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Decompressive craniectomy

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https://www.readbyqxmd.com/read/29033263/-persistent-extra-axial-post-surgical-collections-and-propionibacterium-acnes-infection-presentation-of-two-cases-and-literature-review
#1
Pedro González, José Thenier, Raúl Galárraga, Adolfo de la Lama, Eva Azevedo, Cesáreo Conde
OBJECTIVES: It is common to observe the persistence of extra-axial collections after craniotomies. Most of these disappear in weeks or months but some remain. The onset of focal symptoms or the growth of these persistent collections months or years after surgery may indicate the presence of a chronic and latent infection by germs of low virulence such as Propionibacterium acnes (P. acnes). METHODS: We present two clinical cases with persistent extra-axial collections, which required surgery years after diagnosis, in which P...
October 13, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29027859/quantitative-cerebral-blood-flow-using-xenon-enhanced-ct-after-decompressive-craniectomy-in-traumatic-brain-injury
#2
Aditya Vedantam, Claudia S Robertson, Shankar P Gopinath
OBJECTIVE Few studies have reported on changes in quantitative cerebral blood flow (CBF) after decompressive craniectomy and the impact of these measures on clinical outcome. The aim of the present study was to evaluate global and regional CBF patterns in relation to cerebral hemodynamic parameters in patients after decompressive craniectomy for traumatic brain injury (TBI). METHODS The authors studied clinical and imaging data of patients who underwent xenon-enhanced CT (XeCT) CBF studies after decompressive craniectomy for evacuation of a mass lesion and/or to relieve intractable intracranial hypertension...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29026665/lasting-bilateral-mydriasis-after-traumatic-brain-injury-may-not-always-be-a-lost-case
#3
Alkinoos Athanasiou, Ioannis Balogiannis, Ioannis Magras
BACKGROUND: Lasting bilateral mydriasis and absence of pupillary light reflex following severe traumatic brain injury (TBI) are considered signs of irreversible brainstem damage and have been strongly associated with poor outcome. CASE DESCRIPTION: A young female patient presented with severe TBI, contusions, and diffuse brain edema. She was initially treated medically, but developed delayed secondary refractory intracranial hypertension and bilaterally dilated, non-reactive pupils for 12 h...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29019265/sinking-skin-flap-syndrome-following-decompressive-craniectomy
#4
Clément Cholet, Arthur André, Bruno Law-Ye
No abstract text is available yet for this article.
October 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28973642/letter-role-of-decompressive-craniectomy-in-traumatic-brain-injury-how-much-wiser-are-we-after-randomized-evaluation-of-surgery-with-craniectomy-for-uncontrollable-elevation-of-intracranial-pressure-trial
#5
https://www.readbyqxmd.com/read/28973347/a-report-of-2-cases-of-brainstem-hemorrhage-after-suboccipital-craniectomy-for-chiari-decompression
#6
Sean P Polster, Mark C Dougherty, Hussein A Zeineddine, Seon-Kyu Lee, David Frim
BACKGROUND AND IMPORTANCE: Decompression surgery for Chiari malformation is known to have very low procedure-related complications. There has been no report of post-Chiari malformation decompression surgery development of brainstem hemorrhage. We report 2 post-Chiari decompression surgery brainstem hemorrhage cases with 2-yr follow-up. CLINICAL PRESENTATION: Two cases were reviewed in which patients underwent uncomplicated suboccipital craniectomy with expansive autologous pericranium duraplasty for Chiari decompression...
July 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28965156/decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-including-patients-with-additional-involvement-of-the-anterior-and-or-posterior-cerebral-artery-territory-outcome-analysis-and-definition-of-prognostic-factors
#7
Sven Kürten, Christopher Munoz, Kerim Beseoglu, Igor Fischer, Jason Perrin, Hans-Jakob Steiger
BACKGROUND: According to current evidence, adding decompressive craniectomy (DC) to best medical therapy reduces case fatality rate of malignant middle cerebral artery infarction by 50-75%. There is currently little information available regarding the outcome of subgroups, in particular of patients with extensive infarctions exceeding the territory of the middle cerebral artery. METHODS: The records of 101 patients with large hemispheric infarctions undergoing DC were retrospectively reviewed...
September 30, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28963681/decompressive-craniectomy-icp-monitoring-and-secondary-necrosectomy-as-treatment-options-in-patients-presenting-with-malignant-ischemic-infarctions-extending-beyond-the-middle-cerebral-artery-territory
#8
EDITORIAL
https://www.readbyqxmd.com/read/28956193/decompressive-craniectomy-for-intracerebral-haematoma-the-influence-of-additional-haematoma-evacuation
#9
Alexis Hadjiathanasiou, Patrick Schuss, Inja Ilic, Valeri Borger, Hartmut Vatter, Erdem Güresir
Intracerebral haemorrhage (ICH) may lead to intractable elevation of intracranial pressure (ICP), which may lead to decompressive craniectomy (DC). In this setting, surgical evacuation of ICH is controversially discussed. We therefore analysed radiological and clinical parameters to investigate the influence of additional haematoma evacuation to DC in patients with ICH. Forty-four patients suffering from spontaneous, hypertensive ICH between August 2007 and February 2016 underwent DC with and without ICH evacuation at the author's institution...
September 27, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28944947/posttraumatic-cerebral-infarction-after-decompressive-craniectomy-for-traumatic-brain-injury-incidence-risk-factors-and-outcome
#10
Tsung-Ming Su, Chu-Mei Lan, Tsung-Han Lee, Fu-Yuan Shih, Shih-Wei Hsu, Cheng-Hsien Lu
AIM: To investigate the incidence, timing, risk factors of posttraumatic cerebral infarction (PTCI) and its influence on mortality in patients with moderate to severe traumatic brain injury (TBI). MATERIAL AND METHODS: After reviewing the medical records and radiographs over a 6-year period, 173 patients with moderate to severe TBI were enrolled to determine the risk factors for the development of PTCI following unilateral decompressive craniectomy (DC). RESULTS: The incidence of PTCI following DC was 31...
July 23, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28933211/traumatic-brain-injury-current-treatment-strategies-and-future-endeavors
#11
Michael Galgano, Gentian Toshkezi, Xuecheng Qiu, Thomas Russell, Lawrence Chin, Li-Ru Zhao
Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. Treatment modalities vary extensively based on the severity of the injury and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. Guidelines have been set forth regarding the optimal management of TBI, but they must be taken in context of the situation and cannot be used in every individual circumstance...
July 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28930819/recovery-of-an-injured-corticobulbar-tract-in-a-patient-with-stroke-a-case-report
#12
Sungho Jang, Jonghoon Kim, Yousung Seo, Soyoung Kwak
RATIONALE: The corticobulbar tract (CBT) is known to be involved in the motor function of the non-oculomotor cranial nuclei and controls the muscles of the face, head, and neck. Several studies have reported injury of the CBT in patients with brain injury, however, little is known about recovery of the injured CBT. PATIENT CONCERNS: A 59-year-old right-handed male underwent decompressive craniectomy for management of brain swelling and intracerebral hemorrhage following an infarction in the left middle cerebral artery territory...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28925731/detection-of-metabolic-pattern-following-decompressive-craniectomy-in-severe-traumatic-brain-injury-a-microdialysis-study
#13
Deepak Gupta, Raghav Singla, Anna T Mazzeo, Eric B Schnieder, Vivek Tandon, S S Kale, A K Mahapatra
OBJECTIVE: The aim of the study was to detect mitochondrial dysfunction and ischaemia in severe traumatic brain injury and their relationship with outcome. METHODS: Forty-one patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy were prospectively monitored with intracerebral microdialysis catheters (MD). Variables related to energy metabolism were studied using microdialysis. RESULTS: Twentysix patients (63...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28898108/the-safety-of-simultaneous-cranioplasty-and-shunt-implantation
#14
Xiao-Feng Yang, Hao Wang, Liang Wen, Xin Huang, Gu Li, Jiang-Biao Gong
BACKGROUND: A large cranial defect combined with hydrocephalus is a frequent sequela of decompressive craniectomy (DC) performed to treat malignant intracranial hypertension. Currently, many neurosurgeons perform simultaneous cranioplasty and shunt implantation on such patients, but the safety of this combined procedure remains controversial. METHODS: We retrospectively evaluated 58 patients treated via cranioplasty and shunt implantation after DC. Twenty patients underwent simultaneous procedures (simultaneous operation group) and 38 underwent staged procedures (staged operation group)...
September 12, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28893697/incidence-of-postoperative-hematomas-requiring-surgical-treatment-in-neurosurgery-a-retrospective-observational-study
#15
Kadri Lillemäe, Johanna Järviö, Marja Kaarina Silvasti-Lundell, Jussi Antinheimo, Juha Hernesniemi, Tomi Tapio Niemi
OBJECTIVE: We aimed to characterize the occurrence of postoperative hematoma (POH) after neurosurgery overall and according to procedure type, and describe the prevalence of possible confounders. METHODS: Patient data between 2010 and 2012 at the Department of Neurosurgery in Helsinki University Hospital were retrospectively analyzed. Data search was performed according to the type of surgery including craniotomies; shunt procedures, spine surgery and spinal cord stimulators (SCS) implantation...
September 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28893696/medullary-decompression-by-sling-repositioning-of-vertebral-artery-with-operative-video
#16
Luis C Ascanio, Abdulrahman Y Alturki, Christoph J Griessenauer, Rouzbeh Motiei-Langroudi, Sandeep Kumar, Christopher S Ogilvy
BACKGROUND: Vascular compression of the medullary pyramid resulting in neurologic compromise is rare; therefore diagnosis is difficult and ultimately delayed. Most patients present with a combination of cranial nerve, autonomic, and/or motor and sensory dysfunction. Presentation with a single sign such as hemiparesis is rare. The low number of cases reported has made it impossible to define a standard treatment for this unusual disorder. CASE DESCRIPTION: Here, we present a patient with progressive left hemiparesis due to compression of the upper medulla by the vertebral artery, which was treated with repositioning of the artery using a sling...
September 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882465/remote-cerebellar-hemorrhage-caused-by-undetected-dural-tear-after-lumbar-spinal-surgery
#17
Estela Val-Jordán, Pilar Seral-Moral, Beatriz Novo-González
Remote cerebellar haemorrhage is a rare but serious complication after spinal surgery. Although the mechanism is not well known, it always occurs after loss of cerebrospinal fluid due to dural tear, not always identified, which produces remote venous bleeding. Prognosis depends largely on the severity of this bleeding. We report a case of 67-year-old female who suffered a cerebellar and subarachnoid haemorrhage and subdural haematoma after elective lumbar fusion surgery and eventually required decompressive craniectomy...
September 4, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28876566/a-survey-of-selected-key-areas-of-management-of-south-african-neurosurgical-patients
#18
C H Daniel, M D du Trevou
BACKGROUND: Previous surveys of neurosurgical patient management, including a South African (SA) survey conducted in 2001, confirmed the existence of significant dissimilarities in management on national and international levels. This survey aimed to determine current SA neurosurgical patient management and to compare this with international trends. METHOD: Questionnaires in multiple choice question (MCQ) and free text entry format covering key areas of neurosurgical practice were emailed to SA neurosurgeons following ethics approval...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871418/time-spent-with-impaired-autoregulation-is-linked-with-outcome-in-severe-infant-paediatric-traumatic-brain-injury
#19
Konstantin Hockel, Jennifer Diedler, Felix Neunhoeffer, Ellen Heimberg, Carmen Nagel, Martin U Schuhmann
BACKGROUND: It could be shown in traumatic brain injury (TBI) in adults that the functional status of cerebrovascular autoregulation (AR), determined by the pressure reactivity index (PRx), correlates to and even predicts outcome. We investigated PRx, cerebral perfusion pressure (CPP) and intracranial pressure (ICP) and their correlation to outcome in severe infant and paediatric TBI. METHODS: Seventeen patients (range, 1 day to 14 years) with severe TBI (median GCS at presentation, 4) underwent long-term computerised ICP and mean arterial pressure (MAP) monitoring using dedicated software to determine CPP and PRx and optimal CPP (CPP level where PRx shows best autoregulation) continuously...
September 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28868201/never-say-never-again-a-bone-graft-infection-due-to-a-hornet-sting-thirty-nine-years-after-cranioplasty
#20
Rosario Maugeri, Roberto G Giammalva, Francesca Graziano, Luigi Basile, Carlo Gulì, Antonella Giugno, Domenico G Iacopino
BACKGROUND: Cranioplasty (CP) is a widespread surgical procedure aimed to restore skull integrity and physiological cerebral hemodynamics, to improve neurological functions and to protect the underlying brain after a life-saving decompressive craniectomy (DC). Nevertheless, CP is still burdened by surgical complications, among which early or late graft infections are the most common outcome-threatening ones. CASE DESCRIPTION: We report the case of 48-year-old man admitted to our neurosurgical unit because of a painful right frontal swelling and 1-week purulent discharge from a cutaneous fistula...
2017: Surgical Neurology International
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