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Neurosurgical Approach

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https://www.readbyqxmd.com/read/27931320/constant-rate-infusion-of-dexmedetomidine-to-manage-thiopental-anesthesia-during-intracranial-surgery-in-cynomolgus-macaques-macaca-fascicularis
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#5
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27867120/transforaminal-resection-of-cervical-dumbbell-schwannomas-in-patients-with-additional-tumors
#6
Ji Zhang, Xiang-Heng Zhang, Zi-Feng Wang, You-Ping Li, Zheng-Quan Zhu, Ji-Cheng Sun, Zheng-He Chen, Shao-Yong Wu, Ke Sai, Jian Wang, Yong-Gao Mou, Zhong-Ping Chen
BACKGROUND: It is rare for two primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible. MATERIAL AND METHODS: Twelve patients with concurrent CTs and CDSs were identified from three medical centers...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27837166/an-unusual-lethal-gunshot-wound-to-the-head
#7
Elmas Shaqiri, Bledar Xhemali, Zija Ismaili, Admir Sinamati, Gentian Vyshka
Atypical gunshot wounds present a challenge for the forensic expert, and sometimes differentiating these from a blunt trauma can be difficult. A careful crime scene investigation can be helpful in finding additional evidence and clarifying the nature of the injuries. We describe a case of an unusual craniocerebral injury that was initially interpreted as a blow from a wooden object. The appearance of the wound lacked the classical characteristics of entrance and exit bullet wounds, but the investigation showed it was due to the ricocheting of a destabilized bullet...
November 11, 2016: Medico-legal Journal
https://www.readbyqxmd.com/read/27834596/ventriculo-ureteral-shunt-insertion-using-percutaneous-nephrostomy-a-novel-minimally-invasive-option-in-a-patient-with-chronic-hydrocephalus-complicated-by-multiple-distal-ventriculoperitoneal-shunt-failures
#8
Ashok Pillai, Georgie Mathew, Sivasankaran Nachimuthu, Sanjeevan Vasudevan Kalavampara
The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27822762/clinical-practice-audit-concerning-antimicrobial-prophylaxis-in-paediatric-neurosurgery-results-from-a-german-paediatric-oncology-unit
#9
Katja Weiss, Arne Simon, Norbert Graf, Jakob Schöpe, Joachim Oertel, Stefan Linsler
BACKGROUND: Perioperative antimicrobial prophylaxis (PAP) has been identified as an important target for internal audits, concerning the judicious use of antibiotics. Paediatric oncology patients with brain tumours face an increased risk of surgical site infection (SSI) after neurosurgery and receive routine PAP in this setting. PATIENTS AND METHODS: All patients younger than 18 years admitted to the paediatric oncology centre (POC) with a neurosurgical intervention...
November 7, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27809900/significance-of-nucleic-acid-testing-in-diagnosis-and-treatment-of-post-neurosurgical-meningitis-caused-by-multidrug-resistant-acinetobacter-baumannii-a-case-report
#10
Ngo Tat Trung, Trinh Van Son, Dao Thanh Quyen, Dang Thi Viet Anh, Vu Viet Sang, Nguyen Xuan Lam, Nguyen Dang Manh, Vuong Phuc Duong, Bui Tri Cuong, Quyen Dang Tuyen, Nguyen Xuan Chinh, Phan Quoc Hoan, Hoang Van Tong, Christian G Meyer, Le Huu Song
BACKGROUND: Neurosurgery may pose the risk of patients' developing nosocomial meningitis caused by infection with hospital pathogens. Rapid detection of the causative pathogens is essential for selecting the appropriate antibiotic treatment. However, the classical culture-based detection of bacterial infection is time-consuming and often fails to establish the correct diagnosis. Molecular techniques offer improved diagnostic means to guide the proper antibiotic therapy. CASE PRESENTATION: A 32-year-old Vietnamese man underwent neurosurgery and subsequently developed meningitis...
November 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27801403/-a-technique-of-tachocomb-application-in-dura-mater-reconstruction-in-surgery-for-posterior-cranial-fossa-tumors
#11
V N Shimansky, V K Poshataev, D A Odamanov, K V Shevchenko
INTRODUCTION: Liquorrhea is a condition characterized by cerebrospinal fluid (CSF) leakage from the cranial cavity due to injury to the integrity of the dura mater (DM) and bone structures of the skull base. Surgery for posterior cranial fossa (PCF) lesions distinguishes wound CSF leakage when CSF leaks from a surgical wound as well as basal CSF leakage (nasal liquorrhea and, less often, otoliquorrhea). The main cause of basal CSF leakage is injury (including surgical injury) resulting in a defect in the DM and bone structures (cells of the mastoid process in the case of a suboccipital retrosigmoid approach)...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27801398/-surgical-treatment-of-%C3%A2-mirror%C3%A2-aneurysms-of-the-internal-carotid-artery
#12
A O Sosnov, A V Dubovoi, V S Kiselev, D M Galaktionov, K S Ovsyannikov, A V Cherepanov, T K Istomina
BACKGROUND: A relatively high occurrence of "mirror" aneurysms of the anterior cerebral circulation in neurosurgical practice necessitates generalization of experience of using different surgical approaches. The choice of treatment is usually associated with the number of surgical stages. MATERIAL AND METHODS: Forty nine patients (19 males and 30 females) with mirror aneurysms of the anterior circulation underwent one- and two-step surgery at the Novosibirsk Federal Center of Neurosurgery in 2013-2015...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27800481/intraoperative-fluorescence-imaging-for-personalized-brain-tumor-resection-current-state-and-future-directions
#13
REVIEW
Evgenii Belykh, Nikolay L Martirosyan, Kaan Yagmurlu, Eric J Miller, Jennifer M Eschbacher, Mohammadhassan Izadyyazdanabadi, Liudmila A Bardonova, Vadim A Byvaltsev, Peter Nakaji, Mark C Preul
INTRODUCTION: Fluorescence-guided surgery is one of the rapidly emerging methods of surgical "theranostics." In this review, we summarize current fluorescence techniques used in neurosurgical practice for brain tumor patients as well as future applications of recent laboratory and translational studies. METHODS: Review of the literature. RESULTS: A wide spectrum of fluorophores that have been tested for brain surgery is reviewed. Beginning with a fluorescein sodium application in 1948 by Moore, fluorescence-guided brain tumor surgery is either routinely applied in some centers or is under active study in clinical trials...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27793767/ruptured-distal-posterior-inferior-cerebellar-artery-pica-aneurysms-associated-with-cerebellar-arterial-venous-malformations-avms-a-case-series-and-review-of-the-literature-demonstrating-the-need-for-angiographic-evaluation-and-feasibility-of-endovascular-treatment
#14
David Case, David Kumpe, Luis Cava, Robert Neumann, Andrew White, Christopher Roark, Joshua Seinfeld
OBJECTIVE: The characteristics, diagnosis, and preferred management strategies for distal posterior inferior cerebellar artery (PICA) aneurysms associated with cerebellar arteriovenous malformation (AVMs) are poorly understood. We present a case series with attention to aneurysm angioarchitecture, diagnostic imaging, treatment approaches, and a thorough review of the literature. With this information, we demonstrate a specific anatomical pattern for these aneurysms, an underreported need for conventional digital subtraction angiography (DSA) during evaluation, along with the utility of endovascular treatment with liquid embolic agents...
October 25, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27792792/economic-analysis-of-children-s-surgical-care-in-low-and-middle-income-countries-a-systematic-review-and-analysis
#15
Anthony T Saxton, Dan Poenaru, Doruk Ozgediz, Emmanuel A Ameh, Diana Farmer, Emily R Smith, Henry E Rice
BACKGROUND: Understanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of children's surgical care in low- and middle-income countries (LMICs). METHODS: We searched MEDLINE (Pubmed), Embase, and Web of Science for relevant articles published between Jan. 1996 and Jan. 2015. We summarized reported cost information for individual interventions by country, including all costs, disability weights, health outcome measurements (most commonly disability-adjusted life years [DALYs] averted) and cost-effectiveness ratios (CERs)...
2016: PloS One
https://www.readbyqxmd.com/read/27759850/pediatric-minor-head-trauma-do-cranial-ct-scans-change-the-therapeutic-approach
#16
Felipe P Andrade, Roberto Montoro, Renan Oliveira, Gabriela Loures, Luana Flessak, Roberta Gross, Camille Donnabella, Andrea Puchnick, Lisa Suzuki, Rodrigo Regacini
OBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale ≥13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014...
October 1, 2016: Clinics
https://www.readbyqxmd.com/read/27759681/beyond-the-cyst-the-many-contributions-of-isadore-tarlov-1905-1977-to-contemporary-neurosurgical-practice
#17
Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
https://www.readbyqxmd.com/read/27757432/single-level-selective-dorsal-rhizotomy-for-spastic-cerebral-palsy
#18
David Graham, Kristian Aquilina, Stephanie Cawker, Simon Paget, Neil Wimalasundera
The management of cerebral palsy (CP) is complex and requires a multidisciplinary approach. Selective dorsal rhizotomy (SDR) is a neurosurgical technique that aims to reduce spasticity in the lower limbs. A minimally invasive approach to SDR involves a single level laminectomy at the conus and utilises intraoperative electromyography (EMG). When combined with physiotherapy, SDR is effective in selected children and has minimal complications. This review discusses the epidemiology of CP and the management using SDR within an integrated multidisciplinary centre...
September 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27749350/spine-surgery-and-blood-loss-systematic-review-of-clinical-evidence
#19
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27722828/structural-brain-anomalies-in-healthy-adolescents-in-the-ncanda-cohort-relation-to-neuropsychological-test-performance-sex-and-ethnicity
#20
Edith V Sullivan, Barton Lane, Dongjin Kwon, M J Meloy, Susan F Tapert, Sandra A Brown, Ian M Colrain, Fiona C Baker, Michael D De Bellis, Duncan B Clark, Bonnie J Nagel, Kilian M Pohl, Adolf Pfefferbaum
Structural MRI of volunteers deemed "normal" following clinical interview provides a window into normal brain developmental morphology but also reveals unexpected dysmorphology, commonly known as "incidental findings." Although unanticipated, these anatomical findings raise questions regarding possible treatment that could even ultimately require neurosurgical intervention, which itself carries significant risk but may not be indicated if the anomaly is nonprogressive or of no functional consequence. Neuroradiological readings of 833 structural MRI from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) cohort found an 11...
October 8, 2016: Brain Imaging and Behavior
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