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https://www.readbyqxmd.com/read/28219414/severe-skull-base-osteomyelitis-caused-by-pseudomonas-aeruginosa-with-successful-outcome-after-prolonged-outpatient-therapy-with-continuous-infusion-of-ceftazidime-and-oral-ciprofloxacin-a-case-report
#1
Cristina Conde-Díaz, Jara Llenas-García, Mónica Parra Grande, Gertrudis Terol Esclapez, Mar Masiá, Félix Gutiérrez
BACKGROUND: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Currently, there is no consensus about the best therapeutic option. Here we describe a case of severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin...
February 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28219164/-a-combination-use-of-endoscope-and-microscope-in-cerebral-pontine-angle-surgery
#2
Z Y Wang, H Jia, J Yang, H Y Tan, H Wu
Objective: To evaluate the application of combination use of microscope and endoscope in cerebral pontine angle (CPA) surgery. Methods: A total of 72 patients undergone lateral skull base surgeries via endoscope under microscopic control from January 2006 to January 2015 was reviewed respectively. The patients including 35 males and 37 females were composed of 22 cases of vestibular swannnomas, 45 cases of cranial neuropathy and 5 cases of CPA chelesteatoma. Twenty cases of vestibular swannnomas, 15 cases of cranial neuropathy and 2 cases of CPA chelesteatoma undergone the surgery via retrosigmoid approach, while other cases undergone the surgery via retrolabyrinthine approach...
February 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28218643/diffusion-assessment-of-cortical-changes-induced-by-traumatic-spinal-cord-injury
#3
Peng Sun, Rory K J Murphy, Paul Gamble, Ajit George, Sheng-Kwei Song, Wilson Z Ray
Promising treatments are being developed to promote functional recovery after spinal cord injury (SCI). Magnetic resonance imaging, specifically Diffusion Tensor Imaging (DTI) has been shown to non-invasively measure both axonal and myelin integrity following traumatic brain and SCI. A novel data-driven model-selection algorithm known as Diffusion Basis Spectrum Imaging (DBSI) has been proposed to more accurately delineate white matter injury. The objective of this study was to investigate whether DTI/DBSI changes that extend to level of the cerebral peduncle and internal capsule following a SCI could be correlated with clinical function...
February 17, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28214640/the-art-of-mimicry-anterior-clinoid-dural-based-cavernous-hemangioma-mistaken-for-a-meningioma
#4
Tarek R Mansour, Yacine Medhkour, Pouya Entezami, Robert Mrak, Jason Schroeder, Azedine Medhkour
BACKGROUND: Cavernous hemangiomas account for 5-13% of central nervous system vascular lesions. They are usually found intra-axially but rarely involve extra-axial structures, most commonly the middle cranial fossa. A cavernous hemangioma presenting as a clinoid meningioma is extremely rare. CASE DESCRIPTION: We present a 36-year-old male with an asymptomatic intracranial mass found incidentally after an ATV accident. Preoperative MRI revealed a well-defined dural-based lesion arising from the right anterior clinoid process which was nearly homogenously enhancing, with a radiological diagnosis of meningioma...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#5
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...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28209740/quantitative-mri-volumetry-diffusivity-cerebrovascular-flow-and-cranial-hydrodynamics-during-head-down-tilt-and-hypercapnia-the-spacecot-study
#6
Larry Allen Kramer, Khader M Hasan, Ashot E Sargsyan, Karina Marshall-Goebel, Jörn Rittweger, Dorit Donoviel, Saki Higashi, Benson Mwangi, Darius A Gerlach, Eric M Bershad
PURPOSE: In order to improve the pathophysiologic understanding of visual changes observed in astronauts, we aimed to use quantitative MRI to measure anatomic and physiologic responses during a ground-based spaceflight analogue (head down tilt, HDT) combined with increased ambient carbon dioxide (CO2). METHODS: Six healthy, male subjects participated in the double-blinded, randomized cross-over design study with two conditions: 26.5 h of -12° HDT with ambient air and with 0...
February 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28207625/a-three-dimensional-geometric-morphometric-study-to-quantify-temporal-bone-growth-and-its-consequences-for-the-success-of-implanting-bone-anchored-hearing-devices
#7
Sebastian Schilde, Stefan K Plontke, Torsten Rahne
OBJECTIVE: A computed tomography (CT)-based morphological-investigation to describe temporal bone growth and to devise a predictive test of the likely success of Bonebridge implantation into the growing mastoid region of the temporal bone in young patients. STUDY DESIGN: Retrospective cross-sectional study. SETTING: University Hospital Halle (Saale), Germany. PATIENTS: Two cohorts participated. This first, of patients aged less than 21 years, comprised 42 men, and 33 women patients...
February 15, 2017: Otology & Neurotology
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
#8
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/28202828/-diagnosis-of-cochleovestibular-neurovascular-compression-syndrome-a-scoring-system-based-on-five-clinical-characteristics
#9
Tomomi Okamura, Takafumi Nishizaki, Norio Ikeda, Shigeki Nakano, Takanori Sakakura, Natsumi Fujii, Takeshi Okuda
: The optimal method for diagnosing cochleovestibular neurovascular compression syndrome(CNVC)remains controversial, and the aim of this study is to develop a standard diagnostic instrument for the condition. The clinical features of 53 sides of 50 patients with a combination of vertigo, tinnitus, and/or hearing loss were retrospectively evaluated. The following five clinical features were evaluated and given a score of 1 or 0:1)a long history of recurrent vertigo, tinnitus, or hearing loss;2)neurological findings related to positional vertigo, nystagmus, tinnitus, or hearing loss;3)neuro-otological findings involving tinnitus, audiometry, or vestibular testing;4)auditory brainstem response(ABR)evaluation with the detection of a low 25-75% II wave amplitude on the contralateral side and delayed interpeak latency in the I-III or I-V waves(usually low II wave amplitude combined with double peaks and a wide-based form)during ABR evaluation using 80 and 90dB clicks;and 5)the detection of vascular contact with the eighth cranial nerve on magnetic resonance imaging-constructive interference in steady state or air computed tomography imaging...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28199316/knoetschkesuchus-langenbergensis-gen-nov-sp-nov-a-new-atoposaurid-crocodyliform-from-the-upper-jurassic-langenberg-quarry-lower-saxony-northwestern-germany-and-its-relationships-to-theriosuchus
#10
Daniela Schwarz, Maik Raddatz, Oliver Wings
We report a new, small-sized atoposaurid crocodyliform from the Upper Jurassic of Langenberg, Northeastern Germany. Atoposaurids are small-sized Mesozoic crocodyliforms of mainly European distribution, which are considered to be phylogenetically close to the origin of Eusuchia. Knoetschkesuchus langenbergensis gen. nov. sp. nov. is represented by two well-preserved skulls and additional cranial and postcranial remains representing different ontogenetic stages. 3D reconstructions of a juvenile skull based on micro-computed tomography allow the most detailed description of cranial remains of any atoposaurid hitherto presented...
2017: PloS One
https://www.readbyqxmd.com/read/28197624/-nerve-distribution-and-density-in-the-canine-hip-joint-capsule-comparison-of-healthy-and-dysplastic-hip-joints
#11
Felix Giebels, Andreas Prescher, Stefan Wagenpfeil, Arno Bücker, Sylvia Kinzel
OBJECTIVE: The hip-joint capsule is exposed to increased tension forces during canine hip dysplasia, resulting in inflammation of the capsular tissue. It has been postulated that inflammation is associated with an increased nerve-distribution density. Therefore, it could be supposed that the nerve-distribution density in the hip-joint capsule is higher in dogs with dysplastic hip compared to healthy dogs. MATERIAL AND METHODS: In 16 Labrador Retriever dogs that had been euthanised due to unrelated reasons, the hip joints were classified as normoplastic (group 1, n = 18) or dysplastic (group 2, n = 14) based on radiography...
February 15, 2017: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
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
#12
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
#13
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
#14
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/28185970/risk-factors-for-hemorrhagic-transformation-following-intravenous-thrombolysis-in-acute-cerebral-infarction-a-retrospective-single-center-study
#15
Xiahong Xu, Changsong Li, Ting Wan, Xiaobo Gu, Wenxia Zhu, Junjie Hao, Huan Bao, Lian Zuo, Hui Hu, Gang Li
OBJECTIVE: To investigate the risk factors for the hemorrhagic transformation (HT) following intravenous thrombolysis using a recombinant tissue plasminogen activator (r-tPA) in acute cerebral infarction. METHODS: Acute cerebral infarction patients receiving r-tPA thrombolysis in Shanghai Eastern Hospital were retrospectively studied. Based upon the cranial CT or MRI examination, after the intravenous thrombolysis, the patients were divided into two groups: HT group and non-HT group...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185320/orientation-of-the-lateral-semicircular-canal-in-xenarthra-and-its-links-with-head-posture-and-phylogeny
#16
Florence Coutier, Lionel Hautier, Raphaël Cornette, Eli Amson, Guillaume Billet
The orientation of the semicircular canals of the inner ear in the skull of vertebrates is one of the determinants of the capacity of this system to detect a given rotational movement of the head. Past functional studies on the spatial orientation of the semicircular canals essentially focused on the lateral semicircular canal (LSC), which is supposedly held close to horizontal during rest and/or alert behaviors. However, they generally investigated this feature in only a few and distantly related taxa. Based on 3D-models reconstructed from µCT-scans of skulls, we examined the diversity of orientations of the LSC within one of the four major clades of placental mammals, that is, the superorder Xenarthra, with a data set that includes almost all extant genera and two extinct taxa...
February 10, 2017: Journal of Morphology
https://www.readbyqxmd.com/read/28183556/blood-loss-and-transfusion-requirements-with-epsilon-aminocaproic-acid-use-during-cranial-vault-reconstruction-surgery
#17
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
#18
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/28181025/surgical-management-of-chiari-i-malformation-based-on-different-cerebrospinal-fluid-flow-patterns-at-the-cranial-vertebral-junction
#19
Tao Fan, HaiJun Zhao, XinGang Zhao, Cong Liang, YinQian Wang, QiFei Gai
Chiari I malformation has been shown to present different cerebrospinal fluid (CSF) flow patterns at the cranial-vertebral junction (CVJ). Posterior fossa decompression is the first-line treatment for symptomatic Chiari I malformation. However, there is still controversy on the indication and selection of decompression procedures. This research aims to investigate the clinical indications, outcomes, and complications of the decompression procedures as alternative treatments for Chiari I malformation, based on the different CSF flow patterns at the cranial-vertebral junction...
February 9, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28180036/low-dose-gamma-knife-radiosurgery-for-vestibular-schwannomas-tumor-control-and-cranial-nerve-function-preservation-after-11-gy
#20
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
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