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https://www.readbyqxmd.com/read/28885133/the-addition-of-duraplasty-to-posterior-fossa-decompression-in-the-surgical-treatment-of-pediatric-chiari-malformation-type-i-a-systematic-review-and-meta-analysis-of-surgical-and-performance-outcomes
#1
Victor M Lu, Kevin Phan, Sean P Crowley, David J Daniels
OBJECTIVE Surgery is the definitive treatment of Chiari malformation Type I (CM-I). It involves posterior fossa decompression, which can be performed along with C-1 laminectomy, reconstructive duraplasty, or tonsil shrinkage. The aim of this study was to provide an updated systematic review and meta-analysis of the latest available evidence regarding posterior fossa decompression only (PFDO) versus posterior fossa decompression with duraplasty (PFDD) in the treatment of CM-I in children. METHODS A literature search was performed in compliance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for article identification, screening, eligibility, and inclusion...
September 8, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#2
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
August 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28838875/comparison-of-porcine-and-bovine-collagen-dural-substitutes-in-posterior-fossa-decompression-for-chiari-i-malformation-in-adults
#3
Christine K Lee, Tara Mokhtari, Ian D Connolly, Gordon Li, Lawrence M Shuer, Steven D Chang, Gary K Steinberg, Melanie Hayden Gephart
BACKGROUND: Posterior fossa decompression surgeries for Chiari malformations are susceptible to post-operative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been employed to improve surgical outcomes. OBJECTIVE: This study examined whether the collagen matrix dural substitute type correlated with the incidence of post-operative complications following posterior fossa decompression in adult patients with Chiari I malformations...
August 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28838117/technique-for-mini-open-decompression-of-chiari-type-i-malformation-in-adults
#4
Peyman Pakzaban
BACKGROUND: The technique for decompression of Chiari type I malformation relies on open exposure of craniocervical junction for suboccipital craniectomy and upper cervical laminectomy with or without duraplasty. There is no detailed technical report of a minimally invasive approach for Chiari decompression in adults. OBJECTIVE: To describe a mini-open technique for decompression of Chiari type I malformation (including duraplasty) in adults. METHODS: Six consecutive adult patients with symptomatic Chiari type I malformation underwent decompression through a 3 to 4 cm midline incision via a speculum retractor...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28796104/seizure-after-cranioplasty-incidence-and-risk-factors
#5
Haifeng Wang, Kewei Zhang, Hongshi Cao, Xiaohong Zhang, Ye Li, Qiang Wei, Dezhi Zhang, Qian Jia, Li Bie
BACKGROUND: To investigate clinical characteristics of postcranioplasty seizures (PCS) first observed after cranioplasty after decompressive craniectomy (DC) to treat traumatic brain injury and to define factors that increase PCS risk. METHODS: This retrospective study, covering the period between January 2008 and July 2015, compared PCS in postcranioplasty patients. Postcranioplasty seizures risk factors included diabetes mellitus, hypertension, time between DC and cranioplasty, duraplasty material, cranioplasty contusion location, electrocautery method, PCS type, and infection...
September 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#6
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#7
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28693072/-comparison-of-posterior-fossa-decompression-with-and-without-duraplasty-for-surgical-management-for-adult-chiari-malformation-type-%C3%A2
#8
H Y Li, Y M Li, H Chen, Y Li, X W Shi
Objective: To evaluate and compare the efficacy between posterior fossa decompression without duraplasty (PFD) and posterior fossa decompression with duraplasty (PFDD) in the surgical management for adult Chiari Ⅰ malformation. Methods: Fifty-seven patients suffered from Chiari malformation type Ⅰ were treated in Department of Neurosurgery, Henan Provincial People's Hospital from August 2008 to October 2013. Twenty-three patients received posterior fossa decompression without duraplasty and the other 34 patients received posterior fossa decompression with duraplasty...
July 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28665861/reconstruction-of-a-marjolin-ulcer-defect-of-the-scalp-invading-brain-and-causing-brain-abscess-formation-using-free-latissimus-dorsi-flap
#9
Goktekin Tenekeci, Alper Sari, Vural Hamzaoglu, Hakan Ozalp
Marjolin ulcers are known as aggressive malignant tumors that mostly arise over chronic wounds and cutaneous scars. Brain abscess is a serious medical condition that requires surgical drainage along with antibiotic treatment. Here, we report a case with a Marjolin ulcer located over the right parietal bone with intracranial abscess formation along with tumor invasion into brain parenchyma. This patient was a 64-year-old man and had a 4 × 4 cm open wound on his scalp from which a purulent discharge was coming...
June 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28665388/-posterior-decompression-of-the-craniovertebral-junction-in-syringomyelia-combined-with-chiari-1-malformation-in-children
#10
A V Sanakoeva, A E Korshunov, Sh U Kadyrov, E A Khukhlaeva, Yu V Kushel'
OBJECTIVE: to develop the algorithm for defining the amount of posterior decompression of the craniovertebral junction in children with syringomyelia combined with Chiari-1 malformation. MATERIAL AND METHODS: Sixty eight children with syringomyelia and Chiari-1 malformation, under age of 18 years, underwent posterior decompression of the craniovertebral junction (PDCVJ) in the period from January 2001 to June 2016. Seven (10%) patients underwent extradural decompression (EDD), 16 (24%) patients underwent extra-arachnoid duraplasty (EAD), 25 (37%) patients underwent intra-arachnoid dissection (IAD) and duraplasty, and 20 (29%) patients underwent PDCVJ and placement of a fourth ventricle-subarachnoid shunt...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28644544/the-frontal-peak-sign-a-potential-new-indication-of-open-approach-in-frontal-sinus-mucoceles-with-posterior-table-erosion-a-retrospective-chart-review-of-thirty-seven-patients
#11
E Béquignon, J-P Blancal, J-P Guichard, K Ruellan, R Kania, E Sauvaget, D Bresson, P Herman, B Verillaud
No abstract text is available yet for this article.
June 23, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28585676/evaluation-of-apparent-diffusion-coefficients-in-the-cerebellar-tonsils-and-bulbus-in-chiari-type-i-malformations-comparison-before-and-after-surgery
#12
Bekir Akgun, Sait Ozturk, Ismail Taskent, Mehmet Besir Surme, Fatih Serhat Erol, Hanefi Yildirim
AIM: To evaluate the preoperative and postoperative 6th month mean apparent diffusion coefficient (ADC) values of the cerebellar tonsils and bulbus in patients with Chiari Malformation Type I (CMI), and to compare the results with healthy controls. MATERIAL AND METHODS: We included 15 patients with CMI who underwent suboccipital decompression, upper cervical laminectomy, and duraplasty surgery, and compared them with 10 healthy individuals. Three regions of interest were placed, one each in the cerebellar tonsils and one in the bulbus...
May 7, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28575349/safety-and-efficacy-of-a-novel-self-adhering-dural-substitute-in-a-canine-supratentorial-durotomy-model
#13
Kevin M Lewis, Jenifer Sweet, Scott T Wilson, Serge Rousselle, Heinz Gulle, Bernhard Baumgartner
BACKGROUND: Cerebrospinal fluid (CSF) leaks increase postoperative risk for complication, likelihood of reoperation, and costs. OBJECTIVE: To investigate a novel, self-adhering polyethylene glycol-coated collagen pad (PCC) as a dural substitute relative to Duragen XS (DGX; Integra LifeSciences Corporation, Plainsboro, New Jersey) and as a dural sealant relative to Tachosil (Takeda Austria GmbH, Linz, Austria), a fibrinogen and thrombin-coated collagen pad (FTC)...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28532916/spinal-intramedullary-tuberculosis-with-concurrent-supra-and-infratentorial-intracranial-disease-in-a-9-month-old-boy-case-report-and-review-of-the-literature
#14
REVIEW
Michael George Zaki Ghali, Visish M Srinivasan, C J Kim, Archana Malik
Tuberculous involvement of the spinal cord parenchyma is an exceedingly rare clinical entity; even more so is concurrent intracranial tuberculosis (TB). Spinal intramedullary TB presents with a characteristic subacute myelopathy, with slowly progressive paraplegia, sensory deficits, and/or bowel and bladder dysfunction. Diagnosis is strongly suspected with a clinical history of known TB in conjunction with characteristic findings on magnetic resonance imaging. Management involves multi-agent antitubercular chemotherapy without or with operative intervention...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28484540/a-common-case-with-an-unusual-association-chiari-i-malformation-with-holocord-syrinx
#15
Sumit Bansal, Sachin A Borkar, Ashok K Mahapatra
Authors are presenting a common case of Chiari malformation but with a very unusual associated finding, holocord syringomyelia, which responded to posterior fossa decompression. An 11-year-old male patient presented with progressive left hemiparesis and numbness on left half of the body for 4 years. Magnetic resonance imaging of the spine revealed peg-shaped herniation of tonsils 8 mm below the foramen magnum and holocord syringomyelia. No focal intraspinal mass was seen. Chiari I malformation with holocord syrinx was diagnosed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28437811/symptomatic-outcome-after-bone-only-suboccipital-decompression-in-adult-patients-with-chiari-type-i-malformations-in-the-absence-of-hydromyelia-or-hydrocephalus
#16
Nicolas Olmo Koechlin, Hazem J Abuhusain, Manuri Gunawardena, Tyler S Auschwitz, Charles Teo
Background Type I Chiari malformation presents without an associated hydromyelia in 30 to 70% of cases, yet there is no agreement regarding the optimal surgical treatment for these patients. We review our experience for treating symptomatic adult type I Chiari malformation without hydromyelia using a suboccipital bone decompression of the hindbrain and no duraplasty in 12 adult patients. Outcome was measured according to the Chicago Chiari Outcome Scale (CCOS). Results Nine of 12 patients were female; average age at surgery was 34...
July 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28427053/growing-skull-fracture-and-the-orbitocranial-variant-nuances-of-surgical-management
#17
Vikram Singh, Gopalakrishnan M Sasidharan, Dhananjaya Ishwar Bhat, Bhagavatula Indira Devi
AIMS: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. METHODS: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28407447/hierarchical-micro-nanofibrous-bioscaffolds-for-structural-tissue-regeneration
#18
Yun Xu, Wenguo Cui, Yanxia Zhang, Pinghui Zhou, Yong Gu, Xiaofeng Shen, Bin Li, Liang Chen
Various biomimetic scaffolds with hierarchical micro/nanostructures are designed to closely mimic native extracellular matrix network and to guide cell behavior to promote structural tissue generation. However, it remains a challenge to fabricate hierarchical micro/nanoscaled fibrous scaffolds with different functional components that endow the scaffolds with both biochemical and physical features to exert different biological roles during the process of tissue healing. In this study, a biomimetic designed micro/nanoscaled scaffold with integrated hierarchical dual fibrillar components is fabricated in order to repair dura mater and prevent the formation of epidural scars via collagen molecule self-assembly, electrospinning, and biological interface crosslinking strategies...
April 13, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28384597/no-significant-difference-between-chiari-malformation-type-1-5-and-type-i
#19
Wei Liu, Hongxing Wu, Yalikun Aikebaier, Maoliti Wulabieke, Rexiti Paerhati, Xiaopeng Yang
OBJECTIVE: Chiari malformation Type 1.5 (CM 1.5) was defined as the association of Chiari malformation Type I (CM I) and brainstem herniation. The objective was to demonstrate the difference of clinical features and surgical outcomes between CM 1.5 and CM I. PATIENTS AND METHODS: All CM 1.5 and CM I adult patients who underwent posterior fossa decompression with duraplasty at our institution between 2006 and 2010 were retrospectively reviewed. Clinical characteristics, imaging features, and long-term outcomes were compared between CM 1...
March 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28357687/efficacy-and-safety-of-non-suture-dural-closure-using-a-novel-dural-substitute-consisting-of-polyglycolic-acid-felt-and-fibrin-glue-to-prevent-cerebrospinal-fluid-leakage-a-non-controlled-open-label-multicenter-clinical-trial
#20
MULTICENTER STUDY
Shunsuke Terasaka, Toshiaki Taoka, Satoshi Kuroda, Nobutaka Mikuni, Toru Nishi, Hiroyuki Nakase, Yukihiko Fujii, Yasuhiko Hayashi, Jun-Ichi Murata, Ken-Ichiro Kikuta, Toshihiko Kuroiwa, Sachie Shimokawa, Kiyohiro Houkin
The objective of this study is to evaluate the efficacy and safety of non-suture dural closure using a novel dural substitute (GM111) consisting of polyglycolic acid felt with a fibrin-glue-coated area commensurate in size with the dural defect. This was a non-controlled, open-label, multicenter clinical trial. The efficacy evaluation endpoints were (1) GM111's intra-operative capability to close dural defects and (2) prevention of cerebrospinal fluid (CSF) leakage and subcutaneous CSF retention throughout the postoperative period (evaluated by diagnostic imaging)...
May 2017: Journal of Materials Science. Materials in Medicine
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