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Lumbar drainage

Chen Liang, Ling Yang, Shiwen Guo
The present study aimed to compare the complications and clinical outcomes of serial lumbar puncture (LP) and lumbar cerebrospinal fluid (CSF) drainage (LD) of patients with aneurysmal subarachnoid hemorrhage and provide more evidence to guide clinical management. In this retrospective study, 41 and 39 aneurysmal subarachnoid hemorrhage patients were enrolled in the LP and LD group, respectively. Clinical outcomes, including CSF infection, intracerebral hemorrhage, vasospasm, hydrocephalus, death, length of stay, duration of drainage and the Glasgow Outcome Scale score were compared between the two groups...
July 23, 2018: Journal of Biomedical Research
Yuan Hong, Yuanjian Fang, Qun Wu, Jianmin Zhang, Yongjie Wang
INTRODUCTION: Ganglioglioma is a generally benign tumor, mostly occurring in patients <30 years old. Temporal lobe is most frequently involved. Up to now, only 3 cases were reported of ganglioglioma in the pituitary gland, all being confined to the neurohypophysis. Here, we are the first to report an adenohypophysis ganglioglioma. CASE PRESENTATION: A 43-year-old woman presented with chronic headache was referred to our hospital. Magnetic resonance imaging (MRI) indicated pituitary adenoma...
July 2018: Medicine (Baltimore)
M Hulens, R Rasschaert, W Dankaerts, I Stalmans, G Vansant, F Bruyninckx
Fibromyalgia (FM) exhibits characteristics of a neurological disorder, and similarities have been identified between FM and idiopathic intracranial hypertension (IICH). When intracranial pressure rises, the drainage of excess cerebrospinal fluid (CSF) through the subarachnoid space of the cranial and spinal nerves increases. Higher CSF pressure irritates nerve fibers inside nerve root sheaths and may consequently cause radicular pain, as was reported in patients with IICH. Moreover, the cut-off of 20-25 cm H2 0 used to define IICH may be too high, as has been suggested in patients with chronic fatigue syndrome...
September 2018: Medical Hypotheses
H-J Li, D-W Ge, S Zhang, A-J Aisikeerbayi, H Wang, Y-L He, J Bian, X-J Cao, L Yang, J-W Yan
OBJECTIVE: To compare the clinical effects, operation safety and radiation exposure of mini-open TLIF via Wiltse's approach (MOTLIF) and conventional open TLIF (COTLIF) in the treatment of single-segment lumbar degenerative disease via the prospective control study. PATIENTS AND METHODS: A total of 77 patients were enrolled from November 2012 to July 2014, including 42 patients in the mini-open group (MOTLIF) and 35 patients in the COTLIF group. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores before operation, operation time, intraoperative blood loss, postoperative drainage volume, blood transfusion rates, postoperative bedridden time, postoperative hospital stays, intraoperative fluoroscopic time, levels of serum creatine phosphokinase (CPK) before operation, 3 days and 1 week after operation, VAS scores before operation, 3 days and 1 week after operation, and ODI and VAS scores in the last follow-up between the two groups were compared...
July 2018: European Review for Medical and Pharmacological Sciences
Justin Seltzer, Michelle A Wedemeyer, Phillip A Bonney, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Incidental pituitary adenomas (IPAs) are commonly discovered during cranial imaging evaluations obtained for unrelated indications. The optimal management of IPA remains controversial. The authors investigated the outcomes and safety of the surgical treatment of IPAs at their institution. METHODS Clinical outcome data for 1692 patients surgically treated for pituitary adenomas at the Keck Medical Center of USC/USC Pituitary Center over a 17-year period (1999-2016) were reviewed to identify all cases with surgically managed IPAs...
June 1, 2018: Journal of Neurosurgery
Toshihiro Ogiwara, Alhusain Nagm, Takatoshi Hasegawa, Yoshiki Hanaoka, Shunsuke Ichinose, Tetsuya Goto, Kazuhiro Hongo
Various skull base reconstruction techniques have been developed in endoscopic endonasal approach (EEA) for skull base lesions to prevent postoperative cerebrospinal fluid (CSF) leakage. This study was performed to evaluate the efficacy and pitfalls of our method of skull base reconstruction after EEA. A total of 123 patients who underwent EEA (127 surgeries) between October 2014 and May 2017 were reviewed. Our algorithm for skull base reconstruction in EEA was categorized based on intraoperative CSF leakage graded as follows: grade 0 was excluded from this study; grade 1, dural suturing with abdominal fat graft or packing of gelatin sponge into the cavity; grade 2, method for grade 1 with addition of mucosal flap or nasoseptal flap (NSF); and grade 3, duraplasty in fascia patchwork closure with NSF...
July 7, 2018: Neurosurgical Review
Tatsuya Ohtonari, Shinzo Ota, Takahiro Himeno, Nobuharu Nishihara, Michiyoshi Sato, Akio Tanaka
OBJECTIVE: The effects of large-volume epidural blood patch (EBP) remain unclear in patients with cerebrospinal fluid (CSF) leak. We report excellent outcomes from 15 consecutive CSF leak cases that underwent a large-volume EBP using an intravenous catheter from a single lumbar entry point, together with outcomes from 4 patients who underwent direct surgical closure or drip-and-rest therapy during the same period. METHODS: Nineteen patients with idiopathic CSF leaks were enrolled in this study since November 2011 (12 women; mean age, 43...
June 30, 2018: World Neurosurgery
Theodore Delmonico, Andrew H Stephen, Daithi S Heffernan
BACKGROUND: Necrotizing soft tissue infection (NSTI) is a rapidly progressive infection characterized by tissue necrosis, septic shock, and is associated with a high risk of death. Key aspects of successful treatment include early recognition and emergent surgical source control. Necrotizing soft tissue infection may occur from a range of etiologies but may also occur rarely from gastrointestinal routes. We report a case of severe lumbar NSTI arising from an ileal pouch fistula in a patient with inflammatory bowel disease...
July 2018: Surgical Infections
Harald Hegen, Raimund Helbok, Mario Kofler, Bettina Pfausler, Alois Schiefecker, Erich Schmutzhard, Ronny Beer
BACKGROUND: Brain autoimmunity has been reported in patients with preceding infection of the central nervous system by herpesviridae. It has been hypothesized that neuronal damage releasing antigens might trigger secondary immune response. The objective of the study was to investigate whether brain damage due to spontaneous subarachnoid haemorrhage (SAH) or intracerebral haemorrhage (ICH) induces reactivity against neuronal surface proteins. METHODS: Patients with spontaneous SAH and ICH, who had cerebrospinal fluid (CSF) and serum sampling within 2 weeks after disease onset (baseline) and afterwards at least 10 days later (follow-up), were included...
June 28, 2018: BMC Neurology
Girard Cua, Neal Holland, Ashleigh Wright
BACKGROUND: Anticoagulation is the mainstay of treatment for pulmonary embolism. However, if bleeding unfortunately occurs, the risks and benefits of anticoagulation present a challenge. Management of one hemorrhagic complication, retroperitoneal hematoma, is rare, difficult, and controversial. CASE PRESENTATION: A 73-year-old white man presented with left lower extremity swelling and dyspnea. He was tachycardic, hypertensive, and demonstrated poor oxygen saturation of 81% on ambient air...
June 22, 2018: Journal of Medical Case Reports
Kai-Chuang Yang, Tejashwi Shrestha, Manish Kolakshyapati, Ling-Fei Shi, Zheng Wang, Min Li, Lin Lou, Jia Zhou
RATIONALE: Klebsiella pneumonia (K. pneumonia), primarily a hospital-acquired pathogen, can cause a variety of deep-seated infections with significant morbidities. However, in the current scenario of global rise in antibiotic abuse, unexpected infection could be caused by K. pneumoniae. PATIENT CONCERNS: A 56-year-old male who presented with intermittent headache and low fever was admitted, he had transsphenoidal surgery for pituitary adenoma 3 years ago. Routine laboratory tests revealed an elevated WBC count of 10...
June 2018: Medicine (Baltimore)
John Dickinson, Derek Kroll, Josh Bentley, Aaron J Gustin
Pseudohypoxic brain swelling (or the more recent term, postoperative intracranial hypotension-associated venous congestion) is a rare and potentially deadly complication that can occur after routine spine or brain surgery. The mechanism of this injury has been described as a rapid cerebral spinal fluid drainage leading to venous cerebral congestion. The clinical and radiographic findings mimic those found in a patient who has suffered an anoxic brain injury. We present the third reported case of postoperative intracranial hypotension-associated venous congestion following spinal surgery...
April 9, 2018: Curēus
Yasushi Motoyama, Tsukasa Nakajima, Yoshiaki Takamura, Tsutomu Nakazawa, Daisuke Wajima, Yasuhiro Takeshima, Ryosuke Matsuda, Kentaro Tamura, Shuichi Yamada, Hiroshi Yokota, Ichiro Nakagawa, Fumihiko Nishimura, Young-Su Park, Mitsutoshi Nakamura, Hiroyuki Nakase
OBJECTIVE Lumbar spinal drainage (LSD) during neurosurgery can have an important effect by facilitating a smooth procedure when needed. However, LSD is quite invasive, and the pathology of brain herniation associated with LSD has become known recently. The objective of this study was to determine the risk of postoperative brain herniation after craniotomy with LSD in neurosurgery overall. METHODS Included were 239 patients who underwent craniotomy with LSD for various types of neurological diseases between January 2007 and December 2016...
June 8, 2018: Journal of Neurosurgery
Shiyuan Shi, Xiaozhang Ying, Qi Zheng, Bo Zhu, Yanghui Jin, Jian Shen, Mingfeng Zheng, Shunping Hu
OBJECTIVE: To investigate the clinical efficacy of cortical bone trajectory screws (CBTs) in the treatment of elderly patients with lumbar spinal tuberculosis. METHODS: A total of 45 elderly patients with lumbar spinal tuberculosis were allocated to two groups based on different surgical methods: 22 patients in Group A received posterior CBT fixation combined with anterior debridement with a small incision and bone grafting, and 23 patients in Group B underwent posterior pedicle screw fixation combined with anterior debridement with a small incision and bone grafting...
June 1, 2018: World Neurosurgery
Ji Tu, Wenbin Hua, Wentian Li, Wei Liu, Rongjin Luo, Shuai Li, Yukun Zhang, Liang Kang, Kun Wang, Yu Song, Shuahua Yang, Cao Yang
The aim of the study was to evaluate the safety and short-term effects of dynamic stabilization via minimally invasive system for degenerative lumbar spinal stenosis. Patients with degenerative lumbar spinal stenosis and treated with Transforaminal Lumbar Interbody Fusion via minimally invasive minimally system (mis-TLIF) were served as the control group.From April 2011 to March 2015, 47 patients (29 male, 18 female; mean age 47.6 [range, 26-52] years) with lumbar spinal stenosis were treated with decompression and excision of herniated disk via the minimally invasive system combined with the dynamic fixation technique, and 42 patients as control group with mis-TLIF...
June 2018: Medicine (Baltimore)
Pierre-Alexis Lépine, Jean-François Naud, Philippe Boisvert
A 62-year-old man presented to the emergency department with massive hemoptysis. After bronchial artery embolization, he developed ischemic myelitis, a rare complication in this setting for which no specific therapy is currently recommended. The symptoms were managed with lumbar drainage of cerebrospinal fluid and blood pressure augmentation therapy. To our knowledge, this is the first report of using lumbar drainage of cerebrospinal fluid and blood pressure augmentation in the treatment of anterior medullary ischemia after bronchial artery embolization for massive hemoptysis...
June 1, 2018: A&A practice
Jun Peng, Yulin Zhan, Yingjie Liu, Yang Zong, Yanjie Mao
Objective: To compare the effectiveness of cortical bone trajectory screw (CBTS) and conventional pedicle screw for posterior lumbar interbody fusion (PLIF) in the treatment of single segment lumbar degenerative disease. Methods: Between May 2013 and May 2016, a total of 97 patients with single segment lumbar degenerative disease were treated with PLIF. Fifty-one patients were fixed with CBTS in PLIF (trajectory screw group) and 46 with pedicle screw (pedicle screw group)...
November 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Tao Zhang, Jianzhong Hu, Jianhuang Wu, Jinyang Liu, Shuangfei Ni, Chunyue Duan
OBJECTIVE: The aim of this study was to evaluate the clinical outcomes of one-stage posterior debridement, interbody fusion, and instrumentation, combined with irrigation and drainage, for treating lumbar spondylodiscitis. METHODS: The study included 23 patients (13 male and 10 female, mean age: 45 years) who had posterior debridement, interbody fusion, and instrumentation, followed by continuous closed irrigation and drainage for lumbar postoperative spondylodiscitis...
May 17, 2018: Acta Orthopaedica et Traumatologica Turcica
Da-Peng Duan, Zhi-Long Chen, Hong-Hai Xu, Zong-Zhi Liu
OBJECTIVE: To compare the clinical effect between the lamina osteotomy and former vertebral plates regraft method and total laminectomy and interbody fusion method in treating single-segment lumbar degenerative disease. METHODS: The clinical data of 167 patients with single-segment lumbar degenerative disease underwent surgical treatment from January 2010 to December 2014 were retrospectively analyzed. There were 92 males and 75 females, aged from 45 to 75 years old with an average of (59...
April 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
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