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https://www.readbyqxmd.com/read/29151054/effect-of-ephedrine-and-phenylephrine-on-brain-oxygenation-and-microcirculation-in-anaesthetised-patients-with-cerebral-tumours-study-protocol-for-a-randomised-controlled-trial
#1
Klaus Ulrik Koch, Anna Tietze, Joel Aanerud, Gorm von Öettingen, Niels Juul, Jens Christian Hedemann Sørensen, Lone Nikolajsen, Leif Østergaard, Mads Rasmussen
INTRODUCTION: During brain tumour surgery, vasopressor drugs are commonly administered to increase mean arterial blood pressure with the aim of maintaining sufficient cerebral perfusion pressure. Studies of the commonly used vasopressors show that brain oxygen saturation is reduced after phenylephrine administration, but unaltered by ephedrine administration. These findings may be explained by different effects of phenylephrine and ephedrine on the cerebral microcirculation, in particular the capillary transit-time heterogeneity, which determines oxygen extraction efficacy...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150478/early-versus-late-application-of-subthalamic-deep-brain-stimulation-to-parkinson-s-disease-patients-with-motor-complications-elass-protocol-of-a-multicentre-prospective-and-observational-study
#2
Lulu Jiang, Wai Sang Poon, Elena Moro, Wenbiao Xian, Chao Yang, Xian Lun Zhu, Jing Gu, Xiaodong Cai, Jinlong Liu, Vincent Mok, Yanmei Liu, Shaohua Xu, Qiyu Guo, Wanru Chen, Ling Chen
INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson's disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. METHODS AND ANALYSIS: 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149808/delayed-hypoxemia-following-traumatic-brain-injury-exacerbates-long-term-behavioral-deficits
#3
McKenzie Davies, Addison Jacobs, David L Brody, Stuart H Friess
Hypoxemia during initial stabilization of patients with severe traumatic brain injury (TBI) has been associated with poorer outcomes. However, the effects of delayed hypoxemia occurring during intensive care following TBI on outcome is unclear. Preclinical models of TBI have rarely shown cognitive or behavioral deficits beyond six weeks post injury and commonly have not included modeling of secondary insults. We have previously developed a murine model of TBI followed by delayed hypoxemia to model the secondary insult of hypoxemia and brain hypoxia occurring in the intensive care setting...
November 17, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#4
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#5
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29147637/subtotal-resection-of-a-thalamic-glioblastoma-multiforme-through-transsylvian-approach
#6
Rouzbeh Motiei-Langroudi, Homa Sadeghian, Alireza M Mohammadi
Glioblastoma multiforme (GBM) is a malignant brain tumor with an ominous prognosis. The standard treatment includes maximal safe resection plus adjuvant therapy. Thalamic GBMs, however, are unfavorable for microsurgical removal because of deep location and proximity to critical structures. We present a patient presenting with progressive hemiparesis and decreased consciousness with a large thalamic GBM who underwent subtotal resection through a transsylvian approach. His clinical and neurologic condition improved after surgery and he survived nine months after surgery...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29147635/global-and-targeted-pathway-impact-of-gliomas-on-white-matter-integrity-based-on-lobar-localization
#7
David R Ormond, Shawn D'Souza, John A Thompson
Primary brain tumors comprise 28% of all tumors and 80% of malignant tumors. Pathophysiology of high-grade gliomas includes significant distortion of white matter architecture, necrosis, the breakdown of the blood brain barrier, and increased intracranial pressure. Diffusion tensor imaging (DTI), a diffusion weighted imaging technique, can be used to assess white matter architecture. Use of DTI as a non-invasive pathophysiological tool to analyze glioma impact on white matter microstructure has yet to be fully explored...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29147631/automated-whole-brain-tractography-affects-preoperative-surgical-decision-making
#8
Hesham Zakaria, Sameah Haider, Ian Lee
Surgery in and around eloquent brain structures poses a technical challenge when the goal of surgery is maximal safe resection. Magnetic resonance imaging (MRI) has revolutionized the diagnosis and treatment of neurological disorders, but tractography still remains limited in terms of utility because of the requisite manual labor and time required combined with the high risk of bias and inaccuracy. Automated whole brain tractography (AWBT) has simplified this workflow, overcoming historical barriers, and allowing for integration into modern neuronavigation...
September 6, 2017: Curēus
https://www.readbyqxmd.com/read/29147598/dbs-programming-an-evolving-approach-for-patients-with-parkinson-s-disease
#9
REVIEW
Aparna Wagle Shukla, Pam Zeilman, Hubert Fernandez, Jawad A Bajwa, Raja Mehanna
Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols...
2017: Parkinson's Disease
https://www.readbyqxmd.com/read/29146718/deep-brain-nuclei-t1-shortening-after-gadobenate-dimeglumine-in-children-influence-of-radiation-and-chemotherapy
#10
S Kinner, T B Schubert, R J Bruce, S L Rebsamen, C A Diamond, S B Reeder, H A Rowley
BACKGROUND AND PURPOSE: Intrinsic T1-hyperintense signal has recently been reported in the deep gray nuclei on brain MR imaging after multiple doses of gadolinium-based contrast agents. Most reports have included adult patients and excluded those undergoing radiation or chemotherapy. We investigated whether T1 shortening is also observed in children and tried to determine whether radiochemotherapy is a risk factor for this phenomenon. MATERIALS AND METHODS: In this single-center retrospective study, we reviewed clinical charts and images of all patients 18 years of age or younger with ≥4 gadobenate dimeglumine-enhanced MRIs for 6 years...
November 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#11
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146234/the-value-of-patient-directed-brain-mri-scan-with-a-diagnosis-of-migraine
#12
William J Mullally, Kathryn E Hall
OBJECTIVE: To determine if a brain MRI scan in patients with a diagnosis of migraine, who insist on the performance of imaging, is of more benefit in detecting clinically significant unsuspected structural abnormalities than would be expected by chance. METHODS: This prospective, observational, single center study was performed from January 1, 2010 to December 31,2012 and included 100 subjects with a diagnosis of migraine and a normal neurologic exam. A brain MRI scan was performed on all patients, solely at their request, to detect an unsuspected clinically significant structural lesion...
November 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29146230/race-insurance-status-and-traumatic-brain-injury-outcomes-before-and-after-enactment-of-the-affordable-care-act
#13
Eric W Moffet, Tiffany J Zens, Krista L Haines, Megan V Beems, Kaitlyn M McQuistion, Glen E Leverson, Suresh K Agarwal
BACKGROUND: The Affordable Care Act aims to improve patient outcomes. Race/ethnicity and insurance status impact outcomes after traumatic brain injury. We sought to gauge the Affordable Care Act's effect on outcomes after traumatic brain injury, as graded by race/ethnicity and insurance status. METHODS: The National Trauma Data Bank was utilized to identify traumatic brain injury patients before and after the Affordable Care Act. Patient outcomes comprised of hospital duration of stay, in-hospital mortality, discharge to rehabilitation, and surgical procedures...
November 13, 2017: Surgery
https://www.readbyqxmd.com/read/29145339/alveolar-soft-part-sarcoma-with-multiple-brain-and-lung-metastases-in-pregnancy-a-case-report-and-literature-review
#14
Yubo Wang, Jiayue Cui, Xu Yan, Rihua Jin, Xinyu Hong
RATIONAL: Alveolar soft part sarcomas (ASPSs) with multiple brain metastases in pregnancy is a rare entity. PATIENT CONCERNS: We report our experience with a 19-year-old pregnant woman who presented with intermittent headaches and vomiting at 38 weeks gestation. DIAGNOSES: The patient was initially diagnosed as brain metastasis according to computed tomography and magnetic resonance imaging (MRI) imaging. INTERVENTIONS: Cesarean section and craniotomy (complete resection of both brain metastatic lesions) was performed sequentially...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145179/phantom-sensations-supernumerary-phantom-limbs-and-apotemnophilia-three-body-representation-disorders
#15
Laurent Tatu, Julien Bogousslavsky
Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29143958/intraspinal-mesenchymal-chondrosarcoma-report-of-a-pediatric-case-and-literature-review
#16
Angela Di Giannatale, Marta Colletti, Ida Russo, Valentina Ferruzzi, Vito Andrea Dell' Anna, Raffaele Cozza, Giovanna Stefania Colafati, Raffaella Messina, Angela Mastronuzzi, Rita De Vito, Giuseppe Maria Milano
PURPOSE: Mesenchymal chondrosarcoma (MCS) is an aggressive variant of chondrosarcoma and is a rare tumor, particularly within the pediatric population. Commonly, MCS originates in the bone, but it can also arise in extraskeletal sites, such as the brain and the intraspinal area. Due to the rarity of this tumor, there are no guidelines for its optimal treatment. METHODS: We report a case of intradural extramedullary MCS, located at the T11-T12 level, in a 14-year-old male...
November 15, 2017: Tumori
https://www.readbyqxmd.com/read/29142633/risk-factors-of-delayed-surgical-intervention-after-conservatively-treated-acute-traumatic-subdural-hematoma
#17
Hyungjoo Kwon, Kyu-Sun Choi, Hyeong-Joong Yi, Hyoung-Joon Chun, Young-Jun Lee, Dong-Won Kim
Objective: Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods: From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#18
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142384/hypercapnic-respiratory-failure-in-case-of-chiari-1-5-malformation-case-report-and-review-of-the-literature
#19
Viralkumar M Vasani, Subhas Kanti Konar, S Satish
Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2 of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29141456/increased-serum-levels-of-mbdnf-in-women-with-minimal-and-mild-endometriosis-have-no-predictive-power-for-the-disease
#20
Alexandra Perricos, Kazem Ashjaei, Heinrich Husslein, Katharina Proestling, Lorenz Kuessel, Reinhard Obwegeser, Rene Wenzl, Iveta Yotova
The objective of our pilot clinical, prospective study was to determine the serum levels of mature brain-derived neurotrophic factor, in of women with endometriosis and controls and explore whether mature brain-derived neurotrophic factor is a potential biomarker for the disease. The patients were selected from the Endometriosis Marker Austria prospective cohort study conducted at the tertiary referral certified Endometriosis Center of the Medical University of Vienna. All women underwent laparoscopic surgery because there was a suspicion of endometriosis, or the women had pelvic pain, adnexal cysts, unexplained infertility, or uterine fibroids...
January 1, 2017: Experimental Biology and Medicine
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