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Neurosurgical Approach

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https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#1
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28639000/infections-in-neurocritical-care
#2
John C O'Horo, Priya Sampathkumar
Neurointensive care (NICU) patients experience complex infectious disease challenges. Central nervous system (CNS) infections are difficult to diagnose and treat, and post-neurosurgical patients are vulnerable to a unique set of healthcare-acquired infections (HAI) in addition to those typical of critically ill patients. The purpose of this review is to summarize the approach to suspected infection in the NICU and discuss management of several infectious syndromes in the NICU setting.
June 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28637947/neurosurgical-virtual-reality-simulation-for-brain-tumor-using-high-definition-computer-graphics-a-review-of-the-literature
#3
Taichi Kin, Hirofumi Nakatomi, Naoyuki Shono, Seiji Nomura, Toki Saito, Hiroshi Oyama, Nobuhito Saito
Simulation and planning of surgery using a virtual reality model is becoming common with advances in computer technology. In this study, we conducted a literature search to find trends in virtual simulation of surgery for brain tumors. A MEDLINE search for "neurosurgery AND (simulation OR virtual reality)" retrieved a total of 1,298 articles published in the past 10 years. After eliminating studies designed solely for education and training purposes, 28 articles about the clinical application remained. The finding that the vast majority of the articles were about education and training rather than clinical applications suggests that several issues need be addressed for clinical application of surgical simulation...
June 22, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28625902/obesity-in-neurosurgery
#4
REVIEW
Mendel D Castle-Kirszbaum, Jin W Tee, Patrick Chan, Martin K Hunn
Obesity is an important consideration in neurosurgical practice. 28.3% of Australian adults are obese and it is estimated that over two-thirds of Australia's population will be overweight or obese by 2025. This review of the effects of obesity on neurosurgical procedures demonstrated that, in patients undergoing spinal surgery, an increased BMI is a significant risk factor for surgical site infection, venous thromboembolism, major medical complications, prolonged length of surgery and increased financial cost...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28605723/a-combined-cognitive-and-gait-quantification-to-identify-normal-pressure-hydrocephalus-from-its-mimics-the-geneva-s-protocol
#5
Gilles Allali, Magali Laidet, Stéphane Armand, Shahan Momjian, Bruno Marques, Arnaud Saj, Frédéric Assal
OBJECTIVES: Idiopathic normal pressure hydrocephalus (iNPH) is very prevalent in aging, underdiagnosed, and represents a rare cause of reversible neurological condition. The clinical triad of iNPH - gait, cognitive and urinary symptoms - and its neuroradiological features (i.e. ventriculomegaly) are not specific and found a various neurodegenerative and/or vascular conditions. We present our iNPH standardized protocol at the Geneva University Hospitals involving a multispecialty team of behavioral neurologists, neurosurgeons, neuropsychologists, engineers, and physical therapists...
June 6, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28602925/supracerebellar-infratentorial-paramedian-approach-in-helsinki-neurosurgery-cornerstones-of-a-safe-and-effective-route-to-the-pineal-region
#6
Joham Choque-Velasquez, Roberto Colasanti, Julio C Resendiz-Nieves, Behnam Rezai Jahromi, Danil A Kozyrev, Peeraphong Thiarawat, Juha Hernesniemi
OBJECTIVE: The supracerebellar infratentorial (SCIT) paramedian approach in sitting position represents one of the most used surgical route for dealing with pineal region lesions. Purpose of our study is to determine the cornerstones to perform this approach in a simple, safe and effective way, so that it could be easily reproduced in other neurosurgical centers, particularly in those with modest resources. METHODS: We reviewed and analyzed the surgical videos of twenty-four pineal region lesions that were operated on through a SCIT approach between June 2012 and October 2015...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602922/the-spheno-pterional-point-a-strategic-point-for-burr-role-placement-in-frontotemporal-craniotomies
#7
Baltazar Leão Reis, Roberto Leal da Silveira, Sebastião Nataniel Silva Gusmão
BACKGROUND: Frontotemporal craniotomies are the most commonly performed neurosurgical approaches. We studied the external bony landmarks on the lateral surface of the skull to identify a "strategic" point where both the anterior and middle cranial fossae are exposed simultaneously during frontotemporal craniotomies through a single burr hole placed over the greater wing of sphenoid bone (spheno-pterional point). OBJECTIVE: This study aimed to anatomically define the spheno-pterional point via craniometric measurements taken on the lateral surface of the human skull...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28583451/assessment-of-cost-drivers-in-transsphenoidal-approaches-for-resection-of-pituitary-tumors-using-the-value-driven-outcome-database
#8
Michael Karsy, Andrea A Brock, Jian Guan, Erica F Bisson, William T Couldwell
INTRODUCTION: Reducing healthcare costs while improving quality of care has become imperative in neurosurgical care. The Value-Driven Outcome (VDO) database at the University of Utah is one approach that identifies cost drivers and tracks changes over time. METHODS: A retrospective review by was performed for transsphenoidal resections of pituitary adenomas from July 2012 to September 2016. Total cost, subcategory costs, and potential cost drivers were evaluated...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28574314/a-microcontroller-based-simulation-of-dural-venous-sinus-injury-for-neurosurgical-training
#9
Daniel R Cleary, Dominic A Siler, Nathaniel Whitney, Nathan R Selden
OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures...
June 2, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28571951/update-in-mild-traumatic-brain-injury
#10
REVIEW
María Dolores Freire-Aragón, Ana Rodríguez-Rodríguez, Juan José Egea-Guerrero
There has been concern for many years regarding the identification of patients with mild traumatic brain injury (TBI) at high risk of developing an intracranial lesion (IL) that would require neurosurgical intervention. The small percentage of patients with these characteristics and the exceptional mortality associated with mild TBI with IL have led to the high use of resources such as computerised tomography (CT) being reconsidered. The various protocols developed for the management of mild TBI are based on the identification of risk factors for IL, which ultimately allows more selective indication or discarding both the CT application and the hospital stay for neurological monitoring...
May 29, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28557242/unexpected-complications-of-novel-deep-brain-stimulation-treatments-ethical-issues-and-clinical-recommendations
#11
REVIEW
Hannah Maslen, Binith Cheeran, Jonathan Pugh, Laurie Pycroft, Sandra Boccard, Simon Prangnell, Alexander L Green, James FitzGerald, Julian Savulescu, Tipu Aziz
BACKGROUND: Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. OBJECTIVE: This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments...
May 30, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28551652/successful-treatment-of-pituitary-germinoma-with-etoposide-cisplatin-vincristine-methotrexate-and-bleomycin-chemotherapy-without-radiotherapy
#12
Amina Scherz, Katrin Feller, Sabina Berezowska, Vera Genitsch, Martin Zweifel
We report on the case of a 25-year-old man with pituitary germinoma. The patient had noticed polydipsia, reduced sexual function, and loss of body hair. Laboratory investigations confirmed panhypopituitarism including diabetes insipidus. Magnetic resonance imaging of the brain showed a 14×8.4 mm enhancing lesion of the pituitary stalk and histopathology of the neurosurgical biopsy confirmed pituitary germinoma. The patient was treated with 3 cycles of chemotherapy, consisting of 150 mg/m(2) etoposide and 75 mg/m(2) cisplatin, with the administration of intrathecal 12...
June 2017: Anticancer Research
https://www.readbyqxmd.com/read/28544168/presurgical-language-fmri-mapping-of-six-critical-regions
#13
Christopher F Benjamin, Patricia D Walshaw, Kayleigh Hale, William D Gaillard, Leslie C Baxter, Madison M Berl, Monika Polczynska, Stephanie Noble, Rafeed Alkawadri, Lawrence J Hirsch, R Todd Constable, Susan Y Bookheimer
Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language-critical areas are now well-known. We evaluated whether clinicians could use a novel approach, including clinician-driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area...
May 23, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28533868/-rare-medico-surgical-emergency-spinal-epidural-abscess-about-3-cases
#14
Abderrazzak El Saqui, Mohamed Aggouri, Mohamed Benzagmout, Khalid Chakour, Mohamed El Faiz Chaoui
The awareness about infections in the epidural space is increasing thanks to the development of neurosurgery, including MRI. Spinal epidural abscess is a rare pathology but extremely serious from a functional point of view and potentially life threatening. We report three cases of male patients (the first one aged 52 years, the second 57 years and the third 63 years) with diagnosed spinal epidural abscess. Two patients were admitted to the Neurosurgical Emergencies with slow progressive spinal cord compression evolving in the context of infection...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28524125/-surgical-management-of-venous-compression-causing-trigeminal-neuralgia
#15
V K Poshataev, A N Konovalov, V N Shimanskiy
Venous compression is a rare cause of trigeminal neuralgia (TN). Vascular decompression of the trigeminal nerve root, as the only etiopathogenetic treatment of trigeminal neuralgia, is a well-known procedure that is extensively used at various neurosurgical clinics. As the number of interventions for TN increases, the absolute number of surgeries for eliminating venous compression of the trigeminal nerve also grows. Five hundred TN patients underwent surgery at the Neurosurgical Institute in the period from 2000 to 2015...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28516966/expanded-transcanal-transpromontorial-approach-to-the-internal-auditory-canal-and-cerebellopontine-angle-a-cadaveric-study
#16
L Presutti, M Bonali, D Marchioni, G Pavesi, A Feletti, L Anschuetz, M Alicandri-Ciufelli
The aim of this paper is to describe and evaluate the feasibility of an expanded endoscopic transcanal transpromotorial approach (ExpTTA) to the internal auditory canal and the cerebellopontine angle. To this end, we performed a cadaveric dissection study in September 2015. In total, 2 heads (4 sides) were dissected focusing on anatomical landmarks and surgical feasibility. Data from dissections were reviewed and analysed for further consideration. In all 4 sides of the cadavers the procedure was feasible. In all cadavers, it was necessary to extensively drill the temporo-mandibular joint and to calibrate the external ear canal to allow adequate room to manoeuver the instruments and optics and to comfortably access the cerebellopontine angle...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28509682/new-neurosurgical-approaches-for-tremor-and-parkinson-s-disease
#17
Alfonso Fasano, Andres M Lozano, Esther Cubo
PURPOSE OF REVIEW: The objective of this review is to gather the newest advances in the surgical treatment of tremor and Parkinson's disease. We will briefly discuss the potential applications of the new technologies of deep brain stimulation (DBS), and we will focus on MRI-guided focused ultrasound (MRgFUS). RECENT FINDINGS: Novel DBS devices are being progressively adopted, particularly electrodes allowing a longer stimulating surface (suitable for multiple targets stimulation) and current radial steering (to minimize side effects of stimulation)...
May 13, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28502682/intra-rectal-anesthesia-in-neurosurgery
#18
REVIEW
Ladina Greuter, Alexander G Weil, Gerhard Hildebrandt, Werner Surbeck
In the early days of modern neurological surgery, the inconveniences and potential dangers of general anesthesia by chloroform and ether using the so-called "open-drop technique" led to the quest for alternative methods of anesthesia. This became all the more necessary, since patient positioning and the surgical arrangements often hindered the use of a drop bottle. One approach to solve this problem was intra-rectal ether application. The present article aims to shed light on this original, less well-known anesthesia technique in the neurosurgical field...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28499903/utilization-of-paine-s-technique-projecting-puncture-point-to-the-skull-and-skin
#19
Hiroaki Matsuzaki, Tadahiro Otsuka, Ken Uekawa, Takashi Nakagawa, Nobuyuki Tsubota
OBJECTIVE: Ventriculostomy from Paine's point is an effective technique to obtain a slack brain for aneurysm surgery. This study aimed to use Paine's point for other neurosurgical procedures (except for those that require pterional approach) by delineation of surface landmarks for identification of Paine's point on the cranium and scalp. METHODS: Based on the anatomical knowledge and examination of 3D CT images of skull, we determined novel surface landmarks to identify Paine's point on cranium and scalp...
May 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28498054/first-clinical-use-of-stereotaxy-in-humans-the-key-role-of-x-ray-localization-discovered-by-gaston-contremoulins
#20
Pierre Bourdillon, Caroline Apra, Marc Lévêque
Although attempts to develop stereotactic approaches to intracranial surgery started in the late 19th century with Dittmar, Zernov, and more famously, Horsley and Clarke, widespread use of the technique for human brain surgery started in the second part of the 20th century. Remarkably, a significant similar surgical procedure had already been performed in the late 19th century by Gaston Contremoulins in France and has remained unknown. Contremoulins used the principles of modern stereotaxy in association with radiography for the first time, allowing the successful removal of intracranial bullets in 2 patients...
May 12, 2017: Journal of Neurosurgery
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