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Neurosurgical planning

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https://www.readbyqxmd.com/read/28414967/pharmacodynamics-of-remifentanil-induced-intracranial-spike-activity-in-mesial-temporal-lobe-epilepsy
#1
Troels Wesenberg Kjaer, Hans Hogenhaven, Andrea P Lee, Flemming Find Madsen, Bo Jespersen, Jannick Brennum, Lennart Derm, Finn Borgbjerg Moltke
Patients with medically refractory epilepsy may benefit from resective epilepsy surgery. However even the best centers experience surgical failures. It is therefore important to find techniques that may aid in neurosurgical planning of epileptic focus resection. Recordings of electrical brain activity with EEG during seizures reveal abnormal cortical hypersynchronization. Between seizures the EEG often shows interictal depolarizing phenomena such as spikes reflecting an irritable focus of the brain. In the present study we investigated the effect of intravenous remifentanil on the spike activity in the temporal neocortex and hippocampus...
March 31, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28400898/many-neurology-readmissions-are-nonpreventable
#2
Sidney T Le, S Andrew Josephson, Hans A Puttgen, Lorrie Gibson, Elan L Guterman, Heather M Leicester, Carla L Graf, John C Probasco
INTRODUCTION: Reducing unplanned hospital readmissions has become a national focus due to the Centers for Medicare and Medicaid Services' (CMS) penalties for hospitals with high rates. A first step in reducing unplanned readmission is to understand which patients are at high risk for readmission, which readmissions are planned, and how well planned readmissions are currently captured in comparison to patient-level chart review. METHODS: We examined all 5455 inpatient neurology admissions over a 2-year period to University of California San Francisco Medical Center and Johns Hopkins Hospital via chart review...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28382397/does-scope-of-practice-correlate-with-the-outcomes-of-craniotomy-for-tumor-resection-in-children
#3
Symeon Missios, Kimon Bekelis
BACKGROUND: The relationship of scope of practice (predominantly adult, versus predominantly pediatric) with the outcomes of brain tumor surgery in children remains uncertain. We investigated the association of practice focus with the outcomes of neurosurgical oncology operations in pediatric patients. METHODS: We performed a cohort study of all pediatric patients (younger than 18 years old) who underwent craniotomies for tumor resections from 2009 to 2013 and were registered in the Statewide Planning and Research Cooperative System (SPARCS) database...
April 5, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28377253/implementing-functional-preoperative-mapping-in-the-clinical-routine-of-a-neurosurgical-department-technical-note
#4
Nico Sollmann, Bernhard Meyer, Sandro M Krieg
BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for mapping of various brain functions and nTMS-based tractography in neurosurgical departments worldwide. When a department starts integrating nTMS data into the clinical workflow, smooth implementation in the existing hospital's infrastructure is mandatory. However, standardized approaches beyond the mapping or tractography procedures themselves have not yet been described. METHODS: To create an effective workflow for neurosurgical nTMS mapping, we present the results of our 7 years of experience and progressive integration into clinical routine...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28362962/correlation-of-subjective-hospital-compare-metrics-with-objective-outcomes-of-cranial-neurosurgical-procedures-in-new-york-state
#5
Kimon Bekelis, Symeon Missios, Shannon Coy, Redi Rahmani, Todd A MacKenzie, Anthony L Asher
BACKGROUND: Public reporting is at the forefront of health care reform. OBJECTIVE: To investigate whether patient satisfaction as expressed in a public reporting platform correlates with objective outcomes for cranial neurosurgery patients. METHODS: We performed a cohort study involving patients undergoing cranial neurosurgery from 2009 to 2013 who were registered in the Statewide Planning and Research Cooperative System database. This cohort was merged with the corresponding data from the Centers for Medicare and Medicaid Services Hospital Compare website...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362934/three-dimensional-printed-modeling-of-diffuse-low-grade-gliomas-and-associated-white-matter-tract-anatomy
#6
Jayesh P Thawani, Nickpreet Singh, Jared M Pisapia, Kalil G Abdullah, Drew Parker, Bryan A Pukenas, Eric L Zager, Ragini Verma, Steven Brem
BACKGROUND: Diffuse low-grade gliomas (DLGGs) represent several pathological entities that infiltrate and invade cortical and subcortical structures in the brain. OBJECTIVE: To describe methods for rapid prototyping of DLGGs and surgically relevant anatomy. METHODS: Using high-definition imaging data and rapid prototyping technologies, we were able to generate 3 patient DLGGs to scale and represent the associated white matter tracts in 3 dimensions using advanced diffusion tensor imaging techniques...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28362185/reoperations-within-48-hours-following-7942-pediatric-neurosurgery-procedures
#7
Anil K Roy, Jason Chu, Caroline Bozeman, Samir Sarda, Michael Sawvel, Joshua J Chern
OBJECTIVE Various indicators are used to evaluate the quality of care delivered by surgical services, one of which is early reoperation rate. The indications and rate of reoperations within a 48-hour time period have not been previously reported for pediatric neurosurgery. METHODS Between May 1, 2009, and December 30, 2014, 7942 surgeries were performed by the pediatric neurosurgery service in the operating rooms at a single institution. Demographic, socioeconomic, and clinical characteristics associated with each of the operations were prospectively collected...
March 31, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28359922/first-application-of-7t-magnetic-resonance-imaging-in-endoscopic-endonasal-surgery-of-skull-base-tumors
#8
Thomas F Barrett, Hadrien A Dyvorne, Francesco Padormo, Puneet S Pawha, Bradley N Delman, Raj K Shrivastava, Priti Balchandani
BACKGROUND: Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. METHODS: Images were acquired at 7T on 11 patients with skull base lesions...
March 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28331887/android-application-for-determining-surgical-variables-in-brain-tumor-resection-procedures
#9
Rohan C Vijayan, Reid C Thompson, Lola B Chambless, Peter J Morone, Le He, Logan W Clements, Rebekah H Griesenauer, Hakmook Kang, Michael I Miga
The fidelity of image-guided neurosurgical procedures is often compromised due to the mechanical deformations that occur during surgery. In recent work, a framework was developed to predict the extent of this brain shift in brain-tumor resection procedures. The approach uses preoperatively determined surgical variables to predict brain shift and then subsequently corrects the patient's preoperative image volume to more closely match the intraoperative state of the patient's brain. However, a clinical workflow difficulty with the execution of this framework is the preoperative acquisition of surgical variables...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#10
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28291210/-long-association-tracts-of-the-human-white-matter-an-analysis-of-18-hemisphere-dissections-and-in-vivo-hardi-csd-tractography
#11
S A Goryainov, A V Kondrashov, M F Gol'dberg, A I Batalov, R A Sufianov, N E Zakharova, I N Pronin, D A Gol'bin, V Yu Zhukov, G F Dobrovol'sky, S Yu Shelyakin, V N Vorob'ev, S S Dadykin, A A Potapov
BACKGROUND: Anatomy of the conduction tracts of the cerebral cortex has been studied for a long time. Invention of diffusion tensor tractography renewed interest in this subject. The objectives of this work were to develop and improve protocols for dissection of the long association tracts of the human brain with studying the features of their segmentation, topography, and variability, compare the obtained data with the MR tractography data, and prepare for further clinical and anatomical studies...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28286317/7t-fmri-faster-temporal-resolution-yields-optimal-bold-sensitivity-for-functional-network-imaging-specifically-at-high-spatial-resolution
#12
Peter E Yoo, Sam E John, Shawna Farquharson, Jon O Cleary, Yan T Wong, Amanda Ng, Claire Mulcahy, David B Grayden, Roger J Ordidge, Nicholas L Opie, Terence J O'Brien, Thomas J Oxley, Bradford A Moffat
Recent developments in accelerated imaging methods allow faster acquisition of high spatial resolution images. This could improve the applications of functional magnetic resonance imaging at 7 T (7T-fMRI), such as neurosurgical planning and Brain Computer Interfaces (BCIs). However, increasing the spatial and temporal resolution will both lead to signal-to-noise ratio (SNR) losses due to decreased signal intensity and T1-relaxation effect, respectively. This could potentially offset the SNR efficiency gains made with increasing temporal resolution...
March 7, 2017: NeuroImage
https://www.readbyqxmd.com/read/28236117/3d-ultrasound-registration-based-visual-servoing-for-neurosurgical-navigation
#13
Oliver Zettinig, Benjamin Frisch, Salvatore Virga, Marco Esposito, Anna Rienmüller, Bernhard Meyer, Christoph Hennersperger, Yu-Mi Ryang, Nassir Navab
PURPOSE: We present a fully image-based visual servoing framework for neurosurgical navigation and needle guidance. The proposed servo-control scheme allows for compensation of target anatomy movements, maintaining high navigational accuracy over time, and automatic needle guide alignment for accurate manual insertions. METHOD: Our system comprises a motorized 3D ultrasound (US) transducer mounted on a robotic arm and equipped with a needle guide. It continuously registers US sweeps in real time with a pre-interventional plan based on CT or MR images and annotations...
February 24, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28220369/severe-head-injury-in-very-old-patients-to-treat-or-not-to-treat-results-of-an-online-questionnaire-for-neurosurgeons
#14
Claudia Unterhofer, Sebastian Hartmann, Christian F Freyschlag, Claudius Thomé, Martin Ortler
Due to the aging population, neurosurgeons are confronted with an increasing number of very old patients suffering from traumatic brain injury. Many of these patients present with an acute subdural hematoma. There is a lack of data on neurosurgical decision-making in elderly people. We investigated the importance of imaging criteria, patients' wishes, their surrogates' wishes, and patient demographics on treatment decisions chosen by neurosurgeons. An online questionnaire was sent to all German neurosurgical units via the German Society of Neurosurgery (DGNC)...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#15
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28216396/estimating-the-cost-of-neurosurgical-procedures-in-a-low-income-setting-an-observational-economic-analysis
#16
Jihad Abdelgadir, Tu Tran, Alex Muhindo, Doomwin Obiga, John Mukasa, Hussein Ssenyonjo, Michael Muhumza, Joel Kiryabwire, Michael M Haglund, Frank A Sloan
BACKGROUND: There are no data on cost of neurosurgery in low- and middle-income countries. This study's objective was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. METHODS: In this observational economic analysis, micro-costing was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). RESULTS: During the study period, October 2014-September 2015, a total of 1,440 charts were reviewed...
February 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28170143/prevalence-of-brain-injuries-and-recurrence-of-seizures-in-children-with-post-traumatic-seizures
#17
Mohamed K Badawy, Peter S Dayan, Michael G Tunik, Frances M Nadel, Kathleen A Lillis, Michelle Miskin, Dominic A Borgialli, Michael C Bachman, Shireen M Atabaki, John D Hoyle, James F Holmes, Nathan Kuppermann
OBJECTIVES: Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with post-traumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBI) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBI on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS...
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28162253/-intramedullary-ependymomas-a-french-retrospective-multicenter-study-of-221%C3%A2-cases
#18
N Aghakhani, M Messerer, P David, A Herbrecht, F Parker
AIM: Intramedullary ependymomas (IE) are the most frequent intramedullary tumors in the adult population. The gold standard treatment is to obtain gross total removal without any new postoperative neurological deficit. The authors report the results of a multicenter series with a long-term follow-up and the analysis of clinical, radiological, surgical data as well as the complementary treatments. MATERIALS AND METHODS: A retrospective analysis of adult patients with IE operated on between January 1984 and December 2011 at 7 French centers (Bordeaux, Kremlin-Bicêtre, Lille, Lyon, Marseille, Montpellier, Nice, and Nîmes) was performed...
February 2, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28140499/deterministic-tractography-of-the-descending-tract-of-the-spinal-trigeminal-nerve-using-diffusion-tensor-imaging
#19
Daniel J Burkett, Jonathan R Garst, Jacquelyn P Hill, Anthony Kam, Douglas E Anderson
BACKGROUND AND PURPOSE: Pain information from the face enters the pons via the trigeminal nerve before creating an anatomical "elbow" that turns caudally into the spinal trigeminal tract (SpTV). Visualization of the descending tract of the trigeminal nerve as it begins its descent from the nerve root entry zone (NREZ) in the pons would improve the accuracy of current procedures aimed at altering or lesioning the trigeminal nerve within the brainstem. The focus of this study was to develop a standardized protocol using diffusion tensor imaging (DTI) and deterministic tractography methods to image the SpTV...
January 31, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28075197/validation-of-an-established-prognostic-score-after-re-irradiation-of-recurrent-glioma
#20
Kerstin A Kessel, Josefine Hesse, Christoph Straube, Claus Zimmer, Friederike Schmidt-Graf, Jürgen Schlegel, Bernhard Meyer, Stephanie E Combs
BACKGROUND: Re-irradiation (Re-RT) is offered widely in clinical routine, and has been established as a key element in the treatment of recurrent gliomas. At our center, generally re-resection is performed widely by an experienced neurosurgical team. Thus, Re-RT mostly offered to patients with macroscopic residuals or irresectable lesions, is applied later compared to other centers. Therefore, we sought to validate the Combs Prognostic Score developed in 2012 using our independent patient cohort...
March 2017: Acta Oncologica
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