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Craniotomy

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https://www.readbyqxmd.com/read/28544917/effective-and-safe-mannitol-administration-in-patients-undergoing-supratentorial-tumor-surgery-a-prospective-randomized-and-double-blind-study
#1
Eren Fatma Akcil, Ozlem Korkmaz Dilmen, Esra Sultan Karabulut, Serdar Selcuk Koksal, Fatis Altindas, Yusuf Tunali
OBJECTIVES: Although osmotic diuresis with mannitol is commonly used to provide brain relaxation, there is no consensus regarding its optimal dose and combination with loop diuretics. The aim of the present study is to evaluate the effects of mannitol and combination of furosemide with different doses of mannitol on brain relaxation and on blood electrolytes, lactate level, urine output, fluid balance and blood osmolarity in patients undergoing supratentorial tumor surgery. PATIENTS AND METHODS: This prospective, randomized, double blind, placebo-controlled study included 51 patients (ASA I-III) scheduled for elective supratentorial craniotomy...
May 15, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28542049/hitting-the-nail-on-the-head-a-case-report-demonstrating-the-importance-of-a-multidisciplinary-approach-to-an-unusual-penetrating-intracranial-injury
#2
Allison L Thoeny, Iman A Hadaya, Benn M Lancman, Vincent Lew
A 28-year-old man presented with a penetrating injury by a nail gun to the head. Imaging revealed a nail abutting the superior sagittal sinus without active extravasation. An anesthesia-led multidisciplinary team devised a detailed perioperative plan including conception of a complex decision tree, coordination of care, and resource utilization. In the operating room, the nail was removed under general anesthesia, with blood products and equipment for craniotomy readily available, and imaging modalities reserved for immediate use...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28541579/tailored-extended-bifrontal-craniotomy-for-anterior-skull-base-tumors-anatomic-description-of-a-modified-surgical-technique-and-case-series
#3
Michael M Safaee, Michael W McDermott, Arnau Benet, Philip V Theodosopoulos
BACKGROUND: Open transcranial approaches to the anterior skull base remain an integral component of current skull base practice. Evolution of these and other techniques has resulted in revisions of standard, tried-and-true methods in attempts to improve patient outcomes and cosmesis, while still providing the best combination of surgical exposure and ergonomics. OBJECTIVE: To describe a modified approach for midline tumors of the anterior skull base. METHODS: We describe the anatomy and techniques of a modified extended bifrontal craniotomy for anterior skull base tumors...
May 24, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28541463/reducing-surgical-infections-and-implant-costs-via-a-novel-paradigm-of-enhanced-physician-awareness
#4
Nitin Agarwal, Prateek Agarwal, Ashley Querry, Anna Mazurkiewicz, Brittany Whiteside, Oscar C Marroquin, Stephen F Koscumb, Daniel A Wecht, Robert M Friedlander
BACKGROUND: Studies have demonstrated that physicians are often unaware of prescription drug, laboratory, diagnostic, and surgical supply costs. OBJECTIVE: To investigate the effects of increased physician awareness on infection incidence and surgical device cost containment. METHODS: Within our institution, physicians were informed of individual, independently adjudicated, craniotomy and ventricular shunt infection incidence and rankings among peers, after which a protocol aimed at reducing skin bacterial burden was implemented for craniotomies...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28540130/corpora-amylacea-mimicking-low-grade-glioma-and-manifesting-as-a-seizure-case-report
#5
Seung J Lee, Minsu Kim, Carlito Lagman, Timothy T Bui, William H Yong, Isaac Yang
BACKGROUND: Corpora amylacea (CA) are accumulations of polyglucosan bodies typically found in astrocytic foot processes, and rarely, can mimic neoplasm. CA accumulation has also been associated with seizure disorders. We report the first case of a histologically confirmed intracranial, intraparenchymal CA lesion mimicking a low-grade glioma and manifesting as a seizure. CASE DESCRIPTION: A 43-year-old man presented after a general tonic-clonic (GTC) seizure. Brain magnetic resonance imaging (MRI) revealed a small lesion in the right mesial temporal lobe with radiologic features of a low-grade glioma...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540120/remote-cerebellar-hemorrhage-report-of-two-different-cases
#6
Alireza Tabibkhooei, Morteza Taheri, Arash Fattahi, Feyzollah Ebrahimniya, Mohsen Benam
BACKGROUND: Remote cerebellar hemorrhage (RCH) is a rare complication after supratentorial craniotomies, which usually presents as linear hemorrhages on the surface of the cerebellum; the exact mechanism of it is not established yet. CASE DESCRIPTION: In case one, a 57-year-old patient demonstrated hemorrhage in the cerebellar sulci in favor of RCH 2 days after craniotomy for sphenoidal wing meningioma resection. He was asymptomatic and showed good prognosis after conservative treatment...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28538627/early-heparin-administration-after-tbi-prolonged-cognitive-recovery-associated-with-reduced-cerebral-edema-and-neutrophil-sequestration
#7
Katsuhiro Nagata, Kevin D Browne, Yujin Suto, Kenichiro Kumasaka, John Cognetti, Victoria E Johnson, Joshua Marks, Douglas H Smith, Jose L Pascual
BACKGROUND: Early administration of unfractionated heparin (UFH) after TBI reduces early in vivo circulating leukocytes (LEU) in peri-injury penumbral brain tissue, enhancing cognitive recovery 2 days after injury. It remains unclear how long this effect lasts and if this is related to persistently accumulating LEU in penumbral brain tissue. We hypothesized that UFH reduces LEU brain tissue sequestration resulting in prolonged cognitive recovery. METHODS: CD1 male mice underwent either TBI by controlled cortical impact (CCI) or sham craniotomy...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538574/sparing-a-craniotomy-the-role-of-intraoperative-methylene-blue-in-management-of-midline-dermoid-cysts
#8
Alannah L Phelan, Christine M Jones, Ashley S Ceschini, Cathy R Henry, Donald R Mackay, Thomas D Samson
BACKGROUND: Midline nasal dermoid cysts are rare congenital anomalies that extend intracranially in approximately 10 percent of cases. Cysts with intracranial extension require a craniotomy to avoid long-term complications, including meningitis, abscesses, and cavernous sinus thrombosis. Current guidelines recommend preoperative imaging with either magnetic resonance imaging or computed tomography to determine appropriate management. METHODS: Patients who underwent excision of a midline nasal dermoid cyst between January 1995 and September 2016 were identified using Current Procedural Terminology codes...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28534074/facial-nerve-sparing-surgery-for-large-vestibular-schwannomas
#9
Paolo Ferroli, Lorenzo Bosio, Morgan Broggi
BACKGROUND: Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage. METHODS: The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression...
May 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28532922/awake-craniotomy-anesthesia-a-comparison-between-the-monitored-anesthesia-care-versus-the-asleep-awake-asleep-technique
#10
Chikezie I Eseonu, Karim ReFaey, Oscar Garcia, Amballur John, Alfredo Quinones-Hinojosa, Punita Tripathi
BACKGROUND: The commonly used sedation techniques for an awake craniotomy includes monitored anesthesia care(MAC), using an unprotected airway, or the asleep-awake-asleep(AAA) technique, using a partially or totally protected airway. We present a comparative analysis between the MAC and AAA technique evaluating anesthetic management, perioperative outcomes, and complications in a consecutive series of patients undergoing the removal of an eloquent brain lesion. METHODS: Eighty-one patients underwent an awake craniotomy for an intracranial lesion over a nine-year period by a single-surgeon and a team of anesthesiologists...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#11
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28526645/carotid-falciform-optic-neuropathy-microsurgical-treatment
#12
M Neil Woodall, Cargill H Alleyne
BACKGROUND: Several recent reports have implicated vascular ectasia and vessel contact with dysfunction of the visual apparatus. A subset of patients with pre-chiasmatic visual deterioration have an ectatic internal carotid artery (ICA) that displaces and flattens the optic nerve (ON) rostrally as the ON exits the skull base. We will offer a proposed pathophysiological mechanism and describe a straightforward surgical technique for dealing with this interesting problem. METHODS: Via an ipsilateral pterional craniotomy, the bony roof of the optic canal is removed...
May 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28524796/improvement-of-visual-field-defects-after-focal-resection-for-occipital-lobe-epilepsy-case-report
#13
Takahiro Yamamoto, Tadashi Hamasaki, Hideo Nakamura, Kazumichi Yamada
Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe...
May 19, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28524790/cognard-type-v-intracranial-dural-arteriovenous-fistula-presenting-in-a-pediatric-patient-with-rapid-progressive-myelopathy
#14
Walter J Jermakowicz, Alexander G Weil, Artyom Vlasenko, Sanjiv Bhatia, Toba N Niazi
Cognard Type V dural arteriovenous fistulas (dAVFs) are a unique type of cranial vascular malformation characterized by congestion of the perimedullary venous system that may lead to devastating spinal cord pathology if left untreated. The authors present the first known case of a pediatric patient diagnosed with a Type V dAVF. A 14-year-old girl presented with a 3-week history of slowly progressive unilateral leg weakness that quickly progressed to bilateral leg paralysis, sphincter dysfunction, and complete sensory loss the day of her presentation...
May 19, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28522383/cranium-bifidum-occultum-associated-with-hypertelorism-treated-with-posterior-vault-reconstruction-and-orbital-box-osteotomies-case-report-and-technical-note
#15
Rimal H Dossani, David M Yates, Piyush Kalakoti, Anil Nanda, Christina Notarianni, Jennifer Woerner, Ghali E Ghali
Cranium bifidum occultum is a disorder of skull ossification presenting as an enlarged posterior fontanelle in the upper posterior angle of the parietal bone near the intersection of the sagittal and lambdoid sutures. The standard treatment for cranium bifidum occultum is observation. We present a case of a 5-year-old boy who presented with a 15x4.5 cm midline posterior cranial vault defect consistent with diagnosis of cranium bifidum occultum associated with orbital hypertelorism and a widened nose. The patient underwent posterior vault reconstruction for correction of cranium bifidum occultum defect followed by bifrontal craniotomy and orbital box osteotomies for correction of orbital hypertelorism and nasal deformity...
May 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28521439/arteriovenous-malformation-and-thyroid-metastasis-from-underlying-renal-cell-carcinoma-an-unusual-presentation-of-malignancy-a-case-report
#16
H J Albandar, E S Roberto, J R H See, J H Sabiers
Renal Clear Cell Carcinoma (RCC) comprises over 80% of renal malignancies in adults. Thyroid gland metastasis is rare in RCC. Few studies have described cases of RCC mistaken for benign arteriovenous malformation (AVM). To the best of our knowledge, an AVM arising from underlying RCC metastasis to the brain has not yet been reported. The current study presents a case of RCC metastasis to the thyroid gland, with an AVM identified to be a result of metastatic involvement in the brain. A 45-year-old African-American female presented with left-sided weakness, slurred speech, facial droop and seizure...
May 2017: Oncology Letters
https://www.readbyqxmd.com/read/28521355/minimally-invasive-middle-fossa-keyhole-craniectomy-for-repair-of-superior-semicircular-canal-dehiscence
#17
Trieu Vanessa, Panayiotis E Pelargos, Marko Spasic, Lawrance K Chung, Brittany Voth, Nolan Ung, Quinton Gopen, Isaac Yang
BACKGROUND: Superior semicircular canal dehiscence (SSCD) presents with varying degrees of auditory and vestibular dysfunction. The condition is confirmed on high-resolution computed tomography (CT) imaging, and symptoms are often improved by surgical repair. Although a classic middle fossa craniotomy has been used with good results, recent advances in technique have allowed for modification of the traditional approach into a smaller skin incision and a minimally invasive middle fossa keyhole craniectomy roughly 1...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521349/postoperative-hematoma-requiring-recraniotomy-in-1149-consecutive-patients-with-intracranial-tumors
#18
Teruyoshi Kageji, Shinji Nagahiro, Yoshifumi Mizobuchi, Kohei Nakajima
BACKGROUND: The reported 30-day mortality rate after brain tumor surgery is 2.2% to 2.9%, with a postoperative hematoma (POH) as the most frequent cause of death. OBJECTIVE: To investigate the risk factors for a POH requiring a recraniotomy after brain tumor surgery in a large, contemporary, single-institution consecutive series. METHODS: We included 1149 patients who underwent surgery for intracranial tumors at the Tokushima University Hospital from 1997 to 2014...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28521348/reuse-of-a-reversed-bone-pad-to-perforate-incompletely-penetrated-burr-holes-created-by-automatic-releasing-cranial-perforators
#19
Yasuo Murai, Eitaro Ishisaka, Atsushi Tsukiyama, Shunsuke Nakagawa, Fumihiro Matano, Kojiro Tateyama, Akio Morita
BACKGROUND: It can be difficult to make complete burr holes using a perforator with automatic releasing systems in cases of a soft diploe or thick calvarial bone. OBJECTIVE: To demonstrate the utility of a flipped "bone pad" (BP) in recovery of penetration failure when using an automatic releasing perforator. METHODS: For craniotomy or ventricular drainage, the first step is to make 1 or more burr holes using a craniotome. Neurosurgeons sometimes incompletely penetrate the skull using the latest tools...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28518107/a-large-lateral-craniotomy-procedure-for-mesoscale-wide-field-optical-imaging-of-brain-activity
#20
Michael Kyweriga, Jianjun Sun, Sunny Wang, Richard Kline, Majid H Mohajerani
The craniotomy is a commonly performed procedure to expose the brain for in vivo experiments. In mouse research, most labs utilize a small craniotomy, typically 3 mm x 3 mm. This protocol introduces a method for creating a substantially larger 7 mm x 6 mm cranial window exposing most of a cerebral hemisphere over the mouse temporal and parietal cortices (e.g., bregma 2.5 - 4.5 mm, lateral 0 - 6 mm). To perform this surgery, the head must be tilted approximately 30° and much of the temporal muscle must be retracted...
May 7, 2017: Journal of Visualized Experiments: JoVE
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