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https://www.readbyqxmd.com/read/28633408/risk-factors-for-readmission-with-cerebrospinal-fluid-leakage-within-30-d-of-vestibular-schwannoma-surgery
#1
Ali A Alattar, Brian R Hirshman, Brandon A McCutcheon, Clark C Chen, Thomas Alexander, Jeffrey Harris, Bob S Carter
BACKGROUND: Cerebrospinal fluid (CSF) leak is a well-recognized complication after surgical resection of vestibular schwannomas and is associated with a number of secondary complications, including readmission and meningitis. OBJECTIVE: To identify risk factors for and timing of 30-d readmission with CSF leak. METHODS: Patients who had undergone surgical resection of a vestibular schwannoma from 1995 to 2010 were identified in the California Office of Statewide Health Planning and Development database...
June 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#2
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28629679/how-to-address-cerebrospinal-fluid-leakage-following-ossification-of-the-posterior-longitudinal-ligament-surgery
#3
Jung Hyeon Moon, Sungjoon Lee, Chun Kee Chung, Chi Heon Kim, Won Heo
BACKGROUND: Primary dural repair in ossification of posterior longitudinal ligament (OPLL) surgery via anterior is challenging because of limited space. Based on several years of our experiences, we present our concept for addressing cerebrospinal fluid (CSF) leakage following dural tear during anterior OPLL surgery. METHODS: We reviewed the medical records of 65 patients who underwent anterior OPLL surgery from 2003 to 2014. We included 7 patients whose operation records described dural tear followed by CSF leakage...
June 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28616883/treatment-for-thoracic-ossification-of-posterior-longitudinal-ligament-with-posterior-circumferential-decompression
#4
Zhao-Wan Xu, Yong-Cheng Hu, Chui-Guo Sun, Xiao-Peng Shang, Deng-Xing Lun, Feng Li, Xu-Bin Ji, Da-Yong Liu, Nai-Wang Chen, Qing-Shan Zhuang
OBJECTIVE: To report the results of the posterior approach for thoracic ossification of posterior longitudinal ligament (TOPLL) by using a special "L" osteotome. METHODS: The present study enrolled 16 consecutive patients (9 men and 7 women) between May 2009 and September 2013. All patients underwent a posterior circumferential decompression osteotomy and segmental instrumentation with interbody fusion. The mean age at surgery was 57.3 years (range, 37-68 years)...
June 14, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#5
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28591055/stereoelectroencephalography-based-on-the-leksell-stereotactic-frame-and-neurotech-operation-planning-software
#6
Guangming Zhang, Guoqiang Chen, Dawei Meng, Yanwu Liu, Jianwei Chen, Lanmei Shu, Wenbo Liu
This study aimed to introduce a new stereoelectroencephalography (SEEG) system based on Leksell stereotactic frame (L-SEEG) as well as Neurotech operation planning software, and to investigate its safety, applicability, and reliability.L-SEEG, without the help of navigation, includes SEEG operation planning software (Neurotech), Leksell stereotactic frame, and corresponding surgical instruments. Neurotech operation planning software can be used to display three-dimensional images of the cortex and cortical vessels and to plan the intracranial electrode implantation...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28586397/serum-from-dengue-virus-infected-patients-with-and-without-plasma-leakage-differentially-affects-endothelial-cells-barrier-function-in-vitro
#7
Francielle Tramontini Gomes de Sousa Cardozo, Gyulnar Baimukanova, Marion Christine Lanteri, Sheila Marie Keating, Frederico Moraes Ferreira, John Heitman, Cláudio Sérgio Pannuti, Shibani Pati, Camila Malta Romano, Ester Cerdeira Sabino
BACKGROUND: Although most of cases of dengue infections are asymptomatic or mild symptomatic some individuals present warning signs progressing to severe dengue in which plasma leakage is a hallmark. METHODOLOGY/PRINCIPAL FINDINGS: The present study used Electric Cell-substrate Impedance Sensing (ECIS®) which allows for electrical monitoring of cellular barrier function measuring changes in Transendothelial Electric Resistance (TEER) to investigate the parameters associated with dengue induced leakage...
2017: PloS One
https://www.readbyqxmd.com/read/28574334/modified-dorsal-root-entry-zone-lesioning-for-intractable-pain-relief-in-patients-with-root-avulsion-injury
#8
Keisuke Takai, Makoto Taniguchi
OBJECTIVE Dorsal root entry zone (DREZ) lesioning has been the most effective surgical treatment for the relief of intractable pain due to root avulsion injury, but residual pain and a decrease in pain relief in the follow-up period have been reported in 23%-70% of patients. Based on pain topography in the most recent studies on neuropathic pain, the authors modified the conventional DREZ lesioning procedure to improve clinical outcomes. The presumed rationale for this procedure is to eliminate the spontaneous discharges of neurons in the superficial spinal dorsal horn as well as wide dynamic range neurons in the deep spinal dorsal horn...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28574328/cerebrospinal-fluid-outflow-resistance-as-a-diagnostic-marker-of-spontaneous-cerebrospinal-fluid-leakage
#9
Jürgen Beck, Christian Fung, Christian T Ulrich, Michael Fiechter, Jens Fichtner, Heinrich P Mattle, Marie-Luise Mono, Niklaus Meier, Pasquale Mordasini, Werner J Z'Graggen, Jan Gralla, Andreas Raabe
OBJECTIVE Spinal CSF leakage causes spontaneous intracranial hypotension (SIH). The aim of this study was to characterize CSF dynamics via lumbar infusion testing in patients with and without proven spinal CSF leakage in order to explore possible discriminators for the presence of an open CSF leak. METHODS This analysis included all patients with suspected SIH who were treated at the authors' institution between January 2012 and February 2015. The gold standard for "proven" CSF leakage is considered to be extrathecal contrast accumulation after intrathecal contrast injection...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28511971/learning-curve-for-the-endoscopic-endonasal-approach-for-suprasellar-craniopharyngiomas
#10
Hailin Ding, Ye Gu, Xiaobiao Zhang, Tao Xie, Tengfei Liu, Fan Hu, Yong Yu, Chongjing Sun
The endoscopic endonasal approach is considered an alternative minimally invasive approach for suprasellar craniopharyngiomas. However, the complicated surgical manipulations required by this approach have limited its application. We evaluate whether the approach features a learning curve. Thirty-three patients were retrospectively reviewed and grouped as early (17 patients) and late (16 patient) groups. The operation time, extent of removal, ophthalmology, endocrinology, reconstruction and modifications of standard technique were evaluated...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28499902/dumbbell-shaped-jugular-foramen-tumors-extending-to-the-neck-surgical-considerations-based-on-imaging-findings
#11
J He, J H Wan, B Zhao, H Q Cai, Y H Wu, X J Li, H P Qian, X L Meng
OBJECTIVE: Dumbbell-shaped jugular foramen tumors (DSJFTs) extending to the neck present diagnostic and management difficulties because of their rarity, various pathologies and multidisciplinary involvement. Accurate imaging findings are of great importance for surgical planning and clinical outcomes. However, few articles have discussed this issue to date. METHODS: Thirty-one patients with DSJFTs extending to the neck were surgically treated in a single stage at our institute...
May 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28495137/early-predictors-of-rapidly-evolving-multiple-sclerosis-a-case-report
#12
Kryshani T M Fernando, Michael James
Objective The aim of this case report is to highlight some important features of rapidly evolving Multiple Sclerosis. BACKGROUND: In a small proportion of patients, Multiple Sclerosis (MS) can present as a fulminant disease characterised by severe and frequent relapses. This form of rapidly evolving MS is associated with significant morbidity and mortality. It is therefore important to identify these patients as early as possible, so that they can be managed effectively. However, due to the rarity of fulminant forms of MS, there is limited data on the natural history and management of this condition...
June 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28481397/endoscopic-endonasal-cerebrospinal-fluid-leak-repair-on-the-ventral-midline-skull-base-a-single-neurosurgical-center-experience
#13
Cihan Isler, Merdin Lyutviev Ahmedov, Mehmet Yigit Akgun, Baris Kucukyuruk, Nurperi Gazioglu, Galip Sanus, Necmettin Tanriover
AIM: The aim of this study was to present the results of endoscopic endonasal repair of ventral midline skull base cerebrospinal fluid (CSF) leak (VMSBL) at our institution and to discuss the technique and results from a neurosurgical perspective. MATERIAL AND METHODS: A retrospective analysis of all VMSBL cases that underwent endoscopic endonasal skull base approach (EESBA) for CSF leak repair at a single tertiary neurosurgical center was performed. Twenty six patients with an average age of 44...
March 25, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28478791/oblique-intrathecal-injection-in-lumbar-spine-surgery-a-technical-note
#14
Gordon A E Jewett, Daniel Yavin, Perry Dhaliwal, Tara Whittaker, JoyAnne Krupa, Stephan Du Plessis
OBJECTIVES: Intrathecal morphine (ITM) is an efficacious method of providing postoperative analgesia and reducing pain associated complications. Despite adoption in many surgical fields, ITM has yet to become a standard of care in lumbar spine surgery. Spine surgeons' reticence to make use of the technique may in part be attributed to concerns of precipitating a cerebrospinal fluid (CSF) leak. METHODS: Herein we describe a method for oblique intrathecal injection during lumbar spine surgery to minimize risk of CSF leak...
May 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28452613/fully-endoscopic-combined-transsphenoidal-and-supraorbital-keyhole-approach-for-parasellar-lesions
#15
Yuichi Nagata, Tadashi Watanabe, Tetsuya Nagatani, Kazuhito Takeuchi, Jonsu Chu, Toshihiko Wakabayashi
OBJECTIVE Parasellar tumors that extend far laterally beyond the internal carotid artery or that are fibrous and adhere firmly to critical structures are difficult to remove totally via the endoscopic transsphenoidal approach alone. In such cases, a combined transsphenoidal-transcranial approach is effective to achieve maximal resection in a single stage. In this paper, a new minimally invasive surgical technique for complicated parasellar lesions, a fully endoscopic combined transsphenoidal-supraorbital keyhole approach, is presented...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28451627/disruption-of-the-leptomeningeal-blood-barrier-in-neuromyelitis-optica-spectrum-disorder
#16
Nasrin Asgari, Eoin P Flanagan, Kazuo Fujihara, Ho Jin Kim, Hanne P Skejoe, Jens Wuerfel, Hiroshi Kuroda, Su Hyun Kim, Elisabeth Maillart, Romain Marignier, Sean J Pittock, Friedemann Paul, Brian G Weinshenker
OBJECTIVE: To describe leptomeningeal blood-barrier impairment reflected by MRI gadolinium-enhanced lesions in patients with aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD). METHODS: A retrospective case series of 11 AQP4-IgG-positive NMOSD patients with leptomeningeal enhancement (LME) were collected from 5 centers. External neuroradiologists, blinded to the clinical details, evaluated MRIs. RESULTS: LME was demonstrated on postcontrast T1-weighted and fluid-attenuated inversion recovery images as a sign of leptomeningeal blood-barrier disruption and transient leakage of contrast agent into the subarachnoid space in 11 patients, 6 in the brain and 6 in the spinal cord...
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28447154/radiological-and-clinical-interpretation-of-the-patients-with-csf-leaks-developed-during-or-after-endoscopic-sinus-surgery
#17
Muaid I Aziz Baban, Mokarbesh Hadi, Stefania Gallo, Jacopo Zocchi, Mario Turri-Zanoni, Paolo Castelnuovo
Cerebrospinal fluid (CSF) leaks associated with endoscopic sinus surgery (ESS) are a rare complication related to anatomical and technical factors. The anatomical variations at skull base level are imperative to be detected preoperatively by CT scan to avoid this complication. Identifying the factors playing a role in the incidence of the CSF leaks during and after ESS and the common leak sites. A retrospective review of 24 patients presented with incidental CSF leaks, gathered from 1999 to 2016 was performed...
April 26, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28419438/dinosaur-tail-sign-a-useful-spinal-mri-finding-indicative-of-cerebrospinal-fluid-leakage
#18
Keita Sakurai, Masafumi Kanoto, Motoo Nakagawa, Masashi Shimohira, Aya M Tokumaru, Masashi Kameyama, Keigo Shimoji, Satoru Morimoto, Noriyuki Matsukawa, Minoru Nishio, Yuta Shibamoto
OBJECTIVE: To evaluate the imaging characteristics and diagnostic utility of the "Dinosaur tail sign" in the diagnosis of cerebrospinal fluid (CSF) leakage. BACKGROUND: The authors propose the "Dinosaur tail sign," defined as a combination of the dorsal epidural hyperintensities, fat tissue, spinal cord, and cauda equine on lumbosacral sagittal fat-suppressed T2-weighted image (FST2WI), as a sensitive indicator for diagnosing CSF leakage. METHODS: Imaging characteristics of the "Dinosaur tail sign" was evaluated in seven spontaneous intracranial hypotension (SIH) and 23 iatrogenic CSF leakage (ICSFL) patients...
April 16, 2017: Headache
https://www.readbyqxmd.com/read/28412565/the-use-of-a-novel-perfusion-based-cadaveric-simulation-model-with-cerebrospinal-fluid-reconstitution-comparing-dural-repair-techniques-a-pilot-study
#19
Joshua Bakhsheshian, Ben A Strickland, Neil N Patel, Andre M Jakoi, Michael Minneti, Gabriel Zada, Frank L Acosta, Patrick C Hsieh, Jeffrey C Wang, John C Liu, Martin H Pham
BACKGROUND CONTEXT: Watertight dural repair is crucial for both incidental durotomy and closure after intradural surgery. PURPOSE: The study aimed to describe a perfusion-based cadaveric simulation model with cerebrospinal fluid (CSF) reconstitution and to compare spine dural repair techniques. STUDY DESIGN/SETTING: The study is set in a fresh tissue dissection laboratory. SAMPLE SIZE: The sample includes eight fresh human cadavers...
April 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28357687/efficacy-and-safety-of-non-suture-dural-closure-using-a-novel-dural-substitute-consisting-of-polyglycolic-acid-felt-and-fibrin-glue-to-prevent-cerebrospinal-fluid-leakage-a-non-controlled-open-label-multicenter-clinical-trial
#20
Shunsuke Terasaka, Toshiaki Taoka, Satoshi Kuroda, Nobutaka Mikuni, Toru Nishi, Hiroyuki Nakase, Yukihiko Fujii, Yasuhiko Hayashi, Jun-Ichi Murata, Ken-Ichiro Kikuta, Toshihiko Kuroiwa, Sachie Shimokawa, Kiyohiro Houkin
The objective of this study is to evaluate the efficacy and safety of non-suture dural closure using a novel dural substitute (GM111) consisting of polyglycolic acid felt with a fibrin-glue-coated area commensurate in size with the dural defect. This was a non-controlled, open-label, multicenter clinical trial. The efficacy evaluation endpoints were (1) GM111's intra-operative capability to close dural defects and (2) prevention of cerebrospinal fluid (CSF) leakage and subcutaneous CSF retention throughout the postoperative period (evaluated by diagnostic imaging)...
May 2017: Journal of Materials Science. Materials in Medicine
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