keyword
https://read.qxmd.com/read/38473288/establishment-of-different-intraoperative-monitoring-and-mapping-techniques-and-their-impact-on-survival-extent-of-resection-and-clinical-outcome-in-patients-with-high-grade-gliomas-a-series-of-631-patients-in-14-years
#21
JOURNAL ARTICLE
Franziska Staub-Bartelt, Marian Preetham Suresh Babu, Andrea Szelényi, Marion Rapp, Michael Sabel
BACKGROUND: The resection of brain tumors can be critical concerning localization, but is a key point in treating gliomas. Intraoperative neuromonitoring (IONM), awake craniotomy, and mapping procedures have been incorporated over the years. Using these intraoperative techniques, the resection of eloquent-area tumors without increasing postoperative morbidity became possible. This study aims to analyze short-term and particularly long-term outcomes in patients diagnosed with high-grade glioma, who underwent surgical resection under various technical intraoperative settings over 14 years...
February 25, 2024: Cancers
https://read.qxmd.com/read/38471741/is-the-use-of-intraoperative-neuromonitoring-justified-during-lumbar-anterior-approach-surgery
#22
JOURNAL ARTICLE
Scott L Blumenthal, Joel I Edionwe, Emily C Courtois, Richard D Guyer, Alexander M Satin, Donna D Ohnmeiss
BACKGROUND: Intraoperative neuromonitoring (IONM) became widely used in spine surgery to reduce the risk of iatrogenic nerve injury. However, the proliferation of IONM has fallen into question based on effectiveness and costs, with a lack of evidence supporting its benefit for specific spine surgery procedures. The purpose of this study was to evaluate the use of IONM and the rate of neurological injury associated with anterior lumbar spinal surgery. METHODS: This was a retrospective study on a consecutive series of 359 patients undergoing lumbar anterior approach surgery for anterior lumbar interbody fusion (ALIF), total disc replacement (TDR), or hybrid (ALIF with TDR) for the treatment of symptomatic disc degeneration...
March 12, 2024: International Journal of Spine Surgery
https://read.qxmd.com/read/38452426/intraoperative-neuromonitoring-as-real-time-diagnostic-for-cerebral-ischemia-in-endovascular-treatment-of-ruptured-brain-aneurysms
#23
JOURNAL ARTICLE
Abdullah M Al-Qudah, Parthasarathy D Thirumala, Katherine M Anetakis, Donald J Crammond, Saleh A Algarni, Mohammad AlMajali, Varun Shandal, Bradley A Gross, Michael Lang, Nirav R Bhatt, Alhamza R Al-Bayati, Raul G Nogueira, Jeffrey R Balzer
OBJECTIVE: To evaluate the diagnostic accuracy of intraoperative neurophysiological monitoring (IONM) during endovascular treatment (EVT) of ruptured intracranial aneurysms (rIA). METHODS: IONM and clinical data from 323 patients who underwent EVT for rIA from 2014-2019 were retrospectively reviewed. Significant IONM changes and outcomes were evaluated based on visual review of data and clinical documentation. RESULTS: Of the 323 patients undergoing EVT, significant IONM changes were noted in 30 patients (9...
February 27, 2024: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://read.qxmd.com/read/38449456/sex-disparities-in-rectal-cancer-surgery-an-in-depth-analysis-of-surgical-approaches-and-outcomes
#24
REVIEW
Chungyeop Lee, In Ja Park
Anatomical and physiological differences exist between sex, leading to variations in how diseases, such as rectal cancer, are prevalence and treatment outcomes of diseases including rectal cancer. In particular, in the case of rectal cancer, anatomical differences may be associated with surgical challenges, and these factors are believed to be important contributors to potential disparities in postoperative recovery, associated complications, and oncological outcomes between male and female patients. However, there is still ongoing debate regarding this matter...
February 29, 2024: World Journal of Men's Health
https://read.qxmd.com/read/38441871/aborted-ais-spinal-fusion-due-to-persistent-loss-of-ionm-which-patients-are-at-greatest-risk
#25
JOURNAL ARTICLE
Connor Zale, Evan Fene, Claire Bonnyman, Lydia Klinkerman, Amy L McIntosh
PURPOSE: Determine peri-operative risk factors predictive for prematurely stopping surgery prior to completion of deformity correction due to intra-operative neuromonitoring changes. METHODS: A single institution retrospective review of adolescent idiopathic scoliosis (AIS) patients that underwent spinal fusion for curves greater than 70°. Cases aborted due to persistent loss of IONM were compared to completed cases. Demographic, radiographic, neurologic, and surgical information was reviewed...
March 5, 2024: Spine Deformity
https://read.qxmd.com/read/38441155/a-novel-surgical-indication-for-scheuermann-s-kyphosis
#26
JOURNAL ARTICLE
Jason J Haselhuhn, Kari Odland, Paul Brian O Soriano, Kristen E Jones, David W Polly
Scheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This can be determined by comparing lumbar lordosis on standing neutral radiographs and supine extension radiographs. Minimal additional lordosis in extension compared with neutral, abutment of the spinous processes, or greater lumbar lordosis standing than with attempted extension suggest the patient is maximally compensated...
March 1, 2024: Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
https://read.qxmd.com/read/38441121/neuromonitoring-in-the-icu-what-how-and-why
#27
JOURNAL ARTICLE
Rohan Mathur, Geert Mefroidt, Chiara Robba, Robert D Stevens
PURPOSE OF REVIEW: We selectively review emerging noninvasive neuromonitoring techniques and the evidence that supports their use in the ICU setting. The focus is on neuromonitoring research in patients with acute brain injury. RECENT FINDINGS: Noninvasive intracranial pressure evaluation with optic nerve sheath diameter measurements, transcranial Doppler waveform analysis, or skull mechanical extensometer waveform recordings have potential safety and resource-intensity advantages when compared to standard invasive monitors, however each of these techniques has limitations...
February 8, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38441114/autoimmune-and-inflammatory-neurological-disorders-in-the-intensive-care-unit
#28
JOURNAL ARTICLE
Camille Legouy, Anna Cervantes, Romain Sonneville, Kiran T Thakur
PURPOSE OF REVIEW: The present review summarizes the diagnostic approach to autoimmune encephalitis (AE) in the intensive care unit (ICU) and provides practical guidance on therapeutic management. RECENT FINDINGS: Autoimmune encephalitis represents a group of immune-mediated brain diseases associated with antibodies that are pathogenic against central nervous system proteins. Recent findings suggests that the diagnosis of AE requires a multidisciplinary approach including appropriate recognition of common clinical syndromes, brain imaging and electroencephalography to confirm focal pathology, and cerebrospinal fluid and serum tests to rule out common brain infections, and to detect autoantibodies...
February 12, 2024: Current Opinion in Critical Care
https://read.qxmd.com/read/38437023/repeated-l5-nerve-root-compromise-detected-with-motor-evoked-potentials-mep-but-not-electromyography-emg-a-case-report
#29
JOURNAL ARTICLE
Marshall F Wilkinson, Jennyfer P Galdino Chaves, Miguel Vega Arroyo, Mohammed Zarrabian
We report a case where neuromonitoring, using motor evoked potentials (MEP), detected an intraoperative L5 nerve root deficit during a lumbosacral decompression and instrumented fusion procedure. Critically, the MEP changes were not preceded nor accompanied by any significant spontaneous electromyography (sEMG) activity. Presumptive L5 innervated muscles, including tibialis anterior (TA), extensor hallucis longus (EHL) and gluteus maximus, were targets for nerve root surveillance using combined MEP and sEMG techniques...
March 4, 2024: Neurodiagnostic Journal
https://read.qxmd.com/read/38431382/transcranial-sonography-in-the-critical-patient
#30
REVIEW
Juan Antonio Llompart-Pou, Laura Galarza, Rosario Amaya-Villar, Daniel Agustín Godoy
Transcranial ultrasonography is a non-invasive, bedside technique that has become a widely implemented tool in the evaluation and management of neurocritically ill patients. It constitutes a technique in continuous growth whose fundamentals (and limitations) must be known by the intensivist. This review provides a practical approach for the intensivist, including the different sonographic windows and planes of insonation and its role in different conditions of the neurocritical patients and in critical care patients of other etiologies...
March 2024: Medicina intensiva
https://read.qxmd.com/read/38428951/does-spinal-cord-type-predict-intraoperative-neuro-monitoring-alerts-in-scoliosis-correction-surgery-a-systematic-review-and-meta-analysis-of-operative-and-radiologic-predictors
#31
REVIEW
Abdulrahman O Al-Naseem, Abdulaziz O Al-Naseem, Derek T Cawley, Ahmed Aoude, Anthony A Catanzano, Muhammad M Abd-El-Barr, Aman Sharma, Roozbeh Shafafy
STUDY DESIGN: Systematic literature review and meta-analysis. OBJECTIVES: Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification...
March 1, 2024: Global Spine Journal
https://read.qxmd.com/read/38424323/variations-in-autoregulation-based-optimal-cerebral-perfusion-pressure-determination-using-two-integrated-neuromonitoring-platforms-in-a-trauma-patient
#32
JOURNAL ARTICLE
Guillaume Plourde, François Martin Carrier, Philippe Bijlenga, Hervé Quintard
BACKGROUND: Neuromonitoring devices are often used in traumatic brain injury. The objective of this report is to raise awareness concerning variations in optimal cerebral perfusion pressure (CPPopt) determination using exploratory information provided by two neuromonitoring monitors that are part of research programs (Moberg CNS Monitor and RAUMED NeuroSmart LogO). METHODS: We connected both monitors simultaneously to a parenchymal intracranial pressure catheter and recorded the pressure reactivity index (PRx) and the derived CPPopt estimates for a patient with a severe traumatic brain injury...
February 29, 2024: Neurocritical Care
https://read.qxmd.com/read/38424153/usefulness-of-video-laryngoscopy-in-tracheal-intubation-at-thyroid-surgical-position-for-intraoperative-neuromonitoring
#33
JOURNAL ARTICLE
Dongwook Won, Jung-Man Lee, Jiwon Lee, Young Jun Chai, Jin-Young Hwang, Tae Kyong Kim, Jee-Eun Chang, Hyerim Kim, Min Jong Kim, Seong-Won Min
This observational study aimed to compare the glottic view between video and direct laryngoscopy for tracheal intubation in the surgical position for thyroid surgery with intraoperative neuromonitoring. Patients scheduled for elective thyroid surgery with intraoperative neuromonitoring were enrolled. After the induction of anesthesia, patients were positioned in the thyroid surgical posture with a standard inclined pillow under their head and back. An investigator assessed the glottic view using the percentage of glottic opening (POGO) scale and the modified Cormack-Lehane grade in direct laryngoscopy and then video laryngoscopy sequentially while using the same McGRATH™ MAC video laryngoscope at once, with or without external laryngeal manipulation, at the surgical position...
February 29, 2024: Scientific Reports
https://read.qxmd.com/read/38423465/veno-arterial-extracorporeal-membrane-oxygenation-ecmo-va-as-part-of-a-multimodal-approach-for-the-protection-of-spinal-cord-ischemia-in-surgical-repair-of-a-thoracoabdominal-aneurysm
#34
F E Fernández-Suárez, J M López-González, C M Fernández-Vallina, V Cueva-Carril, B M Jiménez Gómez, J García-Menéndez
Spinal cord ischaemia leading to paraplegia or paraparesis is one of the most devastating complications of aortic surgery. The risk of ischaemia is particularly high in repairs involving both the thoracic and abdominal segments, because in these cases blood flow to the spinal arteries can be interrupted. Multimodal protocols have now been developed to reduce the incidence of this complication, and include measures such as cerebrospinal fluid (CSF) drainage, avoidance of hypotension and anaemia, systemic hypothermia, neuromonitoring, maintaining distal perfusion during proximal clamping of the aorta, and reimplantation of intercostal or lumbar arteries, whenever feasible...
February 27, 2024: Revista española de anestesiología y reanimación
https://read.qxmd.com/read/38419161/cervical-spine-stenosis-causing-diaphragmatic-paralysis-a-case-study-and-narrative-review-of-clinical-presentations-and-outcomes
#35
JOURNAL ARTICLE
Colin D Lamb, Alexander J Schupper, Addison Quinones, Jack Y Zhang, Jeremy Steinberger, Konstantinos Margetis
STUDY DESIGN: Case report and narrative review. OBJECTIVE: To explore the therapeutic role of surgical and nonsurgical treatment of diaphragmatic paralysis secondary to spinal cord and nerve root compression. SUMMARY OF BACKGROUND DATA: Phrenic nerve dysfunction due to central or neuroforaminal stenosis is a rare yet unappreciated etiology of diaphragmatic paralysis and chronic dyspnea. Surgical spine decompression, diaphragmatic pacing, and intensive physiotherapy are potential treatment options with varying degrees of evidence...
February 29, 2024: Clinical Spine Surgery
https://read.qxmd.com/read/38413472/pedicle-screw-accuracy-placed-with-assistance-of-machine-vision-technology-in-patients-with-neuromuscular-scoliosis
#36
JOURNAL ARTICLE
Rajendra Sakhrekar, Nicholas Shkumat, Birgit Ertl-Wagner, Stephen Lewis, David Lebel, M J McVey, Mark Camp
INTRODUCTION: Pedicle screws are the primary method of vertebral fixation in scoliosis surgery, but there are lingering concerns over potential malposition. The rates of pedicle screw malposition in pediatric spine surgery vary from 10% to 21%. Malpositioned screws can lead to potentially catastrophic neurological, vascular, and visceral complications. Pedicle screw positioning in patients with neuromuscular scoliosis is challenging due to a combination of large curves, complex pelvic anatomy, and osteopenia...
February 27, 2024: Spine Deformity
https://read.qxmd.com/read/38410409/case-report-acute-common-peroneal-nerve-injury-after-posterior-lumbar-decompression-surgery
#37
Peng Wei Wang, Ming Hsuan Chung, Dueng Yuan Hueng, Chung Ching Hsia
Spine surgery is a prevalently performed procedure. Some authors have proposed an age-related surge in surgical and general complications. During spine surgery, patients are placed in positions that are not physiologic, would not be tolerated for prolonged periods by the patient in the awake state, and may lead to complications. Understanding these uncommon complications and their etiology is pivotal to prevention and necessary. The patient is a 76-year-old woman referred to the outpatient department of neurosurgery in February 2022 by her physiatrist with a chief complaint of chronic low back pain and numbness over the left leg...
2024: Frontiers in Surgery
https://read.qxmd.com/read/38410311/acute-encephalopathy-in-a-10-year-old-patient-with-maple-syrup-urine-disease-a-challenging-diagnosis
#38
Pedro Miragaia, Ana Grangeia, Esmeralda Rodrigues, Raquel Sousa, Augusto Ribeiro
Maple syrup urine disease (MSUD) is a rare autosomal recessive metabolic disorder characterized by a deficiency in the branched-chain alpha-keto acid dehydrogenase complex, leading to the toxic accumulation of leucine, isoleucine and valine. Acute encephalopathy (AE) is a severe neurological disorder with diverse etiologies, demanding prompt identification and intervention. We present a unique case of a previously healthy teenage patient who developed AE during an influenza infection. Despite initial inconclusive investigations, the patient's condition rapidly deteriorated, requiring pediatric intensive care unit (PICU) admission...
January 2024: Curēus
https://read.qxmd.com/read/38405592/current-practice-of-intracranial-pressure-monitoring-in-children-with-severe-traumatic-brain-injury-a-nationwide-prospective-surveillance-study-in-germany
#39
JOURNAL ARTICLE
Pia Brensing, Sandra Greve, Rayan Hojeij, Philipp Dammann, Ursula Felderhoff-Müser, Christian Dohna-Schwake, Nora Bruns
BACKGROUND: For management of severe traumatic brain injuries (sTBI) in children, the overall level of evidence to guide diagnostic and therapeutic procedures is low. Since 2016, international guidelines have subsequently suggested invasive intracranial pressure (ICP) monitoring in patients with initial Glasgow Coma Scale (GCS) ≤8. In Germany, ICP monitoring was an individual case decision from 2011 until the 2022 update of the German pediatric TBI guideline. The aim of this study was to evaluate current clinical practice of invasive ICP monitoring in Germany in children <10 years with respect to guideline recommendations...
2024: Frontiers in Pediatrics
https://read.qxmd.com/read/38401754/axial-sections-of-brainstem-safe-entry-zones-and-clinical-importance-of-intrinsic-structures-a-review
#40
REVIEW
Servet Inci, Baylar Baylarov
Brainstem surgery is more difficult and risky than surgeries in other parts of the brain due to the high density of critical tracts and cranial nerves nuclei in this region. For this reason, some safe entry zones into the brainstem have been described. The main purpose of this article is to bring on the agenda the significance of the intrinsic structures of the safe entry zones to the brainstem. Having detailed information about anatomical localization of these sensitive structures is important to predict and avoid possible surgical complications...
February 22, 2024: World Neurosurgery
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