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https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#1
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29138073/comparision-of-results-between-posterior-fossa-decompression-with-and-without-duraplasty-for-the-surgical-treatment-of-chiari-malformation-type-i%C3%AF-a-systematic-review-and-meta-analysis
#2
REVIEW
Weiwei Lin, Guman Duan, Jinjin Xie, Jiashen Shao, Zhaoqi Wang, Baohua Jiao
BACKGROUND: Posterior fossa decompression without (PFD) or with duraplasty (PFDD) for the treatment of type 1 Chiari malformation (CM-I) is controversial. We thus did a systematic review and meta-analysis of studies to assess the effect on clinical and imaging improvement, operative time, complications and recurrence rate between PFD and PFDD in patients with CM-I. METHODS: We systematically searched PubMed, Embase, Cochrane, Web of Knowledge, and ClinicalTrials...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29133007/comparison-of-clinical-and-radiographic-outcomes-for-posterior-fossa-decompression-with-and-without-duraplasty-for-treatment-of-pediatric-chiari-i-malformation-a-prospective-study
#3
Enze Jiang, Shifu Sha, XinXin Yuan, WeiGuo Zhu, Jian Jiang, Hongbin Ni, Zhen Liu, Yong Qiu, Zezhang Zhu
No abstract text is available yet for this article.
November 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29130121/chiari-i-malformation-surgical-technique-indications-and-limits
#4
Lorenzo Giammattei, F Borsotti, F Parker, M Messerer
BACKGROUND: Chiari malformation type I (CM-I) is a rare disease characterised by herniation of cerebellar tonsils below the foramen magnum with associated anomalies of posterior fossa. We describe here the surgical technique, indications and limits of surgical treatment. METHOD: The authors describe the surgical technique, including: posterior fossa decompression, opening of the foramen of Magendie and duraplasty in case of CM-I. CONCLUSIONS: Posterior fossa decompression plus duraplasty is a safe and effective procedure for patients with CM-I malformation...
November 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29125448/erratum-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
#5
https://www.readbyqxmd.com/read/29125433/a-points-based-algorithm-for-prognosticating-clinical-outcome-of-chiari-malformation-type-i-with-syringomyelia-results-from-a-predictive-model-analysis-of-82-surgically-managed-adult-patients
#6
Sumit Thakar, Laxminadh Sivaraju, Kuruthukulangara S Jacob, Aditya Atal Arun, Saritha Aryan, Dilip Mohan, Narayanam Anantha Sai Kiran, Alangar S Hegde
OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed...
November 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29027876/intradural-pathology-and-pathophysiology-associated-with-chiari-i-malformation-in-children-and-adults-with-and-without-syringomyelia
#7
Brian J Dlouhy, Jeffrey D Dawson, Arnold H Menezes
OBJECTIVE The pathophysiology underlying tonsillar herniation and CSF obstruction in Chiari malformation Type I (CM-I) is unclear, and the cause of CM-I-associated syringomyelia is not well understood. A better understanding of this pathophysiology is important for an improved treatment strategy. Therefore, the authors sought to identify, characterize, and examine the intradural pathology and CSF flow pathophysiology in the posterior fossa and at the level of the foramen magnum that occurs in the setting of CM-I...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29021676/-stealth-cranioplasty-a-novel-endeavor-for-symptomatic-adult-chiari-i-patients-with-syringomyelia-technical-note-appraisal-and-philosophical-considerations
#8
Asifur Rahman, Md Sumon Rana, Paawan Bahadur Bhandari, Dewan Shamsul Asif, Abu Naim Wakil Uddin, Abu Saleh Mohammad Abu Obaida, Md Atikur Rahman, Md Shamsul Alam
AIM AND OBJECTIVE: In this article, we describe a novel technique of reconstruction of posterior fossa by cranioplasty with use of preshaped titanium mesh following posterior fossa decompression (PFD) for Chiari malformation type I (CMI) with syringomyelia (SM) in symptomatic adults. MATERIALS AND METHODS: Eleven patients underwent limited PFD and expansive cranioplasty with preshaped titanium mesh, what we term as "Stealth Cranioplasty" (SCP), following arachnoid preserving duraplasty (APD) and hexagonal tenting of the duraplasty with the cranioplasty (HTDC) for the management of symptomatic adult CMI with SM...
July 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29017977/syrinx-to-subarachnoid-shunting-for-syringomyelia
#9
Keryn Davidson, Jeffrey M Rogers, Marcus A Stoodley
OBJECTIVE: Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. Optimal management is unclear for idiopathic syringomyelia, or where treatment of the putative cause has failed or is high risk. Syrinx to subarachnoid shunting is an option for these cases; a series is reported to assess the outcomes of this approach. METHODS: We retrospectively analysed the clinical and radiological features of a consecutive series of patients with syringomyelia treated with syrinx to subarachnoid shunting...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973347/a-report-of-2-cases-of-brainstem-hemorrhage-after-suboccipital-craniectomy-for-chiari-decompression
#10
Sean P Polster, Mark C Dougherty, Hussein A Zeineddine, Seon-Kyu Lee, David Frim
BACKGROUND AND IMPORTANCE: Decompression surgery for Chiari malformation is known to have very low procedure-related complications. There has been no report of post-Chiari malformation decompression surgery development of brainstem hemorrhage. We report 2 post-Chiari decompression surgery brainstem hemorrhage cases with 2-yr follow-up. CLINICAL PRESENTATION: Two cases were reviewed in which patients underwent uncomplicated suboccipital craniectomy with expansive autologous pericranium duraplasty for Chiari decompression...
July 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
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
#11
REVIEW
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...
November 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
#12
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...
October 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
#13
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
#14
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
#15
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
#16
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the 2 most commonly used treatments for ruptured cerebral aneurysm. Although 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 rates of aneurysm recurrence. 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...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#17
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
#18
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
#19
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
#20
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
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