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https://www.readbyqxmd.com/read/29771825/complex-scalp-and-calvarium-defects-after-giant-basal-cell-carcinoma-excision-management-challanges-outcomes
#1
Utku Ozcan, Mustafa Akyurek, Emrah Arslan
Giant basal cell carcinoma (GBCC) is defined as a tumor ≥5 cm in diameter. GBCC of scalp usually requires extended resection of soft tissues, calvarium, and dura. In this study, we present 5 patients with GBCC of head, who underwent a single-stage combined scalp, calvarium, and dural reconstruction. Herein, we aim to discuss reconstruction methods, cerebrospinal fluid (CSF) leakage, duration of hospital stay, and tumor recurrency. Peroperative and postoperative follow-ups, defect areas, and performed calvarium reconstruction methods of 5 patients, who underwent complex scalp and calvarium reconstruction after GBCC between year 2010 and 2017, were retrospectively maintained...
May 15, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29765818/targeted-epidural-blood-patch-treatment-for-refractory-spontaneous-intracranial-hypotension-in-china
#2
Fei-Fang He, Li Li, Min-Jun Liu, Tai-Di Zhong, Qiao-Wei Zhang, Xiang-Ming Fang
Objective  An epidural blood patch (EBP) is the mainstay of treatment for refractory spontaneous intracranial hypotension (SIH). We evaluated the treatment efficacy of targeted EBP in refractory SIH. Methods  All patients underwent brain magnetic resonance imaging (MRI) with contrast and heavily T2-weighted spine MRI. Whole spine computed tomography (CT) myelography with non-ionic contrast was performed in 46 patients, and whole spine MR myelography with intrathecal gadolinium was performed in 119 patients...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29761002/large-retrospective-study-of-artificial-dura-substitute-in-patients-with-traumatic-brain-injury-undergo-decompressive-craniectomy
#3
Hongtao Sun, Hongda Wang, Yunfeng Diao, Yue Tu, Xiaohong Li, Wanyong Zhao, Jibin Ren, Sai Zhang
Background: Decompressive craniectomy is widely used for treating patients with traumatic brain injury (TBI). Usually patients have dura mater defect due to surgery or injury itself. The defective area may left open or repaired by artificial dura substitutes. A variety of artificial dura substitutes have been used for this purpose. Objective: This study aimed to evaluate bovine-derived pericardium membrane as artificial dural material for patients with decompressive craniectomy...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29749801/treatment-of-atlantoaxial-dislocations-among-patients-with-cervical-osseous-or-vascular-abnormalities-utilizing-hybrid-techniques
#4
Shenglin Wang, Yinglun Tian, Bassel G Diebo, Samantha R Horn, Peter G Passias
OBJECTIVE Most cervical fixations for atlantoaxial dislocation (AAD) are bilateral and symmetric; however, in the setting of osseous and vascular deformity at the craniovertebral junction, asymmetrical and hybrid fixations are used as "salvage" techniques. Because of the rarity of these cases, hybrid cervical fixations for AAD have not been fully explored. The aim of this study was to evaluate the clinical feasibility and outcomes of posterior hybrid cervical fixations for AAD. METHODS Twenty-one AAD cases were retrospectively studied; 18 had cervical myelopathy with Japanese Orthopaedic Association (JOA) scores ranging from 9 to 16 (mean 13...
May 11, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29705021/endoscope-assisted-decompression-of-facial-nerve-for-treatment-of-hemifacial-spasm
#5
J Magnan
Microvascular decompression has become the sole method for a curative treatment of primary hemifacial spasm. Finding the responsible conflicting artery is not always easy as its location can be deeply situated within the cerebellopontine/medullary fissure at the facial root exit zone. Sole or additional offending vessel(s) may be at the meatus of the internal auditory canal (5% of the cases). Identifying the compressive vessel(s) and performing decompression is in most cases possible without cerebellar retraction by classical microsurgical techniques...
April 25, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29694666/comparison-of-dorsal-intercostal-artery-perforator-propeller-flaps-and-bilateral-rotation-flaps-in-reconstruction-of-myelomeningocele-defects
#6
Goktekin Tenekeci, Yavuz Basterzi, Sakir Unal, Alper Sari, Yavuz Demir, Celal Bagdatoglu, Bahar Tasdelen
AIM: Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects...
April 9, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29682061/transcranial-and-epidural-approach-for-spontaneous-cerebrospinal-fluid-leakage-due-to-meningoencephalocele-of-the-lateral-sphenoid-sinus
#7
Ryosuke Shintoku, Masahiko Tosaka, Tatsuya Shimizu, Yuhei Yoshimoto
We experienced a case of sphenoid sinus type meningoencephalocele manifesting as severe cerebrospinal fluid (CSF) rhinorrhea. A 35-year-old man became aware of serous nasal discharge 1 year previously, which had gradually worsened. The nasal discharge was diagnosed as CSF rhinorrhea. Head computed tomography (CT) showed several small depressions in the bone of the left middle cranial fossa, and the largest depression extended through the bone to the lateral sphenoid sinus. Head magnetic resonance imaging revealed that the meningoencephalocele projected to the lateral sphenoid sinus, through this small bone defect of the middle cranial fossa...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29643956/serum-cytokines-in-early-prediction-of-anastomotic-leakage-following-low-anterior-resection
#8
Marek Zawadzki, Małgorzata Krzystek-Korpacka, Andrzej Gamian, Wojciech Witkiewicz
Introduction: Anastomotic leakage continues to be one of the most serious complications following low anterior resections. Early diagnosis of a leak is difficult but critical to minimize morbidity and mortality. Aim: To evaluate changes in serum concentrations of 27 different cytokines following low anterior resection, with the goal of finding new, early biomarkers of anastomotic leak. Material and methods: This is a prospective observational study that includes 32 patients undergoing elective low anterior resection for rectal cancer...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29622505/preoperative-lumbar-drainage-placement-for-surgical-cranioplasty
#9
Henrik Giese, Jennifer Meyer, Andreas Unterberg, Christopher Beynon
OBJECTIVE: Intraoperative reduction of cerebrospinal fluid may be required in patients undergoing cranioplasty (CP) surgery, especially in the presence of bulging cranial defects. Direct cannulation of the frontal horn of the lateral ventricle is associated with risks such as intracerebral haemorrhage or postoperative leakage of cerebrospinal fluid. Here we report our initial experiences with preoperative lumbar drain (LD) placement for cranioplasty surgery in patients with bulging cranial defects...
April 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29621631/spontaneous-intracranial-hypotension-is-diagnosed-by-a-combination-of-lipocalin-type-prostaglandin-d-synthase-and-brain-type-transferrin-in-cerebrospinal-fluid
#10
Yuta Murakami, Koichi Takahashi, Kyoka Hoshi, Hiromi Ito, Mayumi Kanno, Kiyoshi Saito, Kenneth Nollet, Yoshiki Yamaguchi, Masakazu Miyajima, Hajime Arai, Yasuhiro Hashimoto, Tatsuo Mima
BACKGROUND: Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid (CSF) leakage. Definitive diagnosis can be difficult by clinical examinations and imaging studies. METHODS: SIH was diagnosed with the following criteria: (i) evidence of CSF leakage by cranial magnetic resonance imaging (MRI) findings of intracranial hypotension and/or low CSF opening pressure; (ii) no recent history of dural puncture. We quantified CSF proteins by ELISA or Western blotting...
April 2, 2018: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29620550/cerebrospinal-fluid-leakage-after-turbinate-submucosal-diathermy-an-unusual-complication
#11
Abdulaziz H Abobotain, Abdulrazag Ajlan, Saad Alsaleh
Submucosal diathermy of the inferior turbinate (SMDIT) is a generally safe procedure to control inferior turbinate hypertrophy. We present a case of a cerebrospinal fluid (CSF) leak at the craniocervical junction after SMDIT done in another institution. A 27-year-old man presented 3 weeks after undergoing SMDIT with signs and symptoms of meningitis and postnasal rhinorrhea. Nasal endoscopy and imaging revealed a nasopharyngeal CSF fistula at the craniocervical junction. Transnasal endoscopic repair and reconstruction was performed with no recurrence on repeat imaging and clinical follow up...
March 2018: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29607475/idiopathic-cerebrospinal-fluid-rhinorrhoea-an-uncommon-diagnosis-a-case-report-and-a-review-of-the-literature
#12
J Ediale, C O Onyema, K U Tobi
Cerebrospinal fluid (CSF) rhinorrhoea is often seen among head injured patients from road traffic crashes or physical assault, and sometimes it is a complication of nasal surgical procedures. Intracranial tumours may also result in CSF leakage. Blood stained rhinorrhoea often occur at the time of initial insult or injury, while CSF rhinorrhea may be a delayed manifestation. However, idiopathic CSF rhinorrhoea is uncommon, and it is regarded as a diagnosis of exclusion. In this communication, we report a 54-year old woman who developed CSF rhinorrhoea with no prior history of head trauma, physical assault, neurosurgical or nasal surgery...
January 2018: West African Journal of Medicine
https://www.readbyqxmd.com/read/29606049/transbasal-versus-endoscopic-endonasal-versus-combined-approaches-for-olfactory-groove-meningiomas-importance-of-approach-selection
#13
James K Liu, Nicole A Silva, Ilesha A Sevak, Jean Anderson Eloy
OBJECTIVE There has been much debate regarding the optimal surgical approach for resecting olfactory groove meningiomas (OGMs). In this paper, the authors analyzed the factors involved in approach selection and reviewed the surgical outcomes in a series of OGMs. METHODS A retrospective review of 28 consecutive OGMs from a prospective database was conducted. Each tumor was treated via one of 3 approaches: transbasal approach (n = 15), pure endoscopic endonasal approach (EEA; n = 5), and combined (endoscope-assisted) transbasal-EEA (n = 8)...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29605699/tailored-strategies-to-manage-cerebrospinal-fluid-leaks-or-pseudomeningocele-post-surgery-for-tethered-cord-syndrome
#14
Suhas Udayakumaran, Chetan T Rathod
BACKGROUND: Cerebrospinal fluid (CSF) leaks are a dreaded complication after surgery for tethered cord and are associated with significant patient morbidity. Although many strategies for managing postoperative CSF leaks exist, this problem is still daunting, especially in the very young patients. In this article, the authors compared different management techniques for CSF leaks or significant pseudomeningocele in patients with tethered cord syndrome (TCS). METHODS: We analysed a cohort of children who underwent surgery for TCS from January 2011 to March 2016 (n = 260) and postoperatively experienced either a CSF leak or significant pseudomeningocele...
March 29, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29600905/therapeutic-outcomes-of-transsphenoidal-surgery-in-pediatric-patients-with-craniopharyngiomas-a-single-center-study
#15
Shozo Yamada, Noriaki Fukuhara, Mitsuo Yamaguchi-Okada, Hiroshi Nishioka, Akira Takeshita, Yasuhiro Takeuchi, Naoko Inoshita, Junko Ito
OBJECTIVE The aim of this study was to analyze the outcomes of transsphenoidal surgery (TSS) in a single-center clinical series of pediatric craniopharyngioma patients treated with gross-total resection (GTR). METHODS The authors retrospectively reviewed the surgical outcomes for 65 consecutive patients with childhood craniopharyngiomas (28 girls and 37 boys, mean age 9.6 years) treated with TSS (45 primary and 20 repeat surgeries) between 1990 and 2015. Tumors were classified as subdiaphragmatic or supradiaphragmatic...
March 30, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29596011/slow-infusion-of-recombinant-adeno-associated-viruses-into-the-mouse-cerebrospinal-fluid-space
#16
Dan Wang, Jia Li, Karen Tran, Daniel R Burt, Li Zhong, Guangping Gao
Recombinant adeno-associated viruses (rAAVs) are the leading in vivo gene delivery platform, and have been extensively studied in gene therapy targeting various tissues, including the central nervous system (CNS). A single-bolus rAAV injection to the cerebrospinal fluid (CSF) space has been widely used to target the CNS, but it suffers from several drawbacks, such as leakage to peripheral tissues. Here, a protocol is described using an osmotic pump to infuse rAAV slowly into the mouse CSF space. Compared to the single-bolus injection technique, pump infusion can lead to higher CNS transduction and lower transduction in the peripheral tissues...
March 29, 2018: Human Gene Therapy Methods
https://www.readbyqxmd.com/read/29557532/cisterna-magna-arachnoid-membrane-suturing-decreases-incidence-of-pseudomeningocele-formation-and-incisional-csf-leakage
#17
David Pitskhelauri, Elina Kudieva, Dmitrii Moshchev, Evgeny Ananev, Michail Shifrin, Gleb Danilov, Tatiana Melnikova-Pitskhelauri, Igor Kachkov, Andrey Bykanov, Alexander Sanikidze
OBJECTIVE: A pseudomeningocele and an incisional cerebrospinal fluid leak are considered frequent complications following neurosurgical operations. The rate of these complications especially increases following neurosurgical procedures on the posterior cranial fossae. According to some publications, the rate of pseudomeningoceles has been reported as high as 40%, whereas that of incisional cerebrospinal fluid leaks is up to 17%. For the purposes of reducing the risk of these complications after a midline suboccipital craniotomy, we propose suturing the arachnoid membrane of the cisterna magna...
March 20, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29552264/dual-energy-ct-cisternography-in-the-evaluation-of-csf-leaks-a-novel-approach
#18
Alexandra M Foust, Xuan V Nguyen, Luciano Prevedello, Eric C Bourekas, Daniel J Boulter
Cerebrospinal fluid leaks pose a serious threat to patients as they represent an unchecked communication between the subarachnoid space and the extracranial environment. Accurate localization of the leakage site is essential for treatment planning. We describe the novel utilization of dual-energy computed tomography technology in cisternography in the evaluation of a patient with a cerebrospinal fluid leak.
February 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29547085/analysis-of-various-tracts-of-mastoid-air-cells-related-to-csf-leak-after-the-anterior-transpetrosal-approach
#19
Ryota Tamura, Ryosuke Tomio, Farrag Mohammad, Masahiro Toda, Kazunari Yoshida
OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed...
March 16, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29528443/intraoperative-radiotherapy-in-newly-diagnosed-glioblastoma-intrago-an-open-label-dose-escalation-phase-i-ii-trial
#20
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
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