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https://www.readbyqxmd.com/read/29777885/posttraumatic-cerebrospinal-fluid-leak-associated-with-an-upper-cervical-meningeal-diverticulum
#1
Noriya Enomoto, Hideo Mure, Toshiyuki Okazaki, Mai Azumi, Shinya Okita, Shinji Nagahiro, Yasushi Takagi
Spontaneous intracranial hypotension (SIH) has been increasingly recognized as a phenomenon caused by cerebrospinal fluid (CSF) leaks; however, its pathogenesis is still unclear. Here, we report two cases of SIH as a result of CSF leak from a meningeal diverticulum at the C2 nerve root sleeve. The first case is that of a 46-year-old man who had suffered from orthostatic headache after a bicycle accident at age 45. Computed tomography (CT) myelography revealed CSF leaks at the C1/2 level. He underwent epidural blood patch (EBP) therapy, but it was unsuccessful...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775155/long-term-surgical-outcomes-following-transsphenoidal-surgery-in-patients-with-rathke-s-cleft-cysts
#2
Michelle Lin, Michelle A Wedemeyer, Daniel Bradley, Daniel A Donoho, Vance L Fredrickson, Martin H Weiss, John D Carmichael, Gabriel Zada
OBJECTIVE Rathke's cleft cysts (RCCs) are benign epithelial lesions of the sellar region typically treated via a transsphenoidal approach with cyst fenestration and drainage. At present, there is limited evidence to guide patient selection for operative treatment. Furthermore, there is minimal literature describing factors contributing to cyst recurrence. METHODS The authors conducted a retrospective analysis of 109 consecutive cases of pathology-confirmed RCCs treated via a transsphenoidal approach at a single center from 1995 to 2016...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29770252/utility-of-magnetic-resonance-cisternography-with-intrathecal-gadolinium-in-detection-of-cerebrospinal-fluid-fistula-associated-with-mondini-dysplasia-in-a-patient-with-recurrent-meningitis-case-report-and-literature-review
#3
Enrique Caro-Osorio, Alba Espino-Ojeda, Lino Guevara-Maldonado, José C Herrea-Castro
Background: The intrathecal contrast-enhanced magnetic resonance cisternography (MRC) is a diagnostic method that has been proven effective in selected patients with various disorders of the cerebrospinal system, including the detection of cerebrospinal fluid (CSF) leaks. The Mondini dysplasia is a malformation of the inner ear characterized by an incomplete cochlear development. The cerebrospinal fistula associated with Mondini dysplasia usually occurs in the first 5-10 years. Case Description: The case of a 34-year-old woman with CSF rhinorrhea and recurrent meningitis associated with CSF fistula into the right inner ear, which was detected by MRC with intrathecal gadolinium, is presented...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29765818/targeted-epidural-blood-patch-treatment-for-refractory-spontaneous-intracranial-hypotension-in-china
#4
Fei-Fang He, Li Li, Min-Jun Liu, Tai-Di Zhong, Qiao-Wei Zhang, Xiang-Ming Fang
Objective  An epidural blood patch (EBP) is the mainstay of treatment for refractory spontaneous intracranial hypotension (SIH). We evaluated the treatment efficacy of targeted EBP in refractory SIH. Methods  All patients underwent brain magnetic resonance imaging (MRI) with contrast and heavily T2-weighted spine MRI. Whole spine computed tomography (CT) myelography with non-ionic contrast was performed in 46 patients, and whole spine MR myelography with intrathecal gadolinium was performed in 119 patients...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29761066/anterior-skull-base-reconstruction-does-fat-preparation-matter
#5
Joshua Wood, Jaron Densky, John Boughter, Merry Sebelik, Courtney Shires
Objectives  This article aims (1) to determine whether there is any difference in cerebrospinal fluid (CSF) leak rate after anterior skull base autologous fat reconstruction based on how the fat is prepared, and (2) to measure impact on surgical times by reconstruction type. Design  Translational animal model surgical technique 3-arm trial, comparing two different methods of autologous fat skull base reconstruction versus a nonreconstructed control group. Setting  Animal study. Subjects  Adult Sprague-Dawley rats...
April 2018: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#6
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29740678/-complications-of-anterior-skull-base-surgery
#7
REVIEW
M Wagenmann, K Scheckenbach, B Kraus, I Stenin
Anterior skull base operations are complex surgical procedures that are performed to treat serious and complicated diseases. Despite significant advances in surgical techniques, complications are relatively frequent and can be serious. Endoscopic skull base surgery seems to be associated with less complications than open techniques. Different classifications aimed at categorizing these complications have been suggested, the use of which can be recommended when reporting complication rates. The most relevant and frequent complications of anterior skull base surgery are hemorrhage, cerebrospinal fluid (CSF) leak, meningitis, and cranial nerve injury...
May 8, 2018: HNO
https://www.readbyqxmd.com/read/29738390/incidence-and-risk-factors-for-sigmoid-venous-thrombosis-following-cpa-tumor-resection
#8
Matthew Shew, Hannah Kavookjian, Kelly Dahlstrom, Thomas Muelleman, James Lin, Paul Camarata, Luke N Ledbetter, Hinrich Staecker
OBJECTIVE: Our primary aim was to determine the incidence of sigmoid venous thrombosis (SVT) and determine risks factors and sequelae of SVT following cerebellopontine angle tumor resection. STUDY DESIGN: Retrospective cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients over 18 years of age who underwent resection of cerebellopontine angle meningioma or vestibular schwannoma from January 2005 to April 2016 who had postoperative magnetic resonance imaging...
June 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29732935/use-of-autologous-fat-grafts-for-the-endoscopic-reconstruction-of-skull-base-defects-indications-outcomes-and-complications
#9
Kent Lam, Amber U Luong, William C Yao, Martin J Citardi
Background The use of abdominal free fat is a traditional surgical method for the repair and reconstruction of the anterior skull base. Our objective is to assess the outcomes associated with the autologous fat graft to endoscopically repair anterior skull base defects at a single tertiary care center. Methods All patients, who underwent endoscopic skull base repair utilizing abdominal free fat from September 2009 to June 2016, were included for retrospective chart review. Evaluated outcome measurements included (1) the successful closure of preoperative and intraoperative cerebrospinal fluid (CSF) leaks and (2) complications at both donor and recipient graft sites during the postoperative periods...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29730270/management-of-iatrogenic-spinal-cerebrospinal-fluid-leaks-a-cohort-of-124-patients
#10
Royce W Woodroffe, Kirill V Nourski, Logan C Helland, Brian Walsh, Jennifer Noeller, Panagiotis Kerezoudis, Patrick W Hitchon
OBJECTIVES: Cerebrospinal fluid leaks are a frequent complication of spinal surgery, with reported rates between 2 and 20%. Management is highly variable and dependent on comorbidities, complexity of the index procedure, and surgeons' experience. Treatment options include primary or delayed repair, with or without spinal drainage. Using a retrospective cohort, the authors aim to identify the appropriate management of iatrogenic spinal cerebrospinal fluid (CSF) leaks. PATIENTS AND METHODS: We queried our institutional database for postoperative spinal CSF leaks between 1/1/2007 and 3/14/2017 using Current Procedural Terminology (CPT) and International Classification of Disease (ICD) codes...
April 22, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29726777/surgical-outcomes-after-reoperation-for-recurrent-skull-base-meningiomas
#11
Stephen T Magill, David S Lee, Adam J Yen, Calixto-Hope G Lucas, David R Raleigh, Manish K Aghi, Philip V Theodosopoulos, Michael W McDermott
OBJECTIVE Skull base meningiomas are surgically challenging tumors due to the intricate skull base anatomy and the proximity of cranial nerves and critical cerebral vasculature. Many studies have reported outcomes after primary resection of skull base meningiomas; however, little is known about outcomes after reoperation for recurrent skull base meningiomas. Since reoperation is one treatment option for patients with recurrent meningioma, the authors sought to define the risk profile for reoperation of skull base meningiomas...
May 4, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29706650/innovative-strategies-minimize-engraftment-syndrome-in-multiple-myeloma-patients-with-novel-induction-therapy-following-autologous-hematopoietic-stem-cell-transplantation
#12
Gonzalo Gutiérrez-García, Montserrat Rovira, Laura Magnano, Laura Rosiñol, Alex Bataller, María Suárez-Lledó, María Teresa Cibeira, Carlos Fernández de Larrea, Marta Garrote, Sofia Jorge, Ana Moreno, Luis Gerardo Rodríguez-Lobato, Enric Carreras, Maribel Díaz-Ricart, Marta Palomo, Carmen Martínez, Alvaro Urbano-Ispizua, Joan Bladé, Francesc Fernández-Avilés
Autologous stem cell transplantation (PBSCT) is standard for young patients in MM and its TRM has decreased after the 2000s. Bortezomib and immunomodulatory agents (IMiDs) in MM have improved the outcome. However, they seem to boost pro-inflammatory stage increasing the incidence of engraftment syndrome (ES). Favorable factors in PBSCT such as G-CSF could increase inflammatory stage during transplant. Corticosteroids have shown an excellent response of ES and some authors propose them as prophylaxis for ES...
April 29, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29701900/single-s1-dorsal-root-ganglia-stimulation-for-intractable-complex-regional-pain-syndrome-foot-pain-after-lumbar-spine-surgery-a-case-series
#13
Ioannis M Skaribas, Christian Peccora, Elena Skaribas
INTRODUCTION: Intractable complex regional pain syndrome (CRPS)-related chronic foot pain, is a common therapeutic challenge for interventional pain management physicians and patients alike. Dorsal root ganglia (DRG) stimulation is a very target specific dorsal column stimulation technique with very promising clinical outcomes. Patients with CRPS foot pain and previous back surgery can benefit from DRG stimulation but also run a significant risk of epidural trauma from the DRG sheath advancement...
April 27, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#14
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29686958/temporal-lobe-cystic-collection-and-associated-oedema-a-rare-complication-of-translabyrinthine-resection-of-vestibular-schwannoma
#15
Abdurrahman Raeiq
Vestibular schwannomas (VS) are benign tumours arising from the vestibulocochlear nerve. Among the management options available, surgical resection is often considered, especially if lesions are enlarging or symptomatic. Translabyrinthine (TL) resection of a vestibular schwannoma is one of three basic approaches available to the surgeon. Complications generally associated with this approach can include cerebrospinal fluid (CSF) leak, hearing and balance issues, infection, and facial nerve palsies. We present the case of a patient with a previously unreported type of complication: that of cystic CSF collection within the temporal lobe and associated oedema...
February 21, 2018: Curēus
https://www.readbyqxmd.com/read/29685531/imaging-sinonasal-disease-with-mri-providing-insight-over-and-above-ct
#16
REVIEW
Geoiphy George Pulickal, Annakan V Navaratnam, Thi Nguyen, Alina Denisa Dragan, Magdalena Dziedzic, Ravi K Lingam
This article illustrates and discusses the applications and value of magnetic resonance imaging (MRI) in the evaluation of sinonasal disease. There are several clinical scenarios where MRI can add value over conventional computed tomography (CT) evaluation of the sinonasal spaces. Specifically, MRI can provide insight through better depiction of the anatomy of certain sinonasal sub-sites including the olfactory structures. It can aid in evaluating anosmia, sinusitis (fungal sinusitis and complications), benign and malignant lesions, CSF leaks and pathology extending into sinonasal spaces...
May 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29684513/adult-chiari-i-malformations-an-analysis-of-surgical-risk-factors-and-complications-using-an-international-database
#17
Abhiraj D Bhimani, Darian R Esfahani, Steven Denyer, Ryan G Chiu, David Rosenberg, Ashley L Barks, Gregory D Arnone, Ankit I Mehta
BACKGROUND: Chiari I malformations are common in adults, and a frequent procedure in neurosurgical practice. Despite a number of studies, to date there is no consensus about the indications or surgical technique for this common condition. Growing emphasis on value-based care has emphasized reduction of readmissions and reoperations, and is particularly relevant in Chiari, which has traditionally been associated with a high complication rate. OBJECTIVE: To provide a contemporary surgical profile of risk factors and complications for Chiari I malformations in adults...
April 20, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29682061/transcranial-and-epidural-approach-for-spontaneous-cerebrospinal-fluid-leakage-due-to-meningoencephalocele-of-the-lateral-sphenoid-sinus
#18
Ryosuke Shintoku, Masahiko Tosaka, Tatsuya Shimizu, Yuhei Yoshimoto
We experienced a case of sphenoid sinus type meningoencephalocele manifesting as severe cerebrospinal fluid (CSF) rhinorrhea. A 35-year-old man became aware of serous nasal discharge 1 year previously, which had gradually worsened. The nasal discharge was diagnosed as CSF rhinorrhea. Head computed tomography (CT) showed several small depressions in the bone of the left middle cranial fossa, and the largest depression extended through the bone to the lateral sphenoid sinus. Head magnetic resonance imaging revealed that the meningoencephalocele projected to the lateral sphenoid sinus, through this small bone defect of the middle cranial fossa...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682010/craniofacial-trauma-in-pediatric-patients-following-winnowing-blade-injury-review-of-literature
#19
REVIEW
Harsha Huliyappa, Balakrishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava
In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29679194/posterior-cranial-fossa-and-spinal-local-infections
#20
Federico Bianchi, Gianpiero Tamburrini
OBJECT: The aim of this paper is to review the current knowledge on the management of local infections in posterior cranial fossa (PCF) and spinal surgery; the center of our paper will be the diagnosis and management of infections of the wound, the subcutaneous tissue, and muscle strata. RESULTS AND CONCLUSIONS: Very few papers address the problem of local infections in posterior cranial fossa and spinal surgery. The largest amount of the literature data is indeed centered on how to deal with deep infections, CSF leak, and secondary meningitis or hardware infection...
April 20, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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