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https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#1
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29152469/eyebrow-incision-for-surgical-evacuation-of-a-lobar-intracerebral-hematoma-with-a-novel-endoport-system
#2
Dale Ding, Colin J Przybylowski, Robert M Starke, R Webster Crowley, Kenneth C Liu
Large lobar intracerebral hemorrhages (ICHs) can cause rapid neurological deterioration, and affected patients have low rates of survival and functional independence. Currently, the role of surgical intervention in the management patients with lobar ICHs is controversial. Minimally invasive technologies have been developed which may potentially decrease the operative morbidity of ICH surgery. The aim of this case report is to describe the technical aspects of the use of a novel minimally invasive endoport system, the BrainPath (NICO, Indianapolis, IN, USA), through an eyebrow incision for evacuation of a large lobar hematoma...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29145275/asymptomatic-syringomyelia-accompanied-with-metastatic-cerebellar-and-spinal-intramedullary-lymphoma-a-case-report
#3
Jia-Jia Zhou, Jin-Feng Xu, Xu-Ning Zheng, Guo-Ping Peng
RATIONALE: Asympotamic syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma is rare in clinical practice. If the intramedullary lymphoma is large enough, the patient will rapidly develop neurologic signs of spinal injury. The prognosis of this type of complication is always bad. PATIENT CONCERNS: Rapid and correct diagnosis and treatment is important for metastatic extranodal lymphoma with B cell of origin. DIAGNOSES: Syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29139010/radiobiology-and-radiotherapy-of-brain-metastases
#4
Anuradha Thiagarajan, Yoshiya Yamada
Brain metastases are the most common intracranial tumors in adults, accounting for more than 50% of all such cases. The approach to and management of brain metastases have evolved significantly in recent years due to several reasons. These include advances in neurosurgical and radiotherapeutic techniques, improved systemic therapy options offering better systemic and intracranial disease control and prolongation of survival as a result of these improvements, making side-effects of proposed therapies (e.g. neurocognitive decline from whole brain radiotherapy) an important consideration...
November 14, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29135727/comparative-cost-analysis-of-single-and-mutli-stage-temporal-deformity-correction-following-neurosurgical-procedures
#5
Anthony Asemota, Gabriel F Santiago, Susan Zhong, Chad R Gordon
PURPOSE: Temporal hollowing deformity (THD) is a visible concavity/convexity in the temporal fossa; a complication often seen following neurosurgical/craniofacial procedures. Although numerous techniques have been described, no study to date has shown the healthcare costs associated with temporal hollowing correction surgery. Thus, the purpose here is to compare and contrast the direct costs related to temporal cranioplasty using various methods including: liquid poly-methyl-methacrylate (PMMA) implants with screw fixation, prebent, modified titanium mesh implants, and customized cranial implants (CCIs) with dual-purpose design...
November 9, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29135566/management-of-hypertonia-in-cerebral-palsy
#6
Nickolas J Nahm, H Kerr Graham, Mark E Gormley, Andrew G Georgiadis
PURPOSE OF REVIEW: The review provides an update on the treatment of hypertonia in cerebral palsy, including physical management, pharmacotherapy, neurosurgical, and orthopedic procedures. RECENT FINDINGS: Serial casting potentiates the effect of Botulinum neurotoxin A injections for spasticity. Deep brain stimulation, intraventricular baclofen, and ventral and dorsal rhizotomy are emerging tools for the treatment of dystonia and/or mixed tone. The long-term results of selective dorsal rhizotomy and the timing of orthopedic surgery represent recent advances in the surgical management of hypertonia...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29131135/interhemispheric-and-infratentorial-subdural-empyema-with-preseptal-cellulitis-as-complications-of-sinusitis-a-case-report
#7
Muhammad Reza Arifianto, Achmad Zuhro Ma'ruf, Arie Ibrahim, Abdul Hafid Bajamal
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29128284/-brain-injury-knowledge-in-family-members-of-neurosurgical-patients
#8
Blanca Navarro-Main, Ana M Castaño-León, Pablo M Munarriz, Pedro A Gómez, Marcos Rios-Lago, Alfonso Lagares
BACKGROUND AND OBJECTIVES: Several studies have shown misconceptions about brain injury in different populations. The aim of this study was to assess the knowledge and perceptions about brain injury of family members of neurosurgical patients in our hospital. MATERIAL AND METHODS: The participants (n=81) were relatives of patients admitted to the neurosurgery department between February and August 2016. They voluntarily completed a 19-item true-false format survey about brain injury based on a translation of other questionnaires used in previous studies from other countries (USA, Canada, UK, Ireland and New Zealand)...
November 8, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29125525/early-postnatal-bladder-function-in-fetoscopic-myelomeningocele-repair-patients
#9
Gene O Huang, Michael A Belfort, William E Whitehead, Oluyinka O Olutoye, Jonathan Castillo, Heidi Castillo, Kathryn K Ostermaier, Chester J Koh, Duong D Tu
PURPOSE: Prenatal repair of myelomeningocele (MMC) via hysterotomy has demonstrated neurosurgical and motor benefits, when compared to postnatal repairs. Urologic benefits, however, remain to be seen. The purpose of this study was to review early postnatal bladder function in patients undergoing a novel endoscopic approach for MMC repair using an exteriorized uterus. METHODS: A prospective urologic assessment of patients undergoing fetoscopic MMC repair and receiving subsequent care at our facility, was performed...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29125443/neurosurgical-management-in-children-with-bleeding-diathesis-auditing-neurological-outcome
#10
Zaitun Zakaria, Chandrasekaran Kaliaperumal, Darach Crimmins, John Caird
OBJECTIVE The aim of this study was to assess the outcome of neurosurgical treatment in children with bleeding diathesis and also to evaluate the current management plan applied in the authors' service. METHODS The authors retrospectively analyzed all cases in which neurosurgical procedures were performed in pediatric patients presenting with intracranial hematoma due to an underlying bleeding tendency over a 5-year period at their institution. They evaluated the patients' neurological symptoms from the initial referral, hematological abnormalities, surgical treatment, neurological outcome, and scores on the Pediatric Glasgow Outcome Scale-Extended (GOS-E Peds) obtained 1 year after the last operation...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29125266/decision-making-in-very-severe-traumatic-brain-injury-glasgow-coma-scale-3-5-a-literature-review-of-acute-neurosurgical-management-of-the-most-severely-threatened-brain-trauma-patients
#11
Jeroen van Dijck, Florence Reith, Inge van Erp, Thomas van Essen, Andrew Maas, Wilco C Peul, Godard de Ruiter
BACKGROUND: Patients presenting with an early GCS score of 3-5 after blunt or penetrating skull-brain assaults are categorized as having sustained a very severe Traumatic Brain Injury (vs-TBI). This category is often overlooked in literature. Impact on patients and families lives however is huge and the question "whether to surgically treat or not" frequently poses a dilemma to treating physicians. Little is known about mortality and outcome, compared to what is known for the group of severe TBI patients (s-TBI) (GCS 3- 8)...
November 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29122895/migration-of-ventriculoperitoneal-shunt-to-urethral-and-rectal-orifices
#12
Banan Osman, Stella Roushias, Rachel Hargest, Krishna Narahari
Ventriculoperitoneal (VP) shunt surgery remains the most widely used neurosurgical procedure for the management of hydrocephalus. However, shunt complications are common and may require multiple surgical procedures during a patient's lifetime. We report the case of a 29-year-old patient with a background of Dandy-Walker malformation, occipital encephalocele, recurrent hydrocephalus, spina bifida and epilepsy presented with VP shunt migration into urinary and gastrointestinal tracts. In absence of sepsis or peritonism from either bowel or bladder perforation, local control of stent extrusion was successful for several years, although surgery was eventually undertaken...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29122306/carmustine-wafer-implantation-for-high-grade-gliomas-evidence-based-safety-efficacy-and-practical-recommendations-from-the-neuro-oncology-club-of-the-french-society-of-neurosurgery
#13
REVIEW
A Roux, F Caire, J Guyotat, P Menei, P Metellus, J Pallud
There is a growing body of evidence that carmustine wafer implantation during surgery is an effective therapeutic adjunct to the standard combined radio-chemotherapy regimen using temozolomide in newly diagnosed and recurrent high-grade glioma patient management with a statistically significant survival benefit demonstrated across several randomized clinical trials, as well as prospective and retrospective studies (grade A recommendation). Compelling clinical data also support the safety of carmustine wafer implantation (grade A recommendation) in these patients and suggest that observed adverse events can be avoided in experienced neurosurgeon hands...
November 6, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#14
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29110198/surgical-management-of-craniosynostosis-in-the-setting-of-a%C3%A2-ventricular-shunt-a-case-series-and-treatment-algorithm
#15
Michael S Golinko, Danielle N Atwood, Eylem Ocal
PURPOSE: Cerebrospinal fluid diversion via ventricular shunt is a common treatment for hydrocephalus. Change in cranial morphology associated with a sutural fusion has been termed shunt-related or induced craniosynostosis (SRC) or craniocerebral disproportion (CCD). We present a series of patients with SRC who underwent cranial vault remodeling (CVR) and our treatment algorithm. METHODS: Thirteen patients were retrospectively reviewed who had SRC and CVR; 92% of patients had a ventriculoperitoneal (VP) shunt placed for largely intraventricular hemorrhage of prematurity (69% of patients) at a mean age of 2...
November 6, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29106685/a-retrospective-propensity-score-matched-early-thromboembolic-event-analysis-of-prothrombin-complex-concentrate-vs-fresh-frozen-plasma-for-warfarin-reversal-prior-to-emergency-neurosurgical-procedures
#16
Prateek Agarwal, Kalil G Abdullah, Ashwin G Ramayya, Nikhil R Nayak, Timothy H Lucas
BACKGROUND: Reversal of therapeutic anticoagulation prior to emergency neurosurgical procedures is required in the setting of intracranial hemorrhage. Multifactor prothrombin complex concentrate (PCC) promises rapid efficacy but may increase the probability of thrombotic complications compared to fresh frozen plasma (FFP). OBJECTIVE: To compare the rate of thrombotic complications in patients treated with PCC or FFP to reverse therapeutic anticoagulation prior to emergency neurosurgical procedures in the setting of intracranial hemorrhage at a level I trauma center...
June 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29097132/cavernous-carotid-stenosis-following-stereotactic-radiosurgery-for-cushing-s-disease-a-rare-complication-and-review-of-the-literature
#17
Mohana Rao Patibandla, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
Intracranial carotid stenosis or occlusion after SRS is an extraordinarily rare event. Because of the rarity of this event, increased awareness within the neurosurgical community is required. For those with post-radiosurgical carotid stenosis who are asymptomatic, longitudinal follow up is recommended. Management depends on whether the patient is symptomatic or asymptomatic. Those who are symptomatic may require balloon angioplasty, stenting, or bypass surgery.
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29088962/complications-of-invasive-intracranial-pressure-monitoring-devices-in-neurocritical-care
#18
Samon Tavakoli, Geoffrey Peitz, William Ares, Shaheryar Hafeez, Ramesh Grandhi
Intracranial pressure monitoring devices have become the standard of care for the management of patients with pathologies associated with intracranial hypertension. Given the importance of invasive intracranial monitoring devices in the modern neurointensive care setting, gaining a thorough understanding of the potential complications related to device placement-and misplacement-is crucial. The increased prevalence of intracranial pressure monitoring as a management tool for neurosurgical patients has led to the publication of a plethora of papers regarding their indications and complications...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#19
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29076473/-the-management-of-patients-with-new-epileptic-seizures-in-the-early-period-after-resection-of-hemispheric-tumors-two-case-reports-and-a-literature-review
#20
E Yu Sokolova, I A Savin, A B Kadasheva, A V Gavryushin, D I Pitskhelauri, A V Kozlov, K N Lapteva, V V Podlepich
Epileptic seizures developing for the first time after a neurosurgical intervention (de novo seizures) are a challenge for choosing an optimal treatment. The pathogenesis of these seizures is often associated with factors that become inactive in the early postoperative period. These seizures can not serve the basis for diagnosing symptomatic epilepsy and should be regarded as a brain response to surgery, and patients do not need anticonvulsant therapy that reduces the quality of life. But in some situations, new early postoperative seizures serve the onset of symptomatic epilepsy and require prolonged anticonvulsant therapy...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
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