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Surgical Neurology International

Edvin Zekaj, Claudia Menghetti, Christian Saleh, Alessandra Isidori, Alberto R Bona, Enrico Aimar, Domenico Servello
BACKGROUND: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. METHODS: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection...
2016: Surgical Neurology International
Christoph J Griessenauer, Matthew R Fusco, Lucy He, Michelle Chua, Sarah Sieber, Abd A Mazketly, Arra S Reddy, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: The configuration of the anterior communicating artery (AcomA) complex is important in the endovascular treatment of AcomA complex aneurysms. In cases of codominant anterior cerebral arteries (ACA), coil embolization may result in inadvertent occlusion of the contralateral ACA due to poor visualization. A second diagnostic catheter in the contralateral carotid artery may help with visualization of this angiographic blind spot. To our knowledge, the safety and efficacy of this dual diagnostic catheter technique have never been assessed...
2016: Surgical Neurology International
Christopher S Graffeo, Ross C Puffer, Eelco F M Wijdicks, William E Krauss
BACKGROUND: Ischemic stroke following anterior cervical diskectomy and fusion (ACDF) is an exceedingly rare complication. There are only three previous cases focusing on this problem in the literature; here, we present the fourth case. CASE DESCRIPTION: A patient, cared for at an outside institution, developed a delayed ischemic stroke 3 days following an ACDF. This complication was attributed to carotid manipulation precipitating vascular injury in the setting of multiple comorbid vascular and coagulopathic risk factors, including previously undiagnosed carotid atherosclerosis, a prior history of pulmonary embolus requiring Warfarin anticoagulation (held perioperatively), acute dehydration, and atrial fibrillation...
2016: Surgical Neurology International
C-Yoon Kim, In-Kyu Hwang, Hana Kim, Se-Woong Jang, Hong Seog Kim, Won-Young Lee
BACKGROUND: A case report on observing the recovery of sensory-motor function after cervical spinal cord transection. CASE DESCRIPTION: Laminectomy and transection of cervical spinal cord (C5) was performed on a male beagle weighing 3.5 kg. After applying polyethylene glycol (PEG) on the severed part, reconstruction of cervical spinal cord was confirmed by the restoration of sensorimotor function. Tetraplegia was observed immediately after operation, however, the dog showed stable respiration and survival without any complication...
2016: Surgical Neurology International
C-Yoon Kim, William K A Sikkema, In-Kyu Hwang, Hanseul Oh, Un Jeng Kim, Bae Hwan Lee, James M Tour
BACKGROUND: The GEMINI spinal cord fusion protocol has been developed to achieve a successful cephalosomatic anastomosis. Here, for the first time, we report the effects of locally applied water-soluble, conductive PEG(polyethylene glycol)ylated graphene nanoribbons (PEG-GNRs) on neurophysiologic conduction after sharp cervical cord transection in rats. PEG-GNRs were produced by the polymerization of ethylene oxide from anion-edged graphene nanoribbons. These combine the fusogenic potential of PEG with the electrical conducting properties of the graphene nanoribbons...
2016: Surgical Neurology International
C-Yoon Kim, Hanseul Oh, In-Kyu Hwang, Ki-Sung Hong
BACKGROUND: The GEMINI spinal cord fusion protocol has been developed to achieve a successful cephalosomatic anastomosis. Here, we report the preliminary data on the use of a fusogen [polyethylene glycol (PEG)] after full cervical cord transection in mice to facilitate the fusion of both ends of a sharply transected spinal cord. METHODS: Cervical laminectomy and a complete, visually confirmed cervical cord (C 5) transection was performed on female albino mice (n = 16)...
2016: Surgical Neurology International
Sergio Canavero, Xiaoping Ren
No abstract text is available yet for this article.
2016: Surgical Neurology International
Sergio Canavero, XiaoPing Ren, C Yoon Kim
The HEAVEN head transplant initiative needs human data concerning the acute restoration of motor transmission after application of fusogens to the severed cord in man. Data from two centuries ago prove that a fresh cadaver, after hanging or decapitation, can be mobilized by electrical stimulation for up to 3 hours. By administering spinal cord stimulation by applied paddles to the cord or transcranial magnetic stimulation to M1 and recording motor evoked potentials, it should be possible to test fusogens in fresh cadavers...
2016: Surgical Neurology International
Saqib K Bakhshi, Muhammad Waqas, Baila Shakaib, Syed A Enam
BACKGROUND: Intraoperative neurophysiology, high magnification microscopes, and ultrasonic aspirators are considered essential aid for the safe resection of intramedullary spinal cord tumors (IMSCTs). Most centers in developing countries such as Pakistan still lack these facilities. The purpose of this study was to review the management of IMSCTs at our hospital and to determine factors associated with the outcomes of surgery. METHODS: This was a retrospective review of medical records of adult patients undergoing surgery for IMSCT over 12 years...
2016: Surgical Neurology International
Edgardo Quinones, Laura I Potes, Nhora Silva, Javier Lobato-Polo
BACKGROUND: Lymphomatoid granulomatosis is a rare disorder of the central nervous system (CNS) with few cases being reported in literature. We present the case of an adult with an unusual lesion of the CNS who presented with motor seizures and was diagnosed with lymphomatoid granulomatosis, followed by a discussion of the process of evaluation and management. CASE DESCRIPTION: A 42-year-old male presented with motor seizures and loss of consciousness for 10 minutes along with dysarthria and left hemiplegia...
2016: Surgical Neurology International
Srikanth Gajavelli, Jonathan Nakhla, Rani Nasser, Reza Yassari, Karen M Weidenheim, Jerome Graber
BACKGROUND: Ollier disease is a rare, nonfamilial disorder that primary affects the long bones and cartilage of joints with multiple enchondromas. It is associated with a higher risk of central nervous system (CNS) malignancies; although the incidence is unknown. CASE DESCRIPTION: Here, we present the case of a 55-year-old woman who developed an anaplastic astrocytoma with a known diagnosis of Ollier disease with a survival time of over 3 years. CONCLUSION: This report draws attention to the rarity of this disease and the paucity of information regarding CNS involvement in Ollier disease, as well as reviews the current literature...
2016: Surgical Neurology International
Ashish Sharma, Ha Son Nguyen, Andrew Lozen, Abhishiek Sharma, Wade Mueller
BACKGROUND: Brain metastasis during pregnancy is a rare occurrence. In particular, there have only been three prior cases regarding breast cancer metastasis. We report a patient with breast cancer metastasis to the brain during pregnancy and review the literature. CASE DESCRIPTION: The patient was a 35-year-old female with a history of breast cancer (estrogen receptor/progesterone receptor negative, human epidermal growth factor receptor 2/neu positive, status post-neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab therapy, status post-bilateral mastectomies), and prior right frontal brain metastases (status post-resection, capecitabine/lapatinib/temozolomide therapy, and cyberknife treatment)...
2016: Surgical Neurology International
James Barger, Omar Tanweer, Benjamin Liechty, Matija Snuderl, Jafar J Jafar
BACKGROUND: Epithelioid hemangioendothelioma (EHE) is a rare sarcoma of vascular origin, which is clinically and histologically intermediate between benign hemangioma and angiosarcoma. It is most commonly found in the liver, lung, and bone, however, 46 intracranial cases have been reported in the literature, of which this is the fifth reported suprasellar tumor. CASE DESCRIPTION: A 45-year-old woman developed progressive lethargy, somnolence, and memory decline over the course of 6 months...
2016: Surgical Neurology International
Matt Pierson, Nitin Marwaha, Miguel Guzman, Anthony A Mikulec, Jeroen R Coppens
BACKGROUND: Primary leptomeningeal melanocytic neoplasms of the central nervous system are rare. Multifocal lesions typically occur in the setting of cutaneous melanosis. We present the first report of a posterior fossa melanocytoma and subcutaneous melanocytoma of intermediate grade in the absence of cutaneous melanosis. CASE DESCRIPTION: We present the case of a 22-year-old male with decreased hearing on the right side, ataxia, nausea, vomiting and a scalp mass...
2016: Surgical Neurology International
(no author information available yet)
[This corrects the article on p. S174 in vol. 7, PMID: 27057397.].
2016: Surgical Neurology International
Reid Hoshide, Vincent Cheung, Lawrence Marshall, Ekkehard Kasper, Clark C Chen
Neuroprotective strategies for the medical management of traumatic brain injury (TBI) have been elusive. While laboratory studies provide a conceptual framework for the potential efficacy of corticosteroids in this context, clinical trials testing this hypothesis have yielded no convincing evidence of clinical benefit. Here, we review the five key randomized control trials (RCTs) that have examined this issue. Based on the proposed primary endpoints of these RCTs, the five RCTs consistently showed that corticosteroids do not confer significant benefit in the TBI population...
2016: Surgical Neurology International
Michael D Wider
Insufficient hepatic O2 in animal and human studies has been shown to elicit a hepatorenal reflex in response to increased hepatic adenosine, resulting in stimulation of renal as well as muscle sympathetic nerve activity and activating the renin angiotensin system. Low hepatic ATP, hyperuricemia, and hepatic lipid accumulation reported in metabolic syndrome (MetS) patients may reflect insufficient hepatic O2 delivery, potentially accounting for the sympathetic overdrive associated with MetS. This theoretical concept is supported by experimental results in animals fed a high fructose diet to induce MetS...
2016: Surgical Neurology International
Francesco Prada, Massimiliano Del Bene, Francesco DiMeco
No abstract text is available yet for this article.
2016: Surgical Neurology International
Merritt Weaver Brown, Tülin Serap Yilmaz, Ekkehard M Kasper
BACKGROUND: Lumbar puncture (LP) rarely results in complications such as spinal hematomas. However, it remains unclear if certain variables increase likelihood of these events, or if surgical intervention improves outcome. METHODS: In addition to two clinical vignettes, we evaluated the post-1974 literature for cases of spinal hematoma and subsequent intervention. Based on our compilation of data, we evaluated outcome relative to numerous distinct variables. RESULTS: Based on 35 LP-related spinal hematoma cases in the post-1974 literature and our encounters, we found 28...
2016: Surgical Neurology International
Kevyan Mostofi, Reza K Khouzani
BACKGROUND: External ventricular drainage (EVD) is an emergency process intended to reduce intracranial hypertension resulting from the obstruction of cerebrospinal fluid (CSF) flow. This creates a temporary situation to extract CSF that cannot pass through normally. Knowing the surface anatomy for EVD implantation is important to prevent its inadvertent complications. The external landmarks have been designed in this anatomic study to review the classical landmarks and come up with new landmarks to improve this simple but lifesaving procedure...
2016: Surgical Neurology International
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