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Neurosurgery, neurology

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https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#1
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28795286/diagnostic-and-therapeutic-strategies-for-patients-with-malignant-epidural-spinal-cord-compression
#2
REVIEW
Dilan A Patel, Jian L Campian
Malignant epidural spinal cord compression (MESCC) is an oncologic emergency with the potential for devastating consequences for patients if not promptly diagnosed and treated. MESCC is diagnosed by imaging. MRI is by far the most sensitive test, preferably with gadolinium. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should receive prompt administration of dexamethasone with a 10-mg IV loading dose followed by 4 mg every 6 h. Quick taper is recommended once the definitive treatment is established...
August 10, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28782703/the-contribution-of-the-international-pain-policy-fellowship-in-improving-opioid-availability-in-georgia
#3
Pati Dzotsenidze, Martha A Maurer, Dimitri Kordzaia, Ioseb Abesadze, Mary M Skemp Brown, Aaron M Gilson, James F Cleary
In the Republic of Georgia, the incidence and prevalence of cancer is increasing, signifying a growing need for palliative care and pain relief, including with controlled opioid medicines. As a signatory to the Single Convention, the Georgian government has a responsibility to ensure the adequate availability of controlled medicines for medical purposes, however the consumption of morphine is very low, suggesting a high occurrence of unrelieved pain. In Georgia, palliative care development began in the 2000s including the adoption of a policy document in 2005, the creation of the National Palliative Care Coordinator in 2006 and important changes in Georgian legislation in 2007 and 2008, which served to lay a foundation for improving opioid availability...
August 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28780845/-implementation-of-multimodal-navigation-combined-with-intraoperative-magnetic-resonance-imaging-in-the-frameless-stereotactic-biopsy-of-intracranial-lesions
#4
J S Zhang, X L Chen, Q Wang, Y Z Hou, G C Sun, F Y Li, X G Yu, B N Xu
Objective: To investigate the impact and value of multimodal navigation and intraoperative magnetic resonance imaging (iMRI) on the biopsy of intracranial lesions. Methods: From February, 2009 to December, 2016, this study enrolled 156 patients, who underwent multimodal navigation and iMRI-guided brain biopsy in the Neurosurgery Department of PLA General Hospital. Metabolic information was used for biopsy target selection. Intraoperative guidance helped biopsy trajectory avoid the eloquent structures. iMRI was performed to prove the biopsy accuracy and to revise the incorrect biopsy...
August 1, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28765716/simulation-training-in-neurosurgery-advances-in-education-and-practice
#5
REVIEW
Sanjay Konakondla, Reginald Fong, Clemens M Schirmer
The current simulation technology used for neurosurgical training leaves much to be desired. Significant efforts are thoroughly exhausted in hopes of developing simulations that translate to give learners the "real-life" feel. Though a respectable goal, this may not be necessary as the application for simulation in neurosurgical training may be most useful in early learners. The ultimate uniformly agreeable endpoint of improved outcome and patient safety drives these investments. We explore the development, availability, educational taskforces, cost burdens and the simulation advancements in neurosurgical training...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#6
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28754068/a-new-head-mounted-display-based-augmented-reality-system-in-neurosurgical-oncology-a-study-on-phantom
#7
Fabrizio Cutolo, Antonio Meola, Marina Carbone, Sara Sinceri, Federico Cagnazzo, Ennio Denaro, Nicola Esposito, Mauro Ferrari, Vincenzo Ferrari
PURPOSE: Benefits of minimally invasive neurosurgery mandate the development of ergonomic paradigms for neuronavigation. Augmented Reality (AR) systems can overcome the shortcomings of commercial neuronavigators. The aim of this work is to apply a novel AR system, based on a head-mounted stereoscopic video see-through display, as an aid in complex neurological lesion targeting. Effectiveness was investigated on a newly designed patient-specific head mannequin featuring an anatomically realistic brain phantom with embedded synthetically created tumors and eloquent areas...
December 2017: Computer Assisted Surgery (Abingdon, England)
https://www.readbyqxmd.com/read/28751968/lumboperitoneal-shunt-insertion-without-fluoroscopy-guidance-accuracy-of-placement-in-a-series-of-107-procedures
#8
Sabah Al-Rashed, Haider Kareem, Neeraj Kalra, Linda D'Antona, Mouness Obeidat, Bhavesh Patel, Ahmed Toma
Background: Lumboperitoneal (LP) shunts were the mainstay of cerebrospinal fluid diversion therapy for idiopathic intracranial hypertension (IIH). The traditionally cited advantage of LP shunts over ventriculoperitoneal (VP) shunts is the ease of insertion in IIH. This needs to be placed at the level of L3/4 to be below the level of the spinal cord. The objective of this study was to analyse the position of LP shunts inserted without portable fluoroscopy guidance.  Methods: A retrospective analysis of radiology was performed for patients who underwent lumboperitoneal shunts between 2006 and 2016 at the National Hospital for Neurology and Neurosurgery...
2017: F1000Research
https://www.readbyqxmd.com/read/28734188/the-effects-of-neurologic-assessment-e-learning-in-nurses
#9
Ji Yeon Shin, S Barry Issenberg, Young Sook Roh
BACKGROUND: A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. OBJECTIVES: The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. DESIGN: This study used a non-equivalent control group pretest-posttest design. SETTINGS: Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26)...
July 15, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28718304/the-role-of-surgery-in-low-grade-gliomas-do-timing-and-extent-of-resection-matter
#10
Hugues Duffau
Hugues Duffau is a Professor and Chairman of the Neurosurgery Department in the Montpellier University Medical Center and Head of the INSERM 1051 Team "plasticity of the central nervous system, human stem cells and glial tumors" at the Institute for Neurosciences of Montpellier (France). He is an expert in the awake cognitive neurosurgery of slow-growing brain tumors, such as low-grade gliomas, a routine which he has developed since 20 years. His fundamental approach is centered on the concepts of the brain connectomics and neuroplasticity, breaking with the traditional localizationist view of cerebral processing...
July 18, 2017: CNS Oncology
https://www.readbyqxmd.com/read/28713667/absent-congenital-cervical-pedicle-nearly-misdiagnosed-as-a-facet-dislocation-a-case-report
#11
Scott Safir, Jonathan Rasouli, Jeremy Steinberger, Branko Skovrlj, Amish Doshi, Konstantinos Margetis, Saadi Ghatan
BACKGROUND: Cervical spinal injury encompasses up to 1.5% of all pediatric injuries. Children, and more specifically infants, are a difficult subset of patients to obtain neurological exam in the setting of trauma, thus necessitating the use of cervical X-rays, CT scans, and MRI imaging. CASE DESCRIPTION: A healthy, 15-month-old boy had an unwitnessed fall down a flight of stairs and received a CT scan of the head and cervical spine in the emergency department due to cephalohematoma and mechanism of injury...
September 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/28707859/independent-predictors-for-functional-outcome-after-drainage-of-chronic-subdural-hematoma-identified-using-a-logistic-regression-model
#12
Sotirios Katsigiannis, Christina Hamisch, Boris Krischek, Marco Timmer, Anastasios Mpotsaris, Roland Goldbrunner, Pantelis Stavrinou
BACKGROUND: Chronic subdural hematoma (CSDH) is a common indication for undergoing neurosurgery, but the outcome may remain limited despite timely surgical treatment. The factors potentially associated with the functional outcome have not been sufficiently investigated. We set out to identify independent predictors associated with the functional outcome after surgical treatment of CSDH, avoiding arbitrary classifications and thresholds or subjective imaging assessment. METHODS: We retrospectively reviewed 197 consecutive surgical cases of CSDH...
July 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#13
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28697627/launching-an-sbns-accredited-neurosurgical-skills-workshop-for-medical-students-and-foundation-trainees
#14
Mohammed Kamel, Daniel M Fountain, Paul May, Richard Ashpole
The Neurology and Neurosurgery Interest Group (NANSIG), the student arm of the Society of British Neurological Surgeons (SBNS), organised a neurosurgical skills workshop in January 2017 following evidence of high demand among medical students and foundation trainees. The workshop involved ten delegates and five neurosurgical trainees with one senior consultant. Modules covering head positioning, burr holes, ventricular access, and flaps were included. This 'Introduction to Neurosurgery' skills workshop demonstrated significantly improved knowledge and confidence of delegates with attending and assisting in theatre in the future...
July 12, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28694597/management-of-cervical-monoradiculopathy-due-to-prolapsed-intervertebral-disc-an-institutional-experience
#15
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28693072/-comparison-of-posterior-fossa-decompression-with-and-without-duraplasty-for-surgical-management-for-adult-chiari-malformation-type-%C3%A2
#16
H Y Li, Y M Li, H Chen, Y Li, X W Shi
Objective: To evaluate and compare the efficacy between posterior fossa decompression without duraplasty (PFD) and posterior fossa decompression with duraplasty (PFDD) in the surgical management for adult Chiari Ⅰ malformation. Methods: Fifty-seven patients suffered from Chiari malformation type Ⅰ were treated in Department of Neurosurgery, Henan Provincial People's Hospital from August 2008 to October 2013. Twenty-three patients received posterior fossa decompression without duraplasty and the other 34 patients received posterior fossa decompression with duraplasty...
July 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28686119/management-of-peripheral-nerve-sheath-tumors-17-years-of-experience-at-toronto-western-hospital
#17
Daipayan Guha, Benjamin Davidson, Mustafa Nadi, Naif M Alotaibi, Michael G Fehlings, Fred Gentili, Taufik A Valiante, Charles H Tator, Michael Tymianski, Abhijit Guha, Gelareh Zadeh
OBJECTIVE A surgical series of 201 benign and malignant peripheral nerve sheath tumors (PNSTs) was assessed to characterize the anatomical and clinical presentation of tumors and identify predictors of neurological outcome, recurrence, and extent of resection. METHODS All surgically treated PNSTs from the Division of Neurosurgery at Toronto Western Hospital from 1993 to 2010 were reviewed retrospectively. Data were collected on patient demographics, clinical presentation, surgical technique, extent of resection, postoperative neurological outcomes, and recurrence...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28682828/criteria-for-intensive-care-admission-and-monitoring-after-elective-craniotomy
#18
Rafael Badenes, Lara Prisco, Armando Maruenda, Fabio S Taccone
PURPOSE OF REVIEW: The current article revises the recent evidence on ICU admission criteria and postoperative neuromonitoring for patients undergoing elective craniotomy. RECENT FINDINGS: Only a small proportion of elective postoperative neurosurgical patients require specific medical interventions and invasive monitoring. Among these, patients undergoing elective craniotomy are frequently admitted to neuro-ICU, specialist postanaesthesia care units or intermediate-level care unit in the postoperative period...
July 5, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28677169/fibre-dissection-and-sectional-study-of-the-major-porcine-cerebral-white-matter-tracts
#19
R Pascalau, B Szabo
White matter anatomy is the basis for numerous applications in neurology, neurosurgery and fundamental neuroscience. Although the porcine brain is frequently used as experimental model in these fields of research, the description of its white matter is not as thorough as in the human brain or other species. Thus, the aim of this study is to describe the porcine white matter tracts in a complex manner. Two stepwise dissection protocols adapted from human anatomy were performed on six adult pig brain hemispheres prepared according to the Klingler method...
July 4, 2017: Anatomia, Histologia, Embryologia
https://www.readbyqxmd.com/read/28675196/st-hugh-s-military-hospital-head-injuries-oxford-1940-1945
#20
M F Weiner, J Silver
Despite being open for only five years, St Hugh's Military Hospital (Head Injuries) has a seminal place in the history of neurology, neurosurgery and rehabilitation medicine. At its peak, during the Normandy campaign of 1944, it provided 430 beds for the treatment of service personnel. Between 1940 and 1945, 13,000 patients were referred to St Hugh's providing a unique opportunity for ground-breaking research into the management of head injuries. The doctors at St Hugh's collaborated with research scientists at Oxford University in many areas of fundamental research including the treatment of infection, the mechanics of brain injury, brain surgery, neuropsychiatry and rehabilitation, and the use of electroencephalograms...
June 2017: Journal of the Royal College of Physicians of Edinburgh
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