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Neurosurgical complications

Madelyn Batey, Jason Hecht, Cherise Callahan, Wendy Wahl
BACKGROUND: Falls are now the leading cause of trauma and represent the most common type of trauma in the elderly. The use of anticoagulants is increasing in older patients, but there are little data on outcomes after traumatic brain injury while anticoagulated with direct oral anticoagulants compared with warfarin. We hypothesized that anticoagulated patients would have a greater mortality and complications than nonanticoagulated patients, and patients on direct oral anticoagulants would have more fatal outcomes after low-level falls because of lack of reversal agents...
August 8, 2018: Surgery
Wonhyoung Park, Eun Suk Park, Seungjoo Lee, Jung Cheol Park, Jaewoo Chung, Jung Min Lee, Jae Sung Ahn
BACKGROUND: Intracranial hemorrhage, such as intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH) is an extremely rare complication after surgical revascularization for moyamoya disease (MMD). However, the incidence, timing, prognosis, possible mechanism, and prevention are not well known. METHODS: Adult patients with MMD who underwent direct bypass or combined bypass and experienced ICH, SAH, and/or IVH within 7 days postoperatively were enrolled in this study...
August 7, 2018: World Neurosurgery
Tarek Y El Ahmadieh, Cody B Wolfe, Joyce Koueik, Bradley E Weprin, Bermans J Iskandar, Angela V Price
Neuroendoscopy has demonstrated safety and efficacy in the treatment of a host of pediatric neurosurgical pathologies. With the increase in its applicability, several associated complications have been described in the literature. A common practice in pediatric neurosurgery is the use of Gelfoam sponge pledget in the burr hole, followed by bone fragments and dust (obtained from the created burr hole), to cover the dural defect. This technique is used to enhance burr hole sealing and potentially prevent CSF leakage from the surgical site...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Michael D Cearns, Samantha Hettige, Paolo De Coppi, Dominic N P Thompson
OBJECTIVE It is well established that Currarino syndrome (CS) may be associated with spinal dysraphism. Here, the authors report on 10 CS patients with dysraphic anomalies who had undergone a combined neurosurgical and general surgical approach to repair the dysraphic anomalies and resect the presacral mass in a single operation. They discuss the spectrum of spinal dysraphism that may coexist in CS in the context of its developmental etiology. METHODS Children with a confirmed CS diagnosis who had undergone the combined operative approach were identified from a departmental database...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Tetsuya Goto, Kazuhiro Hongo, Toshihiro Ogiwara, Alhusain Nagm, Jun Okamoto, Yoshihiro Muragaki, Michael Lawton, Michael McDormott, Mitchel Berger
OBJECT: Based on our previous reports, stabilizing the surgeon's arm with intraoperative armrest is linked to improve the precision of microsurgical and endoscopic procedures. We have developed the robotic intelligent surgeon's arm supporting system "iArmS", which automatically follows the surgeon's arm and fixes it at an adequate position. MATERIALS AND METHODS: The iArmS has three states ("Free", "Hold", and "Wait") which can be carefully chosen automatically as following: In "Free" state, the arm holder follows the surgeon's arm...
August 6, 2018: World Neurosurgery
Lucas Bordón, Walter Paredes, Romina Pacheco, Noé Graneros, Carina Tolosa, Gustavo Galarza, Daniel Agustín Godoy
Scorpionism is the clinical picture resulting from the inoculation of scorpion venom. It is considered a major public health problem, especially in countries with low resources and tropical or subtropical climate. Poisoning can be fatal especially in the first hours due to respiratory and / or cardiovascular collapse. The compromise of the central nervous system (CNS) is infrequent but varied and complex, being able to be triggered due to multiple and different neurotoxic properties of the toxin. We report here a severe case of poisoning with cardiovascular and neurological compromise in an endemic region of Argentina...
July 2018: Bulletin of Emergency and Trauma
Michael M Safaee, Ramin A Morshed, Jordan Spatz, Sujatha Sankaran, Mitchel S Berger, Manish K Aghi
OBJECTIVE Interfacility neurosurgical transfers to tertiary care centers are driven by a number of variables, including lack of on-site coverage, limited available technology, insurance factors, and patient preference. The authors sought to assess the timing and necessity of surgery and compared transfers to their institution from emergency departments (ED) and inpatient units at other hospitals. METHODS Adult neurosurgical patients who were transferred to a single tertiary care center were analyzed over 12 months...
August 3, 2018: Journal of Neurosurgery
Serdar Demiroz, Ismail Emre Ketenci, Hakan Serhat Yanik, Samet Bayram, Koray Ur, Sevki Erdem
STUDY DESIGN: Retrospective study. PURPOSE: This study aimed to determine the incidence of intraspinal pathologies (ISPs) in individuals with Scheuermann's kyphosis (SK) and to validate whether the routine use of magnetic resonance imaging (MRI) is necessary for preoperative evaluation. OVERVIEW OF LITERATURE: There are several studies on the necessity of routine MRI screening and prevalence of ISPs related to different types of scoliosis have been conducted...
August 2018: Asian Spine Journal
Piotr Kaźmierski, Mirosław Wąsiewicz, Jarosław Chrząstek, Michał Pająk
BACKGROUND: Iatrogenic vascular injuries, due to the particular nature of such pathology, are associated with high morbidity and mortality in the postoperative period. OBJECTIVES: The objective of this study was to present a case of non-classic approach to the therapy of iatrogenic arteriovenous fistula. MATERIAL AND METHODS: We present a case of a 17-year old female patient admitted to the Department of Vascular, General and Oncologic Surgery (Copernicus Memorial Hospital, Łódź, Poland) due to an iatrogenic injury to the common iliac vein and artery, following neurosurgical intervention on the spine...
July 30, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Mustafa Aziz Hatiboglu, Kerime Akdur, Raymond Sawaya
Brain metastasis is a serious complication in patients with systemic cancer. The main goal of the treatment in patients with brain metastasis is to control the disease in the brain, to prevent death from neurological disease and provide a satisfactory quality of life. Management of a patient with brain metastasis is important and sometimes demanding, and several factors such as tumor histology, status of primary disease, number of brain lesions, size of lesions, and performance status may influence the decision making process...
July 29, 2018: Neurosurgical Review
Bruno Dohin
The hip is the joint most exposed to orthopaedic complications in cerebral palsy (CP) which is the main cause of spasticity in paediatric patients. The initial immaturity of the hip allows the forces applied by the spastic and retracted muscles to displace the femoral head, eventually causing it to dislocate. The risk of hip dislocation increases with the severity and extent of CP, exceeding 70% in the most severe cases. Hip dislocation causes pain in up to 30% of cases, carries a risk of orthopaedic and cutaneous complications, and hinders patient installation and nursing care...
July 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Joshua Bakhsheshian, Li Ding, Austin Tang, Tim Wen, Arati Patel, Ben A Strickland, Robert Rennert, Arun Amar, Peter Gruen, Steven Giannotta, William Mack, Frank Attenello
BACKGROUND: Clinical outcomes in the surgical management of severe traumatic brain injury (TBI) have been shown to vary across different hospital institutions. The impact of safety-net burden on postoperative mortality, complication rates and failure to rescue (FTR) rates is unclear. OBJECTIVE: We sought to evaluate the relationship of safety-net burden with outcomes in the management of severe TBI patients undergoing neurosurgery. METHOD: Hospitals were grouped according to their safety-net burden, defined as the proportion of Medicaid and uninsured patient charges for all hospitalizations during that time...
July 25, 2018: World Neurosurgery
Christian Lopez Ramos, Michael G Brandel, Robert C Rennert, Arvin R Wali, Jeffrey A Steinberg, David R Santiago-Dieppa, Brittany N Burton, Jeffrey S Pannell, Scott E Olson, Alexander A Khalessi
BACKGROUND: Hospital readmission is a key surgical quality metric associated with financial penalties and higher healthcare costs. We examined clinical risk factors and postoperative complications associated with 30-day unplanned hospital readmissions after cranial neurosurgery. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database from 2011-2016 for adult patients that underwent a cranial neurosurgical procedure...
July 24, 2018: World Neurosurgery
Simone Bianca Schmidt, Melanie Boltzmann, Jens Dieter Rollnik
BACKGROUND: Most disorders in neurological and neurosurgical early rehabilitation (NNER) are associated with an increased pneumonia risk. Respiratory therapy aims to prevent respiratory complications. However, there are no studies showing an effect of respiratory muscle training on the incidence of pneumonia in NNER. METHOD: The study included 81 phase-B-patients receiving respiratory muscle training and 81 control patients. Routine data such as age, sex, diagnoses, and comorbidities, length of stay, information on ventilation and incidence of pneumonia were analyzed retrospectively...
July 26, 2018: Die Rehabilitation
Olufolahan Carrena, Oluchukwu Oluoha, Amr Wahba, Derek Eshun, Maria Endsley, Henry Okafor
Introduction: The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain. Case summary: A 61-year-old man was admitted with a 2-month history of hemoptysis, pleuritic chest pain, and right upper extremity numbness and weakness. He was found to have multifocal bilateral pulmonary opacities and an abscess collection in the brain...
2018: Case Reports in Cardiology
Hecheng Ren, Long Yin, Lin Ma, Ming Wei, Xiaodong Ma
Postoperative epidural hematoma (POEDH) is a known complication after neurosurgical procedures. Large POEDHs are life-threatening and require emergency evacuation, and open surgery is the mainstay of treatment. Most of POEDHs are hyperdense on computed tomography (CT). We herein report a subset of POEDHs requiring evacuation, which presented with isodense features on CT. The presenting symptoms of patients were severe headache accompanied by nausea and vomiting as well as unilateral limb weakness (n = 1) and consciousness disorder (n = 4)...
July 2018: Medicine (Baltimore)
Kiran Jangra, Kamlesh Kumari, Nidhi B Panda, Navneh Samagh, Ankur Luthra
Postoperative nausea and vomiting (PONV) is a significant complication for neurosurgical patients. PONV affects patient satisfaction, prolongs hospital stay, and increases the economic burden and morbidity. In addition to these problems, there are certain consequences of PONV specific to the craniotomy, including increased intracranial pressure and increased risk of tumor bed hematoma formation. Expert panels have suggested that, if the consequences of PONV are deleterious to the patients, then prophylaxis should be instituted...
July 2018: Neurology India
Alexander Kulikov, Federico Bilotta, Beatrice Borsellino, Denis Sel'kov, Grigory Kobyakov, Andrey Lubnin
BACKGROUND: The asleep-awake-asleep (AAA) craniotomy is a technique that offers the opportunity of having a patient fully cooperative during the awake phase, and minimizes the possible discomfort, due to the asleep phase. The aim of this prospective observational case series, is to test the use of Xenon in the first asleep phase of an AAA craniotomy, in patients undergoing craniotomy for brain tumor resection. METHODS: The data have been collected from 40 awake craniotomy procedures, performed in patients with cerebral tumor, treated with the AAA technique...
July 20, 2018: Minerva Anestesiologica
Alexander Fletcher-Sandersjöö, Eric Peter Thelin, Jiri Bartek, Mikael Broman, Marko Sallisalmi, Adrian Elmi-Terander, Bo-Michael Bellander
Background: Intracranial hemorrhage (ICH) is a common complication in adults treated with extracorporeal membrane oxygenation (ECMO). Objectives: The aim of this study was to conduct a systematic review of the literature on the incidence, outcome and predictors of ECMO-associated ICH in adult patients, supplemented by a narrative review of its pathophysiology, management and future perspectives. Methods: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews and were systematically searched...
2018: Frontiers in Neurology
Bartosz Polis, Lech Polis, Krzysztof Zeman, Jarosław Paśnik, Emilia Nowosławska
PURPOSE: The aim of the article is to describe an immunological reaction to shunt infection in children with hydrocephalus. The main cause of shunt infection involves methicillin resistant Staphylococcus epidermidis (Bhatia et al. Indian J Med Microbiol 35:120-123, 2017; Hayhurst et al. Childs Nerv Syst 24:557-562, 2008; Martínez-Lage et al. Childs Nerv Syst 26: 1795-1798, 2010; Simon et al. PLoS One, 2014; Snowden et al. PLoS One 8:e84089, 2013; Turgut et al. Pediatr Neurosurg 41:131-136, 2005), a bacterial strain which is responsible for the formation of biofilm on contaminated catheters (Snowden et al...
July 21, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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