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vascular neurosurgery

Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Daniel Høyer Iversen, Lasse Løvstakken, Geirmund Unsgård, Ingerid Reinertsen
PURPOSE: In neurosurgery, reliable information about blood vessel anatomy and flow direction is important to identify, characterize, and avoid damage to the vasculature. Due to ultrasound Doppler angle dependencies and the complexity of the vascular architecture, clinically valuable 3-D flow direction information is currently not available. In this paper, we aim to clinically validate and demonstrate the intraoperative use of a fully automatic method for estimation of 3-D blood flow direction from freehand 2-D Doppler ultrasound...
March 13, 2018: International Journal of Computer Assisted Radiology and Surgery
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Mohamed Macki, Mohamed Fakih, Pridvi Kandagatla, Ilan Rubinfeld, Victor Chang
OBJECTIVE: Because of the healthcare initiative on quality improvement projects in academic healthcare, this study explores the impact of different postgraduate years (PGYs) on unexpected re-operation rates. METHODS: Using National Surgical Quality Improvement Program 2005-2014, adult neurosurgical cases were divided into subspecialties: spine, open-vascular, cranial, and functional. Comparison groups: cases involving junior residents [PGY 1-PGY 3], mid-level residents [PGY 4+PGY 5], and senior residents [PGY 6+PGY 7]...
February 21, 2018: World Neurosurgery
Ahmet Gökyar, Cengiz Cokluk
Objective: The aim of this experimental study was to evaluate the feasibility of using fresh cadaveric cow brain as in a training model for microsurgical dissection of sulcus, cisterns, and fissure. Methods: Experimental microneurosurgical activities in this study were performed under the operating microscope. Bilateral sylvian cisterns, interhemispheric fissure, and hemispheric sulcus of the fresh cadaveric cow brain were used as an interested area for this experimental study...
January 2018: Journal of Neurosciences in Rural Practice
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
Sunil Manjila, Vilakshan Alambyan, Gagandeep Singh, Priyanka Satish, Robert T Geertman
Dr. Robert J. White (1926-2010) was an eminent neurosurgeon and bioethicist, renowned for his classic work in hypothermia and pioneering mammalian head transplant experiments. He founded the Division of Neurosurgery at the Cleveland Metropolitan General Hospital (currently MetroHealth Medical Center, a level 1 Trauma County Hospital) and eventually became the youngest full Professor at the Case Western Reserve University in Cleveland, Ohio. With over 500 research papers to his credit, he founded the Brain Research Laboratory at what was then the Cleveland Metropolitan General Hospital which was also home to future leaders in Neurosurgery, Neurosciences and allied specialties...
February 2, 2018: World Neurosurgery
Xinli Li, William Nylander, Tracy Smith, Soonhee Han, William Gunnar
BACKGROUND: Surgical site infection (SSI) complicates approximately 2% of surgeries in the Veterans Affairs (VA) hospitals. Surgical site infections are responsible for increased morbidity, length of hospital stay, cost, and mortality. Surgical site infection can be minimized by modifying risk factors. In this study, we identified risk factors and developed accurate predictive surgical specialty-specific SSI risk prediction models for the Veterans Health Administration (VHA) surgery population...
February 1, 2018: Surgical Infections
Silvia Hernández-Durán, Dorothee Mielke, Veit Rohde, Vesna Malinova
The unruptured intracranial aneurysm treatment score (UIATS) was published in April 2015 as a multidisciplinary consensus regarding treatment of unruptured intracranial aneurysms (UIA). As a tertiary center with focus on vascular neurosurgery, we aimed to investigate whether our treatment decision-making in patients with UIA has been in accordance with the recently published UIATS. A retrospective analysis of patients admitted to our center with UIA was performed. UIATS was applied to all identified UIA. Three decision groups were defined: (a) UIATS favoring treatment, (b) UIATS favoring observation, and (c) UIATS inconclusive...
February 1, 2018: Neurosurgical Review
Douglas A Hardesty, Alaa S Montaser, André Beer-Furlan, Ricardo L Carrau, Daniel M Prevedello
Craniopharyngiomas represent one of the most challenging brain tumors for the neurosurgeon. For most of the 20th century, these parasellar lesions have been approached via the classic open approaches of neurosurgery such as pterional, frontobasal, interhemispheric, and transpetrosal craniotomies. The endoscopic endonasal approach to these tumors, rather than craniotomy, has risen in popularity over the last two decades. Regardless of approach, a detailed knowledge of surgical anatomy and careful preoperative surgical planning are essential to achieve good clinical results; iatrogenic morbidity can potentially be severe due to hypothalamus, optic apparatus, and/or vascular injuries...
January 26, 2018: Journal of Neurosurgical Sciences
Jonathan Russin, Joseph Carey
BACKGROUND: Free flaps are commonly used by other surgical subspecialties for soft tissue reconstruction and revascularization. Cranial applications of these flaps have been limited to only a single case report. OBJECTIVE: To present a new technique for combined revascularization in moyamoya disease using a flow-through free flap. METHODS: Data were obtained from an Institutional Review Board-approved, prospectively maintained database with informed consent from the patient...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Hakeem J Shakir, Hussain Shallwani, Leonardo Rangel-Castilla, Amade Bregy, Jason M Davies, Ashish Sonig, Christopher S Ogilvy, Kenneth V Snyder, L Nelson Hopkins, Adnan H Siddiqui, Elad I Levy
The University at Buffalo's neuroendovascular fellowship is one of the longest running fellowship programs in North America. The burgeoning neurointerventional workforce and the rapid growth in the neurointerventional space on the heels of groundbreaking clinical trials prompted us to assess the fellowship's academic impact and its graduates' perceptions and productivity. An anonymized web-based survey was sent to all former neuroendovascular fellows with specific questions pertaining to current practice, research and funding, and perceptions about the fellowship's impact on their skills, competitiveness, and compensation...
January 17, 2018: Neurosurgery
Drosos Evangelos, Giakoumettis Dimitrios, Themistocleous S Marios
BACKGROUND: Colchicine is an ancient drug. Many uses have been reported in medical books and reports through the centuries. Currently the understanding of its mechanism of action has opened new horizons to its use. OBJECTIVE: This article aims to discuss the use of colchicine in various neurosurgical conditions. METHODS: A pubmed database and clinical trials search was performed, using the key words "colchicine", "Neurosurgery", "low back pain", "stroke" and glioma"...
January 14, 2018: Current Pharmaceutical Design
Alessandro Narducci, Julia Onken, Marcus Czabanka, Nils Hecht, Peter Vajkoczy
BACKGROUND: Over the last years, intraoperative use of fluorescein is gaining ground in the field of neurosurgery, due to development of a microscope-integrated YELLOW 560 module, with reported experiences in brain malignancies, aneurysms, and arteriovenous malformation surgery. The aim of this study is to determine the feasibility and value of fluorescein videoangiography during bypass procedures. METHODS: The authors enrolled 11 patients who underwent extracranial-to-intracranial bypass for moyamoya disease, atherosclerotic steno-occlusive cerebrovascular disease, and flow replacement during a giant middle cerebral artery (MCA) aneurysm treatment...
January 6, 2018: Acta Neurochirurgica
Patrick M Flanigan, Arman Jahangiri, Joshua L Golubovsky, Jaret M Karnuta, Francis J May, Mitchel S Berger, Manish K Aghi
OBJECTIVE The position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors' aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role...
January 5, 2018: Journal of Neurosurgery
Jasper Shen, Kevin Hur, Zhipeng Zhang, Michael Minneti, Martin Pham, Bozena Wrobel, Gabriel Zada
BACKGROUND: The emergence of minimally invasive endoscopic endonasal skull base surgery has necessitated reproducible and realistic simulators of rare vascular injuries. OBJECTIVE: To assess the face and content validity of an innovative perfusion-based cadaveric model developed to simulate internal carotid artery (ICA) injury during endoscopic surgery. METHODS: Otolaryngology and neurosurgery trainees attempted 3 consecutive trials of endoscopic control of a parasellar ICA injury, with standardized technical feedback...
December 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
Josué Hernando, Antonio Aguilar-Salvatierra, Ignacio Osoitz Leizaola-Cardesa, Pedro Martínez Seijas, Pablo Aguirre-Echebarria, Javier Martín, Gerardo Gómez-Moreno
BACKGROUND: Osteomas are infrequent benign bone tumors of uncertain etiology. They are usually situated at extremities and their occurrence in the jaws is relatively rare. There are 3 types of osteoma: central, peripheral, and extraskeletal. Preoperative presumptive diagnosis is performed by means of radiography using orthopantomographs, computerized tomographs, or cone beam scans. Treatment is surgical and consists of careful exeresis and curettage of the adjacent tissue. In recent years, piezoelectric surgery has been used to treat bone pathologies in the maxillofacial area, orthopedic surgery, and neurosurgery...
December 27, 2017: Journal of Craniofacial Surgery
Xiaoping Ren, Ming Li, Xin Zhao, Zehan Liu, Shuai Ren, Yafang Zhang, Shide Zhang, Sergio Canavero
Background: Cephalosomatic anastomosis (CSA) has never been attempted before in man as the transected spinal cords of the body donor and body recipient could not be "fused" back together. Recent advances made this possible. Here, we report on the surgical steps necessary to reconnect a head to a body at the cervical level. Methods: Full rehearsal of a CSA on two recently deceased human cadavers was performed at Harbin Medical University, Harbin, China. Results: The surgery took 18 hours to complete within the time frame planned for this surgery...
2017: Surgical Neurology International
Christian Iorio-Morin, Syed Uzair Ahmed, Mark Bigder, Ayoub Dakson, Cameron Elliott, Daipayan Guha, Michelle Kameda-Smith, Pascal Lavergne, Serge Makarenko, Michael S Taccone, Michael K Tso, Bill Wang, Alexander Winkler-Schwartz, David Fortin
BACKGROUND: Neurosurgical residents face a unique combination of challenges, including long duty hours, technically challenging cases, and uncertain employment prospects. We sought to assess the demographics, interests, career goals, self-rated happiness, and overall well-being of Canadian neurosurgery residents. METHODS: A cross-sectional survey was developed and sent through the Canadian Neurosurgery Research Collaborative to every resident enrolled in a Canadian neurosurgery program as of April 1, 2016...
December 14, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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