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https://www.readbyqxmd.com/read/29778611/traumatic-aorto-cisterna-chlyi-fistula-with-treatment-of-aortic-pseudoaneurysm-with-ct-guided-thrombin-injection
#1
Brian M Freeman, Benjamin C Powell, A Michael Devane, Allyson L Hale, Sagar S Gandhi
INTRODUCTION: Only 3 cases of aorto-cisterna chyli fistula have been described in the literature but none with a resulting pseudoaneurysm (PSA). CASE REPORT: A 68-year-old man presented following a motor vehicle collision. Imaging revealed a retroperitoneal hematoma with enhancement of the cisterna chyli, representing aortic to cisterna chyli fistula. Three days later CTA showed resolution of the fistula, but revealed a PSA. The patient underwent arteriography that confirmed the PSA, and then a CT-guided thrombin injection was performed...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770178/dynamic-stabilization-for-degenerative-diseases-in-the-lumbar-spine-2-years-results
#2
Ahmed Hosny Khalifa, Timo Stübig, Oliver Meier, Christian Walter Müller
Following lumbar fusion, adjacent segment degeneration has been frequently reported. Dynamic systems are believed to reduce main fusion drawbacks. We conducted a retrospective study on patients with degenerative lumbar disease treated with posterior dynamic stabilization with monoaxial hinged pedicular screws and lumbar decompression. VAS and ODI were used to compare clinical outcomes. As radiological outcomes, LL and SVA were used. 51 patients were included with an average follow-up of 24 months. 13 patients were revised because of postoperative radiculopathy (n=4), subcutaneous hematoma (n=2), L5 screw malposition (n=1) and adjacent segment disease (n=6)...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29729844/acute-intracranial-and-spinal-subdural-hematoma-associated-with-vardenafil
#3
Takaaki Nakamura, Genya Watanabe, Ryuhei Harada, Emiko Kawasaki, Kenichi Tsukita, Yasushi Suzuki
A 28-year-old healthy man was admitted to our hospital because of right-sided headache, vomiting, and lower back pain after the administration of vardenafil. Computed tomography and magnetic resonance imaging of the brain showed a small, right-sided, subdural hematoma. A lumbar magnetic resonance imaging showed a longitudinally extended subdural hematoma. He had no history of trauma. We speculated that vardenafil might have had an association with the bleeding. Several reports have suggested a relationship between phosphodiesterase-5 inhibitors and intracerebral or subarachnoid hemorrhage...
May 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29726793/sublaminar-fixation-for-traumatic-lumbar-fracture-subluxation-with-lateral-listhesis-in-a-2-year-old-patient
#4
Daniel S Yanni, Aurora S Cruz, Alexander Y Halim, Amandip S Gill, Michael G Muhonen, Robert F Heary, Ira M Goldstein
Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...
May 4, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29701406/infrarenal-abdominal-penetrating-aortic-ulcer-an-atypical-location-of-a-rare-disease
#5
Nelson Camacho, Gonçalo Rodrigues, Rodolfo Abreu, Rita Ferreira, Joana Catarino, Ricardo Correia, Rita Bento, Maria Emília Ferreira
INTRODUCTION: Penetrating aortic ulcer (PAU) is classically included in acute aortic syndromes, together with aortic dissection and intramural hematoma. These three disorders are considered different stages of the same disease. PAU is the result of medial degeneration with disruption of the intima, mainly due to atherosclerotic risk factors. Most of them are located on descending thoracic aorta and only a few small series and case reports demonstrate location on infrarenal abdominal aorta...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29680443/a-systematic-review-and-meta-analysis-of-wound-drains-in-non-instrumented-lumbar-decompression-surgery
#6
REVIEW
Christopher L Davidoff, Jeffrey M Rogers, Mary Simons, Andrew S Davidson
Wound drains are routinely used in lumbar decompressive surgery (LDS). However, it remains unclear whether this practice helps to prevent symptomatic epidural hematoma formation and associated complications, particularly following non-instrumented procedures. A systematic review and meta-analysis was therefore completed to critically appraise the literature. The search protocol was conducted using the Ovid MEDLINE, EMBASE, Scopus, Cochrane Library, and Google Scholar databases. Articles meeting the following criteria were included: (i) examined patients undergoing LDS; (ii) included cases receiving post-operative wound drains; (iii) detailed adverse outcomes including symptomatic epidural hematomas or wound infection; and (iv) were published in English in a peer-reviewed journal...
April 18, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29662744/postoperative-complications-associated-with-rhbmp2-use-in-posterior-posterolateral-lumbar-fusion
#7
Nabil Esmail, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Hans-Joerg Meisel, Jong-Beom Park, Jim A Youssef, Jeffrey C Wang, S Tim Yoon
Study Design: Retrospective database review. Objective: Posterior/posterolateral lumbar fusion (PLF) is an effective treatment for a variety of spinal disorders; however, variations in surgical technique have different complication profiles. The aim of our study was to quantify the frequency of various complications in patients undergoing PLF with and without human recombinant bone morphogenetic protein 2 (rhBMP2). Methods: We queried the orthopedic subset of the Medicare database (PearlDiver) between 2005 and 2011 for patients undergoing PLF procedures with and without rhBMP2...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29656630/etiopathogenesis-of-traumatic-spinal-epidural-hematoma
#8
Francesco Ciro Tamburrelli, Maria Concetta Meluzio, Giulia Masci, Andrea Perna, Aaron Burrofato, Luca Proietti
Spinal epidural hematoma (SEH) is a rare cause of nerve root or cord compression; its pathogenesis is not always clearly recognizable. The aim of this paper was to investigate possible etiopathological factors in a consecutive series of patients affected by traumatic SEH treated at our institution. Seven patients with neurologic impairment due to traumatic SEH were retrospectively analyzed after diagnosis and surgical treatment. Thoracic localization was found in 5 cases, and lumbar and cervical localization were found in 1 patient each...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29620662/good-outcomes-after-the-delayed-removal-of-an-epidural-hematoma-a-case-report
#9
Yong-Xing Yao, Ming-Xia Li, Lian-Juan Sun
RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29620622/cc1-emergent-endovascular-repair-of-a-ruptured-descending-thoracic-aortic-aneurysm-in-an-arresting-patient
#10
Warren Naselsky, Charles F Evans, Brody Wehman, Bradley S Taylor
OBJECTIVE: Our goal was to present a case of emergent endovascular repair of a ruptured descending aortic aneurysm in an actively arresting patient. PATIENT: The patient was a 75-year-old woman with a known history of a 6.5-cm descending thoracic aortic aneurysm with acute onset of back pain and syncope. A computed tomographic angiogram revealed disruption of the descending thoracic aorta and a mediastinal hematoma. The patient was taken emergently to the operating room...
April 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29573815/safety-of-lumbar-puncture-performed-on-dual-antiplatelet-therapy
#11
Ivan D Carabenciov, Maximiliano A Hawkes, Sara Hocker
Practice guidelines generally recommend delaying lumbar puncture (LP) in patients on dual antiplatelet therapy, with these recommendations often citing an increased risk of hemorrhagic complications, specifically the development of epidural hematomas. However, no data exist about the risks of performing an LP in the setting of dual antiplatelet therapy and conclusions are often based on data from spinal anesthesia literature. We reviewed the medical records of 100 patients who underwent LP while taking dual antiplatelet therapy...
March 22, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29565953/unique-complications-of-percutaneous-endoscopic-lumbar-discectomy-and-percutaneous-endoscopic-interlaminar-discectomy
#12
Chuanli Zhou, Guoqing Zhang, Ripul R Panchal, Xianfeng Ren, Hongfei Xiang, Ma Xuexiao, Xiaoliang Chen, Gu Tongtong, Wang Hong, Alana D Dixson
BACKGROUND: Percutaneous endoscopic discectomy (PED) includes 2 main procedures: percutaneous endoscopic lumbar discectomy (PELD) and percutaneous endoscopic interlaminar discectomy (PEID), both of which are minimally invasive surgical procedures that effectively deal with lumbar degenerative disorders. Because of the challenging learning curve for the surgeon and the individual characteristics of each patient, preventing and avoiding complications is difficult. The most common complications, such as nucleus pulposus omission, nerve root injury, dural tear, visceral injury, nerve root induced hyperalgesia or burning-like nerve root pain, postoperative dysesthesia, posterior neck pain, and surgical site infection, are difficult to avoid; however, more focus on these issues perioperatively may be in order...
March 2018: Pain Physician
https://www.readbyqxmd.com/read/29541489/cerebrospinal-fluid-drains-reduce-risk-of-spinal-cord-injury-for-thoracic-thoracoabdominal-aneurysm-surgery-a-review
#13
REVIEW
Nancy E Epstein
Background: The risk of spinal cord injury (SCI) due to decreased cord perfusion following thoracic/thoracoabdominal aneurysm surgery (T/TL-AAA) and thoracic endovascular aneurysm repair (TEVAR) ranges up to 20%. For decades, therefore, many vascular surgeons have utilized cerebrospinal fluid drainage (CSFD) to decrease intraspinal pressure and increase blood flow to the spinal cord, thus reducing the risk of SCI/ischemia. Methods: Multiple studies previously recommend utilizing CSFD following T/TL-AAA/TEVAR surgery to treat SCI by increasing spinal cord blood flow...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29533044/-chronic-spontaneous-lumbar-spinal-epidural-hematoma-a-case-report
#14
Shuan-Chi Wang, Fang-Fang Wang, Shou-Chao Zheng
No abstract text is available yet for this article.
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29529630/can-aortic-balloon-occlusion-reduce-blood-loss-during-resection-of-sacral-tumors-that-extend-into-the-lower-lumber-spine
#15
Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29524703/neurological-deterioration-due-to-brain-sag-following-bilateral-craniotomy-for-subdural-hematoma-evacuation
#16
James K C Liu
BACKGROUND: Intracranial hypotension from cerebrospinal fluid hypovolemia resulting in cerebral herniation is a rare but known complication that can occur following neurosurgical procedures, usually encountered in correlation with perioperative placement of a lumbar subarachnoid drain. Decrease in CSF volume resulting in loss of buoyancy results in downward herniation of the brain without contributing mass effect, causing a phenomenon known as 'brain sag.' Unreported previously is brain sag occurring without concomitant occult CSF leak or lumbar drainage...
March 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29518872/-the-461th-case-fever-hematuria-and-right-lumbar-pain
#17
Z W Liu, W Qiu, J M Peng, Z W Wang, J L Zhao, Q J Wu
A 56-year-old female was admitted to the Department of Rheumatology, Peking Union Medical College Hospital with complaint of recurrent fever and acute lumbar pain. Fever was complicated with malaise, cough and occasional blood-streaked sputum. Lab tests showed elevated white blood cell count, increased serum creatinine, erythrocyte sedimentation rate and C-reactive protein. Other lab findings included severe anemia, hematuria, and proteinuria. Immunological examinations were positive for antinuclear antibodies, antineutrophil cytoplasmic antibodies and antiglomerular basement membrane antibody...
March 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29504991/delayed-retroperitoneal-arterial-hemorrhage-after-inferior-vena-cava-filter-deployment-a-case-report
#18
Yongzheng Wang, Haiyang Chang, Wujie Wang, Wei Wang, Bin Liu, Zheng Li, Yuliang Li
RATIONALE: Pulmonary embolization is a life-threatening condition. The deployment of inferior vena cava (IVC) filter is the first choice for preventing embolus from the lower extremity. However, IVC filter complications are rare but not to be neglected. Penetration of the arterial wall may result in catastrophic damages. This case report describes a woman who suffered from retroperitoneal hemorrhage after placement of an IVC filter due to a pulmonary embolization. Her filter was found to have penetrated the right lumbar artery and caused the massive bleeding...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29479039/concomitant-intracranial-and-lumbar-chronic-subdural-hematoma-treated-by-fluoroscopic-guided-lumbar-puncture-a-case-report-and-literature-review
#19
Daisuke Ichinose, Satoru Tochigi, Toshihide Tanaka, Tomoya Suzuki, Jun Takei, Keisuke Hatano, Ikki Kajiwara, Fumiaki Maruyama, Hiroki Sakamoto, Yuzuru Hasegawa, Satoshi Tani, Yuichi Murayama
A 40-year-old man presented with a severe headache, lower back pain, and lower abdominal pain 1 month after a head injury caused by falling. Computed tomography (CT) of the head demonstrated bilateral chronic subdural hematoma (CSDH) with a significant amount in the left frontoparietal region. At the same time, magnetic resonance imaging (MRI) of the lumbar spine also revealed CSDH from L2 to S1 level. A simple drainage for the intracranial CSDH on the left side was performed. Postoperatively, the headache was improved; however, the lower back and abdominal pain persisted...
April 15, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29454129/delayed-posttraumatic-subacute-lumbar-subarachnoid-hematoma-case-report-and-review-of-the-literature
#20
Thiébaud Picart, Timothée Jacquesson, Emmanuel Jouanneau, Moncef Berhouma
BACKGROUND: Traumatic spinal subarachnoid hematoma, associated or not with a concurrent subdural hematoma, has rarely been described. The evolution of such hematomas is heterogeneous. This study aims at defining the most accurate management, which is currently not standardized. CASE DESCRIPTION: A 20-year-old man, victim of a high-kinetic road accident 5 days before and with several nonneurologic nonsurgical vertebral fractures, experienced a sudden dorsolumbar pain radiating to his lower limbs...
May 2018: World Neurosurgery
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