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Decompressive craniectomy

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https://www.readbyqxmd.com/read/28427977/decompressive-craniectomy-in-spontaneous-intracerebral-hemorrhage-a-case-control-study
#1
Yu Tung Lo, Angela An Qi See, Nicolas Kon Kam King
BACKGROUND: Decompressive craniectomy is performed to relieve intracranial pressure as an emergency procedure. There is no large study to systematically evaluate the benefit of decompressive craniectomy versus best medical therapy. This study evaluates the survival and long-term functional outcomes of decompressive craniectomy for spontaneous intracranial hemorrhage. METHODS: A total of 54 eligible patients with spontaneous supratentorial hemorrhage (median age 55, IQR 47-64) who underwent decompressive craniectomy were retrospectively matched to 72 patients managed with best medical treatment (median age 58, IQR 32-74)...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28426865/decompressive-craniectomy-for-traumatic-intracranial-hypertension
#2
(no author information available yet)
No abstract text is available yet for this article.
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419880/trepanation-practices-in-asclepieia-systematizing-a-neurosurgerical-innovation
#3
REVIEW
Gregory Tsoucalas, Antonis A Kousoulis, Theodoros Mariolis-Sapsakos, Markos Sgantzos
As ancient Greeks started looking for deities that could fulfil the pragmatic needs of common people, local heroes started being mythologized and worshipped through cults. The most widespread such example was Asclepius, possibly a skilled war surgeon who followed military expeditions to Colchis and Troy. He was worshipped at religious temples called Asclepieia where certain specific medical and surgical techniques were followed. The most advanced must have been skull trepanation, most likely done as an acute operation to release intracranial pressure...
April 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28419358/early-cranioplasty-is-associated-with-greater-neurological-improvement-a-systematic-review-and-meta-analysis
#4
James G Malcolm, Rima S Rindler, Jason K Chu, Falgun Chokshi, Jonathan A Grossberg, Gustavo Pradilla, Faiz U Ahmad
BACKGROUND: Cranioplasty after decompressive craniectomy is a common neurosurgical procedure, yet the optimal timing of cranioplasty has not been well established. OBJECTIVE: To investigate whether the timing of cranioplasty is associated with differences in neurological outcome. METHODS: A systematic literature review and meta-analysis was performed using MEDLINE, Scopus, and the Cochrane databases for studies reporting timing and neurological assessment for cranioplasty after decompressive craniectomy...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28409728/intracranial-pressure-in-patients-undergoing-decompressive-craniectomy-new-perspective-on-thresholds
#5
Thomas Sauvigny, Jennifer Göttsche, Patrick Czorlich, Eik Vettorazzi, Manfred Westphal, Jan Regelsberger
OBJECTIVE Decompressive craniectomy (DC) is an established part of treatment in patients suffering from malignant infarction of the middle cerebral artery (MCA) or traumatic brain injury (TBI). However, no clear evidence for intracranial pressure (ICP)-guided therapy after DC exists. The lack of this evidence might be due to the frequently used, but simplified threshold for ICP of 20 mm Hg, which determines further therapy. Therefore, the objective of this study was to evaluate this threshold's accuracy and to investigate the course of ICP values with respect to neurological outcome...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28400228/keen-s-point-for-external-ventricular-drainage-in-traumatic-brain-injury-patients-an-uncommon-indication-for-an-old-technique
#6
Kevin T Huang, Vamsidhar Chavakula, William B Gormley
BACKGROUND: In cases of severe traumatic brain injury (TBI), cerebrospinal fluid (CSF) diversion though an external ventricular drain (EVD) is a proven method to assist in the control of elevated intracranial pressure (ICP). Under normal circumstances, the EVD is placed in a frontal location. However, in cases of multifocal intracranial injury and swelling, collapse of the frontal horns of the lateral ventricles leads to frequent failure of frontal CSF drainage. In this series we describe the utility of the Keen's point EVD as a safe alternative to maintain continuous CSF diversion for patients in whom frontal drainage is not feasible...
April 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28391551/predicting-posttraumatic-hydrocephalus-derivation-and-validation-of-a-risk-scoring-system-based-on-clinical-characteristics
#7
Hao Chen, Fang Yuan, Shi-Wen Chen, Yan Guo, Gan Wang, Zhi-Feng Deng, Heng-Li Tian
Posttraumatic hydrocephalus (PTH) is a disorder of disturbed cerebrospinal fluid (CSF) dynamics after traumatic brain injury (TBI). It can lead to brain metabolic impairment and dysfunction and has a high risk of clinical deterioration and worse outcomes. The incidence and risk factors for the development of PTH after decompressive craniectomy (DC) has been assessed in previous studies, but rare studies identify patients with higher risk for PTH among all TBI patients. This study aimed to develop and validate a risk scoring system to predict PTH after TBI...
April 9, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28374115/damage-control-surgery-in-intracerebral-hemorrhage-in-acute-leukemia-a-review-of-two-cases
#8
Jaskaran Singh, Kanwaljeet Garg, Rajeev Sharma, Sumit Sinha, Shashank Sharad Kale
INTRODUCTION: Intracerebral hemorrhage is the second most common cause of mortality (after infections) in acute leukemia and is responsible for approximately 20% of deaths due to acute leukemia. Management of intracerebral hemorrhage (ICH) is mostly conservative but there exist certain patients who need emergent surgery due to the poor Glasgow Coma Scale (GCS) despite their coagulopathic state. CASE REPORT: We present here two such cases which were successfully managed with decompressive craniectomy which was done as a damage control surgery thus stating the importance of surgical intervention in the management of acutely deteriorating patients rather than the commonly employed conservative management due to their coagulopathic state...
April 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28368505/effects-of-cranioplasty-on-cerebral-blood-flow-following-decompressive-craniectomy-a-systematic-review-of-the-literature
#9
Sameer H Halani, Jason K Chu, James G Malcolm, Rima S Rindler, Jason W Allen, Jonathan A Grossberg, Gustavo Pradilla, Faiz U Ahmad
BACKGROUND: Cranioplasty after decompressive craniectomy (DC) is routinely performed for reconstructive purposes and has been recently linked to improved cerebral blood flow (CBF) and neurological function. OBJECTIVE: To systematically review all available literature to evaluate the effect of cranioplasty on CBF and neurocognitive recovery. METHODS: A PubMed, Google Scholar, and MEDLINE search adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines included studies reporting patients who underwent DC and subsequent cranioplasty in whom cerebral hemodynamics were measured before and after cranioplasty...
March 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28365031/secondary-decompressive-craniectomy-for-the-management-of-refractory-endocraneal-hypertension-in-severe-traumatic-brain-injury-lights-and-shadows-from-recent-studies
#10
D A Godoy, L R Moscote Zalazar, A Rubiano, Á Muñoz-Sánchez, S Lubillo, F Murillo-Cabezas
No abstract text is available yet for this article.
March 29, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28359069/high-risk-of-seizures-and-epilepsy-after-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-stroke%C3%A2
#11
Rosane Brondani, Andrea Garcia de Almeida, Pedro Abrahim Cherubini, Suelen Mandelli Mota, Luiz Carlos de Alencastro, Apio Cláudio Martins Antunes, Marino Bianchin Muxfeldt
BACKGROUND: Decompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an additional burden for these patients, but its incidence and the risk factors for its development have been poorly investigated. OBJECTIVE: To report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients...
March 30, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28325460/cranioplasty
#12
REVIEW
Matthew Piazza, M Sean Grady
Cranioplasty following craniectomy for trauma is a common, safe neurosurgical procedure that restores the natural cosmesis and protective barrier of the skull and may be instrumental in normalizing cerebrospinal fluid dynamics after decompressive surgery. Understanding the factors influencing patient selection and timing of cranioplasty, the available materials and methods of skull reconstruction, and the technical nuances is critical for a successful outcome. Neurosurgeons must be prepared to manage the complications specific to this operation...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323540/identification-of-multipotent-stem-cells-in-human-brain-tissue-following-stroke
#13
Kotaro Tatebayashi, Yasue Tanaka, Akiko Nakano-Doi, Rika Sakuma, Saeko Kamachi, Manabu Shirakawa, Kazutaka Uchida, Hiroto Kageyama, Toshinori Takagi, Shinichi Yoshimura, Tomohiro Matsuyama, Takayuki Nakagomi
Perivascular regions of the brain harbor multipotent stem cells. We previously demonstrated that brain pericytes near blood vessels also develop multipotency following experimental ischemia in mice and these ischemia-induced multipotent stem cells (iSCs) can contribute to neurogenesis. However, it is essential to understand the traits of iSCs in the poststroke human brain for possible applications in stem cell-based therapies for stroke patients. In this study, we report for the first time that iSCs can be isolated from the poststroke human brain...
April 19, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/28315797/craniotomy-versus-decompressive-craniectomy-for-acute-subdural-hematoma-systematic-review-and-meta-analysis
#14
Kevin Phan, Justin M Moore, Christoph Griessenauer, Adam A Dmytriw, Daniel B Scherman, Sharaf Sheik-Ali, Nimer Adeeb, Christopher S Ogilvy, Ajith Thomas, Jeffrey V Rosenfeld
INTRODUCTION: Acute subdural hematoma (SDH) is a major cause of morbidity following severe traumatic brain injury. Surgical evacuation of the hematoma, either via craniotomy or craniectomy, is the mainstay of treatment in patients with progressive neurological deficits or significant mass effect. However, the decision between either procedure remains controversial. METHODS: A literature search using major online databases and a manual search of reference on the topic of craniotomy and craniectomy for evacuation of subdural hematoma until September 2016 was performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28298042/the-effect-of-cranioplasty-following-decompressive-craniectomy-on-cerebral-blood-perfusion-neurological-and-cognitive-outcome
#15
Adnan Hussain Shahid, Manju Mohanty, Navneet Singla, Bhagwant Rai Mittal, Sunil Kumar Gupta
OBJECTIVE Decompressive craniectomy is an established therapy for refractory intracranial hypertension. Cranioplasty following decompressive craniectomy not only provides protection to the brain along with cosmetic benefits, but also enhances rehabilitation with meaningful functional recovery of potentially reversible cortical and subcortical damaged areas of the affected as well as the contralateral hemisphere. The aim of the study was to assess neurological and cognitive outcome as well as cerebral blood flow after cranioplasty...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28298025/outcome-after-hunt-and-hess-grade-v-subarachnoid-hemorrhage-a-comparison-of-pre-coiling-era-1980-1995-versus-post-isat-era-2005-2014
#16
Juergen Konczalla, Volker Seifert, Juergen Beck, Erdem Güresir, Hartmut Vatter, Andreas Raabe, Gerhard Marquardt
OBJECTIVE Outcome analysis of comatose patients (Hunt and Hess Grade V) after subarachnoid hemorrhage (SAH) is still lacking. The aims of this study were to analyze the outcome of Hunt and Hess Grade V SAH and to compare outcomes in the current period with those of the pre-International Subarachnoid Aneurysm Trial (ISAT) era as well as with published data from trials of decompressive craniectomy (DC) for middle cerebral artery (MCA) infarction. METHODS The authors analyzed cases of Hunt and Hess Grade V SAH from 1980-1995 (referred to in this study as the earlier period) and 2005-2014 (current period) and compared the results for the 2 periods...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28286721/functional-outcome-after-decompressive-craniectomy-in-patients-with-dominant-or-non-dominant-malignant-middle-cerebral-infarcts
#17
Bilal Kamal Alam, Ahmed S Bukhari, Salman Assad, Pir Muhammad Siddique, Haider Ghazanfar, Muhammad Junaid Niaz, Maryam Kundi, Saima Shah, Maimoona Siddiqui
BACKGROUND:  The use of decompressive craniectomy (DC) has been studied in the setting of different conditions, including traumatic brain injury, subarachnoid hemorrhage, and malignant middle cerebral artery (MCA) infarction. The rationale of this study is to determine the functional outcome after DC in patients with malignant MCA infarcts. METHODS:  A longitudinal cohort study was performed based on patients diagnosed with malignant MCA territory infarction admitted to the Neurosurgery Department of a tertiary care hospital in Islamabad, Pakistan between July 2015 and November 2016...
January 26, 2017: Curēus
https://www.readbyqxmd.com/read/28285834/reconsidering-the-role-of-decompressive-craniectomy-for-neurological-emergencies
#18
REVIEW
S Honeybul, K M Ho, G R Gillett
OBJECTIVE: There is little doubt that decompressive craniectomy can reduce mortality. However, there is concern that any reduction in mortality comes at an increase in the number of survivors with severe neurological disability. METHOD: Over the past decade there have been several randomised controlled trials comparing surgical decompression with standard medical therapy in the context of ischaemic stroke and severe traumatic brain injury. The results of each trial are evaluated...
March 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28267369/compound-elevated-skull-fractures-review-of-literature
#19
G Lakshmi Prasad, N Anmol
INTRODUCTION: Compound elevated skull fractures (CESF) are rare traumatic injuries. To date, only 27 cases have been reported. METHODS: The authors report three cases of CESF managed at their institute. All were middle-aged males. The mechanism was assault by sharp-edged objects in two and road traffic accident (RTA) in one case. One underwent simple suturing; debridement and decompressive craniectomy was done in the remaining two cases. Good and poor outcomes were noted in one case each, while one died...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28264750/bilateral-nail-gun-traumatic-brain-injury-presents-as-intentional-overdose-a-case-report
#20
Judith Alain, Pascal Lavergne, Maude St-Onge, Myreille D'Astous, Stéphane Côté
This report describes a rare but life-threatening case of a suicide attempt initially considered as intentional overdose at the emergency department. Persistent altered mental status, despite normal toxicology investigations, led the attending team to order a head computed tomography scan, which revealed a bilateral penetrating nail gun injury with a right temporal hematoma for which a decompressive craniectomy was performed. Although voluntary intoxication is the most frequent form of suicide attempt, emergency physicians must be alert and maintain a broad differential diagnosis...
March 7, 2017: CJEM
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