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Eveline Teresa Hidalgo, Yosef Dastagirzada, Cordelia Orillac, Svetlana Kvint, Emily North, Ramona Bledea, Michelle W McQuinn, Gabriel Redel-Traub, Crystalann Rodriguez, Jeffrey H Wisoff
OBJECTIVE: Duraplasty is one technique successfully used to treat Chiari malformation type I (CM-I). This study describes the timely manner of clinical outcomes and the postoperative course after craniectomy and duraplasty for the treatment of symptomatic CM-I in pediatric children. METHODS: A retrospective chart review was done on 105 consecutive children who underwent surgical decompression of symptomatic CM-I with dural opening by a single surgeon between 1999 and 2015...
June 19, 2018: World Neurosurgery
Orgest Lajthia, Jerry W Chao, Max Mandelbaum, John S Myseros, Chima Oluigbo, Suresh N Magge, Christopher S Zarella, Albert K Oh, Gary F Rogers, Robert F Keating
OBJECTIVE Intracranial empyema is a life-threatening condition associated with a high mortality rate and residual deleterious neurological effects if not diagnosed and managed promptly. The authors present their institutional experience with immediate reimplantation of the craniotomy flap and clarify the success of this method in terms of cranial integrity, risk of recurrent infection, and need for secondary procedures. METHODS A retrospective analysis of patients admitted for management of intracranial empyema during a 19-year period (1997-2016) identified 33 patients who underwent emergency drainage and decompression with a follow-up duration longer than 6 months, 23 of whom received immediate bone replacement...
June 22, 2018: Journal of Neurosurgery. Pediatrics
Cecilia L Dalle Ore, Peter Abraham, Luke P Burns, Samuel Lance, Amanda Gosman, Hal S Meltzer
Reconstructive cranioplasty can be associated with many complications and add to the not insignificant potential risks associated with decompressive craniectomy. In the setting of post-traumatic hydrocephalus, treatment with a ventriculoperitoneal (VP) shunt prior to reconstructive cranioplasty likely increases these risks even further. The authors report a case of a 17-year-old male with a history of a severe closed head injury who initially suffered a life-threatening complication associated with intracranial hypotension after cranioplasty only to succumb to malignant intracranial hypertension following a second cranioplasty attempt...
June 20, 2018: Journal of Craniofacial Surgery
Monique M Montenegro, Jeremy K Cutsforth-Gregory
OBJECTIVE: To review the clinical and radiographic characteristics of orthostatic headache following suboccipital craniectomy without CSF leak after encountering 2 such patients. BACKGROUND: Orthostatic headache may occur without CSF leak, suggesting alternative mechanisms for postural head pain in some patients. METHODS: Patients who were referred for orthostatic headache and suspected CSF leak within 1 year after suboccipital craniectomy but who had negative post-operative head and spine MRI, normal radioisotope cisternography, and normal or elevated CSF opening pressure were identified and their medical records reviewed...
June 19, 2018: Headache
Jesús A Morales-Gómez, Everardo Garcia-Estrada, Jorge E Leos-Bortoni, Miriam Delgado-Brito, Luis E Flores-Huerta, Adriana A De La Cruz-Arriaga, Luis J Torres-Díaz, Ángel R Martínez-Ponce de León
OBJECTIVE Cranioplasty implants should be widely available, low in cost, and customized or easy to mold during surgery. Although autologous bone remains the first choice for repair, it cannot always be used due to infection, fragmentation, bone resorption, or other causes, which led to use of synthetic alternatives. The most frequently used allogenic material for cranial reconstructions with long-term results is polymethylmethacrylate (PMMA). Three-dimensional printing technology has allowed the production of increasingly popular customized, prefabricated implants...
June 15, 2018: Journal of Neurosurgery
Yabo Huang, Zhong Wang, Qingdong Han
RATIONALE: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. PATIENT CONCERNS: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments...
June 2018: Medicine (Baltimore)
Nicole Souper, Claudia Jiménez, Felipe Maldonado
Decompressive craniectomy (DC) is a therapeutic alternative for reducing intracranial pressure after a middle cerebral artery stroke. If thrombolytic therapy is administered, craniectomy is usually postponed for at least 24 hours due to a risk of severe bleeding. We describe a case in which DC was performed on a 38-year-old man who received thrombolytic therapy for an ischemic stroke involving the middle cerebral artery. His neurological and hemodynamic status worsened during its administration, and DC was performed 6 hours after thrombolysis was performed...
June 11, 2018: A&A practice
Pablo David Guerrero-Suarez, Paola Guerrero-López, Abarin Ortiz-Leon, Haydee Samantha Sosa-Castillo, Lenny Marlene Velazquez-Gonzalez, Jaime Jesus Martinez-Anda
Decompressive craniectomy is an urgent procedure that is increasingly used for treatment of intracranial hypertension. After recovery, reconstruction of the cranial defect is necessary. Cranioplasty is an elective procedure with a high potential for morbidity if care is not taken on different surgical factors such as the material used as the cranial flap. In Latin America, high costs in some materials used in cranioplasty make its use prohibitive for some patients and institutions, and looking for alternatives has become a priority in neurosurgical centers...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Brandon G Rocque, Bonita S Agee, Eric M Thompson, Mark Piedra, Lissa C Baird, Nathan R Selden, Stephanie Greene, Christopher P Deibert, Todd C Hankinson, Sean M Lew, Bermans J Iskandar, Taryn M Bragg, David Frim, Gerald Grant, Nalin Gupta, Kurtis I Auguste, Dimitrios C Nikas, Michael Vassilyadi, Carrie R Muh, Nicholas M Wetjen, Sandi K Lam
OBJECTIVE In children, the repair of skull defects arising from decompressive craniectomy presents a unique set of challenges. Single-center studies have identified different risk factors for the common complications of cranioplasty resorption and infection. The goal of the present study was to determine the risk factors for bone resorption and infection after pediatric cranioplasty. METHODS The authors conducted a multicenter retrospective case study that included all patients who underwent cranioplasty to correct a skull defect arising from a decompressive craniectomy at 13 centers between 2000 and 2011 and were less than 19 years old at the time of cranioplasty...
June 8, 2018: Journal of Neurosurgery. Pediatrics
Douglas L Brockmeyer
No abstract text is available yet for this article.
June 8, 2018: Journal of Neurosurgery. Pediatrics
Sophie E C M van de Vijfeijken, Tijmen J A G Münker, Rene Spijker, Luc H E Karssemakers, William P Vandertop, Alfred G Becking, Dirk T Ubbink
BACKGROUND: Currently, various materials are routinely used for cranioplasty after decompressive craniectomy, each with their own features, potential benefits, and harms. OBJECTIVES: To systematically review available literature about safety (infection, resorption, and removal) of different materials used for cranioplasty for any indication. METHODS: A comprehensive search in MEDLINE, EMBASE and the Cochrane library was performed for relevant studies published up to January 2017...
June 4, 2018: World Neurosurgery
Zhong Yao, Xin Hu, Chao You
OBJECT: Patients surviving initial decompressive craniectomy are needed to undergo cranioplasty, which is potentially complicated by postoperative seizures. The definite incidence of post-cranioplasty seizures and application of prophylactic antiepileptic drugs remain controversial. METHODS: We performed systematic review to clarify these issues. Searching through PubMed, Ovid, Web of Science and Cochrane library databases, we included publications recording the incidence of seizures after cranioplasty and prophylactic treatment...
June 6, 2018: British Journal of Neurosurgery
Marija Kusulja, Marija Santini
Herpes simplex encephalitis is a rare disease with significant morbidity and mortality, although targeted therapy is widely available. We present two cases of herpes simplex encephalitis in previously healthy, young adults treated with acyclovir who developed severe brain edema. Decompressive craniectomy prevented imminent brain herniation and fatal outcome in both our patients.
June 2, 2018: International Journal of Infectious Diseases: IJID
Qianxin Hu, Guangfu Di, Xuefei Shao, Wei Zhou, Xiaochun Jiang
Objective: Post-traumatic hydrocephalus (PTH) makes recovery from head trauma after decompression more complicated and is associated with high risks of clinical deterioration and poor outcomes. The aim of this study was to verify the predictors associated with the development of PTH in patients with head injury undergoing unilateral decompressive craniectomy (DC). Methods: Among traumatic brain injury (TBI) patients who underwent unilateral DC between January 2013 and December 2016, the clinical medical records, radiological information, and changes of patients' conditions in the 3-month after injury were reviewed retrospectively...
2018: Frontiers in Neurology
Xian Wang, Min Wu, Xing Zhou, Hengdeng Liu, Yongchao Zhang, Haiping Wang
BACKGROUND: Autologous fat injection is a procedure aimed at eliminating grave defects in the skin surface by subcutaneous injection of the patient's fatty tissue. Fat embolism is a rare but severe complication of this procedure, especially cerebral infarction. It is first reported by Thaunat in 2004. METHODS: were presented to the hospital with sudden unconsciousness and left limb weakness in 24 hours after facial fat injection. Brain computed tomography and magnetic resonance imaging were performed immediately after admission...
May 31, 2018: Journal of Craniofacial Surgery
Sui-To Wong, Wan-Nok Ho, Zhexi He, Kwong-Yui Yam
Developing a surgical plane between the temporalis muscle and the dura is the most technically challenging step when performing cranioplasty for post-decompressive craniectomy defects. The authors report a simple technique to demarcate this surgical plane by laying a multi-slitted, microporous polyesterurethane (MPU) patch during decompressive craniectomy. Specifically, they tried to avoid creating potential spaces around the patch, which is the inherent drawback of published anti-adhesive techniques. In 21 patients undergoing decompressive craniectomy, and in 11 of them subsequently undergoing cranioplasty, there was no wound related complications...
June 4, 2018: British Journal of Neurosurgery
Bartłomiej Błaszczyk, Wojciech Kaspera, Krzysztof Ficek, Maciej Kajor, Marcin Binkowski, Ewa Stodolak-Zych, Aniela Grajoszek, Jerzy Stojko, Henryk Bursig, Piotr Ładziński
The aim of this study was to verify whether L-lactide/DL-lactide copolymer 80/20 (PLDLLA) and platelet-rich plasma (PRP) trigger bone formation within critical-sized calvarial defects in adult sheep ( n = 6). Two craniectomies, each ca. 3 cm in diameter, were created in each animal. The first craniectomy was protected with an inner polylactide membrane, filled with PRP-polylactide granules, and covered with outer polylactide membrane. The second control craniectomy was left untreated. The animals were euthanized at 6, 7, 17, 19, 33, and 34 weeks after surgery, and the quality and the rate of reossification were assessed histomorphometrically and microtomographically...
2018: BioMed Research International
Muhammad Waqas, Noor Malik, Muhammad Shahzad Shamim, Karim Rizwan Nathani, Sumia Andleeb Abbasi
BACKGROUND: The objective of the study was to assess the quality of life of patients who underwent Decompressive Craniectomy (DC) for head injury and satisfaction of the caregivers with the outcomes. METHODS: This was a cross-sectional study conducted at a tertiary care urban center in Paksitan. All the patients with severe traumatic brain injury (TBI) who underwent DC and survived > 6 months were included in the study. Outcomes were assessed using two scoring systems, the Extended Glasgow Outcome Scale (GOSE) and Quality of Life After Traumatic Brain Injury (QOLIBRI) scale...
May 28, 2018: World Neurosurgery
Sebastian Arts, Hans Delye, Erik J van Lindert, Laura Blok, Wilfred Borstlap, Jacques Driessen
OBJECTIVE: The aim of this study was to evaluate pre-, intra-, and postoperative anesthetic parameters in endoscopic strip craniectomy in order to improve anesthesiological care. MATERIALS AND METHODS: This is a retrospective patient cohort study of our first 121 patients treated by endoscopic strip craniectomy. Preoperative as well as intra- and postoperative anesthesiological and neurological parameters were analyzed. Furthermore, the need for intensive care unit admission, blood loss, and blood transfusion rate were measured...
May 30, 2018: Paediatric Anaesthesia
Stephen Honeybul
There is now no little doubt that decompressive craniectomy can reduce mortality following severe traumatic brain injury. However the concern has always been that the reduction in mortality comes at the cost of an increase in the number of survivors with severe neurological disability. It was these concerns that prompted investigators to conduct a number of large multicentre randomised trials investigating surgical efficacy of the procedure. Whilst the results of these trials have confirmed the survival benefit that can be achieved this has only been achieved by increasing the number of survivors with severe disability and dependency...
May 28, 2018: Journal of Neurosurgical Sciences
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