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https://www.readbyqxmd.com/read/28808801/post-operative-seizures-after-burr-hole-evacuation-of-chronic-subdural-hematomas-is-prophylactic-anti-epileptic-medication-needed
#1
Gabriel Flores, Juan C Vicenty, Emil A Pastrana
INTRODUCTION: There are limited data with regards to the associated risk of post-operative seizures in patients with surgically treated chronic subdural hematomas (CSDHs). The use of anti-epileptic drugs (AEDs) is associated with significant side effects. METHODS: A retrospective chart review was performed on patients operated via burr hole for CSDH in our institution from 2004 to 2013. Post-operative seizures at 1-year follow-up were identified. Demographic data, medical history, and imaging characteristics were recorded...
August 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#2
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#3
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28802374/secondary-encephalocele-in-infant-following-subdural-empyema-repaired-endoscopically-a-case-report
#4
Roshan K Verma, Navjot Kaur
Subdural empyema (SDE) is an uncommon entity, mostly associated with meningitis and can be life threatening in infants. Rarely, a subdural empyema can lead to nasal encephalocele which can be challenging situation to manage especially in infant. We present a case of 7 month old infant who presented with subdural empyema that led to formation of nasal encaphalocele after 4 months which was managed endoscopic route.
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28801214/lobar-hemorrhage-induced-by-acquired-factor-xiii-deficiency-in-a-patient-with-cerebral-amyloid-angiopathy
#5
Hidetaka Arishima, Hiroyuki Neishi, Ken-Ichiro Kikuta, Mihoko Morita, Naoko Hosono, Takahiro Yamauchi, Masayoshi Souri, Akitada Ichinose
A 68-year-old man presented with intracranial hemorrhage in the right frontal lobe, which rapidly increased the day after admission. We performed hematoma removal with a biopsy of the cortex around the hematoma. The day after the operation, a subcutaneous hematoma over the craniotomy appeared, and the computed tomography showed a recurrent hemorrhage with an acute subdural hematoma. We were aware of a bleeding tendency, and a detailed hematologic examination by hematologists revealed autoimmune acquired factor XIII deficiency due to an antifactor XIII antibody...
August 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28798216/dual-energy-ct-in-enhancing-subdural-effusions-that-masquerade-as-subdural-hematomas-diagnosis-with-virtual-high-monochromatic-190-kev-images
#6
U K Bodanapally, D Dreizin, G Issa, K L Archer-Arroyo, K Sudini, T R Fleiter
BACKGROUND AND PURPOSE: Extravasation of iodinated contrast into subdural space following contrast-enhanced radiographic studies results in hyperdense subdural effusions, which can be mistaken as acute subdural hematomas on follow-up noncontrast head CTs. Our aim was to identify the factors associated with contrast-enhancing subdural effusion, characterize diffusion and washout kinetics of iodine in enhancing subdural effusion, and assess the utility of dual-energy CT in differentiating enhancing subdural effusion from subdural hematoma...
August 10, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28797973/frontal-fibers-connecting-the-superior-frontal-gyrus-to-broca-s-area-a-cortico-cortical-evoked-potential-study
#7
Satoshi Ookawa, Rei Enatsu, Aya Kanno, Satoko Ochi, Yukinori Akiyama, Tamaki Kobayashi, Yukihiro Yamao, Takayuki Kikuchi, Riki Matsumoto, Takeharu Kunieda, Nobuhiro Mikuni
BACKGROUND: The frontal aslant tract (FAT) is a deep frontal pathway connecting the superior frontal gyrus (SFG) to Broca's area. This fiber is assumed to be associated with language functions, especially speech initiation and spontaneity. OBJECTIVE: The aim of this study was to electrophysiologically investigate this network using cortico-cortical evoked potentials (CCEPs). METHOD: Eight patients with brain tumors or medically intractable focal epilepsies who underwent frontal craniotomy over the language dominant side were enrolled in this study...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28795064/outcome-determinants-of-decompressive-craniectomy-in-patients-with-traumatic-brain-injury-a-single-center-experience-from-southern-iran
#8
Hosseinali Khalili, Amin Niakan, Fariborz Ghaffarpasand, Arash Kiani, Reza Behjat
OBJECTIVE: To investigate the determinants of outcome in patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC) in a large level I trauma center in southern Iran. METHODS: This retrospective cross-sectional study was conducted during an 18-month period from 2013 to 2014 in Shahid Rajaei hospital, a Level I trauma center in Southern Iran. Patients with TBI who had undergone DC were included and the medical charts were reviewed regarding demographics, clinical, radiological and outcome characteristics...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28790212/-neuro-endoscopic-surgery-for-multi-lobular-chronic-subdural-hematoma
#9
Toshihito Ishikawa, Katsuhiro Endo, Yuji Endo, Naoki Sato, Mamoru Ohta
BACKGROUND: Chronic subdural hematoma(CSDH)generally occurs in the elderly, and is usually treated by burr-hole craniotomy with closed-system drainage. Treatment of recurrent CSDH is more challenging, especially when the hematoma is multi-lobular. A variety of approaches to the management of multi-lobular CSDH have been described, including evacuation through a wide craniotomy, placement of an Ommaya reservoir, subdural peritoneal shunting, and embolization of the middle meningeal artery...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28789956/drug-therapy-for-chronic-subdural-hematoma-bench-to-bedside
#10
REVIEW
Shuanglin Fu, Fubin Li, Li Bie
Chronic subdural hematoma (CSDH) is a common neurosurgical condition. Currently, surgery is the most effective medical intervention for treatment of this disorder. Because CSDH is an inflammatory angiogenic disease involving multifactorial mechanisms, a better understanding of CSDH pathogenesis should facilitate clinical management. Therefore, the purpose of this review is to describe recent progress in elucidation of molecular mechanisms causing CSDH and to summarize the body of knowledge gained from past drug treatment studies...
August 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28789675/life-threatening-subdural-hematoma-after-aortic-valve-replacement-in-a-patient-with-heyde-syndrome-a-case-report
#11
Tetsuro Uchida, Azumi Hamasaki, Eiichi Ohba, Atsushi Yamashita, Jun Hayashi, Mitsuaki Sadahiro
BACKGROUND: Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding...
August 8, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28776222/-surgical-techniques-for-severe-brain-injury-with-special-emphasis-on-polytrauma
#12
REVIEW
Georg C Clarici
CLINICAL ISSUE: In Austria approximately 2000 people suffer from severe brain injury per year. Brain trauma is the most common cause of death under the age of 45 years. In polytrauma patients the treatment and management of severe brain injury is particularly challenging because the life-threatening injuries of other organ systems significantly influence the timing of surgery and the outcome. The sequence of the necessary surgery is an interdisciplinary decision already made in the emergency room...
August 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28774762/epidemiology-of-mild-traumatic-brain-injury-with-intracranial-hemorrhage-focusing-predictive-models-for-neurosurgical-intervention
#13
Alessandro Orlando, A Stewart Levy, Matthew M Carrick, Allen Tanner, Charles W Mains, David Bar-Or
OBJECTIVE: To adumbrate differences in neurosurgical intervention (NI) rates between intracranial hemorrhage (ICH) types in mild traumatic brain injuries (mTBIs), and help identify which ICH types are most likely to benefit from the creation of predictive models for NI. METHODS: This was a multi-center retrospective study of adult patients over three years at four Trauma Centers in the USA. Patients were included if they presented with a mTBI (GCS 13-15) and a head CT positive for ICH...
July 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28768968/isolated-adrenocorticotropic-hormone-deficiency-following-chronic-subdural-hematoma-in-an-elderly-man-is-there-a-connection
#14
Satoshi Suzuki, Keiko Suzuki
The delayed diagnosis of adrenal insufficiency is relatively common because its symptoms are non-specific. One of the causes of adrenal insufficiency is isolated adrenocorticotropic hormone deficiency (IAD), which is sometimes caused by traumatic brain injury. Indeed, severe head trauma is considered to contribute to the incidence of this disease. However, the relationship between milder head trauma-such as chronic subdural hematoma - and the occurrence of hormonal deficiency is uncertain. We herein report the case of a 79-year-old man with IAD who presented with leg edema and pain in his extremities following a recent history of chronic subdural hematoma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28768920/neuronavigation-guided-frameless-stereoelectroencephalography-seeg
#15
Ayataka Fujimoto, Tohru Okanishi, Sotaro Kanai, Keishiro Sato, Mitsuyo Nishimura, Hideo Enoki
Stereoelectroencephalography (SEEG) is an invasive surgical procedure used to identify epileptogenic zones. The combination of both subdural grids and depth electrodes (DEs) is currently used for invasive intracranial monitoring in many epilepsy centers. To perform DE implantation, some centers use frame-based stereotactic techniques and others use stereotactic robotic techniques. However, not all epilepsy centers have access to these tools. We hypothesized that DE implantation using a neuronavigation system can be utilized for subsequent epilepsy surgery...
August 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28765766/asystole-in-focal-epilepsy-complicating-a-traumatic-subdural-hematoma
#16
Yuk-Ming Lau, Chi-Hung Lo, Kathy Lai-Fun Lee, Chu-Pak Lau
Ictal asystole due to sinus node suppression is a cause of sudden unexplained death in epilepsy. Here, for the first time, we describe a complete atrioventricular nodal block in a patient with non-compressive traumatic subdural hematoma, who developed ictal asystole as a delayed presentation. A leadless VVI pacemaker (ventricular paced, ventricular sensed, and pacing inhibited in response to a sensed beat) was implanted as a preventive measure against seizure-related heart block.
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765023/a-multicenter-retrospective-cohort-study-of-talk-and-die-after-traumatic-brain-injury
#17
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting, and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. METHODS: We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28758158/simulating-clinical-trials-with-and-without-intracranial-eeg-data
#18
Daniel M Goldenholz, Joseph J Tharayil, Rubin Kuzniecky, Philippa Karoly, William H Theodore, Mark J Cook
OBJECTIVE: It is currently unknown if knowledge of clinically silent (electrographic) seizures improves the statistical efficiency of clinical trials. METHODS: Using data obtained from 10 patients with chronically implanted subdural electrodes over an average of 1 year, a Monte Carlo bootstrapping simulation study was performed to estimate the statistical power of running a clinical trial based on A) patient reported seizures with intracranial EEG (icEEG) confirmation, B) all patient reported events, or C) all icEEG confirmed seizures...
June 2017: Epilepsia open
https://www.readbyqxmd.com/read/28757406/subdural-hemorrhage-from-cerebral-amyloid-angiopathy-related-intracerebral-hemorrhage-a-risk-factor-for-postoperative-hemorrhage
#19
Lei Xia, Wen Min, Xianghe Lu, Chengde Wang, Zeping Jiang, Yu Zhang, Sheng Ye, Zhipeng Su, Weiming Zheng, Meihao Wang, Jianmin Li, Jinseng Wu, Qichuan Zhuge
OBJECTIVE: Surgical treatment for cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage (ICH) remains controversial. A subset of CAA-related ICH with associated subdural hemorrhage (SDH), has been reported. This study aimed to evaluate the clinical results and surgical outcomes of this type of ICH with associated SDH. METHODS: Ninety-eight cases of CAA-related ICH who met Boston criteria, were enrolled in the study. They were divided into those with and without SDH...
July 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28754644/subdural-fluid-collection-and-hydrocephalus-after-foramen-magnum-decompression-for-chiari-malformation-type-i-management-algorithm-of-a-rare-complication-case-report
#20
Zefferino Rossini, Davide Milani, Francesco Costa, Carlotta Castellani, Giovanni Lasio, Maurizio Fornari
BACKGROUND: Chiari Malformation Type I is a hindbrain abnormality characterized by cerebellar tonsils descent beneath the foramen magnum, frequently associated with symptoms or brainstem compression, impaired cerebrospinal fluid circulation and syringomyelia. Foramen magnum decompression represents the most common way of treatment. Rarely, subdural fluid collection and hydrocephalus represent postoperative adverse events. The treatment of this complication is still debated, and physicians sometimes are faced with the doubt of when undergoing diversion surgery and when more conservative managements...
July 25, 2017: World Neurosurgery
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