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Neurosurgery, meningioma, surgery, neurology

Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
Antonio Bocchetti, Valentina Cioffi, Cristian Gragnaniello, Raffaele de Falco
BACKGROUND: Foramen magnum meningiomas (FMM) represent a challenge for neurosurgeons. Multiple surgical strategies have been reported to treat these lesions in their variable location. Contemporary technical innovations allow the utilization of common sub-occipital craniotomy to treat ventrally, ventro-laterally and dorsally located FMMs. We present our technique and experience. METHODS: From November 2004 to November 2015, we treated 14 patients with FMM at the Department of Neurosurgery of the Santa Maria delle Grazie Hospital in Pozzuoli, Naples, Italy...
September 2017: Journal of Spine Surgery (Hong Kong)
Constantine L Karras, Huy Minh Tran, David Dornbos, Phong Nguyen, Shahid M Nimjee, Daniel M Prevedello, Ciarán J Powers
Cho Ray Hospital is the premier tertiary care center in Ho Chi Minh City, Vietnam's most populous city. The neurosurgical department was founded in 1958 and is currently one of the busiest in the world. Last year the department was responsible for more than 10,000 neurosurgical operations, excluding neuroendovascular cases. Most of the elective cases are craniotomies for complex lesions such as aneurysms, arteriovenous malformations, skull base tumors, gliomas, and meningiomas. Although the neurosurgeons within the department are technically gifted, doing more with less predominates as the mantra at Cho Ray Hospital...
September 2017: World Neurosurgery
Bhavna Hooda, Rajendra Singh Chouhan, Girija Prasad Rath, Parmod Kumar Bithal, Ashish Suri, Ritesh Lamsal
Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
A Ben Nsir, M Chabaane, H Krifa, H Jeme, N Hattab
BACKGROUND: Angiomatous meningiomas (AMs) represent a rare subtype of meningiomas in which the vascular component prevail. They represent less than 1% of all intracranial tumors and approximately 2.1% of all meningeal tumors (Hasselblatt et al., 2004). The purpose of this study was to determine the clinical characteristics, radiological features and prognosis of AMs based on a Tunisian multicenter experience in the management of 58 successive cases of intracranial AMs. To the best of our knowledge, this is the largest series reported to date...
October 2016: Clinical Neurology and Neurosurgery
Oliver Sawyer, Ciaran P O'Boyle
Descriptions of burns as the presenting features of underlying neurological pathology are very rare, with only two previously published case reports available. Both of these reports featured meningioma as the pre-existing pathology and both described burn excision and wound healing, prior to surgical tumour ablation. The authors describe the case of a 35-year-old female, who presented with 25% total body surface area burns and recent global neurological deterioration. MRI imaging revealed a large intracranial tumour...
May 2017: Burns: Journal of the International Society for Burn Injuries
Henrietta Redebrandt Nittby, Antonio Maltese, Nils Ståhl
BACKGROUND: A postoperative haematoma can be a very serious complication following a neurosurgical procedure. Patients should be informed about the risks of such an event prior to surgery. From a practical point of view, it would be important to know when the patient is most likely to deteriorate and to require surgery because of a postoperative haematoma and when it might be safe to transfer the patient to the regular ward. The up-to-date studies regarding this topic are few. METHODS: We therefore undertook the present retrospective study, including a cohort of all patients operated on at the Department of Neurosurgery in Lund during the years 2011-2014, with the aim to define the time windows for clinical deterioration and reoperation, and whether risk factors such as anticoagulant agents/antiplatelet therapy, emergency versus elective surgery and abnormal coagulation blood values were present...
May 2016: Acta Neurochirurgica
S K Lloyd, D G Evans
Neurofibromatosis type 2 (NF2) is a complex disease characterized by the development of multiple schwannomas, especially vestibular schwannomas, as well as other types of benign tumours including meningioma and spinal ependymoma. Due to its multisystem nature, the management of NF2 requires a multidisciplinary approach. In England, the delivery of care for NF2 patients has been centralized to four-"hub" centres in Manchester, Cambridge, Oxford and London each having associated "spoke" centres. Each centre has a core multidisciplinary team consisting of genetics, otolaryngology, neurosurgery, paediatrics, neurology, audiology, radiology, psychology, physiotherapy, specialist nurses and administrative staff...
January 27, 2016: Neuro-Chirurgie
Paolo Ferroli, Morgan Broggi, Silvia Schiavolin, Francesco Acerbi, Valentina Bettamio, Dario Caldiroli, Alberto Cusin, Emanuele La Corte, Matilde Leonardi, Alberto Raggi, Marco Schiariti, Sergio Visintini, Angelo Franzini, Giovanni Broggi
OBJECT The Milan Complexity Scale-a new practical grading scale designed to estimate the risk of neurological clinical worsening after performing surgery for tumor removal-is presented. METHODS A retrospective study was conducted on all elective consecutive surgical procedures for tumor resection between January 2012 and December 2014 at the Second Division of Neurosurgery at Fondazione IRCCS Istituto Neurologico Carlo Besta of Milan. A prospective database dedicated to reporting complications and all clinical and radiological data was retrospectively reviewed...
December 2015: Neurosurgical Focus
Francesco Prada, Massimiliano Del Bene, Alessandro Moiraghi, Cecilia Casali, Federico Giuseppe Legnani, Andrea Saladino, Alessandro Perin, Ignazio Gaspare Vetrano, Luca Mattei, Carla Richetta, Marco Saini, Francesco DiMeco
The main goal in meningioma surgery is to achieve complete tumor removal, when possible, while improving or preserving patient neurological functions. Intraoperative imaging guidance is one fundamental tool for such achievement. In this regard, intra-operative ultrasound (ioUS) is a reliable solution to obtain real-time information during surgery and it has been applied in many different aspect of neurosurgery. In the last years, different ioUS modalities have been described: B-mode, Fusion Imaging with pre-operative acquired MRI, Doppler, contrast enhanced ultrasound (CEUS), and elastosonography...
2015: BioMed Research International
Roberto Stefini, Francesco Zenga, Esposito Giacomo, Andrea Bolzoni, Fulvio Tartara, Giannantonio Spena, Claudia Ambrosi, Marco M Fontanella
BACKGROUND: Olfactory groove meningiomas (OGMs) represent approximately 10% of all intracranial meningiomas. They arise in the olfactory fossa, a variable depression delimited by the lateral lamella and perpendicular plate. The cribriform plate with the lateral lamella and ethmoidal and orbital roof could be viewed as a 'canyon' with the frontal sinus as the main entrance. METHODS: Between January 2000 and December 2013, 32 consecutive patients underwent removal of OGMs through this 'canyon' at the Department of Neurosurgery of Brescia and Turin...
April 2017: Journal of Neurosurgical Sciences
Akihiro Inoue, Hironobu Harada, Noriyoshi Miura, Masahiro Nishikawa, Tetsuya Fukumoto, Shohei Kohno, Shiro Ohue, Nozomu Tanji, Takanori Ohnishi
Here, we report a case of primary intracranial tumor in a chronic hemodialysis patient in which neurosurgery was successful. A 50-year-old man who had been on hemodialysis for 4 years was admitted to our hospital with general fatigue. Neurological examination on admission revealed mild restless. Computed tomography and magnetic resonance imaging performed on admission revealed a large (55 mm×40 mm) tumor mass in contact with the falx. The size of this tumor rapidly increased over the next month. 201Thallium-chloride single photon emission computed tomography revealed abnormal uptake in the same location as the lesion...
December 2013: No Shinkei Geka. Neurological Surgery
Hailiang Tang, Huaping Sun, Liqian Xie, Qisheng Tang, Ye Gong, Ying Mao, Qing Xie, Mingzhe Zheng, Daijun Wang, Hongda Zhu, Jianhong Zhu, Xiaoyuan Feng, Zhenwei Yao, Xiancheng Chen, Liangfu Zhou
OBJECTIVE: Intracranial meningiomas, especially those located at anterior and middle skull base, are difficult to be completely resected due to their complicated anatomy structures and adjacent vessels. It's essential to locate the tumor and its vessels precisely during operation to reduce the risk of neurological deficits. The purpose of this study was to evaluate intraoperative ultrasonography in displaying intracranial meningioma and its surrounding arteries, and evaluate its potential to improve surgical precision and minimize surgical trauma...
June 2013: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Kimon Bekelis, Samuel F Bakhoum, Atman Desai, Todd A Mackenzie, David W Roberts
Accurate knowledge of individualized risks is crucial for decision-making in the surgical management of patients with brain tumors. Precise delineation of those risks remains a topic of debate. We attempted to create a predictive model of outcomes in patients undergoing craniotomies for tumor resection (CTR). We performed a retrospective cohort study involving patients who underwent CTR from 2005 to 2010 and were registered in the American College of Surgeons National Quality Improvement Project database. A model for outcome prediction based on individual patient characteristics was developed...
May 2013: Journal of Neuro-oncology
Judith M Wong, Jaykar R Panchmatia, John E Ziewacz, Angela M Bader, Ian F Dunn, Edward R Laws, Atul A Gawande
OBJECT: Neurosurgery is a high-risk specialty currently undertaking the pursuit of systematic approaches to measuring and improving outcomes. As part of a project to devise evidence-based safety interventions for specialty surgery, the authors sought to review current evidence in cranial tumor resection concerning the frequency of adverse events in practice, their patterns, and current methods of reducing the occurrence of these events. This review represents part of a series of papers written to consolidate information about these events and preventive measures as part of an ongoing effort to ascertain the utility of devising system-wide policies and safety tools to improve neurosurgical practice...
November 2012: Neurosurgical Focus
Jason W Motkoski, Fang Wei Yang, Shelly H H Lwu, Garnette R Sutherland
Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. In this study, a 980-nm contact diode laser was integrated with neuroArm. Preclinical evaluation involved partial hepatectomy, bilateral nephrectomy, splenectomy, and bilateral submandibular gland excision in a Sprague-Dawley rat model (n = 50)...
April 2013: IEEE Transactions on Bio-medical Engineering
Sebastian Foersch, Axel Heimann, Ali Ayyad, Gilles A Spoden, Luise Florin, Konstantin Mpoukouvalas, Ralf Kiesslich, Oliver Kempski, Martin Goetz, Patra Charalampaki
Early detection and evaluation of brain tumors during surgery is crucial for accurate resection. Currently cryosections during surgery are regularly performed. Confocal laser endomicroscopy (CLE) is a novel technique permitting in vivo histologic imaging with miniaturized endoscopic probes at excellent resolution. Aim of the current study was to evaluate CLE for in vivo diagnosis in different types and models of intracranial neoplasia. In vivo histomorphology of healthy brains and two different C6 glioma cell line allografts was evaluated in rats...
2012: PloS One
Michelangelo Bartolo, Chiara Zucchella, Andrea Pace, Gaetano Lanzetta, Carmine Vecchione, Marcello Bartolo, Giovanni Grillea, Mariano Serrao, Cristina Tassorelli, Giorgio Sandrini, Francesco Pierelli
Clinical experience suggests that application of the fundamental principles of rehabilitation medicine can improve the care of patients with cancer. Despite the high incidence of neurological and functional deficits in patients affected by brain tumours (BTs), rehabilitation treatment of this population is not as well established as it is for patients with other neurological conditions. To assess functional outcome in brain tumour inpatients who underwent early rehabilitation after surgery. 75 patients who had undergone neurosurgery for primary BTs and 75 patients affected by stroke were enrolled in a case-control study...
May 2012: Journal of Neuro-oncology
Shu-Qing Yu, Ji-Sheng Wang, Nan Ji, Wei Liu, Ke Qian
BACKGROUND: Atypical meningioma accounts for about 4.7% to 7.2% of all kinds of meningiomas, which is invasive with a relatively high recurrence and mortality. The objective of this study was to investigate the clinical manifestations and therapeutic strategies of atypical meningioma. METHODS: A total of 74 patients who underwent surgical treatment and pathologically confirmed for atypical meningioma in Neurosurgery Department of Beijing Tiantan Hospital from January 2003 to December 2008 were enrolled in this study...
April 2011: Chinese Medical Journal
Ekkehard M Kasper, Philip E Hess, Michelle Silasi, Kee-Hak Lim, James Gray, Hasini Reddy, Lauren Gilmore, Burkhard Kasper
INTRODUCTION: Non-obstetric surgery for intracranial meningioma is uncommon during pregnancy and poses significant risks to both the mother and the fetus. We present a case of a parturient that presented with acute mental status changes and we illustrate the decision making process that resulted in a best-possible outcome. CASE DESCRIPTION: A woman at 29-week gestation presented with acute language and speech deficits and deteriorating mental status after 2 weeks of headache...
2010: Surgical Neurology International
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