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Neurological surgery

Je Jin Lee, Seho Lim, Yeon Sil Lee, Hwa-Yong Shin, Chong-Wha Baek, Yong Hun Jung, Young Cheol Woo, Yong-Hee Park
RATIONALE: Myoclonic movement is a rare side effect after general anesthesia. Since we use various intravenous agents during general anesthesia recently, it is troublesome to find out the exact cause of this neurologic complication. PATIENT CONCERNS: A 31-year-old female patient without any past medical history underwent hip arthroscopic surgery under general anesthesia. DIAGNOSES: Although there was no specific event during the operation, she showed a sudden myoclonic movement confined to left upper extremity in recovery room...
March 2018: Medicine (Baltimore)
V E Guzhin, A V Cherepanov, V M Dzhafarov
AIM: To present own experience in surgical treatment of cervical paragangliomas. MATERIAL AND METHODS: 9 patients with cervical paragangliomas were enrolled. Endovascular embolization of supplying vessels followed by maximally radical surgery and subsequent carotid arteries repair involved into tumoral process reduces the risk of complications. RESULTS: The most careful attitude to caudal group of cranial nerves adjacent or involved into neoplasm allows to minimize postoperative neurological complications...
2018: Khirurgiia
Michael Galgano, Jared Fridley, Adetokunbo Oyelese, Albert Telfian, Thomas Kosztowski, David Choi, Ziya L Gokaslan
Metastatic spinal disease is a source of significant morbidity in patients with cancer. Recent advancements in adjuvant oncologic therapy has led to increased survival for many patients who harbor neoplastic disease. As a result of this, the chance of developing metastatic spinal disease over the course of a cancer patient's lifespan has increased. Symptomatic metastatic spinal disease can cause significant morbidity including severe pain, neurologic deficit, and loss of ambulation. Current treatment of these patients typically involves the use of multiple modalities, including surgery, radiation, and chemotherapy...
March 21, 2018: Expert Review of Anticancer Therapy
Harleen K Sandhu, Kristofer M Charlton-Ouw, Katherine Jeffress, Samuel Leake, Alexa Perlick, Charles C Miller, Ali Azizzadeh, Hazim J Safi, Anthony L Estrera
BACKGROUND: Patients presenting with acute aortic dissection may develop spinal cord ischemia (SCI). We sought to determine how SCI and its recovery affects outcomes. METHODS: We reviewed patients with SCI in acute type A aortic dissection (ATAAD) and acute type B aortic dissection (ATBAD) from September 1999-May 2014. SCI was defined as paraplegia or paraparesis present on admission. Monoparesis/plegia, paraesthesia, or numbness was defined as ischemic neuropathy (IN)...
March 17, 2018: Annals of Thoracic Surgery
Tsuyoshi Yamada, Toshitaka Yoshii, Naoki Yamamoto, Takashi Hirai, Hiroyuki Inose, Atsushi Okawa
BACKGROUND: Concurrent cervical and lumbar spinal canal stenosis is known as tandem spinal stenosis (TSS). As research on TSS is limited, there is no consensus on the optimal surgical approach to this problem. We evaluated the prevalence and clinical characteristics of TSS in patients with symptomatic lumbar spinal canal stenosis (LCS). METHODS: The authors performed a retrospective analysis of the outcomes of 565 patients who underwent lumbar surgeries performed for symptomatic LCS...
March 20, 2018: Journal of Orthopaedic Surgery and Research
Shih-Fan Lai, Yu-Hsuan Chen, Tony Hsiang-Kuang Liang, Che-Yu Hsu, Huang-Chun Lien, Yen-Sen Lu, Chiun-Sheng Huang, Sung-Hsin Kuo
INTRODUCTION: Whole brain (WB) re-irradiation for breast cancer patients with progressive brain metastasis after first-course WB radiotherapy (WBRT) is controversial. In this study, we sought to investigate the association between the molecular sub-classifications and breast-specific Graded Prognostic Assessment (GPA, which includes the Karnofsky performance status, molecular subtypes, and age as its indices) and the outcomes of breast cancer patients who received WB re-irradiation. METHODS: Twenty-three breast cancer patients who received WB re-irradiation for relapsed and progressive intracranial lesions after first-course WBRT between 2004 and 2016 were retrospectively reviewed...
March 20, 2018: Journal of Neuro-oncology
Yifat Manor, Adi A Garfunkel
PURPOSE: To describe a rare case of odontogenic brain abscess. MATERIALS AND METHODS: A healthy, 35-year-old male had two dental implants placed in a simultaneously augmented maxillary sinus. One implant failed and the patient developed a maxillary sinusitis that failed to improve following antibiotic treatment at home. The neglected sinus infection led to formation of a brain abscess. The patient was hospitalised only when he had pan sinusitis with neurological signs...
2018: European Journal of Oral Implantology
Hiroshi Takahashi, Yasuchika Aoki, Arata Nakajima, Masato Sonobe, Fumiaki Terajima, Masahiko Saito, Takuya Miyamoto, Keita Koyama, Keiichiro Yamamoto, Takeo Furuya, Masao Koda, Seiji Ohtori, Masashi Yamazaki, Koichi Nakagawa
PURPOSE: To determine levels of biomarkers reflecting damage to axon, myelin, astrocytes, and neuron in cerebrospinal fluid (CSF) of patients with cervical compression myelopathy. METHODS: We collected 69 CSF samples from patients before spinal surgery for acutely worsening compression myelopathy (AM, 20), chronic compression myelopathy (CM, 20), and lumbar canal stenosis (LCS 29; control). We measured levels of phosphorylated neurofilament subunit H (pNF-H), tau (reflecting axonal damage), myelin basic protein (MBP) (reflecting demyelination), S100b (reflecting astrocyte damage), and neuron-specific enolase (NSE) (reflecting neuronal damage)...
March 19, 2018: European Spine Journal
Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
Jinshan Guo, Wei Sun, Jimin Peter Kim, Xili Lu, Qiyao Li, Min Lin, Oliver Mrowczynski, Elias B Rizk, Juange Cheng, Guoying Qian, Jian Yang
Tissue adhesives play an important role in surgery to close wounds, seal tissues, and stop bleeding, but existing adhesives are costly, cytotoxic, or bond weakly to tissue. Inspired by the water-resistant adhesion of plant-derived tannins, we herein report a new family of bioadhesives derived from a facile, one-step Michael addition of tannic acid and gelatin under oxidizing conditions and crosslinked by silver nitrate. The oxidized polyphenol groups of tannic acid enable wet tissue adhesion through catecholamine-like chemistry, while both tannic acid and silver nanoparticles reduced from silver nitrate provide antimicrobial sources inherent within the polymeric network...
March 16, 2018: Acta Biomaterialia
Masillamany Sivasanker, Venkatesh S Madhugiri, Aliasgar V Moiyadi, Prakash Shetty, T S Subi
OBJECTIVES: For patients who develop brain metastases from solid tumors, age, KPS, primary tumor status and presence of extracranial metastases have been identified as prognostic factors. However, the factors that affect survival in patients who are deemed fit to undergo resection of brain metastases have not been clearly elucidated hitherto. PATIENTS AND METHODS: This is a retrospective analysis of a prospectively maintained database. All patients who underwent resection of intracranial metastases from solid tumors were included...
March 10, 2018: Clinical Neurology and Neurosurgery
Michael J Link, Morten Lund-Johansen, Christine M Lohse, Colin L W Driscoll, Ehrling Myrseth, Oystein Vesterli Tveiten, Matthew L Carlson
BACKGROUND: The goal of microsurgical removal of a vestibular schwannoma is to completely remove the tumor, to provide long-term durable cure. In many cases, less than gross total resection (GTR) is performed to preserve neurological, and especially facial nerve function. OBJECTIVE: To analyze long-term quality of life (QoL) in a cohort of patients who received either GTR or less than GTR. METHODS: Patients operated for vestibular schwannoma less than 3...
April 1, 2018: Neurosurgery
Tomas Garzon-Muvdi, Allan Belzberg, Mohamad E Allaf, Jean-Paul Wolinsky
BACKGROUND: Robotic-assisted techniques have been implemented in the surgical treatment of tumors in the pelvis, abdomen, and thorax. In pelvic tumors, robotic-assisted techniques evade the need for sizable surgical exposure, but make stimulation of the nerves of the sacral plexus very difficult. OBJECTIVE: To describe how laparoscopic robotic-assisted surgery can couple with tools such as the nerve stimulator to aid in the resection of presacral masses emanating from the neural elements and potentially improve neurological outcome by preventing inadvertent injury to involved nerves...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Cheng-Chia Lee, Daniel M Trifiletti, Arjun Sahgal, Antonio DeSalles, Laura Fariselli, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martínez Álvarez, Ian Paddick, Jean Regis, Samuel Ryu, Ben Slotman, Jason Sheehan
BACKGROUND: Stereotactic radiosurgery (SRS) has become popular as a standard treatment for cavernous sinus (CS) meningiomas. OBJECTIVE: To summarize the published literature specific to the treatment of CS meningioma with SRS found through a systematic review, and to create recommendations on behalf of the International Stereotactic Radiosurgery Society. METHODS: Articles published from January 1963 to December 2014 were systemically reviewed...
March 15, 2018: Neurosurgery
Morgan L Cox, Brian C Gulack, Dylan P Thibault, Xia He, Matthew L Williams, Vinod H Thourani, Jeffery P Jacobs, J Matthew Brennan, Mani A Daneshmand, Deepak Acharya
OBJECTIVES: Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. METHODS: Utilizing the Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2013, patients undergoing urgent or emergent CABG within 7 days of an acute myocardial infarction complicated by cardiogenic shock were identified...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Aderaldo Costa Alves Junior, Pedro Tadao Hamamoto Filho, Marcelo Pacheco Gonçalves, Aristides Augusto Palhares Neto, Marco Antonio Zanini
Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84...
March 16, 2018: Journal of Craniofacial Surgery
Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
K Hirose, T Aoki, T Furukawa, S Fukushima, H Niioka, S Deguchi, M Hashimoto
Label-free visualization of nerves and nervous plexuses will improve the preservation of neurological functions in nerve-sparing robot-assisted surgery. We have developed a coherent anti-Stokes Raman scattering (CARS) rigid endoscope to distinguish nerves from other tissues during surgery. The developed endoscope, which has a tube with a diameter of 12 mm and a length of 270 mm, achieved 0.91% image distortion and 8.6% non-uniformity of CARS intensity in the whole field of view (650 μm diameter). We demonstrated CARS imaging of a rat sciatic nerve and visualization of the fine structure of nerve fibers...
February 1, 2018: Biomedical Optics Express
Anna Suñol, Patricia Montoliu, Marta López, Joan Mascort, Carles Morales
Case summary: A 12-year-old neutered male domestic shorthair cat was presented to our referral hospital with a chronic history of tenesmus and lumbosacral pain. A diagnosis of degenerative lumbosacral stenosis (DLSS) was made and a standard dorsal L7-S1 laminectomy was performed uneventfully, with complete recovery within 1 month. The cat was brought back 4 months later for investigation of lumbosacral pain after having suffered a minor traumatic event. Neurological examination identified a low tail carriage, weakness, exercise intolerance, left pelvic limb lameness and diminished withdrawal reflexes in both pelvic limbs with severe sacrocaudal pain...
January 2018: JFMS Open Reports
Tao Yang, Fei Wang, Chaoshi Niu
The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre- and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively...
April 2018: Oncology Letters
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