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Neurosurgical infection rates

Lukas Grassner, Franz Marhold, Yousif Miron, Andreas Grillhösl, Karl Ungersboeck, Joachim Schulz, Martin Strowitzki
BACKGROUND: Decompressive craniectomy is a commonly performed procedure. It reduces intracranial pressure, improves survival, and thus might have a positive impact on several neurosurgical diseases and emergencies. Sometimes primary skin closure is not possible due to cerebral herniation or extensive skin defects. In order to prevent further restriction of the underlying tissue, a temporary skin expansion might be necessary. METHODS AND MATERIAL: We retrospectively reviewed patients in need for a temporary skin substitute because skin closure was not possible after craniectomy without violating brain tissue underneath in a time period of 6 years (2011-2016)...
December 4, 2018: Acta Neurochirurgica
Cagatay Calikoglu, Murteza Cakir
Objective: The aim of this study was to evaluate the outcomes of patients with lumbar disk hernia operated between 2012 January and 2017 August and to compare the differences between open discectomy (OD) and microdiscectomy (MD). Materials and Methods: Files of 519 patients who presented at our neurosurgical department with lumbar disk herniation were retrospectively reviewed and recorded. Preoperatively, all patients routinely underwent spinal lumbar magnetic resonance imaging (MRI) and anteroposterior as well as lateral lumbar vertebrae X-rays...
October 2018: Eurasian Journal of Medicine
Martin N Stienen, Nathalie Moser, Philipp Krauss, Luca Regli, Johannes Sarnthein
BACKGROUND: Today, there are only few reports on the incidence of surgical site infections (SSIs) in neurosurgery. The objective of this work was to determine the rate of SSI at a tertiary neurosurgical department for benchmarking purpose. METHODS: Data of consecutive patients undergoing neurosurgical treatment between January 2013 and December 2016 were prospectively entered into a registry. SSIs were diagnosed according to the 2017 Centers for Disease Control and Prevention criteria, with severity graded according to the Clavien-Dindo grade (CDG)...
November 27, 2018: Acta Neurochirurgica
Evgenii Belykh, Alessandro Carotenuto, Andrey A Kalinin, Serik K Akshulakov, Talgat Kerimbayev, Vladislav E Borisov, Marat A Aliyev, Peter Nakaji, Mark C Preul, Vadim A Byvaltsev
OBJECTIVE: To analyze the effects of a surgical protocol for infections, nonhealing wound prophylaxis, and analgesia among patients who underwent posterior spinal fusion at a single tertiary care neurosurgical center. METHODS: This prospective study was conducted in the neurosurgery department of a tertiary care neurosurgical center and compared a control group of patients who had posterior spinal fusion within 3 months before implementation of a surgical protocol with a study group of patients enrolled within 1 year after protocol implementation...
November 24, 2018: World Neurosurgery
Muhammad Adnan Khan, Syed Abdul Qader Quadri, Abdulmuqueeth Syed Kazmi, Vishal Kwatra, Anirudh Ramachandran, Aaron Gustin, Mudassir Farooqui, Sajid Sattar Suriya, Atif Zafar
Skull base osteomyelitis (SBO) is a complex and fatal clinical entity that is often misdiagnosed for malignancy. SBO is commonly a direct complication of otogenic, sinogenic, odontogenic, and rhinogenic infections and can present as central, atypical, or pediatric clival SBO. This review describes the clinical profile, investigational approach, and management techniques for these variants. A comprehensive literature review was performed in PubMed, MEDLINE, Research Gate, EMBASE, Wiley Online Library, and various Neurosurgical and Neurology journals with the keywords including: SBO, central or atypical SBO, fungal osteomyelitis, malignant otitis externa, temporal bone osteomyelitis, and clival osteomyelitis...
October 2018: Asian Journal of Neurosurgery
Vicente Pintado, Rosario Pazos, Manuel Enrique Jiménez-Mejías, Azucena Rodríguez-Guardado, Beatriz Díaz-Pollán, Carmen Cabellos, Juan Manuel García-Lechuz, Jaime Lora-Tamayo, Pere Domingo, Elena Muñez, Diego Domingo, Fernando González-Romo, José Antonio Lepe-Jiménez, Carlos Rodríguez-Lucas, Antonio Gil, Iván Pelegrín, Fernando Chaves, Virginia Pomar, Antonio Ramos, Teresa Alarcón, Elisa Pérez-Cecilia
BACKGROUND: Staphylococcus aureus meningitis is an uncommon nosocomial infection usually associated with neurosurgical procedures but spontaneous infections may occasionally appear. AIMS: To compare the features of meningitis caused by methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus and examine the prognostic factors for mortality, including MRSA infection and combined antimicrobial therapy. METHODS: Retrospective cohort study of 350 adults with S...
November 15, 2018: Journal of Hospital Infection
Orion P Keifer, Kate Zeising, Muhibullah S Tora, Melissa Campbell, Yarema B Bezchlibnyk, Nicholas Boulis
BACKGROUND AND IMPORTANCE: Trigeminal ganglion stimulation can be effective for trigeminal neuralgia. For patients who respond well to neurostimulation delivered percutaneously through the foramen ovale but require extensive revision and removal of instrumentation, a sub-temporal approach for stimulation of the trigeminal ganglion is an alternative option as a salvage procedure. CLINICAL PRESENTATION: Here we report a 47-year old woman who responded well to neurostimulation for trigeminal neuropathic pain over a one-year period from 2008-2009...
November 14, 2018: World Neurosurgery
Megan E H Still, Sara Venturini, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
BACKGROUND: Spine pathology is a common reason for admission to neurosurgical units in low- and middle- income countries (LMICs) and can have high morbidity rates from lack of specialized institutes. However, good surgical outcomes and quality of life scores have been reported in LMICs. OBJECTIVES: This study details the complication rates and predictive factors from spine surgery at a large hospital in Cambodia, aiming to identify high-risk patients to improve surgeon understanding of these complications for improved pre-operative planning and patient counseling...
November 14, 2018: World Neurosurgery
M Dedeciusová, T Tyll, V Beneš, D Netuka
Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%. The case report presents a patient with subdural empyema which resulted from sinusitis. The integral and first part of therapy was an urgent neurosurgical drainage of subdural empyema, followed by functional endoscopic sinus surgery performed by ENT surgeon...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Marija Stevic, Dusica Simic, Nina Ristic, Ivana Budic, Vesna Marjanovic, Marija Jovanovski-Srceva, Nikola Repac, Milica Rankovic-Janevski, Goran Tasic
Purpose: Preterm newborns, due to many factors, are at increased risk for poor neural development, intraventricular hemorrhages, infections, and higher rate of mortality. The aim of this study was to evaluate the risk factors associated with poor outcome in preterm neonates with late-onset neonatal sepsis (LONS) who had posthemorrhagic hydrocephalus and underwent neurosurgical procedures for treatment of the hydrocephalus. Patients and methods: Preterm neonates who had undergone insertion of ventriculoperitoneal shunt or Ommaya reservoir, during the 10-year period at University Children's Hospital, were retrospectively analyzed...
2018: Therapeutics and Clinical Risk Management
Patrick J Belton, N Scott Litofsky, William E Humphries
BACKGROUND: Although empiric treatment of urinary tract colonized patients remains a frequent practice in neurosurgery, the value of this practice remains debatable. OBJECTIVE: To analyze the effect of screening and treatment of bacteriuria on surgical site infections, incidence of Clostridium difficile, and mortality in neurosurgical trauma patients. METHODS: Database queries and direct patient chart reviews were used to gather patient chart data...
October 17, 2018: Neurosurgery
Panagiotis Kerezoudis, Amy E Glasgow, Mohammed Ali Alvi, Robert J Spinner, Fredric B Meyer, Mohamad Bydon, Elizabeth B Habermann
BACKGROUND: Return to the operating room (ROR) has been put forth by the National Quality Forum and the American College of Surgeons as a surgical quality indicator. However, current quality metrics fail to consider the nature and etiology of the ROR. OBJECTIVE: To provide a comprehensive description of all reoperations after neurosurgical procedures and assess the validity of ROR as a quality measure in neurosurgery. METHODS: We retrospectively analyzed all neurosurgical procedures performed in a high-volume, tertiary care academic medical center between June 1, 2014 and December 31, 2016...
October 8, 2018: Neurosurgery
Felicia Chow
PURPOSE OF REVIEW: Brain abscesses and spinal epidural abscesses are serious, potentially life-threatening infections of the central nervous system. This article outlines the clinical presentation, evaluation, and management of brain abscesses and spinal epidural abscesses, with a specific focus on bacterial infections. RECENT FINDINGS: The overall incidence of brain abscesses has declined, in part because of fewer brain abscesses associated with otogenic infections...
October 2018: Continuum: Lifelong Learning in Neurology
Ahmed E Helal, Heba Abouzahra, Ahmed Abdelaziz Fayed, Tarek Rayan, Mahmoud Abbassy
Healthcare spending has become a grave concern to national budgets worldwide, and to a greater extent in low-income countries. Brain tumors are a serious disease that affects a significant percentage of the population, and thus proper allocation of healthcare provisions for these patients to achieve acceptable outcomes is a must. The authors reviewed patients undergoing craniotomy for tumor resection at their institution for the preceding 3 months. All the methods used for preoperative planning, intraoperative management, and postoperative care of these patients were documented...
October 2018: Neurosurgical Focus
Tae Seok Jeong, Gi Taek Yee
OBJECTIVE: This study aimed to investigate the rates, types, and risk factors of surgical site infection (SSI) following intracranial neurosurgical procedures evaluated by a Korean SSI surveillance system. METHODS: This was a prospective observational study of patients who underwent neurosurgical procedures at 29 hospitals in South Korea from January 2017 to June 2017. The procedures included craniectomy, craniotomy, cranioplasty, burr hole, and ventriculoperitoneal shunt...
September 2018: Journal of Korean Neurosurgical Society
Allen L Ho, John G D Cannon, Jyodi Mohole, Arjun V Pendharkar, Eric S Sussman, Gordon Li, Michael S B Edwards, Samuel H Cheshier, Gerald A Grant
OBJECTIVE Topical antimicrobial compounds are safe and can reduce cost and complications associated with surgical site infections (SSIs). Topical vancomycin has been an effective tool for reducing SSIs following routine neurosurgical procedures in the spine and following adult craniotomies. However, widespread adoption within the pediatric neurosurgical community has not yet occurred, and there are no studies to report on the safety and efficacy of this intervention. The authors present the first institution-wide study of topical vancomycin following open craniotomy in the pediatric population...
August 24, 2018: Journal of Neurosurgery. Pediatrics
Ankush Gupta, Reman Ramesh Nair, Ranjith K Moorthy, Vedantam Rajshekhar
OBJECTIVE: To study the effect of a staphylococcal decolonization regimen (SDR) and change in antibiotic prophylaxis regimen on postoperative meningitis (bacterial and aseptic) rates in patients undergoing elective cranial surgery. METHODS: Data on elective craniotomy (supratentorial and infratentorial) were collected retrospectively for a total of 4 years-2 years before (2011-2012; group A) and 2 years after (2014-2015; group B) initiation of a SDR and a change in the antibiotic prophylaxis regimen (from chloramphenicol to ceftriaxone) in a neurosurgical unit of a tertiary care hospital...
November 2018: World Neurosurgery
Nicholas J Goel, Arka N Mallela, Prateek Agarwal, Kalil G Abdullah, Omar A Choudhri, David K Kung, Timothy H Lucas, H Isaac Chen
OBJECTIVE: The objective of this study was to assess the independent effect of complications on 30-day mortality in 32,695 patients undergoing elective craniotomy. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was queried for patients undergoing elective craniotomy from 2006 to 2015. Multivariate logistic regression was used to examine the effect of complications on mortality independent of preoperative risk and other postoperative complications...
October 2018: World Neurosurgery
John G D Cannon, Allen L Ho, Jyodi Mohole, Arjun V Pendharkar, Eric S Sussman, Samuel H Cheshier, Gerald A Grant
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if topical vancomycin irrigation reduces the incidence of post-operative surgical site infections following pediatric spinal procedures. Surgical site infections (SSIs) following spinal procedures performed in pediatric patients represent a serious complication. Prophylactic use of topical vancomycin prior to closure has been shown to be effective in reducing incidence of SSIs in adult spinal procedures...
June 28, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Alejandro Enriquez-Marulanda, Luis C Ascanio, Mohamed M Salem, Georgios A Maragkos, Ray Jhun, Abdulrahman Y Alturki, Justin M Moore, Christopher S Ogilvy, Ajith J Thomas
BACKGROUND: In the current dynamic health environment, increasing number of procedures are being completed by advanced practitioners (nurse practitioners and physician assistants). This is the first study to assess the clinical outcomes and safety of external ventricular drain (EVD) placements by specially trained advanced practitioners. OBJECTIVE: Compare the safety and outcomes of EVD placement by advanced practitioners in patients with subarachnoid hemorrhage (SAH)...
June 11, 2018: Neurocritical Care
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