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Guojun Zhang, Guanghui Zheng, Yan Zhang, Ruimin Ma, Xixiong Kang
Post-neurosurgical meningitis (PNM) is one of the most severe hospital-acquired infections (HAI) worldwide, and a large number of pathogens, especially those possessing multi-resistance genes, are related to these infections. Existing methods for detecting bacteria and measuring their response to antibiotics lack sensitivity and stability, and laboratory-based detection methods are inconvenient, which require at least 24h to complete. Rapid identification of bacteria and the determination of their susceptibility to antibiotics are urgently needed, in order to combat the emergence of multi-resistant bacterial strains...
March 17, 2018: International Journal of Infectious Diseases: IJID
David Pitskhelauri, Elina Kudieva, Dmitrii Moshchev, Evgeny Ananev, Michail Shifrin, Gleb Danilov, Tatiana Melnikova-Pitskhelauri, Igor Kachkov, Andrey Bykanov, Alexander Sanikidze
OBJECTIVE: A pseudomeningocele and an incisional cerebrospinal fluid leak are considered frequent complications following neurosurgical operations. The rate of these complications especially increases following neurosurgical procedures on the posterior cranial fossae. According to some publications, the rate of pseudomeningoceles has been reported as high as 40%, whereas that of incisional cerebrospinal fluid leaks is up to 17%. For the purposes of reducing the risk of these complications after a midline suboccipital craniotomy, we propose suturing the arachnoid membrane of the cisterna magna...
March 20, 2018: Acta Neurochirurgica
Thomas Beez, Hans-Jakob Steiger
Randomized controlled trials (RCTs) are gold standard for comparing treatment modalities. Recently, RCTs transformed ischemic stroke care by first proving benefit of decompressive craniectomy (DC) and later of interventional mechanical thrombectomy. Aim of this study was to explore the impact of RCTs on neurosurgical practice. RCTs investigating DC and thrombectomy were identified. Annual numbers of DCs for ischemic stroke between 2000 and 2017 were determined and correlated with publication dates of RCTs. The initial RCTs demonstrating efficacy of DC were published in 2007, followed by an increase in DC numbers between 2008 and 2009...
March 19, 2018: Neurosurgical Review
Martin Barth, Christel Weiss, Kirsten Schmieder
BACKGROUND: The extent of red blood cell units (RBC) needed for different neurosurgical procedures and the time point of their administration are widely unknown, which results in generously cross-matching prior to surgery. However, RBC are increasingly requested in the aging western populations, and blood donations are significantly reduced. Therefore, the knowledge of the extent and time point of administration of RBC is of major importance. METHODS: This is a retrospective single center analysis...
March 20, 2018: Acta Neurochirurgica
Mohamad Abbass, Michael K Tso, Ezekiel Weis, Alim P Mitha
BACKGROUND: Orbital lymphaticovenous malformations (LVM) are congenital vascular lesions that are typically infiltrative in nature. There have been reports of orbital LVMs extending intracranially through orbital fissures, but there have been no reports of intradural extension. CASE DESCRIPTION: We report the first case of orbital LVM extending intradurally through a bony defect in the medial orbital roof. A modified orbitozygomatic approach was used to successfully obliterate this lesion...
March 16, 2018: World Neurosurgery
Bertrand Mathon, Anne-Marie Korinek
No abstract text is available yet for this article.
March 16, 2018: La Presse Médicale
Kaveh Barami
No abstract text is available yet for this article.
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Xiaosong He, Danielle S Bassett, Ganne Chaitanya, Michael R Sperling, Lauren Kozlowski, Joseph I Tracy
Temporal lobe epilepsy tends to reshape the language system causing maladaptive reorganization that can be characterized by task-based functional MRI, and eventually can contribute to surgical decision making processes. However, the dynamic interacting nature of the brain as a complex system is often neglected, with many studies treating the language system as a static monolithic structure. Here, we demonstrate that as a specialized and integrated system, the language network is inherently dynamic, characterized by rich patterns of regional interactions, whose transient dynamics are disrupted in patients with temporal lobe epilepsy...
March 15, 2018: Brain: a Journal of Neurology
Aderaldo Costa Alves Junior, Pedro Tadao Hamamoto Filho, Marcelo Pacheco Gonçalves, Aristides Augusto Palhares Neto, Marco Antonio Zanini
Cranioplasty is a common procedure in neurosurgical practice, but associated with high complication rates. In the current study, the authors describe surgical characteristics and results of cranioplasty performed in a tertiary teaching hospital in Brazil. Data were obtained from electronic medical records of cranioplasties performed between January 2013 and November 2016. The sample comprised of 33 patients, and the mean follow-up time was 16 months. Patients presented most of the times a good preoperative status, with 84...
March 16, 2018: Journal of Craniofacial Surgery
Jonathan T Ting, Brian R Lee, Peter Chong, Gilberto Soler-Llavina, Charles Cobbs, Christof Koch, Hongkui Zeng, Ed Lein
This protocol is a practical guide to the N-methyl-D-glucamine (NMDG) protective recovery method of brain slice preparation. Numerous recent studies have validated the utility of this method for enhancing neuronal preservation and overall brain slice viability. The implementation of this technique by early adopters has facilitated detailed investigations into brain function using diverse experimental applications and spanning a wide range of animal ages, brain regions, and cell types. Steps are outlined for carrying out the protective recovery brain slice technique using an optimized NMDG artificial cerebrospinal fluid (aCSF) media formulation and enhanced procedure to reliably obtain healthy brain slices for patch clamp electrophysiology...
February 26, 2018: Journal of Visualized Experiments: JoVE
Benedito Jamilson Araújo Pereira, Antônio Nogueira de Almeida, Wellingson Silva Paiva, Manoel Jacobsen Teixeira, Suely Kazue Nagahashi Marie
Evaluate whether radiotherapy (RT) after the neurosurgical treatment of atypical meningiomas (AM) has an impact on the reduction rate of recurrence. A Medline search through October 2017 using "atypical meningioma" returned 1277 papers for initial review. Inclusion criteria were as follows. We analyzed the database and included articles in which the anatomic pathological classification of atypical meningiomas was in accordance with WHO 2007 or WHO 2016 criteria, patients > 18 years of age, and there was postoperative external beam radiation to the tumor bed...
March 19, 2018: Neurosurgical Review
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Anna S Berghoff, Priscilla K Brastianos
Brain metastases (BMs) reflect an area of high clinical need, as up to 40% of patients with metastatic cancer will develop this morbid and highly fatal complication. Historically, treatment strategies have relied on local approaches including radiosurgery, whole-brain radiotherapy, and neurosurgical resection. Recently, targeted and immune-modulating therapies have shown promising responses and have been introduced in the clinical management of patients with BMs. Recent improvements in genomic technologies have enriched our understanding of BMs and have demonstrated that BMs present with significant genetic divergence from the originating primary tumor, such that potentially targetable genetic alterations are detected only in the BMs...
February 2018: Seminars in Neurology
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Hesham Mostafa Zakaria, Peter Joseph Massa, Richard L Smith, Tarek Hazem Moharram, John Corrigan, Ian Lee, Lonni Schultz, Jianhui Hu, Suresh Patel, Brent Griffith
Preoperative identification of the eloquent brain is important for neurosurgical planning. One common method of finding the motor cortex is by localizing "the Omega sign." No studies have tested the reliability of imaging to identify the Omega sign. We identified 40 recent and consecutive patients who had undergone preoperative functional magnetic resonance imaging for identification of the hand motor area prior to tumor resection. We recruited 11 neurosurgical residents of various levels of training and one board-certified neurosurgeon to identify the hand motor cortex Omega...
January 1, 2018: Neuroradiology Journal
Da Li, Yu-Ming Jiao, Liang Wang, Fu-Xin Lin, Jun Wu, Xian-Zeng Tong, Shuo Wang, Yong Cao
OBJECTIVE Surgical management of brainstem lesions is challenging due to the highly compact, eloquent anatomy of the brainstem. This study aimed to evaluate the safety and efficacy of preoperative diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in brainstem cavernous malformations (CMs). METHODS A prospective randomized controlled clinical trial was performed by using stratified blocked randomization. The primary eligibility criterion of the study was being a surgical candidate for brainstem CMs (with informed consent)...
March 16, 2018: Journal of Neurosurgery
Kyriakos Paraskeva, Dimitrios Giakoumettis, Ioannis Nikas, George Georgoulis, George Sfakianos, Marios S Themistocleous
INTRODUCTION: Neck pain and torticollis are common symptoms in the pediatric population that rarely requires further investigation. However, in case symptoms persist, then a more meticulously approach should be considered. Underlying conditions such as infections, neck injury, autoimmune disorders or even cervical spine cancer should be excluded from diagnosis. Cervical spine cancer is a rare neurosurgical entity in the pediatric population and even rarer is atlantoaxial Ewing's sarcoma...
March 3, 2018: Neurologia i Neurochirurgia Polska
Amer Afaneh, Jennifer Ford, Jenna Gharzeddine, Alexandre Mazar, R David Hayward, Joseph Buck
OBJECTIVE: To determine the likelihood that head injured patients on Warfarin with a negative initial head CT will have a positive repeat head CT. A retrospective chart review of our institution's trauma registry was performed for all patients admitted for blunt head trauma and on Warfarin anti-coagulation from January 2009 to April 2014. Inclusion criteria included patients over 18 years of age with initial GCS ≥ 13, INR greater than 1.5 and negative initial head CT. Initial CT findings, repeat CT findings and INR were recorded...
March 15, 2018: BMC Research Notes
A Yu Lubnin
We present an analytical review of various neurosurgical interventions in conscious patients. An analysis of the literature indicates growing interest in this problem. Craniotomy in conscious patients has been extensively used in resection of space-occupying cerebral lesions in the eloquent hemispheric areas and in epilepsy surgery. In recent years, there have been a number of reports on interventions in conscious patients with other neurosurgical pathologies, which may be regarded as a new emerging tendency in neurosurgery and neuroanesthesiology...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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