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Neurosurgical Approach

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https://www.readbyqxmd.com/read/28068291/particle-swarm-optimization-for-programming-deep-brain-stimulation-arrays
#1
Edgar Peña, Simeng Zhang, Steve Deyo, YiZi Xiao, Matthew D Johnson
OBJECTIVE: Deep brain stimulation (DBS) therapy relies on both precise neurosurgical targeting and systematic optimization of stimulation settings to achieve beneficial clinical outcomes. One recent advance to improve targeting is the development of DBS arrays (DBSAs) with electrodes segmented both along and around the DBS lead. However, increasing the number of independent electrodes creates the logistical challenge of optimizing stimulation parameters efficiently. APPROACH: Solving such complex problems with multiple solutions and objectives is well known to occur in biology, in which complex collective behaviors emerge out of swarms of individual organisms engaged in learning through social interactions...
January 9, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28065874/is-complex-sphenoidal-sinus-anatomy-a-contraindication-to-a-transsphenoidal-approach-for-resection-of-sellar-lesions-presentation-of-a-case-series-and-review-of-the-literature
#2
Marco Locatelli, Andrea Di Cristofori, Riccardo Draghi, Giulio Bertani, Claudio Guastella, Lorenzo Pignataro, Giovanna Mantovani, Paolo Rampini, Giorgio Carrabba
BACKGROUND: The transsphenoidal approach (TNS) is considered the gold standard for resection of pituitary adenomas and other sellar region lesions. This approach is guided by few fundamental anatomical landmarks that conduct the surgeon toward the sellar floor. Some anatomical structures may vary a lot (e.g. intrasphenoidal septa, intercarotid distance) and may be difficult to identify. Among those structures, the pneumatization and conformation of the sphenoidal sinus (SS) plays a key role for accessing the floor of the sella and other skull base structures...
January 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28065719/the-currarino-triad-what-pediatric-surgeons-need-to-know
#3
Amr Abdelhamid AbouZeid, Shaimaa Abdelsattar Mohammad, Mohammad Abolfotoh, Ahmed Bassiouny Radwan, Mohamed Mohamed ElSayed Ismail, Tarek Ahmed Hassan
PURPOSE: We report our experience in managing a group of patients with Currarino syndrome, highlighting diagnostic challenges, surgical techniques, in addition to a review of current neurosurgical options. PATIENTS AND METHODS: The study included patients with Currarino syndrome who presented to our pediatric surgery department during the period 2010 through 2016. The 'sacral scimitar' in plain X-ray provided the clue for the diagnosis; while MRI examination was essential to define the nature of the presacral mass and associated spinal anomalies...
December 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28049425/the-variability-of-motor-evoked-potential-latencies-in-neurosurgical-motor-mapping-by-preoperative-navigated-transcranial-magnetic-stimulation
#4
Nico Sollmann, Lucia Bulubas, Noriko Tanigawa, Claus Zimmer, Bernhard Meyer, Sandro M Krieg
BACKGROUND: Recording of motor evoked potentials (MEPs) is used during navigated transcranial magnetic stimulation (nTMS) motor mapping to locate motor function in the human brain. However, factors potentially underlying MEP latency variability in neurosurgical motor mapping are vastly unknown. In the context of this study, one hundred brain tumor patients underwent preoperative nTMS-based motor mapping of the tumor hemisphere between 2010 and 2013. Fourteen predefined predictor variables were recorded, and MEP latencies of abductor pollicis brevis muscle (APB), abductor digiti minimi muscle (ADM), and flexor carpi radialis muscle (FCR) were analyzed using linear mixed-effect multiple regression analysis with the forward step-wise model comparison approach...
January 3, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/28038480/intracranial-ameloblastoma-arising-from-the-maxilla-an-interdisciplinary-surgical-approach
#5
Johanna Quick-Weller, Felix Koch, Nazife Dinc, Stephanie Lescher, Peter Baumgarten, Patrick Harter, Friedrich Scheerer, Robert Sader, Volker Seifert, Gerhard Marquardt, Thomas Freiman
Background Ameloblastomas are a rare tumor entity accounting for only 10% of all odontogenic tumors. They mostly originate from the mandible. Only a few cases are known to grow aggressively and to invade the orbit, nasal cavity, or even the brain. Patient and Methods/Case Report We present the case of a 57-year-old patient who was admitted with a huge tumor involving the nasal cavity, the left maxilla, and the anterior fossa. Histologic diagnosis was made by biopsy. A combined two-stage neurosurgical maxillofacial approach was planned...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28035993/brain-monitoring-in-critically-neurologically-impaired-patients
#6
REVIEW
Salazar Jones, Gary Schwartzbauer, Xiaofeng Jia
Assessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram...
December 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28027173/the-shape-of-the-foramen-ovale-a-visualization-aid-for-cannulation-procedures
#7
Matthew J Zdilla, Kristen M Fijalkowski
Several neurosurgical procedures, including rhizotomy for the management of trigeminal neuralgia, cannulate the foramen ovale (FO) to access intracranial structures. Cannulation procedures, including those utilizing neuronavigational technology, are occasionally complicated by anatomical variation of the FO, sometimes resulting in miscannulation and subsequent adverse events. The FO, while commonly thought of as oval-shaped, has also been described as "almond," "banana," "D shape," "pear," and "triangular." Because of the importance of the FO in neurosurgical procedures and the misunderstanding of FO shape, the aim of this study is to objectively describe the shape of the FO and its most likely shape variation...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28013373/an-update-on-idiopathic-intracranial-hypertension
#8
Mark Portelli, Panagiotis N Papageorgiou
BACKGROUND: Idiopathic intracranial hypertension (IIH) is still a grey area in the knowledge of the aetiology, diagnosis and management of neurosurgical diseases. The definition of IIH has been reviewed over time and many hypotheses have been expressed as cause of the disease. The literature supplies very little evidence-based information to guide our decision-making process when it comes to treat the disease. In this review we sum up the latest information regarding the aetiology and therapy of IIH...
December 24, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28012852/mapping-effective-connectivity-in-the-human-brain-with-concurrent-intracranial-electrical-stimulation-and-bold-fmri
#9
Hiroyuki Oya, Matthew A Howard, Vincent A Magnotta, Anton Kruger, Timothy D Griffiths, Louis Lemieux, David W Carmichael, Christopher I Petkov, Hiroto Kawasaki, Christopher K Kovach, Matthew J Sutterer, Ralph Adolphs
BACKGROUND: Understanding brain function requires knowledge of how one brain region causally influences another. This information is difficult to obtain directly in the human brain, and is instead typically inferred from resting-state fMRI. NEW METHOD: Here, we demonstrate the safety and scientific promise of a novel and complementary approach: concurrent electrical stimulation and fMRI (es-fMRI) at 3T in awake neurosurgical patients with implanted depth electrodes...
December 21, 2016: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28011454/predicting-neurosurgical-outcomes-in-focal-epilepsy-patients-using-computational-modelling
#10
Nishant Sinha, Justin Dauwels, Marcus Kaiser, Sydney S Cash, M Brandon Westover, Yujiang Wang, Peter N Taylor
Surgery can be a last resort for patients with intractable, medically refractory epilepsy. For many of these patients, however, there is substantial risk that the surgery will be ineffective. The prediction of who is likely to benefit from a surgical approach is crucial for being able to inform patients better, conduct principled prospective clinical trials, and ultimately tailor therapeutic approaches to these patients more effectively. Dynamical computational models, informed with patient data, can be used to make predictions and give mechanistic insight...
December 23, 2016: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28009635/perioperative-and-anesthetic-considerations-for-neurosurgical-laser-interstitial-thermal-therapy-ablations
#11
Federico Jimenez-Ruiz, Benjamin Arnold, Claudio E Tatsui, Juan P Cata
OBJECTIVE: To describe the anesthetic considerations in patients undergoing laser interstitial thermal therapy (LITT) for neurosurgical procedures. BACKGROUND: LITT for neurosurgical procedures is being increasingly used in a variety of central nervous system diseases. Several studies have demonstrated promising results including a shorter hospital stay. Given the rising trend for the use of LITT, anesthesiologists need to be familiar with the anesthetic considerations to provide care for patients undergoing these types of procedures...
December 22, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28009309/-modern-approaches-to-correction-of-hypernatremia-in-neurosurgical-patients
#12
D Vassilyev
The article presents the analysis of the intensive therapy through the correction of persistent hypernatremia in neurosurgical patients after removal of brain tumors. The aim of this work was to evaluate the effectiveness of Sterofundin in the framework of complex therapy of hypernatremia in neurosurgical patients after removal of brain tumors. We analyzed the dynamics of the concentrations of sodium, potassium, chorus of the plasma, anion gap and buffer bases in the postoperative period of these patients. For obtaining reliable results, the patients were divided into groups according to the nature of the treatment: Sterofundin and symptomatic correction of hypotonic solution of sodium chloride, saluretic and Verospiron respectively...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#13
Dorian Chauvet, Stéphane Hans, Antoine Missistrano, Celeste Rebours, Wissame El Bakkouri, Guillaume Lot
OBJECTIVE The aim of this study was to confirm the feasibility of an innovative transoral robotic surgery (TORS), using the da Vinci Surgical System, for patients with sellar tumors. This technique was designed to offer a new minimally invasive approach, without soft-palate splitting, that avoids the rhinological side effects of classic endonasal approaches. METHODS The authors performed a prospective study of TORS in patients with symptomatic sellar tumors. Specific anatomical features were required for inclusion in the study and were determined on the basis of preoperative open-mouth CT scans of the brain...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27993742/immediate-titanium-mesh-implantation-for-patients-with-postcraniotomy-neurosurgical-site-infections-a-safe-and-esthetic-alternative-procedure
#14
Gregory Ehrlich, Stefanie Kindling, Holger Wenz, Daniel Hänggi, Dirk Michael Schulte, Peter Schmiedek, Marcel Seiz-Rosenhagen
BACKGROUND: Surgical site infection (SSI) is one of the main complications after craniotomy. The incidence is up to 11% in the literature. The established procedure is debridement, removal of the bone flap and delayed cranioplasty. Delayed cranioplasty has several disadvantages. A promising approach is the immediate titanium mesh implantation at the time of wound revision. We want to report our experience with this technique with regard to outcome measured by reinfection rates and patient satisfaction...
December 16, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27989249/risk-factors-for-surgical-site-infections-following-neurosurgical-spinal-fusion-operations-a-case-control-study
#15
Thomas L Walsh, Ashley M Querry, Sheila McCool, Alison L Galdys, Kathleen A Shutt, Melissa I Saul, Carlene A Muto
OBJECTIVE To determine risk factors for the development of surgical site infections (SSIs) in neurosurgery patients undergoing spinal fusion. DESIGN Retrospective case-control study. SETTING Large, academic, quaternary care center. PATIENTS The study population included all neurosurgery patients who underwent spinal fusion between August 1, 2009, and August 31, 2013. Cases were defined as patients in the study cohort who developed an SSI. Controls were patients in the study cohort who did not develop an SSI...
December 19, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27941480/the-role-of-simulation-in-planning-intraoperative-magnetic-resonance-imaging-guided-neurosurgical-procedures
#16
Tumul Chowdhury, Sergio D Bergese, Suren Soghomonyan, Ronald B Cappellani
Simulation of the actual procedure is a simple and yet effective method of increasing patient safety and reducing the rate of unexpected adverse effects. We present our experience with 2 cases of preprocedural simulation on healthy volunteers that were performed in the intraoperative magnetic resonance imaging suite. During one of the cases, we also simulated a scenario of sudden cardiac arrest. Such an approach helped us to refine the procedures and coordinate the work of different teams within the intraoperative magnetic resonance imaging suite as well as improve the quality of patient management...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27931320/constant-rate-infusion-of-dexmedetomidine-to-manage-thiopental-anesthesia-during-intracranial-surgery-in-cynomolgus-macaques-macaca-fascicularis
#17
Noemi Romagnoli, Alessandra Buonacucina, Carlotta Lambertini, Domenico Ventrella, Angelo Peli
Macaques (Macaca spp.) are often used as animal models in biomedical research involving a neurosurgical approach. The development of new anesthetic techniques is pivotal for these studies. Studies in human anesthesia for intracranial surgery have shown that dexmedetomidine infusion reduces the incidence of cardiocirculatory complications in the perioperative period, reduces the need for supplemental analgesia, and provides an analgesic effect analogous to that of remifentanil. Data regarding the anesthetic effects of dexmedetomidine infusion in NHP including Macaca spp...
November 2016: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/27920937/conversion-technique-from-neuroendoscopy-to-microsurgery-in-ventricular-tumors-technical-note
#18
Pedro Henrique da C F Pinto, Flavio Nigri, Gabriel N Gobbi, Egas M Caparelli-Daquer
BACKGROUND: Ventricular tumors represent a major neurosurgical challenge, making endoscopic approach an invaluable tool as it gained importance due to technological advances. Nevertheless, the method is not exempt of risk and limitations, sometimes requiring an open surgery. Thus, initial measurements must be adopted in order to simplify an eventual need for conversion to open craniotomy. METHODS: Here, we describe a series of 6 patients with ventricular tumors approached by neuroendoscopy where the conversion to microsurgery turned out to be necessary...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27909631/a-nonoperative-approach-for-neurosurgical-management-of-a-sylvian-fissure-dermoid-cyst
#19
Ali S Haider, Clarence Kee, Danielle L DeBacker, Ian T Watson, Eliel N Arrey, Tijani Osumah, Dean Leonard, Chen Chen, Maryam Alam, L Gerard Toussaint Iii
The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27903126/potential-evolution-of-neurosurgical-treatment-paradigms-for-craniopharyngioma-based-on-genomic-and-transcriptomic-characteristics
#20
Leslie C Robinson, Sandro Santagata, Todd C Hankinson
The recent genomic and transcriptomic characterization of human craniopharyngiomas has provided important insights into the pathogenesis of these tumors and supports that these tumor types are distinct entities. Critically, the insights provided by these data offer the potential for the introduction of novel therapies and surgical treatment paradigms for these tumors, which are associated with high morbidity rates and morbid conditions. Mutations in the CTNNB1 gene are primary drivers of adamantinomatous craniopharyngioma (ACP) and lead to the accumulation of β-catenin protein in a subset of the nuclei within the neoplastic epithelium of these tumors...
December 2016: Neurosurgical Focus
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