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Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
Karl Roessler, Burkhard S Kasper, Roland Coras, Soheil Arinrad, Michael Scholz, Hajo H Hamer, Ingmar Blümcke, Michael Buchfelder
BACKGROUND: Temporal lobe resection (TLR) including amygdalo-hippocampectomy (AHE) is the most frequent performed procedure in epilepsy surgery. Due to close anatomical relationship of the mesial temporal structures and the midbrain and choroidal fissure, the risk of severe complications like postoperative stroke is up to 2.5%. METHODS: We developed a modification of the classical technique for AHE by early entering the choroidal fissure for identification of crus cerebri, posterior cerebri artery and oculomotor nerve via the anterior part of the fronto- mesial temporal horn cleft...
March 7, 2018: World Neurosurgery
Vivian M Ussui, Lavinia Goldstein, Enrico Souto, Cynthia Levy
Portal cavernoma colangiopathy (PCC) is an uncommon cause of portal hypertension, and it is an important differential diagnosis of pancreatic malignancy given the expanded network of collateral vessels. On imaging studies, portal cavernoma can be seen as a hypoechoic mass, possibly associated with distal common bile duct obstruction. Most cases occur in non-cirrhotic patients. During the symptomatic phase, these patients carry a high-risk of complications related to sustained biliary obstruction. We report a unique patient with obstructive jaundice and a presumed pancreatic mass that proved to be a portal cavernoma complicated by PCC in the setting of nodular regenerative hyperplasia of the liver...
2018: ACG Case Reports Journal
Flavio Nigri, Jucilana Dos Santos Viana, Pedro Henrique da Costa Ferreira Pinto, Elington Lannes Simões, Carlos Roberto Telles Ribeiro
Microsurgery remains the gold standard treatment for intraventricular lesions, but it is not without limitations. The cerebral ventricles approach is considered a challenge for neurosurgeons because of their deep location and their intimate association with critical areas of the brain. It has been shown that direct endoscopic view is superior to magnetic resonance imaging (MRI) in identifying intraventricular structures and lesions. Also, during neuroendoscopy, there is no cerebrospinal fluid leak causing brain collapse as seen in microsurgery...
January 2018: Case Reports in Neurology
Charles G Kulwin, Troy D Payner, Rick F Nelson, Laurie L Ackerman, Daniel H Fulkerson
BACKGROUND: Brainstem cavernous malformations (cavernomas) in children have a high risk of hemorrhage and neurological deterioration. This risk is magnified if the child has a genetic predisposition for cavernoma formation. The surgical management is challenging and carries a significant risk of morbidity. OBJECTIVE: To describe the feasibility of a posterior petrosal approach to brainstem cavernomas in a pediatric population. METHODS: A single institution operative experience with this technique was reviewed; 2 cases were identified and are technically described here with supportive figures and illustrations, as well as a focused literature review...
March 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Valérie Vilgrain, Valérie Paradis, Morgane Van Wettere, Dominique Valla, Maxime Ronot, Pierre-Emmanuel Rautou
A variety of vascular liver disorders can induce hepatocellular tumors. They may be related to portal venous deprivation, venous outflow obstruction, or arterial diseases. Their common feature is an imbalance between hepatic arterial and portal venous blood flow leading to an increased hepatic arterial inflow. Consequently, hepatocellular tumors may arise, most commonly focal nodular hyperplasia-like lesions but hepatocellular adenomas and hepatocellular carcinoma may be seen as well. This article will review the most common vascular liver diseases associated with hepatocellular nodules (Budd-Chiari syndrome, congenital portosystemic shunt, hereditary hemorrhagic telangiectasia, and portal cavernoma)...
February 19, 2018: Abdominal Radiology
Christopher Jan Schwarzbach, Anne Ebert, Michael G Hennerici, Eva Neumaier-Probst, Michael Platten, Marc Fatar
Background: The safety of systemic thrombolysis in patients with intracranial tumor and cavernoma are unknown. So far evidence is limited to a number of case reports and few case series or unspecified data based on population-based analysis. Our aim was to comprehend the risk of systemic thrombolysis in these patients. Methods: Patients with additional evidence of intracranial tumor or cavernoma who received IV tissue plasminogen activator (t-PA) treatment at our comprehensive stroke center over a period of 7 years were identified in our stroke database and compared to the same number of matched control subjects without any evidence of intracranial tumor and cavernoma...
2018: Therapeutic Advances in Neurological Disorders
Sepide Kashefiolasl, Markus Bruder, Nina Brawanski, Eva Herrmann, Volker Seifert, Stephanie Tritt, Juergen Konczalla
OBJECTIVE: Despite the low annual risk of hemorrhage associated with a cavernous malformation (CM) (0.6%-1.1% per year), the risk of rehemorrhage rate and severity of neurologic deficits is significantly higher; therefore, we aimed to evaluate the rupture risk of CMs depending on various factors. METHODS: We retrospectively analyzed medical records of all patients with CM admitted to our institution between 1999 and April 2016. Cavernoma volume, location of the lesion, existence of a developmental venous anomaly (DVA), number of cavernomas, and patient characteristics (sex, age, hypertension, and antithrombotic therapy) were assessed...
February 2, 2018: Neurology
Robert C Rennert, Reid Hoshide, Mark Calayag, Joanna Kemp, David D Gonda, Hal S Meltzer, Takanori Fukushima, John D Day, Michael L Levy
OBJECTIVE Treatment of hemorrhagic cavernous malformations within the lateral pontine region demands meticulous surgical planning and execution to maximize resection while minimizing morbidity. The authors report a single institution's experience using the extended middle fossa rhomboid approach for the safe resection of hemorrhagic cavernomas involving the lateral pons. METHODS A retrospective chart review was performed to identify and review the surgical outcomes of patients who underwent an extended middle fossa rhomboid approach for the resection of hemorrhagic cavernomas involving the lateral pons during a 10-year period at Rady Children's Hospital of San Diego...
February 2, 2018: Journal of Neurosurgery. Pediatrics
Mehmet Resid Onen, Kelli Moore, Ulas Cikla, Melih Ucer, Bradley Schmidt, Aaron S Field, Mustafa K Baskaya
INTRODUCTION: Hypertrophic olivary degeneration (HOD) occurs as a result of posterior fossa or brainstem lesions that disrupt the dentato-rubro-olivary tract, well known as the Guillain-Mollaret triangle. Clinical and radiological hallmarks of this condition are palatal myoclonus and T2 hyperintensity of the inferior olivary complex on MRI, respectively. Since symptomatic HOD may complicate the recovery of patients with posterior fossa or brainstem lesions, the purpose of this study is to evaluate clinical and imaging findings of patients with HOD...
January 27, 2018: World Neurosurgery
Ayşegül Üçüncü Kefeli, Meriç Şengöz, Selçuk Peker
AIM: Effectiveness and safety of gamma knife radiosurgery (GKRS) for hemorrhagic brainstem cavernous malformations (BSCM) is still an unresolved problem. The purpose of this study was to assess treatment results of GKRS for hemorrhagic BSCMs. MATERIAL AND METHODS: A retrospective review was performed of patients with hemorrhagic BSCMs who were treated at the Acıbadem Kozyatağı Hospital GKRS unit from May 2007 to October 2015. RESULTS: In total 82 patients were identified...
December 17, 2017: Turkish Neurosurgery
Anas Abdallah, Hasan Burak Gündüz, Murad Asiltürk, Özden Erhan Sofuoğlu, Bilge Bilgiç, Erhan Emel, Betül Güler Abdallah
AIM: To assess the clinical outcomes of treatment for radiation-induced meningiomas. MATERIAL AND METHODS: Medical records of all cranial meningioma cases which diagnosed or/and underwent surgery in our hospital, during a 7-year period from 2009 to 2016 were retrospectively reviewed. All radiation-associated meningiomas were selected as the core sample used for this study. RESULTS: This series included one female and three male patients with mean age 47...
December 14, 2017: Turkish Neurosurgery
David Regnault, Louis d'Alteroche, Charlotte Nicolas, Fanny Dujardin, Jean Ayoub, Jean Marc Perarnau
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is considered to be well suited for the treatment of noncirrhotic portal hypertension (NCPHT) because of a usually severe portal hypertension (PHT) and a mild liver failure, but very less data are available. PATIENTS AND METHODS: Records of patients referred for TIPS between 2004 and 2015 for NCPHT were reviewed. No patient should have clinical or biological or histological features of cirrhosis. RESULTS: Twenty-five patients with a wide variety of histological lesions (sinusoidal dilatations, granulomatosis, regenerative nodular hyperplasia, obliterative portal venopathy, or subnormal liver) and a wide variety of associated diseases (thrombophilia, sarcoidosis, common variable immunodeficiency, scleroderma, Castleman's disease, early primitive biliary cirrhosis, congenital liver fibrosis, chemotherapy, purinethol intake, and congenital varices) were included...
January 10, 2018: European Journal of Gastroenterology & Hepatology
Julia Velz, Oliver Bozinov, Johannes Sarnthein, Luca Regli, David Bellut
BACKGROUND: Spinal cavernous malformations (SCM) were once thought to be rare lesions of the spinal cord. However, with the broad use of modern imaging techniques the incidence of SCM has significantly increased over the last decades. Management of both symptomatic and incidental findings is therefore of growing importance. However, experience with treatment and follow-up is very limited. METHODS: We performed a single institution retrospective review of consecutive patients with SCM treated at our Department between 2006-2016 and discuss the clinical features as well as surgical versus conservative outcomes...
January 4, 2018: Journal of Neurosurgical Sciences
Federica Novegno, Filippo Fava, Pierpaolo Lunardi
No abstract text is available yet for this article.
January 4, 2018: Journal of Neurosurgical Sciences
Moussa Toudou Daouda, Siham Bouchal, Naima Chtaou, Aouatef Midaoui, Zouahyr Souirti, Faouzi Belahsen
BACKGROUND: Thrombolysis alert (TA) is a procedure triggered every time a patient consults for sudden focal neurological deficit within 4.5 hours. OBJECTIVE: We aimed to determine firstly the etiological profile of TA and secondly to evaluate the delays in the management not only of thrombolyzed patients but also of nonthrombolyzed patients to determine the intrahospital delays to optimize. METHODS: Patients aged over 18 years who consulted for sudden focal neurological deficit within 4...
December 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tetsuya Negoto, Shota Terachi, Yuko Baba, Shin Yamashita, Terukazu Kuramoto, Motohiro Morioka
BACKGROUND: Brainstem cavernoma (BSC) is rare and difficult to treat. The treatment strategy for symptomatic lesions in elderly patients remains unclear. This review discusses the optimal treatment strategy and considers the effective surgical strategy in elderly patients. CASE DESCRIPTION: The clinical data of eight elderly patients (>70 years) with symptomatic BSC drawn from the literature and two of our own cases have been summarized in this review. The mean age of the patients was 73...
December 27, 2017: World Neurosurgery
Jared Yeo, Kenneth Chang, Lee Ping Ng, Wan Tew Seow, David Low, Sharon Yy Low
No abstract text is available yet for this article.
December 26, 2017: World Neurosurgery
Akash Shukla, Amit Gupte, Vedant Karvir, Prashant Dhore, Shobna Bhatia
Aims: The natural history of portal cavernoma cholangiopathy (PCC) in patients with significant biliary obstruction (SBO) who cannot undergo shunt surgery, is not known. We therefore, analyzed data of patients of extra-hepatic portal venous obstruction (EHPVO) with PCC. Methods: Prospectively recorded details of 620 (age 21.2 [11.4] years; 400 [65%] males) patients with primary EHPVO were reviewed. Outcomes (hepatic decompensation/mortality) of patients with PCC and SBO without shuntable veins were noted at follow up of 7 [4-11] years...
December 2017: Journal of Clinical and Experimental Hepatology
Richard Justin Garling, Gary Rajah, Leonardo Rangel-Castilla, Murali Guthikonda
No abstract text is available yet for this article.
December 2, 2017: Operative Neurosurgery (Hagerstown, Md.)
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