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https://www.readbyqxmd.com/read/29333566/principles-of-management-of-central-nervous-system-infections
#1
REVIEW
Sunit Singhi, Suresh Kumar Angurana
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities...
January 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29325955/endovascular-patch-embolization-for-blood-blister-like-aneurysms-in-the-dorsal-segment-of-the-internal-carotid-artery
#2
Xudong Hao, Guilin Li, Jian Ren, Jingwei Li, Chuan He, Hong-Qi Zhang
OBJECTIVE: Blood blister-like aneurysms (BBAs) in the dorsal segment of the internal carotid artery (ICA) are fragile and difficult to treat, and the optimal treatment for BBAs is still controversial. We report clinical and angiographic results with procedural details for the treatment of BBA by using the endovascular patch embolization method. METHODS: We retrospectively reviewed patients who presented with subarachnoid hemorrhage(SAH) caused by ICA-BBAs and were treated with the endovascular patch embolization method in our center from October 2011 to March 2015...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325312/-outcomes-of-alternative-donor-allogeneic-hematopoietic-stem-cell-transplantation-for-fanconi-anemia-a-five-cases-report
#3
W J Wang, Y Q Sun, F F Tang, T T Han, X D Mo, J Z Wang, X H Zhang, X J Huang, L P Xu
Five patients with Fanconi anemia who received hematopoietic cell transplantation were retrospectively analyzed. The conditioning regimens included fludarabine, cyclophosphamide and anti-thymocyte globulin. Two patients received both bone marrow and peripheral blood stem cells as the source of stem cell grafts from haploidentical matched related donors, while the others received peripheral blood stem cells from unrelated donors. All patients tolerated well and reached hematopoietic reconstitution. One patient died of intracranial infection...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29307925/magnetic-resonance-imaging-findings-in-central-nervous-system-cryptococcosis-comparison-between-immunocompetent-and-immunocompromised-patients
#4
Stenio Bruno Leal Duarte, Mariana Mari Oshima, João Vitor do Amaral Mesquita, Felipe Barjud Pereira do Nascimento, Paula Christina de Azevedo, Fabiano Reis
Objective: To assess the magnetic resonance imaging (MRI) patterns associated with central nervous system infection with Cryptococcus sp. in relation to patient immune status. Materials and Methods: This was a retrospective study of MRI data for 19 patients with neurocryptococcosis who underwent the examination between January 2000 and March 2014. The MRI characteristics examined included lesion topography, aspects of diffusion, T1-weighted images, T2-weighted images, and contrast enhancement patterns...
November 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/29307127/a-case-of-canine-neurological-leishmaniasis
#5
Rosanna Zobba, Maria Antonietta Evangelisti, Maria Lucia Manunta, Alberto Alberti
In this study we describe a case of neurological leishmaniasis in a dog, reported in an endemic area, with signs of multifocal intracranial lesions involving the vestibular system and the cerebellum. Serum biochemistry revealed a decrease of albumin-globulin ratio caused by an increase of alfa2-, beta-, and gamma- globulin, while antibody titers were highly positive for Leishmania spp. Magnetic resonance images of the brain were consistent with a granulomatous in ammation/infection. Cerebrospinal uid revealed a marked mononuclear pleocytosis and was positive to the Pandy Test, as well as to a Leishmania spp...
December 29, 2017: Veterinaria Italiana
https://www.readbyqxmd.com/read/29305711/early-management-of-retained-hemothorax-in-blunt-head-and-chest-trauma
#6
Fong-Dee Huang, Wen-Bin Yeh, Sheng-Shih Chen, Yuan-Yuarn Liu, I-Yin Lu, Yi-Pin Chou, Tzu-Chin Wu
BACKGROUND: Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. MATERIALS AND METHODS: From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled...
January 5, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29305439/optic-nerve-head-edema-among-patients-presenting-to-the-emergency-department
#7
Virender Sachdeva, Caroline Vasseneix, Rabih Hage, Samuel Bidot, Lindsay C Clough, David W Wright, Nancy J Newman, Valérie Biousse, Beau B Bruce
OBJECTIVE: To determine the frequency of and predictive factors for optic nerve head edema (ONHE) among patients with headache, neurologic deficit, visual loss, or elevated blood pressure in the emergency department (ED). METHODS: Cross-sectional analysis was done of patients with ONHE in the prospective Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Demographics, neuroimaging results, management, and patient disposition were collected...
January 5, 2018: Neurology
https://www.readbyqxmd.com/read/29304787/factors-associated-with-prolonged-length-of-stay-for-elective-hepatobiliary-and-neurosurgery-patients-a-retrospective-medical-record-review
#8
Siu Yin Lee, Soo-Hoon Lee, Jenny H H Tan, Howard S L Foo, Phillip H Phan, Alfred W C Kow, Sein Lwin, Penelope M Y Seah, Siti Zubaidah Mordiffi
BACKGROUND: Patients with prolonged length of hospital stay (LOS) not only increase their risks of nosocomial infections but also deny other patients access to inpatient care. Hepatobiliary (HPB) malignancies have some of highest incidences in East and Southeast Asia and the management of patients undergoing HPB surgeries have yet to be standardized. With improved neurosurgery techniques for intracranial aneurysms and tumors, neurosurgeries (NS) can be expected to increase. Elective surgeries account for far more operations than emergencies surgeries...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29303458/complications-following-intracranial-pressure-monitoring-in-children-a-6-year-single-center-experience
#9
Ruichong Ma, David Rowland, Andrew Judge, Amedeo Calisto, Jayaratnam Jayamohan, David Johnson, Peter Richards, Shailendra Magdum, Steven Wall
OBJECTIVE Intracranial pressure (ICP) monitoring is an important tool in the neurosurgeon's armamentarium and is used for a wide range of indications. There are many different ICP monitors available, of which fiber-optic intraparenchymal devices are very popular. Here, the authors document their experience performing ICP monitoring from 2005 to 2015 and specifically complication rates following insertion of the Microsensor ICP monitor. METHODS A retrospective case series review of all patients who underwent ICP monitoring over a 10-year period from 2005 to 2015 was performed...
January 5, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29303450/subcutaneous-bone-flap-storage-after-emergency-craniectomy-cost-effectiveness-and-rate-of-resorption
#10
Griffin Ernst, Fares Qeadan, Andrew P Carlson
OBJECTIVE Decompressive craniectomy is used for uncontrolled intracranial pressure in traumatic brain injury and malignant hemispheric stroke. Subcutaneous preservation of the autologous bone flap in the abdomen is a simple, portable technique but has largely been abandoned due to perceived concerns of resorption. The authors sought to characterize their experience with subcutaneous preservation of the bone flap and cranioplasty. METHODS The authors performed a retrospective single-institution review of subcutaneous preservation of the autologous bone flap after decompressive craniectomy from 2005 to 2015...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29295798/pneumocephalus-after-epidural-injection
#11
Jerel Chacko, Kelly Levis, Barry Hahn
BACKGROUND: Pneumocephalus, or air in the intracranial space, is most commonly encountered after trauma or surgery. Epidural injections are commonly performed in obstetrics and pain management. Complications are uncommon and include hemorrhage, cerebrospinal fluid leak, and infection. A rare complication is pneumocephalus, described in only a few case reports of epidural anesthesia. CASE REPORT: We describe a 34-year-old woman complaining of a generalized headache 6 days after an unremarkable vaginal delivery that was assisted by an epidural injection...
December 30, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29287887/infection-rates-of-mrsa-in-complicated-pediatric-rhinosinusitis-an-up-to-date-review
#12
Chelsea S Hamill, Kevin J Sykes, Christopher J Harrison, Robert A Weatherly
INTRODUCTION: Published studies have reported a rise in MRSA isolates in head and neck infections, but the microbiology of complicated pediatric rhinosinusitis is unclear. One study of such patients showed that MRSA isolates were seen only in the last three years of data collection, suggesting a possible recent increased prevalence. Given the public health concerns of increasing rates of antimicrobial resistance, the goal of this study was to investigate the microbiologic patterns and outcomes of complicated pediatric rhinosinusitis...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29283154/idiopathic-intracranial-hypertension-associated-with-anaemia-secondary-to-antiretroviral-drug-in-a-human-immunodeficiency-virus-positive-patient
#13
J Vijay Ananth, S Sudharshan, Ambika Selvakumar, Bella J Devaleenal, Kavitha Kalaivani, Jyotirmay Biswas
Papilledema in a patient with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome is an alarming finding. Any condition giving rise to raised intracranial tension (ICT) can cause papilledema, and in these patients, it could be secondary to opportunistic infections like meningitis to neoplasm. We report a case of a 28-year old female with HIV on antiretroviral therapy, who presented to us, with papilledema. Her fundus examination revealed superficial hemorrhages and Roth's spots along with papilledema...
January 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29282627/association-between-splenic-contraction-and-the-systemic-inflammatory-response-after-acute-ischemic-stroke-varies-with-age-and-race
#14
Alicia Zha, Farhaan Vahidy, Jaskaren Randhawa, Kaushik Parsha, Thanh Bui, Jaroslaw Aronowski, Sean I Savitz
Animal models have demonstrated the deleterious contribution of splenic immunocytes on secondary brain injury after stroke. While previous work has demonstrated splenic contraction (SC) in patients with acute ischemic stroke (AIS) and intracranial hemorrhage (ICH), no clinical studies have examined the relationship between the systemic inflammatory response syndrome (SIRS) with SC in stroke patients. This is a retrospective analysis of a previous prospective observational study where daily spleen sizes were evaluated in 178 acute stroke patients...
December 27, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/29279795/primary-intracranial-leiomyosarcoma-presenting-with-massive-peritumoral-edema-and-mass-effect-case-report-and-literature-review
#15
Sachidanand Gautam, Rajesh K Meena
Background: Primary intracranial leiomyosarcomas (LMSs) are unusual tumors of the central nervous system (CNS) affecting all age groups, and are recently, becoming more prevalent in immunosuppressive conditions such as in patients with human immunodeficiency virus (HIV) infection. However, only a few CNS LMS case reports exist in the English literature, on the occurrence of this rare entity in immunocompetent adults. Even, rarer is a purely intraparenchymal occurrence without any dural attachment in afflicted individuals...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29273384/surgical-technique
#16
REVIEW
Marc Guénot, Axel Lebas, Bertrand Devaux, Sophie Colnat-Coulbois, Georg Dorfmuller, Aileen McGonigal, Nicolas Reyns, Vianney Gilard, Stéphane Derrey, Jean-Christophe Sol, Stéphane Clémenceau
In SEEG, as for any surgical procedure, the benefit/risk ratio is a key-point. This implies rigorous clinical practice in terms of indication, information delivered to the patient, and surgical technique. Numerous technical options may be used to achieve this goal. All are valuable, as long as they are executed with rigor and consistency. Intracranial bleeding represents the main risk of the procedure (1-4% of cases). The procedure also carries a risk of infection (0.8%), death (total of 6 reported cases in all the literature, <0...
December 19, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29259863/expanded-dengue-syndrome-in-secondary-dengue-infection-a-case-of-biopsy-proven-rhabdomyolysis-induced-acute-kidney-injury-with-intracranial-and-intraorbital-bleeds
#17
Ghazal Tansir, Chhavi Gupta, Shubham Mehta, Prabhat Kumar, Manish Soneja, Ashutosh Biswas
Dengue fever is endemic in the Indian subcontinent and can have myriad presentations. The term expanded dengue syndrome (EDS) is used for atypical manifestations in dengue fever. We present a rare case of EDS in a patient with secondary dengue infection who developed rhabdomyolysis induced acute kidney injury (RAKI) along with intracranial and intraorbital bleeds. Patient was successfully managed in our institute and was discharged in stable condition. To the best of our knowledge, this is the only reported case of simultaneous occurrence of these complications in a dengue patient...
November 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/29258938/a-prospective-study-of-neuroendoscopy-versus-microscopy-213-cases-of-microvascular-decompression-for-trigeminal-neuralgia-performed-by-one-neurosurgeon
#18
Hui Xiang, Guangyong Wu, Jia Ouyang, Ruen Liu
OBJECTIVE: To compare the efficacy and complications of microvascular decompression (MVD) by complete neuroendoscopy versus microscopy for 213 cases of trigeminal neuralgia (TN). METHODS: Between January 2014 and January 2016, 213 patients with TN were randomly assigned to the neuroendoscopy (n = 105) or microscopy (n = 114) group for MVD via the sub-occipital retrosigmoid approach. All procedures were performed by the same neurosurgeon. Follow-up was conducted by telephone interview...
December 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29251339/-extramedullary-intradural-tuberculosis-a-case-report-and-review-of-the-literature
#19
D Quispe, M Alvarado, D Rivas, I Gonzales
INTRODUCTION: Central nervous system tuberculosis is a common chronic infection in developing countries, being the most frequent forms: tuberculous meningitis and intracranial tuberculosis. Extramedullary intradural tuberculosis is a rare entity with few cases described in the world literature, and is usually associated with a history of tuberculous meningitis or during antituberculosis treatment. CASE REPORT: A 17 years-old male patient, without history of tuberculosis, with subacute onset and progressive course of compressive myelopathy...
January 1, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29250759/orbital-cellulitis-presenting-as-giant-cell-arteritis-a-case-report
#20
Yu-Wei Hsu, Fu-Chi Yang, Jiunn-Tay Lee, Hung-Wen Kao, Chia-Kuang Tsai
PURPOSE: To present a case of orbital cellulitis initially mimicking giant cell arteritis. CASE REPORT: An 80-year-old man with a history of hypertension and type 2 diabetes mellitus was referred with a prominent progressive headache over the right temporal and periorbital areas. Non-contrast brain CT results were normal, but ESR was elevated. Giant cell arteritis was suspected initially. However, the symptoms progressed under oral corticosteroid therapy. The subsequent brain MRI with contrast revealed extensive contrast enhancement along the right optic nerve and optic canal with a rim-enhancing lesion in the posterior aspect of the optic nerve...
June 15, 2017: Acta Neurologica Taiwanica
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