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postoperative meningitis

Ziquan Li, Chengxian Yang, Xinjie Bao, Yong Yao, Ming Feng, Kan Deng, Xiaohai Liu, Bing Xing, Renzhi Wang
RATIONALE: The transsphenoidal surgical (TS) approach to sellar masses is the preferred surgical route in most cases. Secondary pituitary abscess (PA) following TS is an extremely rare but serious postoperative complication with potentially high disability and mortality. PATIENT CONCERNS: We describe an uncommon case of secondary PA in a 42-year-old woman, who underwent uncomplicated transsphenoidal procedures without cerebrospinal fluid leak, to treat primary Rathke cleft cyst...
November 2018: Medicine (Baltimore)
Kohei Tsuchimochi, Takato Morioka, Nobuya Murakami, Fumiya Yamashita, Nobuko Kawamura
BACKGROUND: Multiple spinal extradural meningeal cysts (SEMCs) are rare lesions. SEMCs communicate with the subarachnoid space through multiple dural defects and expand into the extradural space with progressive spinal cord compression. CASE PRESENTATION: We report a 5-month-old boy with hydronephrosis involving nine huge SEMCs that were distributed from the T1-L5 levels. Eight SEMCs, except for one small noncommunicating cyst, were exposed through laminoplastic laminotomy at the T10-L5 and T3-5 levels...
November 23, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Priyanka Misale, Anjali Lepcha
To report a series of adult patients diagnosed with congenital cholesteatoma (CC) with respect to symptoms, different varieties of presentation, surgical findings and approach used, complications and the postoperative results. A retrospective chart review of adult cases of CC who were treated in the period from January 2014-2017 was carried out in a tertiary care center. Levenson's criteria were used for diagnosis. Diagnosis was confirmed by imaging and intraoperatively. Postoperative results and complications were also analyzed...
December 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Kenny F Lin, Claire R Stewart, Philip E Steig, Cameron W Brennan, Philip H Gutin, Samuel H Selesnick
Objectives  To determine the incidence of prolonged postoperative systemic corticosteroid therapy after surgery for acoustic neuroma as well as the indications and associated risk factors that could lead to prolonged steroid administration, and the incidence of steroid-related adverse effects. Study Designs  Retrospective chart review. Methods  Retrospective chart review of patients undergoing resection of acoustic neuroma between 2010 and 2017 at two tertiary care medical centers. Patient and tumor characteristics, operative approach, hospital length of stay, initial postoperative taper length, number of discrete postoperative steroid courses, and postoperative complications were analyzed...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Victoria Chu, Diane M Carpenter, Kathleen Winter, Kathleen Harriman, Carol Glaser
In a case-control study within the Kaiser Permanente Northern California adult population, prior head or spine surgery (H/SS) was associated with increased Streptococcus pneumoniae meningitis outside of the postoperative period (no prior H/SS, odds ratio 6.0, 95% CI 1.9-18.6). Among the cases, only 33.3% had received any prior pneumococcal vaccinations.
November 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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
B Z Chel'diev, Yu V Kushel', M O Demin
Treatment of primary malignant neuroepithelial tumors of the posterior cranial fossa (PCF) in childhood includes surgical resection, radiation therapy (RT), and chemotherapy (CT). The radicalness of surgery is one of the most important prognostic factors of survival. Despite the significant advances in treatment, many of these tumors recur. Today, oncologists are increasingly recommending repeated surgery for recurrent malignant neuroepithelial tumors of the PCF to achieve gross total resection (GTR). Patients undergo this surgery after RT and palliative CT, which may increase surgical risks...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
O I Sharipov, M A Kutin, G A Polev, P L Kalinin
Meningoencephalocele is a hernial protrusion of the medulla and meninges through a defect in the skull bones. Due to poor accessibility of meningoencephalocele located in the lateral sphenoid recess region, modern surgical treatment of this pathology prefers to use endoscopic transsphenoidal approaches. MATERIAL AND METHODS: The study included 4 patients with meningoencephalocele of the lateral recess of the sphenoid sinus (1 male and 3 females; mean age, 46.8 years). All patients underwent resection of meningoencephalocele and repair of a skull base defect using the lateral extended transsphenoidal endoscopic approach through the pterygopalatine fossa (transpterygoid approach)...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Yu V Kushel', G V Danilov, A R Tekoev, B Z Chel'diev, Yu V Strunina
Wound liquorrhea is a serious and dangerous complication developing after neurosurgical interventions. The highest risk group includes patients operated on using approaches to the skull base. In pediatric neurosurgery, approaches to the posterior cranial fossa are some of the most common ones, with wound liquorrhea amounting to 33%. Studies devoted to the wound liquorrhea problem have been performed in heterogeneous patient groups, which complicates evaluation of the results and reduces their practical value...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Chuhua Fu, Ning Wang, Bo Chen, Pingli Wang, Huayun Chen, Wangwang Liu, Lijun Liu
OBJECTIVE: To date, no standard surgical procedure has been proven effective for intracerebral haemorrhage, particularly deep haematomas. This retrospective study evaluated the effectiveness and safety of endoscopic surgery, minimally invasive puncture and drainage, and craniotomy for treating moderate basal ganglia intracerebral haemorrhage. METHODS: A total of 177 patients with basal ganglia intracerebral haemorrhage were divided into 3 groups based on the therapeutic intervention as follows: endoscopic surgery group (n=61), minimally invasive puncture and drainage group (n=60), and craniotomy group (n=56)...
November 4, 2018: World Neurosurgery
Patricia Ojeda, Derek Khorsand, Mazen Zawaideh, Orpheus Kolokythas
We present a case of an iatrogenic rectothecal fistula in a 34-year-old man who underwent repair of a congenital anterior sacral meningocele, intraoperatively complicated by rectal perforation. Postoperatively, the patient developed symptoms of meningitis prompting concern for the cerebrospinal fluid leak. Subsequent workup with computed tomography (CT) and magnetic resonance imaging demonstrated a postoperative pseudomeningocele and fistulization with an abdominal fluid collection. CT myelography confirmed the fistulous connection was between the pseudomeningocele and the rectum...
January 2019: Radiology Case Reports
Yan Cai, Le Zhou, Huqing Wang, Li Zhang, Jinqiu Wang, Kanghuai Zhang
WHAT IS KNOWN AND OBJECTIVE: To compare the penetration of vancomycin into cerebrospinal fluid (CSF) in patients with postoperative intracranial infection and community-acquired meningitis, and to identify related factors influencing the penetration in these two diseases. METHODS: The concentrations of vancomycin in serum and CSF were determined by enzyme amplified immunoassay, and the CSF-to-serum ratios were calculated. The correlation between CSF-to-serum ratios of vancomycin and CSF elements was analyzed...
October 27, 2018: Journal of Clinical Pharmacy and Therapeutics
Sarah Bin Abdulqader, Ziyad Al-Ajlan, Abdulrahman Albakr, Wisam Issawi, Mohammed Al-Bar, Pablo F Recinos, Saad Alsaleh, Abdulrazag Ajlan
PURPOSE: Optic pathway gliomas (OPGs) are low-grade neoplasms that primarily affect children. The management of OPGs remains controversial. Reports on the use of the endoscopic endonasal approach (EEA) in OPGs are extremely limited, and no such reports exist on its utility for pediatric OPGs. Here, we report our results and experience with OPGs treated with the EEA. METHODS: We retrospectively reviewed the medical records of OPG patients who were treated surgically via the EEA at our institutions from 2015 to 2017...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Taku Nonaka, Tatsuya Ishikawa, Koji Yamaguchi, Takayuki Yasuda, Yoshihiro Omura, Mieko Oka, Takakazu Kawamata
The occurrence of cerebral vasospasm secondary to bacterial meningitis is relatively rare. Furthermore, there is no specific treatment cerebral vasospasm. Endovascular treatment may be essential for cases with the advanced clinical course. Balloon angioplasty or intra-arterial injection of verapamil, nicardipine, or nitroglycerin has been previously reported. We experienced successful treatment using intra-arterial infusion of fasudil hydrochloride. To our knowledge, this is the first case to report the intra-arterial injection of fasudil hydrochloride for treating cerebral vasospasm secondary to bacterial meningitis...
October 2018: NMC Case Report Journal
Achraf Sayed-Hassan, Ruben Hermann, Frédéric Chidiac, Eric Truy, Nicolas Guevara, Sonanda Bailleux, Olivier Deguine, Blandine Baladi, Yohan Gallois, Alexis Bozorg-Grayeli, Yannick Lerosey, Benoit Godey, Cécile Parietti-Winkler, Bruno Pereira, Thierry Mom
Importance: Infection after cochlear implantation is a rare but serious event that can lead to meningitis. There is no consensus on prevention of infection in these patients, and each center applies its own strategy. Objective: To describe the rates of major surgical site infection for patients undergoing cochlear implantation who receive prolonged antibiotic treatment compared with those who receive a single perioperative dose of antibiotic prophylaxis. Design, Setting, and Participants: Retrospective cohort study of patients who underwent cochlear implantation between January 1, 2011, and July 8, 2015, with a postoperative follow-up of 1 to 3 years...
October 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
Stephanie H Chen, Annelise Sprau, Leon Chieng, Simon Buttrick, Elie S Alam, Sheikh C Ali, Karthik Madhavan, Zoukaa B Sargi, Ricardo Komotar
INTRODUCTION: With a rapidly expanding elderly population in the United States, the incidence of pituitary adenomas in elderly will continue to rise. In this study, we aim to evaluate the safety and efficacy of transsphenoidal endoscopic endonasal resection for pituitary adenomas in the elderly population. METHODS: A retrospective review of 131 consecutive patients who underwent transsphenoidal endoscopic endonasal resection for pituitary adenomas at the University of Miami Hospital between 2012 and 2016 was performed...
October 5, 2018: World Neurosurgery
Alexey N Shkarubo, Konstantin V Koval, Ilia V Chernov, Dmitry N Andreev, Andrey A Panteleyev
INTRODUCTION: With the introduction into the neurosurgical practice of minimally invasive methods using endoscopic techniques, it became possible to effectively remove hard-to-reach tumors, including central tumors of the anterior region of the posterior cranial fossa. OBJECTIVE: To analyze the results of surgical treatment of patients with various centrally located tumors of the base of the skull that extend into the anterior region of the posterior cranial fossa using the endoscopic endonasal transclival approach...
September 24, 2018: World Neurosurgery
Eduardo M Marchan, Jennifer Peterson, Terence T Sio, Kaisorn L Chaichana, Anna C Harrell, Henry Ruiz-Garcia, Anita Mahajan, Paul D Brown, Daniel M Trifiletti
During the past decade, tumor bed stereotactic radiosurgery (SRS) after surgical resection has been increasingly utilized in the management of brain metastases. SRS has risen as an alternative to adjuvant whole brain radiation therapy (WBRT), which has been shown in several studies to be associated with increased neurotoxicity. Multiple recent articles have shown favorable local control rates compared to those of WBRT. Specifically, improvements in local control can be achieved by adding a 2 mm margin around the resection cavity...
2018: Frontiers in Oncology
Jaskaran Singh Gosal, Sanjay Behari, Jeena Joseph, Awadhesh K Jaiswal, Jayesh C Sardhara, Mohammad Iqbal, Anant Mehrotra, Arun K Srivastava
Introduction: Petroclival meningiomas are based on or arising from the petro-clival junction in upper two-thirds of clivus, medial to the fifth cranial nerve. This study focuses on the surgical experience in resecting large-giant tumors >3.5 in size predominantly utilizing middle fossa approaches. Material and Methods: 33 patients with a large or a giant petroclival meningioma (size >3.5 cm) were included. Clinical features, preoperative radiological details, operative findings, and postoperative clinical course at the follow-up visit were reviewed...
September 2018: Neurology India
Masahiro Toda, Kenzo Kosugi, Hiroyuki Ozawa, Kaoru Ogawa, Kazunari Yoshida
Objective  The main purpose of this article is to assess the effectiveness and safety of surgery via the endoscopic endonasal approach (EEA) for cavernous sinus (CS) lesion in patients with nonfunctioning pituitary adenomas (NFPA). Design  Retrospective study. Setting  Keio University Hospital. Participants  Thirty patients who underwent CS surgery via the EEA between 2009 and 2017 for Knosp grade 4 NFPA with pre- and postoperative magnetic resonance imaging available for volumetric analysis. Main Outcome Measures  Clinical presentation, extent of resection, and surgical complications...
October 2018: Journal of Neurological Surgery. Part B, Skull Base
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