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https://www.readbyqxmd.com/read/27920283/what-can-we-do-for-people-with-drug-resistant-epilepsy-the-2016-wartenberg-lecture
#1
Jerome Engel
Treatment goals for epilepsy are no seizures, no side effects, as soon as possible, but these goals are too often unmet. Approximately 1 million people in the United States continue to have seizures despite adequate treatment with antiseizure drugs, representing 40% of those with epilepsy, and 80% of the cost of epilepsy. Drug-resistant epilepsy (DRE) can be associated with developmental delay in infants and young children, and severe disability and morbidity in older children and adults, as well as a mortality rate 5-10 times that of the general population...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27917716/antithrombotic-treatment-management-in-patients-with-intracerebral-hemorrhage-reversal-and-restart
#2
Dimitrios Giakoumettis, George A Alexiou, Dimitrios A Vrachatis, Kostas Themistoklis, Pantelis Stathis, Manolis Vavuranakis, Marios S Themistocleous
BACKGROUND: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages...
December 5, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27913262/neurosurgeons-in-japan-are-exclusively-brain-surgeons
#3
REVIEW
Shunji Asamoto
In Japan, neurosurgeons have mainly treated brain diseases, with most cases involving the spine and spinal diseases historically being treated by orthopedists. Nowadays, spinal surgery is just one of the many subspecialties in the neurosurgical field in Japan. Most patients with neurological deficits or suspected neurological diseases are taken to board-certified neurosurgeons or go to them directly in Japan, not through referrals from family doctors or specialists in other fields. Problems originating in the spine and spinal cord have been overlooked or misdiagnosed in these situations...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913259/-postoperative-delayed-paradoxical-depression-pdpd-after-uncomplicated-intracranial-aneurysm-surgery
#4
Tomas Garzon-Muvdi, Wuyang Yang, Andrew S Luksik, Alejandro Ruiz-Valls, Rafael John Tamargo, Justin Caplan, Rafael J Tamargo
BACKGROUND: Postoperative delayed paradoxical depression (PDPD) is a psychiatric condition described in patients who undergo a major surgery without complications, do not have a history of mood disorders, but nevertheless become clinically depressed. PDPD has been recognized in major surgical interventions such as coronary artery bypass surgery. We sought to determine the incidence and potential factors associated with PDPD after surgical treatment of intracranial aneurysms. METHODS: The cohort of 105 patients was derived from a prospective observational dataset of 3788 consecutive cases of intracranial aneurysms accrued from 1991-2015...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913054/development-of-a-multi-stakeholder-partnership-to-improve-access-to-and-delivery-of-neurosurgical-services-in-ontario
#5
Sunjay Sharma, Des Bohn, Iphigenia Mikroyiannakis, Joslyn Trowbridge, Donna Thompson, Robert Bell, James Rutka
Neurosurgical emergencies require expedient access to definitive care at neurosurgical centers. Neurosurgical resources in province of Ontario are highly centralized, and subsequently, most patients with neurosurgical emergencies will present to non-neurosurgical centers. From 2000-2010, metrics demonstrated the organization of neurosurgical resources might not be optimal. In response to this a program entitled Provincial Neurosurgery Ontario (PNO)- was formed to address these issues in cooperation with neurosurgeons, hospitals and the provincial government...
November 22, 2016: Health Policy
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#6
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27909268/ten-year-review-of-survival-and-management-of-malignant-glioma-in-hong-kong
#7
D Tm Chan, S Yp Hsieh, C Ky Lau, M Km Kam, H Hf Loong, W K Tsang, D Mc Poon, W S Poon
INTRODUCTION: Surgical resection used to be the mainstay of treatment for glioma. In the last decade, however, opinion has changed about the goal of surgical resection in treating glioma. Ample evidence shows that maximum safe resection in glioblastoma improves survival. Neurosurgeons have therefore revised their objective of surgery from diagnostic biopsy or limited debulking to maximum safe resection. Given these changes in the management of glioma, we compared the survival of local Chinese patients with glioblastoma multiforme over a period of 10 years...
December 2, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27907957/surgical-strategies-for-spontaneous-intracerebral-hemorrhage
#8
Wendy Ziai, J Ricardo Carhuapoma, Paul Nyquist, Daniel F Hanley
In recent decades, the medical and surgical treatment of intracerebral hemorrhage (ICH) have become the focus of a number of scientific investigations. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new medical and surgical treatments to facilitate improved clinical outcomes. Currently, two of the most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907955/decompressive-craniectomy-in-neurocritical-care
#9
Erik G Hayman, David B Kurland, Zachary Grunwald, Sebastian Urday, Kevin N Sheth, J Marc Simard
Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906848/calculation-of-an-optic-nerve-injury-risk-profile-before-sphenoid-sinus-surgery
#10
Erdem Atalay Cetinkaya, Koray Koc, Mehmet Fatih Kucuk, Pinar Koc, Nuray Bayar Muluk, Cemal Cingi
OBJECTIVES: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. METHODS: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27906525/the-clinical-utility-of-qsm-disease-diagnosis-medical-management-and-surgical-planning
#11
REVIEW
Sarah Eskreis-Winkler, Yan Zhang, Jingwei Zhang, Zhe Liu, Alexey Dimov, Ajay Gupta, Yi Wang
Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients...
December 1, 2016: NMR in Biomedicine
https://www.readbyqxmd.com/read/27904759/a-review-of-sub-acute-subdural-hematoma-sasdh-with-our-institutional-experience-and-its-management-by-double-barrel-technique-dbt-a-novel-technique
#12
Soubhagya R Tripathy, Pankaj K Swarnakar, Sanjib Mishra, Sudhanshu S Mishra, Manmath K Dhir, Sanjay K Behera, Pratap C Nath, Somnath P Jena, Itibrata Mohanta, Deepak Das, Mani C Satapathy, Sitansu K Rout, Bikash R Behera, Deepak K Parida, Tanushree S Rath
BACKGROUND: Subacute subdural hematoma (SASDH) is an entity which is yet to capture the popular imagination among the neurosurgeons. Its management is often equated clinically to that of the chronic subdural hematoma (CSDH). However, their neurological deterioration is usually rapid, which seems to align them with acute subdural hematoma (ASDH). We proceed for their epidemiological evaluation. The advantages of a novel "double barrel technique (DbT)" over the conventional burrhole drainage are also presented...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904232/inter-professional-practices-of-private-sector-physiotherapists-for-low-back-pain-management-who-how-and-when
#13
Kadija Perreault, Clermont E Dionne, Michel Rossignol, Stéphane Poitras, Diane Morin
Purpose: Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method: A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27903199/the-2016-aans-presidential-address-leading-the-way
#14
H Hunt Batjer, Vin Shen Ban
This AANS presidential address focuses on enduring values of the neurosurgical profession that transcend the current political climate. The address was delivered by Dr. Batjer during a US presidential election year, but the authors have intentionally avoided discussing the current chaos of the American health care system in the knowledge that many pressing issues will change depending on the outcome of the 2016 elections. Instead, they have chosen to focus on clarifying what neurosurgeons, and the American Association of Neurological Surgeons, in particular, stand for; identifying important challenges to these fundamental principles and values; and proposing specific actions to address these challenges...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903189/grade-ii-meningiomas-and-gamma-knife-radiosurgery-analysis-of-success-and-failure-to-improve-treatment-paradigm
#15
Charles A Valery, Matthieu Faillot, Ioannis Lamproglou, Jean-Louis Golmard, Catherine Jenny, Matthieu Peyre, Karima Mokhtari, Jean-Jacques Mazeron, Philippe Cornu, Michel Kalamarides
OBJECTIVE Grade II meningiomas, which currently account for 25% of all meningiomas, are subject to multiple recurrences throughout the course of the disease and represent a challenge for the neurosurgeon. Radiosurgery is increasingly performed for the treatment of Grade II meningiomas and is quite efficient in controlling relapses locally at the site of the lesion, but it cannot prevent margin relapses. The aim of this retrospective study was to analyze the technical parameters involved in producing marginal relapses and to optimize loco-marginal control to improve therapeutic strategy...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903116/endoscopic-endonasal-versus-open-transcranial-resection-of-craniopharyngiomas-a-case-matched-single-institution-analysis
#16
Nelson Moussazadeh, Vishaal Prabhu, Evan D Bander, Ryan C Cusic, Apostolos John Tsiouris, Vijay K Anand, Theodore H Schwartz
OBJECTIVE The authors compared clinical and radiological outcomes after resection of midline craniopharyngiomas via an endoscopic endonasal approach (EEA) versus an open transcranial approach (TCA) at a single institution in a series in which the tumors were selected to be equally amenable to gross-total resection (GTR) with either approach. METHODS A single-institution retrospective review of previously untreated adult midline craniopharyngiomas was performed. Lesions were evaluated by 4 neurosurgeons blinded to the actual approach used to identify cases that were equally amenable to GTR using either an EEA or TCA...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27902558/access-of-patients-with-lumbar-disc-herniations-to-spine-surgeons-the-effect-of-insurance-type-under-the-affordable-care-act
#17
Nidharshan S Anandasivam, Daniel H Wiznia, Chang-Yeon Kim, Ameya V Save, Jonathan N Grauer, Richard R Pelker
STUDY DESIGN: Prospective cohort study. OBJECTIVE: To determine the effects of insurance type (Medicaid vs. a specific private insurance) on patient access to spine surgeons for lumbar disc herniation as measured by (1) acceptance of insurance, (2) need for a referral, and (3) wait time for appointment. SUMMARY OF BACKGROUND DATA: Limited studies have been conducted to examine the issue of patient access to spine surgeons based on different insurance types (Medicaid vs...
November 29, 2016: Spine
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#18
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27899081/endoscopic-endonasal-pituitary-adenomas-surgery-the-surgical-experience-of-178-consecutive-patients-and-learning-curve-of-two-neurosurgeons
#19
Xuefei Shou, Ming Shen, Qilin Zhang, Yichao Zhang, Wenqiang He, Zengyi Ma, Yao Zhao, Shiqi Li, Yongfei Wang
BACKGROUND: We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. METHODS: We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case...
November 30, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27895242/availability-of-endovascular-therapies-for-cerebrovascular-disease-at-primary-stroke-centers
#20
Mark J Alberts, Jean Range, William Spencer, Vicki Cantwell, M J Hampel
BACKGROUND: Endovascular therapies (EVTs) are useful for treating cerebrovascular disease. There are few data about the availability of such services at primary stroke centers (PSCs). Our hypothesis was that some of these services may be available at some PSCs. METHODS: We conducted an internet-based survey of hospitals certified as PSCs by the Joint Commission. The survey inquired about EVTs such as intra-arterial (IA) lytics, IA mechanical clot removal, coiling of aneurysms, and cervical arterial stenting, physician training, coverage models, hospital type, and outcomes...
November 28, 2016: Interventional Neuroradiology
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