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Post CT craniotomy

Jonathan P Riley, Andrew B Boucher, Denise S Kim, Daniel L Barrow, Matthew R Reynolds
BACKGROUND: Transorbital intracranial penetrating trauma (TIPT) with a retained intracranial foreign body is a rare event lacking a widely-accepted diagnostic and therapeutic algorithm. Intraoperative catheter angiography (IOA) has been advocated by some authorities to rule out cerebrovascular injury prior and/or subsequent to removal of the object, but no standard of care currently exists. CASE DESCRIPTION: A 19-year-old male was involved in a construction site accident whereby a framing nail penetrated the left globe, traversed the lateral bony orbit, and terminated in the mid-temporal lobe...
September 28, 2016: World Neurosurgery
Dattaraj Paramanand Sawarkar, Satish Varma, Pankaj Kumar Singh, Ramesh Doddamani, Amandeep Jagdevan, Bhawani Shanker Sharma
INTRODUCTION: Cerebral venous sinus thrombosis (CVST) is a rare condition with the potential to cause severe morbidity and mortality. CVST can also occur after vestibular schwannoma (VS) surgery with the thrombosis of transverse and sigmoid sinus. However, there is not a single report of superior sagittal sinus (SSS) thrombosis after VS surgery reported in the literature. CASE REPORT: A 45-year-old lady presented to our centre with large left sided solid cystic VS...
September 26, 2016: World Neurosurgery
Alessandro Caporlingua, Federico Caporlingua, Jacopo Lenzi
Nonmissile orbitocranial penetrating brain injuries are uncommonly dealt with in a civilian context. Surgical management is controversial, due to the lack of widely accepted guidelines. A 52-year-old man was hit in his left eye by a metallic foreign body (FB). Head computed tomography (CT) scan showed a left subcortical parietal FB with a considerable hemorrhagic trail originating from the left orbital roof. Surgical treatment was staged; an exenteratio oculi and a left parietal craniotomy to extract the FB under intraoperative CT guidance were performed at post trauma day third and sixth, respectively...
July 2016: Asian Journal of Neurosurgery
Liang Wen, Xiao-Feng Yang, Hao Jiang, Hao Wang, Ren-Ya Zhan
BACKGROUND: Postoperative intracranial hematoma (POIH) is a frequent sequela secondary to cranial surgery. The role of routine early postoperative computed tomography (CT) scanning in the detection of POIH remains controversial. The study was aimed at analyzing the effect of routine early CT scanning after craniotomy for the early detection of POIH. METHODS: Routine early postoperative CT scanning was performed at our institute, and a retrospective study was conducted to analyze the data...
August 2016: Acta Neurochirurgica
Vinothan Sivasubramaniam, Varinder Singh Alg, Joseph Frantzias, Shami Yesha Acharya, Marios Costa Papadopoulos, Andrew James Martin
BACKGROUND: Patients often report sounds in the head after craniotomy. We aim to characterize the prevalence and nature of these sounds, and identify any patient, pathology, or technical factors related to them. These data may be used to inform patients of this sometimes unpleasant, but harmless effect of cranial surgery. METHODS: Prospective observational study of patients undergoing cranial surgery with dural opening. Eligible patients completed a questionnaire preoperatively and daily after surgery until discharge...
August 2016: Acta Neurochirurgica
C Guevara, A Wallender, B Steinberg, N J Ranalli
Primary delayed onset craniosynostosis is a rarely reported phenomenon. The unique case of a 2-year-old boy who had computed tomography (CT) scans performed 20 months apart demonstrating the post-gestational development of sagittal suture craniosynostosis is presented. The otherwise healthy male initially presented to the emergency department at age 7 months with soft tissue swelling over his left parietal region secondary to a fall. A CT scan revealed a possible left parietal skull fracture without intracranial pathology and patent cranial sutures with a normocephalic calvarial configuration...
June 4, 2016: International Journal of Oral and Maxillofacial Surgery
Davide Marco Croci, Diepers Michael, Timo Kahles, Ali-Reza Fathi, Javier Fandino, Serge Marbacher
BACKGROUND: Isolated cortical vein thrombosis (ICVT) being a rare condition (6% of intracranial vein thromboses), no clinical guidelines and few radiologic clues to it have been established. ICVT mostly appears in conjunction with sinus vein thromboses. ICVTs primarily occur during pregnancy and puerperium (35%). The great variability of cortical veins and difficulty identifying small occluded vessels complicate ICVT diagnosis. We present the first case of isolated ipsilateral dural thickening and enhancement as a potential radiologic sign of ICVT shown on magnetic resonance imaging...
June 2016: World Neurosurgery
Juanita Garces, Mansour Mathkour, Edison Valle-Giler, Tyler Scullen, J Franklin Berry, Roger D Smith
BACKGROUND: Primary intracranial leiomyoma is an extremely rare occurrence of a low-grade mesenchymal tumor characterized by a proliferation of smooth muscle cells. When present, these lesions predominantly occur in immunocompromised patients in the setting of infection or transplant and have not been known to involve the ventricular system of the brain. In this report, we describe a case of primary leiomyoma of the lateral ventricle in an immunocompetent patient. CASE DESCRIPTION: A 30-year-old man with no medical history presented with progressive diplopia and occipital headaches...
June 2016: World Neurosurgery
Jiadi Dong, Meiping Lu, Han Zhou, Weiqiang Zhang, Yingying Li, Weida Dong
OBJECTIVE: To summarize and analyze the clinical features, diagnosis, surgical approaches and treatment outcomes of patients with primary nasal sinus osteoma. METHODS: A retrospective review of 48 cases with primary nasal sinus osteoma treated from January 2007 to December 2013 was performed. All patients underwent preoperative CT scan and postoperative histopathologic examination. The surgical approaches included lateral rhinotomy in 14 cases, nasal endoscopic resection in 12 cases, coronal surgical incision craniotomy in 13 cases, combined craniofacial approach in 4 cases, and Caldwell-Luc approach in 5 cases...
January 2015: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
P A Beuriat, E Javouhey, A Szathmari, S Courtil-Tesseydre, F P Desgranges, B Grassiot, O Hequet, C Mottolese
Decompressive craniotomy (DC) in children is a life-saving procedure for the treatment of refractory intracranial hypertension related to traumatic, ischemic and infectious lesions. Different surgical procedures have been proposed including uni or bilateral hemicraniectomy, bi-frontal, bi-temporal, or bi-parietal craniotomies. DC can avoid the cascade of events related to tissue hypoxia, brain perfusion reduction, hypotension and the evolution of brain edema that can be responsible for brain herniation. The monitoring of intracranial pressure (ICP) is very important to take a decision as well as the value of Trans cranial Doppler (TCD)...
December 2015: Journal of Neurosurgical Sciences
Justin B Josephsen, Joanna Kemp, Samer K Elbabaa, Mohamad Al-Hosni
BACKGROUND: Neonatal in-hospital falls occur relatively frequently, although they are likely underreported. Significant intracranial head trauma from a fall or birth injury is not common in the immediate newborn period. Furthermore, intracranial bleeding requiring surgical intervention is exceedingly rare. We present an unusual case of an in-hospital fall in the delivery room requiring neurosurgical intervention. CASE REPORT: A term infant, appropriate for gestational age, delivered precipitously from a maternal standing position...
2015: American Journal of Case Reports
Amir R Dehdashti
Ruptured aneurysms with intraparenchymal hematoma and mass effect are primarily treated by surgical clipping. In this video presentation, a 68 year old male with a large ruptured right ICA bifurcation aneurysm is presented. Patient's neurological exam was rapidly deteriorating, therefore the patient was transferred to the operating theater after initial evaluation by CT and CT angiogram. A pterional craniotomy was performed, the frontal hematoma was partially removed and the aneurysm was clipped. Residual hematoma was removed after securing the aneurysm and the aneurysm dome was punctured(detail of surgical clipping in the video)...
January 2015: Neurosurgical Focus
C Michael Dunham, David A Hoffman, Gregory S Huang, Laurel A Omert, David J Gemmel, Renee Merrell
BACKGROUND: The impact of antithrombotic agents (warfarin, clopidogrel, ASA) on traumatic brain injury outcomes is highly controversial. Although cerebral atrophy is speculated as a risk for acute intracranial hemorrhage, there is no objective literature evidence. MATERIALS AND METHODS: This is a retrospective, consecutive investigation of patients with signs of external head trauma and age ≥60 years. Outcomes were correlated with antithrombotic-agent status, coagulation test results, admission neurologic function, and CT-based cerebral atrophy dimensions...
2014: PloS One
Philipp Metzler, Harib H Ezaldein, John A Persing, Derek M Steinbacher
BACKGROUND: Trigonocephalic treatment entails frontoorbital reshaping of the forehead, increasing bitemporal dimensions, and advancing lateral orbits. Various techniques can achieve this, but no consensus exists regarding effects on long-term skull growth. Overcorrecting forehead dimensions is one strategy though preserving a vascularized fronto-orbital bar can influence future growth. We therefore seek to craniomorphologically compare fronto-orbital advancement (FOA), using bandeau widening and advancement, to a pedicled "tilt" procedure to assess whether adequate 3D remodeling is achieved...
October 2014: Journal of Cranio-maxillo-facial Surgery
Rachel A Pastorek, Michael W Cripps, Ira H Bernstein, William W Scott, Christopher J Madden, Kim L Rickert, Steven E Wolf, Herb A Phelan
As a basis for venous thromboembolism (VTE) prophylaxis after traumatic brain injury (TBI), we have previously published an algorithm known as the Parkland Protocol. Patients are classified by risk for spontaneous progression of hemorrhage with chemoprophylaxis regimens tailored to each tier. We sought to validate this schema. In our algorithm, patients with any of the following are classified "low risk" for spontaneous progression: subdural hemorrhage ≤8 mm thick; epidural hemorrhage ≤8 mm thick; contusions ≤20 mm in diameter; a single contusion per lobe; any amount of subarachnoid hemorrhage; or any amount of intraventricular hemorrhage...
October 15, 2014: Journal of Neurotrauma
Nishanta B Baidya, Moncef Berhouma, Mario Ammirati
OBJECTIVE: To demonstrate a flexible endoscope assisted technique to perform microsurgical resection using a retrosigmoid approach of an artificial polymer tumor model that mimics a medium size (15-20mm diameter) vestibular schwannoma. METHODS: Twelve bilateral retrosigmoid dissections were performed in 6 glutaraldehyde embalmed, colored silicone injected, adult cadaveric heads. Using a standard retrosigmoid approach, we first implanted the tumor model at the cerebellopontine angle (CPA) and then we resected the tumor under simultaneous endoscopic and microscopic visualizations...
April 2014: Clinical Neurology and Neurosurgery
Jun Kyeung Ko, Seung Heon Cha, Byung Kwan Choi, Jae Il Lee, Eun Young Yun, Chang Hwa Choi
Cerebrospinal fluid (CSF) diversion is an essential component of neurosurgical care, but the rates and significance of hemorrhage associated with external ventricular drainage (EVD) and ventriculoperitoneal (VP) shunt procedures have not been well quantified. In this retrospective study, the authors examined the frequencies of hemorrhagic complications associated with EVD and VP shunt procedures, and attempted to identify associated risk factors. The treatment records of 370 EVDs in 276 patients and 102 VP shunts in 96 patients performed between 2008 and 2010 were retrospectively reviewed...
2014: Neurologia Medico-chirurgica
John A Onofrey, Lawrence H Staib, Xenophon Papademetris
We present a new strategy to constrain nonrigid registrations of multi-modal images using a low-dimensional statistical deformation model and test this in registering pre-operative and post-operative images from epilepsy patients. For those patients who may undergo surgical resection for treatment, the current gold-standard to identify regions of seizure involves craniotomy and implantation of intracranial electrodes. To guide surgical resection, surgeons utilize pre-op anatomical and functional MR images in conjunction with post-electrode implantation MR and CT images...
2013: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
Surya Kumar Dube, Girija Prasad Rath, Sachidanand Jee Bharti, Ashish Bindra, Pooniah Vanamoorthy, Nidhi Gupta, Charu Mahajan, Parmod Kumar Bithal
BACKGROUND: Re-intubation of neurosurgical patients after a successful tracheal extubation in the operating room is not uncommon. However, no prospective study has ever addressed this concern. This study was aimed at analyzing various risk factors of re-intubation and its effect on patient outcome. METHODS: Patients aged between 18-60 yrs and of ASA physical status I and II undergoing elective craniotomies over a period of two yrs were included. A standard anesthetic technique using propofol, fentanyl, rocuronium, and isoflurane/sevoflurane was followed, in all these patients...
October 2013: Saudi Journal of Anaesthesia
Susanna Annibali, Diana Bellavia, Livia Ottolenghi, Andrea Cicconetti, Maria Paola Cristalli, Roberta Quaranta, Andrea Pilloni
Bone regeneration strategies in dentistry utilize biodegradable scaffolds seeded with stem cells able to induce bone formation. However, data on regeneration capacity of these tissue engineering constructs are still deficient. In this study micro-Computed tomography (micro-CT) and positron emission tomography (PET) analyses were used to investigate bone regeneration induced by two scaffolds [Granular deproteinized bovine bone (GDPB) and Beta-tricalcium phosphate (β-TCP)] used alone or in combination with dental pulp stem cells (DPSC) in a tissue engineered construct implanted in a rat critical calvarial defect...
May 2014: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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