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https://www.readbyqxmd.com/read/27906525/the-clinical-utility-of-qsm-disease-diagnosis-medical-management-and-surgical-planning
#1
REVIEW
Sarah Eskreis-Winkler, Yan Zhang, Jingwei Zhang, Zhe Liu, Alexey Dimov, Ajay Gupta, Yi Wang
Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients...
December 1, 2016: NMR in Biomedicine
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#2
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27861321/laser-interstitial-thermal-therapy-technology-physics-of-magnetic-resonance-imaging-thermometry-and-technical-considerations-for-proper-catheter-placement-during-magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy
#3
Nitesh V Patel, Matthew Mian, R Jason Stafford, Brian V Nahed, Jon T Willie, Robert E Gross, Shabbar F Danish
: Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27818327/an-educational-intervention-optimizes-the-utilization-of-arterial-blood-gases-across-intensive-care-units-from-different-specialties-a-quality-improvement-study
#4
Carlos D Martínez-Balzano, Paulo Oliveira, Michelle O'Rourke, Luanne Hills, Andrés F Sosa
BACKGROUND: Arterial blood gas (ABG) overutilization leads to increased costs, inefficient use of staff work-hours, patient discomfort and blood loss. We developed guidelines to optimize ABG utilization in the intensive care unit (ICU). METHODS: ABG utilization guidelines were implemented on all adult ICUs in our institution: three medical, two trauma-surgery, one cardiovascular and one neurosurgical ICU. While relying on pulse oximetry, we encouraged the utilization of ABGs after an acute respiratory event or for a rational clinical concern, and discouraged obtaining ABGs for routine surveillance, after planned changes of PEEP or FiO2 on the mechanical ventilator, for spontaneous breathing trials, or when a disorder was not suspected...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27817764/supplementary-educational-models-in-canadian-neurosurgery-residency-programs
#5
Won Hyung A Ryu, Sonny Chan, Garnette R Sutherland
BACKGROUND: The proposed implementation of work hour restrictions has presented a significant challenge of maintaining the quality of resident education and ensuring adequate hands-on experience that is essential for novice surgeons. To maintain the level of resident surgical competency, revision of the apprentice model of surgical education to include supplementary educational methods, such as laboratory and virtual reality (VR) simulations, have become frequent topics of discussion...
November 7, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27802190/breast-cancer-brain-metastases-molecular-subtype-treatment-and-survival
#6
Jennifer A Crozier, Lauren F Cornell, Bhupendra Rawal, Edith A Perez
BACKGROUND: No clear guidelines exist for management of breast cancer brain metastases (BCBM). OBJECTIVE: We assessed the relationship between patient and tumor characteristics, treatment, and overall survival (OS). METHODS: We conducted a retrospective review of 196 patients who received brain radiation for BCBM between 2009-2013 at Mayo Clinic. Primary tumor characteristics were collected, including simplified molecular subtype. Other characteristics included patient's ECOG, number of brain lesions at BCBM diagnosis, and treatment received, including neurosurgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS)...
October 14, 2016: Breast Disease
https://www.readbyqxmd.com/read/27801399/-the-modern-role-of-microsurgery-in-treatment-of-large-and-giant-aneurysms-of-the-internal-carotid-artery
#7
O D Shekhtman, Sh Sh Eliava, S B Yakovlev, Yu V Pilipenko, An N Konovalov
INTRODUCTION: Large (1.5-2.5 cm) and giant (>2.5 cm in diameter) aneurysms of the internal carotid artery (ICA) remain one of the complex neurosurgical pathologies in terms of microsurgery. In recent years, endovascular techniques for treatment of paraclinoid aneurysms, in particular ICA reconstruction using flow-diverting stents, have become a priority. However, surgery of flow stents has a number of limitations, therefore the choice of treatment in each case is individual. PURPOSE: To analyze the results of direct surgery in patients with large and giant aneurysms of the ICA and to determine the role and place of modern microsurgical techniques in the treatment of this vascular disease...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27791707/intraoperative-magnetic-resonance-imaging-in-pediatric-neurosurgery-safety-and-utility
#8
Mario Giordano, Amir Samii, Anna C Lawson McLean, Helmut Bertalanffy, Rudolf Fahlbusch, Madjid Samii, Concezio Di Rocco
OBJECTIVE The use of high-field intraoperative MRI has been largely studied for the treatment of intracranial tumors in adult patients. In this study, the authors investigated the safety, advantages, and limitations of high-field iMRI for cranial neurosurgical procedures in pediatric patients, with particular attention to craniopharyngiomas and gliomas. METHODS The authors performed 82 surgical procedures in patients under 16 years of age (range 0.8-15 years) over an 8-year period (2007-2014) using iMRI. The population was divided into 3 groups based on the condition treated: sellar region tumors (Group 1), gliomas (Group 2), and other pathological entities (Group 3)...
October 28, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27760477/the-nottingham-expectation-and-complication-score-following-surgery-necs-an-universal-scale-for-surgical-outcome-audit-and-peer-comparison
#9
Harshal Ingale, Samiul Muquit, Othman Al-Helli, Barrie White, Surajit Basu
BACKGROUND: Consultant Outcomes Publication (COP) is an NHS England initiative for promoting improvements in quality of care. However, at present outcomes are commonly expressed as mortality rates which do not necessarily reflect the performance of surgeons. We developed the Nottingham Expectation and Complication score following Surgery (NECS) to determine the success of surgical treatment from both the clinical perspective and the practical expectations agreed between surgeons and patients during the consent process...
October 20, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27647682/active-delineation-of-meyer-s-loop-using-oriented-priors-through-magnetic-tractography-magnet
#10
Maxime Chamberland, Benoit Scherrer, Sanjay P Prabhu, Joseph Madsen, David Fortin, Kevin Whittingstall, Maxime Descoteaux, Simon K Warfield
Streamline tractography algorithms infer connectivity from diffusion MRI (dMRI) by following diffusion directions which are similarly aligned between neighboring voxels. However, not all white matter (WM) fascicles are organized in this manner. For example, Meyer's loop is a highly curved portion of the optic radiation (OR) that exhibits a narrow turn, kissing and crossing pathways, and changes in fascicle dispersion. From a neurosurgical perspective, damage to Meyer's loop carries a potential risk of inducing vision deficits to the patient, especially during temporal lobe resection surgery...
September 20, 2016: Human Brain Mapping
https://www.readbyqxmd.com/read/27636179/image-guided-endoscopic-surgery-for-spontaneous-supratentorial-intracerebral-hematoma
#11
Guo-Chen Sun, Xiao-Lei Chen, Yuan-Zheng Hou, Xin-Guang Yu, Xiao-Dong Ma, Gang Liu, Lei Liu, Jia-Shu Zhang, Hao Tang, Ru-Yuan Zhu, Ding-Biao Zhou, Bai-Nan Xu
OBJECTIVE Endoscopic removal of intracerebral hematomas is becoming increasingly common, but there is no standard technique. The authors explored the use of a simple image-guided endoscopic method for removal of spontaneous supratentorial hematomas. METHODS Virtual reality technology based on a hospital picture archiving and communications systems (PACS) was used in 3D hematoma visualization and surgical planning. Augmented reality based on an Android smartphone app, Sina neurosurgical assist, allowed a projection of the hematoma to be seen on the patient's scalp to facilitate selection of the best trajectory to the center of the hematoma...
September 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27625895/iatrogenic-spinal-hematoma-as-a-complication-of-lumbar-puncture-what-is-the-risk-and-best-management-plan
#12
Merritt Weaver Brown, Tülin Serap Yilmaz, Ekkehard M Kasper
BACKGROUND: Lumbar puncture (LP) rarely results in complications such as spinal hematomas. However, it remains unclear if certain variables increase likelihood of these events, or if surgical intervention improves outcome. METHODS: In addition to two clinical vignettes, we evaluated the post-1974 literature for cases of spinal hematoma and subsequent intervention. Based on our compilation of data, we evaluated outcome relative to numerous distinct variables. RESULTS: Based on 35 LP-related spinal hematoma cases in the post-1974 literature and our encounters, we found 28...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27564466/functional-connectivity-networks-for-preoperative-brain-mapping-in-neurosurgery
#13
Michael G Hart, Stephen J Price, John Suckling
OBJECTIVE Resection of focal brain lesions involves maximizing the resection while preserving brain function. Mapping brain function has entered a new era focusing on distributed connectivity networks at "rest," that is, in the absence of a specific task or stimulus, requiring minimal participant engagement. Central to this frame shift has been the development of methods for the rapid assessment of whole-brain connectivity with functional MRI (fMRI) involving blood oxygenation level-dependent imaging. The authors appraised the feasibility of fMRI-based mapping of a repertoire of functional connectivity networks in neurosurgical patients with focal lesions and the potential benefits of resting-state connectivity mapping for surgical planning...
August 26, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27542623/reliability-of-smartphone-based-teleradiology-for-evaluating-thoracolumbar-spine-fractures
#14
Ido Stahl, Daniel Dreyfuss, Dror Ofir, Lior Merom, Michael Raichel, Nir Hous, Doron Norman, Elias Haddad
BACKGROUND CONTEXT: Timely interpretation of computed tomography (CT) scans is of paramount importance in diagnosing and managing spinal column fractures, which can be devastating. Out-of-hospital, on-call spine surgeons are often asked to evaluate CT scans of patients who have sustained trauma to the thoracolumbar spine to make diagnosis and to determine the appropriate course of urgent treatment. Capturing radiographic scans and video clips from computer screens and sending them as instant messages have become common means of communication between physicians, aiding in triaging and transfer decision-making in orthopedic and neurosurgical emergencies...
August 16, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27526561/-fractionated-stereotactic-radiosurgery-a-game-changer-for-neurosurgery
#15
EDITORIAL
Ouzi Nissim, Roberto Spiegelmann
The article by Dr. Cohen-Inbar published in this issue of Harefuah is a timely review that brings to the general medical community the recent important developments in the field of radiosurgery--the evolution of multi-session radiosurgery [or "FSR", standing for Fractionated Stereotactic Radiation]. Radiosurgery and FSR continue to have a tremendous impact on modern neurosurgery. Sharing sub-millimetric accuracy in radiation delivery made possible by real-time-imaging positioning, frameless single and multisession radiosurgery have become two faces of a therapeutic technique with wide application in the field of intracranial pathology...
May 2016: Harefuah
https://www.readbyqxmd.com/read/27454265/the-potential-impact-of-venobasillar-system-morphology-and-applied-technique-on-epidural-cement-leakage-with-percutaneous-vertebroplasty
#16
Andrey Bokov, Sergey Mlyavykh, Alexander Aleynik, Marina Kutlaeva, Greg Anderson
BACKGROUND: Bone cement leakage during vertebroplasty is a frequently reported complication with the potential for neural injury. OBJECTIVE: To assess risk factors for epidural cement leakage during vertebroplasty. SETTING: Neurosurgical department of a scientific research institute. STUDY DESIGN: This is a prospective cross-sectional randomized trial. METHODS: Seventy-five patients with intractable pain due to low energy vertebral compression fractures between T11 and L5 were treated with vertebroplasty at 150 vertebral levels...
July 2016: Pain Physician
https://www.readbyqxmd.com/read/27448172/venous-air-embolus-during-prone-cervical-spine-fusion-case-report
#17
Aurora S Cruz, Marc Moisi, Jeni Page, R Shane Tubbs, David Paulson, Michael Zwillman, Rod Oskouian, Arthur Lam, David W Newell
Venous air embolism (VAE) is a known neurosurgical complication classically and most frequently occurring in patients undergoing posterior cranial fossa or cervical spine surgery in a sitting or semi-sitting position. The authors present a case of VAE that occurred during posterior cervical spine surgery in a patient in the prone position, a rare intraoperative complication. The patient was a 65-year-old man who was undergoing a C1-2 fusion for a nonunion of a Type II dens fracture and developed a VAE. While VAE in the prone position is uncommon, it is a neurosurgical complication that may have significant clinical implications both intraoperatively and postoperatively...
December 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27445706/the-co-evolution-of-neuroimaging-and-psychiatric-neurosurgery
#18
REVIEW
Timothy G Dyster, Charles B Mikell, Sameer A Sheth
The role of neuroimaging in psychiatric neurosurgery has evolved significantly throughout the field's history. Psychiatric neurosurgery initially developed without the benefit of information provided by modern imaging modalities, and thus lesion targets were selected based on contemporary theories of frontal lobe dysfunction in psychiatric disease. However, by the end of the 20th century, the availability of structural and functional magnetic resonance imaging (fMRI) allowed for the development of mechanistic theories attempting to explain the anatamofunctional basis of these disorders, as well as the efficacy of stereotactic neuromodulatory treatments...
2016: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/27428785/evaluation-of-diffusion-tensor-imaging-based-tractography-of-the-corticospinal-tract-a-correlative-study-with-intraoperative-magnetic-resonance-imaging-and-direct-electrical-subcortical-stimulation
#19
Seyed Amirhossein Javadi, Arya Nabavi, Mario Giordano, Elham Faghihzadeh, Amir Samii
BACKGROUND: The accuracy of intraoperative diffusion tensor imaging (DTI)-based tractography of the corticospinal tract (CST) is crucial for its use in neurosurgical planning and its implementation in image-guided surgery. To the best of our knowledge, this is the largest prospective study of the intraoperative direct electrical subcortical stimulation (DESS) of the CST with intraoperative DTI tractography of the CST, with application of intraoperative magnetic resonance imaging (iMRI)...
July 13, 2016: Neurosurgery
https://www.readbyqxmd.com/read/27399533/335%C3%A2-a-modular-multimodality-integrative-pipeline-for-neurosurgery-simulation-and-visualization
#20
Anthony Beardsworth Costa, Joshua B Bederson
INTRODUCTION: The practice of pre- and intraoperative interactive visualization and modeling continues to grow as its value to clinical practice is augmented by new technologies, such as virtual and augmented reality, or 3D printing. Current tools that extract the necessary structural information from medical imaging modalities and allow virtual or other interrogation of the data are either difficult to use in a practical clinical setting, or sufficiently simple as to limit the knowledge available to the operator...
August 2016: Neurosurgery
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