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https://www.readbyqxmd.com/read/28230605/microscopic-transnasal-transsphenoidal-surgery-for-pediatric-pituitary-adenomas
#1
Wei Jiao, Yimin Huang, Wei Sun, Ting Lei
Microscopic transnasal transsphenoidal surgery (MTTS) has been a time-confirmed effective treatment for pituitary adenomas; however, the data supporting its use in pediatric patients is limited. In this study, the authors summarize the authors' 5-year experience of pituitary adenomectomy via MTTS in a pediatric population. The authors retrospectively reviewed the medical records of 35 patients aged ≤18 years who underwent microscopic transnasal transsphenoidal approach for pituitary adenomas between January 2011 and December 2015...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#2
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28229571/transnasal-transsphenoidal-brain-injury-by-a-fencing-foil-an-unusual-case-report-and-brief-literature-review
#3
Rafet Özay, Mehmet S Balkan, Çağhan Tönge, Zeki Şekerci
BACKGROUND: In this report, the authors present an unusual case of a 10-year-old child who suffered a severe headache and rhinorrhea that occurred as a result of fencing foil sports injury via transnasal-transsphenoidal (TNTS) pathway. METHODS: Following to trauma, the child had shown neurological symptoms such a pupil dilatation, change in consciousness and mild hemiparesia. Imaging demonstrated destruction of bone structures including posterior wall of sphenoid sinus and anterosuperior part of sella turcica, and also a contusion at right thalamic region...
February 22, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28228623/elucidation-of-mechanism-of-blood-brain-barrier-damage-for-prevention-and-treatment-of-vascular-dementia
#4
Masaki Ueno
It is well-known that the blood-brain barrier (BBB) plays significant roles in transporting intravascular substances into the brain. The BBB in cerebral capillaries essentially impedes the influx of intravascular compounds from the blood to the brain, while nutritive substances, such as glucose, can be selectively transported through several types of influx transporters in endothelial cells. In the choroid plexus, intravascular substances can invade the parenchyma as fenestrations exist in endothelial cells of capillaries...
February 22, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28216365/automated-pressure-controlled-cerebrospinal-fluid-drainage-during-open-thoracoabdominal-aortic-aneurysm-repair
#5
Yamume Tshomba, Marco Leopardi, Daniele Mascia, Andrea Kahlberg, Andrea Carozzo, Silvio Magrin, Germano Melissano, Roberto Chiesa
OBJECTIVE: Perioperative cerebrospinal fluid (CSF) drainage is a well-established technique for spinal cord protection during thoracoabdominal aortic aneurysm (TAAA) open repair and is usually performed using dripping chamber-based systems. A new automated device for controlled and continuous CSF drainage, designed to maintain CSF pressure around the desired set values, thus avoiding unnecessary drainage, is currently available. The aim of our study was to determine whether the use of the new LiquoGuard automated device (Möller Medical GmbH, Fulda, Germany) during TAAA open repair was safe and effective in maintaining the desired CSF pressure values and whether the incidence of complications was reduced compared with a standard catheter connected to a dripping chamber...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#6
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28193123/ventriculoportal-shunt-a-new-transomphalic-extraperitoneal-surgical-technique-in-treatment-of-hydrocephalus
#7
Valentin Titus Grigorean, Aurelia Mihaela Sandu, Mihai Popescu, Victor Strambu
AIM: The aim of this article was to report a new transomphalic extraperitoneal surgical technique for treatment of hydrocephalus, called ventriculoportal shunt. MATERIALS AND METHODS: We performed ventriculoportal shunt on an experimental animal (pig). The particularity of ventriculoportal shunt consists in the fact that the distal end of the catheter is inserted transomphalic extraperitoneally in the portal system through reopened umbilical vein. We present technical details regarding this new surgical technique...
February 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28187815/principles-of-intracranial-pressure-monitoring-and-treatment
#8
M Czosnyka, J D Pickard, L A Steiner
Intracranial pressure (ICP) is governed by volumes of intracranial blood, cerebrospinal fluid, and brain tissue. Expansion of any of these volumes will trigger compensatory changes in the other compartments, resulting in initially limited change in ICP. Due to the rigid skull, once compensatory mechanisms are exhausted, ICP rises very rapidly. Intracranial hypertension is associated with unfavorable outcome in brain-injured patients. This chapter discusses the pathophysiology of raised ICP, as well as typical waveforms, monitoring techniques, and clinical management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#9
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28175991/spontaneous-cerebrospinal-fluid-leaks-in-the-anterior-skull-base-secondary-to-idiopathic-intracranial-hypertension
#10
Gabriel Martínez-Capoccioni, Ramón Serramito-García, Maria Martín-Bailón, Alfredo García-Allut, Carlos Martín-Martín
Spontaneous cerebrospinal fluid (CSF) leaks represent a clinical entity in which CSF rhinorrhea occurs in the absence of any inciting event. Spontaneous CSF leaks are associated with elevated intracranial pressure (ICP) or have underlying idiopathic intracranial hypertension (IIH). We report a cohort of patients who have undergone nasal endoscopic repair for spontaneous CSF leaks. We review our perioperative complications and the effectiveness of the nasal endoscopic approach to repair spontaneous CSF leaks...
February 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28163520/penetrating-anterior-skull-base-fracture-inflicted-by-a-cow-s-horn
#11
Adomas Bunevicius, Karolis Bareikis, Laimutis Kalasauskas, Arimantas Tamasauskas
Farm workers are at increased risk for animal-inflicted head injuries that are associated with significant morbidity and occasionally may be fatal. These injuries may cause permanent eye damage with or without concomitant skull base fracture. Here, we present a male farmer who suffered a cow attack that resulted in perforating orbital injury with comminuted frontobasal cranial fracture caused by a cow's horn. The next day, the patient developed nasal and orbital cerebrospinal fluid (CSF) leak. Computed Tomography cisternography revealed CSF leakage to frontal and maxillary sinuses...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28159879/symptomatic-intracranial-hypertension-during-recovery-from-the-syndrome-of-headache-with-neurologic-deficits-and-cerebrospinal-fluid-lymphocytosis-handl
#12
Eoin Mulroy, Joel Yap, Helen Danesh-Meyer, Neil Anderson
The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HANDL) is rare; it comprises migrainous headaches (generally in headache-naïve people), fluctuating neurological symptoms and cerebrospinal fluid (CSF) lymphocytosis. The syndrome generally runs a benign, self-limiting course over weeks. A small proportion of patients develop intracranial hypertension as a consequence of the illness. Recurrence of headaches or development of visual symptoms following apparent recovery from HANDL should prompt urgent re-evaluation for elevated intracranial pressure...
February 3, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28121972/posttraumatic-oculorrhea-from-the-eyelid
#13
Muhammed Batur, Erbil Seven, Abdurrahman Aycan, Adnan Çinal, Tekin Yaşar
We report a 21-month-old boy with a sutured laceration of the left upper eyelid with drainage of cerebrospinal fluid. Careful evaluation, including computerized tomography, revealed a penetrating injury of the left orbital wall and a linear bone fracture. The wound was resutured carefully. There was no cerebrospinal fluid leakage in the postoperative follow-up period.
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28108577/the-efficacy-and-risk-of-cerebrospinal-fluid-drainage-for-thoracoabdominal-aortic-aneurysm-repair-a-retrospective-observational-comparison-between-drainage-and-non-drainage%C3%A2
#14
Junya Sugiura, Hideki Oshima, Tomonobu Abe, Yuji Narita, Yoshimori Araki, Kazuro Fujimoto, Masato Mutsuga, Akihiko Usui
OBJECTIVES: We reviewed our experiences with thoracoabdominal aortic aneurysm (TAAA) repair to assess the efficacy of cerebrospinal fluid drainage (CSFD) to prevent the neurological deficits and complications associated with CSFD. METHODS: Between 2002 and 2015, 118 patients underwent TAAA repair. Seventy-eight patients underwent CSFD for 2.7 ± 1.1 days after surgery. CSFD was not performed for the other 40 patients due to an urgent situation, chronic disseminated intravascular coagulation or anatomical difficulties...
January 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28107857/prostatic-abscess-of-klebsiella%C3%A2-pneumonia-complicating-septic-pulmonary-emboli-and-meningitis-a-case-report-and-brief-review
#15
Jai-Wen Liu, Tzu-Chieh Lin, Yao-Tien Chang, Che-An Tsai, Sung-Yuan Hu
Prostatic abscess is a rare entity with an incidence of 0.5%-2.5% in all prostate diseases and usually occurs in the 5th and 6th decades of life with immunocompromised status. Prostatic abscess might be a process of evolution from acute prostatitis. Klebsiella pneumoniae is the leading microorganism in the diabetic patients of prostatic abscess in Taiwan. A 60-year-old diabetic man, with a one-week history of acute bacterial prostatitis was reported in this study, presenting to the emergency department with sudden altered mental status...
January 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/28089808/stress-induced-hyperglycemia-after-spontaneous-subarachnoid-hemorrhage-and-its-role-in-predicting-cerebrospinal-fluid-diversion
#16
Bappaditya Ray, Ayumi Ludwig, Lori K Yearout, David M Thompson, Bradley N Bohnstedt
BACKGROUND: Stress induced hyperglycemia (SIH) after acute cerebrovascular disease is common and is associated with adverse clinical outcomes. Incidence of SIH after spontaneous subarachnoid hemorrhage (SAH) and its role in shunt placement has not been systematically investigated. Present study is designed to investigate the incidence of SIH after spontaneous SAH and its determinants. Role of SIH and premorbid hyperglycemia (using glycated hemoglobin, HbA1c) in predicting external ventricular drainage (EVD) and ventriculoperitoneal shunt (VPS) placement is also investigated...
January 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087916/-a-case-of-idiopathic-hypertrophic-cranial-pachymeningitis-presenting-as-chronic-subdural-hematoma
#17
Zhan He, Fang Ding, Jiandong Rong, Yongli Gan
A 26-year-old male presented with a 6-day history of paroxysmal headache which was worsen with nausea and vomiting for 1 day. Head CT on admission revealed left chronic subdural hematoma with midline shift. An emergency Burr hole drainage for hematoma was performed. Headache recurred 6 days later. MRI of the brain revealed a diffuse thickening and a gadolinium-enhancement of the falx, cranial dura mater and tentorium cerebelli on the left side with pia mater involved. Lumber puncture showed increased intracranial pressure and elevated IgG level in cerebrospinal fluid...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28063056/investigating-the-lymphatic-drainage-of-the-brain-essential-skills-and-tools
#18
Nazira J Albargothy, Matthew MacGregor Sharp, Maureen Gatherer, Alan Morris, Roy O Weller, Cheryl Hawkes, Roxana O Carare
In this chapter we describe in detail the surgical and imaging techniques employed for the study of the anatomical routes of drainage of cerebrospinal fluid (CSF) and interstitial fluid (ISF) from the brain. The types of tracers, sites of injection, and volumes injected are crucial. For example, when testing the drainage of ISF from the parenchyma, volumes larger than 0.5 μL result in spillage of ISF into the ventricular CSF.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28061484/cerebrospinal-fluid-lumbar-tapping-utilization-for-suspected-ventriculoperitoneal-shunt-under-drainage-malfunctions
#19
Jong-Beom Lee, Ho-Young Ahn, Hong-Jae Lee, Ji-Ho Yang, Jin-Seok Yi, Il-Woo Lee
OBJECTIVE: The diagnosis of shunt malfunction can be challenging since neuroimaging results are not always correlated with clinical outcomes. The purpose of this study was to evaluate the efficacy of a simple, minimally invasive cerebrospinal fluid (CSF) lumbar tapping test that predicts shunt under-drainage in hydrocephalus patients. METHODS: We retrospectively reviewed the clinical and radiological features of 48 patients who underwent routine CSF lumbar tapping after ventriculoperitoneal shunt (VPS) operation using a programmable shunting device...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28059442/hydroxyapatite-cement-cranioplasty-following-translabyrinthine-approach-long-term-study-of-369-cases
#20
Peter G Volsky, Todd A Hillman, Kellen J Stromberg, Farrel J Buchinsky, Douglas A Chen, Neal M Jackson, Moisés A Arriaga
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm)...
January 6, 2017: Laryngoscope
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