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Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia

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https://www.readbyqxmd.com/read/29452965/reversal-of-antiplatelet-therapy-in-traumatic-intracranial-hemorrhage-does-timing-matter
#1
Urmil Pandya, Alexander Malik, Michael Messina, Abdul-Rahman Albeiruti, Chance Spalding
Reversal of antiplatelet therapy with platelet transfusion in traumatic intracranial hemorrhage remains controversial. Several studies have examined this topic but few have investigated whether the timing of transfusion affects outcomes. Patients admitted to a level 1 trauma center from 1/1/14 to 3/31/16 with traumatic intracranial hemorrhage taking pre-injury antiplatelet therapy were retrospectively analyzed. Patients on concurrent pre-injury anticoagulant therapy were excluded. Per institutional guideline, patients on pre-injury clopidogrel received 2 doses of platelets while patients on pre-injury aspirin received 1 dose of platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29452964/risk-factors-for-platelet-transfusion-in-glioblastoma-surgery
#2
Carlito Lagman, John P Sheppard, Prasanth Romiyo, Thien Nguyen, Giyarpuram N Prashant, Daniel T Nagasawa, Linda M Liau, Isaac Yang
The objectives of this study are to identify risk factors for and to evaluate clinical outcomes of platelet transfusion in glioblastoma surgery. The medical records of adult patients who underwent craniotomy for glioblastoma resection at a single academic medical center were retrospectively reviewed. We stratified patients into 2 groups: those who were transfused at least 1 unit of platelets intraoperatively or postoperatively (no more than 7 days after surgery), and those who were not transfused with platelets...
February 13, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29439908/symptom-associated-change-of-motor-related-neuromagnetic-fields-in-a-patient-with-multiple-sclerosis-a-case-report
#3
Ji Hee Kim, Bong Soo Kim, Su Jeong Hwang, Won Seok Chang, Ki Woong Kim, Hyuk Chan Kwon, Yong Ho Lee, Jin Woo Chang
The objective of this study was to investigate functional abnormalities of the brain in a patient with multiple sclerosis (MS) by using magnetoencephalography (MEG) and a finger-tapping task. A 46-year-old woman that presented with motor weakness of left hand and was diagnosed with MS. Conventional magnetic resonance imaging demonstrated a white matter lesion with hyperintensity on T2-weighted images in the right motor area. MEG recordings were performed during the period of motor weakness and after clinical improvement...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29439907/posterior-spinal-cord-shift-does-not-affect-surgical-outcomes-after-muscle-preserving-selective-laminectomy
#4
Satoshi Nori, Tateru Shiraishi, Ryoma Aoyama, Ken Ninomiya, Junichi Yamane, Kazuya Kitamura, Seiji Ueda
Postoperative posterior spinal cord shift (PSS) has been considered a required radiographic endpoint of posterior decompression procedures. To achieve PSS, laminoplasty for cervical compressive myelopathy (CCM) has been consecutively performed on four or more laminae (C2-C7, C3-C7, or C3-C6). However, the clinical significance of PSS remains controversial. By selecting the surgically treated laminae, selective laminectomy (SL) can achieve adequate decompression without disturbing the extensor musculature and facet joints...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29439906/dermoid-cysts-of-the-conus-medullaris-clinical-review-case-series-and-management-strategies
#5
Salah G Aoun, Mary Ashley Liu, Megan Still, Tarek Y El Ahmadieh, Mazin Al Tamimi, Wayne Gluf
BACKGROUND: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris. OBJECTIVE: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris. METHODS: Two clinical cases of dermoid cysts of the conus are presented, as well as a commented surgical video...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29439905/three-dimensional-intracranial-middle-cerebral-artery-aneurysm-models-for-aneurysm-surgery-and-training
#6
Liang Wang, Xun Ye, Qiang Hao, Li Ma, Xiaolin Chen, Hao Wang, Yuanli Zhao
To develop a realistic model of middle cerebral artery (MCA) aneurysms using three-dimensional (3D) printing for surgical planning, research, and training of neurosurgical residents. This study included eight MCA aneurysm cases. The aneurysm together with the adjacent arteries and skull base were printed based on raw computed tomography angiography (CTA) data using a 3D printer with acrylonitrile-butadiene-styrene as the model material. The aneurysm models were used for surgical planning, and craniotomy and clipping practice by neurosurgical residents...
February 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429789/a-purely-functional-imaging-based-approach-for-transcortical-resection-of-lesion-involving-the-dominant-atrium-towards-safer-imaging-guided-tailored-cortico-leucotomies
#7
Alessandro Frati, Alessandro Pesce, Giancarlo D'Andrea, Flavia Fraschetti, Maurizio Salvati, Marco Cimatti, Vincenzo Esposito, Antonino Raco
BACKGROUND AND STUDY OBJECT: The Dominant Atrium (DA) is a crossroad of eloquent white matter bundles difficult to preserve with a standard "anatomical" approach. The aim of this work is to evaluate the results of a cohort of patients who underwent surgery with the aid of a purely functional MRI and DTI-based approach. MATERIALS AND METHODS: 43 patients suffering from lesions involving the DA have been included in the final cohort and studied in regards to quality of life (KPS); a special attention was lent on the incidence of new or worsening of preexisting neurological deficits, with a focus on motor, visual and speech disturbances after the surgical treatment...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429788/novel-sgce-mutation-in-a-patient-with-myoclonus-dystonia-syndrome-diagnostic-delay-of-more-than-40%C3%A2-years
#8
Dorothee Kübler, Friederike Borngräber, Katja Lohmann, Andrea A Kühn
We present a case of myoclonus-dystonia syndrome illustrated by three videos in which we found a novel SGCE mutation. As the patient described here was suffering from predominant psychiatric comorbidities it took more than 40 years from the first manifestation of the disease until the diagnosis. Having detected the genetically proven cause for his motor and non-motor symptoms was an enormous relief to our patient. We want to share this instructive case in order to prompt neurologists and psychiatrists to look closely at both movement disorders and neuropsychiatric signs in order to diagnose and treat patients to the latest standard...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429787/the-difficulty-of-predicting-clinical-outcome-after-intended-submaximal-resection-of-large-vestibular-schwannomas
#9
Rebecca MacKenzie, Peter Sporns, Tarek Zoubi, Mario Koopmann, Christian Ewelt, Walter Stummer, Benjamin Brokinkel, Eric Suero Molina
INTRODUCTION: Intended subtotal resection of large vestibular schwannomas (T4a and b according to the Hannover classification system) has been shown to be safe and, in combination with stereotactic radiosurgery, might enable sufficient tumor control. However, risk factors for postoperative neurological deterioration in these surgically challenging lesions are largely unknown. METHODS: Pre- and postoperative symptoms, clinical and radiological data of patients who underwent intended subtotal resection for vestibular schwannoma in our department between 2010 and 2014 were reviewed...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429786/evaluation-and-management-of-small-dural-tears-in-primary-lumbar-spinal-decompression-and-discectomy-surgery
#10
Marcelo Galarza, Roberto Gazzeri, Raúl Alfaro, Pedro de la Rosa, Cinta Arraez, Claudio Piqueras
Incidental dural tear is one of the most common intraoperative complications in lumbar spine surgery. Yet, its technical management for the prevention of CSF leak is controversial. The technique of managing dural tears depends on the location of the dural tears as well on the length and anatomical characteristics of the dural tear. We propose an anatomical classification for small (less than one cm) dural tears and report on the outcome of managing these dural tears types using different technique for different type...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429785/spinal-primary-central-nervous-system-lymphoma-case-report-and-literature-review
#11
REVIEW
Li Feng, Dingbang Chen, Hongyan Zhou, Cunzhou Shen, Haiyan Wang, Xunsha Sun, Xiulin Liang, Ling Chen
Primary central nervous system lymphoma (PCNSL) is a very rare tumor of increasing incidence. It is often misdiagnosed due to the unspecific presentation or unavailable biopsy, and results in poor prognosis. PCNSL involved the spinal cord is extremely sparse. Here we report a gentleman presented with one-year history of progressive tremor in the left limbs and slight dysarthria as well as three-month history of paraparesis, tinnitus and insomnia. MR images disclosed the swollen cerebellum and cauda equine, with contrast enhancement in both meninges and nerve roots...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29429784/rapid-progressive-visual-decline-and-visual-field-defects-in-two-patients-with-the-heidenhain-variant-of-creutzfeld-jakob-disease
#12
Janine Lenk, Kay Engellandt, Naim Terai, Antonia Bottesi, Egbert Matthé
BACKGROUND: Heidenhain variant of Creutzfeldt-Jakob (HvCJD) is a rare disease, patients presenting with loss of visual acuity and a decline in visual fields. CASE PRESENTATION: Two patients with rapid loss of visual acuity and declining visual fields presented with homonymic hemianopsia over several weeks. Cranial MRI showed neither stroke nor other morphological changes explaining the severe visual field defects. Neurological examination revealed no pathologies...
February 8, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428269/comparison-of-craniotomy-and-decompressive-craniectomy-in-large-supratentorial-intracerebral-hemorrhage
#13
Dong Bin Kim, Sang Kyu Park, Byeong Hoo Moon, Byeong Rae Cho, Dong Kyu Jang, Kyeong Sool Jang
Intracerebral hemorrhage (ICH) is devastating disease with high mortality and morbidity rates. Most ICH is evacuated by either craniotomy (CR) or decompressive craniectomy (DC) although optimal treatment has not been established yet. The objective of this study was to compare clinical outcomes of spontaneous ICH patients between CR and DC groups and determine clinical factors affecting clinical prognosis. We retrospectively analyzed our single-center experience with large supratentorial ICH. From January 2011 to December 2016, 286 consecutive supratentorial large ICH patients underwent surgery in our institute...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428268/web-of-the-carotid-artery-an-under-recognized-cause-of-ischemic-stroke
#14
Federico Pacei, Luca Quilici, Stephen Mullin, Alessandro Innocenti, Luca Valvassori, Raffaele Nardone, Luciano Bet
Ischemic stroke has rarely been reported in association with a web of the carotid artery. We describe here an additional case of ischemic stroke caused by a carotid web in a young healthy woman. Detection of this vascular abnormality required the use of CT angiography and cerebral digital subtraction angiography. Although there is little evidence regarding the optimal management of this condition, under medical treatment with dual antiplatelet therapy our patient remained free of recurrent stroke events. This case report study illustrates that the web of the carotid artery is an uncommon cause of stroke which should always be considered and ruled out, especially in young patients with otherwise cryptogenic stroke...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428267/disseminated-cerebral-toxoplasmosis-in-a-patient-with-chronic-lymphocytic-leukemia
#15
Jordan Xu, Rod J Nault, Andres Maldonado-Naranjo, Leonardo A Frizon, Kuruvilla John, Katherine Holman, Sean J Nagel
Infections are one of the most common causes of mortality in immunocompromised patients. In patients diagnosed with hematologic malignancies, treatment with stem cell transplants (SCT) or T-cell suppressing chemotherapy increases the risk of central nervous system (CNS) infections, of which toxoplasmosis is the most common. We report the case of a 63 year-old woman with chronic lymphocytic leukemia (CLL) that presented with gait instability and visual changes. Intracranial lesions were noted on initial neuro-imaging...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428266/duraplasty-using-amniotic-membrane-versus-temporal-muscle-fascia-a-clinical-comparative-study
#16
Agus Turchan, Taufiq Fatchur Rochman, Arie Ibrahim, Dyah Fauziah, Joni Wahyuhadi, M Arifin Parenrengi, Asra Al Fauzi, Erliano Sufarnap, Abdul Hafid Bajamal, Ferdiansyah, Heri Suroto, Purwati, Fedik Abdul Rantam, Adanti Wido Paramadini, Christianto Benjamin Lumenta
In the field of neurosurgery, often the dura mater cannot be sutured, and consequently, it requires a duraplasty procedure using a dural fascial graft. Since 1890, various materials have been researched as dura mater substitutes. Amniotic membrane, for example, is suitable as a dural graft material and has been used in neurosurgery since 2012. However, there has been little research on human patient's dural healing after the use of amniotic membrane in their duraplasty procedure. To address this gap, a clinical experimental study was undertaken to evaluate the human dural healing of 16 patients who had undergone duraplasty in decompressive craniectomy surgery at Dr...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428265/first-line-management-of-chronic-subdural-hematoma-with-the-subdural-evacuating-port-system-institutional-experience-and-predictors-of-outcomes
#17
Haydn Hoffman, Robert Ziechmann, Timothy Beutler, Brendon Verhave, Lawrence S Chin
Chronic subdural hematoma (cSDH) is a common condition that disproportionately affects older patients. Given the greater risks of general anesthesia in this population, interest has turned towards less invasive surgical approaches such as the subdural evacuating port system (SEPS; Medtronic, Inc., Minneapolis, MN). There is a relative dearth of information about the outcomes following this procedure. Here, we present our institution's experience with SEPS and analyze factors associated with the outcomes. Using a prospectively maintained institutional database, we retrospectively identified all patients who presented with cSDH and received first line therapy with SEPS...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428264/images-in-neuroscience-calvarial-hyperostosis-associated-with-multiple-intracranial-tumours
#18
Mario Ganau, Marco Paris, Chris Uff
No abstract text is available yet for this article.
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428263/evidence-based-diagnosis-and-management-of-chronic-subdural-hematoma-a-review-of-the-literature
#19
REVIEW
Vikram Mehta, Stephen C Harward, Eric W Sankey, Gautam Nayar, Patrick J Codd
Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the subdural space on a non-contrast computed tomography (CT) scan, best appreciated on sagittal or coronal reformats. Initial medical management involves reversing anticoagulant/antiplatelet therapies, and often initiation of anti-epileptic drugs (AEDs). Operative interventions, such as twist-drill craniostomy (TDC), burr-hole craniostomy (BHC), and craniotomy are indicated if imaging implies compression (maximum fluid collection thickness >1 cm) or the patient is symptomatic...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428262/intracranial-hemorrhage-as-initial-manifestation-of-plasma-cell-myeloma-a-case-report
#20
Jonathan G Hobbs, Charles Van Slambrouck, Jonathan L Miller, Bakhtiar Yamini
This is the case of a previously healthy 48 year-old male whom presented with mild confusion, low-grade headache, and left sided weakness. Computed tomography of the head revealed a large acute right frontal lobe intracranial hemorrhage (ICH) and intraventricular extension, with normal vascular imaging. Initial laboratory testing was inconsequential. The patient required emergent evacuation, with pathology revealing only elements of a hematoma. Further laboratory testing and bone marrow biopsy results confirmed the diagnosis of plasma cell myeloma...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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