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Neurovascular complications

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https://www.readbyqxmd.com/read/29026673/endoscopic-management-of-a-cavernous-malformation-on-the-floor-of-third-ventricle-and-aqueduct-of-sylvius-technical-case-report-and-review-of-the-literature
#1
Luis Alberto Ortega-Porcayo, Alexander Perdomo-Pantoja, Isaac Jair Palacios-Ortíz, Salomon Cohen Cohen, Juan Pablo González-Mosqueda, Juan Luis Gómez-Amador
BACKGROUND: Intraventricular cavernous malformations are unusual intracranial vascular malformations; their deep anatomical location complicates their surgical management. Microsurgical approaches are the gold standard approaches for the resection of ventricular lesions, however, they imply considerable neurovascular risks. CASE DESCRIPTION: A 51-year-old patient presented with acute headache, diplopia, vertigo, blurred vision, and a depressed level of consciousness...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29026661/tenth-case-of-bilateral-hemifacial-spasm-treated-by-microvascular-decompression-review-of-the-pathophysiology
#2
REVIEW
Warley Carvalho da Silva Martins, Lucas Alverne Freitas de Albuquerque, Gervásio Teles Cardoso de Carvalho, Jules Carlos Dourado, Marcos Dellaretti, Atos Alves de Sousa
BACKGROUND: Bilateral hemifacial spasm (BHFS) is a rare neurological syndrome whose diagnosis depends on excluding other facial dyskinesias. We present a case of BHFS along with a literature review. METHODS: A 64-year-old white, hypertense male reported involuntary left hemiface contractions in 2001 (aged 50). In 2007, right hemifacial symptoms appeared, without spasm remission during sleep. Botulinum toxin type A application produced partial temporary improvement...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29020717/ulnar-nerve-injury-on-removal-of-a-contraceptive-implant
#3
Eva E O'Grady, Dominic M Power
The close proximity of contraceptive implant placement to the course of the ulnar nerve can result in injury. Several factors have been implicated in this complication including: low BMI, erroneous placement of the implant, implantation over the brachial groove, and migration of the implant from its original insertion. Clinicians should familiarise themselves with the vulnerable neurovascular structures in the area and refer promptly to a specialist if any neurological symptoms develop during placement or removal of these devices...
December 2016: Practitioner
https://www.readbyqxmd.com/read/29017302/cervical-pedicle-screw-placement-using-medial-funnel-technique
#4
Jung Hwan Lee, Byung Kwan Choi, In Ho Han, Won Gyu Choi, Kyoung Hyup Nam, Hwan Soo Kim
OBJECTIVE: Cervical pedicle screw (CPS) placement is very challenging due to high risk of neurovascular complications. We devised a new technique (medial funnel technique) to improve the accuracy and feasibility of CPS placement. METHODS: We reviewed 28 consecutive patients undergoing CPS instrumentation using the medial funnel technique. Their mean age was 51.4 years (range, 30-81 years). Preoperative diagnosis included degenerative disease (n=5), trauma (n=22), and infection (n=1)...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28990533/blood-brain-barrier-disruption-leads-to-postoperative-cognitive-dysfunction
#5
Bin Wang, Siyuan Li, Xipeng Cao, Xinghui Dou, Jingzhu Li, Ling Wang, Mingshan Wang, Yanlin Bi
BACKGROUND: Postoperative cognitive dysfunction (POCD) has received considerable attention as one of the main postoperative complications. The underlying mechanism of POCD in elderly subjects has not been fully elucidated to date. The central nervous system (CNS) is isolated from the bloodstream by the blood brain barrier (BBB) that consists of endothelial cells, capillary blood vessels and the tight junctions. The tight junctions carry out significant biological functions that are associated with the CNS and the blood circulation...
October 9, 2017: Current Neurovascular Research
https://www.readbyqxmd.com/read/28987927/blood-brain-barrier-dysfunction-and-recovery-after-ischemic-stroke
#6
REVIEW
Xiaoyan Jiang, Anuska V Andjelkovic, Ling Zhu, Tuo Yang, Michael V L Bennett, Jun Chen, Richard F Keep, Yejie Shi
The blood-brain barrier (BBB) plays a vital role in regulating the trafficking of fluid, solutes and cells at the blood-brain interface and maintaining the homeostatic microenvironment of the CNS. Under pathological conditions, such as ischemic stroke, the BBB can be disrupted, followed by the extravasation of blood components into the brain and compromise of normal neuronal function. This article reviews recent advances in our knowledge of the mechanisms underlying BBB dysfunction and recovery after ischemic stroke...
October 5, 2017: Progress in Neurobiology
https://www.readbyqxmd.com/read/28984806/petrous-apex-cholesterol-granulomas-outcomes-complications-and-hearing-results-from-surgical-and-wait-and-scan-management
#7
Golda Grinblat, Ashish Vashishth, Francesco Galetti, Antonio Caruso, Mario Sanna
OBJECTIVE: 1. To analyze the surgical outcomes in the management of petrous apex cholesterol granulomas (PACG) with a brief literature review.2. To evaluate the importance of wait-and-scan management option. STUDY DESIGN: Retrospective review. SETTING: Quaternary referral center for otology and skull base surgery. SUBJECTS AND METHODS: Charts of 55 patients with at least 12 months of follow-up were analyzed for demographic, clinical, audiometric, and radiological features...
October 4, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28973693/endoscopic-endonasal-and-transcranial-surgery-for-microsurgical-resection-of-ventral-foramen-magnum-meningiomas-a-preliminary-experience
#8
Nicolas Khattar, Maria Koutourousiou, Joseph D Chabot, Eric W Wang, Aaron A Cohen-Gadol, Carl H Snyderman, Juan C Fernandez-Miranda, Paul A Gardner
BACKGROUND: Purely ventral foramen magnum meningiomas are challenging tumors to treat given their location, and proximity and relationship to vital neurovascular structures. OBJECTIVE: To present endoscopic endonasal surgery (EES) as a complementary approach to the far-lateral suboccipital approach (FLA) for ventral midline tumors. METHODS: From May 2008 to October 2013, 5 patients underwent EES and 5 FLA for primary ventral foramen magnum meningiomas...
July 22, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28971089/posterior-sacroiliac-osteotomy-an-alternative-to-the-ilioinguinal-approach-for-pelvic-reconstruction-in-misalignment-lesions
#9
João Antonio Matheus Guimarães, Vinícius Magno da Rocha, André Luiz Loyelo Barcellos
Pelvic ring fractures occur in association with potentially fatal lesions, whose treatment is a priority in the polytrauma setting. As consequence, the definitive orthopedic approach may be postponed, leading patients to chronic and potentially disabling deformities. The treatment of these deformities is a challenge, requiring highly complex and staged surgical reconstructions. The ilioinguinal approach has been widely used in these surgeries, because it allows the release and mobilization of the hemipelvis and, in some cases, anterior fixation of the sacroiliac joint...
2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28967306/retrosigmoid-transmeatal-and-suprajugular-approach-for-cerebellopontine-angle-meningioma-operative-video
#10
Ken Matsushima, Michihiro Kohno
Surgical management of cerebellopontine angle meningiomas is challenging due to the intricate neurovascular structures within the limited operative field and the compression of eloquent structures including the brainstem. Surgery on tumors extending into the temporal bone is especially difficult and demands complicated approaches. However, modifications to the retrosigmoid approach utilizing intradural temporal bone drilling enable access to such tumoral extensions without any additional invasive approaches...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28963365/long-term-follow-up-of-bifurcation-aneurysms-treated-with-braided-stent-assisted-coiling-and-complex-t-and-y-stent-constructs
#11
Nicholas K Cheung, Albert Hy Chiu, Andrew Cheung, Jason D Wenderoth
BACKGROUND: Stent assisted coil embolization (SACE) of bifurcation aneurysms is challenging. Heterogeneous results have been achieved to date, but largely for laser cut stents. While braided stents offer multiple technical advantages, their long term efficacy has yet to be validated. OBJECTIVE: To report the first long term 18 month results for the durability of bifurcation aneurysms treated with braided stents. MATERIALS AND METHODS: Over a 4 year period, 59 consecutive patients with 60 bifurcation aneurysms underwent elective braided SACE across three Australian neurovascular centers...
September 29, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28961750/flow-diverting-stents-for-the-obliteration-of-symptomatic-infectious-cavernous-carotid-artery-aneurysms
#12
Andrew Joshua Kobets, Aleka Scoco, Jonathan Nakhla, Allan Leonard Brook, Merritt Drew Kinon, Nrupen Baxi, David Altschul
BACKGROUND: Intracavernous aneurysms constitute up to 9% of all intracranial aneurysms and 6% are infectious (IIA). First line therapy is a protracted antibiotic course, yet with failure, surgery and endovascular parent vessel sacrifice have been utilized. Reconstructive endovascular therapies have emerged for aneurysm control and may demonstrate a safer therapeutic alternative. OBJECTIVE: To present an IIA treated with a flow-diverting Pipeline stent (ev3 Neurovascular, Irvine, California)...
August 5, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28956507/detection-and-characterization-of-the-accessory-mental-foramen-using-cone-beam-computed-tomography
#13
Yihan Li, Xiangwen Yang, Bichu Zhang, Bin Wei, Yao Gong
OBJECTIVE: This study aimed to investigate the frequency and characteristics of accessory mental foramina (AMFs) and their bony canals in a selected Chinese population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Reconstructed CBCT images of the mandible in 784 Chinese patients (305 males and 479 females) were retrospectively analysed to identify the AMF. The presence, dimension and location of the AMF as well as the origin and course of the associated bony canal were evaluated and classified...
September 28, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/28951640/minimally-invasive-plate-osteosynthesis-on-anterior-pelvic-ring-injury-and-anterior-column-acetabular-fracture
#14
Hadisoebroto Dilogo Ismail, Yoshi Pratama Djaja, Jessica Fiolin
INTRODUCTION: In performing surgery for fractures of the pelvis and acetabulum, various surgical approaches have been introduced with their own advantages and drawbacks. The extensile nature of ilioinguinal approach gives excellent exposure but was related to wound healing problems. Modified stoppa has a higher difficulty and poses a risk for neurovascular injury. In this study, we elaborate our experience using the Modified Stoppa approach with additional lateral window while adding few modifications to simplify the procedure and facilitate future implant removal...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28943489/frequency-of-the-pectoralis-minor-compression-syndrome-in-patients-treated-for-thoracic-outlet-syndrome
#15
Myriam Ammi, Matthieu Péret, Samir Henni, Mickaël Daligault, Pierre Abraham, Xavier Papon, Bernard Enon, Jean Picquet
BACKGROUND: Pectoralis minor compression syndrome (PMCS) is a compression of the neurovascular structures in the sub-pectoral tunnel and remains underestimated in the management of patients with thoracic outlet syndrome (TOS). Its underdiagnosis may be responsible for incomplete or failed treatment. The aim of the study was to evaluate the frequency of PMCS in our experience. METHOD: We retrospectively reviewed all patients treated for TOS in our department. We selected those in whom PMCS was diagnosed with a systematic dynamic arteriography...
September 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28933198/iatrogenic-injuries-in-percutaneous-pinning-techniques-for-fifth-metacarpal-neck-fractures
#16
Sheriff D Akinleye, Garret Garofolo-Gonzalez, Maya Deza Culbertson, Jack Choueka
BACKGROUND: There is little information regarding anatomic structures at risk during closed percutaneous treatment of fifth metacarpal neck fractures. This study evaluates a variety of common percutaneous techniques with the hypothesis that each approach presents unique risks to tendons and neurovascular structures. METHODS: Seven cadaveric hands were used for this study. The senior author, a board-certified hand surgeon with more than 20 years of experience, used a mini-C arm to pass 1...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28931617/normobaric-hyperoxia-reduces-blood-occludin-fragments-in-rats-and-patients-with-acute-ischemic-stroke
#17
Shuhai Shi, Zhifeng Qi, Qingfeng Ma, Rong Pan, Graham S Timmins, Yongmei Zhao, Wenjuan Shi, Yunzhou Zhang, Xunming Ji, Ke Jian Liu
BACKGROUND AND PURPOSE: Damage of the blood-brain barrier (BBB) increases the incidence of neurovascular complications, especially for cerebral hemorrhage after tPA (tissue-type plasminogen activator) therapy. Currently, there is no effective method to evaluate the extent of BBB damage to guide tPA use. Herein, we investigated whether blood levels of tight junction proteins could serve as biomarker of BBB damages in acute ischemic stroke (AIS) in both rats and patients. We examined whether this biomarker could reflect the extent of BBB permeability during cerebral ischemia/reperfusion and the effects of normobaric hyperoxia (NBO) on BBB damage...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28927914/c1-c2-pedicle-screw-fixation-for-atlantoaxial-dislocation-in-pediatric-patients-younger-than-5-years-a-case-series-of-15-patients
#18
Yue-Hui Zhang, Jiang Shao, Dean Chou, Jian-Feng Wu, Jia Song, Jing Zhang
OBJIECTIVE: C1-C2 pedicle screw fixation has become popular for providing excellent bony purchase and avoiding neurovascular complications. However, it may be technically challenging in children. The objective of this study is to investigate the safety and efficacy of C1-C2 pedicle screw fixation for atlantoaxial dislocation (AAD) in pediatric patients younger than 5 years, and to evaluate the preliminary clinical and radiographic results. METHODS: During a 7-year period, 15 patients with a mean age of 3...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28924526/first-report-of-tripled-retromolar-foramina
#19
Puhan He, Joe Iwanaga, Mindy K Truong, Nimer Adeeb, R Shane Tubbs, Koh-Ichi Yamaki
The retromolar foramen (RMF) is the bony entrance of the retromolar canal, through which a neurovascular bundle runs. It is essential to locate such anatomic variants in a patient in order to avoid complications in surgery, implant placement, or anesthesia of the area. To our knowledge, there has only been one case report of supernumerary RMF, which reported one bilateral doubled retromolar foramina and one doubled left RMF. We present an extremely rare case in which a right triple RMF was observed on cone beam computed tomography in a cadaver...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28922701/unicortical-and-bicortical-plating-in-the-fixation-of-comminuted-fractures-of-the-clavicle-a-biomechanical-study
#20
John M Looft, Lincoln Corrêa, Minoo Patel, Mathew Rawlings, David C Ackland
BACKGROUND: Intraoperative neurovascular complications with clavicle fracture fixation are often due to far cortex penetration by drills and screws, but could be avoided using a unicortical construct. The objective of this study was to compare the bending and torsional strength of a unicortical locking screw plate construct and a hybrid (with central locked and outer non-locked long oblique screws) unicortical plate construct for clavicle fracture fixation with that of a conventional bicortical locking screw construct of plate fixation...
September 18, 2017: ANZ Journal of Surgery
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