neurosurgery arrhythmia

BACKGROUND AND OBJECTIVES: Cerebral aneurysms in complex anatomical locations and intraoperative rupture can be challenging. Many methods to reduce blood flow can facilitate its exclusion from the circulation. This study evaluated the safety and efficacy of using adenosine, rapid ventricular pacing, and hypothermia in cerebral aneurysm clipping. METHODS: Databases (PubMed, Embase, and Web of Science) were systematically searched for studies documenting the use of adenosine, rapid ventricular pacing, and hypothermia in cerebral aneurysm clipping and were included in this single-arm meta-analysis...

OBJECTIVE: Perioperative risk assessment and stratification before craniotomy is necessary to identify and optimize modifiable risk factors. Due to the high costs of diagnostic testing and concerns for delaying surgery, some have questioned whether and when surgery delays are warranted and supported by the current body of literature. The objective of this scoping review was to evaluate the available evidence on the prognostic value of preoperative risk assessment before anesthesia for elective craniotomy...

Neurological and muscular immune-related adverse events (irAEs) associated with cancer treatment using immune checkpoint inhibitors (ICIs) may show a diverse clinical presentation. Myasthenia gravis (MG) represents a serious irAE associated with the aforementioned therapy. Recent studies have discussed the clinical features of MG that occurs as an irAE (irAE-MG). The incidence of irAE-MG is estimated to be 1%. This complication occurs during the early phase of ICI treatment and rapidly worsens, resulting in severe bulbar muscle involvement and myasthenic crisis and significantly elevated serum creatine kinase levels...

Aconite belongs to the genus Aconitum and the Ranunculaceae family, which contains approximately 300 species worldwide. Aconite, the poison mentioned in Agatha Christie's novel 4.50 from Paddington, contains aconitum alkaloids in all parts of the plant, including the roots, stem, leaves, and flowers. Aconitum alkaloids continuously activate voltage-gated sodium channels in the myocardium, central nervous system, and skeletal muscle. Activated sodium channels trigger automaticity and cause pre-excitation of cardiomyocytes, which precipitates various types of ventricular arrhythmias...

A Pocket Full of Rye is a full-length novel featured in Agatha Christie's series, "Miss Marple." Taxine, used for murder in this novel, is an alkaloid compound isolated from parts of the yew tree other than the pulp and is based on a diterpene, with a nitrogen element incorporated as a side chain in one of its many skeletal structures. Taxine binds to sodium channels, resulting in unregulated muscle contraction and arrhythmias.

STUDY DESIGN: Retrospective database analysis PURPOSE: The aim of this study assesses the impact of baseline cannabis use disorder [CUD] on perioperative complication outcomes in patients undergoing primary 1-to-2-level anterior cervical discectomy and fusion (ACDF) surgery. METHODS: The PearlDiver Database was queried from January 2010 to December 2021 for patients who underwent primary 1-to-2-level ACDF surgery for degenerative spine disease. Patients with CUD diagnosis six months prior to the index ACDF surgery, i...

Letter: We have read the recent article published by Zhang et al titled "The Efficacy and Safety of Topical Saline Irrigation with Tranexamic Acid on Perioperative Blood Loss in Patients Treated with Percutaneous Endoscopic Interlaminar Diskectomy: A Retrospective Study". In this retrospective study, authors performed interlaminar endoscopic lumbar discectomy (IELD) for L5-S1 disc herniations, categorizing patients into two groups. One group underwent IELD with saline irrigation fluid containing 0.33 gm of tranexamic acid (TXA) per 1L of saline, while the other group received only saline irrigation fluid...

BACKGROUND: Cardiac complications are related to poor prognosis after spontaneous intracerebral hemorrhage (ICH). This study aims to predict the cardiac complications arising from small intracranial hematoma at ultra-early stage. METHODS: The data of this work was derived from the Risk Stratification and Minimally Invasive Surgery in Acute Intracerebral Hemorrhage Patients (Risa-MIS-ICH) study (ClinicalTrials.gov Identifier: NCT03862729). This work included patients with ICH but without brain herniation, as confirmed by a brain computed tomography (CT) scan within 48 hours of symptom onset...

OBJECTIVES: The mechanism and pathological substrate of arrhythmogenic events in dystrophic myopathy type 1 (DM1) have not been fully established, especially for patients without progression of motor and/or cardiac disability. Therefore, we aimed to clarify the pathological appearance and genetic factors, other than CTG repeats in DMPK, associated with sudden cardiac death in patients with DM1. METHODS: A pathological investigation including the cardiac conduction system in the heart and whole-exome sequencing was conducted for three young adults (Patient 1; 25-year-old female, Patient 2; 35-year-old female, Patient 3; 18-year-old male) with DM1 who suffered sudden death...

Background Electrocardiographic (ECG) changes are frequently reported findings in patients with subarachnoid hemorrhage (SAH). We conducted a retrospective descriptive study to assess the prevalence of electrocardiographic changes in patients with non-traumatic SAH.  Methods In this single-center retrospective cross-sectional study, ECG recordings of 45 patients who presented to Tribhuvan University Teaching Hospital in the year 2019 with SAH were collected and analyzed to detect any abnormalities.  Results In our study, 88...

BACKGROUND: Analgesia Nociception Index (ANI) is a device based on analysis of the R-R interval and respiratory sinus arrhythmia to assess the balance between sympathetic and parasympathetic activity. The autonomic system is directly affected by load changes. Therefore, monitoring sympathetic tone and its change could theoretically allow tracking of load changes during volume expansion. The aim of the present study was to determine whether changes in ANI are able to track the increase in stroke volume caused by volume expansion (SV)...

BACKGROUND: The trigeminocardiac reflex (TCR) is a brainstem reflex commonly elicited during percutaneous balloon compression (PBC) for the treatment of trigeminal neuralgia (TN), which is characterized by drastic hemodynamic disturbances, such as bradycardia, arrhythmias and even cardiac arrest. In order to prevent catastrophic consequences, it is vital to screen the risk factors of TCR during perioperative period. The primary purpose of this study was to identify potential risk factors associated with TCR in patients with TN undergoing PBC, and to summarize the enlightenment of clinical anesthesia management...

BACKGROUND: Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study. METHOD: The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers...

BACKGROUND: Gorlin-Goltz syndrome is a rare autosomal dominant disorder resulting from PTCH1 gene mutation and presents with variable clinical manifestations. The co-occurrence of medulloblastoma and cardiac fibroma in Gorlin-Goltz syndrome is extremely rare. The present article discusses a patient diagnosed with Gorlin-Goltz syndrome and concurrent medulloblastoma and cardiac fibroma. CASE PRESENTATION: A 19-month-old boy transferred to our hospital after a radiological finding of posterior fossa lesion and hydrocephalus...

No abstract text is available yet for this article.

OBJECTIVE: The analysis of morbidity and mortality is fundamental for improving the quality of patient care. The objective of this study was to evaluate the combined medical and surgical morbidity and mortality of neurosurgical patients. METHODS: We performed a daily prospective compilation of morbidities and mortalities during a consecutive 4-month period in all the patients who were 18 years of age or older and had been admitted to the neurosurgery service at the Puerto Rico Medical Center...

OBJECTIVES: A wide variety of electrocardiographic (ECG) changes has been described in the context of neurological catastrophe. There has been diverse and plentiful literature emphasizing the cardiac changes in acute cerebrovascular events and traumatic brain injury. In stark contrast, there is scarce literature on the incidence of cardiac dysfunction caused by raised intracranial pressure (ICP) resulting from brain tumors. The study aimed to observe the ECG changes concurrent with intracranial hypertension resulting from supratentorial brain tumors...

BACKGROUND: The efficacy of targeted temperature management, including the appropriate length of time, in pediatric traumatic brain injury is inconclusive. We aimed to compare the efficacy of normothermia and therapeutic hypothermia administered for various durations. METHODS: We searched four databases without language limitations until December 2021 and included peer-reviewed published randomized controlled trials comparing normothermia (>35.1°C) with therapeutic hypothermia (32°C -35°C) in children aged <18 years with an acute closed severe head injury (Glasgow Coma Scale < 8) requiring hospitalization...

Cardiac arrest (CA) in the operating room is rare. Among known perioperative CA causes, Takotsubo syndrome (TTS) is a well-recognized one. Perioperative TTS is more common than existing reported cases therefore anesthesiologists should be aware of its diagnosis and management. TTS is an acquired and self-limited stress cardiomyopathy usually triggered by a precipitating stress factor and should be considered in any hospitalized patient presenting with symptoms such as acute coronary syndrome, cardiac arrhythmias or CA...

INTRODUCTION: Pompe disease is a rare, autosomal recessive, lysosomal disorder caused by deficiency of alpha glucosidase (GAA). It leads to the accumulation of glycogen in body tissues, with severe myopathy and cardiomegaly as a hallmark of the classic infantile form. Non-classical, or late onset, Pompe disease (LOPD) manifests after 12 months of age or in adulthood. MATERIAL AND METHODS: The clinical heterogeneity of LOPD causes delay in diagnosis and pharmacological treatment...