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https://www.readbyqxmd.com/read/29788439/repair-of-temporal-bone-defects-via-the-middle-cranial-fossa-approach-treatment-of-2-pathologies-with-1-operation
#1
Daniel B Eddelman, Stephan Munich, Ryan B Kochanski, Michael Eggerstedt, Robert P Kazan, Roham Moftakhar, Lorenzo Munoz, Rich W Byrne, R Mark Wiet
BACKGROUND: Temporal bone dehiscence (TBD) often results in leakage of cerebrospinal fluid (CSF) and/or encephalocele. TBD can also occur over the superior semicircular canal, causing debilitating vertigo. Both can be repaired surgically, but traditional treatment is focused only on one pathology, not both. OBJECTIVE: To report our experience in the treatment of TBD via the middle cranial fossa (MCF) approach. METHODS: A retrospective review was conducted for all patients who underwent MCF approach for surgical repair of any temporal fossa dehiscence...
May 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29777885/posttraumatic-cerebrospinal-fluid-leak-associated-with-an-upper-cervical-meningeal-diverticulum
#2
Noriya Enomoto, Hideo Mure, Toshiyuki Okazaki, Mai Azumi, Shinya Okita, Shinji Nagahiro, Yasushi Takagi
Spontaneous intracranial hypotension (SIH) has been increasingly recognized as a phenomenon caused by cerebrospinal fluid (CSF) leaks; however, its pathogenesis is still unclear. Here, we report two cases of SIH as a result of CSF leak from a meningeal diverticulum at the C2 nerve root sleeve. The first case is that of a 46-year-old man who had suffered from orthostatic headache after a bicycle accident at age 45. Computed tomography (CT) myelography revealed CSF leaks at the C1/2 level. He underwent epidural blood patch (EBP) therapy, but it was unsuccessful...
May 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29775155/long-term-surgical-outcomes-following-transsphenoidal-surgery-in-patients-with-rathke-s-cleft-cysts
#3
Michelle Lin, Michelle A Wedemeyer, Daniel Bradley, Daniel A Donoho, Vance L Fredrickson, Martin H Weiss, John D Carmichael, Gabriel Zada
OBJECTIVE Rathke's cleft cysts (RCCs) are benign epithelial lesions of the sellar region typically treated via a transsphenoidal approach with cyst fenestration and drainage. At present, there is limited evidence to guide patient selection for operative treatment. Furthermore, there is minimal literature describing factors contributing to cyst recurrence. METHODS The authors conducted a retrospective analysis of 109 consecutive cases of pathology-confirmed RCCs treated via a transsphenoidal approach at a single center from 1995 to 2016...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29765818/targeted-epidural-blood-patch-treatment-for-refractory-spontaneous-intracranial-hypotension-in-china
#4
Fei-Fang He, Li Li, Min-Jun Liu, Tai-Di Zhong, Qiao-Wei Zhang, Xiang-Ming Fang
Objective  An epidural blood patch (EBP) is the mainstay of treatment for refractory spontaneous intracranial hypotension (SIH). We evaluated the treatment efficacy of targeted EBP in refractory SIH. Methods  All patients underwent brain magnetic resonance imaging (MRI) with contrast and heavily T2-weighted spine MRI. Whole spine computed tomography (CT) myelography with non-ionic contrast was performed in 46 patients, and whole spine MR myelography with intrathecal gadolinium was performed in 119 patients...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29738390/incidence-and-risk-factors-for-sigmoid-venous-thrombosis-following-cpa-tumor-resection
#5
Matthew Shew, Hannah Kavookjian, Kelly Dahlstrom, Thomas Muelleman, James Lin, Paul Camarata, Luke N Ledbetter, Hinrich Staecker
OBJECTIVE: Our primary aim was to determine the incidence of sigmoid venous thrombosis (SVT) and determine risks factors and sequelae of SVT following cerebellopontine angle tumor resection. STUDY DESIGN: Retrospective cohort study. SETTING: Academic tertiary care hospital. PATIENTS: Patients over 18 years of age who underwent resection of cerebellopontine angle meningioma or vestibular schwannoma from January 2005 to April 2016 who had postoperative magnetic resonance imaging...
June 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29737744/-clinical-analysis-of-adult-spontaneous-cerebrospinal-fluid-rhinorrhea
#6
Zheng Jie Zhu, Lan Cheng, Jun Yang, Qi Huang, Guo Zhen Meng, Rong Ping Cao
OBJECTIVES: To discuss the clinical characteristics, diagnosis and treatment of adult spontaneous cerebrospinal fluid rhinorrhea (CSFR). METHODS: A retrospective study was conducted on 18 patients of CSFR. Nasal secretion was collected for biochemical analysis. Imaging examination was done for identification of the bony defect in skull base. RESULTS: In all cases, the glucose concentration of nasal secretion were more than 1.7 mmol/L, and the β-2 transferrin detected by immunoelectrophoresis technique were positive...
March 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29685531/imaging-sinonasal-disease-with-mri-providing-insight-over-and-above-ct
#7
REVIEW
Geoiphy George Pulickal, Annakan V Navaratnam, Thi Nguyen, Alina Denisa Dragan, Magdalena Dziedzic, Ravi K Lingam
This article illustrates and discusses the applications and value of magnetic resonance imaging (MRI) in the evaluation of sinonasal disease. There are several clinical scenarios where MRI can add value over conventional computed tomography (CT) evaluation of the sinonasal spaces. Specifically, MRI can provide insight through better depiction of the anatomy of certain sinonasal sub-sites including the olfactory structures. It can aid in evaluating anosmia, sinusitis (fungal sinusitis and complications), benign and malignant lesions, CSF leaks and pathology extending into sinonasal spaces...
May 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29682061/transcranial-and-epidural-approach-for-spontaneous-cerebrospinal-fluid-leakage-due-to-meningoencephalocele-of-the-lateral-sphenoid-sinus
#8
Ryosuke Shintoku, Masahiko Tosaka, Tatsuya Shimizu, Yuhei Yoshimoto
We experienced a case of sphenoid sinus type meningoencephalocele manifesting as severe cerebrospinal fluid (CSF) rhinorrhea. A 35-year-old man became aware of serous nasal discharge 1 year previously, which had gradually worsened. The nasal discharge was diagnosed as CSF rhinorrhea. Head computed tomography (CT) showed several small depressions in the bone of the left middle cranial fossa, and the largest depression extended through the bone to the lateral sphenoid sinus. Head magnetic resonance imaging revealed that the meningoencephalocele projected to the lateral sphenoid sinus, through this small bone defect of the middle cranial fossa...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682014/neurosurgical-interventions-for-occipital-encephalocele
#9
Lal Rehman, Ghulam Farooq, Irum Bukhari
Aims and Objectives: The aim of this study is to find the outcome of repair and resection of the occipital encephalocele. Study Design: Case series. Materials and Methods: The clinical data of fifty consecutive occipital encephalocele patients were retrieved from medical records including operative notes, postoperative follow-up visits, and postsurgical complications were noted for analysis from November 2009 to November 2013 at the Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29678699/acute-communicating-hydrocephalus-as-spinal-cord-surgery-complication-in-a-patient-with-lumbar-lipomyelocele-case-report
#10
Alessandro Prior, Mariasavina Severino, Andrea Rossi, Marco Pavanello, Gianluca Piatelli, Alessandro Consales
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5-15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery. CASE DESCRIPTION: A 6-year-old girl, who had undergone several surgeries in another Institution for lumbar lipomyeloschisis, came to our attention for a second opinion about the management of her spinal dysraphism...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29629045/iatrogenic-development-of-cerebrospinal-fluid-leakage-in-diagnosing-spontaneous-intracranial-hypotension
#11
Chang-Joon Lee, Sung-Min Shim, Sang-Hyeon Cho, Jae-Ho Park, Young Ki Kim
A 34-year-old woman came to the emergency room complaining of a severe orthostatic headache. Results of a cerebrospinal fluid tap and brain computed tomography were normal. Based on her history and symptoms, she was found to have spontaneous intracranial hypotension. She was hospitalized and her symptoms improved with conservative treatment. On the next day, her headache suddenly worsened. Cisternography was performed to confirm the diagnosis and determine the spinal level of her cerebrospinal fluid leak. It revealed multiple cerebrospinal fluid leaks in the lumbar and upper thoracic regions...
March 2018: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29557532/cisterna-magna-arachnoid-membrane-suturing-decreases-incidence-of-pseudomeningocele-formation-and-incisional-csf-leakage
#12
David Pitskhelauri, Elina Kudieva, Dmitrii Moshchev, Evgeny Ananev, Michail Shifrin, Gleb Danilov, Tatiana Melnikova-Pitskhelauri, Igor Kachkov, Andrey Bykanov, Alexander Sanikidze
OBJECTIVE: A pseudomeningocele and an incisional cerebrospinal fluid leak are considered frequent complications following neurosurgical operations. The rate of these complications especially increases following neurosurgical procedures on the posterior cranial fossae. According to some publications, the rate of pseudomeningoceles has been reported as high as 40%, whereas that of incisional cerebrospinal fluid leaks is up to 17%. For the purposes of reducing the risk of these complications after a midline suboccipital craniotomy, we propose suturing the arachnoid membrane of the cisterna magna...
May 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29554360/evaluation-of-intranasal-flap-perfusion-by-intraoperative-indocyanine-green-fluorescence-angiography
#13
Mathew Geltzeiler, Ana Carolina Igami Nakassa, Meghan Turner, Pradeep Setty, George Zenonos, Andrea Hebert, Eric Wang, Juan Fernandez-Miranda, Carl Snyderman, Paul Gardner
BACKGROUND: Vascularized intranasal flaps are the primary reconstructive option for endoscopic skull base defects. Flap vascularity may be compromised by injury to the pedicle or prior endonasal surgery. There is currently no validated technique for intraoperative evaluation of intranasal flap viability. OBJECTIVE: To evaluate the efficacy of indocyanine green (ICG) near-infrared angiography in predicting the viability of pedicled intranasal flaps during endoscopic skull base surgery through a pilot study...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29534203/behavioral-variant-frontotemporal-dementia-as-a-serious-complication-of-spontaneous-intracranial-hypotension
#14
Wouter I Schievink, M Marcel Maya, Zachary R Barnard, Franklin G Moser, Stacey Jean-Pierre, Alan D Waxman, Miriam Nuño
BACKGROUND: Behavioral variant frontotemporal dementia (bvFTD) is a devastating early onset dementia. Symptoms of bvFTD may be caused by spontaneous intracranial hypotension (SIH), a treatable disorder, but no comprehensive study of such patients has been reported. OBJECTIVE: To describe detailed characteristics of a large cohort of patients with SIH and symptoms of bvFTD. METHODS: We identified patients with SIH who met clinical criteria for bvFTD...
March 8, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29515417/microsurgical-treatment-of-intraventricular-cavernoma-with-prior-planning-neuroendoscopy
#15
Flavio Nigri, Jucilana Dos Santos Viana, Pedro Henrique da Costa Ferreira Pinto, Elington Lannes Simões, Carlos Roberto Telles Ribeiro
Microsurgery remains the gold standard treatment for intraventricular lesions, but it is not without limitations. The cerebral ventricles approach is considered a challenge for neurosurgeons because of their deep location and their intimate association with critical areas of the brain. It has been shown that direct endoscopic view is superior to magnetic resonance imaging (MRI) in identifying intraventricular structures and lesions. Also, during neuroendoscopy, there is no cerebrospinal fluid leak causing brain collapse as seen in microsurgery...
January 2018: Case Reports in Neurology
https://www.readbyqxmd.com/read/29510289/-ethmoid-meningoencephalocele-in-a-patient-with-cerebrofacial-arteriovenous-metameric-syndrome-a-case-report
#16
Rodrigo Fernandez-Gajardo, Joao Paulo Almeida, Suganth Suppiah, Ian Witterick, Gelareh Zadeh
BACKGROUND: Skull base meningoencephaloceles are a rare condition, frequently secondary to traumatic or iatrogenic causes. Cerebrofacial arteriovenous metameric syndrome (CAMS) is characterized by the presence of retinal, facial and cerebral arteriovenous malformations (AVMs) with metameric distribution. To the best of our knowledge, this is the first reported case associating these two conditions. CASE DESCRIPTION: A 45 years old female previously diagnosed with CAMS type 2 presented with a long history of cerebrospinal fluid (CSF) rhinorrhea...
March 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29490545/use-of-a-flexible-hollow-core-carbon-dioxide-laser-for-microsurgical-resection-of-vestibular-schwannomas
#17
Marc S Schwartz, Gregory P Lekovic
OBJECTIVE The CO2 laser has been used on an intermittent basis in the microsurgical resection of brain tumors for decades. These lasers were typically cumbersome to use due to the need for a large, bulky design since infrared light cannot be transmitted via fiber-optic cables. Development of the OmniGuide cable, which is hollow and lined with an omnidirectional dielectric mirror, has facilitated the reintroduction of the CO2 laser in surgical use in a number of fields. This device allows for handheld use of the CO2 laser in a much more ergonomically favorable configuration, holding promise for microneurosurgical applications...
March 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29485341/delayed-clearance-of-cerebrospinal-fluid-tracer-from-entorhinal-cortex-in-idiopathic-normal-pressure-hydrocephalus-a-glymphatic-magnetic-resonance-imaging-study
#18
Per K Eide, Geir Ringstad
The glymphatic system plays a key role for clearance of waste solutes from the rodent brain. We recently found evidence of glymphatic circulation in the human brain when using magnetic resonance imaging (MRI) contrast agent as cerebrospinal fluid (CSF) tracer in conjunction with multiple MRI acquisitions (gMRI). The present study explored the hypothesis that reduced glymphatic clearance in entorhinal cortex (ERC) may be instrumental in idiopathic normal pressure hydrocephalus (iNPH) dementia. gMRI acquisitions were obtained over a 24-48 h time span in cognitively affected iNPH patients and non-cognitively affected patients with suspected CSF leaks...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29485295/-five-layer-gasket-seal-watertight-closure-for-reconstruction-of-the-skull-base-in-complex-bilateral-traumatic-intraorbital-meningoencephaloceles-a-case-report-and-literature-review
#19
Dan Zhao, Shanwei Tao, Dewei Zhang, Mengyang Qin, Yijun Bao, Anhua Wu
PURPOSE: Traumatic meningoencephalocele primarily occurs as a rare but complex complication of cranial base and orbital roof fractures. Traumatic intraorbital meningoencephalocele, which is rare and easily overlooked, can be life-threatening since cephalomeningitis occurs due to cerebrospinal fluid (CSF) leakage. It is obscure for the operative indications or standard surgical methods of traumatic meningoencephaloceles since the combined intricate craniofacial and basal fractures, brain injury, and CSF leak may exist...
2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29437266/noninvasive-assessment-of-intracranial-elastance-and-pressure-in-spontaneous-intracranial-hypotension-by-mri
#20
Yi-Hsin Tsai, Hung-Chieh Chen, Hsin Tung, Yi-Ying Wu, Hsian-Min Chen, Kuan-Jung Pan, Da-Chuan Cheng, Jeon-Hor Chen, Clayton Chi-Chang Chen, Jyh-Wen Chai, Wu-Chung Shen
BACKGROUND: Spontaneous intracranial hypotension (SIH) is often misdiagnosed, and can lead to severe complications. Conventional MR sequences show a limited ability to aid in this diagnosis. MR-based intracranial pressure (MR-ICP) may be able to detect changes of intracranial elastance and pressure. PURPOSE: To determine whether MR-ICP is able to differentiate SIH patients from normal subjects, improve diagnostic sensitivity, and provide an insight into the pathophysiology...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
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