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Neurosurgery technique

Fraser Henderson, Istvan Takacs
BACKGROUND: Troubleshooting of deep brain stimulators (Activa SC/PC/RC Medtronic PLC) sometimes results in a decision to replace a tunneled stretch-coil extension cable. We present a simple technique to accomplish this atraumatically without a tunneling tool. OBJECTIVES: In the treatment of patients with deep brain stimulators, complication avoidance and efficiency of operative time are paramount. We sought to find the most safe, effective, and rapid method for performing the conceptually-simple yet technically-nuanced act of replacing lead extension cables...
October 18, 2016: World Neurosurgery
Volkan Etus, Gokmen Kahilogullari, Hakan Karabagli, Agahan Unlu
AIM: Neonatal intraventricular hemorrhage (IVH) usually results in posthemorrhagic hydrocephalus (PHH). This multicenter study describes the approach of early neuroendoscopic ventricular irrigation for the treatment of IVH/PHH and compares the results with the cases that have been initially treated only with conventional temporary CSF diversion techniques. MATERIAL AND METHODS: The data of total 74 neonatal PHH cases that have been treated at three pediatric neurosurgery centers were retrospectively analyzed...
August 30, 2016: Turkish Neurosurgery
Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Jamil Abdolmohammadi, Mohsen Shafiee, Fariborz Faeghi, Douman Arefan, Alireza Zali, Rouzbeh Motiei-Langroudi, Zahra Farshidfar, Ali Kiani Nazarlou, Ali Tavakkoli, Mohammad Yarham
INTRODUCTION: Timely diagnosis of brain tumors could considerably affect the process of patient treatment. To do so, para-clinical methods, particularly MRI, cannot be ignored. MRI has so far answered significant questions regarding tumor characteristics, as well as helping neurosurgeons. In order to detect the tumor cellularity, neuro-surgeons currently have to sample specimens by biopsy and then send them to the pathology unit. The aim of this study is to determine the tumor cellularity in the brain...
August 2016: Electronic Physician
Manas Panigrahi, Manoranjitha Kumari, Sudhindra Vooturi
BACKGROUND: Keeping the operating field clean and visible is an important technique in neurosurgery. Continuous irrigation-suction (IS) of the surgical field is currently often done using devices available that are expensive and demand technical proficiency. We report a simple method of continuous ISusing widely available central venous catheter and controlled suction cannula. METHODS: We used a controlled suction cannula attached to a central suction system. Single lumen central venous catheter is passed through the key hole of a controlled suction cannula, which is connected to a continuous irrigation system...
October 12, 2016: World Neurosurgery
Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Yasuhiro Shibata, Sota Kurihara, Seiji Arai, Haruo Kato, Tomomi Suzuki, Yoshiyuki Miyazawa, Hidekazu Koike, Kazuto Ito, Tetsuya Nakamura, Kazuhiro Suzuki
OBJECTIVES: Microsurgical subinguinal varicocelectomy is one of the best treatment modalities for varicoceles related to male infertility and scrotal pain. However, the difficulty in identifying testicular arteries, which should be spared, is a limitation of this technique. To visualize and identify the testicular arteries in spermatic cord during the operation, we examined the efficacy of intraoperative indocyanine green angiography (ICGA), which is regularly used in microsurgical neurosurgery...
October 13, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
Sara Giovanna Romeo, Alfredo Conti, Francesca Polito, Chiara Tomasello, Valeria Barresi, Domenico La La Torre, Maria Cucinotta, Flavio Filippo Angileri, Marcello Bartolotta, Rosa Maria Di Giorgio, M'Hammed Aguennouz
Sirtuins are a family of 7 histone deacetylases largely involved in the regulation of cell proliferation, survival and death. The role of sirtuins in tumorigenesis and cancer progression has been previously studied in certain cancer types. Few studies have investigated sirtuin expression in gliomas, with controversial results. The aim of the present study was to investigate the expression of sirtuin-1 (Sirt-1) in diffuse astrocytoma [low grade astrocytoma (LGA)], anaplastic astrocytoma (AA) and glioblastoma multiforme (GBM) and in primary glioma cell lines: PLGAC (primary LGA cells); PAAC (primary AA cells); and PGBMC (primary GBM cells)...
October 2016: Oncology Letters
Yu-Chen Ji, Yan Li, Jing-Xia Hu, Hong-Bo Zhang, Peng-Xiang Yan, Huan-Cong Zuo
Hemangioblastomas (HBMs) are highly vascular tumors of the central nervous system. Sporadic HBMs are nearly always solitary, and solitary HBMs are similar to intracranial arteriovenous malformations due to their highly vascular characteristics. However, to the best of our knowledge, cases of HBM in the cerebellum mimicking an aneurysm have never been reported in the literature. The present study reports a case of an HBM on the right cerebellar hemisphere mimicking an aneurysm, which originated from the right posterior inferior cerebellar artery, as determined using magnetic resonance angiography and digital subtraction angiography...
October 2016: Oncology Letters
Ahmed Abdullah, Hisham El Shitany, Waleed Abbass, Amr Safwat, Amr K Elsamman, Ehab El Refaee
OBJECTIVES: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. MATERIALS AND METHODS: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas...
October 2016: Journal of Neurosciences in Rural Practice
Angela Coppola, Vincenzo Tramontano, Federica Basaldella, Chiara Arcaro, Giovanna Squintani, Francesco Sala
INTRODUCTION: Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M Májovský, D Netuka, V Beneš
INTRODUCTION: The pineal region is a deep-seated part of the brain surrounded by highly eloquent structures. Differential diagnosis of space-occupying lesions in this region encompasses pineal gland cysts, pineal gland tumours, metastases, germ cell tumours, meningiomas, gliomas, hemangioblastomas and neuroectodermal tumours. A treatment strategy is based mainly on tumour anatomical characteristics and histological type. Except germinatous tumours, a surgical excision is the treatment of choice...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Alessandro Bertuccio, Chiara Robba, Giannantonio Spena, Pietro Primo Versari
INTRODUCTION: Dural arteriovenous fistulas (DAVFs) is a challenging condition in vascular neurosurgery. Development of new endovascular techniques has progressively modified treatment strategies; however, surgery is still considered a valid option of treatment of this pathology. MATERIALS AND METHODS: From a retrospective analysis of our database, we selected 107 patients who underwent surgical treatment for DAVFs. Patients were grouped into five categories according to the Borden and Cognard classifications...
2016: Acta Neurochirurgica. Supplement
Assunta Filippini, Francesco Prada, Massimiliano Del Bene, Francesco DiMeco
PURPOSE: To assess the usefulness of intraoperative Ultrasound (ioUS) and Echo-Color-Doppler (ECD) for the surgical removal of a specific deep-sited lesion. METHODS: Case report of a woman underwent surgery of a third ventricle colloid cyst removal. RESULTS: The ioUS technique depicted the deep intraventricular lesion and all the anatomical structures surrounding the lesion; helping us defining the best trajectory for the safest surgical removal...
September 2016: Journal of Ultrasound
Otávio T da Silva, César C de Almeida, Ricardo F Iglesio, Jessie M de Navarro, Manoel J Teixeira, Kleber P Duarte
BACKGROUND: In this article, the authors described their experience in microvascular decompression for trigeminal neuralgia. METHODS: The microvascular decompression technique used in the authors' institution is described in a step by step manner with some illustrative cases as well as a cadaver dissection to highlight the differences with other previously described techniques. RESULTS: Since 2013, 107 patients were operated in the Neurosurgery Division of the University of São Paulo using the described technique, with a shorter operative time and avoiding cerebellar retractor compared with classic techniques...
2016: Surgical Neurology International
Bernardo Drummond Braga, Sebastião Berquó Peleja, Guaracy Macedo, Carlos Roberto S A Drummond, Pollyana H V Costa, Marco T Garcia-Zapata, Marcelo Magaldi Oliveira
INTRODUCTION: Neurosurgery simulation has gained attention recently due to changes in the medical system. First-year neurosurgical residents in low-income countries usually perform their first craniotomy on a real subject. Development of high-fidelity, cheap, and largely available simulators is a challenge in residency training. An original model for the first steps of craniotomy with cerebrospinal fluid (CSF) leak avoidance practice using a coconut is described. MATERIAL AND METHODS: The coconut is a drupe from Cocos nucifera L...
September 6, 2016: World Neurosurgery
V E Hudson, A Elniel, I Ughratdar, B Zebian, R Selway, J P Lin
: Cochlear implants for sensorineural deafness in children is one of the most successful neuromodulation techniques known to relieve early chronic neurodisability, improving activity and participation. In 2012 there were 324,000 recipients of cochlear implants globally. AIM: To compare cochlear implant (CI) neuromodulation with deep brain stimulation (DBS) for dystonia in childhood and explore relations between age and duration of symptoms at implantation and outcome...
August 3, 2016: European Journal of Paediatric Neurology: EJPN
Ouzi Nissim, Roberto Spiegelmann
The article by Dr. Cohen-Inbar published in this issue of Harefuah is a timely review that brings to the general medical community the recent important developments in the field of radiosurgery--the evolution of multi-session radiosurgery [or "FSR", standing for Fractionated Stereotactic Radiation]. Radiosurgery and FSR continue to have a tremendous impact on modern neurosurgery. Sharing sub-millimetric accuracy in radiation delivery made possible by real-time-imaging positioning, frameless single and multisession radiosurgery have become two faces of a therapeutic technique with wide application in the field of intracranial pathology...
May 2016: Harefuah
Samuel Grodofsky
This review includes a summary of contemporary theories of pain processing and advocates a multimodal analgesia approach for providing perioperative care. A summary of various medication classes and anesthetic techniques is provided that highlights evidence emerging from neurosurgical literature. This summary covers opioid management, acetaminophen, nonsteroidal antiinflammatories, ketamine, lidocaine, dexmedetomidine, corticosteroids, gabapentin, and regional anesthesia for neurosurgery. At present, there is not enough investigation into these areas to describe best practices for treating or preventing chronic pain in neurosurgery; but providers can identify a wider range of options available to personalize perioperative care strategies...
September 2016: Anesthesiology Clinics
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