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Postoperative cerebral hematoma

Lei Xia, Ming-Xing Liu, Jun Zhong, Ning-Ning Dou, Bin Li, Hui Sun, Shi-Ting Li
Although the microvascular decompression (MVD) surgery has become an effective remedy for cranial nerve rhizopathies, it is still challengeable and may result in a fatal sequel sometimes. Therefore, the operative skill needs to be further highlighted with emphasis on the safety and a preplan for management of postoperative fatal complications should be established. We retrospectively analyzed 6974 cases of MVD. Postoperatively, 46 patients (0.66 %) presented decline in consciousness with a positive finger-nose test (or failure to be tested) after wake up from the anesthesia, whom were focused on in this study...
October 12, 2016: Neurosurgical Review
Guo-Chen Sun, Xiao-Lei Chen, Yuan-Zheng Hou, Xin-Guang Yu, Xiao-Dong Ma, Gang Liu, Lei Liu, Jia-Shu Zhang, Hao Tang, Ru-Yuan Zhu, Ding-Biao Zhou, Bai-Nan Xu
OBJECTIVE Endoscopic removal of intracerebral hematomas is becoming increasingly common, but there is no standard technique. The authors explored the use of a simple image-guided endoscopic method for removal of spontaneous supratentorial hematomas. METHODS Virtual reality technology based on a hospital picture archiving and communications systems (PACS) was used in 3D hematoma visualization and surgical planning. Augmented reality based on an Android smartphone app, Sina neurosurgical assist, allowed a projection of the hematoma to be seen on the patient's scalp to facilitate selection of the best trajectory to the center of the hematoma...
September 16, 2016: Journal of Neurosurgery
Rick F Nelson, Joseph P Roche, Bruce J Gantz, Marlan R Hansen
OBJECTIVE: To determine the efficacy and morbidity of repairing spontaneous cerebrospinal fluid (CSF) leaks with the middle cranial fossa (MCF) approach without the use of a lumbar drain (LD), as perioperative use of LD remains controversial. STUDY DESIGN: Retrospective review from 2003 to 2015. SETTING: University of Iowa Hospitals and Clinics and Indiana University Health Center. PATIENTS: Those with a confirmed lateral skull base spontaneous CSF leaks and/or encephaloceles...
September 14, 2016: Otology & Neurotology
Nitin Agarwal, Giulio Zuccoli, Geoffrey Murdoch, Brian T Jankowitz, Stephanie Greene
INTRODUCTION: Developmental venous anomalies (DVAs) are cited as the most common cerebral vascular malformations. Still, intracerebral hematomas are rarely thought to be caused by DVAs. In this report, the authors present a unique case of a DVA that hemorrhaged spontaneously, rather than hemorrhaging into a venous infarction following DVA thrombosis as has been more commonly reported. CLINICAL PRESENTATION: A 22-year-old previously healthy male presented to the emergency department with a severe headache, confusion, and progressive hemiparesis...
September 9, 2016: Neuroradiology Journal
Junhui Chen, Yuhai Wang, Peipei Li, Weiliang Chen, Jingxu Zhou, Xu Hu, Jie Zhu, Bingjie Jiang
Arteriovenous malformations (AVMs) associated with aneurysm have rarely been reported in the literature. The present study reports the case of a 21-year-old pregnant female patient who presented with a subarachnoid hemorrhage and an intracranial hematoma located in the anterior end of the corpus callosum. Furthermore, an anterior cerebral aneurysm and an AVM were identified by digital subtraction angiography and magnetic resonance angiography. The aneurysm was clipped and the AVM was successfully removed by microsurgery...
September 2016: Experimental and Therapeutic Medicine
Themistocles S Protopsaltis, Anthony J Boniello, Frank J Schwab
A wide range of neuromuscular diseases, including Parkinson disease, cerebral palsy, multiple sclerosis, and myopathy, are associated with spinal deformities. The most common postural deformities include anterocollis, Pisa syndrome (pleurothotonus), scoliosis, and camptocormia. Nonsurgical management of spinal deformity in patients with neuromuscular disease centers on maximizing the medical management of the underlying neurodegenerative pathology before surgical intervention is contemplated. Surgical management can include decompression alone, or decompression and fusion with short or long fusion constructs...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Han-Song Sheng, Nu Zhang, Jian Lin, Fen-Chun Lin, Bo Yin, Mao-de Wang
OBJECTIVES: Surgical management of cranial burst fracture (CBF) usually involves craniotomy to remove the devitalized brain tissues, followed by watertight repair of dural tears. However, there were times when the dural tear was so extensive that a substantially large bone flap would have to be removed in order to expose the retracted dural margins before it could be repaired. In such cases, strict dural repair would incur a significantly higher risk of damages to the surrounding neural tissues and severe bleeding, especially when the fracture was in the vicinity of eloquent cortical areas and sinus...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Low Y Y Sharon, N G Wai Hoe
Burr-hole drainage of chronic subdural hematomas are routine operative procedures done by neurosurgical residents. Common postoperative complications include acute epidural and/or subdural bleeding, tension pneumocephalus, intracranial hematomas and ischemic cerebral infarction. We report an interesting post-operative complication of a 'subarachnoid cyst' after burr-hole evacuation of a chronic subdural hematoma. The authors hypothesize that the 'cyst' is likely secondary to the splitting of the adjacent neomembrane within its arachnoid-brain interface by iatrogenic irrigation of the subdural space...
July 2016: Asian Journal of Neurosurgery
Roberto Centonze, Emiliano Agostini, Samantha Massaccesi, Stefano Toninelli, Letterio Morabito
BACKGROUND: A large variety of biological and artificial materials are employed in dural repair, each of them with major limitations. Autologous grafts have limited availability and require an additional incision and surgical time. Cadaveric preparations and heterologous materials entail the risk of iatrogenic transmission of prions, whereas synthetic substitutes have been reported to cause inflammatory reactions and graft rejection. An equine-derived pericardium membrane has been developed (Heart(®), Bioteck, Vicenza, Italy) with mechanical and safety-related features that could make it suitable for neurosurgical application...
July 2016: Asian Journal of Neurosurgery
Akihiro Inoue, Kanehisa Kohno, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Hajime Miyazaki, Saya Ozaki, Shinji Iwata
Herein, we describe the case of a superficial temporal artery(STA)- and occipital artery (OA)-middle cerebral artery (MCA) double anastomoses that we performed to treat a hemorrhagic twig-like MCA. A 55-year-old man presented to our hospital for investigation of an incidentally identified left MCA occlusion. Left cerebral angiography revealed a twig-like MCA. The (123)I-IMP-single photon emission computed tomography( SPECT) demonstrated no reduction in the cerebral blood flow (CBF), so the patient was initially observed with no treatment...
June 2016: No Shinkei Geka. Neurological Surgery
Tadashi Doden, Hiromasa Sato, Etsuko Sasahara, Takahiro Murata, Takehiro Yako, Kazuo Kitazawa, Kayoko Higuchi, Shigeaki Kobayashi, Takao Hashimoto
OBJECTIVE: We aim to clarify the clinico-radiological characteristics of cerebral amyloid angiopathy-related intracerebral hemorrhage and to investigate the efficacy of pathological diagnosis using biopsy specimens. METHOD: We retrospectively reviewed 253 consecutive patients with cortico-subcortical hemorrhage who had been admitted to Aizawa Hospital between January 2006 and July 2013. We had performed craniotomy and hematoma evacuation in 48 patients, as well as biopsy of the evacuated hematoma, cerebral parenchyma adjacent to the hematoma, or both, and they were classified according to the histological results (positive or negative for vascular amyloid deposition) and to the Boston criteria...
July 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Guan Sun, Lei Shi, Tianhong Pan, Xiaoliang Li, Shuguang Zhang
BACKGROUND: Bifrontal contusion is a common clinical brain injury. In the early stage, it is often mild, but it progresses rapidly and frequently worsens suddenly. This condition can become life threatening and therefore requires surgery. Conventional decompression craniectomy is the commonly used treatment method. In this study, the effect of intracranial pressure (ICP) monitored stepwise intracranial decompression surgery on the prognosis of patients with acute severe bifrontal contusion was investigated...
2016: Frontiers in Neurology
Weijun Wang
Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13-145 mL); postoperative follow-up was 3 months...
2016: BioMed Research International
Isaac Phang, Argyro Zoumprouli, Samira Saadoun, Marios C Papadopoulos
OBJECTIVE A novel technique for monitoring intraspinal pressure and spinal cord perfusion pressure in patients with traumatic spinal cord injury was recently described. This is analogous to monitoring intracranial pressure and cerebral perfusion pressure in patients with traumatic brain injury. Because intraspinal pressure monitoring is a new technique, its safety profile and impact on early patient care and long-term outcome after traumatic spinal cord injury are unknown. The object of this study is to review all patients who had intraspinal pressure monitoring to date at the authors' institution in order to define the accuracy of intraspinal pressure probe placement and the safety of the technique...
September 2016: Journal of Neurosurgery. Spine
Hajime Miyazaki, Kanehisa Kohno, Hideo Tanaka, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Noriyuki Fumoto, Saya Ozaki, Toshiharu Maeda
We report a case of ruptured peripheral cerebral aneurysm at abnormal vessels associated with severe stenosis at the middle cerebral artery (MCA). A 66-year-old woman was admitted at our hospital with headache on foot. Computed tomography (CT) showed intracerebral hemorrhage in the left fronto-basal area. Three-dimensional-CT and conventional angiogram revealed abnormal vessels, which were similar to those seen in moyamoya disease, with a small enhancement close to the hematoma. On day 11, subsequent cerebral angiogram demonstrated an aneurysm at the peripheral portion of an abnormal vessel arising from the left A2...
April 2016: No Shinkei Geka. Neurological Surgery
Karen Handojo, Diederik Meylemans, Kurt Devroe, Koen Vermeiren, Chris Aelvoet, Tim Tollens
INTRODUCTION: The Ultrapro® Advanced™ mesh (Ethicon, Sommerville, NJ) is a new mesh design, using the best characteristics from the previous platform, while adding new, advanced features. Our centre, Imelda Hospital, Bonheiden, Belgium, was chosen as one of the first clinical testing sites. The aim of this study was to present our preliminary data on complication rate and patient satisfaction. MATERIALS AND METHODS: From October 1, 2015 until January 31, 2016, we treated 57 patients, implementing 67 Ultrapro® Advanced™ meshes...
April 2016: Surgical Technology International
Kejie Mou, Zheng Zhou, Jinbo Yin, Hui Yang, Jun Liu
To analyze the clinical characteristics, therapies, and outcomes of distal intracranial aneurysms, the authors retrospectively studied the clinical and imaging data of 18 patients with distal intracranial aneurysms. There were 10 males and 8 females, aged from 11 months to 59 years (mean, 40.4 ± 11.4 years). All patients were diagnosed by digital subtract angiography. Aneurysm locations were as follows: distal anterior cerebral artery (n = 5), distal middle cerebral artery (n = 2), distal posterior cerebral artery (n = 6), distal posterior inferior cerebellar artery (n = 3), distal anterior inferior cerebellar artery (n = 1), and distal superior cerebellar artery (n = 1)...
May 2016: Journal of Craniofacial Surgery
Yasushi Ogasawara, Yoshitaka Kubo, Takahiro Koji, Yuiko Sato, Shunrou Fujiwara, Kuniaki Ogasawara
We describe the case of subarachnoid hemorrhage and cerebral infarction that developed simultaneously and was caused by suspected dissection of the anterior communicating artery. A 65-year-old woman presented with sudden onset of headache and nausea. Head computed tomography(CT)and magnetic resonance imaging revealed subarachnoid hemorrhage in the interhemispheric fissure and a spotty ischemic lesion in the right frontal cortex. Both, CT angiography and angiography with arterial catheterization showed an aneurysmal dilatation of the anterior communicating artery...
March 2016: No Shinkei Geka. Neurological Surgery
Deepak K Gupta, Raghav Singla, Shashank S Kale, Bhawani S Sharma
CONTEXT: Traumatic brain injury (TBI) remains a major cause of morbidity and mortality worldwide. Largely, the prognosis is dependent on the nonmodifiable factors such as severity of the initial injury, Glasgow coma scale score, pupillary response, age, and presence of additional physiological derangements such as hypoxia or hypotension. However, secondary insults continue to take place after the initial injury and resuscitation. The study hypothesis in the present research article was that hypoglycemia is an independent outcome prognosticator in severe traumatic brain injury...
March 2016: Neurology India
Yuichiro Ota, Osamu Araki, Shuichi Oki, Tetsuji Inagawa, Katsuya Emoto, Masaaki Shibukawa, Hiroyuki Yamasaki, Yukari Kano, Itaru Tani
A 59-year-old woman presented with right sensory loss and right hemiparesis. In February 2013, she was admitted to Araki Neurosurgical Hospital. A magnetic resonance imaging was performed that revealed a left temporal lobe hemorrhage. The image also showed a chronic stereotype hematoma. After 14 days of hospitalization, she underwent a stereotactic craniotomy. Subsequently, by postoperative pathological evaluation, the hematoma was diagnosed as a cavernous angioma. She had no postoperative complications. She was provided rehabilitation support and was discharged 28 days after the admission following which she rejoined work...
February 2016: No Shinkei Geka. Neurological Surgery
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