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Neurosurgical infections

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https://www.readbyqxmd.com/read/29682060/rapidly-developing-subdural-empyema-in-an-adult-with-sinusitis-a-neurosurgical-threat-alert
#1
Kabilan Chokkappan, Rahul Lohan
Subdural empyema (SDE) is collection of pus in the potential space between the dura and arachnoid layers of the meninges. Leading causes of SDE are sinonasal and otomastoid infections. Commonly affecting patients in the second and third decades, SDE could have a fulminant course with immediate complications and delayed morbidities including hydrocephalus, focal deficits, and epilepsy.
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29663282/the-frozen-brain-state-of-cryptococcus-gattii-a-globe-trotting-tropical-neurotropic-fungus
#2
Paul T Akins, Brian Jian
Initially reported in tropical regions, Cryptococcus gattii infection is now diagnosed globally. METHODS: case report; Literature review. Although initial reports described outbreaks of pulmonary and central nervous system (CNS) disease in tropical regions such as Australia and New Guinea, it is now clear that Cryptococcus gattii is a global, neurotropic pathogen. In contrast with C. neoformans, C. gattii patients are more likely to present with cryptococcomas in the brain and lungs and are often HIV negative...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29656619/impact-of-resident-involvement-in-neurosurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-database-analysis-of-33-977-patients
#3
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Warren R Selman, Nicholas C Bambakidis
OBJECTIVE: There is conflicting and limited literature on the effect of intraoperative resident involvement on surgical outcomes. Our study assessed effects of resident involvement on outcomes in patients undergoing neurosurgery. METHODS: We identified 33,977 adult neurosurgical cases from 374 hospitals in the 2006-2012 National Surgical Quality Improvement Program, a prospectively collected national database with established reproducibility and validity. Outcomes were compared according to resident involvement before and after 1:1 matching on procedure and perioperative risk factors...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29648985/feasibility-of-telemetric-intracranial-pressure-monitoring-in-the-neuro-intensive-care-unit
#4
Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
March 16, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29629575/adult-hospital-admissions-associated-with-multiple-sclerosis-in-finland-in-2004-2014
#5
Anna-Leena Pirttisalo, Jussi O T Sipilä, Merja Soilu-Hänninen, Päivi Rautava, Ville Kytö
INTRODUCTION: Treatment of multiple sclerosis (MS) has developed significantly and several new immunotherapeutic drugs have become available in Finland since 2004. We studied whether this is associated with changes in hospital admission frequencies and healthcare costs and whether admission rates due to infection have increased. METHODS: The national Care Register for Health Care was searched for all discharges from neurological, medical, surgical, neurosurgical and intensive care units with MS as a primary diagnosis or an auxiliary diagnosis for primary infection diagnosis in 2004-2014...
April 9, 2018: Annals of Medicine
https://www.readbyqxmd.com/read/29629228/cranial-autologous-bone-flap-resorption-after-a-cranioplasty-a-case-report
#6
Sabrina A de França, Thales B Nepomuceno, Wellingson S Paiva, Almir F Andrade, Manoel J Teixeira, Wagner M Tavares
Background: Craniectomies and cranioplasty are common neurosurgical procedures performed after brain trauma, ischemia, tumor resection, or infection. Post-cranioplasty autologous bone flap resorption may occur in patients after delayed cranial reconstruction. The occurrence is usually low when bone flaps are stored in subcutaneous abdominal tissue. We report a unique case of post-cranioplasty cranial bone flap. Case Description: We report a total autologous bone flap resorption in a 28-year-old man with a history of alcohol abuse...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29626685/discrepancy-between-neurosurgery-morbidity-and-mortality-conference-discussions-and-hospital-quality-metric-standards
#7
Lauren E Rotman, Matthew C Davis, Arsalaan A Salehani, Devin R Broadwater, Nathaniel H Reeve, Kristen O Riley
OBJECTIVE: Medical institutions use quality metrics to track complications seen in hospital admissions. Similarly, morbidity and mortality (M&M) conferences are held to peer review complications. The purpose of this study was to compare the complications identified in a cohort of patients within 30 days of neurosurgical intervention with those captured in a cohort of M&M conferences. METHODS: All complications that occurred within 30 days of surgery were obtained for patients admitted to the neurosurgical service between May and September 2013...
April 4, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29625304/independent-factors-affecting-postoperative-complication-rates-after-custom-made-porous-hydroxyapatite-cranioplasty-a-single-center-review-of-109-cases
#8
Megan Still, Abdoulaye Kane, Alexandre Roux, Marc Zanello, Edouard Dezamis, Eduardo Parraga, Xavier Sauvageon, Jean-François Meder, Johan Pallud
BACKGROUND: Cranioplasties are an important neurosurgical procedure not only for improved cosmesis, but also for improved functional recover after craniectomy with a large cranial defect. The aim of this study was to identify predictive factors of post-cranioplasty complications using custom-made porous hydroxyapatite cranioplasty. METHODS: A retrospective review was conducted of all patients who underwent a reconstructive cranioplasty using custom-made hydroxyapatite at our institution between February 2008 to September 2017...
April 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29618119/external-ventricular-drain-placement-accuracy-and-safety-when-done-by-midlevel-practitioners
#9
Nathaniel R Ellens, D Luke Fischer, Jason E Meldau, Brett A Schroeder, Sanjay E Patra
BACKGROUND: External ventricular drains (EVDs) measure intracranial pressure, divert cerebrospinal fluid, and allow for orthotropic administration of pharmacologic agents. Currently, neurosurgeons and neurosurgery residents are the primary practitioners placing EVDs. Due to the urgency of neurosurgical pathologies and the lack of qualified residents at most hospitals, midlevel practitioner (MLP) placement of EVDs would be advantageous. OBJECTIVE: To assess the accuracy and complication rates of MLP and neurosurgeon EVD placement...
March 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29608437/intra-operative-inspired-fraction-of-oxygen-and-the-risk-of-surgical-site-infections-in-patients-with-type-1-surgical-incisions
#10
Brendan T Wanta, Kristine T Hanson, Joseph A Hyder, Thomas M Stewart, Timothy B Curry, Elie F Berbari, Elizabeth B Habermann, Daryl J Kor, Michael J Brown
BACKGROUND: Whether the fraction of inspired oxygen (FI O2 ) influences the risk of surgical site infection (SSI) is controversial. The World Health Organization and the World Federation of Societies of Anesthesiologists offer conflicting recommendations. In this study, we evaluate simultaneously three different definitions of FI O2 exposure and the risk of SSI in a large surgical population. PATIENTS AND METHODS: Patients with clean (type 1) surgical incisions who developed superficial and deep organ/space SSI within 30 days after surgery from January 2003 through December 2012 in five surgical specialties were matched to specialty-specific controls...
April 2, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29582969/incidence-and-risk-factors-of-neurosurgical-site-infections-results-of-a-prospective-multicenter-cohort-study-on-6359-surgeries
#11
Laura Valentini, Francesca Chiaffarino, Nicoletta Bonfanti, Marilou Pannacci, Paolo Cortellazzi, Caterina Uberti-Foppa, Marika Furlanetto, Francesco DI Meco, Luca Massimi
OBJECTIVES: Neurosurgical surgical site infections (SSI) are life-threatening complications, requiring medical treatment and additional surgeries and remain a substantial cause of morbidity. In order to identify the incidence and the main risk factors for SSI, we developed the Prophylaxis with Antibiotic protocol for neuroSurgical Site Infections Study (PASSIS), a prospective observational multicenter cohort study for examining a large number of neurosurgical procedures. METHODS: The study PASSIS involved four Italian Neurosurgical Departments applying the same antibiotic prophylaxis (ABP) protocol on 6359 consecutive neurosurgical procedures...
March 26, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29580895/the-effect-of-mobile-laminar-airflow-units-on-airborne-bacterial-contamination-during-neurosurgical-procedures
#12
Ann-Christin von Vogelsang, Petter Förander, Martin Arvidsson, Peter Löwenhielm
BACKGROUND: Surgical site infections (SSIs) after neurosurgery are potentially life threatening and entails great costs. SSI can occur from airborne bacteria in the operating room (OR), and ultraclean air is desired during infection-prone clean procedures. Door openings and the number of persons present in the OR affects the air quality. Mobile laminar airflow (MLAF) units, with horizontal laminar airflow, have previously shown to effectively reduce airborne bacterial contamination. AIM: To assess the effect of MLAF units on airborne bacterial contamination during neurosurgical procedures...
March 23, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29578382/pre-operative-screening-for-asymptomatic-bacteriuria-and-associations-with-post-operative-outcomes-in-patients-with-spinal-cord-injury
#13
Margaret A Fitzpatrick, Katie J Suda, Stephen P Burns, Linda Poggensee, Swetha Ramanathan, Charlesnika T Evans
CONTEXT: Screening for asymptomatic bacteriuria (ASB) before non-urologic surgery is common but of unclear benefit. Our aim was to describe pre-operative ASB screening and post-operative outcomes in patients with neurogenic bladder due to spinal cord injury (SCI). METHODS: This was a descriptive retrospective cohort study of adults with SCI undergoing neurosurgical spine or orthopedic lower limb surgery from 10/1/2012-9/30/2014 at Veterans Affairs (VA) medical centers...
March 26, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29569086/pediatric-cerebellar-pilocytic-astrocytoma-presenting-with-spontaneous-intratumoral-hemorrhage
#14
REVIEW
Carmine Antonio Donofrio, Filippo Gagliardi, Marcella Callea, Camillo Ferrari da Passano, Maria Rosa Terreni, Andrea Cavalli, Alfio Spina, Stefania Acerno, Michele Bailo, Samer K Elbabaa, Pietro Mortini
Pilocytic astrocytomas (PAs) are benign glial tumors and one of the most common childhood posterior fossa tumors. Spontaneous intratumoral hemorrhage in PAs occurs occasionally, in about 8-20% of cases. Cerebellar hemorrhages in pediatric population are rare and mainly due to head injuries, rupture of vascular malformations, infections, or hematological diseases. We have investigated the still controversial and unclear pathophysiology underlying intratumoral hemorrhage in PAs. Bleeding in low-grade tumors might be related to structural abnormalities and specific angio-architecture of tumor vessels, such as degenerative mural hyalinization, "glomeruloid" endothelial proliferation, presence of encased micro-aneurysms, and glioma-induced neoangiogenesis...
March 22, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29568514/prevalence-and-antibiotic-resistance-of-bacteria-isolated-from-the-cerebrospinal-fluid-of-neurosurgical-patients-at-peking-union-medical-college-hospital
#15
Jian-Bo Chang, Hao Wu, He Wang, Bai-Tao Ma, Ren-Zhi Wang, Jun-Ji Wei
Background: Postoperative central nervous system infections (PCNSIs) represent a serious complication, and the timely use of antibiotics guided by the identification of the causative pathogens and their antibiotic sensitivities is essential for treatment. However, there are little data regarding the prevalence of PCNSI pathogens in China. The aim of this study is to investigate the features of pathogens in patients with PCNSIs, which could help clinicians to choose the appropriate empirical antibiotic therapy...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29563488/pyogenic-ventriculitis-and-meningitis-caused-by-streptococcus-acidominimus-in-humans-a-case-report
#16
Gaurang S Shah
BACKGROUND Streptococcus acidominimus, which belongs to the viridans streptococci group, is rarely considered pathogenic in humans. However, over the past 10 years, this bacterium has been reported to cause serious infections in humans, particularly among the critically ill. This article is the first case report of pyogenic ventriculitis (PV) and meningitis caused by S. acidominimus in North America. CASE REPORT A 49-year-old Asian male presented to the emergency department with complaints of a headache, fever greater than 37...
March 22, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29559366/evaluation-of-a-micro-nanofluidic-chip-platform-for-the-high-throughput-detection-of-bacteria-and-their-antibiotic-resistance-genes-in-post-neurosurgical-meningitis
#17
Guojun Zhang, Guanghui Zheng, Yan Zhang, Ruimin Ma, Xixiong Kang
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains...
March 17, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29554074/cranioplasty-an-institutional-experience
#18
Aderaldo Costa Alves Junior, Pedro Tadao Hamamoto Filho, Marcelo Pacheco Gonçalves, Aristides Augusto Palhares Neto, Marco Antonio Zanini
Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84...
March 16, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29550593/spine-trauma-as-a-component-of-essential-neurosurgery-an-outcomes-analysis-from-cambodia
#19
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29547164/aggressive-management-of-vasospasm-with-direct-intra-arterial-nimodipine-therapy
#20
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
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