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Neurosurgery technique

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https://www.readbyqxmd.com/read/28346963/point-of-care-testing-in-neurosurgery
#1
Christopher Beynon, Lars Wessels, Andreas W Unterberg
Coagulation disorders can have a major impact on the outcome of neurosurgical patients. The central nervous system is located within the closed space of the skull, and therefore, intracranial hemorrhage can lead to intracranial hypertension. Acute brain injury has been associated with alterations of various hemostatic parameters. Point-of-care (POC) techniques such as rotational thromboelastometry are able to identify markers of coagulopathy which are not reflected by standard assessment of hemostasis (e.g...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28343872/orbital-decompression-for-thyroid-eye-disease
#2
Daniel B Rootman
The literature regarding orbital decompression for thyroid eye disease is vast, spanning multiple specialty areas including neurosurgery, head and neck, maxillofacial and ophthalmic plastic surgery. Although techniques have advanced considerably over the more than 100 years during which this procedure has been performed, the four major approaches remain: transorbital, transcranial, transantral and transnasal. The explosion in literature related to orbital decompression has mostly involved minor technical variations on broader surgical themes...
March 23, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28338432/dual-labeling-with-5-aminolevulinic-acid-and-fluorescein-for-fluorescence-guided-resection-of-high-grade-gliomas-technical-note
#3
Eric Suero Molina, Johannes Wölfer, Christian Ewelt, André Ehrhardt, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Fluorescence guidance with 5-aminolevulinic acid (5-ALA) helps improve resections of malignant gliomas. However, one limitation is the low intensity of blue light for background illumination. Fluorescein has recently been reintroduced into neurosurgery, and novel microscope systems are available for visualizing this fluorochrome, which highlights all perfused tissues but has limited selectivity for tumor detection. Here, the authors investigate a combination of both fluorochromes: 5-ALA for distinguishing tumor and fluorescein for providing tissue fluorescence of adjacent brain tissue...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28300715/operative-learning-curve-after-transition-to-endoscopic-transsphenoidal-pituitary-surgery
#4
Tasneem Shikary, Norberto Andaluz, Jareen Meinzen-Derr, Collin Edwards, Philip Theodosopoulos, Lee A Zimmer
OBJECTIVES: No clear consensus yet defines the endpoints for operative learning curves in the transition to minimally invasive endoscopic techniques. This retrospective review of our first 202 patients who underwent endoscopic pituitary resection examines the statistical learning curve related to operative times--a measure of our surgical team's efficiency and complication rates, a reflection of surgical skill and maturity. METHODS: Retrospective chart review included patient demographics, tumor type, operative times, complication rates, and follow-up...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28300710/frameless-and-maskless-stereotactic-navigation-with-a-skull-mounted-tracker-a-technical-report
#5
Andrew A Fanous, Timothy G White, Matthew B Hirsch, Shamik Chakraborty, Peter D Costantino, David J Langer, John A Boockvar
Intraoperative image-guided navigation has revolutionized neurosurgery. It undoubtedly increases the surgeon's confidence and the perception of safety. While fiducials and facial masks are currently the most widely used tools for intraoperative navigation, their use is associated with certain complications. For instance, such tools require rigid fixation of the head, which increases the risk of skull fractures and epidural hematomas, and decreases both surgical flexibility and surgeon's comfort. In addition, the use of a facial mask is at times undesirable, as it may represent an obstacle during surgeries involving the face and forehead...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28292695/neurosurgical-relevance-of-the-dissection-of-the-diencephalic-white-matter-tracts-using-the-klingler-technique
#6
Susana M Silva, Diogo Cunha-Cabral, José Paulo Andrade
OBJECTIVE: The Klingler fiber dissection technique is a relevant and reliable method for neurosurgery to identify with accuracy the fine structure of the brain anatomy highlighting white matter tracts. In order to demonstrate the significance of the application of this technique, we aimed to observe the course and relations of the mammillothalamic and habenulo-interpeduncular tracts as there are very few papers showing these important diencephalic tracts. MATERIAL AND METHODS: Twelve formalin-fixed brains were dissected using the Klingler technique in order to expose the medial diencephalic surface...
March 2, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28291426/case-report-of-a-6-year-old-girl-with-mycoplasma-hominis-ventriculoperitoneal-shunt-infection
#7
Masanori Sato, Noriko Kubota, Yoshihiko Katsuyama, Yota Suzuki, Yosuke Miyairi, Kisei Minami, Masashi Kasai
Mycoplasma hominis is a rare causative pathogen for surgical site infections after neurosurgical procedures. This organism lacks a cell wall, rendering it undetectable by Gram staining and making it resistant to beta-lactam antibiotics. In addition, some special techniques are required to identify this organism. Thus, it is very difficult to diagnose infections caused by this pathogen. Here, the authors report a pediatric case of M. hominis ventriculoperitoneal shunt (VPS) infection with central nervous system involvement for which beta-lactam antibiotics were not effective and Gram staining revealed no pathogens...
March 3, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28291221/-a-new-concept-of-organization-and-scope-of-neurosurgical-care-in-the-us-army-during-armed-conflicts-in-the-early-2000s
#8
Yu V Khrapov, D E Alekseev, D V Svistov
Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28291211/-surgical-anatomy-of-the-peri-insular-association-tracts-part-i-the-superior-longitudinal-fascicle-system
#9
A E Bykanov, D I Pitskhelauri, A I Batalov, I N Pronin, M A Shkarubo, G F Dobrovol'sky, G L Kobyakov, S B Buklina, V L Puchkov, N E Zakharova, A S Smirnov, A Z Sanikidze, D A Gol'bin, E L Pogosbekyan, E S Kudieva, A M Shkatova, A A Potapov
AIM: To study the peri-insular association tract anatomy and define the permissible anatomical boundaries for resection of glial insular tumors with allowance for the surgical anatomy of the peri-insular association tracts. MATERIAL AND METHODS: In an anatomic study of the superior longitudinal fascicle system (SLF I, SLF II, SLF III, arcuate fascicle), we used 12 anatomical specimens (6 left and 6 right hemispheres) prepared according to the Klingler's fiber dissection technique...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28290395/indian-society-of-neuro-oncology-consensus-guidelines-for-the-contemporary-management-of-medulloblastoma
#10
Tejpal Gupta, Chitra Sarkar, Vedantam Rajshekhar, Sandip Chatterjee, Neelam Shirsat, Dattatreya Muzumdar, Sona Pungavkar, Girish Chinnaswamy, Rakesh Jalali
INTRODUCTION: The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes...
March 2017: Neurology India
https://www.readbyqxmd.com/read/28253483/factors-that-influence-recurrent-lumbar-disc-herniation
#11
M E Yaman, A Kazancı, N D Yaman, F Baş, G Ayberk
INTRODUCTION: The most common cause of poor outcome following lumbar disc surgery is recurrent herniation. Recurrence has been noted in 5% to 15% of patients with surgically treated primary lumbar disc herniation. There have been many studies designed to determine the risk factors for recurrent lumbar disc herniation. In this study, we retrospectively analysed the influence of disc degeneration, endplate changes, surgical technique, and patient's clinical characteristics on recurrent lumbar disc herniation...
March 3, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#12
Matthew A Sexton, Arnoley S Abcejo, Jeffrey J Pasternak
BACKGROUND: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. METHODS: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively)...
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28207664/descriptive-analysis-of-spinal-neuroaxial-injections-surgical-interventions-and-physical-therapy-utilization-for-degenerative-lumbar-spondylolisthesis-within-medicare-beneficiaries-from-2000-to-2011
#13
Joseph A Sclafani, Alexandra Constantin, Pei-Shu Ho, Venu Akuthota, Leighton Chan
STUDY DESIGN: A retrospective, observational study. OBJECTIVE: The aim of this study was to determine the utilization of various treatment modalities in the management of degenerative spondylolisthesis within Medicare beneficiaries. SUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis is a condition often identified in symptomatic low back pain. A variety of treatment algorithms including physical therapy and interventional techniques can be used to manage clinically significant degenerative spondylolisthesis...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#14
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28191601/the-maxillary-artery-and-its-variants-an-anatomical-study-with-neurosurgical-applications
#15
Jorge E Alvernia, Joaquin Hidalgo, Marc P Sindou, Chad Washington, Gustavo Luzardo, Eddie Perkins, Remi Nader, Patrick Mertens
BACKGROUND: The maxillary artery (MA) has gained attention in neurosurgery particularly in cerebral revascularization techniques, intracranial endonasal approaches and endovascular procedures. OBJECTIVES: To describe and illustrate the anatomy of the MA and its neurosurgical importance in a detailed manner. METHODS: Six cadaveric heads (12 MAs) were injected with latex. The arteries and surrounding structures were dissected and studied using microsurgical techniques...
February 13, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28185969/joseph-buford-pennybacker-cbe-md-frcs-1907-1983-continuing-sir-hugh-cairns-oxford-legacy-and-pioneer-of-the-modern-management-of-cerebral-abscesses
#16
REVIEW
Ravindran Visagan, Harold Ellis
The authors examine the life and contribution of Joseph Buford Pennybacker to British neurosurgery and the modern management of cerebral abscesses. Pennybacker's inspirational journey began with him aspiring to Ephraim McDowell. It saw him cross the Atlantic, learn medicine at Edinburgh, train in neurology at Queen Square in London and learn neurosurgery under Sir Hugh Cairns in Oxford. He navigated a successful career through World War Two and together with Cairns established the Radcliffe Infirmary in Oxford as a highly esteemed neurosurgical unit...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28169225/intensity-based-2d-3d-registration-for-lead-localization-in-robot-guided-deep-brain-stimulation
#17
Stefan Hunsche, Dieter Sauner, Faycal El Majdoub, Clemens Neudorfer, Jörg Poggenborg, Axel Goßmann, Mohammad Maarouf
Intraoperative assessment of lead localization has become a standard procedure during deep brain stimulation surgery in many centers, allowing immediate verification of targeting accuracy and, if necessary, adjustment of the trajectory. The most suitable imaging modality to determine lead positioning, however, remains controversially discussed. Current approaches entail the implementation of computed tomography and magnetic resonance imaging. In the present study, we adopted the technique of intensity-based 2D 3D registration that is commonly employed in stereotactic radiotherapy and spinal surgery...
March 21, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28162255/direct-electrical-bipolar-electrostimulation-for-functional-cortical-and-subcortical-cerebral-mapping-in-awake-craniotomy-practical-considerations
#18
J Pallud, O Rigaux-Viode, R Corns, J Muto, C Lopez Lopez, C Mellerio, X Sauvageon, E Dezamis
INTRODUCTION: The aim of brain glioma surgery is to maximize the quality of resection, while minimizing the risk of sequelae. Due to the frequent location of gliomas near or within eloquent areas, owing to their infiltrative feature, and because of major interindividual variability, the anatomofunctional organization and connectivity must be studied individually. Therefore, to optimize the benefit-to-risk ratio of surgery, intraoperative functional mapping is extensively used. MATERIAL AND METHODS: This article aims at describing the rationale, indications and practical aspects of intraoperative direct electrical bipolar electrostimulation for cortical and subcortical mapping under awake conditions using the asleep-awake asleep anaesthetic protocol in the setting of cerebral gliomas...
February 2, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28162217/-clinical-experience-of-302-cases-with-brain-abscess
#19
X P Cui, X W Cai, Z Zhang, N N Gao, P R Liu, J Li, S Y Yang, J N Zhang, X Y Yang
Objective: To compare the diagnosis and treatment experience of brain abscesses and improve prognosis. Methods: The data of 302 patients of brain abscess at Department of Neurosurgery in Tianjin Medical University General Hospital from 1980 to 2014 was analyzed retrospectively. There were 215 male and 87 female patients aged from 11 to 82 years with mean age of (30±8) years. The patients was divided into 1980-2001 group and 2002-2014 group according to different diagnosis and the treatment methods. The therapy methods include operation and conservative treatment...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28137543/brain-tumor-interface-dissection-technique-with-surgical-blade-from-laboratory-to-neurosurgical-operating-room
#20
Survendra Kumar R Rai, Cristina Mancarella, Atul H Goel
BACKGROUND: Ideal tumor resection requires brain/ spinal cord tumor interface separation in perfect and precise surgical plane within few micrometers for radical tumor resection and maximum normal tissue preservation. Despite the availability of several dissection techniques, search for additional alternatives and an ideal technique continues. We evaluated the feasibility and advantages of dissection using number 15- blade scalpel in special brain tumor surgery situation. We developed a leaf model wherein its outer layer is progressively dissected from its inner skeleton using scalpel...
January 27, 2017: World Neurosurgery
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