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https://www.readbyqxmd.com/read/28722516/pre-operative-obesity-does-not-predict-poorer-symptom-control-and-quality-of-life-after-lumbar-disc-surgery
#1
Paul M Brennan, James J M Loan, Neil Watson, Pragnesh M Bhatt, Peter Alwyn Bodkin
PURPOSE: We aimed to determine whether there was a difference in post-operative symptomatic control and quality of life (QoL) between patients who were obese (BMI >30) and non-obese (BMI <30) pre-operatively. This information may inform the decision making of Physicians and patients whether to proceed to surgery for management of symptomatic lumbar disc prolapse. METHODS: We conducted a prospective questionnaire-based study of QoL and symptom control in 120 patients with postal follow-up at 3 and 12 months after lumbar disc surgery...
July 19, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#2
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28717753/surgery-for-cns-tumors-in-the-brazilian-national-health-care-system
#3
Luciola Pontes, Maryam Nemati Shafaee, Benjamin Haaland, Gilberto Lopes
PURPOSE: Resource limitations in low- and middle-income countries make the management of CNS tumors challenging, particularly in Brazil, a country with major disparities in socioeconomic status and access to health care. We aimed to evaluate cancer-related neurosurgical procedures in the public health care system. METHODS: On the basis of Brazil's public health system database, we collected data for neurosurgical procedures related to CNS tumors performed between January 2008 and November 2013...
April 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716567/moving-the-goalposts-a-comparison-of-different-definitions-for-primary-external-ventricular-drain-infection-and-its-risk-factors-a-multi-center-study-of-2575-patients
#4
Peter Y M Woo, Hoi-Tung Wong, Jenny K S Pu, Wai-Kei Wong, Larry Y W Wong, Michael W Y Lee, Kwong-Yui Yam, Wai-Man Lui, Wai-Sang Poon
External ventricular drainage is the most common procedure performed in daily neurosurgical practice. One devastating complication is ventriculostomy-associated infection, but the establishment of evidence-based management guidelines has been hindered by the lack of an universal definition. There is also limited data with regard to the utility of comorbidity health indices and surgery-related factors in predicting infection. This study aims to compare the incidence of infection according to five commonly used definitions and to identify risk factors for this complication...
July 14, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28708018/endoscopic-third-ventriculostomy-and-repeat-endoscopic-third-ventriculostomy-in-pediatric-patients-the-dutch-experience
#5
Gerben E Breimer, Ruben Dammers, Peter A Woerdeman, Dennis R Buis, Hans Delye, Marjolein Brusse-Keizer, Eelco W Hoving
OBJECTIVE After endoscopic third ventriculostomy (ETV), some patients develop recurrent symptoms of hydrocephalus. The optimal treatment for these patients is not clear: repeat ETV (re-ETV) or CSF shunting. The goals of the study were to assess the effectiveness of re-ETV relative to initial ETV in pediatric patients and validate the ETV success score (ETVSS) for re-ETV. METHODS Retrospective data of 624 ETV and 93 re-ETV procedures were collected from 6 neurosurgical centers in the Netherlands (1998-2015)...
July 14, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28700464/cryptococcal-meningitis-after-transnasal-transsphenoidal-pituitary-microsurgery-of-acth-secreting-pituitary-adenoma-a-case-report
#6
Yang Liu, Ming Feng, Yong Yao, Kan Deng, Xinjie Bao, Xiaohai Liu, Renzhi Wang
RATIONALE: Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection. PATIENT CONCERNS AND DIAGNOSIS: Here, we report a case of 37-year-old male who had cryptococcal meningitis after transnasal transsphenoidal pituitary microsurgery of a relapsing ACTH-secreting pituitary adenoma...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28694621/the-challenges-of-management-of-high-grade-gliomas-in-nigeria
#7
Chika Anele Ndubuisi, Wilfred C Mezue, Martin Nzegwu, Okwuoma Okwunodulu, Gabriel Ejembi, Samuel C Ohaegbulam
BACKGROUND: High-grade gliomas (HGG) are among the most challenging brain tumors despite many research efforts worldwide. AIM: The aim of this study was to evaluate the local challenges that may influence outcome of HGG managed in a neurosurgical center in Nigeria. METHODOLOGY: Retrospective analysis of prospectively recorded data of patients managed for intracranial HGG at Memfys Hospital for Neurosurgery, Enugu, Nigeria, between the year 2006 and 2015...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28691984/stepwise-rostrocaudal-brainstem-anesthesia-as-a-complication-of-local-anesthesia-a-case-report
#8
Braden Waters, Ryan R Kroll, John Muscedere, Lysa Boissé Lomax, Jessica E Burjorjee
Iatrogenic cranial nerve palsies can rarely complicate neurosurgical, oral maxillofacial, and otolaryngological procedures. Among the most serious complications of cranial nerve palsy is upper airway obstruction, which is life threatening. We present a case of multiple cranial nerve palsies evolving rapidly in a rostrocaudal stepwise fashion after infiltration of lidocaine to repair a cerebrospinal fluid leak in a patient postoccipital craniectomy. This led to hypoxic respiratory failure requiring mechanical ventilation before resolving spontaneously...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28688992/intramedullary-cervical-spinal-cord-abscess
#9
Joshua Bakhsheshian, Paul Kim, Frank Attenello
Intramedullary spinal cord abscesses are rarely encountered in modern neurosurgical practice. Select patients remain at high risk for developing an intramedullary spinal cord abscess, which can result in acute neurologic deficits. Patients with failed conservative management may benefit from early surgical intervention. However, the evidence is limited by level 3 studies. In the following case presentation, the patient failed conservative management for a cervical intramedullary spinal cord abscess and developed acute neurologic deficits...
July 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28681208/surgical-considerations-in-the-optimal-management-of-patients-with-malignant-brain-tumors
#10
REVIEW
Jaclyn J Renfrow, Roy E Strowd, Adrian W Laxton, Stephen B Tatter, Carol P Geer, Glenn J Lesser
Advances in technology are revolutionizing medicine and the limits of what we can offer to our patients. In neurosurgery, technology continues to reduce morbidity, increase surgical accuracy, facilitate tissue acquisition, and promote novel techniques for prolonging survival in patients with neuro-oncologic disease. Surgery has been the backbone of glioma diagnosis and treatment by providing adequate, high quality material for precise histologic diagnosis, and genomic characterization in the setting of significant intratumoral heterogeneity, thus allowing personalized treatment selection in the clinic...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28674345/trend-of-malpractice-litigation-against-neurosurgeons-in-japan-an-analysis-of-disclosed-database-by-courts-in-japan-from-2001-through-2015
#11
Hisashi Nagashima, Yoshitaka Wada, Kazuhiro Hongo
Following the modern raising of public awareness, the numbers of malpractice litigation are increasing in the health care delivery system in Japan despite the extensive efforts of physicians. Authors reviewed the issues of litigation and the reasons for court decision from the healthcare-related negligence lawsuits in the past 15 years in Japan and investigated the cautionary points for reducing potential litigation. Healthcare-related negligence lawsuits between January 2001 and December 2015 were retrieved and sorted in each clinical field from the database in Courts in Japan and investigated on the proportional factors of the claims and court decisions in the neurosurgical field...
June 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28673409/neurosurgical-emergencies-in-sport
#12
REVIEW
Brian Sindelar, Julian E Bailes
Sports related severe brain and spinal cord injuries are medical and potentially surgical emergencies that require timely intervention in order to reduce worsening secondary injury. For this reason, it is important for all medical professionals managing athletic injuries to be knowledgeable in the clinical approach to this type of acute event. This article reviews the initial evaluation of the athlete that occurs on the field and also within the emergency department with a focus on presenting clinical signs of a neurosurgical emergency...
August 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28669694/epidemiology-of-preoperative-hematologic-assessment-of-children-cared-for-in-a-pediatric-emergency-department
#13
Christopher Woll, P Brian Smith, James Walter Fox
OBJECTIVE: To assess frequency of preoperative hematologic testing in a tertiary care pediatric emergency department (PED) and how often these values predict clinical outcome or change management decisions. METHODS: Single-center retrospective cohort study in a tertiary-care children's hospital PED. Patients 0-18years old, presenting between July 1, 2009-July 1, 2011, ultimately undergoing a surgical procedure within 48h of presentation were included. Patients were defined as having "preoperative" hematologic assessment if these studies were performed solely because the child was going to the operative suite...
June 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28669297/establishing-reconstructive-neurosurgery-as-a-subspecialty
#14
Justin M Brown, Mark A Mahan, Ross Mandeville, Bob S Carter
Neurosurgery is experiencing the emergence of a new subspecialty focused on function restoration. New, evolving, and reappraised surgical procedures have provided an opportunity to restore function to many patients with previously undertreated disorders. Candidates for reconstruction were previously limited to those with peripheral nerve and brachial plexus injuries, but this has been expanded to include stroke, spinal cord injury, and a host of other paralyzing disorders affecting both upper and lower motor neurons...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669295/nerve-transfer-versus-muscle-transfer-to-restore-elbow-flexion-after-pan-brachial-plexus-injury-a-cost-effectiveness-analysis
#15
Arvin R Wali, David R Santiago-Dieppa, Justin M Brown, Ross Mandeville
OBJECTIVE Pan-brachial plexus injury (PBPI), involving C5-T1, disproportionately affects young males, causing lifelong disability and decreased quality of life. The restoration of elbow flexion remains a surgical priority for these patients. Within the first 6 months of injury, transfer of spinal accessory nerve (SAN) fascicles via a sural nerve graft or intercostal nerve (ICN) fascicles to the musculocutaneous nerve can restore elbow flexion. Beyond 1 year, free-functioning muscle transplantation (FFMT) of the gracilis muscle can be used to restore elbow flexion...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669268/introduction-to-the-supratentorial-cerebral-arteriovenous-malformation-video-supplement
#16
Robert M Starke, Felipe C Albuquerque, Michael T Lawton
It is with great pleasure that we present this Neurosurgical Focus video supplement on supratentorial cerebral arteriovenous malformations (AVMs). We were privileged to view a remarkable number of outstanding videos demonstrating current state-of-the-art management of brain AVMs using endovascular and microsurgical modalities. Careful and critical review was required to narrow down the submitted videos to a workable volume for this supplement, which reflects the excellent work being done at multiple centers with these lesions...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28665866/intracranial-aneurysms-of-neuro-ophthalmologic-relevance
#17
Jonathan A Micieli, Nancy J Newman, Daniel L Barrow, Valérie Biousse
BACKGROUND: Intracranial saccular aneurysms are acquired lesions that often present with neuro-ophthalmologic symptoms and signs. Recent advances in neurosurgical techniques, endovascular treatments, and neurocritical care have improved the optimal management of symptomatic unruptured aneurysms, but whether the chosen treatment has an impact on neuro-ophthalmologic outcomes remains debated. EVIDENCE ACQUISITION: A review of the literature focused on neuro-ophthalmic manifestations and treatment of intracranial aneurysms with specific relevance to neuro-ophthalmologic outcomes was conducted using Ovid MEDLINE and EMBASE databases...
June 29, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28649230/high-compliance-with-scheduled-nimodipine-is-associated-with-better-outcome-in-aneurysmal-subarachnoid-hemorrhage-patients-cotreated-with-heparin-infusion
#18
Aaron Wessell, Matthew J Kole, Neeraj Badjatia, Gunjan Parikh, Jennifer S Albrecht, David L Schreibman, J Marc Simard
INTRODUCTION: We sought to determine whether compliance with scheduled nimodipine in subarachnoid hemorrhage patients impacted patient outcomes, with the intent of guiding future nimodipine management in patients who experience nimodipine-induced hypotension. METHODS: We performed a retrospective analysis of 118 consecutive aneurysmal subarachnoid hemorrhage patients treated with the Maryland Low-Dose IV Heparin Infusion Protocol. Patients were categorized into three independent nimodipine compliance groups: ≥1 dose held, ≥1 dose split, and no missed or split-doses...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28647660/novel-oral-anticoagulants-in-patients-undergoing-cranial-surgery
#19
Davide Marco Croci, Maria Kamenova, Raphael Guzman, Luigi Mariani, Jehuda Soleman
BACKGROUND: The number of patients treated with NOACS is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACS are still lacking. OBJECTIVES: The aim of this study was to analyze the occurrence of postoperative bleeding events and factors which might influence bleeding rates of these patients. METHODS: Out of 1353 consecutive patients undergoing cranial neurosurgical procedures 30 patients (2...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28645585/thrombocytopenia-and-neurosurgery-a-literature-review
#20
REVIEW
Daphne Li, Taylor Glor, G Alexander Jones
The absence of evidence-based guidelines for platelet transfusion surrounding invasive neurosurgical procedures leads to uncertainty in management. Multiple studies have illuminated this lack of high quality data, and subsequent reliance on expert opinion. The generally accepted threshold for platelet transfusion has hovered around 100,000/μl. We have conducted a review of available clinical literature, in order to identify any evidence that may support or refute these general guidelines, in an attempt to clarify the need for platelet transfusion in the patient requiring neurosurgical intervention...
June 20, 2017: World Neurosurgery
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