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https://www.readbyqxmd.com/read/28343313/spontaneous-cervical-intradural-disc-herniation-presenting-with-brown-s%C3%A3-quard-and-horner-s-syndrome-lesson-learned-from-a-very-unique-case
#1
Irene Baudracco, Gordan Grahovac, Vittorio M Russo
PURPOSE: Cervical spontaneous intradural disc herniation (IDH) is an extremely rare condition. We describe a unique case of a patient presenting with a Brown-Séquard syndrome (BSS) and Horner's syndrome (HS). This study aimed to report an unusual case of spontaneous cervical intradural disc herniation that presented with Horner's and Brown-Séquard syndrome (BSS) and discuss difficulties in preoperative diagnosis and treatment difficulties of intradural cervical disc. METHODS: Notes and images review, and analysis of the relevant literature...
March 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28342919/radiation-exposure-to-the-surgeon-during-ultrasound-assisted-transforaminal-percutaneous-endoscopic-lumbar-discectomy-a-prospective-study
#2
Ruihui Wu, Xuqiang Liao, Hong Xia
PURPOSE: To determine the radiation dose to the surgeon during ultrasound-assisted transforaminal percutaneous endoscopic lumbar discectomy (transforaminal PELD) for lumbar disc herniation, and investigate whether the usage of ultrasonography could reduce the radiation exposure to surgeon. METHODS: The stages of needle insertion and foraminal plasty for transforaminal PELD were performed under ultrasound guidance and confirmed by fluoroscopy according to the standard technique by two spinal surgeons separately in 25 transforaminal PELDs (25 levels)...
March 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#3
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#4
Yi-Chen Lai, Yuan-Yi Chia, Wei-Hung Lien
Intracranial hypotension syndrome (IHS) is generally caused by cerebrospinal fluid (CSF) leakage. Complications include bilateral subdural hygroma or haematoma and herniation of the cerebellar tonsils. Epidural blood patch (EBP) therapy is indicated if conservative treatment is ineffective. We reported the case of a 46-year-old man with a history of postural headache and dizziness. The patient was treated with bed rest and daily hydration with 2000 mL of fluid for 2 weeks. However, dizziness and headache did not resolve, and he became drowsy and disoriented with incomprehensible speech...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339442/clinical-outcome-of-full-endoscopic-interlaminar-discectomy-for-single-level-lumbar-disc-herniation-a-minimum-of-5-year-follow-up
#5
Zhiming Tu, Ya Wei Li, Bing Wang, Guohua Lu, Lei Li, Lei Kuang, Yuliang Dai
BACKGROUND: Full-endoscopic interlaminar discectomy (FEID) is widely applied for the treatment of lumbar disc herniation (LDH) and satisfactory short-term outcomes have been achieved. However, the long-term evaluation for this technique is still lacking, especially the comparison between FEID and microendoscopic discectomy (MED). OBJECTIVE: To evaluate the clinical outcome of FEID technique in comparison with MED for single-level LDH with a minimum of 5-year follow-up...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339437/complications-of-lumbar-disc-herniation-following-full-endoscopic-interlaminar-lumbar-discectomy-a-large-single-center-retrospective-study
#6
Tian-Hang Xie, Jian-Cheng Zeng, Zhu-Hai Li, Liang Wang, Hong-Fei Nie, Hu-Shan Jiang, Yue-Ming Song, Qing-Quan Kong
BACKGROUND: The new surgical procedure of full-endoscopic interlaminar lumbar discectomy (FILD) has achieved favorable effects in the treatment of lumbar disc herniation (LDH). Along with the wide range of applications of FILD, a series of complications related to the operation has gradually emerged. OBJECTIVE: To describe the types, incidences, and characteristics of complications following FILD and to explore preventative and treatment measures. STUDY DESIGN: Retrospective, observational study...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#7
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28338452/differentiation-of-idiopathic-spinal-cord-herniation-from-dorsal-arachnoid-webs-on-mri-and-ct-myelography
#8
Randall Schultz, Andrew Steven, Aaron Wessell, Nancy Fischbein, Charles A Sansur, Dheeraj Gandhi, David Ibrahimi, Prashant Raghavan
OBJECTIVE Dorsal arachnoid webs (DAWs) and spinal cord herniation (SCH) are uncommon abnormalities affecting the thoracic spinal cord that can result in syringomyelia and significant neurological morbidity if left untreated. Differentiating these 2 entities on the basis of clinical presentation and radiological findings remains challenging but is of vital importance in planning a surgical approach. The authors examined the differences between DAWs and idiopathic SCH on MRI and CT myelography to improve diagnostic confidence prior to surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28336484/lumbar-mri-findings-in-patients-with-and-without-waddell-signs
#9
J S Cox, S Blizzard, H Carlson, J Hiratza, J U Yoo
BACKGROUND CONTEXT: Waddell Signs (WS), introduced as a method to establish patients with substantial psychosocial components to their low back pain, carry a negative association despite no literature evaluating whether physical disease is associated with them. PURPOSE: To compare lumbar MRI findings between the patients with and without Waddell's Signs. STUDY DESIGN: Retrospective cohort study based on prospectively collected data PATIENT SAMPLE: Thirty patients aged 35-55 with an ODI score >50 randomly selected such that there was an even distribution of patients based on number of WS OUTCOME MEASURES: ODI and SF-12 scores, number of WS, presence and severity of spinal pathology METHODS: MRIs were reviewed by three spine specialists blinded to clinical exam findings, number of WS, and patient identity...
March 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28336482/surgical-treatment-of-lumbar-disc-herniation-in-different-ages-evaluation-of-11-237-patients
#10
Fredrik Strömqvist, Björn Strömqvist, Bo Jönsson, Magnus K Karlsson
BACKGROUND CONTEXT: Surgical treatment of lumbar disc herniation (LDH) may lead to different outcome in young, middle aged and elderly. However, no study has by the same data ascertainment evaluated referral pattern, improvement and outcome in different age strata. PURPOSE: To evaluate referral pattern and outcome in patients surgically treated due to LDH in different ages. STUDY DESIGN: Register study of prospectively collected data. PATIENT SAMPLE: In SweSpine, the national Swedish register for spinal surgery, we identified 11...
March 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28332154/altered-cerebrospinal-fluid-dynamics-in-neurofibromatosis-type-l-severe-arachnoid-thickening-in-patients-with-neurofibromatosis-type-1-may-cause-abnormal-csf-dynamic
#11
Young Sill Kang, Eun-Kyung Park, Yong-Oock Kim, Ju-Seong Kim, Dong-Seok Kim, U W Thomale, Kyu-Won Shim
INTRODUCTION: The object of this study is to understand abnormal dynamic of cerebrospinal fluid (CSF) in patients with neurofibromatosis type 1 (NF1), which may cause temporal lobe herniation and bulging of temporal fossa. METHODS: Four patients, three females and one male, with NF1 were studied retrospectively. They presented with a similar craniofacial deformity, which consisted of pulsatile exophthalmos, an enlarged bony orbit, dysplasia of the sphenoid wing with the presence of a herniation of the temporal lobe into the orbit, and a bulging temporal fossa...
March 22, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28331980/combined-intra-extradural-approach-for-posterolateral-thoracic-disk-herniations-preliminary-study-and-technical-note
#12
Antonio Bocchetti, Valentina Cioffi, Raffaele de Falco
Purpose Thoracic disk herniation is uncommon. It still represents a challenge for spinal surgeons. Multiple surgical strategies are available and, often, they are matter of debate. We describe a preliminary experience about a combined extra-intra dural approach for posterolateral disk herniation in patients affected by spinal cord compression. METHODS: We performed a combined extra-intra dural approach in two preliminary cases. We performed bilateral laminectomy of adjacent vertebrae and unilateral partial medial arthrectomy of the involved segment...
March 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28331979/clinical-and-radiological-factors-related-to-the-presence-of-motor-deficit-in-lumbar-disc-prolapse-a-prospective-analysis-of-70-consecutive-cases-with-neurological-deficit
#13
Vibhu Krishnan, Shanmuganathan Rajasekaran, Siddharth N Aiyer, Rishi Kanna, Ajoy Prasad Shetty
PURPOSE: To analyse the clinic-radiological factors associated with neurological deficit following lumbar disc herniation. METHODS: A prospective, cross-sectional study was performed in 140 cases of micro-discectomy following lumbar disc herniation. Group 1 included 70 consecutive patients with motor deficit and group 2 (controls) included 70 patients with intact neurology. Motor deficit was defined as the occurrence of motor power ≤3/5 in L2-S1 myotomes. Multiple clinical and radiological parameters were studied between the two groups...
March 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28331218/identification-of-a-novel-heterozygous-mutation-of-the-aggrecan-gene-in-a-family-with-idiopathic-short-stature-and-multiple-intervertebral-disc-herniation
#14
Sumito Dateki, Akiko Nakatomi, Satoshi Watanabe, Hitomi Shimizu, Yukiko Inoue, Hideo Baba, Koh-Ichiro Yoshiura, Hiroyuki Moriuchi
Aggrecan is a critical proteoglycan component of the extracellular matrix of the growth plates and articular cartilage and has a key role in the biophysical and biomechanical properties of cartilage. Recently, heterozygous mutations in the ACAN gene, which encodes aggrecan, have been identified in patients with short stature and accelerated bone age. We herein report another family with a heterozygous ACAN mutation associated with idiopathic short stature along with accelerated bone age and early-onset herniation of the lumbar discs at the levels of L1/2 through L5/S1...
March 23, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28330972/fatal-cerebral-edema-with-status-epilepticus-in-children-with-dravet-syndrome-report-of-5-cases
#15
Kenneth A Myers, Jacinta M McMahon, Simone A Mandelstam, Mark T Mackay, Renate M Kalnins, Richard J Leventer, Ingrid E Scheffer
Dravet syndrome (DS) is a well-recognized developmental and epileptic encephalopathy associated with SCN1A mutations and 15% mortality by 20 years. Although over half of cases succumb to sudden unexpected death in epilepsy, the cause of death in the remainder is poorly defined. We describe the clinical, radiologic, and pathologic characteristics of a cohort of children with DS and SCN1A mutations who developed fatal cerebral edema causing mass effect after fever-associated status epilepticus. Cases were identified from a review of children with DS enrolled in the Epilepsy Genetics Research Program at The University of Melbourne, Austin Health, who died after fever-associated status epilepticus...
March 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28329305/association-between-spousal-suicide-and-mental-physical-and-social-health-outcomes-a-longitudinal-and-nationwide-register-based-study
#16
Annette Erlangsen, Bo Runeson, James M Bolton, Holly C Wilcox, Julie L Forman, Jesper Krogh, M Katherine Shear, Merete Nordentoft, Yeates Conwell
Importance: Bereavement after spousal suicide has been linked to mental disorders; however, a comprehensive assessment of the effect of spousal suicide is needed. Objective: To determine whether bereavement after spousal suicide was linked to an excessive risk of mental, physical, and social health outcomes when compared with the general population and spouses bereaved by other manners. Design, Setting, and Participants: This nationwide, register-based cohort study conducted in Denmark of 6...
March 22, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28328613/endoscopic-endonasal-repair-of-isolated-medial-orbital-wall-fracture-with-balloon-technique
#17
Kazutaka Soejima, Tsutomu Kashimura, Takashi Yamaki, Hiroyuki Sakurai, Hiroaki Nakazawa
Endonasal endoscopic repair of medial orbital wall fractures is minimally invasive and benefits the patients. The authors describe the authors' modified balloon technique, which allows longer support of the orbital wall. From October 2010 through January 2016, the author repaired 9 isolated medial wall fractures by this method. Five patients were diagnosed as having enophthalmos of greater than 2 mm, and 6 patients had persistent diplopia before the operation. The herniated orbital contents that filled the anterior ethmoidal sinus were gently reduced with a 4-mm-diameter 0° sinus endoscope...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#18
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28327939/a-new-classification-for-pathologies-of-spinal-meninges-part-1-dural-cysts-dissections-and-ectasias
#19
Jörg Klekamp
BACKGROUND: The clinical significance of pathologies of the spinal dura is often unclear and their management controversial. OBJECTIVE: To classify spinal dural pathologies analogous to vascular aneurysms, present their symptoms and surgical results. METHODS: Among 1519 patients with spinal space-occupying lesions, 66 patients demonstrated dural pathologies. Neuroradiological and surgical features were reviewed and clinical data analyzed. RESULTS: Saccular dural diverticula (type I, n = 28) caused by defects of both dural layers, dissections between dural layers (type II, n = 29) due to defects of the inner layer, and dural ectasias (type III, n = 9) related to structural changes of the dura were distinguished...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326451/application-of-endoscopic-third-ventriculostomy-for-treating-hydrocephalus-correlated-chiari-type-i-malformation-in-a-single-chinese-neurosurgery-centre
#20
Yiping Wu, Chuzhong Li, Xuyi Zong, Xinsheng Wang, Songbai Gui, Caiping Gu, Yazhuo Zhang
The correlation between hydrocephalus and Chiari type I malformation (CIM) has been debated since Chiari's first descriptions of CIM but some studies have shown that CIM and hydrocephalus (HCP) could cause symptoms/disease of each other or vice versa. Recent research has found that treatment focused on hydrocephalus with ventricle enlargement also provides alleviation of CIM and even of syringomyelia. However, the lack of consensus among previous studies left unanswered the question of how endoscopic third ventriculostomy (ETV) addresses CIM and why it fails...
March 22, 2017: Neurosurgical Review
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