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Decompressive craniectomy

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https://www.readbyqxmd.com/read/28735123/surgery-for-cerebellar-hemorrhage-a-nsqip-database-analysis-of-patient-outcomes-and-factors-associated-with-30-day-mortality-and-prolonged-ventilation
#1
Gregory D Arnone, Darian R Esfahani, Matt Wonais, Prateek Kumar, Justin K Scheer, Ali Alaraj, Sepideh Amin-Hanjani, Fady T Charbel, Ankit I Mehta
OBJECTIVE: Primary cerebellar hemorrhage accounts for 10% of all intracranial hemorrhages. Given the confined space of the posterior fossa, cerebellar hemorrhage management sometimes necessitates suboccipital decompression and hematoma evacuation. In this study, we examine outcomes following surgery for primary cerebellar hemorrhage, and identify risk factors associated with adverse outcomes. METHODS: A retrospective review of the 2005-2014 ACS-NSQIP database was performed, with CPT Code 61315 (suboccipital craniectomy or craniotomy for evacuation of cerebellar hemorrhage) queried between 2005 and 2014...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#2
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28723776/a-case-of-idiopathic-hypertrophic-pachymeningitis-presenting-with-chronic-headache-and-multiple-cranial-nerve-palsies-a-case-report
#3
Yuanyuan Huang, Jun Chen, Li Gui
RATIONALE: Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition, characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura mater, but rarely both. Here, we report a rare case of IHP affecting both the intracranial and spinal dura mater. We also discussed the diagnosis, management, and outcome of IHP. PATIENT CONCERNS: We reviewed the case of a 60-year-old woman presenting with chronic headache, multiple cranial nerve palsies and gait disturbance...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28715363/decompressive-craniectomy-vs-craniotomy-only-for-intracranial-hemorrhage-evacuation-a-propensity-matched-study
#4
Faisal Jehan, Asad Azim, Peter Rhee, Muhammad Khan, Lynn Gries, Terence OʼKeeffe, Narong Kulvatunyou, Andrew Tang, Bellal Joseph
BACKGROUND: Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established, however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing decompressive craniectomy (DC) vs. craniotomy only (CO) for the evacuation of intracranial hemorrhage...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28713633/the-floating-anchored-craniotomy
#5
Matthew J Gutman, Elena How, Teresa Withers
BACKGROUND: The "floating anchored" craniotomy is a technique utilized at our tertiary neurosurgery institution in which a traditional decompressive craniectomy has been substituted for a floating craniotomy. The hypothesized advantages of this technique include adequate decompression, reduction in the intracranial pressure, obviating the need for a secondary cranioplasty, maintained bone protection, preventing the syndrome of the trephined, and a potential reduction in axonal stretching...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28713626/recurrent-hemorrhage-in-hemangioblastoma-involving-the-posterior-fossa-case-report
#6
Eric Marvin, Asad S Akhter, Jeroen R Coppens
BACKGROUND: Hemangioblastomas (HGBs) are the most common primary intra-axial posterior fossa tumor in adults. Although spontaneous hemorrhage of these tumors is exceedingly rare, despite their vascular nature, we describe a case of recurrent hemorrhage with associated tonsillar herniation, and demonstrate that a surgical approach can provide a suitable outcome. CASE DESCRIPTION: A 54-year-old female with von Hippel-Lindau (VHL) syndrome presented with acute loss of consciousness and Glasgow Coma Scale (GCS) was 4...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28712904/pitfalls-in-diagnosis-and-management-of-testicular-choriocarcinoma-metastatic-to-the-brain-report-of-two-cases-and-review-of-literature
#7
REVIEW
Haydn Hoffman, Gentian Toshkezi, Joseph M Fullmer, Walter Hall, Lawrence S Chin
INTRODUCTION: Pure choriocarcinoma of the testes is a rare, aggressive germ cell tumor (GCT) that can metastasize to the brain. Although its prognosis has improved with the development of cisplatin-based chemotherapy regimens, cerebral metastases are prone to hemorrhage and are associated with high morbidity. Here, we present two cases of testicular choriocarcinoma with cerebral metastasis and discuss potential pitfalls in their diagnosis and management. We also review cases in the literature that feature these rare lesions...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28665250/prognostic-value-of-changes-in-brain-tissue-oxygen-pressure-before-and-after-decompressive-craniectomy-following-severe-traumatic-brain-injury
#8
Santiago T Lubillo, Dácil M Parrilla, José Blanco, Jesús Morera, Jaime Dominguez, Felipe Belmonte, Patricia López, Ismael Molina, Candelaria Ruiz, Francisco J Clemente, Daniel A Godoy
OBJECTIVE In severe traumatic brain injury (TBI), the effects of decompressive craniectomy (DC) on brain tissue oxygen pressure (PbtO2) and outcome are unclear. The authors aimed to investigate whether changes in PbtO2 after DC could be used as an independent prognostic factor. METHODS The authors conducted a retrospective, observational study at 2 university hospital ICUs. The study included 42 patients who were admitted with isolated moderate or severe TBI and underwent intracranial pressure (ICP) and PbtO2 monitoring before and after DC...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28655201/unplanned-reoperation-after-craniotomy-for-tumor-a-national-surgical-quality-improvement-program-analysis
#9
Hormuzdiyar H Dasenbrock, Sandra C Yan, Vamsi Chavakula, William B Gormley, Timothy R Smith, Elizabeth B Claus, Ian F Dunn
BACKGROUND: Reoperation has been increasingly utilized as a metric evaluating quality of care. OBJECTIVE: To evaluate the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for tumor in a nationally accrued population. METHODS: Patients who underwent cranial tumor resection were extracted from the prospective National Surgical Quality Improvement Program registry (2012-2014). Multivariate logistic regression examined predictors of unplanned cranial reoperation...
June 26, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28651554/validation-of-an-international-classification-of-disease-ninth-revision-coding-algorithm-to-identify-decompressive-craniectomy-for-stroke
#10
Hormuzdiyar H Dasenbrock, David J Cote, Yuri Pompeu, Viren S Vasudeva, Timothy R Smith, William B Gormley
BACKGROUND: Although International Classification of Disease, Ninth Revision, Clinical Modification (ICD9-CM) coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial infarction. METHODS: Patients who underwent decompressive craniectomy for stroke at our institution were retrospectively identified and their associated ICD9-CM codes were extracted from billing data...
June 26, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28642178/neurological-outcome-after-decompressive-craniectomy-predictors-of-outcome-in-different-pathologies
#11
Taco Goedemans, Dagmar Verbaan, Bert A Coert, Bertjan Kerklaan, René van den Berg, Jonathan M Coutinho, Tessa van Middelaar, Paul J Nederkoorn, W Peter Vandertop, Pepijn van den Munckhof
OBJECTIVE: Decompressive craniectomy (DC) has been proposed as lifesaving treatment in patients with elevated intracranial pressure, but its effectiveness on reaching favorable neurological outcome remains unclear. We identified predictors of outcome in a large, single-center cohort of patients undergoing DC for different pathologies. METHODS: This retrospective study included all patients undergoing DC from 2006-2014. One-year outcome, assessed using the Glasgow Outcome Scale (GOS), was dichotomized into favorable (GOS 4-5) and unfavorable (GOS 1-3) outcome...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28637109/closing-the-dura-dural-hitching-versus-surgicel-and-tisseel-overlay-graft-in-craniocervicaldecompression-for-chiari-1-malformation
#12
Michael Tonkins, Naeem Farooqi, Rohan Ahmed, Saurabh Sinha, Debapriya Bhattacharyya
BACKGROUND: This study compares dural hitching to surgicel and tisseel overlay graft following craniocervical decompression and C1 laminectomy with simple durotomy for Chiari I malformation. Outcome measures were syrinx decompression, headache resolution and complication rates. METHODS: A retrospective analysis of case notes was conducted. Patients who had undergone craniocervical decompression (CCD) were grouped by method of dural closure. Outcomes compared were rates of syrinx decompression, headache resolution, and post-operative complications...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633982/corrigendum-to-does-size-and-site-matter-in-therapeutic-decompressive-craniectomy-a-laboratory-based-experimental-study-world-neurosurgery-95-2016-441-446
#13
https://www.readbyqxmd.com/read/28623468/-intracranial-pressure-monitoring-in-polytrauma-patients-with-traumatic-brain-injury
#14
REVIEW
T Neubauer, W Buchinger, E Höflinger, J Brand
BACKGROUND: The monitoring of intracranial pressure (ICP) represents a cornerstone in the intensive care of patients with traumatic brain injury (TBI) and the industry provides various technical solutions to this end. Decompressive craniectomy can be an option if conservative measures fail to reduce excessive ICP. OBJECTIVE: To examine the pathophysiology of ICP in trauma, the management of polytrauma involving TBI, and the indications for decompressive craniectomy; and to compare the different monitoring systems and their complications...
June 16, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28621627/factors-associated-with-shunt-dependent-hydrocephalus-after-decompressive-craniectomy-for-traumatic-brain-injury
#15
Aditya Vedantam, Jose-Miguel Yamal, Hyunsoo Hwang, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Posttraumatic hydrocephalus (PTH) affects 11.9%-36% of patients undergoing decompressive craniectomy (DC) and is an important cause of morbidity after traumatic brain injury (TBI). Early diagnosis and treatment of PTH can prevent further neurological compromise in patients who are recovering from TBI. There is limited data on predictors of shunting for PTH after DC for TBI. METHODS Prospectively collected data from the erythropoietin severe TBI randomized controlled trial were studied. Demographic, clinical, and imaging data were analyzed for enrolled patients who underwent a DC...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28604106/decompressive-craniectomy-for-the-treatment-of-malignant-middle-cerebral-artery-infarction
#16
Kapil Mohan Rajwani, Matthew Crocker, Barry Moynihan
INTRODUCTION: Malignant middle cerebral artery (MCA) infarction is associated with up to 80% mortality in the first week, despite maximal medical therapy. Decompressive craniectomy (DC) has been shown to improve survival rates in these patients. However, there are concerns that DC prolongs poor quality of life by increasing the number of survivors with major disability. This review will assess if DC in patients with malignant MCA infarction improves functional outcomes compared to maximal medical therapy...
June 12, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28600010/hemicraniectomy-for-ischemic-and-hemorrhagic-stroke-facts-and-controversies
#17
REVIEW
Aman Gupta, Mithun G Sattur, Rami James N Aoun, Chandan Krishna, Patrick B Bolton, Brian W Chong, Bart M Demaerschalk, Mark K Lyons, Jamal McClendon, Naresh Patel, Ayan Sen, Kristin Swanson, Richard S Zimmerman, Bernard R Bendok
Malignant large artery stroke is associated with high mortality of 70% to 80% with best medical management. Decompressive craniectomy (DC) is a highly effective tool in reducing mortality. Convincing evidence has accumulated from several randomized trials, in addition to multiple retrospective studies, that demonstrate not only survival benefit but also improved functional outcome with DC in appropriately selected patients. This article explores in detail the evidence for DC, nuances regarding patient selection, and applicability of DC for supratentorial intracerebral hemorrhage and posterior fossa ischemic and hemorrhagic stroke...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28593628/outcome-of-microsurgical-revascularization-in-patients-with-moyamoya-disease-first-report-from-iranian-population
#18
Abdolkarim Rahmanian, Mohammad Sadehgh Masoudi, Fariborz Ghaffarpasand, Mohammad Hossein Ashraf, Ehsanali Alibai
AIM: The aim of this study was to report the outcome of microsurgical revascularization in patients with moyamoya disease in Southern Iran. MATERIAL AND METHODS: This cross-sectional study was conducted in Southern Iran during a 7-year period from 2009 to 2016. All the patients with moyamoya disease (confirmed with digital substraction angiography) who underwent microsurgical revascularization (extracranial-intracranial bypass or synangiosis) were included. All the patients were followed for at least 1 year and the outcome was measured using Glasgow outcome scale (GOS) and modified Rankin scale (MRS)...
May 7, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28565992/pipeline-flow-diversion-of-ruptured-blister-aneurysms-of-the-supraclinoid-carotid-artery-using-a-single-device-strategy
#19
Robert W Ryan, Amir S Khan, Rebecca Barco, Armen Choulakian
OBJECTIVE Ruptured blister aneurysms remain challenging lesions for treatment due to their broad, shallow anatomy and thin, fragile wall. Historical challenges with both open microsurgical approaches and intrasaccular endovascular approaches have led to increased use of flow diversion for management of these aneurysms. However, the optimum paradigm, including timing of treatment, use of dual antiplatelet therapy, and number of flow-diverter devices to use remains unknown. The authors describe their experience with ruptured blister aneurysms treated with flow diversion at their institution, and discuss rates of rebleeding and number of devices used...
June 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28547518/life-threatening-posterior-reversible-encephalopathy-syndrome-in-the-cerebellum-treated-by-posterior-fossa-decompression
#20
Yousef Abusabha, Athanasios K Petridis, Bastian Kraus, Marcel A Kamp, Hans-Jakob Steiger, Kerim Beseoglu
Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome associated with various clinical conditions, such as headache, encephalopathy, and seizures. It is reversible if a prompt diagnosis is made and treatment undertaken. We report a 52-year-old male with hypertensive crisis. Progressing somnolence and an unresponsive left pupil occurred. MRI revealed an intra-axial hyperintensity of the cerebellum and brainstem and occlusive hydrocephalus suggestive of encephalitis or a tumor...
July 2017: Acta Neurochirurgica
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