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Neurosurgical anesthesia

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https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#1
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29226114/comparison-the-effects-of-intraoperative-labetalol-and-lidocaine-on-postoperative-blood-pressure-and-heart-rate-in-brain-surgeries
#2
Mohammadali Attari, Behrooz Ziai, Ahmad Raeisi
Background: Long-term anesthesia applied in some operations, especially in neurosurgical operations leads to unwanted complications. This study aimed to compare the effect of intraoperative labetalol and lidocaine injection on the rate of changes in postoperative blood pressure and heart beat in patients undergoing brain operation. Materials and Methods: This is a simple double-blind randomized clinical trial study conducted in Al-Zahra and Kashani Hospitals on 90 patients' candidate for craniotomy operation with the age range of 18-65 years, Glasgow Coma Scale (GCS) ≥13 before anesthesia, physical class of American Society of Anesthesiologists I, II, insensitivity to labetalol who were divided into two groups of 45 individuals in the random allocation method...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#3
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29122534/influence-of-antithrombotic-agents-on-recurrence-rate-and-clinical-outcome-in-patients-operated-for-chronic-subdural-hematoma
#4
Tammam Abboud, Lasse Dührsen, Christina Gibbert, Manfred Westphal, Tobias Martens
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common pathology encountered in neurosurgical practice, especially in elderly patients, who frequently require antithrombotic agents. The aim of this study was to investigate the influence of antithrombotic agents on recurrence rates and clinical outcomes in patients operated for cSDH. METHODS: A cohort of patients operated for cSDH at one center during a 5 years period was analyzed retrospectively. Presenting symptoms, coagulation testing, history of antithrombotic agents and comorbidities were obtained from the patient charts...
November 6, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29093782/central-sagittal-angle-of-the-sacrum-as-a-new-risk-factor-for-patients-with-persistent-low-back-pain-after-caesarean-section
#5
Hizir Kazdal, Ayhan Kanat, Osman Ersagun Batcik, Bulent Ozdemir, Senol Senturk, Murat Yildirim, Leyla Kazancioglu, Ahmet Sen, Sule Batcik, Mehmet Sabri Balik
Study Design: Retrospective. Purpose: This study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia. Overview of Literature: Many women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia. Methods: We examined two groups of patients who underwent cesarean delivery under spinal anesthesia...
October 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/29022129/the-utility-of-local-anesthesia-for-neurosurgical-interventions-in-a-low-resource-setting-a-case-series
#6
Jessica Eaton, Asma Bilal Hanif, Suzgisam Mzumara, Anthony Charles
INTRODUCTION: Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked. METHOD: This is a retrospective case review of patients with operable lesions, such as extra-axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia...
October 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29017455/the-ec90-of-remifentanil-for-blunting-cardiovascular-responses-to-head-fixation-for-neurosurgery-under-total-intravenous-anesthesia-with-propofol-and-remifentanil-based-on-bispectral-index-monitoring-estimation-with-the-biased-coin-up-and-down-sequential-method
#7
Jung-Man Lee, Jae-Hyon Bahk, Young-Jin Lim, Jiwon Lee, Leerang Lim
BACKGROUND: Head fixation can induce hemodynamic instability. Remifentanil is commonly used with propofol for total intravenous anesthesia (TIVA) during neurosurgery. This study investigated the 90% effective concentration (EC90) of remifentanil for blunting of cardiovascular responses to head fixation during neurosurgery via bispectral index (BIS) monitoring. METHODS: Fifty patients undergoing neurosurgery requiring head fixation were enrolled. This study was performed using the biased coin up-and-down design sequential method (BCD)...
October 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28960172/resting-state-functional-magnetic-resonance-imaging-for-surgical-planning-in-pediatric-patients-a-preliminary-experience
#8
Jarod L Roland, Natalie Griffin, Carl D Hacker, Ananth K Vellimana, S Hassan Akbari, Joshua S Shimony, Matthew D Smyth, Eric C Leuthardt, David D Limbrick
OBJECTIVE Cerebral mapping for surgical planning and operative guidance is a challenging task in neurosurgery. Pediatric patients are often poor candidates for many modern mapping techniques because of inability to cooperate due to their immature age, cognitive deficits, or other factors. Resting-state functional MRI (rs-fMRI) is uniquely suited to benefit pediatric patients because it is inherently noninvasive and does not require task performance or significant cooperation. Recent advances in the field have made mapping cerebral networks possible on an individual basis for use in clinical decision making...
September 29, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28960161/geriatric-comanagement-reduces-perioperative-complications-and-shortens-duration-of-hospital-stay-after-lumbar-spine-surgery-a-prospective-single-institution-experience
#9
Owoicho Adogwa, Aladine A Elsamadicy, Victoria D Vuong, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE Geriatric patients undergoing lumbar spine surgery have unique needs due to the physiological changes of aging. They are at risk for adverse outcomes such as delirium, infection, and iatrogenic complications, and these complications, in turn, contribute to the risk of functional decline, nursing home admission, and death. Whether preoperative and perioperative comanagement by a geriatrician reduces the incidence of in-hospital complications and length of in-hospital stay after elective lumbar spine surgery remains unknown...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28856114/total-intravenous-anesthesia-for-neurosurgical-procedures-in-narcoleptic-patients-two-case-reports
#10
Sara Pedrosa, Nuno Lareiro, Pedro Amorim
INTRODUCTION: Narcoleptic patients may be at increased risk of prolonged emergence, postoperative hypersomnia, apneic episodes, and sleep paralysis after general anesthesia. Modafinil is the first-line treatment, however, the implication it has on general anesthesia is not clear. This report present 2 cases of narcoleptic patients medicated with modafinil that were submitted to total intravenous anesthesia for neurosurgical procedures. CASE PRESENTATION: Informed consent was obtained from both patients...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28810347/-history-of-world-neurosurgery
#11
X Wang
In 5000 BC, South American tribes digged the bones in the living head to seek ways to communicate with the gods, which was primitive trephination and may be the first neurosurgical behavior. In 2600 BC, Imhotep in ancient Egypt took the brain out of the head from the nose, for a better preserve of the mummy, which was a prototype of modern transsphenoidal surgery. And the development of anatomy in ancient Greek laid a solid foundation for neurosurgery. From 500 to 1500 AD, the rise of religion and the occurrence of war, prompted a large number of craniocerebral trauma, which contributed greatly to the early development of neurosurgery as a distinct specialty...
May 28, 2017: Zhonghua Yi Shi za Zhi, Chinese Journal of Medical History
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#12
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28797982/identification-of-preoperative-and-intraoperative-risk-factors-for-complications-in-the-elderly-undergoing-elective-craniotomy
#13
Stephen J Johans, Jonathan R Garst, Daniel J Burkett, Kurt Grahnke, Brendan Martin, Tarik F Ibrahim, Douglas E Anderson, Vikram C Prabhu
BACKGROUND: Neurosurgical patients are aging as the general population is becoming older. METHODS: A retrospective review of patients ≥65 years of age who underwent an elective craniotomy from 2007 to 2015 to identify risk factors for 30-day morbidity/mortality was conducted. Key preoperative variables included age, comorbidities, and functional status based on the Karnofsky Performance Status score and modified Rankin Scale score. Outcome variables included long-term care (LTC) complications, neurologic complications, systemic/infectious complications, length of stay, functional outcomes, and mortality...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28707996/effect-of-the-degree-of-head-elevation-on-the-incidence-and-severity-of-venous-air-embolism-in-cranial-neurosurgical-procedures-with-patients-in-the-semisitting-position
#14
Hatice Türe, M Volkan Harput, Nural Bekiroğlu, Özgül Keskin, Özge Köner, Uğur Türe
OBJECTIVE The semisitting position of a patient confers numerous advantages in various neurosurgical procedures, but venous air embolism is one of the associated complications of this position. To date, no prospective studies of the relationship between the degree of head elevation and the rate and severity of venous air embolism for patients undergoing a procedure in this position have been performed. In this study, the authors compared changes in the severity of venous air embolism according to the degree of head elevation (30° or 45°) in patients undergoing an elective cranial neurosurgical procedure in the semisitting position...
July 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28691984/stepwise-rostrocaudal-brainstem-anesthesia-as-a-complication-of-local-anesthesia-a-case-report
#15
Braden Waters, Ryan R Kroll, John Muscedere, Lysa Boissé Lomax, Jessica E Burjorjee
Iatrogenic cranial nerve palsies can rarely complicate neurosurgical, oral maxillofacial, and otolaryngological procedures. Among the most serious complications of cranial nerve palsy is upper airway obstruction, which is life threatening. We present a case of multiple cranial nerve palsies evolving rapidly in a rostrocaudal stepwise fashion after infiltration of lidocaine to repair a cerebrospinal fluid leak in a patient postoccipital craniectomy. This led to hypoxic respiratory failure requiring mechanical ventilation before resolving spontaneously...
November 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28681208/surgical-considerations-in-the-optimal-management-of-patients-with-malignant-brain-tumors
#16
REVIEW
Jaclyn J Renfrow, Roy E Strowd, Adrian W Laxton, Stephen B Tatter, Carol P Geer, Glenn J Lesser
Advances in technology are revolutionizing medicine and the limits of what we can offer to our patients. In neurosurgery, technology continues to reduce morbidity, increase surgical accuracy, facilitate tissue acquisition, and promote novel techniques for prolonging survival in patients with neuro-oncologic disease. Surgery has been the backbone of glioma diagnosis and treatment by providing adequate, high quality material for precise histologic diagnosis, and genomic characterization in the setting of significant intratumoral heterogeneity, thus allowing personalized treatment selection in the clinic...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#17
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28543052/norepinephrine-reduces-arterial-compliance-less-than-phenylephrine-when-treating-general-anesthesia-induced-arterial-hypotension
#18
F Vallée, O Passouant, A Le Gall, J Joachim, J Mateo, A Mebazaa, E Gayat
INTRODUCTION: During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. METHODS: Patients scheduled for a neurosurgical procedure under general anesthesia were prospectively included...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28518084/subcutaneous-trigeminal-nerve-field-stimulation-for-refractory-facial-pain
#19
Martin Jakobs, Sigrid Schuh-Hofer, Andreas Unterberg, Rezvan Ahmadi
Chronic or neuropathic trigeminal facial pain can be challenging to treat. Neurosurgical procedures should be applied when conservative treatment fails. Neuromodulation techniques for chronic facial pain include deep brain stimulation and motor cortex stimulation, which are complex to perform. Subcutaneous nerve field stimulation is certified for chronic back pain and is the least invasive form of neuromodulation. We applied this technique to treat chronic and neuropathic trigeminal pain as an individual therapy concept...
May 10, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28502682/intrarectal-anesthesia-in-neurosurgery
#20
REVIEW
Ladina Greuter, Alexander G Weil, Gerhard Hildebrandt, Werner Surbeck
In the early days of modern neurologic surgery, the inconveniences and potential dangers of general anesthesia by chloroform and ether using the so-called "open-drop technique" led to the quest for alternative methods of anesthesia. This became all the more necessary, since patient positioning and the surgical arrangements often hindered the use of a drop bottle. One approach to solve this problem was intrarectal ether application. The present article aims to shed light on this original, less well-known anesthesia technique in the neurosurgical field...
August 2017: World Neurosurgery
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