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https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#1
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28203372/diagnostic-challenges-and-management-of-a-patient-with-acromegaly-due-to-ectopic-growth-hormone-releasing-hormone-secretion-from-a-bronchial-carcinoid-tumour
#2
Nikolaos Kyriakakis, Jacqueline Trouillas, Mary N Dang, Julie Lynch, Paul Belchetz, Márta Korbonits, Robert D Murray
: A male patient presented at the age of 30 with classic clinical features of acromegaly and was found to have elevated growth hormone levels, not suppressing during an oral glucose tolerance test. His acromegaly was originally considered to be of pituitary origin, based on a CT scan, which was interpreted as showing a pituitary macroadenoma. Despite two trans-sphenoidal surgeries, cranial radiotherapy and periods of treatment with bromocriptine and octreotide, his acromegaly remained active clinically and biochemically...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#3
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190436/neurologic-complications-of-cardiac-and-vascular-surgery
#4
K N Sheth, E Nourollahzadeh
This chapter will provide an overview of the major neurologic complications of common cardiac and vascular surgeries, such as coronary artery bypass grafting and carotid endarterectomy. Neurologic complications after cardiac and vascular surgeries can cause significant morbidity and mortality, which can negate the beneficial effects of the intervention. Some of the complications to be discussed include ischemic and hemorrhagic stroke, seizures, delirium, cognitive dysfunction, cerebral hyperperfusion syndrome, cranial nerve injuries, and peripheral neuropathies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#5
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28183556/blood-loss-and-transfusion-requirements-with-epsilon-aminocaproic-acid-use-during-cranial-vault-reconstruction-surgery
#6
Mark E Thompson, Charles Saadeh, Phillip Watkins, Laszlo Nagy, Joshua Demke
OBJECTIVE: To determine whether epsilon-aminocaproic acid (EACA) load of 50 mg∙kg(-1) before skin incision, and infusion of 25 mg∙kg(-1)∙h(-1) until skin closure during cranial vault reconstruction (CVR) were associated with decreased estimated blood loss and transfusion requirements. BACKGROUND: Antifibrinolytic medications decrease bleeding and transfusion requirements during cardiothoracic and orthopedic surgeries with high blood loss, but practical reductions in blood loss and transfusion requirements have not been consistently realized in children undergoing CVR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181184/anesthesia-for-awake-craniotomy-a-how-to-guide-for-the-occasional-practitioner
#7
Lingzhong Meng, David L McDonagh, Mitchel S Berger, Adrian W Gelb
Awake craniotomy (AC), defined as the performance of at least part of an open cranial procedure with the patient awake, has been tied to beneficial outcomes compared with similar surgery under general anesthesia. Improved anesthetic techniques have made a major contribution to the increasing popularity of AC. However, the heterogeneity of practice among institutions doing large numbers of ACs raises questions (often among those who only occasionally perform AC - i.e., practitioners in low-volume AC institutions) as to the ideal anesthetic technique for AC...
February 8, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28180036/low-dose-gamma-knife-radiosurgery-for-vestibular-schwannomas-tumor-control-and-cranial-nerve-function-preservation-after-11-gy
#8
Andrew J Schumacher, Rohan R Lall, Rishi R Lall, Allan Nanney Iii, Amit Ayer, Samir Sejpal, Benjamin P Liu, Maryanne Marymont, Plato Lee, Bernard R Bendok, John A Kalapurakal, James P Chandler
Objectives This study aims to report tumor control rates and cranial nerve function after low dose (11.0 Gy) Gamma knife radiosurgery (GKRS) in patients with vestibular schwannomas. Methods A retrospective chart review was performed on 30 consecutive patients with vestibular schwannomas treated from March 2004 to August 2010 with GKRS at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. The marginal dose for all patients was 11.0 Gy prescribed to the 50% isodose line. Median follow-up time was 42 months...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28178096/relative-location-of-fundus-meatus-acustici-interni-via-porus-acusticus-internus-in-facial-nerve-decompression
#9
Xu Liu, Haodong Wang, Kailiang Cheng, Youqiong Li
Facial neural edema is the pathophysiological base of Bell's palsy. The middle cranial fossa approach is used to relieve the oppression of facial nerve at its most narrow course in the facial canal. In this research, the authors mainly discussed the internal auditory canal segment of facial nerve, completely in the shadow of the bony structure, which is inconvenient for transmastoid decompression. Therefore, the objective was to explore the definite position of the fundus meatus acustici interni from internal acoustic pore...
February 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28163520/penetrating-anterior-skull-base-fracture-inflicted-by-a-cow-s-horn
#10
Adomas Bunevicius, Karolis Bareikis, Laimutis Kalasauskas, Arimantas Tamasauskas
Farm workers are at increased risk for animal-inflicted head injuries that are associated with significant morbidity and occasionally may be fatal. These injuries may cause permanent eye damage with or without concomitant skull base fracture. Here, we present a male farmer who suffered a cow attack that resulted in perforating orbital injury with comminuted frontobasal cranial fracture caused by a cow's horn. The next day, the patient developed nasal and orbital cerebrospinal fluid (CSF) leak. Computed Tomography cisternography revealed CSF leakage to frontal and maxillary sinuses...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28153613/fourth-ventricle-outlet-obstruction-with-expanding-space-on-the-surface-of-cerebellum-a-case-report
#11
Shimoda Yoshiteru, Murakami Kensuke, Narita Norio, Tominaga Teiji
BACKGROUND: Hydrocephalus is classified as noncommunicating and communicating based on whether all ventricular and subarachnoid spaces are communicating. Although the diagnosis between the two different states is crucial, it is difficult in certain conditions. In particular, communicating hydrocephalus and noncommunicating hydrocephalus due to fourth ventricle outlet obstruction are highly misdiagnosed. We describe a case of fourth ventricle outlet obstruction of unknown origin that was initially misdiagnosed as communicating hydrocephalus...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28125310/juvenile-psammomatoid-ossifying-fibroma-in-paranasal-sinus-and-skull-base
#12
Mingjie Wang, Bing Zhou, Shunjiu Cui, Yunchuan Li
CONCLUSION: The endoscopic transnasal approach with IGS is a safe and effective technique, allowing completely resection of JPOF, with minimal morbidity and recurrence. OBJECTIVES: JPOF is a benign but locally aggressive fibro-osseous lesion. This study presents a series of JPOF cases, involving anterior skull base and orbit, treated by endoscopic transnasal approach with image guidance system (IGS) to resect the mass completely. METHOD: This study retrospectively reviewed the clinical presentations, surgical procedures, and complications of 11 patients with JPOF who were treated by endoscopic approach from May 2009 to April 2014...
January 26, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28124515/anatomic-criteria-determining-high-risk-carotid-surgery-patients
#13
Pavlos Tsantilas, Andreas Kuehnl, Erich Brenner, Hans H Eckstein
BACKGROUND: Based on randomized trials, carotid endarterectomy (CEA) is the standard procedure for patients with a 50-99% symptomatic carotid stenosis and carefully selected patients with an asymptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) is a technical alternative for patients with a high surgical risk or difficult anatomic conditions (e.g., recurrent stenosis). This study aims to provide an overview of anatomic factors associated with a higher risk of CEA complications...
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28121968/outcomes-of-the-suture-pull-through-technique-for-repair-of-lateral-skull-base-csf-fistula-and-encephaloceles
#14
Brendan P O'Connell, Jacob B Hunter, Alex D Sweeney, Reid C Thompson, Lola B Chambless, George B Wanna, Alejandro Rivas
OBJECTIVE: Describe the safety profile and surgical outcomes of a combined transmastoid-middle cranial fossa suture "pull-through" technique for repair of lateral skull base defects. STUDY DESIGN: Retrospective. SETTING: Tertiary care hospital. PATIENTS: Patients undergoing surgery for cerebrospinal fluid (CSF) fistula and/or encephalocele. INTERVENTION: Combined transmastoid and middle fossa approach using suture pull-through technique...
March 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28120070/tips-and-tricks-for-anterior-cranial-base-reconstruction
#15
Oreste de Divitiis, Alberto Di Somma, Luigi Maria Cavallo, Paolo Cappabianca
Reconstruction procedures come last in skull base surgery, but they are not the least important phase-rather, reconstruction is one of the most important steps required to prevent complications. In our opinion, there are three general principles upon which a good reconstruction of the skull base stand: (1) anatomo-surgical knowledge; (2) approach/route selection; and (3) the cooperation of the skull base surgical team. In general, three major complications may occur when a good skull base reconstruction has not been achieved, i...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28119180/teriparatide-attenuates-scarring-around-murine-cranial-bone-allograft-via-modulation-of-angiogenesis
#16
Doron Cohn Yakubovich, Uzi Eliav, Eran Yalon, Yeshai Schary, Dmitriy Sheyn, Galen Cook-Wiens, Shuting Sun, Charles E McKenna, Shaya Lev, Alexander M Binshtok, Gadi Pelled, Gil Navon, Dan Gazit, Zulma Gazit
Nearly all bone fractures in humans can deteriorate into a non-union fracture, often due to formation of fibrotic tissue. Cranial allogeneic bone grafts present a striking example: although seemingly attractive for craniofacial reconstructions, they often fail due to fibrosis at the host-graft junction, which physically prevents the desired bridging of bone between the host and graft and revitalization of the latter. In the present study we show that intermittent treatment with recombinant parathyroid hormone-analogue (teriparatide) modulates neovascularization feeding in the graft surroundings, consequently reducing fibrosis and scar tissue formation and facilitates osteogenesis...
January 21, 2017: Bone
https://www.readbyqxmd.com/read/28091816/pediatric-cerebral-sinovenous-thrombosis-following-cranial-surgery
#17
Dmitriy Petrov, Michael Y Uohara, Rebecca Ichord, Zarina Ali, Laura Jastrzab, Shih-Shan Lang, Lori Billinghurst
PURPOSE: Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. METHODS: An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014...
January 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28074281/one-step-cad-cam-titanium-cranioplasty-after-drilling-template-assisted-resection-of-intraosseous-skull-base-meningioma-technical-note
#18
A Carolus, S Weihe, K Schmieder, C Brenke
INTRODUCTION: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery. A preoperative virtual planning of resection margins and the simultaneously fabrication of the cranioplasty could be a possibility to subsume the steps tumor resection and cosmetic restoration to a single procedure. METHODS: We present two cases of patients with complex intra-osseous spheno-orbital meningioma...
March 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28064284/surgery-modified-pi-with-triple-bonnet-flap-and-fronto-orbital-advancement
#19
Uday Singh Raswan, Sarbjit Singh Chhiber, Altaf Umar Ramzan
INTRODUCTION: Craniosynostosis is the premature fusion of one or more of the cranial sutures and can occur as part of a syndrome or as an isolated defect. Pansynostosis is a rare form of craniosynostosis that involves premature fusion of all the cranial sutures (coronal, sagittal, metopic, and occipital). Particularly in cases of late presentation, there are heightened clinical concerns, both functional and aesthetic. In untreated cases of pansynostosis and increased intracranial pressure, optic nerve damage progresses to optic atrophy and then blindness...
January 7, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28050819/preventing-fusion-mass-shift-avoids-postoperative-distal-curve-adding-on-in-adolescent-idiopathic-scoliosis
#20
Hideki Shigematsu, Jason Pui Yin Cheung, Mauro Bruzzone, Hiroaki Matsumori, Kin-Cheung Mak, Dino Samartzis, Keith Dip Kei Luk
BACKGROUND: Surgery for adolescent idiopathic scoliosis (AIS) is only complete after achieving fusion to maintain the correction obtained intraoperatively. The instrumented or fused segments can be referred to as the "fusion mass". In patients with AIS, the ideal fusion mass strategy has been established based on fulcrum-bending radiographs for main thoracic curves. Ideally, the fusion mass should achieve parallel endplates of the upper and lower instrumented vertebra and correct any "shift" for truncal balance...
January 3, 2017: Clinical Orthopaedics and related Research
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