranio-vertebral junction (CVJ) is an underrecognized source of suboccipital and neck pain, limited range of motion and cervicogenic headaches. Correlation of radiographic findings with clinical symptoms is often difficult. Limited evidence currently exists to support the use of bone single-photon emission computed tomography/computed tomography (SPECT/CT) in this subgroup of patients. The aim of this study was to describe the scintigraphic patterns of joint arthropathy at the CVJ on bone SPECT/CT in patients with suboccipital/neck pain and cervicogenic headache...
November 16, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27845572/post-craniotomy-intracranial-infection-in-patients-with-brain-tumors-a-retrospective-analysis-of-5723-consecutive-patients
#13
Zhong-Hua Shi, Ming Xu, Yong-Zhi Wang, Xu-Ying Luo, Guang-Qiang Chen, Xin Wang, Tao Wang, Ming-Zhong Tang, Jian-Xin Zhou
AIM: To determine the risk factors for and the incidence, outcomes, and causative pathogens of post-craniotomy intracranial infection (PCII) in patients with brain tumors. METHODS: A retrospective study was performed of 5723 patients with brain tumors who were surgically treated between January 2012 and December 2013 in Beijing Tiantan Hospital. The patients' demographics, pathohistological diagnoses, surgical procedures, postoperative variables, causative pathogens, and outcomes were evaluated...
November 15, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27809595/plexiform-schwannoma-of-the-thoracolumbar-spine-a-rare-clinical-entity-a-case-report
#14
Victor Lam Shin Cheung, John Provias, Aleksa Cenic
Plexiform schwannomas are peripheral nerve sheath tumours rarely found in the spine. We present a case of a 65-year-old male with a spinal plexiform schwannoma in order to add to the general fund of knowledge regarding the natural history, diagnosis and surgical management of this extremely rare clinical entity.
November 4, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27802777/prognostic-factor-analysis-after-surgical-decompression-and-stabilization-for-cervical-spinal-cord-injury
#15
Jin Hoon Park, Jeoung Hee Kim, Sung Woo Roh, Seung Chul Rhim, Sang Ryong Jeon
INTRODUCTION: Several studies have demonstrated the role of decompression surgery in preventing secondary injury and improving the neurological outcome after spinal cord injury (SCI). We retrospectively analyzed the prognostic factors affecting the outcomes of decompression surgery in patients with SCI. METHODS: We performed one-level decompression and fusion surgery on 73 patients with cervical SCI. We classified all patients based on their interval to decompression, sex, age, surgical level, presence of high signal intensity, American Spinal Injury Association Impairment scale (AIS) before surgery, blood pressure at admission, the amount of cord compression, surgical time, estimated blood loss during surgery, and steroid use...
November 2, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27782754/pulmonary-metastases-from-benign-calvarial-meningioma-a-case-report
#16
Byung-Rae Cho, Wan-Soo Yoon
The most common intracranial tumour is meningioma, which rarely presents with extracranial metastasis, especially in benign cases. We report a case of meningioma recurrence with multiple pulmonary metastases in a patient who had a benign meningioma removed 12 years prior.
October 26, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27782751/osteocutaneous-bone-flap-a-useful-variant-of-the-osteoplastic-flap-in-pediatric-patients
#17
Prasad Krishnan, Krishnamurthy Sridhar
Traditional teaching describes two types of bone flaps in craniotomies - 'free bone flap' and osteoplastic craniotomies. While in the former, the entire bone flap devoid of soft tissue attachments is removed, in the latter the bone flap that is turned is hinged on a pedicle of temporalis muscle with the aim of retaining its vascular supply. We describe a variant of the latter in 13 pediatric patients in whom the lower margin of the craniotomy was above the attachment of the temporalis muscle and where the bone flap was lifted with all the layers of the scalp including the skin and galea, highlighting the thought process behind its performance and the advantages of the same...
October 26, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27781487/kernohan-woltman-notch-phenomenon-a-review-article
#18
C H Zhang, R M DeSouza, J S B Kho, S Vundavalli, G Critchley
Kernohan-Woltman notch phenomenon (KWNP) is a false localising sign which may still cause diagnostic confusion. It was first described by Kernohan and Woltman in 1929, through post-mortem studies on 297 patients following cases of false localisation. They proposed that raised intracranial pressure causes uncal herniation, which can compress the contralateral cerebral peduncle against the tough tentorium, manifesting as hemiparesis ipsilateral to the primary brain lesion. A number of case reports have been written since the original description of this phenomenon, primarily secondary to intracranial bleeds, and little has been written about long-term outcome of patients who develop KNWP...
October 26, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27774823/endoscopic-third-ventriculostomy-a-historical-review
#19
Amin Demerdash, Brandon G Rocque, James Johnston, Curtis J Rozzelle, Bulent Yalcin, Rod Oskouian, Johnny Delashaw, R Shane Tubbs
BACKGROUND: Endoscopic third ventriculostomy (ETV) has become one of the most common neuroendoscopic procedures. METHODS: In this article, we will review the major milestones in the history of ETV development from its early use by Walter Dandy to the techniques currently employed with advanced technology. CONCLUSIONS: ETV has become an important technique in the armamentarium of the neurosurgeon. From a meager beginning with few applications, our knowledge of long-term outcomes has evolved...
October 22, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27774811/the-financial-outcome-of-traumatic-brain-injury-a-single-centre-study
#20
Daniel M Fountain, Angelos G Kolias, Rodney J Laing, Peter J Hutchinson
OBJECTIVES: Severe traumatic brain injury (TBI) is a potentially devastating insult to the brain with high rates of fatality and neurological deficits. TBI can result in substantial costs to the centre providing care. We sought to present the experience of a Major Trauma Centre (MTC) and ascertain the financial implications of this healthcare provision, in particular detailed costs, reimbursement and the surplus or deficit accrued by the centre. DESIGN: All cranial non-elective neurosurgical admissions with a TBI over 4...
October 22, 2016: British Journal of Neurosurgery
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