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https://www.readbyqxmd.com/read/29772400/neuro-endoscope-for-skull-base-tumors
#1
REVIEW
Hua Gao, Chunhui Liu, Yazhuo Zhang
The endoscope has traditionally been used in neurosurgery to access a lesion within a natural body cavity. The challenge has been to access and resect deep-seated intraparenchymal lesions using a minimally invasive endoscopic technique. Endoscopic endonasal trans-sphenoidal surgery has gained increasing acceptance by otolaryngologists and neurosurgeons. Surgical procedures of the skull base include exposure, resection, and base reconstruction. These approaches start at the sphenoid sinus, which provides a reference point to important vascular and neural structures...
May 14, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29755736/surgical-specialty-and-preoperative-medical-consultation-based-on-commercial-health-insurance-claims
#2
Stephan R Thilen, Alex L Woersching, Anda M Cornea, Elliott Lowy, Edward M Weaver, Miriam M Treggiari
Background: Surgical patients are sometimes referred for preoperative evaluations by consultants in other medical specialties, although consultations are unnecessary for many patients, particularly for healthy patients undergoing low-risk surgeries. Surgical specialty has been shown to predict usage of preoperative consultations. However, evidence is generally limited regarding factors associated with preoperative consultations. This study evaluates surgical specialty and other predictors of preoperative consultations...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29712524/patient-out-of-pocket-spending-in-cranial-neurosurgery-single-institution-analysis-of-6569-consecutive-cases-and-literature-review
#3
Seungwon Yoon, Michael A Mooney, Michael A Bohl, John P Sheehy, Peter Nakaji, Andrew S Little, Michael T Lawton
OBJECTIVE With drastic changes to the health insurance market, patient cost sharing has significantly increased in recent years. However, the patient financial burden, or out-of-pocket (OOP) costs, for surgical procedures is poorly understood. The goal of this study was to analyze patient OOP spending in cranial neurosurgery and identify drivers of OOP spending growth. METHODS For 6569 consecutive patients who underwent cranial neurosurgery from 2013 to 2016 at the authors' institution, the authors created univariate and multivariate mixed-effects models to investigate the effect of patient demographic and clinical factors on patient OOP spending...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29687253/real-time-intraoperative-contrast-enhanced-ultrasound-ceus-in-vascularized-spinal-tumors-a-technical-note
#4
Giuseppe Maria Della Pepa, Pier Paolo Mattogno, Giuseppe La Rocca, Giovanni Sabatino, Alessandro Olivi, Luca Ricciardi, Filippo Maria Polli
BACKGROUNDS: Intra-operative ultrasound (ioUS), and the recently introduced contrast-enhanced ultrasound (CEUS) demonstrated to be an extremely valuable tool in oncological cerebral neurosurgery. METHODS: The authors applied ioUS/CEUS techniques to spinal oncological surgery as showed in the illustrative case of a dorsal hemangiopericytoma. RESULTS AND CONCLUSIONS: ioUS and CEUS provide real-time information that proved useful in identifying both vascular and parenchymatous tumoral patterns, anatomical relations with nervous structure, plan surgical strategy, and identify residuals...
April 23, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29682030/maximum-surgical-blood-order-schedule-for-elective-neurosurgery-in-a-university-teaching-hospital-in-northern-thailand
#5
Ananchanok Saringcarinkul, Siriwan Chuasuwan
Context: Preoperative blood bank testing should optimize the trade-off between intraoperative transfusion delay and blood wastage. Aims: This study aims to develop a maximal surgical blood order schedule (MSBOS) for elective neurosurgery. Settings and Design: Prospective data in University Teaching Hospital, Northern Thailand. Subjects and Methods: Blood transfusion data were collected on all adult patients satisfying inclusion/exclusion criteria in 2015...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29670570/mexican-national-institute-of-neurology-and-neurosurgery-stroke-registry-results-of-a-25-year-hospital-based-study
#6
Antonio Arauz, Juan Manuel Marquez-Romero, Miguel A Barboza, Fabiola Serrano, Carol Artigas, Luis Manuel Murillo-Bonilla, Carlos Cantú-Brito, José Luis Ruiz-Sandoval, Fernando Barinagarrementeria
Background and purpose: Stroke has been scarcely studied in Latin America (LA). The Mexican Institute of Neurology Stroke Registry was established in 1990 as a prospective computer-based database to register data obtained from patients admitted with stroke. Using this data, we attempted to define the profile of risk factors and outcomes. Methods: The demographic data, stroke description, ancillary tests, vascular risk factors, and modified Rankin scale (mRs) were registered...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29651751/usefulness-of-venous-catheter-as-an-intraluminal-stent-for-end-to-end-venous-anastomosis
#7
Tetsuyoshi Horiuchi, Yoshinari Miyaoka, Takatoshi Hasegawa, Kiyoshi Ito, Kazuhiro Hongo
BACKGROUND: Venous anastomosis is one of the most difficult techniques in vascular neurosurgery. METHOD: We present a simple technique of end-to-end venous anastomosis for reconstruction of accidentally injured vein. A venous catheter was used for the stent during the end-to-end anastomosis. RESULTS: The venous catheter as the stent facilitated confirmation of the ostium of the vein. The venous end-to-end anastomosis was successfully performed...
April 12, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29617854/microsurgical-treatment-of-bowhunter-s-syndrome-3-dimensional-operative-video
#8
Vijay Agarwal, Daniel L Barrow
We present the case of a 56-yr-old previously healthy male who presented with an approximately 1-yr history of intermittent dizziness, near syncope, and holocephalic headaches when turning his head to the left side for a prolonged period of time. He had a distant history of a previous anterior cervical discectomy and fusion at the C6-7 level. He was neurologically intact. Static, dynamic, and vascular imaging confirmed hypoplasia of the right vertebral artery and dominance of the left vertebral artery that completely filled the posterior circulation...
March 29, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29563841/nonprojectile-penetrating-iron-rod-from-the-oral-cavity-to-the-posterior-cranial-fossa-a-case-report-and-review-of-literature
#9
Zhi Gang Lan, Seidu A Richard, Jin Li, Chaohua Yang
Introduction: Nonprojectile penetrating skull base injuries as a result of falls have rarely been confronted in normal neurosurgery although a few nonmissile injuries have been reported. These kinds of injuries represent a life-threatening emergency. Case presentation: We present an unusual case of a 25-year-old male construction worker who suffered an accidental penetrating skull base injury when he fell on a metal rod while he was walking on a 2-meter-high platform...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29547944/has-current-french-training-for-military-orthopedic-surgeons-deployed-in-external-operations-been-appropriately-adapted
#10
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
https://www.readbyqxmd.com/read/29542136/five-year-trends-in-perioperative-red-blood-cell-transfusion-from-index-cases-in-five-surgical-specialties-2011-to-2015
#11
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
https://www.readbyqxmd.com/read/29536326/automatic-intraoperative-estimation-of-blood-flow-direction-during-neurosurgical-interventions
#12
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
https://www.readbyqxmd.com/read/29519377/a-multidisciplinary-approach-on-the-perioperative-antithrombotic-management-of-patients-with-coronary-stents-undergoing-surgery-surgery-after-stenting-2
#13
REVIEW
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
https://www.readbyqxmd.com/read/29476999/the-impact-of-different-postgraduate-year-training-in-neurosurgery-residency-on-30-day-return-to-operating-room-a-national-surgical-quality-improvement-program-study
#14
Mohamed Macki, Mohamed Fakih, Pridvi Kandagatla, Ilan Rubinfeld, Victor Chang
OBJECTIVE: Because of the health care initiative on quality improvement projects in academic medicine, this study explores the impact of different postgraduate years (PGYs) on unexpected re-operation rates. METHODS: Using the National Surgical Quality Improvement Program 2005-2014, adult neurosurgical cases were divided into subspecialties: spine, open vascular, cranial, and functional. Comparison groups were 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
https://www.readbyqxmd.com/read/29456341/using-of-fresh-cadaveric-cow-brain-in-the-microsurgical-training-model-for-sulcal-cisternal-and-fissural-dissection
#15
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
https://www.readbyqxmd.com/read/29441169/perioperative-stroke-pathophysiology-and-management
#16
REVIEW
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
https://www.readbyqxmd.com/read/29408298/from-hypothermia-to-cephalosomatic-anastomoses-the-legacy-of-robert-white-1926-2010-at-case-western-reserve-university-of-cleveland
#17
REVIEW
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 became the youngest full professor at the Case Western Reserve University in Cleveland, Ohio. With over 500 research articles 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...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29389252/risk-factors-and-predictive-model-development-of-thirty-day-post-operative-surgical-site-infection-in-the-veterans-administration-surgical-population
#18
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...
April 2018: Surgical Infections
https://www.readbyqxmd.com/read/29388120/the-application-of-the-unruptured-intracranial-aneurysm-treatment-score-a-retrospective-single-center-study
#19
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
https://www.readbyqxmd.com/read/29378389/limits-of-endoscopic-endonasal-surgery-for-craniopharyngioma
#20
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
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