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https://www.readbyqxmd.com/read/28927205/rare-neurosurgical-complications-of-epidural-injections-an-8-yr-single-institution-experience
#1
Gabriel A Smith, Jonathan Pace, Madeleine Strohl, Anand Kaul, Salim Hayek, Jonathan P Miller
BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28925334/comparative-patient-satisfaction-and-feasibility-of-a-pilot-parkinson-s-disease-enrichment-program
#2
Tabina K Choudhury, Celeste Harris, Kathleen Crist, Terry K Satterwhite, Michele K York
BACKGROUND: Available treatment options for Parkinson's disease (PD) are primarily aimed at pharmacological and/or neurosurgical management of motor symptoms. However, many patients also experience chronic non-motor symptoms (NMS), including significant cognitive and mood changes. Currently, there is a gap in the neuropsychological literature regarding the efficacy of nonpharmacological treatment options for cognitive and mood changes in PD. OBJECTIVE: We sought to evaluate the efficacy and patient satisfaction of a pilot nonpharmacological intervention for alleviating NMS in patients with PD...
September 2017: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/28923147/idiopathic-syringomyelia-in-a-military-helicopter-pilot
#3
Anthony Schiemer
BACKGROUND: A syrinx is a fluid-filled cavity within the spinal cord. They can lead to a variety of symptoms, including limb weakness and back pain. Incidental finding of syringomyelia provides a challenge for clinicians due to the wide variety of possible symptoms. In military aviation, neurological findings in pilots can result in extensive investigation that can lead to potentially invasive management. Conversely, the potential for chronic progression of a spinal syrinx and subsequent neurological deterioration makes early identification critical...
October 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#4
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28894384/technology-that-achieves-the-triple-aim-an-economic-analysis-of-the-brainpath%C3%A2-approach-in-neurosurgery
#5
Sidney P Norton, Evan M Dickerson, Charles G Kulwin, Mitesh V Shah
BACKGROUND: The Triple Aim is defined as: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care. The purpose of this analysis was to evaluate the economic value of a new neurosurgical technique, the BrainPath™ approach, for use in patients with subcortical tumors and intracerebral hemorrhage (ICH). METHODS: Inpatient length of stay (LOS) data were collected for ICH and brain tumor surgical patient cases between August 2013 and November 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28891898/vascular-anomalies-of-posterior-fossa-and-their-implications
#6
Rajani Singh, Raj Kumar, Arushi Kumar
Posterior fossa houses very vital and sensitive structures namely midbrain, pons, medulla, and cerebellum. These structures are irrigated by vertebral, posterior inferior cerebellar, anterior inferior cerebellar, and superior cerebellar arteries. Parts of brain located in posterior fossa control important parts of body so any variation pertaining to stenosis, atresia, hypoplasia, fenestration, agenesis, and duplication in the arteries supplying these parts alter the irrigation pattern culminating into various morbid and mortal neurologic disorders...
September 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28884229/time-to-event-analysis-of-surgically-treated-posthemorrhagic-hydrocephalus-in-preterm-infants-a-single-institution-retrospective-study
#7
Rowland H Han, Daniel Berger, Mohamed Gabir, Brandon S Baksh, Diego M Morales, Amit M Mathur, Christopher D Smyser, Jennifer M Strahle, David D Limbrick
PURPOSE: The purpose of this study is to report time points relevant to the neurosurgical management of posthemorrhagic hydrocephalus (PHH). METHODS: Data were collected retrospectively on 104 preterm infants with intraventricular hemorrhage (IVH) who received neurosurgical intervention for PHH at St. Louis Children's Hospital from 1994 to 2016. Kaplan-Meier curves were constructed for various endpoints. RESULTS: IVH grade on head ultrasound obtained through routine clinical care was II, III, and IV in 5 (4...
September 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28882606/managing-spine-surgery-referrals-the-consultation-of-neurosurgery-and-its-nuances
#8
B Debono, P Sabatier, A Koudsie, K Buffenoir, O Hamel
INTRODUCTION: Spinal disorders, particularly low back pain, are among the most common reasons for general practitioner (GP) consultation and can sometimes be a source of professional friction. Despite their frequency and published guidelines, many patients are still mistakenly referred by their GP to specialists for spinal surgery consultation which can create colleague relationship problems, suboptimal or unnessary delayed care, as well as the financial implications for patients. PURPOSE: To assess the management of GP lumbar spine referrals made to 4 neurosurgeons from 3 neurosurgical teams specialized in spinal surgery...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#9
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28868158/near-miss-for-big-red-a-unique-case-of-penetrating-glass-injury-of-the-thoracic-spine-and-posterior-mediastinum
#10
Paul J Deramo, Vaidehi Agrawal, Henry C Jefferson
INTRODUCTION: A 42-year-old female with no significant comorbidities presented to our care with a penetrating glass injury to her mid-thoracic spine after falling backwards onto a table. CASE PRESENTATION: A large fragment of glass was protruding from her spine, and multi-planar computed tomography imaging revealed protrusion through the thoracic spinal vertebrae with the glass shards located 2 mm from the aortic lumen. The management of this patient posed several challenges, including initial care of the patient, evaluation of potentially affected structures and the appropriate sequence of therapeutic interventions...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28844915/moyamoya-disease-in-a-8-year-old-boy-direct-bypass-surgery-in-a-province-of-peru
#11
Joham Choque-Velasquez, Roberto Colasanti, Danil A Kozirev, Juha Hernesniemi, Akitsugu Kawashima
BACKGROUND: Pediatric moyamoya cases may be very arduous, even more in a developing country where the access to specialized centers may be prevented by different factors. CASE DESCRIPTION: Herein, we report a challenging case, which was managed in the new Neurosurgical Center of Trujillo, regarding the direct anastomosis between the left superficial temporal artery and a cortical branch of the left middle cerebral artery in a 8-year-old Peruvian boy with moyamoya disease...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28840075/vestibular-schwannoma-appears-to-be-very-rare-in-a-region-of-sub-saharan-africa
#12
S Ohaegbulam, O Okwunodulu, C Ndubuisi, W Mezue, M Chikani, S Nkwerem, M Ekuma
BACKGROUND: Vestibular schwannoma (VS) is a significant neurosurgical problem hence it enjoys a special attention at conferences and workshops. It accounts for about 8-10% of all intracranial tumors with an annual incidence of about 11-14 per million per year. Most VS are sporadic with 5-10% attributed to neurofibromatosis type 2 (NF2). However, VS is alleged to be rare in Africans and uncommon in African Americans, connoting a racial bias. To our knowledge, no study from sub-Saharan Africa has addressed this subject...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28840065/management-of-acute-subdural-hematoma-in-a-patient-with-portopulmonary-hypertension-on-prostanoid-therapy
#13
Richard Rammo, Adam Robin, Jessin John, Aqueel Pabaney, Panayiotis Varelas, Max Kole
BACKGROUND: Treprostinil is a prostacyclin analog used to treat portopulmonary hypertension (PPHTN) and is one of several drugs shown to increase survival, but results in platelet dysfunction. Little is known about the management of patients on treprostinil who present with an acute subdural hematoma (aSDH). We describe such a case and offer our recommendations on management based on our experience and review of the literature. CASE DESCRIPTION: A 63-year-old, right-handed female with a history of PPHTN presented with severe headache and was found to have a large left aSDH with midline shift on imaging...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28838026/-acute-care-rehabilitation-is-the-first-link-in-a-chain-of-rehabilitation-interventions
#14
Joachim Beyer, Egbert J Seidel
An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation)...
August 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28836877/management-of-hyperglycemia-in-the-neurosurgery-patient
#15
Rene Daniel, Satya Villuri, Kevin Furlong
Hyperglycemia is associated with adverse outcomes in patients who are candidates for or underwent neurosurgical procedures. Specific concerns and settings that relate to these patients are preoperative glycemic control, intraoperative control, management in the neurological intensive care unit (NICU), and postoperative control. In each of these settings, physicians have to ensure appropriate glycemic control to prevent or minimize adverse events. The glycemic control is usually managed by a neurohospitalist in co-management with the neurosurgery team pre- and post-operatively, and by the neurocritical care team in the setting of NICU...
August 30, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28835132/two-year-experience-of-multi-disciplinary-team-mdt-outcomes-for-brain-metastases-in-a-tertiary-neuro-oncology-centre
#16
Daniel Loh, Florence Hogg, Penelope Edwards, Jillian MacColl, Christian Brogna, Ranjeev Bhangoo, Keyoumars Ashkan, Francesco Vergani
Brain metastases (BMs) are the most common intracranial tumour in adults and form a significant proportion of the neuro-oncology workload. Their management has progressed significantly in the last few decades but a gold-standard evidence-based management strategy has not been defined to date and several guidelines based on available evidence exist to support clinical decision-making. This paper evaluates the decision-making process of the neuro-oncology multi-disciplinary team (MDT) in a tertiary neuro-oncology centre over a two-year period...
August 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28828384/management-of-penetrating-skull-base-injury-a-single-institutional-experience-and-review-of-the-literature
#17
Danfeng Zhang, Jigang Chen, Kaiwei Han, Mingkun Yu, Lijun Hou
BACKGROUND: Penetrating skull base injury (PSBI) is uncommon among head injuries, presenting unique diagnostic and therapeutic challenges. Although many cases of PSBIs have been reported, comprehensive understanding of its initial diagnosis, management, and outcome is still unavailable. MATERIALS AND METHODS: A retrospective review was performed for patients treated in neurosurgical department of Changzheng Hospital for PSBIs. Presurgical three-dimensional (3D) Slicer-assisted reconstructions were conducted for each patient...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28802356/intracranial-complications-of-csom-in-pediatric-patients-a-persisting-problem-in-developing-countries
#18
Avani Jain, Nikhil Arora, Ravi Meher, J C Passey, Ramanuj Bansal
BACKGROUND: Intracranial complications (ICC) of chronic suppurative otitis media (CSOM) occur even in the antibiotic area. These complications are commonly seen in pediatric patients due to poor hygiene and low immunity. They are more prevalent in developing countries due to illiteracy, low socioeconomic status and lack of access to health care facilities. OBJECTIVE: To study the incidence, clinical profile, treatment and outcome of pediatric patients presenting with intracranial complications of chronic suppurative otitis media...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28799855/surgical-management-of-cervical-spine-deformity-in-chondrodysplasia-punctata
#19
Nobuhito Morota, Satoshi Ihara, Hideki Ogiwara, Goichiro Tamura
OBJECTIVE Chondrodysplasia punctata (CDP), a rare skeletal dysplasia, can lead to cervical spine instability and deformity. However, an optimal neurosurgical intervention has yet to be established. Thus, a retrospective study was conducted to assess the efficacy of various surgical interventions for children with CDP. METHODS The authors retrospectively reviewed 9 cases of CDP in which cervical decompression with or without posterior fusion was performed between April 2007 and May 2016. Patient demographics, preoperative clinical conditions, radiographic findings, surgical procedures, and the postoperative course were analyzed in detail...
August 11, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28799016/intraparenchymal-intracranial-pressure-monitoring-for-hydrocephalus-and-cerebrospinal-fluid-disorders
#20
Aswin Chari, Debayan Dasgupta, Alexander Smedley, Claudia Craven, Edward Dyson, Samir Matloob, Simon Thompson, Lewis Thorne, Ahmed K Toma, Laurence Watkins
BACKGROUND: Elective intraparenchymal intracranial pressure (ICP) monitoring is useful for the diagnosis and treatment of hydrocephalus and cerebrospinal fluid (CSF) disorders. This retrospective study analyzes median ICP and pulse amplitude (PA) recordings in neurosurgically naïve patients undergoing elective ICP monitoring for suspected CSF disorders. METHODS: Retrospective review of prospectively collated database of neurosurgically naïve patients undergoing elective ICP monitoring for suspected hydrocephalus and CSF disorders...
August 10, 2017: Acta Neurochirurgica
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