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Neurosurgical Approach

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https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#1
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29158591/surgical-oncology-for-gliomas-the-state-of-the-art
#2
REVIEW
Nader Sanai, Mitchel S Berger
Surgical resection remains the mainstay of treatment for patients with glioma of any grade. Maximal resection of the tumour is central to achieving long-term disease control; however, the relationship between the extent of glioma resection and actual clinical benefit for the patient is predicated on the balance between cytoreduction and neurological morbidity. For the neurosurgical oncologist, the clinical rationale for undertaking increasingly extensive resections has gained traction. In parallel, novel surgical techniques and technologies have been developed that help improve patient outcomes...
November 21, 2017: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29158099/a-novel-dissection-method-using-a-flexible-neuroendoscope-for-resection-of-tumors-around-the-aqueduct-of-sylvius-a-case-report
#3
Takayuki Ishikawa, Kazuhito Takeuchi, Nobuhiro Tsukamoto, Teppei Kawabata, Toshihiko Wakabayashi
Flexible endoscopes have both a wide range of movement and a wide field of view and are thus widely used for endoscopic third ventriculostomy and biopsy. However, tumor resection using flexible endoscopes has scarcely been reported, likely owing to their single port, which has a diameter of 1.2-2.0 mm. Furthermore, flexible endoscopes do not allow some of the basic neurosurgical manipulations, especially sharp dissection with counter tension. Additionally, the position of the forceps and coagulators is fixed within the endoscope...
November 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#4
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29152470/fluoroscopy-guided-combined-surgical-endovascular-treatment-of-dural-arteriovenous-fistula
#5
So Hee Park, Jong-Hoon Kim, Chul-Hoon Chang, Young-Jin Jung
For dural arteriovenous fistula (DAVF), when the usual endovascular or neurosurgical approaches are difficult to treat, multi-modal treatment can be helpful. We present a case of a 71-year-old woman with DAVF, who presented with an intracerebral haemorrhage. Digital subtraction angiography revealed a DAVF of the transverse sinus, with cortical venous reflux. Transvenous and transarterial approaches for coil embolization failed. In the operating room, a small craniotomy was performed, and coil embolization was done under fluoroscopy...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29147674/pediatric-otogenic-sigmoid-sinus-thrombosis-case-report-and-literature-reappraisal
#6
Andrea Scherer, Andrew Jea
The purpose of this study was to review our experience with a single case of mastoiditis associated with sigmoid sinus thrombosis and increased intracranial pressure, and to review the experience of others through prior publications. We reviewed a case of a 6-year-old boy with an acute otitis media and mastoiditis, with associated ipsilateral sigmoid sinus and contralateral distal transverse sinus thrombosis. Based on the literature and our own experience, we conclude that most children with dural sinus thrombosis from acute otitis media and mastoiditis, in the setting of increased intracranial pressure, attain a good neurological outcome with a conservative neurosurgical approach...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29146466/causal-mapping-of-emotion-networks-in-the-human-brain-framework-and-initial-findings
#7
Julien Dubois, Hiroyuki Oya, J Michael Tyszka, Matthew Howard, Frederick Eberhardt, Ralph Adolphs
Emotions involve many cortical and subcortical regions, prominently including the amygdala. It remains unknown how these multiple network components interact, and it remains unknown how they cause the behavioral, autonomic, and experiential effects of emotions. Here we describe a framework for combining a novel technique, concurrent electrical stimulation with fMRI (es-fMRI), together with a novel analysis, inferring causal structure from fMRI data (causal discovery). We outline a research program for investigating human emotion with these new tools, and provide initial findings from two large resting-state datasets as well as case studies in neurosurgical patients with electrical stimulation of the amygdala...
November 13, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/29139010/radiobiology-and-radiotherapy-of-brain-metastases
#8
Anuradha Thiagarajan, Yoshiya Yamada
Brain metastases are the most common intracranial tumors in adults, accounting for more than 50% of all such cases. The approach to and management of brain metastases have evolved significantly in recent years due to several reasons. These include advances in neurosurgical and radiotherapeutic techniques, improved systemic therapy options offering better systemic and intracranial disease control and prolongation of survival as a result of these improvements, making side-effects of proposed therapies (e.g. neurocognitive decline from whole brain radiotherapy) an important consideration...
November 14, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29131135/interhemispheric-and-infratentorial-subdural-empyema-with-preseptal-cellulitis-as-complications-of-sinusitis-a-case-report
#9
Muhammad Reza Arifianto, Achmad Zuhro Ma'ruf, Arie Ibrahim, Abdul Hafid Bajamal
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29125525/early-postnatal-bladder-function-in-fetoscopic-myelomeningocele-repair-patients
#10
Gene O Huang, Michael A Belfort, William E Whitehead, Oluyinka O Olutoye, Jonathan Castillo, Heidi Castillo, Kathryn K Ostermaier, Chester J Koh, Duong D Tu
PURPOSE: Prenatal repair of myelomeningocele (MMC) via hysterotomy has demonstrated neurosurgical and motor benefits, when compared to postnatal repairs. Urologic benefits, however, remain to be seen. The purpose of this study was to review early postnatal bladder function in patients undergoing a novel endoscopic approach for MMC repair using an exteriorized uterus. METHODS: A prospective urologic assessment of patients undergoing fetoscopic MMC repair and receiving subsequent care at our facility, was performed...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29117574/an-astrocyte-derived-extracellular-matrix-coating-reduces-astrogliosis-surrounding-chronically-implanted-microelectrode-arrays-in-rat-cortex
#11
Robert S Oakes, Michael D Polei, John L Skousen, Patrick A Tresco
Available evidence suggests that the magnitude of the foreign body response (FBR) to implants placed in cortical brain tissue is affected by the extent of vasculature damage following device insertion and the magnitude of the ensuing macrophage response. Since the extracellular matrix (ECM) serves as a natural hemostatic and immunomodulatory agent, we examined the ability of an FDA-approved neurosurgical hemostatic coating and an ECM coating derived from primary rat astrocytes to reduce the FBR surrounding a penetrating microelectrode array chronically implanted in rat cortex...
October 29, 2017: Biomaterials
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#12
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29106670/initial-experience-using-a-high-definition-3-dimensional-exoscope-system-for-microneurosurgery
#13
Jayson Sack, Jeffrey A Steinberg, Robert C Rennert, Dustin Hatefi, Jeffrey S Pannell, Michael Levy, Alexander A Khalessi
BACKGROUND: The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope ("exoscope") operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29106668/usim-a-new-device-and-app-for-case-specific-intraoperative-ultrasound-simulation-and-rehearsal-in-neurosurgery-a-preliminary-study
#14
Alessandro Perin, Francesco Ugo Prada, Michela Moraldo, Andrea Schiappacasse, Tommaso Francesco Galbiati, Enrico Gambatesa, Piergiorgio d'Orio, Nicole Irene Riker, Curzio Basso, Matteo Santoro, Torstein Ragnar Meling, Karl Schaller, Francesco DiMeco
BACKGROUND: Intraoperative ultrasound (iUS) is an excellent aid for neurosurgeons to perform better and safer operations thanks to real time, continuous, and high-quality intraoperative visualization. OBJECTIVE: To develop an innovative training method to teach how to perform iUS in neurosurgery. METHODS: Patients undergoing surgery for different brain or spine lesions were iUS scanned (before opening the dura) in order to arrange a collection of 3-dimensional, US images; this set of data was matched and paired to preoperatively acquired magnetic resonance images in order to create a library of neurosurgical cases to be studied offline for training and rehearsal purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29105281/semi-autonomous-image-guided-brain-tumour-resection-using-an-integrated-robotic-system-a-bench-top-study
#15
Danying Hu, Yuanzheng Gong, Eric J Seibel, Laligam N Sekhar, Blake Hannaford
BACKGROUND: Complete brain tumour resection is an extremely critical factor for patients' survival rate and long-term quality of life. This paper introduces a prototype medical robotic system that aims to automatically detect and clean up brain tumour residues after the removal of tumour bulk through conventional surgery. METHODS: We focus on the development of an integrated surgical robotic system for image-guided robotic brain surgery. The Behavior Tree framework is explored to coordinate cross-platform medical subtasks...
November 3, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29101639/an-automatic-markerless-registration-method-for-neurosurgical-robotics-based-on-an-optical-camera
#16
Fanle Meng, Fangwen Zhai, Bowei Zeng, Hui Ding, Guangzhi Wang
PURPOSE: Current markerless registration methods for neurosurgical robotics use the facial surface to match the robot space with the image space, and acquisition of the facial surface usually requires manual interaction and constrains the patient to a supine position. To overcome these drawbacks, we propose a registration method that is automatic and does not constrain patient position. METHODS: An optical camera attached to the robot end effector captures images around the patient's head from multiple views...
November 3, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29099299/perfusion-based-human-cadaveric-specimen-as-a-simulation-training-model-in-repairing-cerebrospinal-fluid-leaks-during-endoscopic-endonasal-skull-base-surgery
#17
Eisha A Christian, Joshua Bakhsheshian, Ben A Strickland, Vance L Fredrickson, Ian A Buchanan, Martin H Pham, Andrew Cervantes, Michael Minneti, Bozena B Wrobel, Steven Giannotta, Gabriel Zada
OBJECTIVE Competency in endoscopic endonasal approaches (EEAs) to repair high-flow cerebrospinal fluid (CSF) leaks is an essential component of the neurosurgical training process. The objective of this study was to demonstrate the feasibility of a simulation model for EEA repair of anterior skull base CSF leaks. METHODS Human cadaveric specimens were utilized with a perfusion system to simulate a high-flow CSF leak. Neurological surgery residents (postgraduate year 3 or greater) performed a standard EEA to repair a CSF leak using a combination of fat, fascia lata, and pedicled nasoseptal flaps...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29099298/contralateral-anterior-interhemispheric-transcallosal-transrostral-approach-to-the-subcallosal-region-a-novel-surgical-technique
#18
Feres Chaddad-Neto, Marcos Devanir Silva da Costa, Baran Bozkurt, Hugo Leonardo Doria-Netto, Daniel de Araujo Paz, Ricardo da Silva Centeno, Andrew W Grande, Sergio Cavalheiro, Kaan Yağmurlu, Robert F Spetzler, Mark C Preul
OBJECTIVE The authors report a novel surgical route from a superior anatomical aspect-the contralateral anterior interhemispheric-transcallosal-transrostral approach-to a lesion located in the subcallosal region. The neurosurgical approach to the subcallosal region is challenging due to its deep location and close relationship with important vascular structures. Anterior and inferior routes to the subcallosal region have been described but risk damaging the branches of the anterior cerebral artery. METHODS Three formalin-fixed and silicone-injected adult cadaveric heads were studied to demonstrate the relationships between the transventricular surgical approach and the subcallosal region...
November 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29092965/penile-mondor-s-disease-after-anterolateral-retroperitoneal-approach-for-lumbar-fracture
#19
Mauro Dobran, Roberta Benigni, Davide Nasi, Daniele Cantoro
This is a rare case of thrombosis of the dorsal vein of the penis (Mondor's disease) occurred after an anterior-lateral retroperitoneal approach for a vertebral stabilisation in thoracolumbar vertebral fracture. Potential causes are traumatism, neoplasms, excessive sexual activity or abstinence. Although penile Mondor's disease is a clinical diagnosis, ultrasound imaging is the gold standard to confirm it. In the reported case, 1 week after neurosurgical retroperitoneal procedure of vertebral stabilisation, the patient complained of a painful cord-like mass midshaft of penis...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29090678/risk-of-transmission-of-sporadic-creutzfeldt-jakob-disease-by-surgical-procedures-systematic-reviews-and-quality-of-evidence
#20
Fernando J García López, María Ruiz-Tovar, Javier Almazán-Isla, Enrique Alcalde-Cabero, Miguel Calero, Jesús de Pedro-Cuesta
BACKGROUND: Sporadic Creutzfeldt-Jakob disease (sCJD) is potentially transmissible to humans. OBJECTIVE: This study aimed to summarise and rate the quality of the evidence of the association between surgery and sCJD. DESIGN AND METHODS: Firstly, we conducted systematic reviews and meta-analyses of case-control studies with major surgical procedures as exposures under study. To assess quality of evidence, we used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach...
October 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
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