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Neurosurgical complications

Cattleya Thongrong, Patitha Chullabodhi, Pornthep Kasemsiri, Amnat Kitkhuandee, Narin Plailaharn, Lumyai Sabangban, Thirada Jimarsa
Background: Postoperative nausea and vomiting (PONV) is a common problem and may lead to catastrophic complications, especially in neurosurgical cases. The aim of this study was to evaluate the effects of dexamethasone and ondansetron for preventing PONV in patients who underwent microvascular decompression (MVD) surgery. Methods: A prospective, double-blinded, randomized control trial was conducted with 54 patients who underwent MVD. Patients were allocated into two groups...
2018: Anesthesiology Research and Practice
Patrick Hill, Avani Vaishnav, Blake Kushwaha, Steven McAnany, Todd Albert, Catherine Himo Gang, Sheeraz Qureshi
Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery...
September 9, 2018: Neurospine
Anthony Divito, Keith Kerr, Christopher Wilkerson, Scott Shepard, Alex Choi, Ryan Kitagawa
OBJECTIVES: Anticoagulant therapy (ACT) after traumatic intracranial hemorrhage may lead to progression of hemorrhage, but in the presence of thromboembolic events the clinician must decide if the benefits outweigh the risks. Currently, no data exist to guide therapy in the acute setting. PATIENTS AND METHODS: We retrospectively identified all patients admitted to our institution with traumatic intracranial hemorrhage that received intravenous heparin, full dose enoxaparin, or warfarin during their initial hospitalization over a three-year period...
December 5, 2018: World Neurosurgery
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
Amey R Savardekar, Devi P Patra, Vinayak Narayan, Jai D Thakur, Anil Nanda
BACKGROUND: Complications arising from cerebral venous occlusion/sacrifice during neurosurgical procedures have received comparatively less attention in the neurosurgical literature. Consequently, cerebral venous complications are not given due recognition, even though most practicing neurosurgeons would agree that they are not uncommon. We present a review of complications arising from venous sacrifice/occlusion during neurosurgery and discuss strategies described in the literature to prevent such occurrences...
November 2018: World Neurosurgery
Yasuo Murai, Shun Sato, Kanako Yui, Daijiro Morimoto, Tomohiro Ozeki, Masahiro Yamaguchi, Kojiro Tateyama, Toshiki Nozaki, Shigeyuki Tahara, Fumio Yamaguchi, Akio Morita
BACKGROUND: The exoscope has been reported as a novel neurosurgical instrumentation in clinical practice. OBJECTIVE: To investigate the possibility that ORBEYE (OE), a novel instrument that excludes eyepiece lenses and allows for microsurgery by observation of the 4K3D monitor, could replace microscopes. METHODS: We report 22 clinical cases by 5 experienced neurosurgeons and the comparative results of training 10 residents. An observation study with questionnaire survey was conducted on usability...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Daniele Bongetta, Cesare Zoia, Sabino Luzzi, Mattia Del Maestro, Andrea Peri, Germana Bichisao, Debora Sportiello, Isabella Canavero, Andrea Pietrabissa, Renato J Galzio
Bariatric surgery is gaining popularity as the treatment of choice of morbid obesity since this condition is constantly increasing over the last decades. Several complications have emerged as the number of surgeries and follow-up data increase. No systematic review of the neurosurgery-related potential complications has been performed to date. Objective of this work is to fill this gap. We reviewed the literature for bariatric surgery-related complications involving the neurosurgical practice. Moreover, we present explicative cases dealing with peri- and post-operative therapeutic precautions...
November 13, 2018: Clinical Neurology and Neurosurgery
Panagiotis Kerezoudis, Mohammed Ali Alvi, Robert J Spinner, Fredric B Meyer, Elizabeth B Habermann, Mohamad Bydon
BACKGROUND: In the modern, increasingly pay-for-performance era, unplanned ROR is gaining attention as a surgical quality metric. However, large-scale data on the appropriateness and utility of this measure in neurosurgery are scarce. OBJECTIVE: To provide a comprehensive description of all unplanned returns to the operating room (RORs) after neurosurgical procedures in a national surgical registry and identify factors associated with ROR. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program multicenter database for patients undergoing neurosurgical procedures during 2012-2016...
November 27, 2018: World Neurosurgery
Bolin Liu, Yuan Wang, Shujuan Liu, Tianzhi Zhao, Binfang Zhao, Xue Jiang, Lin Ye, Lanfu Zhao, Wenhai Lv, Yufu Zhang, Tao Zheng, Yafei Xue, Lei Chen, Long Chen, Yingxi Wu, Zhengmin Li, Jing Yan, Shasha Wang, Xude Sun, Guodong Gao, Yan Qu, Shiming He
OBJECT: The aim of this study was to evaluate the effect of preoperative oral carbohydrate loading versus fasting on the outcomes of patients undergoing elective craniotomy. METHODS: In a single-center randomized controlled study, 120 neurosurgical patients who were admitted for elective craniotomy were included and randomized into 2 groups: 58 patients received 400 mL of oral carbohydrate loading 2 h before surgery (intervention group), and 62 patients were fasting for 8 h prior to surgery as routine management (control group)...
November 17, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
(no author information available yet)
OBJECTIVECerebral vasospasm (VS) is a severe complication of aneurysmal subarachnoid hemorrhage (SAH). Urotensin II (UII) is a potent vasoactive peptide activating the urotensin (UT) receptor, potentially involved in brain vascular pathologies. The authors hypothesized that UII/UT system antagonism with the UT receptor antagonist/biased ligand urantide may be associated with post-SAH VS. The objectives of this study were 2-fold: 1) to leverage an experimental mouse model of SAH with VS in order to study the effect of urotensinergic system antagonism on neurological outcome, and 2) to investigate the association between plasma UII level and symptomatic VS after SAH in human patients...
October 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEHemifacial spasm (HFS) is characterized by involuntary tonic and/or clonic contractions of facial nerve muscles. Fully endoscopic microvascular decompression (E-MVD) for HFS has not been widely adopted. This paper aims to illustrate the safety and efficacy of the fully endoscopic technique for HFS treatment.METHODSThe authors conducted a single-center retrospective study of 27 patients (28 separate E-MVD cases; 1 patient had bilateral E-MVD) diagnosed with HFS who underwent fully E-MVD from January 2013 to October 2016...
October 1, 2018: Journal of Neurosurgery
Daniel G Eichberg, Justin K Achua, Eduardo Locatelli, Ricardo J Komotar, Ali J Ghods
BACKGROUND: Primary diffuse leptomeningeal melanomatosis (PDLM) is an extremely rare pathologic condition that can mimic several other neurologic disease states. METHODS: We report a rare case of PDLM without evidence of a primary focus. Additionally, we performed a comprehensive review of the literature to describe all previously reported cases of PDLM. RESULTS: In the presented case, making the diagnosis of PDLM was difficult. A brain and frontal dural biopsy was nondiagnostic...
November 26, 2018: World Neurosurgery
Nurperi Gazioglu, Huseyin Canaz, Mahmut Camlar, Necmettin Tanrıöver, Naci Kocer, Civan Islak, Olcay Evliyaoglu, Oya Ercan
AIM: Pituitary adenomas are rare in childhood in contrast with adults. Adrenocorticotropic hormone (ACTH)-secreting adenomas account for Cushing's disease (CD) which is the most common form of ACTH-dependent Cushing's syndrome (CS). Treatment strategies are generally based on data of adult CD patients, although some difficulties and differences exist in pediatric patients. The aim of this study is to share our experience of 10 children and adolescents with CD. PATIENTS AND METHOD: Medical records, images, and operative notes of 10 consecutive children and adolescents who underwent transsphenoidal surgery for CD between 1999 and 2014 in Cerrahpasa Faculty of Medicine were retrospectively reviewed...
November 28, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jena L Miller, Mari L Groves, Ahmet A Baschat
INTRODUCTION: Spina bifida is the most common non-lethal congenital birth defect of the central nervous system that causes chronic disability due to the combined effects of local nerve damage and the sequelae of non-communicating hydrocephalus. This abnormality can be identified early in gestation and the damage can be progressive over the course of pregnancy. Advances in fetal treatment have made minimally invasive prenatal surgery a realistic consideration for spina bifida in order to improve the outcome for children affected this condition...
November 27, 2018: Minerva Ginecologica
(no author information available yet)
OBJECTIVEThere remains uncertainty regarding the appropriate level of care and need for repeating neuroimaging among children with mild traumatic brain injury (mTBI) complicated by intracranial injury (ICI). This study's objective was to investigate physician practice patterns and decision-making processes for these patients in order to identify knowledge gaps and highlight avenues for future investigation.METHODSThe authors surveyed residents, fellows, and attending physicians from the following pediatric specialties: emergency medicine; general surgery; neurosurgery; and critical care...
October 1, 2018: Journal of Neurosurgery. Pediatrics
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
Rafael De la Garza Ramos, Michael Longo, Yaroslav Gelfand, Murray Echt, Merritt D Kinon, Reza Yassari
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To investigate the effect of timing of initiation of prophylactic anticoagulation (AC) on the incidence of venous thromboembolism (VTE) after surgery for metastatic tumors of the spine. SUMMARY OF BACKGROUND DATA: VTE is a known complication in patients undergoing surgery for metastatic spine disease. However, there is limited data on the use of prophylactic AC in this population and its impact on the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as the risk of epidural hematoma...
November 20, 2018: Spine
Shinya Ichimura, Kento Takahara, Masato Nakaya, Keisuke Yoshida, Yoichi Mochizuki, Masahito Fukuchi, Koji Fujii
The present study evaluated the safety and effectiveness of neuroendoscopic hematoma removal with a small craniotomy for the treatment of acute subdural hematoma (ASDH). Five patients (4 men and 1 woman) with ASDH underwent neuroendoscopic surgery with a small-size craniotomy between October 2016 and June 2018. The mean age was 87.4 years (range, 82-94). The eligibility criteria were as follows: 1) the presence of symptoms; 2) no moderate or massive brain contusion or edema; and 3) inability to use a large craniotomy because of poor general condition or absence of an anesthesiologist...
November 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Borys M Kwinta, Roger M Krzyżewski, Kornelia M Kliś, Marcin R Dragan, Paulina Donicz, Małgorzata Gackowska, Krzysztof Stachura, Marek Moskała
INTRODUCTION: Complications occurring after neurosurgical procedures which lead to reoperations are associated with poor treatment outcomes. The aim of our study was to establish predictive factors of unplanned early reoperations after intracranial meningioma removal. MATERIALS AND METHODS: We retrospectively analyzed 177 patients who underwent craniotomy due to an intracranial meningioma. Early reoperation was de ned as reoperation during the same hospital stay...
2018: Folia Medica Cracoviensia
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
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