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Surgical Neurology International

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https://www.readbyqxmd.com/read/29296288/posterior-epidural-migration-of-lumbar-disc-will-the-real-disc-please-stand-up
#1
Harsh Deora, A R Prabhuraj, Nupur Pruthi
Background: Posterior epidural lumbar disc fragment migration is rare and most commonly occurs at the L3-L4 level where it may contribute to cauda equina compression. Case Description: Here, we report three cases of epidural migration of a lumbar disc, two of which led to bladder dysfunction/cauda equina compression. Early decompression (e.g., laminectomy) and aggressive postoperative physiotherapy led to significant postoperative improvement in all three patients...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29296287/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#2
REVIEW
Nancy E Epstein, Renee D Hollingsworth
Background: Patients with lumbar disc disease may present with low back pain, pain that radiates down to the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies (magnetic resonance imaging, computed tomographic examinations) to determine whether there is any significant nerve root or thecal sac compression. Methods: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29296286/nursing-review-of-cervical-laminectomy-and-fusion
#3
Nancy E Epstein
Background: Cervical radiiculopathy/nerve root compression, myelopathy/cord compression are variously attributed to stenosis/narrowing of the spinal canal [anterior/posterior (AP) to less than 10 mm is defined as absolute stenosis, and 13 mm as relative stenosis]. Additional pathology includes disc herniations, ossification of the posterior longitudinal ligament (OPLL), and ossification of the yellow ligament (OYL). Patients, typically over 60 years of age, may present with severe myeloradicular syndromes requiring multilevel laminectomies and posterior instrumented fusions...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29296285/tisseel-s-impact-on-hemostasis-for-2-3-and-4-6-level-lumbar-laminectomies
#4
Nancy E Epstein
Background: Tisseel (Baxter International Inc., Westlake Village, CA, USA), a fibrin sealant, was originally devised to strengthen repairs of spinal cerebrospinal fluid (CSF) fistulas. Here, we evaluated how Tisseel correlated with hemostasis (e.g., defined as reduced postoperative drainage, time to drain removal, length of stay (LOS), and postoperative transfusion requirements) in 58 patients undergoing 2-3 vs. 79 patients having 4-6 level lumbar laminectomies. Methods: We assessed how Tisseel correlated with hemostasis in 58 patients undergoing 2-3 level laminectomies/stenosis (with 48 herniated discs and 20 synovial cysts, 1 degenerative spondylolisthesis) vs...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285414/deep-brain-stimulation-for-obsessive-compulsive-disorder-knowledge-and-concerns-among-psychiatrists-psychotherapists-and-patients
#5
Matilda Naesström, Patric Blomstedt, Marwan Hariz, Owe Bodlund
Background: Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285413/minimally-invasive-repair-of-a-pseudomeningocele-caused-by-a-sheared-intrathecal-catheter-following-implantation-of-a-drug-delivery-system
#6
S Raju, P O Champagne, L Walsh, Daniel J Denis
Background: Shearing of an intrathecal catheter during implantation of a drug delivery system is an underreported complication that can be challenging to manage. Case Description: A 53-year-old man with refractory cancer pain had an intrathecal pump system implanted. The procedure was complicated with catheter shear and retention in the intrathecal space. A second catheter was successfully placed but formation of a painful pseudomeningocele and ineffective pain relief complicated the outcome...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285412/nontraumatic-posterior-circulation-pseudoaneurysm-of-the-basilar-artery-summit-with-complete-spontaneous-resolution-case-report-and-literature-review
#7
Danil A Kozyrev, Juha Hernesniemi
No abstract text is available yet for this article.
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285411/simple-training-tricks-for-mastering-and-taming-bypass-procedures-in-neurosurgery
#8
Ahmad Hafez, Rahul Raj, Michael T Lawton, Mika Niemelä
Background: Neurosurgeons devoted to bypass neurosurgery or revascularization neurosurgery are becoming scarcer. From a practical point of view, "bypass neurosurgeons" are anastomosis makers, vessels technicians, and time-racing repairers of vessel walls. This requires understanding the key features and hidden tricks of bypass surgery. The goal of this paper is to provide simple and inexpensive tricks for taming the art of bypass neurosurgery. Most of these tricks and materials described can be borrowed, donated, or purchased inexpensively...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285410/the-clinical-examination-in-the-patient-with-subarachnoid-hemorrhage-is-still-the-most-reliable-parameter-for-predicting-pathophysiological-changes
#9
Athanasios K Petridis, Kerim Beseoglu, Hans J Steiger
Background: Macrovasospasms and delayed cerebral injury are factors which correlate with high morbidity in patients suffering a subarachnoid hemorrhage. Transcranial Doppler (TCD) ultrasonography and perfusion computed tomography (PCT) are diagnostic tools used to diagnose such pathologies. However, TCD is not very reliable and PCT exposes patients to radiation and cannot be performed daily. Case Description: We present the case of a 47-year-old female with subarachnoid hemorrhage caused by rupture of an intracranial aneurysm...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285409/massive-lumbar-spine-hematoma-post-spinal-tap
#10
Ahmed Al Jishi, Naresh Murty
Background: Lumbar puncture is a well-known procedure. The indications for lumbar puncture vary among different medical and surgical disciplines, though obtaining a sample for cerebrospinal fluid analysis is the most common one. A normal coagulation profile is crucial prior to pursing the procedure. Occasionally, an urgent sample is needed to guide an appropriate treatment while the patient's coagulation status is suboptimum. In those specific critical situations, some may accept suboptimal correction owing to the urgency of the case...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285408/a-technique-for-sequential-progressive-clipping-for-a-giant-thrombosed-distal-anterior-cerebral-artery-aneurysm-technical-note
#11
Yosuke Sato, Madjid Samii
Background: Giant thrombosed aneurysms often present with thickened walls and a hard thrombus, including in the near-neck aneurysmal sac. These usually make it difficult to achieve complete neck clipping with preservation of local branch patency. Here, we demonstrate a simple but safe and effective technique to overcome these problems in a patient with a 6-cm giant thrombosed distal anterior cerebral artery aneurysm. Case Description: A 77-year-old-man suffered from loss of volitional activity due to the frontal mass effect...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#12
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285406/virtual-autopsy-to-assess-sacral-anatomy-conditions-for-a-minimal-invasive-approach-to-the-spinal-canal-through-the-hiatus-sacralis
#13
Andrea Bodmer, Steffen Ross, Andreas Raabe, Jürgen Beck, Christian T Ulrich, Philippe Schucht
Background: Despite multiple advantages of minimally invasive techniques in spinal surgery, the currently used approaches may lead to postoperative pain and spinal instability. As a natural orifice, the hiatus sacralis offers a nontransmuscular alternative entry point for endoscopic approaches. In this study, we collected data about the complex anatomical conditions of the sacral canal as a basis for the development of a sacral endoscope. Methods: We retrospectively evaluated 192 postmortem human cadaveric specimens with computed tomography (CT)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285405/prepontine-arachnoid-cyst-presenting-with-headache-and-diplopia-a-case-report-study
#14
Omidvar Rezaee, Kaveh Ebrahimzadeh, Ehsan Nazari Maloumeh, Armin Jafari, Misagh Shafizad, Mohammad Hallajnejad
Background: Arachnoid cysts are found everywhere in cerebrospinal axis, most often in the middle cranial fossa. They are very rare in prepontine location. Case Description: In this study, we report a 26-year-old female presenting with a 3-month history of headache and diplopia. On physical examination, she had clinical manifestations of sixth cranial nerve palsy. Magnetic resonance imaging revealed a prepontine arachnoid cyst with extension into interpeduncular and suprasellar cisterns...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285404/cervicothoracic-syringomyelia-caused-by-cervical-spinal-stenosis-case-report-and-literature-review
#15
Mohamed Badri, Ghassen Gader, Kamel Bahri, Ihsen Zammel
Background: Syringomyelia is commonly associated with Chiari malformations, spinal trauma, arachnoiditis, or tumors. However, rarely, cervical canal stenosis is implicated in intramedullary cavitations. Case Discription: Here, we report the case of a 60-year-old male patient who presented with loss of pain and temperature sensation in upper extremities associated with a spastic tetraparesis. On magnetic resonance imaging, the patient was found to have syringomyelia extending from C1 to Th3...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29285403/sacroiliac-stabilization-for-sacral-metastasis-a-case-series
#16
Morenikeji A Buraimoh, Charles C Yu, Michael P Mott, Gregory P Graziano
Background: The sacrum is a rare location for spinal metastasis. These lesions are typically large and destructive by the time of diagnosis, making treatment difficult. When indicated, surgical stabilization offers pain relief and preserves independence in patients with impending and acute pathological sacral fractures. Case Description: Three consecutive patients presented with sacral metastases. After either failing radiation therapy or presenting with acute fracture and instability, the patients underwent intralesional excision, bilateral L4 to ilium fusion with instrumentation, and sacroiliac (SI) screw fixation...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29279802/reconstructing-the-severed-spinal-cord
#17
EDITORIAL
Sergio Canavero, Xiaoping Ren, C-Yoon Kim
No abstract text is available yet for this article.
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29279801/technical-factors-affecting-outcomes-following-endovascular-treatment-of-posterior-circulation-atherosclerotic-lesions
#18
Matthew D Alexander, Jeffrey M Rebhun, Steven W Hetts, Matthew R Amans, Fabio Settecase, Robert J Darflinger, Christopher F Dowd, Van V Halbach, Randall T Higashida, Daniel L Cooke
Background: Atherosclerotic disease of the vertebrobasilar system causes significant morbidity and mortality. All lesions require aggressive medical management, but the role of endovascular interventions remains unsettled. This study examines such endovascular interventions for vertebrobasilar atherosclerosis. Methods: Retrospective review was performed of prospectively maintained procedure logs at three hospitals with comprehensive neurointerventional services...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29279800/closed-therapy-of-thoracic-and-lumbar-vertebral-body-fractures-in-trauma-patients
#19
Jarvis W Walters, Tammy R Kopelman, Arpan A Patel, Patrick J O'Neill, Poya Hedayati, Paola G Pieri, Sydney J Vail, Salvatore C Lettieri, Iman Feiz-Erfan
Background: The failure rate for the closed/non-surgical treatment of thoracic and lumbar vertebral body fractures (TLVBF) in trauma patients has not been adequately evaluated utilizing computed tomography (CT) studies. Methods: From 2007 to 2008, consecutive trauma patients, who met inclusion criteria, with a CT diagnosis of acute TLVBF undergoing closed treatment were assessed. The failure rates for closed therapy, at 3 months post-trauma, were defined by progressive deformity, vertebral body collapse, or symptomatic/asymptomatic pseudarthrosis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29279799/prediction-of-30-day-mortality-in-spontaneous-cerebellar-hemorrhage
#20
Diaa Al Safatli, Albrecht Guenther, Aaron Lawson McLean, Albrecht Waschke, Rolf Kalff, Christian Ewald
Background: Cerebellar hemorrhage is a potentially life-threatening condition and an understanding of the factors influencing outcome is essential for sound clinical decision-making. Methods: We retrospectively evaluated data from 50 consecutive patients who suffered a first spontaneous cerebellar hemorrhage (SCH) from 2005 to 2014, analysing their short-term outcomes and identifying possible clinical, radiological and therapeutic risk factors for poor prognosis and death within 30 days...
2017: Surgical Neurology International
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