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https://www.readbyqxmd.com/read/29031542/complications-and-30-day-readmission-rates-after-craniotomy-craniectomy-a-single-institutional-study-of-243-consecutive-patients
#1
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/29031035/-controversy-in-the-postoperative-treatment-of-low-grade-gliomas
#2
T Kazda, R Lakomý, A Poprach, P Pospíšil, R Jančálek, P Šlampa
BACKGROUND: The optimal treatment for low-grade gliomas remains controversial. Neurosurgery, radiotherapy, and chemotherapy are the main treatment options. Despite advances in oncology, there are still a lot of uncertainties, and the optimal sequences, combinations, and timings of these procedures have not yet been optimized. It is still unclear whether temozolomide can replace effective, but toxic PCV chemotherapy (procarbazine, lomustine, vincristine) and whether temozolomide can be used upfront alone instead of radiotherapy alone...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/29029314/small-aneurysms-account-for-the-majority-and-increasing-percentage-of-aneurysmal-subarachnoid-hemorrhage-a-25-year-single-institution-study
#3
Matthew T Bender, Haley Wendt, Thomas Monarch, Narlin Beaty, Li-Mei Lin, Judy Huang, Alexander Coon, Rafael J Tamargo, Geoffrey P Colby
BACKGROUND: Prospective studies of unruptured aneurysms have shown very low rates of rupture for small aneurysms (<10 mm) and suggested that the risk of treatment outweighs benefit. However, common clinical practice shows that patients with aneurysmal subarachnoid hemorrhage (aSAH) frequently have small aneurysms. OBJECTIVE: To investigate trends in size and location of ruptured aneurysms over a 25-yr period. METHODS: A prospective, Institutional Review Board-approved database of all patients presenting to our institution with aSAH from 1991 to 2016 was analyzed...
October 6, 2017: Neurosurgery
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/29026662/intrathecal-and-intraventricular-antibiotics-for-postoperative-gram-negative-meningitis-and-ventriculitis
#5
Saad Akhtar Khan, Muhammad Waqas, Usman T Siddiqui, Muhammad Shahzad Shamim, Karim Rizwan Nathani, Rashid Jooma, Faisal Mehmood
BACKGROUND: Postoperative meningitis is a growing cause of concern, especially with the evolution of multidrug-resistant organism. The authors evaluate the use of intraventricular/intrathecal (IVT/IT) antibiotics for postoperative gram-negative meningitis in patients whom intravenous antibiotics were ineffective. METHODS: Medical records were retrospectively reviewed and neurosurgery patients with gram-negative postoperative infection meningitis/ventriculitis were enrolled in the study...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29022129/the-utility-of-local-anesthesia-for-neurosurgical-interventions-in-a-low-resource-setting-a-case-series
#6
Jessica Eaton, Asma Bilal Hanif, Suzgisam Mzumara, Anthony Charles
INTRODUCTION: Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked. METHOD: This is a retrospective case review of patients with operable lesions, such as extra-axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia...
October 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29018554/psychiatric-neurosurgery-in-the-21st-century-overview-and-the-growth-of-deep-brain-stimulation
#7
REVIEW
Kenneth Barrett
Ambulatory deep brain stimulation (DBS) became possible in the late 1980s and was initially used to treat people with movement disorders. Trials of DBS in people with treatment-resistant psychiatric disorder began in the late 1990s, initially focusing on obsessive-compulsive disorder, major depressive disorder and Tourette syndrome. Despite methodological issues, including small participant numbers and lack of consensus over brain targets, DBS is now being trialled in a wide range of psychiatric conditions...
October 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28991499/outcome-of-traumatic-brain-injury-in-patients-on-antiplatelet-agents-a-retrospective-20-year-observational-study-in-a-single-neurosurgery-unit
#8
Kyoko Sumiyoshi, Takanori Hayakawa, Hiroshi Yatsushige, Keigo Shigeta, Toshiya Momose, Masaya Enomoto, Shin Sato, Yoshio Takasato
OBJECTIVE: To evaluate the outcomes after Traumatic Brain Injury (TBI) in patients taking Antiplatelet Agents (APAs). METHODS: We reviewed the clinical records of 934 patients with TBI between 1995 and 2014. Multivariate analysis was performed to correlate patient outcome with various factors, including pre-injury APA intake. Cause of death was compared among groups stratified according to APA dose. RESULTS: Increasing doses of APAs were positively associated with mortality rates, however, differences were primarily due to non-traumatic causes...
October 9, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28988668/-neurophysiological-monitoring-options-in-brain-tumour-resections-consensus-statement-from-the-spanish-society-of-neurosurgery-s-senec-neuro-oncology-working-group-and-the-spanish-society-of-clinical-neurophysiology-senfc
#9
Cristian de Quintana-Schmidt, Estela Lladó-Carbo, Victoria Eugenia Cortés-Doñate
Brain tumours located in or in proximity to eloquent areas are a significant neurosurgical challenge. Performing this kind of surgery with neurophysiological monitoring to improve resections with reduced permanent focal neurological deficit has become widely accepted in the literature. However, how to conduct this monitoring, the exact definition of an eloquent area and whether to perform this surgery with the patient awake or asleep are still subject to rigorous scientific debate. Members of the Neuro-oncology Working Group (GTNO) of the Spanish Society of Neurosurgery (SENEC) and members of the Spanish Society of Clinical Neurophysiology (SENFC) have published a consensus statement to explain the different neurophysiological monitoring options currently available in awake and asleep patients to obtain better surgical resection without neurological deficits...
October 5, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28987857/intracranial-hemorrhage-in-patients-with-durable-mechanical-circulatory-support-devices-institutional-review-and-proposed-treatment-algorithm
#10
Wyatt L Ramey, Robyn L Basken, Christina M Walter, Zain Khalpey, G Michael Lemole, Travis M Dumont
OBJECTIVE: Spontaneous intracranial hemorrhage (ICH) is frequently managed in neurosurgery. Patients with durable mechanical circulatory support devices, including total artificial hearts (TAHs) and left ventricular assist devices (LVADs) are often encountered in the setting of ICH. While durable mechanical circulatory support devices have improved survival and quality of life for patients with advanced heart failure, ICH is one of the most feared complications following LVAD and TAH implantation...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28986230/machine-learning-and-neurosurgical-outcome-prediction-a-systematic-review
#11
REVIEW
Joeky T Senders, Patrick C Staples, Aditya V Karhade, Mark M Zaki, William B Gormley, Marike L D Broekman, Timothy R Smith, Omar Arnaout
OBJECTIVE: Accurate measurement of surgical outcomes is highly desirable to optimize surgical decision-making. An important element of surgical decision making is identification of the patient cohort that will benefit from surgery prior to the intervention. Machine learning (ML) enables computers to learn from previous data to make accurate predictions on new data. In this systematic review, we evaluate the potential of ML for neurosurgical outcome prediction. METHODS: A systematic search in the Pubmed and Embase databases was performed to identify all potential relevant studies up to January 1, 2017...
October 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28978177/binostril-endoscopic-transsphenoidal-neurosurgery-for-pituitary-adenomas-experience-with-42-patients
#12
Guan Sun, Ying Cao, Nan Jiang, Dekang Nie, Zhengqiang Wan, Min Li, Chiyuan Ma, Jun Guo
Here we review the technical aspects of our experience with the neuroendoscopic bilateral nostril (binostril) transsphenoidal approach for pituitary adenomas. A total of 42 patients were treated in our hospital from September 2013 to December 2015. Total tumor resection was completed in 31 cases, nearly full resection was achieved in 9 cases, and partial resection was achieved in 2 cases. In most cases clinical symptoms were relieved after surgery. These included 18/22 cases with visual field and vision disorders; 19/25 cases with headaches; 11/15 cases where high baseline PRL returned to normal levels; 6/7 cases where elevated blood GH returned to normal levels; and 2/3 cases where elevated blood ACTH returned to normal levels after surgery...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28973637/complications-of-head-immobilization-devices-in-children-contact-mechanics-and-analysis-of-a-single-institutional-experience
#13
Mohamed A Zaazoue, Mostafa Bedewy, Liliana C Goumnerova
BACKGROUND: Head immobilization devices (HIDs) are a staple of neurosurgical procedures, including in the intraoperative magnetic resonance imaging (iMRI) operating rooms (ORs) where material modifications were necessary for compatibility with the magnets utilized. OBJECTIVE: To present the experience in this OR environment and discuss the multifactorial nature of the observed adverse events. METHODS: A retrospective chart review was performed, utilizing the Department of Neurosurgery and iMRI OR databases to identify patients who suffered complications related to HIDs between November 2007 and March 2016...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971161/controversies-in-the-differential-diagnosis-of-brown-sequard-syndrome-due-to-cervical-spinal-disease-from-stroke-a-case-series
#14
REVIEW
Vaner Koksal, Ozcan Yavasi
Stroke is generally considered to be the first preliminary diagnosis in patients presenting with acute hemiparesia in the emergency department. But rarely in unexpected spontaneous neurological pathologies that may lead to hemiparesis. The data from 8 non-traumatic patients who underwent surgical treatment for brown-sequard syndrome (BSS) were reviewed retrospectively. All patients were initially misdiagnosed with strokes. Two of the patients had spinal canal stenosis, two had spinal epidural hematomas, one had an ossified herniated disc and three had soft herniated discs...
September 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28964546/three-dimensional-printing-role-in-neurologic-disease
#15
REVIEW
Adrien-Maxence Hespel
Three-dimensional printing has evolved dramatically in recent years and is now available for clinical use. Technical operations of 2 of the most common rapid prototyping processes (stereolithography and fused deposition modeling) and the steps involved in the creation of a prototype are discussed. Current applications in human neurosurgery including presurgical planning and educational opportunities are reviewed before focusing on the current applications in veterinary neurology.
September 27, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28960543/pedunculopontine-nucleus-deep-brain-stimulation-in-parkinson-s-disease-a-clinical-review
#16
REVIEW
Wesley Thevathasan, Bettina Debu, Tipu Aziz, Bastiaan R Bloem, Christian Blahak, Christopher Butson, Virginie Czernecki, Thomas Foltynie, Valerie Fraix, David Grabli, Carole Joint, Andres M Lozano, Michael S Okun, Jill Ostrem, Nicola Pavese, Christoph Schrader, Chun-Hwei Tai, Joachim K Krauss, Elena Moro
Pedunculopontine nucleus region deep brain stimulation (DBS) is a promising but experimental therapy for axial motor deficits in Parkinson's disease (PD), particularly gait freezing and falls. Here, we summarise the clinical application and outcomes reported during the past 10 years. The published dataset is limited, comprising fewer than 100 cases. Furthermore, there is great variability in clinical methodology between and within surgical centers. The most common indication has been severe medication refractory gait freezing (often associated with postural instability)...
September 28, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28960172/resting-state-functional-magnetic-resonance-imaging-for-surgical-planning-in-pediatric-patients-a-preliminary-experience
#17
Jarod L Roland, Natalie Griffin, Carl D Hacker, Ananth K Vellimana, S Hassan Akbari, Joshua S Shimony, Matthew D Smyth, Eric C Leuthardt, David D Limbrick
OBJECTIVE Cerebral mapping for surgical planning and operative guidance is a challenging task in neurosurgery. Pediatric patients are often poor candidates for many modern mapping techniques because of inability to cooperate due to their immature age, cognitive deficits, or other factors. Resting-state functional MRI (rs-fMRI) is uniquely suited to benefit pediatric patients because it is inherently noninvasive and does not require task performance or significant cooperation. Recent advances in the field have made mapping cerebral networks possible on an individual basis for use in clinical decision making...
September 29, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28958650/is-routine-head-ct-indicated-in-awake-stable-older-patients-after-a-ground-level-fall
#18
Rebecca Sartin, Christine Kim, Sharmila Dissanaike
BACKGROUND: Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who present with a normal GCS after a ground level fall, and to identify factors that could predict the need for neurosurgical intervention. METHODS: A retrospective study was conducted on hemodynamically stable patients >55 years of age with GCS of 15, who presented to a level 1 trauma center after a ground level fall...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28950367/national-databases-for-neurosurgical-outcomes-research-options-strengths-and-limitations
#19
Aditya V Karhade, Alexandra M G Larsen, David J Cote, Heloise M Dubois, Timothy R Smith
BACKGROUND: Quality improvement, value-based care delivery, and personalized patient care depend on robust clinical, financial, and demographic data streams of neurosurgical outcomes. The neurosurgical literature lacks a comprehensive review of large national databases. OBJECTIVE: To assess the strengths and limitations of various resources for outcomes research in neurosurgery. METHODS: A review of the literature was conducted to identify surgical outcomes studies using national data sets...
August 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28945910/natural-and-artificial-intelligence-in-neurosurgery-a-systematic-review
#20
Joeky T Senders, Omar Arnaout, Aditya V Karhade, Hormuzdiyar H Dasenbrock, William B Gormley, Marike L Broekman, Timothy R Smith
BACKGROUND: Machine learning (ML) is a domain of artificial intelligence that allows computer algorithms to learn from experience without being explicitly programmed. OBJECTIVE: To summarize neurosurgical applications of ML where it has been compared to clinical expertise, here referred to as "natural intelligence." METHODS: A systematic search was performed in the PubMed and Embase databases as of August 2016 to review all studies comparing the performance of various ML approaches with that of clinical experts in neurosurgical literature...
September 7, 2017: Neurosurgery
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