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https://www.readbyqxmd.com/read/29101074/regression-of-giant-calcified-thoracic-disc-and-spinal-cord-compression-following-thoracic-laminectomy-and-posterior-instrumented-fusion
#1
Fernando Alonso, Manish K Kasliwal
A 55 year old full time employed lady presented with urinary urgency and occasional lower extremity numbness and tingling with motor function preservation. CT and MRI revealed a 20mm x 9mm T10-T11 calcified disc (Figure A, B, C). Anterior and posterior approaches were discussed with the patient along with associated risks such as CSF leak due to possible intradural extension and small but possible risk of new onset motor deficit following disc removal. Considering her almost intact neurological function and to avoid slight albeit realistic morbidity from attempted discectomy regardless of an anterior transthoracic or posterolateral approach, a strategy consisting of a wide long segment T10-T11 laminectomy and T9-T12 posterior instrumented fusion was performed with the assumption that micro motion elimination through a fusion will eliminate dynamic compression from spinal cord draping over the anterior calcified disc fragment...
October 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29038894/the-supraorbital-eyebrow-approach-for-removal-of-craniopharyngioma-in-children-a-case-series
#2
Ricardo Santos de Oliveira, Dinark Conceição Viana, Lucas Pires Augusto, Marcelo Volpon Santos, Hélio Rubens Machado
OBJECTIVE: Craniopharyngiomas can be a surgical challenge for the pediatric neurosurgeon. Ideally, total removal must be achieved. However, the need to reduce surgical morbidity and preserve quality of life has led to a number of neurosurgical approaches in order to attain this goal. The aim of this article is to present an alternative surgical approach to these lesions and to provide the rationale for this technique. MATERIAL AND METHODS: Medical charts and operative records of eight pediatric patients harboring craniopharyngiomas who underwent surgical treatment using a supraorbital eyebrow approach (SOA) were reviewed from 2014 to 2016...
October 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29026671/bilateral-caudate-nucleus-infarcts-a-case-report-of-a-rare-complication-following-endoscopic-resection-of-a-tuberculum-sellae-meningioma
#3
Joel Bierer, Amparo Wolf, Donald H Lee, Brian W Rotenberg, Neil Duggal
BACKGROUND: We present a rare complication of bilateral caudate infarcts and necrosed nasoseptal flaps after endoscopic transsphenoidal resection of tuberculum sellae meningioma. This case highlights the importance of early and accurate diagnosis and treatment of a postoperative cerebrospinal fluid (CSF) leak and associated bacterial meningitis, and reviews any existing guidelines regarding its management. CASE DESCRIPTION: A 54-year-old otherwise healthy man presented with progressive bitemporal hemianopsia...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#4
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28838117/technique-for-mini-open-decompression-of-chiari-type-i-malformation-in-adults
#5
Peyman Pakzaban
BACKGROUND: The technique for decompression of Chiari type I malformation relies on open exposure of craniocervical junction for suboccipital craniectomy and upper cervical laminectomy with or without duraplasty. There is no detailed technical report of a minimally invasive approach for Chiari decompression in adults. OBJECTIVE: To describe a mini-open technique for decompression of Chiari type I malformation (including duraplasty) in adults. METHODS: Six consecutive adult patients with symptomatic Chiari type I malformation underwent decompression through a 3 to 4 cm midline incision via a speculum retractor...
August 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28833931/rate-of-complications-following-spinal-cord-stimulation-paddle-electrode-removal
#6
Andres L Maldonado-Naranjo, Leonardo A Frizon, Navin C Sabharwal, Roy Xiao, Olivia Hogue, Darlene A Lobel, Andre G Machado, Sean J Nagel
OBJECTIVE: Spinal cord stimulation (SCS) is a safe, reversible surgical treatment for complex regional pain syndrome and failed back surgery syndrome refractory to conventional medical management. Paddle electrodes are routinely used for the permanent implant because of the reduced risk of migration, lower energy requirements, and expanded coverage options. The risks associated with paddle lead removal are not well defined in the literature. METHODS: We retrospectively reviewed the outcomes of all patients at the Cleveland Clinic who underwent removal of SCS paddle electrodes between 2009 and 2016...
August 22, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28790007/targeted-epidural-blood-patch-under-o-arm-guided-stereotactic-navigation-in-patients-with-intracranial-hypotension-associated-with-a-spinal-cerebrospinal-fluid-leak-and-ventral-dural-defect
#7
Keisuke Takai, Makoto Taniguchi
OBJECTIVE: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection, such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention because of the insufficient coverage of injected blood. METHODS: Eight patients with intracranial hypotension owing to a CSF leak diagnosed with myelographic computed tomography (CT) and thin-cut magnetic resonance imaging (MRI) received an epidural blood patch under O-arm-guided stereotactic navigation...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysreflexia-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#8
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Alex Pham, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal retethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury, leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28764208/assessing-the-viability-of-hadad-flap-by-postoperative-contrast-enhanced-magnetic-resonance-imaging
#9
Hegde Jyotirmay, Sunil Kumar Saxena, A S Ramesh, K Nagarajan, Shreshta Bhat
INTRODUCTION: The Expanded Endonasal Approaches (EEAs) have been widely used for various skull base lesions. The reconstruction of the skull base defects is of vital importance to prevent postoperative complications. The vascular pedicled-nasoseptal flap (Hadad-Bassagasteguy flap) is used as a workhorse in reconstruction of majority of the defects. AIM: The purpose of this study was: (a) To assess the postoperative MRI appearance of vascularised pedicled nasoseptal flap for its viability; (b) To determine the variations in MRI that may suggest potential flap failure...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28731395/nasoseptal-flap-necrosis-a-rare-complication-of-endoscopic-endonasal-surgery
#10
Joseph D Chabot, Chirag R Patel, Marion A Hughes, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The vascularized nasoseptal flap (NSF) has become the workhorse for skull base reconstruction during endoscopic endonasal surgery (EES) of the ventral skull base. Although infrequently reported, as with any vascularized flap the NSF may undergo ischemic necrosis and become a nidus for infection. The University of Pittsburgh Medical Center's experience with NSF was reviewed to determine the incidence of necrotic NSF in patients following EES and describe the clinical presentation, imaging characteristics, and risk factors associated with this complication...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#11
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
BACKGROUND: Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation, and only 6 cases have been reported in the literature so far(17). CASE DESCRIPTION: We present a unique case of a 64-year-old woman who presented with a 2-year history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 years and suffered from meningitis. She underwent magnetic resonance imaging, computed tomography cisternogram, as well as computed tomography of the brain, which showed clival defect with CSF leak into the sphenoid sinus...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28676464/endonasal-endoscopic-odontoidectomy-in-ventral-diseases-of-the-craniocervical-junction-results-of-a-multicenter-experience
#12
Salvatore Chibbaro, Helene Cebula, Sorin Aldea, Bertrand Baussart, Leonardo Tigan, Julien Todeschi, Antonio Romano, Mario Ganau, Christian Debry, Franco Servadei, Francois Proust, Stephane Gaillard
BACKGROUND: Over the past decades, supported by preliminary anatomic and clinical studies exploring its feasibility and safety, experience has increased of the use of the endoscopic endonasal approach (EEA) to ventral diseases at the craniocervical junction (CCJ). METHODS: A multicenter study was carried out over a 4-year period of 14 patients managed by EEA odontoidectomy for CCJ diseases causing irreducible atlantoaxial dislocation. The surgical setup included an IGS system based on computed tomography and magnetic resonance images fusion, and 0° and 30° angled endoscopes with dedicated endoscopic tools...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28575349/safety-and-efficacy-of-a-novel-self-adhering-dural-substitute-in-a-canine-supratentorial-durotomy-model
#13
Kevin M Lewis, Jenifer Sweet, Scott T Wilson, Serge Rousselle, Heinz Gulle, Bernhard Baumgartner
BACKGROUND: Cerebrospinal fluid (CSF) leaks increase postoperative risk for complication, likelihood of reoperation, and costs. OBJECTIVE: To investigate a novel, self-adhering polyethylene glycol-coated collagen pad (PCC) as a dural substitute relative to Duragen XS (DGX; Integra LifeSciences Corporation, Plainsboro, New Jersey) and as a dural sealant relative to Tachosil (Takeda Austria GmbH, Linz, Austria), a fibrinogen and thrombin-coated collagen pad (FTC)...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28474582/delayed-extensive-lumbar-sub-dural-effusion-following-discectomy-clinical-imaging-and-case-report
#14
Arun-Kumar Kaliya-Perumal, Meng-Ling Lu, Fu-Cheng Kao, Chi-Chien Niu
Incidental durotomy during lumbar spine surgery is a commonly reported complication. Those presenting with cerebrospinal fluid (CSF) leak are usually recognized and repaired intraoperatively. In some circumstances, it may either be unrecognised or occur as a delayed complication. Such delayed occurrences cannot be predicted and its management remain a challenge to the surgeon, especially when it presents as a subdural effusion. We report a 55-year-old man who underwent mini open lumbar discectomy through left side for a prolapsed L4-L5 disc...
March 2017: BioMedicine
https://www.readbyqxmd.com/read/28452710/excavating-meningoencephaloceles-a-newly-recognized-entity
#15
Patricia A Loftus, Sarah K Wise, Pedram Daraei, Kristen Baugnon, John M DelGaudio
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks are largely attributed to idiopathic intracranial hypertension and typically present as skull base defects with or without prolapse of intracranial contents. However, in our practice, we have encountered a distinct type of spontaneous CSF leak that presents in a different manner. OBJECTIVE: To discuss a newly-classified, difficult to treat, subset of spontaneous CSF leaks that present as excavation of the bone of the skull base in a tunnel- or canal-like fashion by a meningocele or meningoencephalocele instead of as a localized area of bony dehiscence...
March 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28451020/foramen-magnum-meningioma-s-management-the-experience-of-the-department-of-neurosurgery-in-marrakesh
#16
Farouk Hajhouji, Mohammed Lmejjati, Khalid Aniba, Mehdi Laghmari, Houssine Ghannane, Said Ait Benali
Our study is a retrospective analysis of the clinical data, surgical outcomes, histological finding and prognosis of foramen magnum meningiomas through a serie of 8 cases operated at the department of neurosurgery at Mohammed VI medical university hospital, Marrakesh. From January 2002 to December 2015. There were 3 male and 5 female patients (mean age, 46.75 years). Cervico-occipital pain (100%) and motor deficit (100%) were the most common presenting symptoms. MRI was the most appropriate diagnostic tool in visualizing tumors of this region...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28435930/spinal-subdural-hematoma-a-rare-case-of-spinal-subdural-hematoma-complicating-routine-minimally-invasive-lumbar-discectomy-and-decompression-and-relevant-literature-review
#17
Chelsea C Boe, Brett A Freedman, Ravi Kumar, Kendall Lee, Robert McDonald, John Port
We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic injury. Hitherto, no case of acute postoperative subdural hematoma has been reported in the postoperative setting in the absence of known iatrogenic dural injury. A 76-year-old male with central and lateral recess spinal stenosis underwent apparently uncomplicated bilateral L3-4 and left sided L4-5 decompressive partial laminectomies and discectomy...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#18
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28409727/clival-chordomas-considerations-after-16-years-of-endoscopic-endonasal-surgery
#19
Matteo Zoli, Laura Milanese, Rocco Bonfatti, Marco Faustini-Fustini, Gianluca Marucci, Giovanni Tallini, Corrado Zenesini, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
OBJECTIVE In the past decade, the role of the endoscopic endonasal approach (EEA) has relevantly evolved for skull base tumors. In this study, the authors review their surgical experience with using an EEA in the treatment of clival chordomas, which are deep and infiltrative skull base lesions, and they highlight the advantages and limitations of this ventral approach. METHODS All consecutive cases of chordoma treated with an EEA between 1998 and 2015 at a single institution are included in this study. Preoperative assessment consisted of neuroimaging (MRI and CT with angiography sequences) and endocrinological, neurological, and ophthalmological evaluations, which were repeated 3 months after surgery and annually thereafter...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28402198/ventral-longitudinal-intraspinal-fluid-collection-rare-presentation-as-brachial-amyotrophy-and-intracranial-hypotension
#20
Veeramani Preethish-Kumar, Seena Vengalil, Sarbesh Tiwari, Kiran Polavarapu, M Netravathi, Aravinda Hanumanthapura Ramalingaiah, Atchayaram Nalini
CONTEXT: Ventral longitudinal intraspinal fluid collection (VLISFC) presenting as hand amyotrophy has been described only in a few cases and there are no reports on associated intracranial CSF hypovolemia (ICH). We describe the clinical and imaging findings of a case with combined brachial amyotrophy and ICH secondary to VLISFC. FINDINGS: A 31 year old man presented with severe positional neck discomfort, radiating pain, progressive asymmetrical wasting and weakness of distal upper limbs...
April 12, 2017: Journal of Spinal Cord Medicine
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