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Decompressive craniectomy

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https://www.readbyqxmd.com/read/27907955/decompressive-craniectomy-in-neurocritical-care
#1
Erik G Hayman, David B Kurland, Zachary Grunwald, Sebastian Urday, Kevin N Sheth, J Marc Simard
Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907954/today-s-approach-to-treating-brain-swelling-in-the-neuro-intensive-care-unit
#2
Shreyansh Shah, W Taylor Kimberly
Brain swelling is an urgent clinical problem that frequently accompanies ischemic stroke, brain hemorrhage, and traumatic brain injury; it increases morbidity and mortality associated with them. It occurs due to failure of membrane transporters and leakage of the blood-brain barrier (BBB), resulting in combination of cytotoxic, ionic, and vasogenic edema. Currently, decompressive craniectomy and osmotherapy are the mainstays of management, but these therapies do not halt the underlying molecular cascade leading to brain swelling...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906426/continuous-monitoring-of-intracranial-pressure-for-prediction-of-postoperative-complications-of-hypertensive-intracerebral-hemorrhage
#3
S-X Yu, Q-S Zhang, Y Yin, Z Liu, J-M Wu, M-X Yang
OBJECTIVE: This study evaluates the value of continuous dynamic monitoring of intracranial pressure (ICP) in patients with hypertensive intracerebral hemorrhage to predict early postoperative complications. PATIENTS AND METHODS: Data from 80 patients treated in our hospital from February 2014 to February 2015 were analyzed. The patients all underwent decompressive craniectomies, and their ICP changes were monitored invasively and continuously for 1 to 7 days after surgery...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27904753/skin-flap-complications-after-decompressive-craniectomy-and-cranioplasty-proposal-of-classification-and-treatment-options
#4
Alessandro Di Rienzo, Pier Paol Pangrazi, Michele Riccio, Roberto Colasanti, Ilaria Ghetti, Maurizio Iacoangeli
BACKGROUND: The list of complications reported after decompressive craniectomy (DC) and cranioplasty is progressively increasing. Nonetheless, the exact incidence of these events is still ill-defined. Problems affecting skin flaps after DC and cranioplasty have never been accurately analyzed in papers and their impact on patients' prognosis is largely underestimated. METHODS: In a 10-year time, we treated by DC 450 patients, 344 of whom underwent cranioplasty, either with autologous bone or artificial implants (hydroxyapatite, polyetheretherketone, titanium, polymethylmethacrylate)...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904429/there-are-no-differences-between-factors-determining-graft-infection-in-autologous-bone-flap-replacement-and-acrylic-cranioplasty-a-prospective-observational-study-at-hospital-kuala-lumpur
#5
Siti Azleen Mohamad, Mohd Safari Mohd Haspani, Badrisyah Idris
OBJECTIVES: This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL). METHODOLOGY: This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventy-two patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38...
September 2016: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/27858578/severe-cerebral-edema-following-nivolumab-treatment-for-pediatric-glioblastoma-case-report
#6
Xiao Zhu, Michael M McDowell, William C Newman, Gary E Mason, Stephanie Greene, Mandeep S Tamber
Nivolumab is an immune checkpoint inhibitor (ICI) currently undergoing Phase III clinical trials for the treatment of glioblastoma. The authors present the case of a 10-year-old girl with glioblastoma treated with nivolumab under compassionate-use guidelines. After the first dose of nivolumab the patient developed hemiparesis, cerebral edema, and significant midline shift due to severe tumor necrosis. She was managed using intravenous dexamethasone and discharged on a dexamethasone taper. The patient's condition rapidly deteriorated after the second dose of nivolumab, demonstrating hemiplegia, seizures, and eventually unresponsiveness with a fixed and dilated left pupil...
November 18, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27857933/retro-odontoid-pseudotumor-without-atlantoaxial-subluxation-or-rheumatic-arthritis
#7
Seung Han Yu, Hyuk Jin Choi, Won Ho Cho, Seung Heon Cha, In Ho Han
We present a case of retro-odontoid pseudotumor (ROP) without rheumatoid arthritis (RA) or atlantoaxial subluxation (AAS). A 76-year-old woman presented with paresthesia and weakness of both lower and upper extremities. She had no laboratory or physical findings of RA. Dynamic X-ray showed no AAS and magnetic resonance imaging (MRI) showed a retro-odontoid mass compressing the spinal cord. Transdural mass debulking and biopsy were performed via minimal left suboccipital craniectomy and C1 hemilaminectomy. Two months after surgery, her symptoms were aggravated...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857926/intracerebral-hemorrhagic-infarction-after-cranioplasty-in-a-patient-with-sinking-skin-flap-syndrome
#8
Jai-Hyuck Han, Mou-Seop Lee
The sinking skin flap syndrome (SSFS) is a rare complication after a large craniectomy. Hemorrhage infarction after a cranioplasty is a very rare complication with only 4 cases to date. We report a case of the patient who underwent an autologous cranioplasty to treat SSFS that developed intracerebral hemorrhage infarction. A 20-year-old male was admitted to our emergency department with stuporous mentality. Emergent decompressive craniectomy (DC) have done. He had suffered from SSFS and fever of unknown origin (FUO) since DC...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857913/addition-of-resection-of-temporal-muscle-and-fascia-in-decompressive-craniectomy-in-the-treatment-of-traumatic-brain-injury
#9
Seung Han Yu, Byung Chul Kim, Jae Young Choi, Jae Il Lee, Won Ho Cho, Hyuk Jin Choi
OBJECTIVE: Decompressive craniectomy (DC) is a widely used surgical procedure for control of severely increased intracranial pressure in various conditions. The goal of this study is to evaluate the effectiveness of the addition of resection of temporalis muscle and fascia in DC particularly in the treatment of traumatic brain injury. METHODS: Twenty patients underwent temporalis muscle and fascia resection in addition to conventional DC and duroplasty due to massive brain swelling in a single tertiary hospital from 2013 to 2015 were enrolled...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857912/biomarkers-of-physiological-disturbances-for-predicting-mortality-in-decompressive-craniectomy
#10
Young Ha Jeong, So Hyun Kim, Eun Hee Choi, Kum Whang
OBJECTIVE: Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS: Ninety six patients with acute subdural hematoma underwent decompressive craniectomy between January 2014 and December 2015. The clinical data and laboratory variables of these patients were recorded and analyzed retrospectively...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857911/a-faster-and-wider-skin-incision-technique-for-decompressive-craniectomy-n-shaped-incision-for-decompressive-craniectomy
#11
Ho Seung Yang, Dongkeun Hyun, Chang Hyun Oh, Yu Shik Shim, Hyeonseon Park, Eunyoung Kim
OBJECTIVE: Decompressive craniectomy (DC) is a useful surgical method to achieve adequate decompression in hypertensive intracranial patients. This study suggested a new skin incision for DC, and analyzed its efficacy and safety. METHODS: In the retrograde reviews, 15 patients underwent a newly suggested surgical approach using n-shape skin incision technique (Group A) and 23 patients were treated with conventional question mark skin incision technique (Group B)...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857909/the-effect-of-preoperative-antiplatelet-therapy-on-hemorrhagic-complications-after-decompressive-craniectomy-in-patients-with-traumatic-brain-injury
#12
Hokyun Han, Eun Jung Koh, Hyunho Choi, Byong-Cheol Kim, Seung Yeob Yang, Keun-Tae Cho
OBJECTIVE: Traditionally, it is generally recommended that antiplatelet agent should be discontinued before surgery. However, decompressive craniectomy (DC) in patients with traumatic brain injury (TBI) is performed emergently in most cases. Therefore, DC cannot be delayed to the time when the effect of antiplatelet agent on bleeding tendency dissipates. In this study, we evaluated the effect of preinjury antiplatelet therapy on hemorrhagic complications after emergent DC in patients with TBI...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857908/therapeutic-hypothermia-for-increased-intracranial-pressure-after-decompressive-craniectomy-a-single-center-experience
#13
Hyun Taek Rim, Jun Hyong Ahn, Ji Hee Kim, Jae Keun Oh, Joon Ho Song, In Bok Chang
OBJECTIVE: Therapeutic hypothermia (TH) and decompressive craniectomy are neuroprotective interventions following severe brain swelling. The precise benefits, risks, and clinical outcomes in brain swelling after TH are still being investigated. We aimed to investigate the effects of TH in severe brain injury after decompressive craniectomy. METHODS: We reviewed the cases of 24 patients who underwent decompressive craniectomy with intracranial pressure (ICP) monitor insertion in one medical center between January 2012 and May 2016...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857859/emergency-decompressive-craniectomy-after-removal-of-convexity-meningiomas
#14
Paolo Missori, Maurizio Domenicucci, Sergio Paolini, Cristina Mancarella, Serena Tola, Alessandro D'Elia, Nicola Marotta, Arsen Seferi, Vincenzo Esposito
BACKGROUND: Convexity meningiomas are benign brain tumors that are amenable to complete surgical resection and are associated with a low complication rate. The aim of this study was to identify factors that result in acute postoperative neurological worsening after the removal of convexity meningiomas. METHODS: Clinical evaluation and neuroradiological analysis of patients who underwent removal of a supratentorial convexity meningioma were reviewed. Patients were selected when their postoperative course was complicated by acute neurological deterioration requiring decompressive craniectomy...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27851642/2008-sinking-skin-flap-syndrome-phenomenon-of-neurologic-deterioration-after-decompressive-craniectomy
#15
Saad Ullah, Noman Khan, Hassan Zeb, Hassan Tahir, Joshan Suri
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27847759/analysis-of-the-outcome-and-prognostic-factors-of-decompressive-craniectomy-between-young-and-elderly-patients-for-acute-middle-cerebral-artery-infarction
#16
Byung Rhae Yoo, Chan Jong Yoo, Myeong Jin Kim, Woo-Kyung Kim, Dae Han Choi
OBJECTIVE: We compared the effect of decompressive craniectomy between patients < 65 and ≥ 65 years age and investigated prognostics factors that may help predict favorable outcome in acute stroke patients undergoing decompressive surgery. MATERIALS AND METHODS: 52 patients diagnosed with acute middle cerebral artery (MCA) territory infarction that underwent decompressive craniectomy were retrospectively reviewed. The outcome of all patients were evaluated by assessing the Glasgow coma scale, Glasgow outcome scale (GOS), and Modified Rankin scale (mRS) six months after the onset of the disease...
September 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27847685/early-decompressive-craniectomy-for-malignant-cerebral-infarction-meta-analysis-and-clinical-decision-algorithm
#17
REVIEW
Christopher D Streib, Linda M Hartman, Bradley J Molyneaux
BACKGROUND: Decompressive craniectomy (DC) is an aggressive life-saving surgical intervention for patients with malignant cerebral infarction (MCI). However, DC remains inconsistently and infrequently utilized, primarily due to enduring concern that increased survival occurs only at the cost of poor functional outcome. Our aim was to clarify the role of DC performed within 48 hours (early DC) for patients with MCI, including patients aged >60 years. METHODS: We performed a meta-analysis of all available randomized controlled trials comparing early DC to best medical care for MCI...
October 2016: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/27836704/perioperative-risk-assessment-of-patients-with-gliomatosis-cerebri
#18
Nir Shimony, Ben Shofty, Zvi Ram, Rachel Grossman
BACKGROUND: Gliomatosis-cerebri (GC) is a rare diffusely infiltrating malignant glial neoplasm. Presenting symptoms may include seizures, neurological deficits, and not infrequently, symptoms related to increased intra-cranial pressure(ICP). Surgical intervention, including brain biopsy may induce worsening of these neurological symptoms. We reviewed our database to identify prognostic and risk factors for peri-operative deterioration specifically associated with elevated ICP. METHODS: Between 2006-2014 seventy-eight patients were treated for GC...
November 8, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27833717/two-stage-cranioplasty-tissue-expansion-directly-over-the-craniectomy-defect-prior-to-cranioplasty
#19
Ellianne Jacira Dos Santos Rubio, Eelke M Bos, Ruben Dammers, Maarten J Koudstaal, Anton G Dumans
Performing a skull reconstruction for a long-term existing large cranium defect usually needs either skin enhancement or skin flaps and cranioplasty. This procedure can be accompanied with aesthetic and functional complications. The presented case describes a 27-year-old man in need of a cranial reconstruction following decompressive craniectomy as treatment for severe traumatic brain injury. Autologous cranioplasty after decompressive craniectomy failed due to bone flap infection. Because of cognitive behavioral problems, a protective helmet needed to be worn in awaiting cranioplasty...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27819403/-treatment-of-syringomyelia-in-patients-with-chiari-malformation-and-craniosynostosis-a-case-report-and-review-of-the-literature
#20
A Aransay-Garcia, F J Villarejo-Ortega
INTRODUCTION: Patients with multisutural or single craniosynostosis, often suffer from Chiari malformation and syringomyelia. The surgical management of syringomyelia in these patients is controversial. CASE REPORT: A 3-year-old girl was referred with complex craniosynostosis that had not been corrected surgically. She was asymptomatic despite the cranial MRI showed a Chiari malformation and one year later she developed a cervico-dorso-lumbar syringomyelia. She underwent a decompressive suboccipital craniectomy but subsequently suffered a worsening of syringomyelia...
November 16, 2016: Revista de Neurologia
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