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Csf leakage

Frank A Giordano, Stefanie Brehmer, Bettina Mürle, Grit Welzel, Elena Sperk, Anke Keller, Yasser Abo-Madyan, Elisabeth Scherzinger, Sven Clausen, Frank Schneider, Carsten Herskind, Martin Glas, Marcel Seiz-Rosenhagen, Christoph Groden, Daniel Hänggi, Peter Schmiedek, Bahman Emami, Luis Souhami, Kevin Petrecca, Frederik Wenz
BACKGROUND: The median time to recurrence of glioblastoma (GB) following multimodal treatment is ∼7 mo. Nearly all cancers recur locally, suggesting that augmenting local treatments may improve outcomes. OBJECTIVE: To investigate whether intraoperative radiotherapy (IORT) to the resection cavity is safe and effective. METHODS: INTRAGO was a phase I/II trial to evaluate the safety and tolerability of IORT with 20 to 40 Gy of low-energy photons in addition to standard radiochemotherapy (ClinicalTrials...
March 8, 2018: Neurosurgery
Ismail Kürşad Gökce, Hatice Turgut, Ramazan Ozdemir, Selami Cagatay Onal
Cerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound-healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery...
March 9, 2018: Journal of Neurosurgery. Pediatrics
Shaoqing Li, Peng Zhang, Xianda Gao, Dechao Miao, Yanlong Gao, Yong Shen
Objective: Our purpose here was to identify risk factors of poor outcome after anterior operation in patients with cervical ossification of the posterior longitudinal ligament (OPLL). Methods: This study retrospectively reviewed 98 patients who underwent anterior surgery for improving neurological symptoms. The Japanese Orthopedic Association (JOA) recovery rate <50% was defined as poor surgical outcome. We investigated the relationship between various predictors and outcome by logistic regression analysis and receiver operating characteristic curves...
2018: Therapeutics and Clinical Risk Management
Dong-Ho Lee, Jae Hwan Cho, Choon Sung Lee, Chang Ju Hwang, Sung Hoon Choi, Chul Gie Hong
BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Dan Zhao, Shanwei Tao, Dewei Zhang, Mengyang Qin, Yijun Bao, Anhua Wu
PURPOSE: Traumatic meningoencephalocele primarily occurs as a rare but complex complication of cranial base and orbital roof fractures. Traumatic intraorbital meningoencephalocele, which is rare and easily overlooked, can be life-threatening since cephalomeningitis occurs due to cerebrospinal fluid (CSF) leakage. It is obscure for the operative indications or standard surgical methods of traumatic meningoencephaloceles since the combined intricate craniofacial and basal fractures, brain injury, and CSF leak may exist...
February 27, 2018: Brain Injury: [BI]
Murat Kutlay, Abdullah Durmaz, İlker Özer, Cahit Kural, Çağlar Temiz, Serdar Kaya, İlker Solmaz, Mehmet Daneyemez, Yusuf Izci
OBJECTIVE: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. PATIENTS AND METHODS: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions...
February 21, 2018: Clinical Neurology and Neurosurgery
Nasrin Yazdani, Mohammad Taghi Khorsandi-Ashtiani, Hamed Tashakorinia, Mahtab Rabbani Anari, Narges Mikaniki
Cerebrospinal fluid (CSF) leakages of the temporal bone may arise during mastoid surgery. The leakages can have multiple potential etiologies, for instance, using a cutting burr near the bony tegmen or monopolar electrocautery on the surface of the dura mater. In this paper, we introduced an effective and simple technique for the management of CSF leakages of the temporal bone. In a prospective case series, 36 patients (16 males and 20 females) who have had an experience of incidental or inevitable CSF otorrhea or otorhinorrhea during temporal bone surgery were selected...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Maria Carla Piastra, Andreas Nüßing, Johannes Vorwerk, Harald Bornfleth, Robert Oostenveld, Christian Engwer, Carsten H Wolters
In Electro- (EEG) and Magnetoencephalography (MEG), one important requirement of source reconstruction is the forward model. The continuous Galerkin finite element method (CG-FEM) has become one of the dominant approaches for solving the forward problem over the last decades. Recently, a discontinuous Galerkin FEM (DG-FEM) EEG forward approach has been proposed as an alternative to CG-FEM (Engwer et al., 2017). It was shown that DG-FEM preserves the property of conservation of charge and that it can, in certain situations such as the so-called skull leakages , be superior to the standard CG-FEM approach...
2018: Frontiers in Neuroscience
M Sindou, P Mercier
Over the last decades microvascular decompression (MVD) has been established as the curative treatment of the primary Hemifacial Spasm (HFS), proven to be linked in almost all cases to a neurovascular compression of the facial nerve. Because the disease is not life-threatening and MVD not totally innocuous, efficacy and safety have to be weighted before decision taken of indicating surgery. The authors have been charged by the French Speaking Society of Neurosurgery to conduct a detailed evaluation of the probability of relief of the spasm that MVD is able to obtain, together with its potential complications...
February 14, 2018: Neuro-Chirurgie
Agus Turchan, Taufiq Fatchur Rochman, Arie Ibrahim, Dyah Fauziah, Joni Wahyuhadi, M Arifin Parenrengi, Asra Al Fauzi, Erliano Sufarnap, Abdul Hafid Bajamal, Ferdiansyah, Heri Suroto, Purwati, Fedik Abdul Rantam, Adanti Wido Paramadini, Christianto Benjamin Lumenta
In the field of neurosurgery, often the dura mater cannot be sutured, and consequently, it requires a duraplasty procedure using a dural fascial graft. Since 1890, various materials have been researched as dura mater substitutes. Amniotic membrane, for example, is suitable as a dural graft material and has been used in neurosurgery since 2012. However, there has been little research on human patient's dural healing after the use of amniotic membrane in their duraplasty procedure. To address this gap, a clinical experimental study was undertaken to evaluate the human dural healing of 16 patients who had undergone duraplasty in decompressive craniectomy surgery at Dr...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ivan Savin, Ksenia Ershova, Nataliya Kurdyumova, Olga Ershova, Oleg Khomenko, Gleb Danilov, Michael Shifrin, Vladimir Zelman
PURPOSE: To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS: An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. We utilized relative risk analysis, regressions, and ML to identify factors associated with HAVM development. RESULTS: 2286 patients of all ages were included, 216 of them had HAVM...
February 5, 2018: Journal of Critical Care
Stephen Y Kang, Antoine Eskander, Ralph Abi Hachem, Enver Ozer, Theodoros N Teknos, Matthew O Old, Daniel M Prevedello, Ricardo L Carrau
BACKGROUND: When locoregional flaps fail to reconstruct the skull base, the microvascular surgeon faces several reconstructive challenges. We present our technique and results of salvage anterior skull base reconstruction utilizing the vastus lateralis free tissue transfer (VLFTT). METHODS: Four patients with anterior skull base defects after previous locoregional flap failure underwent free tissue transfer reconstruction with VLFTT. RESULTS: The success rate of free tissue transfer was 100%...
February 6, 2018: Head & Neck
Takahiro Asami, Makoto Ishii, Ho Namkoong, Kazuma Yagi, Sadatomo Tasaka, Takanori Asakura, Shoji Suzuki, Tetsuro Kamo, Satoshi Okamori, Hirofumi Kamata, Haiyue Zhang, Ahmed E Hegab, Naoki Hasegawa, Tomoko Betsuyaku
BACKGROUND: Pneumonia is the fourth leading cause of death worldwide, and Streptococcus pneumoniae is the most commonly associated pathogen. Increasing evidence suggests that mesenchymal stromal cells (MSCs) have anti-inflammatory roles during innate immune responses such as sepsis. However, little is known about the effect of MSCs on pneumococcal pneumonia. METHODS: Bone marrow-derived macrophages (BMDMs) were stimulated with various ligands in the presence or absence of MSC-conditioned medium...
January 31, 2018: Cytotherapy
Patrick Schuss, Alexis Hadjiathanasiou, Dietrich Klingmüller, Ági Güresir, Hartmut Vatter, Erdem Güresir
Transsphenoidal surgery is a common procedure in patients with pituitary adenomas. Several techniques have been previously postulated to achieve sufficient sellar reconstruction to avoid cerebrospinal fluid (CSF) leakage. We analyzed our institutional database concerning two sellar reconstruction techniques and development of postoperative CSF leakage. From 2009 to 2015, 255 patients underwent transsphenoidal pituitary surgery at our institution. According to the technique used for sellar reconstruction, patients were divided into two groups: (1) with muscle patch and fibrin glue and (2) with fibrin glue alone...
February 1, 2018: Neurosurgical Review
Yuanliang Ye, Fuyu Wang, Tao Zhou, Yi Luo
To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site...
December 2017: Medicine (Baltimore)
Guang Yong Chen, Long Ma, Mei Ling Xu, Jin Nan Zhang, Zhi Dong He, Cheng Yan He, Cong Hai Zhao, Chao Fu, Miao Li, Yu Fei Gao
INTRODUCTION: Spontaneous cerebrospinal fluid leakage is usually caused by developmental abnormalities and is rare, accounting for approximately 5% of the cases of cerebrospinal fluid (CSF) leakage. To the best of our knowledge, clival dysplasia-caused CSF rhinorrhea has never been reported in the neurosurgical field. CONCLUSION: Spontaneous cerebrospinal fluid rhinorrhea is often treated by surgery, and a transsphenoidal approach repair is the main surgical method used, offering the advantages of less trauma, fewer complications, rapid postoperative recovery, and low recurrence rate...
February 2018: Medicine (Baltimore)
Oluwaseun O Akinduro
INTRODUCTION: Prolactinomas may rarely present with meningitis and cerebrospinal fluid (CSF) rhinorrhea secondary to erosion of the wall of the sella turcica. It is even more un-common for this abnormal communication to be caused by an ectopic prolactinoma arising from the sphenoid sinus and eroding into the sella. This atypical growth pattern makes diagnosis very difficult, as there may be no displacement of the normal pituitary gland. The authors present the first reported case of a patient with an ectopic prolactinoma presenting primarily with meningitis, and discuss the management strategy as well as surgical and non-surgical treatment options for these patients...
January 26, 2018: World Neurosurgery
Tetsuo Ikezono, Tomohiro Matsumura, Han Matsuda, Satomi Shikaze, Shiho Saitoh, Susumu Shindo, Setsuo Hasegawa, Seung Ha Oh, Yoshiaki Hagiwara, Yasuo Ogawa, Hiroshi Ogawa, Hiroaki Sato, Tetsuya Tono, Ryuichiro Araki, Yukihide Maeda, Shin-Ichi Usami, Yasuhiro Kase
Perilymphatic fistula is defined as an abnormal communication between the perilymph-filled space and the middle ear, or cranial spaces. The manifestations include a broad spectrum of neuro-otological symptoms such as hearing loss, vertigo/dizziness, disequilibrium, aural fullness, tinnitus, and cognitive dysfunction. By sealing the fistula, perilymphatic fistula is a surgically correctable disease. Also, appropriate recognition and treatment of perilymphatic fistula can improve a patient's condition and hence the quality of life...
2018: PloS One
Min Yan, Yange Hu, Min Yao, Shisan Bao, Yong Fang
BACKGROUND: Skin wound healing involves complex coordinated interactions of cells, tissues and mediators. Maintaining microvascular barrier integrity is one of the key events for endothelial homeostasis during wound healing. Vasodilation is observed after vasoconstriction, which causes blood vessels to become porous, facilitates leukocyte infiltration and aids angiogenesis at the wound-area, post-injury. Eventually, vessel integrity has to be re-established for vascular maturation. Numerous studies have found that granulocyte macrophage colony-stimulating factor (GM-CSF) accelerates wound healing by inducing recruitment of repair cells into the injury area and releases of cytokines...
January 12, 2018: Wound Repair and Regeneration
Yuichi Kondo, Kazunari Fushimi, Makoto Takasawa, Shigeo Kanamori, Takaki Miyagawa, Kenji Kawashima, Kazutoshi Yokoyama, Haruhiko Akiyama
Intracranial hemorrhage is a rare complication of spinal surgery. Case 1 was a 58-year-old man who underwent cervical laminoplasty. No apparent iatrogenic dural rupture or cerebrospinal fluid leakage was observed. An hour after the surgery, the patient had convulsions and became restless thereafter. CT revealed an intracranial SAH. The patient recovered normal consciousness the next morning. Case 2 was a 68-year-old woman who underwent cervical laminoplasty without postoperative CSF leakage. Six days after the surgery, the patient continued to complain of nausea and headache...
January 12, 2018: International Journal of Neuroscience
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