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https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#1
Seungjun Song, Suk-Won Song, Tae Hoon Kim, Kwang-Hun Lee, Kyung-Jong Yoo
BACKGROUND: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies. Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial. METHODS: From 2012 to 2014, 162 patients underwent TEVAR at a single institution...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28929378/external-ventricular-drains-after-subarachnoid-hemorrhage-is-less-more
#2
David Y Chung, Stephan A Mayer, Guy A Rordorf
External ventricular drains (EVD) are essential in the early management of hydrocephalus and elevated intracranial pressure after subarachnoid hemorrhage (SAH). Once in place, management of the EVD is thought to influence long-term patient outcomes, rates of ventriculitis, incidence of delayed cerebral ischemia, need for a ventriculoperitoneal shunt, and intensive care unit (ICU) and hospital length of stay. The available evidence supports adopting early clamp trials and intermittent cerebrospinal fluid (CSF) drainage...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28921013/spinal-cord-injury-as-a-complication-of-thoracic-endovascular-aneurysm-repair
#3
REVIEW
Taijiro Sueda, Shinya Takahashi
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented. METHODS AND RESULTS: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid...
September 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28903061/lymphatic-drainage-system-of-the-brain-a-novel-target-for-intervention-of-neurological-diseases
#4
REVIEW
Bao-Liang Sun, Li-Hua Wang, Tuo Yang, Lei-Lei Mao, Jing-Yi Sun, Ming-Feng Yang, Hui Yuan, Robert A Colvin, Xiao-Yi Yang
The belief that the vertebrate brain functions normally without classical lymphatic drainage vessels has been held for many decades. On the contrary, new findings show that functional lymphatic drainage does exist in the brain. The brain lymphatic drainage system is composed of basement membrane-based perivascular pathway, a brain-wide glymphatic pathway, and cerebrospinal fluid (CSF) drainage routes including sinus-associated meningeal lymphatic vessels and olfactory/cervical lymphatic routes. The brain lymphatic systems function physiological as a route of drainage for interstitial fluid (ISF) from brain parenchyma to nearby lymph nodes...
September 10, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/28894709/prognosis-and-risk-factors-influencing-recurrence-in-surgery-treated-patients-with-primary-sacral-tumors
#5
Xiliang Dang, Liping Lian, Dongsheng Wu
BACKGROUND: We aimed to explore the prognosis and risk factors influencing tumor recurrence in surgery-treated patients with primary sacral tumors. METHODS: Fifty-six patients between February 2011 and December 2016 in Yishui Central Hospital with primary sacral tumors were selected and treated with radical surgeries. The perioperative outcomes and postoperative neurological functions were observed. After postoperative follow-up, the overall survival time (OS), disease-free survival time (DFS), and recurrence were recorded to analyze the potential risk factors influencing tumor recurrence...
August 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28892572/deconstructing-normal-pressure-hydrocephalus-ventriculomegaly-as-early-sign-of-neurodegeneration
#6
REVIEW
Alberto J Espay, Gustavo A Da Prat, Alok K Dwivedi, Federico Rodriguez-Porcel, Jennifer E Vaughan, Michela Rosso, Johnna L Devoto, Andrew P Duker, Mario Masellis, Charles D Smith, J George T Mandybur, Aristide Merola, Anthony E Lang
Idiopathic normal pressure hydrocephalus (NPH) remains both over-suspected on clinical grounds and under-confirmed when based on immediate and sustained response to cerebrospinal fluid diversion. Poor long-term post-shunt benefits and findings of neurodegenerative pathology in most patients with adequate follow up suggests that hydrocephalic disorders appearing in late adulthood may often result from initially unapparent parenchymal abnormalities. We critically review the NPH literature, highlighting the near universal lack of blinding and controls, the absence of specific clinical, imaging, or pathologic features, and the ongoing dependence for diagnostic confirmation on variable cutoffs of gait response to bedside fluid-drainage testing...
September 11, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28887075/role-of-cathepsin-k-in-the-development-of-chronic-subdural-hematoma
#7
Satoshi Tsutsumi, Ikuko Ogino, Masakazu Miyajima, Senshu Nonaka, Masanori Ito, Yukimasa Yasumoto, Hajime Arai
Despite extensive investigations, the process of development of chronic subdural hematoma (CSDH) is not known. The present study aims to investigate CSDH by measuring biomarkers in it, gas analysis, and immunohistochemical examination. A total of 42 patients with symptomatic CSDH who underwent burr-hole drainage were enrolled. Intraoperatively, hematoma fluid and peripheral venous blood (PVCSDH) were simultaneously collected. As controls, peripheral venous blood (PVControl) and intracranial cerebrospinal fluid (CSF) were collected from other subjects during other surgeries...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28872159/cerebrospinal-fluid-rhinorrhoea-following-transsphenoidal-surgery-for-pituitary-adenoma-experience-in-a-chinese-centre
#8
C Zhang, X Ding, Y Lu, L Hu, G Hu
The aim of this study was to elucidate the risk factors for cerebrospinal fluid (CSF) rhinorrhoea following transsphenoidal surgery and discuss its prevention and treatments. We retrospectively reviewed 474 consecutive cases of pituitary adenoma treated with 485 transsphenoidal surgical procedures from January 2008 to December 2011 in our department. We analysed the incidence of intra- and post-operative CSF leakage and outcomes of various repair strategies. Intra-operative CSF leakage was encountered in 85 cases (17...
August 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28868047/in-premature-newborns-intraventricular-hemorrhage-causes-cerebral-vasospasm-and-associated-neurodisability-via-heme-induced-inflammasome-mediated-interleukin-1-production-and-nitric-oxide-depletion
#9
Michael Eisenhut, Samyami Choudhury
BACKGROUND: Intraventricular hemorrhage (IVH) occurs in 60-70% of neonates weighing 500-750 g and 10-20% of those weighing 1,000-1,500 g. All forms of IVH have been associated with neurocognitive deficits. Both subarachnoid and IVHs have been associated with delayed vasospasm leading to neurological deficits. Pathways linking hemoglobin release from blood clots to vasospasm include heme-induced activation of inflammasomes releasing interleukin-1 (IL-1) that can cause calcium dependent and independent vasospasm...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28866068/treating-csf-rhinorrhea-without-dura-repair-a-case-report-of-posterior-fossa-choroid-plexus-papilloma
#10
François Lechanoine Resident, Ilyess Zemmoura, Stéphane Velut
BACKGROUND: Choroid plexus papilloma revealed by non traumatic cerebrospinal fluid (CSF) rhinorrhea had only been described five times in the literature. The challenges in this situation are to recognize CSF leak, to rapidly understand the pathophysiology of the leak, and to choose the best treatment strategy in emergency. We report an original case of posterior fossa choroid plexus papilloma revealed by CSF leak. We then discuss the surgical strategy and the pathophysiology of CSF leak, which is explained, in this case, by both hyperproduction of CSF and local skull base erosion...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28862640/understanding-the-functions-and-relationships-of-the-glymphatic-system-and-meningeal-lymphatics
#11
Antoine Louveau, Benjamin A Plog, Salli Antila, Kari Alitalo, Maiken Nedergaard, Jonathan Kipnis
Recent discoveries of the glymphatic system and of meningeal lymphatic vessels have generated a lot of excitement, along with some degree of skepticism. Here, we summarize the state of the field and point out the gaps of knowledge that should be filled through further research. We discuss the glymphatic system as a system that allows CNS perfusion by the cerebrospinal fluid (CSF) and interstitial fluid (ISF). We also describe the recently characterized meningeal lymphatic vessels and their role in drainage of the brain ISF, CSF, CNS-derived molecules, and immune cells from the CNS and meninges to the peripheral (CNS-draining) lymph nodes...
September 1, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28842361/risk-factors-and-molecular-epidemiology-of-extended-spectrum-%C3%AE-lactamase-producing-klebsiella-pneumoniae-in-xiamen-china
#12
Jie Deng, Yan-Ting Li, Xu Shen, Yi-Wen Yu, Hui-Ling Lin, Qi-Feng Zhao, Tian-Ci Yang, Shu-Lian Li, Jian-Jun Niu
OBJECTIVES: The aim of this study was to evaluate the risk factors for pneumonia due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) and to analyse the molecular epidemiology of ESBL-KP in Xiamen, China. METHODS: A case-control study was conducted at Zhongshan Hospital from January 2014 to August 2015. Medical records of patients with nosocomial pneumonia caused by K. pneumoniae were collected. A total of 40 cases with ESBL-KP infection and 90 controls with non-ESBL-KP infection were included...
August 23, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#13
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28812141/next-generation-of-ventricular-catheters-for-hydrocephalus-based-on-parametric-designs
#14
M Galarza, A Giménez, J M Amigó, M Schuhmann, R Gazzeri, U Thomale, J P McAllister
BACKGROUND: The flow pattern of the cerebrospinal fluid is probably the most important factor related to obstruction of ventricular catheters during the normal treatment of hydrocephalus. To better comprehend the flow pattern, we have carried out a parametric study via numerical models of ventricular catheters. In previous studies, the flow was studied under steady and, recently, in pulsatile boundary conditions by means of computational fluid dynamics (CFD) in three-dimensional catheter models...
August 15, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28799877/volume-of-cerebrospinal-fluid-drainage-as-a-predictor-for-pretreatment-aneurysmal-rebleeding
#15
Jasper H van Lieshout, Ina Pumplün, Igor Fischer, Marcel A Kamp, Jan F Cornelius, Hans J Steiger, Hieronymus D Boogaarts, Athanasios K Petridis, Kerim Beseoglu
OBJECTIVE Initiation of external CSF drainage has been associated with a significant increase in rebleeding probability after aneurysmal subarachnoid hemorrhage (aSAH). However, the implications for acute management are uncertain. The purpose of this study was to evaluate the role of the amount of drained CSF on aneurysmal rebleeding. METHODS Consecutive patients with aSAH were analyzed retrospectively. Radiologically confirmed cases of aneurysmal in-hospital rebleeding were identified and predictor variables for rebleeding were retrieved from hospital records...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28793057/noninvasive-intracranial-pressure-monitoring-for-hiv-associated-cryptococcal-meningitis
#16
V R Bollela, G Frigieri, F C Vilar, D L Spavieri, F J Tallarico, G M Tallarico, R A P Andrade, T M de Haes, O M Takayanagui, A M Catai, S Mascarenhas
Mortality and adverse neurologic sequelae from HIV-associated cryptococcal meningitis (HIV-CM) remains high due to raised intracranial pressure (ICP) complications. Cerebrospinal fluid (CSF) high opening pressure occurs in more than 50% of HIV-CM patients. Repeated lumbar puncture with CSF drainage and external lumbar drainage might be required in the management of these patients. Usually, there is a high grade of uncertainty and the basis for clinical decisions regarding ICP hypertension tends to be from clinical findings (headache, nausea and vomiting), a low Glasgow coma scale score, and/or fundoscopic papilledema...
August 7, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28768799/microrna-changes-in-cerebrospinal-fluid-after-subarachnoid-hemorrhage
#17
Søren Bache, Rune Rasmussen, Maria Rossing, Finn Pedersen Laigaard, Finn Cilius Nielsen, Kirsten Møller
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) accounts for a major part of the morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). MicroRNAs (miRNAs) are pathophysiologically involved in acute cerebral ischemia. This study compared miRNA profiles in cerebrospinal fluid from neurologically healthy patients, as well as SAH patients with and without subsequent development of DCI. METHODS: In a prospective case-control study of SAH patients treated with external ventricular drainage and neurologically healthy patients, miRNA profiles in cerebrospinal fluid were screened and validated using 2 different high-throughput real-time quantification polymerase chain reaction techniques...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28762181/sternum-splitting-anterior-approach-following-posterior-decompression-and-fusion-in-patients-with-massive-ossification-of-the-posterior-longitudinal-ligament-in-the-upper-thoracic-spine-report-of-2-cases-and-literature-review
#18
Yoshiharu Kawaguchi, Shoji Seki, Yasuhito Yahara, Takahiro Homma, Tomoatsu Kimura
PURPOSE: Anterior approach to the upper thoracic spine is difficult. It is important for spine surgeons to know the indication and the effect of anterior decompression for upper thoracic lesions and also to recognize the complications which are related to the approach with sternotomy. We present two patients for whom we took the sternum-splitting anterior approach for thoracic ossification of the posterior longitudinal ligament (OPLL) following posterior decompression and fusion surgery; the clinical course and surgical outcome are discussed, with particular reference to complication avoidance and also we review the previous literature...
July 31, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28754644/subdural-fluid-collection-and-hydrocephalus-after-foramen-magnum-decompression-for-chiari-malformation-type-i-management-algorithm-of-a-rare-complication-case-report
#19
Zefferino Rossini, Davide Milani, Francesco Costa, Carlotta Castellani, Giovanni Lasio, Maurizio Fornari
BACKGROUND: Chiari Malformation Type I is a hindbrain abnormality characterized by cerebellar tonsils descent beneath the foramen magnum, frequently associated with symptoms or brainstem compression, impaired cerebrospinal fluid circulation and syringomyelia. Foramen magnum decompression represents the most common way of treatment. Rarely, subdural fluid collection and hydrocephalus represent postoperative adverse events. The treatment of this complication is still debated, and physicians sometimes are faced with the doubt of when undergoing diversion surgery and when more conservative managements...
July 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28751035/risk-factors-of-neurosurgical-site-infection-after-craniotomy-a-systematic-review-and-meta-analysis
#20
Chenyan Fang, Tao Zhu, Ping Zhang, Liang Xia, Caixing Sun
BACKGROUND: Neurosurgical site infection (SSI) is a complication related to craniotomy, which may lead to severe morbidity and higher hospital costs during the postoperative period. METHODS: Retrospective cohorts, case-control studies, or prospective investigations addressing risk factors of SSI updated until January 2017 were systematically searched in 2 databases (PubMed and Embase). The Newcastle-Ottawa Scale was used to evaluate quality of the included studies, heterogeneity was assessed by I(2) tests, and a funnel plot and Egger test were used for the evaluation of publication bias...
July 24, 2017: American Journal of Infection Control
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