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https://www.readbyqxmd.com/read/28790007/targeted-epidural-blood-patch-under-o-arm-guided-stereotactic-navigation-in-patients-with-intracranial-hypotension-associated-with-a-spinal-csf-leak-and-ventral-dural-defect
#1
Keisuke Takai, Makoto Taniguchi
OBJECTIVE: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention due to the insufficient coverage of injected blood. METHODS: Eight patients with intracranial hypotension due to a CSF leak diagnosed by myelographic CT and thin-cut MRI received an epidural blood patch under O-arm-guided stereotactic navigation...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysrefleixa-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#2
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal re-tethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28771533/mechanisms-by-which-porphyromonas-gingivalis-evades-innate-immunity
#3
Kaveh Abdi, Tsute Chen, Brian A Klein, Albert K Tai, Jill Coursen, Xiangdong Liu, Jeff Skinner, Saravanan Periasamy, Youngnim Choi, Benedikt M Kessler, Robert J Palmer, Apostolos Gittis, Polly Matzinger, Margaret J Duncan, Nevil J Singh
The oral cavity is home to unique resident microbial communities whose interactions with host immunity are less frequently studied than those of the intestinal microbiome. We examined the stimulatory capacity and the interactions of two oral bacteria, Porphyromonas gingivalis (P. gingivalis) and Fusobacterium nucleatum (F. nucleatum), on Dendritic Cell (DC) activation, comparing them to the effects of the well-studied intestinal microbe Escherichia coli (E. coli). Unlike F. nucleatum and E. coli, P. gingivalis failed to activate DCs, and in fact silenced DC responses induced by F...
2017: PloS One
https://www.readbyqxmd.com/read/28765065/reconstructive-outcome-of-intraoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-surgery-for-tumors-involving-skull-base
#4
Chi-Man Jeon, Sang Duk Hong, Ho Jun Seol, Jung-Il Lee, Do-Hyun Nam, Yoon Jung Hwang, Doo-Sik Kong
Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28764208/assessing-the-viability-of-hadad-flap-by-postoperative-contrast-enhanced-magnetic-resonance-imaging
#5
Hegde Jyotirmay, Sunil Kumar Saxena, A S Ramesh, K Nagarajan, Shreshta Bhat
INTRODUCTION: The Expanded Endonasal Approaches (EEAs) have been widely used for various skull base lesions. The reconstruction of the skull base defects is of vital importance to prevent postoperative complications. The vascular pedicled-nasoseptal flap (Hadad-Bassagasteguy flap) is used as a workhorse in reconstruction of majority of the defects. AIM: The purpose of this study was: (a) To assess the postoperative MRI appearance of vascularised pedicled nasoseptal flap for its viability; (b) To determine the variations in MRI that may suggest potential flap failure...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761510/a-systematic-review-about-the-position-related-complications-of-acoustic-neuroma-surgery-via-suboccipital-retrosigmoid-approach-sitting-versus-lateral
#6
REVIEW
Mahdi Safdarian, Manouchehr Safdarian, Roger Chou, Seyed Mahmoud Ramak Hashemi, Vafa Rahimi-Movaghar
This systematic review wasdesigned to compare the complications of acoustic neuroma surgery via the suboccipital retrosigmoid approach in the sitting versus lateral positions. Searches for randomized trials and observational studies about the complications of acoustic neuroma surgery were performed in five medical databases (though October 2015) including PubMed, MEDLINE (In-Process and Other Non-Indexed Citations), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and PsycINFO. Primary outcomes in this study were venous air emboli, neuropsychological defects, CSF leak, facial and abducens nerves palsy, postoperative deafness, hydrocephalus and mortality...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28755201/update-on-the-diagnosis-and-treatment-of-spontaneous-intracranial-hypotension
#7
REVIEW
Peter G Kranz, Michael D Malinzak, Timothy J Amrhein, Linda Gray
PURPOSE OF REVIEW: The purpose of this study is to provide an update on recent developments in the understanding, diagnosis, and treatment of spontaneous intracranial hypotension (SIH). RECENT FINDINGS: SIH is an important cause of headaches caused by spinal cerebrospinal fluid (CSF) leaks, with an increasingly broad spectrum of clinical presentations and diagnostic findings. A simple conception of the condition as being defined by the presence of low CSF pressure is no longer sufficient or accurate...
August 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28753091/neuroendoscopic-surgery-in-children-does-age-at-intervention-influence-safety-and-efficacy-a-single-center-experience
#8
Amy L Bowes, Josh King-Robson, William J Dawes, Greg James, Kristian Aquilina
OBJECTIVE The aim of this study was to review the safety of pediatric intraventricular endoscopy across separate age groups and to determine whether intraventricular endoscopy is associated with an increased risk of complications or reduced efficacy in infants younger than 1 year. METHODS In this retrospective cohort study, 286 pediatric patients younger than 17 years underwent intraventricular endoscopy at Great Ormond Street Hospital between December 2005 and December 2014. The primary diagnosis, procedure, and complications were recorded...
July 28, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28751035/risk-factors-of-neurosurgical-site-infection-after-craniotomy-a-systematic-review-and-meta-analysis
#9
Chenyan Fang, Tao Zhu, Ping Zhang, Liang Xia, Caixing Sun
BACKGROUND: Neurosurgical site infection (SSI) is a complication related to craniotomy, which may lead to severe morbidity and higher hospital costs during the postoperative period. METHODS: Retrospective cohorts, case-control studies, or prospective investigations addressing risk factors of SSI updated until January 2017 were systematically searched in 2 databases (PubMed and Embase). The Newcastle-Ottawa Scale was used to evaluate quality of the included studies, heterogeneity was assessed by I(2) tests, and a funnel plot and Egger test were used for the evaluation of publication bias...
July 24, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28748855/clinical-characteristics-and-endoscopic-endonasal-removal-of-foreign-bodies-within-sinuses-orbit-and-skull-base
#10
Yi-Hui Wen, Wei-Jian Hou, Wen-Bin Lei, Feng-Hong Chen, Xiao-Lin Zhu, Zhang-Feng Wang, Ren-Qiang Ma, Wei-Ping Wen
BACKGROUND: Foreign bodies within the sinuses, orbit, and skull base (FBSOS) are rare; hence, diagnosis and management guidelines are lacking. Endoscopic sinus surgery (ESS) removal is preferred because of the less invasiveness and minimal morbidity. This study was designed to summarize clinical experience with ESS management of FBSOS. METHODS: We retrospectively reviewed clinical manifestations, imaging findings, treatment, and outcomes in consecutive patients with ESS removal of FBSOS between 2004 and 2015 at a tertiary academic medical center...
August 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28744321/an-18-f-positron-emitting-fluorescent-cerebrospinal-fluid-probe-for-imaging-damage-to-the-brain-and-spine
#11
Harikrishna Kommidi, Hua Guo, Nandi Chen, Dohyun Kim, Bin He, Amy P Wu, Omer Aras, Richard Ting
Fluorescein is modified to bear (18)F so that it can act as both a positron emitter, and a fluorophore, allowing detection by positron emission tomography (PET), scintillation, and fluorescent imaging (FL). [(18)F]-2 is injected into the intrathecal space of rats and used to observe the cerebrospinal fluid (CSF) that bathes the brain and spine. Injury in three different applications is visualized with [(18)F]-2: 1) detection of a 0.7 mm paranasal-sinus CSF leak (CSFL); 2) detection of 0.5 mm puncture damage to the thoracic spine (acute spinal cord injury); and 3) detection of intracerebral hemorrhage/edema because of traumatic brain injury...
2017: Theranostics
https://www.readbyqxmd.com/read/28736350/antibiotic-prophylaxis-in-endoscopic-endonasal-pituitary-and-skull-base-surgery
#12
Laura Milanese, Matteo Zoli, Giacomo Sollini, Chiara Martone, Corrado Zenesini, Carmelo Sturiale, Paolo Farneti, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study was to assess the efficacy of our intraoperative antibiotic prophylaxis by analyzing the risk factors of postoperative meningitis in our series. METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days were included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction; no postoperative administrations were performed after 2005...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#13
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28726587/repair-of-tympanic-membrane-perforations-with-customized-bioprinted-ear-grafts-using-chinchilla-models
#14
Che-Ying Kuo, Emmanuel Wilson, Andrew Fuson, Nidhi Gandhi, Reza Monfaredi, Audrey Jenkins, Maria Romero, Marco Santoro, John P Fisher, Kevin Cleary, Brian Reilly
The goal of this work is to develop an innovative method that combines bioprinting and endoscopic imaging to repair tympanic membrane perforations (TMPs). TMPs are a serious health issue because they can lead to both conductive hearing loss and repeated otitis media. TMPs occur in 3 to 5% of cases after ear tube placement as well as in cases of acute otitis media (the second most common infection in pediatrics), chronic otitis media with or without cholesteatoma, or as a result of barotrauma to the ear. About 55,000 tympanoplasties, the surgery performed to reconstruct TMPs, are performed every year and the commonly used cartilage grafting technique has a success rate between 43% to 100%...
July 20, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#15
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
BACKGROUND: Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation, and only 6 cases have been reported in the literature so far(17). CASE DESCRIPTION: We present a unique case of a 64-year-old woman who presented with a 2-year history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 years and suffered from meningitis. She underwent magnetic resonance imaging, computed tomography cisternogram, as well as computed tomography of the brain, which showed clival defect with CSF leak into the sphenoid sinus...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28690123/pedicled-omental-flaps-in-the-treatment-of-complex-spinal-wounds-after-en-bloc-resection-of-spine-tumors
#16
Andrea Sambri, Alessandro Gasbarrini, Sergio Cialdella, Pierandrea De Iaco, Stefano Boriani
STUDY DESIGN: The present paper presents a retrospective study of 5 patients who underwent pedicled omental flap procedure following spine tumor removal. SUMMARY OF BACKGROUND DATA: Postoperative wound dehiscence represents a major complication in spinal surgery, particularly after en bloc tumor resection, because of the extended sacrifice of soft tissues and adjuvant radiation therapy and chemotherapy. METHODS: Five patients, with a mean age of 52 years (range, 24-71 years), who underwent omental flaps for the treatment of postoperative complication in spine tumor resections were retrospectively evaluated...
June 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28689974/endoscopic-surgery-for-sinonasal-tumors-the-transcribriform-approach
#17
R Thomas, P Martin, D Patrick, M Justin
Over the past 10 to 20 years, endoscopic endonasal surgery has become for many teams the preferred treatment for sinonasal tumors. Technical advances in the field of surgical instrumentation (good visualization, hemostasis…) and the progress of imaging guidance (to avoid neurovascular complication) has made those procedures simpler and safer. Nevertheless, endonasal endoscopic procedures require a trained surgical team of ENT specialist and neurosurgeon. Endoscopic endonasal surgery has been reported to be feasible for all types of sinonasal tumors whether benign tumors such as inverted papillomas, or malignant tumors...
July 8, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28684150/sandwich-technique-using-fibrin-coated-collagen-fleece-for-sellar-reconstruction-in-large-dural-defects-during-transsphenoidal-surgery
#18
Jaeyoung So, Hunho Park, Kyeong-Soo Sung, Kyu Sung Lee, Chang-Ki Hong
PURPOSE: Various surgical methods to prevent intraoperative and postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal approach (TSA) surgeries have been reported, but surgical techniques to address large dural defects have been less thoroughly investigated in the literature. The authors retrospectively evaluated the usefulness of the sandwich technique using fibrin-coated collagen fleece (TachoSil) to prevent intraoperative CSF leakage from large dural defects in TSA surgery...
September 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28680734/hydroxyapatite-bone-cement-application-for-the-reconstruction-of-retrosigmoid-craniectomy-in-the-treatment-of-cranial-nerves-disorders
#19
Nouman Aldahak, Derrick Dupre, Mohamed Ragaee, Sebastien Froelich, Jack Wilberger, Khaled M Aziz
BACKGROUND: Retromastoid craniectomy (RSC) is a cardinal surgical approach used to access the posterior fossa. Hydroxyapetite bone cement (HBC) is frequently employed for cranioplasty in efforts to prevent cerebrospinal fluid (CSF) leak, whilst maintaining low complication rates and good cosmetic satisfaction. The authors aim to determine the safety and effectiveness of HBC for reconstruction RSC used for treatment of various cranial nerves disorders. METHODS: The authors conducted a retrospective one-center two surgeons review of 113 patients who underwent RSC filled with HBC for the treatment of cranial nerve disorders...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28676464/endonasal-endoscopic-odontoidectomy-in-ventral-pathologies-of-the-cranio-cervical-junction-results-of-a-multicenter-experience
#20
Salvatore Chibbaro, Helene Cebula, Sorin Aldea, Bertrand Baussart, Leonardo Tigan, Julien Todeschi, Antonio Romano, Mario Ganau, Christian Debry, Franco Servadei, Francois Proust, Stephane Gaillard
BACKGROUND: Over the past decades, supported by preliminary anatomical and clinical studies exploring its feasibility and safety, an ever growing experience was built on the use of the endoscopic endonasal approach (EEA) to ventral pathologies at the cranio-cervical junction (CCJ). PATIENTS AND METHODS: Multicenter study over a 4 years period on 14 patients managed by EEA odontoidectomy for CCJ pathologies causing irreducible atlanto-axial dislocation. The surgical set up included an IGS system based on CT and MRI images fusion, and 0° and 30° angled endoscopes with dedicated endoscopic tools...
July 1, 2017: World Neurosurgery
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