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Neurosurgical infections

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https://www.readbyqxmd.com/read/29038894/the-supraorbital-eyebrow-approach-for-removal-of-craniopharyngioma-in-children-a-case-series
#1
Ricardo Santos de Oliveira, Dinark Conceição Viana, Lucas Pires Augusto, Marcelo Volpon Santos, Hélio Rubens Machado
OBJECTIVE: Craniopharyngiomas can be a surgical challenge for the pediatric neurosurgeon. Ideally, total removal must be achieved. However, the need to reduce surgical morbidity and preserve quality of life has led to a number of neurosurgical approaches in order to attain this goal. The aim of this article is to present an alternative surgical approach to these lesions and to provide the rationale for this technique. MATERIAL AND METHODS: Medical charts and operative records of eight pediatric patients harboring craniopharyngiomas who underwent surgical treatment using a supraorbital eyebrow approach (SOA) were reviewed from 2014 to 2016...
October 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29031542/complications-and-30-day-readmission-rates-after-craniotomy-craniectomy-a-single-institutional-study-of-243-consecutive-patients
#2
Aladine A Elsamadicy, Amanda Sergesketter, Owoicho Adogwa, Michael Ongele, Oren N Gottfried
Early hospital readmission has become a proxy for quality of care and contributes significantly to high health care costs in the United States, with more than $20 billion health care dollars are spent on 30-day readmission annually. Cranial neurosurgical procedures (i.e., craniotomy, craniectomy) are associated with high readmission rates; however, studies examining readmission after cranial procedures are limited and relatively unknown. The aim of this study is to identify the drivers of 30-day unplanned readmission in consecutive patients undergoing craniotomies and craniectomies...
October 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29030268/topical-vancomycin-to-reduce-surgical-site-infections-in-neurosurgery-study-protocol-for-a-multi-center-randomized-controlled-trial
#3
Alexander J Jonokuchi, Jared Knopman, Ryan E Radwanski, Moises A Martinez, Blake Eaton Samuel Taylor, Michael Rothbaum, Sean Sullivan, Trae R Robison, Brandon R Christophe, Dimitri Sigounas, Brett Youngerman, Emilia Bagiella, Peter D Angevine, Franklin D Lowy, E Sander Connolly
Surgical-site infections (SSIs) account for 20% of all healthcare-associated infections, are the most common nosocomial infection among surgical patients, and are a focus of quality improvement initiatives. Despite implementation of many quality care measures (e.g. prophylactic antibiotics), SSIs remain a significant cause of morbidity, mortality, and economic burden, particularly in the field of neurosurgery. Topical vancomycin is increasingly utilized in instrumented spinal and cardiothoracic procedures, where it has been shown to reduce the risk of SSIs...
October 10, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29027867/unplanned-readmission-within-90-days-after-pediatric-neurosurgery
#4
Silky Chotai, Bradley S Guidry, Emily W Chan, Katherine D Sborov, Stephen Gannon, Chevis Shannon, Christopher M Bonfield, John C Wellons, Robert P Naftel
OBJECTIVE Readmission and return to operating room after surgery are increasingly being used as a proxy for quality of care. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in health care costs. The authors set out to analyze the incidence of readmission at their center, to define causes of unplanned readmission, and to determine the preoperative and surgical variables associated with readmissions following pediatric neurosurgery. METHODS A total of 536 children who underwent operations for neurosurgical diagnoses between 2012 and 2015 and who were later readmitted were included in the final analysis...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29027589/diagnosis-and-treatment-of-severe-neurosurgical-patients-with-pyogenic-ventriculitis-caused-by-gram-negative-bacteria
#5
Feng Shang, Yueqiao Xu, Ning Wang, Weitao Cheng, Wenjin Chen, Wanru Duan
The aim of the study is to explore the experiences in diagnosis and treatment of severe neurosurgical patients with pyogenic ventriculitis caused by gram-negative bacteria (G(-)). Nineteen patients with pyogenic ventriculitis were reviewed for their treatment. The bacterial testing results of cerebrospinal fluid (CSF), the clinical intervention, and the patients' prognosis were evaluated. The bacterial smears of ventricular drainage from all the cases were G(-) bacteria. Head CT and MRI scans confirmed that they were intraventricular empyema...
October 13, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28991759/the-importance-of-perioperative-prophylaxis-with-cefuroxime-or-ceftriaxone-in-the-surgical-site-infections-prevention-after-cranial-and-spinal-neurosurgical-procedures
#6
Aleksandra Dimovska-Gavrilovska, Aleksandar Chaparoski, Andreja Gavrilovski, Zvonko Milenkovikj
Introduction Surgical site infections pose a significant problem in the treatment of neurosurgical procedures, regardless of the application of perioperative prophylaxis with systemic antibiotics. The infection rate in these procedures ranges from less than 1% to above 15%. Different antibiotics and administration regimes have been used in the perioperative prophylaxis so far, and there are numerous comparative studies regarding their efficiency, however, it is generally indicated that the choice thereof should be based on information and local specifics connected to the most probable bacterial causers, which would possibly contaminate the surgical site and cause infection, and moreover, the mandatory compliance with the principles of providing adequate concentration of the drug at the time of the anticipated contamination...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28989043/cerebrospinal-fluid-leak-at-percutaneous-exit-of-ventricular-catheter-as-crucial-risk-factor-for-external-ventricular-drainage-related-infection-in-adult-neurosurgical-patients
#7
Jaechan Park, Yeon-Ju Choi, Boram Ohk, Hyun-Ha Chang
OBJECTIVE: The placement of a ventricular catheter for temporary cerebrospinal fluid (CSF) diversion is associated with a considerable risk of CSF infection. The authors investigated the effect of a CSF leak on CSF-related infection and the predisposing factors for a CSF leak. METHODS: Fifty-two patients who underwent external ventricular drainage (EVD) for acute hydrocephalus associated with a subarachnoid hemorrhage (SAH) or intraventricular hemorrhage (IVH) were enrolled in this prospective study...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28967307/introduction-surgical-management-of-skull-base-meningiomas
#8
Gabriel Zada, Mustafa K Başkaya, Mitesh V Shah
Meningiomas represent the most common primary intracranial neoplasm treated by neurosurgeons. Although multimodal treatment of meningiomas includes surgery, radiation-based treatments, and occasionally medical therapy, surgery remains the mainstay of treatment for most symptomatic meningiomas. Because of the intricate relationship of the dura mater and arachnoid mater with the central nervous system and cranial nerves, meningiomas can arise anywhere along the skull base or convexities, and occasionally even within the ventricular system, thereby mandating a catalog of surgical approaches that neurosurgeons may employ to individualize treatment for patients...
October 2017: Neurosurgical Focus
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/28927205/rare-neurosurgical-complications-of-epidural-injections-an-8-yr-single-institution-experience
#10
Gabriel A Smith, Jonathan Pace, Madeleine Strohl, Anand Kaul, Salim Hayek, Jonathan P Miller
BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#11
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28892887/active-surveillance-of-health-care-associated-infections-in-neurosurgical-patients
#12
Reshu Agarwal, Sarita Mohapatra, Girija Prasad Rath, Arti Kapil
INTRODUCTION: Health Care Associated Infections (HCAI) are frequent complications in neurosurgery. There is limited data available on the incidence and burden of HCAI in neurosurgical patients of Southeast Asian region. AIM: To identify various HCAIs, associated aetiological agents and their antimicrobial susceptibility pattern among the patients admitted in the neurosurgery unit. MATERIALS AND METHODS: An observational prospective study was carried out for three months duration on all neurosurgical patients admitted to a tertiary-care center...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28874930/prevalence-of-intracranial-hemorrhage-after-blunt-head-trauma-in-patients-on-pre-injury-dabigatran
#13
James A Chenoweth, M Austin Johnson, Laura Shook, Mark E Sutter, Daniel K Nishijima, James F Holmes
INTRODUCTION: Dabigatran etexilate was the first direct-acting oral anticoagulant approved in the United States. The prevalence of intracranial hemorrhage after blunt head trauma in patients on dabigatran is currently unknown, complicating adequate ability to accurately compare the risks and benefits of dabigatran to alternative anticoagulants. We aimed to determine the prevalence of intracranial hemorrhage for patients on dabigatran presenting to a Level I trauma center. METHODS: This is a retrospective observational study of adult patients on dabigatran who presented to a Level I trauma center and received cranial computed tomography (CT) following blunt head trauma...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28868201/never-say-never-again-a-bone-graft-infection-due-to-a-hornet-sting-thirty-nine-years-after-cranioplasty
#14
Rosario Maugeri, Roberto G Giammalva, Francesca Graziano, Luigi Basile, Carlo Gulì, Antonella Giugno, Domenico G Iacopino
BACKGROUND: Cranioplasty (CP) is a widespread surgical procedure aimed to restore skull integrity and physiological cerebral hemodynamics, to improve neurological functions and to protect the underlying brain after a life-saving decompressive craniectomy (DC). Nevertheless, CP is still burdened by surgical complications, among which early or late graft infections are the most common outcome-threatening ones. CASE DESCRIPTION: We report the case of 48-year-old man admitted to our neurosurgical unit because of a painful right frontal swelling and 1-week purulent discharge from a cutaneous fistula...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28838799/the-potential-contribution-of-16s-ribosomal-rna-polymerase-chain-reaction-to-antimicrobial-stewardship-in-culture-negative-infection
#15
S O'Donnell, L Gaughan, M Skally, Z Baker, K O'Connell, E Smyth, F Fitzpatrick, H Humphreys
Empiric broad-spectrum antimicrobial therapy frequently results in culture-negative specimens making rationalization of therapy difficult. We retrospectively reviewed 16S rRNA polymerase chain reaction (PCR) results from 78 specimens in 60 patients. 16S rRNA was detected in 28 (47%) patients with de-escalation of therapy in five (21%). Microbial DNA was not detected in 32 (53%) patients with antimicrobials discontinued in two (8%). Neurosurgical patients had a higher proportion of positive results (53% vs 34%) and treatment rationalizations (17% vs 12%)...
August 21, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28838110/subpectoral-implantation-of-internal-pulse-generators-for-deep-brain-stimulation-technical-note-for-improved-cosmetic-outcomes
#16
Gabrielle A White-Dzuro, Wendell Lake, Joseph S Neimat
BACKGROUND: Deep brain stimulation is increasingly used to treat a variety of disorders. As the prevalence of this technology increases, greater demands are placed on neurosurgical practitioners to improve cosmetic results, maximize patient comfort, and minimize complication rates. We have increasingly employed subpectoral implantation of internal pulse generators (IPGs) to improve patient satisfaction. OBJECTIVE: To determine the complication rates of subpectorally placed IPGs as compared to those placed in a subcutaneous location...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28800928/post-operative-bracing-after-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-a-cost-effectiveness-study
#17
REVIEW
Matthew Piazza, Saurabh Sinha, Prateek Agarwal, Arka Mallela, Nikhil Nayak, James Schuster, Sherman Stein
PURPOSE: While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. METHODS: Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28799855/surgical-management-of-cervical-spine-deformity-in-chondrodysplasia-punctata
#18
Nobuhito Morota, Satoshi Ihara, Hideki Ogiwara, Goichiro Tamura
OBJECTIVE Chondrodysplasia punctata (CDP), a rare skeletal dysplasia, can lead to cervical spine instability and deformity. However, an optimal neurosurgical intervention has yet to be established. Thus, a retrospective study was conducted to assess the efficacy of various surgical interventions for children with CDP. METHODS The authors retrospectively reviewed 9 cases of CDP in which cervical decompression with or without posterior fusion was performed between April 2007 and May 2016. Patient demographics, preoperative clinical conditions, radiographic findings, surgical procedures, and the postoperative course were analyzed in detail...
October 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28775247/spinal-abscess-caused-by-salmonella-bacteremia-in-a-patient-with-primary-myelofibrosis
#19
Shehab Fareed, Abdulqadir J Nashwan, Sulieman Abu Jarir, Ahmed Husain, Dina Sameh Suliman, Friyal Ibrahim, Abbas Moustafa, Muhammad S Akhter, Mohamed A Yassin
BACKGROUND In Primary Myelofibrosis (PMF; a clonal disorder arising from the neoplastic transformation of early hematopoietic stem cells) patients, spinal cord compression (SCC) is a common complication or even a presentation symptom due to extramedullary hematopoiesis (EMH). However, a case of SCC caused by a spinal abscess is unusual. To the best of our knowledge, this is the first case report of this rare condition. CASE REPORT We are reporting the case of a 50-year-old male with primary myelofibrosis and long-standing splenomegaly with back pain as a presenting symptom who was found to have spinal cord compression...
August 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28761529/severity-of-anemia-and-hemostatic-parameters-are-strong-predictors-of-outcome-in-postoperative-neurosurgical-patients
#20
Mrinalini Kotru, Satya Shiv Munjal, Deepti Mutreja, Guresh Kumar, Manmohan Singh, Tullika Seth, Hara Prasad Pati
OBJECTIVE: Post-operative neurosurgical patients are commonly associated with haemostatic derangements; many a times leading to development of overt disseminated intravascular coagulation (DIC) and eventually death in some of them. The present study has analysed the factors that would predict the outcome in post operative neurosurgical patients with deranged haemostatic parameters. METHODS: This is a prospective, descriptive study over a period of 15 months on 115 post operative neurosurgical patients who were clinically suspected to have DIC and investigated for the haemostatic parameters...
July 2017: Asian Journal of Neurosurgery
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