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https://www.readbyqxmd.com/read/30515666/transsphenoidal-surgery-for-pituitary-adenomas-early-results-from-a-single-center
#1
I Karamouzis, M Caputo, C Mele, A Nuzzo, M Zavattaro, P Car, G Panzarasa, F Prodam, P Marzullo, Gianluca Aimaretti
OBJECTIVE: To evaluate early results of transsphenoidal surgery for pituitary adenomas. DESIGN: Retrospective evaluation of 90 consecutive patients undergoing endoscopic pituitary adenoma surgery (2007-2016) at "Maggiore della Carità" Hospital in Novara, Italy. Age at diagnosis, sex, symptoms at presentation, hormonal and radiological data, complications of surgery, and short-term follow-up information were collected. RESULTS: The majority of patients were male (M/F: 1...
December 4, 2018: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/30497854/two-site-blind-epidural-blood-patch-versus-targeted-epidural-blood-patch-in-spontaneous-intracranial-hypotension
#2
Curie Ahn, Eugene Lee, Joon Woo Lee, Choong Guen Chee, Yusuhn Kang, Heung Sik Kang
Spontaneous intracranial hypotension (SIH), caused by CSF leaks, can trigger headaches, and is treated using epidural blood patch (EBP) procedures. We aimed to determine the effectiveness of a newly devised two-site blind EBP procedure as the initial treatment for SIH and compare its effectiveness with that of conventional targeted EBP. We retrospectively reviewed data for 116 patients who underwent EBP for SIH between November 2013 and April 2017. Patients were divided into two groups: those who initially received two-site blind EBP (n = 28) at the cervicothoracic (C7/T1) and thoracolumbar junctions (T12/L1) for sealing CSF leaks at all levels, and those who received targeted EBP after CT myelography (n = 88)...
November 26, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/30497227/postoperative-cerebral-venous-sinus-thrombosis-in-the-setting-of-surgery-adjacent-to-the-major-dural-venous-sinuses
#3
(no author information available yet)
OBJECTIVECerebral venous sinus thrombosis (CVST) is a known complication of surgeries near the major dural venous sinuses. While the majority of CVSTs are asymptomatic, severe sinus thromboses can have devastating consequences. The objective of this study was to prospectively evaluate the true incidence and risk factors associated with postoperative CVST and comment on management strategies.METHODSA prospective study of 74 patients who underwent a retrosigmoid, translabyrinthine, or suboccipital approach for posterior fossa tumors, or a supratentorial craniotomy for parasagittal/falcine tumors, was performed...
October 1, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30497207/fourth-ventricle-stent-placement-for-treatment-of-recurrent-syringomyelia-in-patients-with-type-i-chiari-malformations
#4
(no author information available yet)
OBJECTIVEIn patients with syringomyelia and type I Chiari malformation (CM-I) who have required reoperation because of persistent, recurrent, or expanding syrinx, the senior author placed a stent from the fourth ventricle to the cervical subarachnoid space in hopes of promoting circulation of CSF out of the ventricle and away from the central canal of the spinal cord. This study was undertaken to determine the long-term success of this operative stratagem in eliminating the syrinx, as well as to document the complications that occurred following stent placement...
October 1, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/30485224/does-lumbar-drainage-reduce-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery-a-prospective-randomized-controlled-trial
#5
(no author information available yet)
OBJECTIVEBased on a null hypothesis that the use of short-term lumbar drainage (LD) after endoscopic endonasal surgery (EES) for intradural pathology does not prevent postoperative CSF leaks, a trial was conducted to assess the effect of postoperative LD on postoperative CSF leak following standard reconstruction.METHODSA prospective, randomized controlled trial of lumbar drain placement after endoscopic endonasal skull base surgery was performed from February 2011 to March 2015. All patients had 3-month follow-up data...
October 1, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30485207/three-types-of-dural-suturing-for-closure-of-csf-leak-after-endoscopic-transsphenoidal-surgery
#6
(no author information available yet)
OBJECTIVETranssphenoidal surgery (TSS) is commonly used for anterior skull base surgery, especially in the sella turcica (sellar) region. However, because of its anatomical position, CSF leakage is a major complication of this approach. The authors introduced a new grading reconstruction strategy for anterior skull base surgery with continuous dural suturing in 2013. In this paper the authors report on their methods and results.METHODSAll patients with sellar or anterior skull base lesions that were removed with TSS or extended TSS by a single neurosurgeon between April 2013 and March 2017 at Nagoya University Hospital and several cooperating hospitals were retrospectively identified...
October 1, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30481622/stereotactic-placement-of-intratumoral-catheters-for-continuous-infusion-delivery-of-hsv-1-g207-in-pediatric-malignant-supratentorial-brain-tumors
#7
Joshua D Bernstock, Zachary Wright, Asim K Bag, Florian Gessler, G Yancey Gillespie, James M Markert, Gregory K Friedman, James M Johnston
OBJECTIVE: G207, an engineered HSV-1, is a promising therapeutic option for CNS tumors. The first-ever pediatric Phase 1 trial of continuous-infusion delivery of G207 via intratumoral catheters for recurrent/progressive malignant brain tumors is ongoing. Herein, we describe surgical techniques for the accurate placement of catheters in multiple supratentorial locations and perioperative complications associated with such procedures. METHODS: A prospective study of G207 in children with recurrent malignant supratentorial tumors is ongoing...
November 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30475077/a-low-cost-dural-closure-simulation-model-for-tomorrow-s-spinal-neurosurgeons
#8
Deborah Ferguson, Kevin Agyemang, Christopher Barrett, Calan Mathieson
INTRODUCTION: We present a low cost model that can be used to improve a trainee's skills in spinal dural closure. Development of microsurgical skills in a simulated environment provides a safe environment in which patients are protected. We argue that this is likely to improve the quality of dural closure, especially for surgeons early in their training and may lead to a commensurate reduction in post-operative CSF leak. METHOD: In our model, two consultant spine surgeons assessed the ability of participants to close the spinal dura...
November 26, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/30472121/management-of-spontaneous-temporal-bone-cerebrospinal-fluid-leak-a-30-year-experience
#9
Esther Cheng, David Grande, John Leonetti
PURPOSE: The goal of this study was to describe the incidence of and our long-term results in the management of spontaneous temporal bone CSF leak and to determine if there is any association with an increase in body mass index (BMI). METHODS: This was an Institutional Review Board (IRB) approved retrospective review of 58 patients who underwent repair of spontaneous temporal bone CSF leaks by a single surgeon at a tertiary care academic medical center between 1988 and 2017...
September 26, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/30470650/a-novel-technique-for-stabilization-of-high-grade-spondylolisthesis-with-transvertebral-fusion-without-reduction
#10
Chester J Donnally, Karthik Madhavan, Alexander J Butler, Jonathan I Sheu, Dustin H Massel, Barth A Green, Joseph P Gjolaj
Surgical treatment of high-grade spondylolisthesis and spondyloptosis is recommended in symptomatic patients, yet there exists much debate regarding the optimal surgical approach and the need for reduction. Similar to the Bohlman technique in that fixation is achieved across two vertebral endplates, we discuss a novel technique with the advantage of using bilateral threaded pedicle screws of large diameter and length instead of a single fibula allograft. Patients underwent posterior instrumented fusion without spondylolisthesis reduction using a novel technique placing pedicle screws with a transvertebral trajectory through the two end plates involved in the spondylolisthesis...
November 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/30461525/application-of-ultrasonic-bone-aspirator-for-decompression-of-the-internal-auditory-canal-via-the-middle-cranial-fossa-approach
#11
Gavriel D Kohlberg, Noga Lipschitz, Kareem O Tawfik, Zoe Walters, Joseph T Breen, Mario Zuccarello, Norberto Andaluz, Vincent A Dinapoli, Myles L Pensak, Ravi N Samy
OBJECTIVE: Evaluate the safety and efficacy of the ultrasonic bone aspirator (UBA) during middle cranial fossa (MCF) approach to vestibular schwannoma (VS). STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: Charts of 192 consecutive VS patients over 18 years of age were reviewed to identify 65 patients who underwent MCF approach to VS resection between 2006 and 2017. A combination of UBA and high-speed drill (HSD) was used to decompress the internal auditory canal (IAC) in 25 patients and HSD alone was used in the other 40 patients...
November 19, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/30458322/piezosurgery-for-infra-and-supratentorial-craniotomies-in-brain-tumors-surgery
#12
Ignazio G Vetrano, Francesco Prada, Alessandro Perin, Cecilia Casali, Francesco DiMeco, Marco Saini
OBJECTIVE: Piezoelectric surgery represents an innovative technique to perform safe and effective osteotomies, alternative to traditional bony tissue management using rotating or perforating instruments. We evaluated safety and feasibility of craniotomies using an ultrasonic device that allows the selective cut of mineralized structures, avoiding damages to the vascular, dural and parenchymal structures. METHODS: We analyzed a series of 300 patients (range 1-81 years, SD±15...
November 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30456027/pediatric-endoscopic-endonasal-approaches-for-skull-base-lesions-in-the-very-young-is-it-safe-and-effective
#13
Javan Nation, Alexander J Schupper, Adam Deconde, Michael Levy
Introduction  The fully endoscopic expanded endonasal approach (EEA) has been shown to be safe and efficacious in pediatric patients. However, in the very young patient (ages six and under), the anatomical challenge of working through a small nasal corridor is problematic. The ability to repair the skull base and use a nasoseptal flap (NSF) has also been called into question. Here, we review skull base resections using EEA in patients aged 6 years and younger. Methods  A retrospective chart review was conducted on pediatric patients age 6 years and younger who underwent EEA skull base resections over a 3-year period (June 2014 through June 2017)...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/30456024/lumbar-puncture-for-the-injection-of-intrathecal-fluorescein-should-it-be-avoided-in-a-subset-of-patients-undergoing-endoscopic-endonasal-resection-of-sellar-and-parasellar-lesions
#14
Michael Zhang, Tej D Azad, Harminder Singh, Smeer Salam, Saurabh Jain, Vijay K Anand, Theodore H Schwartz
Objectives  The use of intrathecal fluorescein (ITF) has become an increasingly adopted practice for the identification of cerebrospinal fluid (CSF) leaks during endoscopic skull base surgery for pituitary adenomas. Administration through lumbar puncture can result in postoperative positional headaches, increasing morbidity, cost, and length of stay. We sought to identify the incidence of and variables associated with postoperative headaches to determine if there was a subgroup of patients in whom this procedure should be avoided...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/30456020/revision-surgery-for-vestibular-schwannomas
#15
Kevin A Peng, Brian S Chen, Mark B Lorenz, Gregory P Lekovic, Marc S Schwartz, William H Slattery, Eric P Wilkinson
Objectives  To describe clinical outcomes of patients undergoing revision surgery for vestibular schwannomas. Design  Retrospective case series. Setting  Tertiary private neurotologic practice. Participants  Patients who underwent revision surgeries for recurrent/residual vestibular schwannomas between 1985 and 2015. Main Outcome Measures  Degree of resection, facial nerve function, cerebrospinal fluid (CSF) leak. Results  A total of 234 patients underwent 250 revision surgeries for recurrent/residual vestibular schwannomas...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/30443809/real-world-safety-experience-of-tevagrastim-ratiograstim-biograstim-and-tbo-filgrastim-short-acting-recombinant-human-granulocyte-colony-stimulating-factors
#16
Camille N Abboud, Nicole Lang, Henry Fung, Andreas Lammerich, Anton Buchner, Patrick Liu, Udo Mueller, Ruth Pettengell, Ingo J Diel, Hartmut Link, Ashutosh Pathak
PURPOSE: Recombinant granulocyte colony-stimulating factors (rG-CSFs), such as filgrastim, are administered to prevent complications in patients receiving chemotherapy. In Europe, a biosimilar to filgrastim, tevagrastim/ratiograstim/biograstim, was approved in 2008. In the USA, the same product was approved as tbo-filgrastim under a 351(a) biologic license application in 2012 with the brand name Granix®. Postmarket surveillance remains a priority for monitoring the safety of biologics and biosimilars to identify rare and immunogenicity-related events...
November 15, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/30439737/dural-reconstruction-with-autologous-rectus-fascia-a-new-technique-for-addressing-large-sized-defects-during-cranioplasty
#17
Gabriel Santiago, Amir Wolff, Judy Huang, Jon Weingart, Henry Brem, Chad R Gordon
INTRODUCTION: Patients requiring cranioplasty reconstruction with customized cranial implants may unexpectedly present with cerebrospinal fluid (CSF) leaks and durotomies following previous neurosurgical procedures. As such, multiple factors influence the type of dural reconstruction chosen at this time, which are essential for achieving long-term success. Overall, the most common material used for duraplasty is currently an "off-the-shelf" xenograft construct. However, some believe that they are not suitable for large-sized defects and accompany a higher incident of complications...
November 13, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/30431710/preoperative-management-of-spontaneous-cerebrospinal-fluid-rhinorrhea-with-acetazolamide
#18
Ashwini M Tilak, Heather Koehn, José Mattos, Spencer C Payne
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) rhinorrhea has been associated with elevated intracranial pressure (ICP). As such, ICP reducing measures are commonly employed to optimize repair. Although postoperative acetazolamide use has been described, no data currently exists on the potential for preoperative use. METHODS: A retrospective review was performed including patients treated for anterior spontaneous CSF leaks by a single surgeon over a 6-year period during which acetazolamide therapy (250 mg twice daily) was employed before considering surgical repair...
November 15, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/30404164/systemic-capillary-leak-syndrome-clarkson-syndrome-in-cancer-patients-a-systematic-review
#19
Jae Il Shin, Keum Hwa Lee, I Re Lee, Ji Hyun Oh, Dong Wook Kim, Jae Won Shin, Tae Seong Eo, Andreas Kronbichler, Michael Eisenhut, Hans J van der Vliet
Systemic capillary leak syndrome (SCLS) is a rare disease characterized by shock caused by capillary hyperpermeability. The disease can occur in cancer patients and effective therapeutic strategies have not been established yet. The aim of the study was to analyze the clinical and laboratory data, treatment modalities, and mortality rate of patients and to identify contributing factors leading to mortality of SCLS in cancer. We searched MEDLINE (inception to July 2018) and of 4612 articles, we identified 62 case reports on SCLS associated with cancer or cancer-related drugs in a total of 53 articles...
November 6, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/30401570/endoscopic-transnasal-repair-of-two-cases-of-spontaneous-cerebrospinal-fluid-fistula-in-the-foramen-rotundum
#20
Benjamin Harley, Agadha Wickremesekera, Neil Tan, Elgan Davies, Simon Robinson, Campbell Baguley, Peter J Wormald
We report two female patients aged 16 and 33 who presented with spontaneous cerebrospinal fluid (CSF) rhinorrhoea. Beta-2 transferrin was positive in both cases. Initial high-resolution CT showed fluid in the maxillary sinus but no obvious bony defect. MR imaging revealed maxillary sinus cysts with high signal on T2 sequences. Endoscopic transnasal surgery with intrathecal fluorescein was undertaken and in both cases a leak was identified from foramen rotundum and repaired. Both patients are symptom free at 6 months...
November 3, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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