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Craniectomy

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https://www.readbyqxmd.com/read/28230585/decompressive-craniectomy-with-bifrontal-coronal-incision-in-the-management-of-fronto-temporal-contusion-and-laceration-for-early-cranioplasty
#1
Zhong Wang, Ning Su, Ri-Le Wu, Yi-Song Zhang, Xiao-Jun Zhang, Jian-Jun Qi, Wei-Ping Zhao, Zhong Zhang, Jun-Qing Wang
The present study aims to explore the effectiveness of decompressive craniectomy with bifrontal coronal incision in the management of severe contusion and laceration of bilateral fronto-temporal lobes, as well as the outcomes of early cranioplasty. The authors performed the bifrontal decompressive craniectomy on 56 patients with contusion and laceration of bilateral frontal and temporal lobes, and their follow-up treatment outcomes were tracked within 6 months using Glasgow Outcome Scale. The results showed that 33 patients (out of 56, 58...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28226284/does-suboccipital-decompression-and-evacuation-of-intraparenchymal-hematoma-improve-neurological-outcome-in-patients-with-spontaneous-cerebellar-hemorrhage
#2
Katharina A M Hackenberg, Andreas W Unterberg, Carla S Jung, Julian Bösel, Silvia Schönenberger, Klaus Zweckberger
OBJECTIVE: Spontaneous cerebellar hemorrhages (SCH) can lead to life-threatening complications with high mortality rates of 20-50%. Although complications of SCH can be prevented by surgical therapy, there is a lack of consensus concerning the optimal surgical technique for evacuating SCH. METHODS: In this retrospective study 85 patients with SCH were divided into four treatment groups: (1) Decompression and Hematoma Evacuation via suboccipital craniectomy and removal of the posterior arch of C1 (DHE)...
February 3, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#3
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28223249/predicted-unfavorable-neurological-outcome-is-overestimated-by-the-marshall-ct-score-crash-and-impact-models-in-severe-tbi-patients-management-with-early-decompressive-craniectomy
#4
Jose D Charry, Jorman H Tejada, Miguel A Pinzon, Wilson A Tejada, Juan D Ochoa, Manuel Falla, Jesus H Tovar, Ana M Cuellar-Bahamón, Juan P Solano
INTRODUCTION: Traumatic Brain Injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed in order to establish neurologic outcome. We tested prognostic models (the Marshall CT score, IMPACT, and CRASH) for 14-day mortality, 6-month mortality, and 6-month outcome in TBI patients in a university Hospital in Colombia. METHODS: A 127 patients' cohort with TBI was treated in a regional trauma center in Colombia over 2 years and Bivariate and Multivariate analyses were used...
February 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28216211/the-association-of-surgical-method-with-outcomes-of-acute-subdural-hematoma-patients-experience-with-643-consecutive-patients
#5
Rimantas Vilcinis, Adomas Bunevicius, Arimantas Tamasauskas
OBJECTIVE: Optimal surgical management strategy of acute subdural hematoma (ASDH) patients is challenging. We investigated the association of decompressive craniectomy (DC) and osteoplastic craniotomy (OC) with outcomes in consecutive patients undergoing surgical evacuation of ASDH, and analyzed prognostic indicators. METHODS: We reviewed prospective institutional database of all adult ASDH patients operated by craniotomy from January, 2009 until January, 2016. Mortality and discharge outcomes (Glasgow outcomes scale or GOS) were analyzed as a function of surgical method adjusting for age, admission GCS, ASDH thickness and midline shift...
February 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28207472/intradiploic-epithelial-inclusion-cyst-of-the-cranium-mimicking-fibrous-dysplasia
#6
Max Mandelbaum, Jerry W Chao, Gary F Rogers, Cheng-Ying Ho, Suresh N Magge
Intradiploic inclusion cysts are exceedingly rare in the pediatric population. The authors present a 16-year-old male patient who presented with a large growing calvarial mass with a preoperative diagnosis of fibrous dysplasia based on radiologic imaging. Craniectomy followed by autogenous reconstruction was performed. Histopathological examination revealed a relatively small inclusion cyst of the intradiploic space, surrounded by reactive bone. This patient demonstrates a highly unusual presentation of a rare entity, and the authors discuss the diagnosis and management of intradiploic inclusion cysts...
February 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28203185/reversible-cerebral-vasoconstriction-syndrome-with-intracranial-hypertension-should-decompressive-craniectomy-be-considered
#7
Ségolène Mrozek, Laurent Lonjaret, Aude Jaffre, Anne-Christine Januel, Nicolas Raposo, Sergio Boetto, Jean-François Albucher, Olivier Fourcade, Thomas Geeraerts
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. METHODS: Case report. RESULTS: We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine...
January 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28188356/brain-trauma-foundation-guidelines-for-intracranial-pressure-monitoring-compliance-and-effect-on-outcome
#8
Alberto Aiolfi, Elizabeth Benjamin, Desmond Khor, Kenji Inaba, Lydia Lam, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring in patients who sustained severe traumatic brain injury (TBI). Compliance to BTF guidelines is variable, and the effect of ICP monitoring on outcomes remains a controversial issue. The purpose of this study was to assess guidelines compliance in patients who sustain a severe TBI and to analyze the effect of ICP monitoring on outcomes. METHODS: Trauma Quality Improvement Program database study, which included patients with isolated severe blunt head trauma (head Abbreviated Injury Scale ≥3 with Glasgow Coma Scale <9)...
February 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28187815/principles-of-intracranial-pressure-monitoring-and-treatment
#9
M Czosnyka, J D Pickard, L A Steiner
Intracranial pressure (ICP) is governed by volumes of intracranial blood, cerebrospinal fluid, and brain tissue. Expansion of any of these volumes will trigger compensatory changes in the other compartments, resulting in initially limited change in ICP. Due to the rigid skull, once compensatory mechanisms are exhausted, ICP rises very rapidly. Intracranial hypertension is associated with unfavorable outcome in brain-injured patients. This chapter discusses the pathophysiology of raised ICP, as well as typical waveforms, monitoring techniques, and clinical management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#10
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#11
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28179178/cranioplasty-outcomes-and-analysis-of-the-factors-influencing-surgical-site-infection-a-retrospective-review-of-over-10-years-of-institutional-experience
#12
Keita Shibahashi, Hidenori Hoda, Yuichi Takasu, Kazuo Hanakawa, Takafumi Ide, Yuichi Hamabe
BACKGROUND: As a large amount of clinical evidence supports the effects of craniectomy, the frequency of subsequent cranioplasty is on the rise. Complication rates and risk factors of cranioplasty have been reported; however, they have been conflicting. We aimed to review over 10 years of institutional experience and identify the risk factors of surgical-site infection (SSI) after cranioplasty. METHODS: A retrospective review was conducted for patients who underwent primary cranioplasty...
February 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28178299/a-simple-prediction-score-system-for-malignant-brain-edema-progression-in-large-hemispheric-infarction
#13
KwangWook Jo, Suhas S Bajgur, Hoon Kim, Huimahn A Choi, Pil-Woo Huh, Kiwon Lee
Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed...
2017: PloS One
https://www.readbyqxmd.com/read/28178101/iatrogenic-intradiploic-epidermoid-cyst-following-strip-craniectomy-for-sagittal-craniosynostosis
#14
Michael T Friel, Joaquin Hidalgo, J Mason Shiflett
INTRODUCTION: The increased incidence and success of strip craniectomy with postoperative helmet therapy in the treatment of sagittal craniosynostosis has been documented by multiple centers throughout the country and world. The authors report a child with a postoperative implantation intradiploic epidermoid cyst following a strip craniectomy, a complication, that to our knowledge, has not been reported. METHODS: This clinical report involves a 3-year-old boy with a scaphocephalic appearance who was transferred to our center following an interstate adoption...
February 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28175585/377%C3%A2-craniectomy-versus-craniotomy-in-traumatic-brain-injury-a-propensity-matched-analysis-of-long-term-functional-and-quality-of-life-outcomes
#15
Michael L Kelly, Berje Haroutuon Shammassian, Mary Joan Roach, Charles Thomas, Amy K Wagner
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28163065/a-standardized-method-to-measure-brain-shifts-with-decompressive-hemicraniectomy
#16
Askiel Bruno, Abdurrehman Zahran, Nina Paletta, Laith Maali, Fenwick T Nichols, Ramon Figueroa
BACKGROUND: A standardized, reliable, and practical method for measuring decompressive hemicraniectomy (DHC) defects and brain shifts in malignant middle cerebral artery (MCA) territory infarction is needed for reliable comparisons between computed tomography (CT) scans. Such a method could facilitate further studies on the effects of DHC. NEW METHOD: We describe and apply a method for measuring DHC defects and brain shifts on CT scans in 25 patients with malignant MCA territory infarction...
February 2, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28160738/on-the-mechanical-behaviour-of-peek-and-ha-cranial-implants-under-impact-loading
#17
D Garcia-Gonzalez, J Jayamohan, S N Sotiropoulos, S-H Yoon, J Cook, C R Siviour, A Arias, A Jérusalem
The human head can be subjected to numerous impact loadings such as those produced by a fall or during sport activities. These accidents can result in skull fracture and in some complex cases, part of the skull may need to be replaced by a biomedical implant. Even when the skull is not damaged, such accidents can result in brain swelling treated by decompressive craniectomy. Usually, after recovery, the part of the skull that has been removed is replaced by a prosthesis. In such situations, a computational tool able to analyse the choice of prosthesis material depending on the patient's specific activity has the potential to be extremely useful for clinicians...
January 10, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28144849/biocompatible-bacterial-cellulose-membrane-in-dural-defect-repair-of-rat
#18
Frederico de Melo Tavares de Lima, Flávia Cristina Morone Pinto, Belmira Lara da Silveira Andrade-da-Costa, Jaiurte Gomes Martins da Silva, Olávio Campos Júnior, José Lamartine de Andrade Aguiar
Duraplasty is necessary in nearly 30% of all neurological surgeries. Different tissues and materials have been evaluated in dura mater repair or as dural substitutes in neurosurgery. The aim was to evaluate the biocompatibility of the bacterial cellulose (BC) membranes, produced from sugarcane molasses, for dural defect repair in rats. Forty adults males Wistar rats divided into two groups: a control (ePTFE) and an experimental (BC). Bilateral frontoparietal craniectomy was performed, and a dural defect was created...
March 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28138909/colloidal-gels-with-extracellular-matrix-particles-and-growth-factors-for-bone-regeneration-in-critical-size-rat-calvarial-defects
#19
Jakob M Townsend, S Connor Dennis, Jonathan Whitlow, Yi Feng, Jinxi Wang, Brian Andrews, Randolph J Nudo, Michael S Detamore, Cory J Berkland
Colloidal gels encapsulating natural materials and exhibiting paste-like properties for placement are promising for filling complex geometries in craniofacial bone regeneration applications. Colloidal materials have demonstrated modest clinical outcomes as bone substitutes in orthopedic applications, but limited success in craniofacial applications. As such, development of a novel colloidal gel will fill a void in commercially available products for use in craniofacial reconstruction. One likely application for this technology is cranial reconstruction...
January 30, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28137550/intraoperative-indocyanine-green-icg-based-cortical-perfusion-assessment-in-patients-suffering-from-severe-traumatic-brain-injury
#20
Marcel A Kamp, Sevgi Sarikaya-Seiwert, Athanasios K Petridis, Thomas Beez, Jan-Frederick Cornelius, Hans-Jakob Steiger, Bernd Turowski, Philipp J Slotty
The pathophysiology of traumatic brain injury (TBI) largely involves the brains vascular structural integrity. We analyzed the value of an intraoperative cortical ICG-angiography in patients with severe TBI and acute subdural hematoma who underwent decompressive craniectomy. Indocyanine green (ICG)-derived fluorescence curves of cortex and cerebral vessels were recorded using a software integrated into a surgical microscope in 10 patients. The maximum intensity, rise time (RT), time to peak (TTP) and residual fluorescence intensity (FI) were estimated from cortical arteries, the parenchyma and veins...
January 27, 2017: World Neurosurgery
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