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https://www.readbyqxmd.com/read/28339449/reversal-of-progressive-conscious-disturbance-with-epidural-blood-patch-for-cerebrospinal-fluid-leakage-at-c2-level
#1
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/28338451/superficial-siderosis-of-the-central-nervous-system-associated-with-intraspinal-hemorrhage-from-ventral-thoracic-epidural-veins-and-a-ventral-spinal-csf-leak-case-report
#2
Keisuke Takai, Takashi Komori, Manabu Niimura, Makoto Taniguchi
In most patients with superficial siderosis of the CNS, the exact source of bleeding remains unknown because of a lack of objective surgical data. The authors herein describe the case of a 58-year-old man with superficial siderosis of the CNS. The patient also had spinal CSF leakage due to a spinal dural defect. Repair surgery for the dural defect was performed using posterior laminoplasty with a transdural approach without spinal fixation. During repair surgery, the bleeding source was found to be the epidural vein around the defect...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28336418/treatment-of-cerebrospinal-fluid-leak-after-spine-surgery
#3
REVIEW
Zhao Fang, Rong Tian, Yu-Tao Jia, Tian-Tong Xu, Yang Liu
Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF) leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1) creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2) retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28330628/analysis-of-the-dura-involvement-in-cholesteatoma-surgery
#4
David Schwarz, Antoniu-Oreste Gostian, Sami Shabli, Philipp Wolber, Karl Bernd Hüttenbrink, Andreas Anagiotos
OBJECTIVE: The involvement of the dura is a rare yet potentially life-threatening complication during cholesteatoma surgery. Thus, the knowledge about treatment and consequences of this issue is of great importance to every ear surgeon. METHODS: This retrospective study analyzed the dura involvement with regard to the type of defect, reconstruction method used, and the post-operative complications of 1291 pediatric and adult cholesteatoma surgeries performed at an academic tertiary care center over a twelve-year period...
March 19, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28327892/safety-and-efficacy-of-tachosil-absorbable-fibrin-sealant-patch-compared-with-current-practice-for-the-prevention-of-cerebrospinal-fluid-leaks-in-patients-undergoing-skull-base-surgery-a-randomized-controlled-trial
#5
Bernard George, Christian Matula, Lars Kihlström, Enrique Ferrer, Vilhelm Tetens
BACKGROUND: Cerebrospinal fluid (CSF) leakage associated with incomplete sealing of the dura mater is a major complication of intradural procedures. OBJECTIVE: To compare the efficacy and safety of adjunctive TachoSil (Takeda Pharma A/S, Roskilde, Denmark) with current practice for the prevention of postoperative CSF leaks in patients undergoing elective skull base surgery involving dura mater closure. METHODS: Patients were intraoperatively randomized to TachoSil or current practice immediately before primary dura closure by suturing ± duraplasty...
March 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28299308/malignant-transformation-of-an-intracranial-extradural-epidermoid-cyst-into-squamous-cell-carcinoma-presented-with-cerebrospinal-fluid-leakage
#6
Bahram Seif, Reza Pourkhalili, Ahmad Shekarchizadeh, Parvin Mahzouni
We report a case of malignant transformation of an intracranial extradural epidermoid cyst into squamous cell carcinoma (SCC), that presented with cerebrospinal fluid (CSF) leakage at the time of recurrence. Intracranial epidermoid cysts are histologically benign and slow-growing neoplasms. They are congenital lesions that develop from ectodermal remnants during neuroembryogenesis. Malignant transformation of epidermoid cysts into SCC is very rare. Various clinical presentations of these tumors after malignant transformation are mentioned in the literature...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28296723/surgical-treatment-for-bacterial-meningitis-after-spinal-surgery-a-case-report
#7
Li-Min Zhang, Liang Ren, Zhen-Qi Zhao, Yan-Rui Zhao, Yin-Feng Zheng, Jun-Lin Zhou
RATIONALE: Bacterial meningitis (BM) has been recognized as a rare complication of spinal surgery. However, there are few reports on the management of postoperative BM in patients who have undergone spinal surgery. The initial approach to the treatment of patients suspected with acute BM depends on the stage at which the syndrome is recognized, the speed of the diagnostic evaluation, and the need for antimicrobial and adjunctive therapy. PATIENT CONCERNS: Here, we report the case of a patient with lumbar spinal stenosis and underwent a transforaminal lumbar interbody fusion at L4-L5...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28283371/chiari-like-displacement-due-to-spontaneous-intracranial-hypotension-in-an-adolescent-successful-treatment-by-epidural-blood-patch
#8
Jan Schönberger, Markus Möhlenbruch, Angelika Seitz, Cornelia Bußmann, Heidi Bächli, Stefan Kölker
BACKGROUND: Spontaneous intracranial hypotension is a rarely diagnosed cause of headache, especially in children and adolescents. It is due to cerebrospinal fluid (CSF) leakage via spinal fistulae occurring without major trauma. CASE PRESENTATION: An adolescent patient presented with a 3-month history of strictly postural headache. Cranial magnetic resonance imaging (MRI) showed pronounced Chiari-like prolapse of the cerebellar tonsils, narrow ventricles and enlarged cerebral veins...
February 20, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28281008/efficacy-of-endoscopic-endonasal-transsphenoidal-surgery-for-cushing-s-disease-in-230-patients-with-positive-and-negative-mri
#9
Hélène Cebula, Bertrand Baussart, Chiara Villa, Guillaume Assié, Anne Boulin, Luc Foubert, Sorin Aldea, Saad Bennis, Michèle Bernier, François Proust, Stephan Gaillard
OBJECT: The primary objective was to assess the remission rate, and the secondary objectives were to evaluate the early complications and recurrence rate and to define the predictive factors for the remission and recurrence rates. PATIENTS AND METHODS: This prospective single-center study included 230 consecutive patients, operated on by a single surgeon for Cushing's disease via a transsphenoidal endoscopic endonasal approach, over a 6-year period (2008-2013). The patients included in this series were all adults (>18 years of age), who presented with clinical and biological characteristics of Cushing's disease confirmed based on dedicated MRI pituitary imaging...
March 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28256168/multidisciplinary-management-for-the-treatment-of-proximal-posterior-inferior-cerebellar-artery-aneurysms
#10
Kwang-Chun Cho, Yong Bae Kim, Sang Hyun Suh, Jin Yang Joo, Chang-Ki Hong
OBJECTIVES: Aneurysms of the proximal posterior inferior cerebellar artery (PICA) are rare. The management of proximal PICA aneurysms is challenging with either surgical or endovascular treatment. We report our successful experience of treating PICA aneurysms with a multimodal approach. METHODS: Of 2382 treated aneurysms, 22 aneurysms in 21 patients (male:female 8:13, mean age 48.9 years) were enrolled from March 1998 to December 2015. We treated the aneurysms with a multimodal approach and performed angiography to examine aneurysm regrowth at the 12 months follow-up...
March 3, 2017: Neurological Research
https://www.readbyqxmd.com/read/28229571/transnasal-transsphenoidal-brain-injury-by-a-fencing-foil-an-unusual-case-report-and-brief-literature-review
#11
Rafet Özay, Mehmet S Balkan, Çağhan Tönge, Zeki Şekerci
BACKGROUND: In this report, the authors present an unusual case of a 10-year-old child who suffered a severe headache and rhinorrhea that occurred as a result of fencing foil sports injury via transnasal-transsphenoidal (TNTS) pathway. METHODS: Following to trauma, the child had shown neurological symptoms such a pupil dilatation, change in consciousness and mild hemiparesia. Imaging demonstrated destruction of bone structures including posterior wall of sphenoid sinus and anterosuperior part of sella turcica, and also a contusion at right thalamic region...
February 22, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28202822/-idiopathic-intracranial-hypotension
#12
Iwao Takeshita, Satoshi O Suzuki, Toru Iwaki
Idiopathic intracranial hypotension (hypovolemia) is almost exclusively provoked by cerebrospinal fluid (CSF) leakage through spontaneously rent dural sac. An initial clinical feature of a severe headache with or without nausea/vomiting should be differentiated from a life-threatening stroke. An early diagnosis and proper therapy may guarantee a good outcome, while delays may promote complicated manifestations and irreversible poor outcome in a few patients. In this article, neuro-imaging studies of some demonstrable cases are presented and the outlets of the spinal CSF and spinal CSF pathways are shown with immunohistological staining...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#13
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28176642/granulocyte-colony-stimulating-factor-attenuates-blood-brain-barrier-damage-and-improves-cognitive-function-in-spontaneously-hypertensive-rats
#14
Xin Wei, Yan Xu, Yanling Jin, Hongliang Feng, Shouquan Dong
Cerebral small vessel diseases (CSVDs) always coincide with endothelial dysfunction and blood-brain barrier (BBB) damage. Granulocyte-colony stimulating factor (G-CSF) can play a neuroprotective role in many neurological diseases. We investigated whether G-CSF exerts positive effects in spontaneously hypertensive rats (SHRs), a rat model of CSVD. Twenty-four-week-old SHRs, displaying the early histopathological changes of CSVD, received daily administrations of either G-CSF (50μg/kg) or saline for 7 days. The novel object recognition test was then conducted after treatment...
February 7, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28164124/characteristics-of-hemorrhagic-stroke-following-spine-and-joint-surgeries
#15
REVIEW
Fei Yang, Jianning Zhao, Haidong Xu
Hemorrhagic stroke can occur after spine and joint surgeries such as laminectomy, lumbar spinal fusion, tumor resection, and total joint arthroplasty. Although this kind of stroke rarely happens, it may cause severe consequences and high mortality rates. Typical clinical symptoms of hemorrhagic stroke after spine and joint surgeries include headache, vomiting, consciousness disturbance, and mental disorders. It can happen several hours after surgeries. Most bleeding sites are located in cerebellar hemisphere and temporal lobe...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28163520/penetrating-anterior-skull-base-fracture-inflicted-by-a-cow-s-horn
#16
Adomas Bunevicius, Karolis Bareikis, Laimutis Kalasauskas, Arimantas Tamasauskas
Farm workers are at increased risk for animal-inflicted head injuries that are associated with significant morbidity and occasionally may be fatal. These injuries may cause permanent eye damage with or without concomitant skull base fracture. Here, we present a male farmer who suffered a cow attack that resulted in perforating orbital injury with comminuted frontobasal cranial fracture caused by a cow's horn. The next day, the patient developed nasal and orbital cerebrospinal fluid (CSF) leak. Computed Tomography cisternography revealed CSF leakage to frontal and maxillary sinuses...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28156208/image-guided-intrathecal-baclofen-pump-catheter-implantation-a-technical-note-and-case-series
#17
Shenandoah Robinson, Faith C Robertson, Hormuzdiyar H Dasenbrock, Cormac P O'Brien, Charles Berde, Horacio Padua
OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Although prior reports have described drilling through the lumbar fusion mass with a high-speed bur, as well as IT catheter implantation at the foramen magnum or cervical spine, these approaches have notable limitations...
February 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28146023/effective-repair-of-dural-tear-using-bioabsorbable-sheet-with-fibrin-glue
#18
Akira Iwata, Masahiko Takahata, Ken Kadoya, Hideaki Sudo, Terufumi Kokabu, Katsuhisa Yamada, Norimasa Iwasaki
STUDY DESIGN: Basic Science OBJECTIVE.: This study aimed to compare the techniques of surgical repair of dural tear using bioabsorbable material and fibrin glue. SUMMARY OF BACKGROUND DATA: Cerebrospinal fluid (CSF) leakage caused by dural tear can often be difficult to manage even after repair when the same materials are used in a similar manner. METHODS: Burst pressure was measured for repaired porcine dura with holes of different diameters using spray of combined fibrinogen and thrombin solution (fibrin spray) alone as a control and the 5-mm hole following different methods using fibrinogen and thrombin solutions plus polyglactin 910 sheet (PGS)...
January 31, 2017: Spine
https://www.readbyqxmd.com/read/28128699/surgical-results-and-complications-of-anterior-decompression-and-fusion-as-a-revision-surgery-after-initial-posterior-surgery-for-cervical-myelopathy-due-to-ossification-of-the-posterior-longitudinal-ligament
#19
Seiichi Odate, Jitsuhiko Shikata, Tsunemitsu Soeda, Satoru Yamamura, Shinji Kawaguchi
OBJECTIVE Ossification of the posterior longitudinal ligament (OPLL) is a progressive disease. An anterior cervical decompression and fusion (ACDF) procedure for cervical OPLL is theoretically feasible, as the lesion exists anteriorly; however, such a procedure is considered technically demanding and is associated with serious complications. Cervical laminoplasty is reportedly an effective alternative procedure with few complications; it is recognized as a comparatively safe procedure, and has been widely used as an initial surgery for cervical OPLL...
January 27, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28128693/endoscopic-endonasal-versus-transcranial-approach-to-tuberculum-sellae-and-planum-sphenoidale-meningiomas-in-a-similar-cohort-of-patients
#20
Evan D Bander, Harminder Singh, Colin B Ogilvie, Ryan C Cusic, David J Pisapia, Apostolos John Tsiouris, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Planum sphenoidale (PS) and tuberculum sellae (TS) meningiomas cause visual symptoms due to compression of the optic chiasm. The treatment of choice is surgical removal with the goal of improving vision and achieving complete tumor removal. Two options exist to remove these tumors: the transcranial approach (TCA) and the endonasal endoscopic approach (EEA). Significant controversy exists regarding which approach provides the best results and whether there is a subset of patients for whom an EEA may be more suitable...
January 27, 2017: Journal of Neurosurgery
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