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https://www.readbyqxmd.com/read/27911244/neurosurgical-management-in-lateral-meningocele-syndrome-case-report
#1
Erik C Brown, Kunal Gupta, Christina Sayama
Lateral meningocele syndrome (LMS) is a rare genetic connective tissue disorder. It is associated with morphological changes similar to those of other connective tissue disorders, with the unique distinction of multiple, often bilateral and large, lateral meningoceles herniating through the spinal foramina. In some cases, these lateral meningoceles can cause pain and discomfort due to their presence within retroperitoneal tissues or cause direct compression of the spinal nerve root exiting the foramen; in some cases compression may also involve motor weakness...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#2
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27910709/management-of-infections-associated-with-neurosurgical-implanted-devices
#3
Anna Conen, Christoph A Fux, Peter Vajkoczy, Andrej Trampuz
Neurosurgical devices are increasingly used. With it, neurosurgical device-related infections gain relevance. As biofilms are involved in implant-associated infections the diagnosis and treatment is challenging and requires specific anti-biofilm concepts and management algorithms. Areas covered: The literature concerning the management of neurosurgical device-associated infections is scarce and heterogeneous treatment concepts are discussed, but no standardized diagnostic and treatment procedures exist. Therefore, we emphasize extrapolating management strategies predominantly from orthopedic device-associated infections, where the concept is better established and clinically validated...
December 2, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27909631/a-nonoperative-approach-for-neurosurgical-management-of-a-sylvian-fissure-dermoid-cyst
#4
Ali S Haider, Clarence Kee, Danielle L DeBacker, Ian T Watson, Eliel N Arrey, Tijani Osumah, Dean Leonard, Chen Chen, Maryam Alam, L Gerard Toussaint Iii
The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909114/conservative-treatment-of-chronic-subdural-hematoma-in-hiv-associated-thrombocytopenia-with-tranexamic-acid
#5
Raja K Kutty, Anil Kumar Peethambaran, Sunilkumar, M Anilkumar
Chronic subdural hematomas (CSDHs) and its management comprise a majority work in a neurosurgical specialty. The effectiveness of surgery is beyond doubt and sometimes even lifesaving in severe cases. However, the straightforward surgery is sometimes complicated by the associated comorbidities of the patient. Comorbidities in the form of coagulopathies secondary to chronic liver diseases, drugs (warfarin, ecosprin, clopidogrel), thrombocytopenia secondary to systemic illness are always a challenge to deal with in patients with CSDH...
December 1, 2016: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#6
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906765/hemodynamic-disturbances-in-the-early-phase-after-subarachnoid-hemorrhage-regional-cerebral-blood-flow-studied-by-bedside-xenon-enhanced-ct
#7
Henrik Engquist, Anders Lewén, Tim Howells, Ulf Johnson, Elisabeth Ronne-Engström, Pelle Nilsson, Per Enblad, Elham Rostami
BACKGROUND: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome...
November 30, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27906525/the-clinical-utility-of-qsm-disease-diagnosis-medical-management-and-surgical-planning
#8
REVIEW
Sarah Eskreis-Winkler, Yan Zhang, Jingwei Zhang, Zhe Liu, Alexey Dimov, Ajay Gupta, Yi Wang
Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients...
December 1, 2016: NMR in Biomedicine
https://www.readbyqxmd.com/read/27904759/a-review-of-sub-acute-subdural-hematoma-sasdh-with-our-institutional-experience-and-its-management-by-double-barrel-technique-dbt-a-novel-technique
#9
Soubhagya R Tripathy, Pankaj K Swarnakar, Sanjib Mishra, Sudhanshu S Mishra, Manmath K Dhir, Sanjay K Behera, Pratap C Nath, Somnath P Jena, Itibrata Mohanta, Deepak Das, Mani C Satapathy, Sitansu K Rout, Bikash R Behera, Deepak K Parida, Tanushree S Rath
BACKGROUND: Subacute subdural hematoma (SASDH) is an entity which is yet to capture the popular imagination among the neurosurgeons. Its management is often equated clinically to that of the chronic subdural hematoma (CSDH). However, their neurological deterioration is usually rapid, which seems to align them with acute subdural hematoma (ASDH). We proceed for their epidemiological evaluation. The advantages of a novel "double barrel technique (DbT)" over the conventional burrhole drainage are also presented...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27903126/potential-evolution-of-neurosurgical-treatment-paradigms-for-craniopharyngioma-based-on-genomic-and-transcriptomic-characteristics
#10
Leslie C Robinson, Sandro Santagata, Todd C Hankinson
The recent genomic and transcriptomic characterization of human craniopharyngiomas has provided important insights into the pathogenesis of these tumors and supports that these tumor types are distinct entities. Critically, the insights provided by these data offer the potential for the introduction of novel therapies and surgical treatment paradigms for these tumors, which are associated with high morbidity rates and morbid conditions. Mutations in the CTNNB1 gene are primary drivers of adamantinomatous craniopharyngioma (ACP) and lead to the accumulation of β-catenin protein in a subset of the nuclei within the neoplastic epithelium of these tumors...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27884843/traumatic-brain-injury-in-england-and-wales-prospective-audit-of-epidemiology-complications-and-standardised-mortality
#11
T Lawrence, A Helmy, O Bouamra, M Woodford, F Lecky, P J Hutchinson
OBJECTIVES: To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. DESIGN: The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. SETTING: Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14(n)) model multivariate TBI outcome prediction model...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27873569/establishing-a-standard-of-care-for-deep-brain-stimulation-centers-in-canada
#12
Michel Panisset, Marina Picillo, Nicolas Jodoin, Yu-Yan Poon, Alejandro Valencia-Mizrachi, Alfonso Fasano, Renato Munhoz, Christopher R Honey
During the "DBS Canada Day" symposium held in Toronto July 4-5, 2014, the scientific committee invited experts to share their knowledge regarding deep brain stimulation (DBS) management of movement disorders in three domains: (1) the programming algorithms, (2) the necessary team to run a neurosurgery program, and (3) the appropriate scales to better define in a more comprehensive fashion the effect of the brain surgery. Each presentation was followed by an open discussion, and this article reports on the conclusions of this meeting on these three questions...
November 22, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27871133/civilian-cerebral-gunshot-wounds-a-south-african-experience
#13
Victor Kong, Jocinta Odendaal, Benn Sartorius, Damian Clarke, Petra Brysiewicz, Ellen Jerome, John Bruce, Grant Laing
BACKGROUND: Cerebral gunshot wounds represent one of the most lethal forms of traumatic brain injury, but there is a paucity of literature on the topic, especially from the developing world. We reviewed our experience and describe the spectrum and outcome of civilian cerebral gunshot wounds in a major metropolitan trauma centre in South Africa. METHODS: This was a retrospective study of all patients with isolated cerebral gunshot wounds managed by the Pietermaritzburg Metropolitan Trauma Service over a 5-year period from 2010 to 2014...
November 21, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27867128/evaluation-of-meropenem-penetration-into-cerebrospinal-fluid-in-patients-with-meningitis-after-neurosurgery
#14
Yuyi Zhang, Jing Zhang, Yuancheng Chen, Jicheng Yu, Guoying Cao, Xiaojie Wu, Mingyu Chen, Jufang Wu, Xu Zhao
OBJECTIVE: Meropenem is important for management of post-neurosurgical meningitis, but the data about its penetration into cerebrospinal fluid (CSF) are inadequate. This prospective, open-label study investigated the pharmacokinetic profile of meropenem in patients with post-neurosurgical meningitis, especially its CSF penetration. METHODS: A total of 82 patients with post-neurosurgical meningitis were included to receive meropenem intravenously according to regimen of 2g q8h, 1g q8h or 1g q6h...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27867120/transforaminal-resection-of-cervical-dumbbell-schwannomas-in-patients-with-additional-tumors
#15
Ji Zhang, Xiang-Heng Zhang, Zi-Feng Wang, You-Ping Li, Zheng-Quan Zhu, Ji-Cheng Sun, Zheng-He Chen, Shao-Yong Wu, Ke Sai, Jian Wang, Yong-Gao Mou, Zhong-Ping Chen
BACKGROUND: It is rare for two primary tumors to occur simultaneously in a patient. Management of cervical dumbbell schwannomas (CDSs) with concurrent tumors (CTs) requires a specific neurosurgical strategy. The primary objective of this study is to investigate surgical strategies for CDSs with CTs while preserving as much of the mechanically relevant bone structures as possible. MATERIAL AND METHODS: Twelve patients with concurrent CTs and CDSs were identified from three medical centers...
November 17, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27866097/current-therapy-and-the-evolving-molecular-landscape-of-paediatric-ependymoma
#16
REVIEW
Soumen Khatua, Vijay Ramaswamy, Eric Bouffet
Ependymomas are the third commonest paediatric central nervous system (CNS) tumour, accounting for 6-12% of brain tumours in children. The management of these tumours has seen considerable changes over the last two decades, leading to a significant improvement in outcomes. However, despite advances in neurosurgical, neuroimaging and postoperative adjuvant therapy, management of these tumours remain challenging, and recurrence occurs in over 50% of cases, particularly when complete resection is not achieved prior to conformal radiotherapy...
November 17, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27843682/large-spontaneous-spinal-subdural-epidural-hematoma-after-epidural-anesthesia-for-caesarean-section-conservative-management-with-excellent-outcome
#17
Ioannis D Siasios, Kunal Vakharia, Kevin J Gibbons, Vassilios G Dimopoulos
BACKGROUND: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively. CASE DESCRIPTION: A 38-year-old woman came to the emergency department (ED) complaining of severe neck and back pain...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27834599/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#18
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...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27834596/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
#19
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...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27828761/temperature-management-in-neurological-and-neurosurgical-intensive-care-unit
#20
Patrick Lyden, Gretchen M Brophy, Nicolas Deye, Christopher M Horn
No abstract text is available yet for this article.
December 2016: Therapeutic Hypothermia and Temperature Management
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