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Decompressive craniectomy

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https://www.readbyqxmd.com/read/29457118/preoperative-elevated-fdp-may-predict-severe-intraoperative-hypotension-after-dural-opening-during-decompressive-craniectomy-of-traumatic-brain-injury
#1
Kei Kamiutsuri, Naoki Tominaga, Shunji Kobayashi
Purpose: Coagulation disorder and intraoperative hypotension are representative complications of traumatic brain injury which cause worse perioperative outcome. The aim of this study was to survey the relation of coagulation disorder and intraoperative hypotension (IH) during decompressive craniectomy. Method: Patients who underwent emergency decompressive craniectomy due to traumatic brain injury were retrospectively surveyed. The relation between preoperative coagulation date and intraoperative hypotension (systolic blood pressure < 60 mmHg after dural opening) was analyzed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456841/successful-treatment-of-extensively-drug-resistant-acinetobacter-baumannii-ventriculitis-with-polymyxin-b-and-tigecycline-a-case-report
#2
Wei Guo, Shao-Chun Guo, Min Li, Li-Hong Li, Yan Qu
Background: Acinetobacter baumannii nosocomial ventriculitis/meningitis, especially those due to drug-resistant strains, has substantially increased over recent years. However, limited therapeutic options exist for the Acinetobacter baumannii ventriculitis/meningitis because of the poor penetration rate of most antibiotics through the blood-brain barrier. Case presentation: A 57-year-old male patient developed ventriculitis from an extensively drug-resistant strain of Acinetobacter baumannii after the decompressive craniectomy for severe traumatic brain injury...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29452194/decompressive-craniectomy-protects-against-hippocampal-edema-and-behavioral-deficits-at-an-early-stage-of-a-moderately-controlled-cortical-impact-brain-injury-model-in-adult-male-rats
#3
Zonggang Hou, Runfa Tian, Feifei Han, Shuyu Hao, Weichuan Wu, Xiang Mao, Xiaogang Tao, Te Lu, Jinqian Dong, Yun Zhen, Baiyun Liu
A decompressive craniectomy (DC) has been shown to be a life-saving therapeutic treatment for traumatic brain injury (TBI) patients, which also might result in post-operative behavioral dysfunction. However, there is still no definite conclusion about whether the behavioral dysfunction already existed at an early stage after the DC operation or is just a long-term post-operation complication. Therefore, the aim of the present study was to analyze whether DC treatment was beneficial to behavioral function at an early stage post TBI...
February 13, 2018: Behavioural Brain Research
https://www.readbyqxmd.com/read/29428269/comparison-of-craniotomy-and-decompressive-craniectomy-in-large-supratentorial-intracerebral-hemorrhage
#4
Dong Bin Kim, Sang Kyu Park, Byeong Hoo Moon, Byeong Rae Cho, Dong Kyu Jang, Kyeong Sool Jang
Intracerebral hemorrhage (ICH) is devastating disease with high mortality and morbidity rates. Most ICH is evacuated by either craniotomy (CR) or decompressive craniectomy (DC) although optimal treatment has not been established yet. The objective of this study was to compare clinical outcomes of spontaneous ICH patients between CR and DC groups and determine clinical factors affecting clinical prognosis. We retrospectively analyzed our single-center experience with large supratentorial ICH. From January 2011 to December 2016, 286 consecutive supratentorial large ICH patients underwent surgery in our institute...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29428266/duraplasty-using-amniotic-membrane-versus-temporal-muscle-fascia-a-clinical-comparative-study
#5
Agus Turchan, Taufiq Fatchur Rochman, Arie Ibrahim, Dyah Fauziah, Joni Wahyuhadi, M Arifin Parenrengi, Asra Al Fauzi, Erliano Sufarnap, Abdul Hafid Bajamal, Ferdiansyah, Heri Suroto, Purwati, Fedik Abdul Rantam, Adanti Wido Paramadini, Christianto Benjamin Lumenta
In the field of neurosurgery, often the dura mater cannot be sutured, and consequently, it requires a duraplasty procedure using a dural fascial graft. Since 1890, various materials have been researched as dura mater substitutes. Amniotic membrane, for example, is suitable as a dural graft material and has been used in neurosurgery since 2012. However, there has been little research on human patient's dural healing after the use of amniotic membrane in their duraplasty procedure. To address this gap, a clinical experimental study was undertaken to evaluate the human dural healing of 16 patients who had undergone duraplasty in decompressive craniectomy surgery at Dr...
February 7, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29421447/prognostic-significance-of-magnetic-resonance-imaging-in-patients-with-severe-nonpenetrating-traumatic-brain-injury-requiring-decompressive-craniectomy
#6
Kwok M Ho, Steve Honeybul, Ravi Ambati
BACKGROUND: Diffuse axonal injury (DAI) detected on magnetic resonance imaging (MRI) may be useful to predict outcome after traumatic brain injury (TBI). METHODS: This study compared the ability of the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic model with DAI on MRI, to predict 18-months neurological outcome in 56 patients who had required a decompressive craniectomy after TBI. RESULTS: Of the 56 patients included in the study (19 scans occurred within 14 days; median time for all patients 24 days, interquartile range 14-42), 18 (32%) had evidence of DAI on the MRI scans...
February 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29419694/akinetic-mutism-following-prefrontal-injury-by-an-electrical-grinder-a-case-report-a-diffusion-tensor-tractography-study
#7
Sung Ho Jang, Seong Ho Kim, Han Do Lee
RATIONALE: A 72-year-old male had suffered from head trauma resulting from injury to his frontal area by an electrical grinder while working at his home. PATIENT CONCERNS: He lost consciousness for approximately 10 minutes and experienced continuous post-traumatic amnesia. DIAGNOSES: He was diagnosed as traumatic intracerebral hemorrhage in both frontal lobes, intraventricular hemorrhage, and subarachnoid hemorrhage, and underwent decompressive craniectomy and hematoma removal...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29411714/effects-of-tissue-processing-on-bioactivity-of-cartilage-matrix-based-hydrogels-encapsulating-osteoconductive-particles
#8
Jakob M Townsend, Taylor A Zabel, Yi Feng, Jinxi Wang, Brian T Andrews, Randy Nudo, Cory Berkland, Michael S Detamore
In the treatment of severe traumatic brain injury (TBI), decompressive craniectomy is commonly used to remove a large portion of calvarial bone to allow unimpeded brain swelling. Hydrogels have the potential to revolutionize TBI treatment by permitting a single-surgical intervention, remaining pliable during brain swelling, and tuned to regenerate bone after swelling has subsided. With this motivation, our goal is to present a pliable material capable of regenerating calvarial bone across a critical size defect...
February 7, 2018: Biomedical Materials
https://www.readbyqxmd.com/read/29409774/adult-tethered-cord-syndrome-following-chiari-decompression
#9
Christina Jackson, Brian W Yang, Wenya Linda Bi, E Antonio Chiocca, Michael W Groff
BACKGROUND: Adult tethered cord syndrome is a rare neurological disorder that classically presents with back or leg pain, weakness, and urinary dysfunction. Spinal cord tethering has been associated with acquired Chiari malformations. While the effects of tethered cord release on Chiari malformation symptoms have been previously described, we report an unusual case of acquired tethered cord syndrome following Chiari decompression. CASE DESCRIPTION: We report a 68-year-old man with a history of distant T12-level spinal cord injury who presented with two weeks of progressive bilateral lower extremity weakness...
January 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29369063/long-term-outcome-following-decompressive-craniectomy-an-inconvenient-truth
#10
Stephen Honeybul, Kwok M Ho, Grant R Gillett
PURPOSE OF REVIEW: There is little doubt that decompressive craniectomy can reduce mortality following malignant middle cerebral infarction or severe traumatic brain injury. However, the concern has always been that the reduction in mortality comes at the cost of an increase in the number of survivors with severe neurological disability. RECENT FINDINGS: There has been a number of large multicentre randomized trials investigating surgical efficacy of the procedure...
January 23, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29355383/changes-of-cortical-perfusion-in-the-early-phase-of-subarachnoid-bleeding-in-a-rat-model-and-the-role-of-intracranial-hypertension
#11
M Kolar, K Nohejlova, F Duska, J Mares, J Pachl
Brain perfusion is reduced early after subarachnoid hemorrhage (SAH) due to intracranial hypertension and early vasospasm. The contribution of these two mechanisms is unknown. By performing a prophylactic decompressive craniectomy (DC) in a rat model of SAH we aimed to study brain perfusion after the component of intracranial hypertension has been eliminated. We used 2x2 factorial design, where rats received either decompressive craniectomy or sham operation followed by injection of 250 microl of blood or normal saline into prechiasmatic cistern...
December 30, 2017: Physiological Research
https://www.readbyqxmd.com/read/29354235/compare-the-intracranial-pressure-trend-after-the-decompressive-craniectomy-between-massive-intracerebral-hemorrhagic-and-major-ischemic-stroke-patients
#12
Joon Huh, Seo-Yeon Yang, Han-Yong Huh, Jae-Kun Ahn, Kwang-Wook Cho, Young-Woo Kim, Sung-Lim Kim, Jong-Tae Kim, Do-Sung Yoo, Hae-Kwan Park, Cheol Ji
Objective: Massive intracerebral hemorrhage (ICH) and major infarction (MI) are devastating cerebral vascular diseases. Decompression craniectomy (DC) is a common treatment approach for these diseases and acceptable clinical results have been reported. Author experienced the postoperative intracranaial pressure (ICP) trend is somewhat different between the ICH and MI patients. In this study, we compare the ICP trend following DC and evaluate the clinical significance. Methods: One hundred forty-three patients who underwent DC following massive ICH (81 cases) or MI (62 cases) were analyzed retrospectively...
January 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29326127/skill-sets-required-for-the-management-of-military-head-face-and-neck-trauma-a-multidisciplinary-consensus-statement
#13
John Breeze, R Blanch, J Baden, A M Monaghan, D Evriviades, S E Harrisson, S Roberts, A Gibson, N MacKenzie, D Baxter, A J Gibbons, S Heppell, J G Combes, R F Rickard
INTRODUCTION: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. METHOD: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma...
January 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29325887/stiffness-and-strength-of-cranioplastic-implant-systems-in-comparison-to-cranial-bone
#14
Johan Persson, Benedikt Helgason, Håkan Engqvist, Stephen J Ferguson, Cecilia Persson
PURPOSE: The aim of this study was to evaluate skull replacement options after decompressive craniectomy by systematically investigating which combination of geometrical properties and material selection would result in a mechanical response comparable in stiffness to that of native skull bone and a strength as high or higher than the same. MATERIALS AND METHODS: The study was conducted using a Finite Element Model of the top part of a human skull. Native skull bone, autografts and commercial implants made of PEEK, solid titanium, two titanium meshes and a titanium-ceramic composite were modeled under a set load to evaluate deformation and maximum stress...
December 13, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29317364/early-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-in-asian-patients-a-single-center-study
#15
Prakash Paliwal, Farasat Kazmi, Hock Luen Teoh, Leonard L L Yeo, Raymond C S Seet, Tseng Tsai Yeo, Lwin Sein, Ning Chou, Thomas Tan, Bernard P L Chan, Vijay K Sharma
INTRODUCTION: Early decompression craniectomy (within 48 hours of stroke onset) in acute and malignant middle cerebral artery (MCA) ischemic stroke (IS) reduces mortality and increases the proportion of patients with favorable functional outcome. Various cultural and social issues among Asians lead to some differences in clinical practice, especially when surgical interventions are involved. Accordingly, decompressive craniectomy in Asian patients with stroke is often delayed. MATERIALS AND METHODS: Data for all patients with acute IS hospitalized in our center were entered into a prospectively maintained registry...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29307021/cerebellar-infarction-after-posterior-direct-reduction-and-fixation-to-treat-an-unstable-jefferson-fracture-a-case-report
#16
Seung Hwan Baek, Seung Ho Yoo, Kyoung Rai Cho, Jun Jae Shin
A 42-year-old man had an unstable Jefferson type IV atlas fracture with unilateral vertebral artery occlusion after a diving accident. We performed C1-ring reconstruction with a crosslink rod and C2 fixation to directly reduce the fracture fissure. Within 6 h, cerebellar hemisphere infarction developed. After decompressive craniectomy, duroplasty, and release of the vertebral artery occlusion caused by the transfixing rod, a postoperative computed tomography angiogram showed that blood flow in the right vertebral artery improved...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29303450/subcutaneous-bone-flap-storage-after-emergency-craniectomy-cost-effectiveness-and-rate-of-resorption
#17
Griffin Ernst, Fares Qeadan, Andrew P Carlson
OBJECTIVE Decompressive craniectomy is used for uncontrolled intracranial pressure in traumatic brain injury and malignant hemispheric stroke. Subcutaneous preservation of the autologous bone flap in the abdomen is a simple, portable technique but has largely been abandoned due to perceived concerns of resorption. The authors sought to characterize their experience with subcutaneous preservation of the bone flap and cranioplasty. METHODS The authors performed a retrospective single-institution review of subcutaneous preservation of the autologous bone flap after decompressive craniectomy from 2005 to 2015...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29291174/clinical-study-to-assess-the-outcome-in-surgically-managed-patients-of-spontaneous-intracerebral-hemorrhage
#18
Yashwanth S Sandeep, M Raja Guru, Ranjan Kumar Jena, Veldurti Ananta Kiran Kumar, Amit Agrawal
Introduction: Spontaneous intracerebral hemorrhage (SICH) subtype of stroke is characterized by bleeding into brain parenchyma which is not accompanied by trauma. Emergency surgical evacuation of large size SICH increases the chances of survival but does not help in functional recovery of the patients. The present study was conducted to assess the outcome of surgical management in patients with SICH. Materials and Methods: All patients who were diagnosed with SICH and underwent surgical evacuation of the hematoma included in the study...
October 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29262431/decompressive-craniectomy-for-malignant-middle-cerebral-artery-stroke
#19
Mark M Landreneau, Kevin N Sheth
Advancements in the treatment of ischemic stroke have led to a recent decline in overall stroke mortality, but patients with hemispheric infarcts remain at high risk for death. Recent advances in the approach to this devastating disease include early identification of patients at high risk for swelling and standardized approaches to medical therapy. However, surgical decompression continues to be the most effective treatment for malignant edema from large hemispheric strokes. Patient selection in the past had been strictly limited to younger ages and the nondominant hemisphere...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29243997/transdural-approach-to-resection-of-retro-odontoid-cysts-in-elderly-patients-report-of-3-cases
#20
Karthik Madhavan, Lee Onn Chieng, Brandon G Gaynor, Allan D Levi
Retro-odontoid cysts that arise from the tectorial membrane are uncommon lesions that can occur in elderly patients. They arise secondary to degenerative changes, including calcium pyrophosphate deposition within the ligaments. Surgical treatment is indicated when these lesions result in intractable pain, instability, and/or myelopathy. Several surgical techniques to treat this condition exist, but the optimal approach in elderly patients with comorbidities remains controversial. Here, the authors present a case series of 3 patients who underwent successful resection of a retro-odontoid lesion performed through a transdural approach...
December 15, 2017: Journal of Neurosurgery. Spine
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