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https://www.readbyqxmd.com/read/28331261/bilateral-traumatic-intracranial-hematomas-and-its-outcome-a-retrospective-study
#1
Sharad Pandey, Vivek Sharma, Kulwant Singh, Deepa Pandey, Mukesh Sharma, Deepak Bhanudas Patil, Neeraj Shende, Richa Singh Chauhan
The objective of this study was to evaluate the age distribution, mode of injury, type of hematomas, and their surgical outcome in patients with bilateral traumatic head injuries. The present study included 669 cases of traumatic head injury who presented at the neurosurgery emergency out of which 94 cases had bilateral head injuries from the period of August 2009 to April 2014. The data from the hospital computerized database were retrospectively analysed. Cases of bilateral traumatic head injury included 94 patients out of which 88...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28327980/frontal-sinus-breach-during-routine-frontal-craniotomy-significantly-increases-risk-of-surgical-site-infection-10-year-retrospective-analysis
#2
Joseph R Linzey, Thomas J Wilson, Stephen E Sullivan, B Gregory Thompson, Aditya S Pandey
BACKGROUND: Frontotemporal craniotomies are commonly performed for a variety of neurosurgical pathologies. Infections related to craniotomies cause significant morbidity. We hypothesized that the risk of cranial surgical site infections (SSIs) may be increased in patients whose frontal sinuses are breached during craniotomy. OBJECTIVE: To compare the rate of cranial SSIs in patients undergoing frontotemporal craniotomies with and without frontal sinus breach (FSB)...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327952/risk-of-venous-thromboembolism-and-operative-duration-in-patients-undergoing-neurosurgical-procedures
#3
Kimon Bekelis, Nicos Labropoulos, Shannon Coy
BACKGROUND: The association of operative duration with the risk of venous thromboembolism (VTE) has not been quantified in neurosurgery. OBJECTIVE: To investigate the association of surgical duration for several neurosurgical procedures and the incidence of VTE. METHODS: We performed a retrospective cohort study involving patients who underwent neurosurgical procedures from 2005 to 2012 and were registered in the American College of Surgeons National Quality Improvement Project registry...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#4
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28325463/perioperative-management-of-anticoagulation
#5
REVIEW
Daipayan Guha, R Loch Macdonald
Antiplatelet and anticoagulant drugs (antithrombotics) predispose to acute and chronic subdural hematomas. Patients on these drugs are at higher likelihood of presenting with larger hematomas and more severe neurologic deficits. Standard neurosurgical and neurocritical care of subdural hematomas involves reversal of antithrombosis preoperatively, whereas reversing antiplatelet drugs is less clear. This article highlights the spectrum of antithrombotic agents in common use, their mechanisms of action, and strategies for reversal...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325460/cranioplasty
#6
REVIEW
Matthew Piazza, M Sean Grady
Cranioplasty following craniectomy for trauma is a common, safe neurosurgical procedure that restores the natural cosmesis and protective barrier of the skull and may be instrumental in normalizing cerebrospinal fluid dynamics after decompressive surgery. Understanding the factors influencing patient selection and timing of cranioplasty, the available materials and methods of skull reconstruction, and the technical nuances is critical for a successful outcome. Neurosurgeons must be prepared to manage the complications specific to this operation...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325458/chronic-subdural-hematoma-icu-management
#7
REVIEW
Jeremy T Ragland, Kiwon Lee
Patients with cSDH presenting with new or worsening neurological deficits, especially if they are debilitating and adversely affecting quality of life require urgent medical and surgical attention. Neurological and neurosurgical critical care team need to stabilize the patient by reversing any underlying coagulopathy states in order to prevent further hematoma expansion.In the event of brain herniation and presumed ICP elevation and CPP compromise, step-wise ICP management should be instituted promptly.Seizure prophylaxis treatment is reasonable...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325456/minimally-invasive-surgical-approaches-for-chronic-subdural-hematomas
#8
REVIEW
Ian A Buchanan, William J Mack
Chronic subdural hematomas are one of the most common clinical entities encountered in today's neurosurgical practices owing to an aging population and continued increases in life expectancy. Although there is a role for conservative management, surgical drainage remains the mainstay of current therapy. Regardless of the technique used for hematoma drainage, there is level I evidence to suggest that use of closed-system drainage during the perioperative period significantly decreases the likelihood for hematoma recurrence, length of hospital stay, and mortality...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323182/treatment-of-large-and-giant-middle-cerebral-artery-aneurysms-risk-factors-for-unfavorable-outcomes
#9
Wonhyoung Park, Jaewoo Chung, Jae Sung Ahn, Jung Cheol Park, Byung Duk Kwun
OBJECTIVE: This study aimed to assess the clinical and radiological outcomes after neurosurgical treatment of large and giant aneurysms of the middle cerebral artery (MCA). In addition, we aimed to identify risk factors for unfavorable outcomes. METHODS: This retrospective study included 105 patients with 106 large or giant MCA aneurysms treated with neurosurgical methods, including microsurgery and endovascular treatment, over a 15-year period. RESULTS: The mean aneurysm size was 15...
March 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28321190/skeletal-dysplasias-growing-therapy-for-growing-bones
#10
REVIEW
Angie C Jelin, Elizabeth O'Hare, Karin Blakemore, Eric B Jelin, David Valle, Julie Hoover-Fong
Skeletal dysplasias represent a large and diverse group of rare conditions affecting collagen and bone. They can be clinically classified based on radiographic and physical features, and many can be further defined at a molecular level (Bonafe et al., 2015). Early diagnosis is critical to proper medical management including pharmacologic treatment when available. Patients with severe skeletal dysplasias often have small chests with respiratory insufficiency or airway obstruction and require immediate intubation after birth...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28318956/carotid-endarterectomy-to-remove-retained-solitaire-stent-retriever-inside-carotid-stent-after-mechanical-thrombectomy
#11
Mary In-Ping Huang Cobb, Tony P Smith, Patrick A Brown, L Fernando Gonzalez, Ali R Zomorodi
BACKGROUND: Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT: A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot...
March 16, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28314403/management-of-cavernous-sinus-involvement-in-sinonasal-and-ventral-skull-base-malignancies
#12
REVIEW
Amol Raheja, William T Couldwell
Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. The article discusses the indications, techniques, nuances, advantages, limitations, and complications of minimally invasive CS biopsy, transcranial microscopic, and transfacial endoscopic approaches to the CS using illustrative diagrams and operative videos...
April 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28306420/ventriculo-ureteral-shunt-insertion-using-percutaneous-nephrostomy-a-novel-minimally-invasive-option-in-a-patient-with-chronic-hydrocephalus-complicated-by-multiple-distal-ventriculoperitoneal-shunt-failures
#13
Ashok Pillai, Georgie Mathew, Sivasankaran Nachimuthu, Sanjeevan Vasudevan Kalavampara
The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#14
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#15
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28299313/perioperative-factors-contributing-the-post-craniotomy-pain-a-synthesis-of-concepts
#16
REVIEW
Tumul Chowdhury, Rakesh Garg, Veena Sheshadri, Lakshmi Venkatraghavan, Sergio Daniel Bergese, Ronald B Cappellani, Bernhard Schaller
The perioperative management of post-craniotomy pain is controversial. Although the concept of pain control in non-neurosurgical fields has grown substantially, the understanding of neurosurgical pain and its causative factors in such a population is inconclusive. In fact, the organ that is the center of pain and its related mechanisms receives little attention to alleviate distress during neurosurgical procedures. In contrast to the old belief that pain following intracranial surgery is minimal, recent data suggest the exact opposite...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28298034/a-protocol-for-postoperative-admission-of-elective-craniotomy-patients-to-a-non-icu-or-step-down-setting
#17
Jeffrey E Florman, Deborah Cushing, Lynne A Keller, Anand I Rughani
OBJECTIVE Selecting the appropriate patients undergoing craniotomy who can safely forgo postoperative intensive care unit (ICU) monitoring remains a source of debate. Through a multidisciplinary work group, the authors redefined their institutional care process for postoperative monitoring of patients undergoing elective craniotomy to include transfer from the postanesthesia care unit (PACU) to the neurosurgical floor. The hypothesis was that an appropriately selected group of patients undergoing craniotomy could be safely managed outside the ICU in the postoperative period...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28293961/commentary-preconceptions-about-the-neurosurgical-management-of-brain-metastases
#18
Rasheed Zakaria, Michael D Jenkinson
No abstract text is available yet for this article.
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28292204/a-national-survey-of-the-management-of-patients-with-incidental-meningioma-in-the-united-kingdom
#19
Mujtaba H Mohammad, Emmanuel Chavredakis, Rasheed Zakaria, Andrew Brodbelt, Michael D Jenkinson
BACKGROUND: Incidental meningiomas are increasingly being diagnosed due to widespread use of brain imaging. Treatment options include surveillance, surgery and stereotactic radiosurgery, but the natural history of these tumours is not fully understood and there are no accepted management guidelines to aid clinical decision-making. The aim of this study was to assess current practice in the United Kingdom and identify areas of variation for further study. METHODS: A questionnaire was distributed to all members of the Society of British Neurosurgeons (SBNS)...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28290395/indian-society-of-neuro-oncology-consensus-guidelines-for-the-contemporary-management-of-medulloblastoma
#20
Tejpal Gupta, Chitra Sarkar, Vedantam Rajshekhar, Sandip Chatterjee, Neelam Shirsat, Dattatreya Muzumdar, Sona Pungavkar, Girish Chinnaswamy, Rakesh Jalali
INTRODUCTION: The high success rate in the management medulloblastoma achieved in the western world is not exactly mirrored in developing countries including India. Socio-demographic differences, health-care disparity, and lack in uniformity of care with resultant widespread variations in the clinical practice are some of the reasons that may partly explain this difference in outcomes. Patients with medulloblastoma require a multi-disciplinary team approach involving but not limited to neuro-radiology, neurosurgery; neuropathology, molecular biology, radiation oncology, pediatric medical oncology and rehabilitative services for optimizing outcomes...
March 2017: Neurology India
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