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Neurosurgical planning

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https://www.readbyqxmd.com/read/29779186/mastoid-foramen-mastoid-emissary-vein-and-clinical-implications-in-neurosurgery
#1
Martin Hampl, David Kachlik, Katerina Kikalova, Roxane Riemer, Matej Halaj, Vlastimil Novak, Premysl Stejskal, Miroslav Vaverka, Lumir Hrabalek, David Krahulik, Ondrej Nanka
BACKGROUND: Mastoid emissary vein is especially important from the neurosurgical point of view, because it is located in variable number in the area of the occipitomastoid suture and it can become a source of significant bleeding in surgical approaches through the mastoid process, especially in retrosigmoid craniotomy, which is used for approaches to pathologies localized in the cerebellopontine angle. Ideal imaging method for diagnosis of these neglected structures when planning a surgical approach is high-resolution computed tomography...
May 20, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29767766/cost-transparency-in-neurosurgery-a-single-institution-analysis-of-patient-out-of-pocket-spending-in-13-673-consecutive-neurosurgery-cases
#2
Michael A Mooney, Seungwon Yoon, Tyler Cole, John P Sheehy, Michael A Bohl, F David Barranco, Peter Nakaji, Andrew S Little, Michael T Lawton
BACKGROUND: Patient out-of-pocket (OOP) spending is an increasingly discussed topic; however, there is minimal data available on the patient financial burden of surgical procedures. OBJECTIVE: To analyze hospital and surgeon expected payment data and patient OOP spending in neurosurgery. METHODS: This is a retrospective cohort study of neurosurgical patients at a tertiary-referral center from 2013 to 2016. Expected payments, reflecting negotiated costs-of-care, as well as actual patient OOP payments for hospital care and surgeon professional fees were analyzed...
May 15, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29754046/brain-stiffens-post-mortem
#3
J Weickenmeier, M Kurt, E Ozkaya, R de Rooij, T C Ovaert, R L Ehman, K Butts Pauly, E Kuhl
Alterations in brain rheology are increasingly recognized as a diagnostic marker for various neurological conditions. Magnetic resonance elastography now allows us to assess brain rheology repeatably, reproducibly, and non-invasively in vivo. Recent elastography studies suggest that brain stiffness decreases one percent per year during normal aging, and is significantly reduced in Alzheimer's disease and multiple sclerosis. While existing studies successfully compare brain stiffnesses across different populations, they fail to provide insight into changes within the same brain...
April 22, 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29753080/palatal-position-of-patient-tracker-for-magnetic-neuronavigation-system-technical-note
#4
Giuseppe Catapano, Francesco Giovanni Sgulò, Piedad Elizabeth Acurio Padilla, Pietro Spennato, Giuseppe Di Nuzzo, Vincenzo Boniello, Matteo de Notaris
OBJECTIVE: Recently, the neuronavigation system (NS) has become an essential intraoperative tool for many neurosurgical procedures allowing for precise lesion localization. For such reason, it is particularly important to avoid errors during the navigation process. In the present study focus on a novel technique with the palatal position of patient tracker to ensure an optimal accuracy during magnetic navigation in different neurosurgical procedures. METHODS: The present retrospective study included a total of 34 patients treated in our Institution between June 2017 and January 2018...
May 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29746544/free-water-modeling-of-peritumoral-edema-using-multi-fiber-tractography-application-to-tracking-the-arcuate-fasciculus-for-neurosurgical-planning
#5
Shun Gong, Fan Zhang, Isaiah Norton, Walid I Essayed, Prashin Unadkat, Laura Rigolo, Ofer Pasternak, Yogesh Rathi, Lijun Hou, Alexandra J Golby, Lauren J O'Donnell
PURPOSE: Peritumoral edema impedes the full delineation of fiber tracts due to partial volume effects in image voxels that contain a mixture of cerebral parenchyma and extracellular water. The purpose of this study is to investigate the effect of incorporating a free water (FW) model of edema for white matter tractography in the presence of edema. MATERIALS AND METHODS: We retrospectively evaluated 26 consecutive brain tumor patients with diffusion MRI and T2-weighted images acquired presurgically...
2018: PloS One
https://www.readbyqxmd.com/read/29743581/evolution-of-gamma-knife-capsulotomy-for-intractable-obsessive-compulsive-disorder
#6
REVIEW
Euripedes C Miguel, Antonio C Lopes, Nicole C R McLaughlin, Georg Norén, André F Gentil, Clement Hamani, Roseli G Shavitt, Marcelo C Batistuzzo, Edoardo F Q Vattimo, Miguel Canteras, Antonio De Salles, Alessandra Gorgulho, João Victor Salvajoli, Erich Talamoni Fonoff, Ian Paddick, Marcelo Q Hoexter, Christer Lindquist, Suzanne N Haber, Benjamin D Greenberg, Sameer A Sheth
For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions...
May 9, 2018: Molecular Psychiatry
https://www.readbyqxmd.com/read/29738857/the-effect-of-tumour-neovasculature-on-fmri-bold-activation
#7
Layla Gould, Chelsea Ekstrand, Daryl R Fourney, Marla J S Mickleborough, Tasha Ellchuk, Ron Borowsky
We report a 40-year-old patient with a large, WHO grade III oligodendroglioma in the left parietal lobe. Presurgical planning included fMRI localization of language, motor, and somatosensory processing. The fMRI results for the motor and somatosensory tasks revealed activation in peri-lesional regions near the surgical resection, as well as deactivation in the tumour for the sensory task, suggesting that there is decreased autoregulation in the region due to the glioma. The fMRI results showed left hemisphere dominance for language, as well as activation in peri-lesional regions for all three speech tasks (i...
May 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29712524/patient-out-of-pocket-spending-in-cranial-neurosurgery-single-institution-analysis-of-6569-consecutive-cases-and-literature-review
#8
Seungwon Yoon, Michael A Mooney, Michael A Bohl, John P Sheehy, Peter Nakaji, Andrew S Little, Michael T Lawton
OBJECTIVE With drastic changes to the health insurance market, patient cost sharing has significantly increased in recent years. However, the patient financial burden, or out-of-pocket (OOP) costs, for surgical procedures is poorly understood. The goal of this study was to analyze patient OOP spending in cranial neurosurgery and identify drivers of OOP spending growth. METHODS For 6569 consecutive patients who underwent cranial neurosurgery from 2013 to 2016 at the authors' institution, the authors created univariate and multivariate mixed-effects models to investigate the effect of patient demographic and clinical factors on patient OOP spending...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29682053/penetrating-injury-to-cauda-equina-from-a-missile-fragment-completely-recovered-after-delayed-surgical-removal-of-ballistic-fragment
#9
Kamble Jayaprakash Harsha, Anu Thomas
Penetrating injuries to cauda equina due to missile fragment are rare. The mechanism of injury may be more complex due to thermal effect of missile fragment, apart from mechanisms described in penetrating gunshot injuries or stab injuries. We report a case of a 42-year-old male with penetrating missile injury to cauda equina, improved completely after delayed surgical exploration and removal of ballistic fragment. Furthermore, his bowel and bladder dysfunction improved completely within 1 week of neurosurgical exploration...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682029/meningioma-consistency-correlation-between-magnetic-resonance-imaging-characteristics-operative-findings-and-histopathological-features
#10
Mahmoud Alyamany, Mohammad M Alshardan, Abdullah Abu Jamea, Nahid ElBakry, Lahbib Soualmi, Yasser Orz
Introduction: Intracranial meningiomas account for 30% of all primary intracranial tumors. Surgical resection remains the mainstay of the treatment for meningiomas. The magnetic resonance of intracranial meningiomas has been largely discussed in many reports of the radiological and neurosurgical literature. To date, a few studies have been attempted to differentiate the tumor characteristics of meningiomas based on magnetic resonance imaging (MRI) studies. Objective: The objective of the study is to evaluate the relationship between MRI signal characteristics of intracranial meningiomas and consistency of tumor using objective measures...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29675718/ultrasound-guided-brain-surgery-echographic-visibility-of-different-pathologies-and-surgical-applications-in-neurosurgical-routine
#11
Domenico Policicchio, Artan Doda, Enrico Sgaramella, Stefano Ticca, Filippo Veneziani Santonio, Riccardo Boccaletti
BACKGROUND: The use of intraoperative ultrasound (iUS) has increased in the last 15 years becoming a standard tool in many neurosurgical centers. Our aim was to assess the utility of routine use of iUS during various types of intracranial surgery. We reviewed our series to assess ultrasound visibility of different pathologies and iUS applications during the course of surgery. MATERIALS AND METHODS: This is a retrospective review of 162 patients who underwent intracranial surgery with assistance of the iUS guidance system (SonoWand)...
April 19, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29665151/validation-of-the-pediatric-nexus-ii-head-ct-decision-instrument-for-selective-imaging-of-pediatric-patients-with-blunt-head-trauma
#12
Malkeet Gupta, William R Mower, Robert M Rodriguez, Gregory W Hendey
BACKGROUND: Data suggests that clinicians, when evaluating pediatric patients with blunt head trauma, may be over-ordering head computed tomography. Prior decision instruments aimed at aiding clinicians in safely forgoing CTs may be paradoxically increasing CT utilization. This study evaluated a novel decision instrument that aims for high sensitivity while also improving specificity over prior instruments. METHODS: We conducted a planned secondary analysis of the NEXUS Head CT decision instrument (DI) among patients less than 18 years old...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29657910/anterolateral-triangle-a-cadaveric-study-with-neurosurgical-significance
#13
Andre Granger, Ornella Bricoune, Tina Rajnauth, David Kimball, Heather Kimball, R Shane Tubbs, Marios Loukas
The anterolateral triangle is one of 10 surgical triangles of the cavernous sinus and serves as an important anatomic landmark for the skull base surgeon. There are few studies in the English literature that have precisely defined and measured the borders of the anterolateral triangle and little agreement has been made regarding the nomenclature within the English literature. A total of 12 midsagittally hemisected adult human cadaveric head halves were dissected to expose the anterolateral triangle. The triangle was defined and measurements of the anterior, posterior, and lateral borders were taken...
February 12, 2018: Curēus
https://www.readbyqxmd.com/read/29569513/a-role-for-the-frontal-aslant-tract-in-speech-planning-a-neurosurgical-case-study
#14
Benjamin L Chernoff, Alex Teghipco, Frank E Garcea, Max H Sims, David A Paul, Madalina E Tivarus, Susan O Smith, Webster H Pilcher, Bradford Z Mahon
Frontal and temporal white matter pathways play key roles in language processing, but the specific computations supported by different tracts remain a matter of study. A role in speech planning has been proposed for a recently described pathway, the frontal aslant tract (FAT), which connects the posterior inferior frontal gyrus to the pre-SMA. Here, we use longitudinal functional and structural MRI and behavioral testing to evaluate the behavioral consequences of a lesion to the left FAT that was incurred during surgical resection of a frontal glioma in a 60-year-old woman, Patient AF...
May 2018: Journal of Cognitive Neuroscience
https://www.readbyqxmd.com/read/29554354/application-of-lean-principles-to-neurosurgical-procedures-the-case-of-lumbar-spinal-fusion-surgery-a-literature-review-and-pilot-series
#15
Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29547092/the-reliability-of-identifying-the-omega-sign-using-axial-t2-weighted-magnetic-resonance-imaging
#16
Hesham Mostafa Zakaria, Peter Joseph Massa, Richard L Smith, Tarek Hazem Moharram, John Corrigan, Ian Lee, Lonni Schultz, Jianhui Hu, Suresh Patel, Brent Griffith
Preoperative identification of the eloquent brain is important for neurosurgical planning. One common method of finding the motor cortex is by localizing "the Omega sign." No studies have tested the reliability of imaging to identify the Omega sign. We identified 40 recent and consecutive patients who had undergone preoperative functional magnetic resonance imaging for identification of the hand motor area prior to tumor resection. We recruited 11 neurosurgical residents of various levels of training and one board-certified neurosurgeon to identify the hand motor cortex Omega...
January 1, 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29547081/surgical-outcome-of-motor-deficits-and-neurological-status-in-brainstem-cavernous-malformations-based-on-preoperative-diffusion-tensor-imaging-a-prospective-randomized-clinical-trial
#17
Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29543216/-evidence-based-medicine-opportunities-of-the-propensity-score-matching-psm-method-in-eliminating-selection-bias-in-retrospective-neurosurgical-studies
#18
A V Moskalev, V S Gladkikh, A A Al'shevskaya, A P Kovalevskiy, A I Sakhanenko, K Yu Orlov, N A Konovalov, A V Krut'ko
To date, a large amount of retrospectively collected data about treatment of neurosurgical pathology have been accumulated. Modern methods of medical statistics are necessary for correct interpretation of the data. The article purpose is to demonstrate application of one of the modern methods, Propensity Score Matching (PSM), in neurosurgery. The use of PSM avoids misinterpretation of retrospectively collected data and obviates errors in planning further prospective studies. For the past 10 years, the number of published international PSM-based studies has increased more than 10-fold, with the number of articles by Russian authors accounting for less than 0...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29543211/-preoperative-and-postoperative-endocrine-disorders-associated-with-pituitary-stalk-injuries-caused-by-suprasellar-growing-tumors
#19
B A Kadashev, A N Konovalov, L I Astaf'eva, P L Kalinin, M A Kutin, I S Klochkova, D V Fomichev, O I Sharipov, D N Andreev
The pituitary stalk (PS) is a relatively thin bundle connecting the hypophyseal stalk to the pituitary gland; it consists of both axons of the hypothalamic nuclei (terminating in the neurohypophysis) and the system of portal vessels. Compression of the PS by a space-occupying lesion or its transection (forced or intended) during surgery may lead to the development of endocrine disorders: hypopituitarism, diabetes insipidus, and hyperprolactinemia. The modern literature lacks studies evaluating the severity of endocrine disorders depending on the PS condition before and after surgery...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29531877/a-suspected-vestibular-schwannoma-with-uncharacteristic-growth-dynamic-and-symptom-severity-a-case-report
#20
Felix Ehret, Alexander Muacevic
Vestibular schwannomas are mostly sporadic, neuroectodermal, benign tumors of the myelin-forming cells of the vestibulocochlear nerve. Typical initial symptoms of vestibular schwannomas often include unilateral hearing loss, tinnitus, vertigo, and headaches. As schwannomas characteristically show a slow growth rate and various symptoms, different therapeutic approaches are possible, ranging from a watchful waiting strategy to radiation therapy and neurosurgical tumor removal. In addition, these treatment options should be evaluated carefully and assigned individually to the patients' needs and symptoms while respecting the feasibility and possible outcome of the chosen treatment...
January 5, 2018: Curēus
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