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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
Emilie Béquignon, Jean-Philippe Blancal, Jean-Pierre Guichard, Katell Ruellan, Romain Kania, Elisabeth Sauvaget, Damien Bresson, Philippe Herman, Benjamin Verillaud
To date, most frontal mucoceles are treated endoscopically, provided that there is no major neo-osteogenesis and that the frontal sinus floor is wide enough to provide an adequate working space: the presence of a sinus wall dehiscence is not considered as a contraindication to an endoscopic approach. We report on a series of 37 patients presenting with frontal sinus mucoceles with posterior table erosion. Thirty-three (89.2%) had minimal erosion and/or a limited protrusion of the mucocele within the anterior cranial fossa on CT-scan, and were successfully operated on through an endoscopic approach...
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/28327950/a-new-classification-for-pathologies-of-spinal-meninges-part-2-primary-and-secondary-intradural-arachnoid-cysts
#16
Jörg Klekamp
BACKGROUND: Spinal intradural arachnoid cysts are rare causes of radiculopathy or myelopathy. Treatment options include resection, fenestration, or cyst drainage. OBJECTIVE: To classify intradural spinal arachnoid cysts and present results of their treatment. METHODS: Among 1519 patients with spinal space occupying lesions, 130 patients demonstrated intradural arachnoid cysts. Neuroradiological and surgical features were reviewed and clinical data analyzed...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327892/safety-and-efficacy-of-tachosil-absorbable-fibrin-sealant-patch-compared-with-current-practice-for-the-prevention-of-cerebrospinal-fluid-leaks-in-patients-undergoing-skull-base-surgery-a-randomized-controlled-trial
#17
Bernard George, Christian Matula, Lars Kihlström, Enrique Ferrer, Vilhelm Tetens
BACKGROUND: Cerebrospinal fluid (CSF) leakage associated with incomplete sealing of the dura mater is a major complication of intradural procedures. OBJECTIVE: To compare the efficacy and safety of adjunctive TachoSil (Takeda Pharma A/S, Roskilde, Denmark) with current practice for the prevention of postoperative CSF leaks in patients undergoing elective skull base surgery involving dura mater closure. METHODS: Patients were intraoperatively randomized to TachoSil or current practice immediately before primary dura closure by suturing ± duraplasty...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28223250/dorsal-cervical-spinal-cord-herniation-precipitated-by-kyphosis-deformity-correction-for-spinal-cord-tethering
#18
Robert S Heller, Steven W Hwang, Ron I Riesenburger
INTRODUCTION: Cervical spinal cord herniation is a rare clinical entity. Reported after previous intradural surgery or surgery complicated by durotomy, patients return several months to years later with symptoms of worsening myelopathy. Herein is presented a case of a 51-year-old female patient with spinal cord herniation in the cervical spine after kyphosis deformity correction. CASE DESCRIPTION: A 51-year old female patient presented to the neurosurgery clinic with worsening cervical myelopathy due to cervical spinal cord tethering and adhesions from previous intradural surgery for Chiari malformation...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28192262/intraoperative-ultrasonography-for-definition-of-less-invasive-surgical-technique-in-patients-with-chiari-type-i-malformation
#19
Roger Schmidt Brock, Mario Augusto Taricco, Matheus Fernandes de Oliveira, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
INTRODUCTION: Chiari malformation type I (CM) is the main congenital malformation disease of the craniovertebral junction. The ideal surgical treatment is still controversial. Invasive procedures inside the cerebrospinal fluid (CSF) space and associated with dural repair are considered the gold standard; however, less invasive surgery with isolated bone decompression without dural opening may be possible in selected patients. Our study evaluates the efficacy of intraoperative CSF flow measurement with ultrasonography (USG) as a determining parameter in the selection of these patients...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28144849/biocompatible-bacterial-cellulose-membrane-in-dural-defect-repair-of-rat
#20
Frederico de Melo Tavares de Lima, Flávia Cristina Morone Pinto, Belmira Lara da Silveira Andrade-da-Costa, Jaiurte Gomes Martins da Silva, Olávio Campos Júnior, José Lamartine de Andrade Aguiar
Duraplasty is necessary in nearly 30% of all neurological surgeries. Different tissues and materials have been evaluated in dura mater repair or as dural substitutes in neurosurgery. The aim was to evaluate the biocompatibility of the bacterial cellulose (BC) membranes, produced from sugarcane molasses, for dural defect repair in rats. Forty adults males Wistar rats divided into two groups: a control (ePTFE) and an experimental (BC). Bilateral frontoparietal craniectomy was performed, and a dural defect was created...
March 2017: Journal of Materials Science. Materials in Medicine
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