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neurosurgical management

A V Kalinovskiy, D A Rzaev, K Yoshimitsu
INTRODUCTION: Modern neurosurgical practice is impossible without access to various information sources. The use of MRI and MSCT data during surgery is an integral part of the neurosurgeon's daily practice. Devices capable of managing an image viewer system without direct contact with equipment simplify working in the operating room. AIM AND OBJECTIVES: To test operation of a non-contact MRI and MSCT image viewer system in the operating room and to evaluate the system effectiveness...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Long Wang, Li Cai, Shuaibin Lu, Hai Qian, Michael T Lawton, Xiang'en Shi
Internal maxillary artery (IMA) bypass has gain momentum in the last 5 years for the treatment of complex cerebrovascular disorders and skull base tumors. However, some issues regarding this treatment modality have been proposed. As one of the most experienced neurosurgical team to perform internal maxillary artery bypass in the world (>100 clinical cases), we reviewed literature in aspects of basic anatomy of maxillary artery with its variations to the lateral pterygoid muscle, initial anastomosis modalities and subsequent exposure techniques in cadaver studies, pre-operative arterial evaluation methods, optimal interposed graft selections and surgical outcome in the management of complex aneurysms, skull base tumors and steno-occlusive disorders...
March 7, 2018: World Neurosurgery
Alessandro Cipriano, Alessio Pecori, Alessandra Eugenia Bionda, Michele Bardini, Francesca Frassi, Francesco Leoli, Valentina Lami, Lorenzo Ghiadoni, Massimo Santini
Prognosis after mild traumatic brain injury (MTBI) on oral anticoagulant therapy (OAT) is uncertain. We evaluated the rate of immediate and delayed traumatic intracranial hemorrhage (ICH) comparing vitamin K antagonists (VKAs) to direct oral anticoagulants (DOACs) and the safety of a clinical management protocol. In this single-center prospective observational study, we enrolled 220 patients on OAT with MTBI. After a first negative CT scan, asymptomatic patients underwent a close neurological observation; if neurologically stable, they were discharged without a second CT scan and followed up for 1 month...
March 8, 2018: Internal and Emergency Medicine
Doortje C Engel, Simone Peraio, Sotirios Bisdas, Jens Schittenhelm, Marcos Tatagiba
No abstract text is available yet for this article.
March 6, 2018: Journal of Neurosurgical Sciences
Junji Wei, Rongcai Jiang, Lihong Li, Dezhi Kang, Guodong Gao, Chao You, Jianmin Zhang, Liang Gao, Qibing Huang, Duanwu Luo, Gang Zhao, Hongyi Zhang, Shuo Wang, Renzhi Wang
OBJECTIVE: China has limited data on stress-related gastrointestinal ulcers in patients admitted for neurosurgical care. This study evaluated the incidence of upper gastrointestinal bleeding (UGIB) and use of stress ulcer prophylaxis (SUP) in Chinese neurocritical care patients (Glasgow Coma Scale [GCS] score ≤ 10). METHODS: This multicenter, retrospective study was performed from January 2015 to July 2015. Medical records of 1468 patients hospitalized during 2014 were reviewed...
March 2, 2018: Current Medical Research and Opinion
Guru Dutta Satyarthee, Datta Raj Sawarkar
No abstract text is available yet for this article.
March 2018: World Neurosurgery
Luis Rafael Moscote-Salazar, Juan Bosco Gonzalez, Andrei F Joaquim, Alfonso Pacheco-Hernandez
No abstract text is available yet for this article.
March 2018: World Neurosurgery
Mallory Peterson, Benjamin C Warf, Steven J Schiff
OBJECTIVE While there is a long history of interest in measuring brain growth, as of yet there is no definitive model for normative human brain volume growth. The goal of this study was to analyze a variety of candidate models for such growth and select the model that provides the most statistically applicable fit. The authors sought to optimize clinically applicable growth charts that would facilitate improved treatment and predictive management for conditions such as hydrocephalus. METHODS The Weibull, two-term power law, West ontogenic, and Gompertz models were chosen as potential models...
March 2, 2018: Journal of Neurosurgery. Pediatrics
Hari S Raman, David D Limbrick, Wilson Z Ray, Dean W Coble, Sophie Church, Ralph G Dacey, Gregory J Zipfel
OBJECTIVE The challenging nature of neurosurgical residency necessitates that appropriate measures are taken by training programs to ensure that residents are properly progressing through their education. Residents who display a pattern of performance deficiencies must be identified and promptly addressed by faculty and program directors to ensure that resident training and patient care are not affected. While studies have been conducted to characterize these so-called "problem residents" in other specialties, no current data regarding the prevalence and management of such residents in neurosurgery exist...
March 2, 2018: Journal of Neurosurgery
Anmol Pandey, Bhaskar Thakur, Florence Hogg, Christian Brogna, Jamie Logan, Roopen Arya, Richard Gullan, Ranjeev Bhangoo, Keyoumars Ashkan
OBJECTIVE Venous thromboembolism (VTE) is a major cause of morbidity in patients undergoing neurosurgical intervention. The authors postulate that the introduction of a routine preoperative deep vein thrombosis (DVT) screening protocol for patients undergoing neurosurgical intervention for brain tumors would result in a more effective diagnosis of DVT in this high-risk subgroup, and subsequent appropriate management of the condition would reduce pulmonary embolism (PE) rates and improve patient outcomes. METHODS The authors conducted a prospective study of 115 adult patients who were undergoing surgical intervention for a brain tumor...
March 2, 2018: Journal of Neurosurgery
Ramsis F Ghaly, Armen Haroutunian, Kenneth D Candido, Nebojsa Nick Knezevic
Background: Altered mental status describes impaired mental functioning ranging from confusion to coma and indicates an illness, either metabolic or structural in nature. Metabolic causes include hypothyroidism, hyperuremia, hypo/hyperglycemia, hypo/hypernatremia, and encephalopathy. The structural causes include tumors, brain hemorrhage, infection, and stroke. To our knowledge, this is the first case in which a patient presented with altered mental status from both metabolic (myxedema coma) and structural diseases (frontal meningioma) with vasogenic edema and midline shift...
2018: Surgical Neurology International
Reid Hoshide, Harrison Faulkner, Mario Teo, Charles Teo
OBJECTIVE There are numerous treatment strategies in the management for large vestibular schwannomas, including resection only, staged resections, resections followed by radiosurgery, and radiosurgery only. Recent evidence has pointed toward maximal resection as being the optimum strategy to prevent tumor recurrence; however, durable tumor control through aggressive resection has been shown to occur at the expense of facial nerve function and to risk other approach-related complications. Through a retrospective analysis of their single-institution series of keyhole neurosurgical approaches for large vestibular schwannomas, the authors aim to report and justify key techniques to maximize tumor resection and reduce surgical morbidity...
March 2018: Neurosurgical Focus
Vikas Vazhayil, Nishanth Sadashiva, Nithish Nayak, A R Prabhuraj, Dhaval Shukla, Sampath Somanna
INTRODUCTION: Colloid cysts are uncommon lesions in the pediatric age group, which most commonly occur in the fourth through fifth decades. The authors hereby report a series of 36 patients with colloid cysts in the pediatric age group. MATERIAL AND METHOD: A retrospective chart review was conducted on all patients with colloid cyst who underwent surgery in our institute between November 2003 and December 2016 (13 years). Patients above the age of 18 were excluded from the study...
February 27, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Assaf Berger, Rotem Tellem, Michal Arad, Uri Hochberg, Tal Gonen, Ido Strauss
Pain is one of the most common symptoms among cancer patients, and particularly in those who suffer from metastatic or terminal disease. There is great importance in delivering good pain management to these patients in order to alleviate their suffering, improve their functional status and their overall quality of life. In most cases, pain management is based on pharmacotherapy with opioids and other medications. However, there are selected patients for whom pharmacotherapy does not achieve acceptable pain relief or is associated with marked side effects...
February 2018: Harefuah
Abraham F Bezuidenhout, Ekkehard M Kasper, Olivier Baledent, Rafael Rojas, Rafeeque A Bhadelia
BACKGROUND: Most patients with pineal cysts referred for neurosurgical consultation have no specific symptoms or objective findings except for pineal cyst size to help in management decisions. Our purpose was to assess the relationship between pineal cyst size and aqueductal CSF flow using PC-MRI. METHODS: Eleven adult patients with pineal cysts (> 1-cm in size) referred for neurosurgical consultations were included. Cyst volume was calculated using 3D T1 images...
February 23, 2018: Journal of Neurosurgical Sciences
David N Holmes, Lara Armstrong, James Bennett, H Neil Simms
Nocardia farcinica and Enterococcus faecium are both rare causes of cerebral abscess. The former is associated with high morbidity and mortality. We describe a neurosurgical approach to the management of multiple intracranial abscesses of dual microbial pathology in an immunocompetent patient to achieve a good outcome.
February 2018: Journal of Surgical Case Reports
Luis C Ascanio, Georgios A Maragkos, Brett C Young, Myles D Boone, Ekkehard M Kasper
Stroke in pregnant women has a mortality rate of 1.4 deaths per 100,000 deliveries. Vascular malformations are the most common cause of hemorrhagic stroke in this population; preeclampsia and other risk factors have been identified. However, nearly a quarter of strokes have an undeterminable cause. Spontaneous intracranial hemorrhage (ICH) is less frequent but results in significant morbidity. The main objective of this study is to review the literature on pregnant patients who had a spontaneous ICH. A systematic review of the literature was conducted on PubMed and the Cochrane library from January 1992 to September 2016 following the PRISMA guidelines...
February 23, 2018: Neurocritical Care
Aziz Waseem, Ismael Ahmed, Shihan Hadeel
BACKGROUND: The neurosurgical management of microcerebral aneurysms with diameter smaller than 3 mm remains a great challenge as many complications can occur. AIM: Our target was to assess the efficacy and usefulness of endovascular treatment of these lesions. METHODS: We did a prospective and retrospective gathering of the results of endovascular treatments for a group of 16 patients with 16 microcerebral aneurysms. Four patients were treated by direct coil embolization, and 12 patients were managed by remodeling techniques...
February 20, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Muhammad AlMatter, Marta Aguilar Péreza, Pervinder Bhogal, Victoria Hellstern, Oliver Ganslandt, Hans Henkes
OBJECTIVES: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of morbidities and fatalities. The continuous evolution of neurosurgical, endovascular and neuro-intensive cares has improved the overall mortality. In this study we sought to evaluate the clinical outcome after aSAH from a single tertiary center. PATIENTS AND METHODS: We retrospectively identified and reviewed all consecutive patients with aSAH treated at our center between 2007 and 2016...
February 13, 2018: Clinical Neurology and Neurosurgery
Yu-Ju Chen, Chao-Liang Chou, Kuan-Ju Lai, Ya-Ju Lin Lin
PURPOSE: Invasive mycosis caused by the Aspergillus, Fusarium, and Mucor can be fetal, especially in the immunocompromised patients with central nervous system (CNS) involvement. Here we present a case of CNS Fusarium infection, and this is the first reported case of Fusarium brain abscess in Taiwan. CASE REPORT: A 65-year-old woman presented with fever and conscious disturbance for 3 days. Neurological examination showed stupor consciousness, neck stiffness, multiple cranial nerves palsy, and bilateral Babinski signs...
September 15, 2017: Acta Neurologica Taiwanica
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