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Operative neurosurgery

Jinlu Yu, Yunbao Guo, Baofeng Xu, Kan Xu
The middle meningeal artery (MMA) is a very important artery in neurosurgery. Many diseases, including dural arteriovenous fistula (DAVF), pseudoaneurysm, true aneurysm, traumatic arteriovenous fistula (AVF), moyamoya disease (MMD), recurrent chronic subdural hematoma (CSDH), migraine and meningioma, can involve the MMA. In these diseases, the lesions occur in either the MMA itself and treatment is necessary, or the MMA is used as the pathway to treat the lesions; therefore, the MMA is very important to the development and treatment of a variety of neurosurgical diseases...
2016: International Journal of Medical Sciences
Nicola Acciarri, Giorgio Palandri, Andrea Cuoci, Adelaide Valluzzi, Giuseppe Lanzino
BACKGROUND: Cranioplasty is a surgical procedure that has still a high rate of complications, although it is commonly considered an easy and routine operation. In the literature, cranioplasty complications may rise up to 41% of cases, and the most frequently reported are infections, autologous bone flap resorption, and hematomas. Although possible, poor cosmetic results are rarely mentioned. METHODS: We retrospectively analyzed the cases of 313 patients who underwent 377 surgical procedures for cranioplasty and reoperations for complications between 2008 and 2014...
October 13, 2016: Journal of Neurosurgical Sciences
Felix Neumaier, Mario Paterno, Serdar Alpdogan, Etienne E Tevoufouet, Toni Schneider, Jürgen Hescheler, Walid Albanna
Brain surgery to promote behavioural or affective changes in men remains one of the most controversial topics at the interface of medicine, psychiatry, neuroscience and bioethics. Rapid expansion of neuropsychiatric deep brain stimulation has recently revived the field and warrants a careful appraisal of its two sides, namely the promise to help severely devastated patients on the one hand and the dangers of premature application without appropriate justification on the other. Here, we reconstruct the vivid history of the field and examine its present status to delineate the progression from crude free-hand operations into a multi-disciplinary treatment of last resort...
October 13, 2016: World Neurosurgery
Manas Panigrahi, Manoranjitha Kumari, Sudhindra Vooturi
BACKGROUND: Keeping the operating field clean and visible is an important technique in neurosurgery. Continuous irrigation-suction (IS) of the surgical field is currently often done using devices available that are expensive and demand technical proficiency. We report a simple method of continuous ISusing widely available central venous catheter and controlled suction cannula. METHODS: We used a controlled suction cannula attached to a central suction system. Single lumen central venous catheter is passed through the key hole of a controlled suction cannula, which is connected to a continuous irrigation system...
October 12, 2016: World Neurosurgery
Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Ikemefuna Onyekwelu, Steven D Glassman, Anthony L Asher, Christopher I Shaffrey, Praveen V Mummaneni, Leah Y Carreon
OBJECTIVE Prior studies have shown obesity to be associated with higher complication rates but equivalent clinical outcomes following lumbar spine surgery. These findings have been reproducible across lumbar spine surgery in general and for lumbar fusion specifically. Nevertheless, surgeons seem inclined to limit the extent of surgery, perhaps opting for decompression alone rather than decompression plus fusion, in obese patients. The purpose of this study was to ascertain any difference in clinical improvement or complication rates between obese and nonobese patients following decompression alone compared with decompression plus fusion for lumbar spinal stenosis (LSS)...
October 14, 2016: Journal of Neurosurgery. Spine
Y Wu, J Kang, Q Wang
Intracranial infection by gram-positive cocci is commonly found after craniotomy. Norvancomycin was independently developed in China, and had demonstrated therapeutic capability against gram-positive infection. This study investigated the serum and cerebrospinal fluid (CSF) concentrations in patients that received intravenous injection of norvancomycin after craniotomy. Patients with an indwelling catheter in the operational area/ventricle after craniotomy were administered norvancomycin by two approaches: (1) The conventional group consisted of 14 cases that were infused with 0...
October 13, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Yasuhiro Shibata, Sota Kurihara, Seiji Arai, Haruo Kato, Tomomi Suzuki, Yoshiyuki Miyazawa, Hidekazu Koike, Kazuto Ito, Tetsuya Nakamura, Kazuhiro Suzuki
OBJECTIVES: Microsurgical subinguinal varicocelectomy is one of the best treatment modalities for varicoceles related to male infertility and scrotal pain. However, the difficulty in identifying testicular arteries, which should be spared, is a limitation of this technique. To visualize and identify the testicular arteries in spermatic cord during the operation, we examined the efficacy of intraoperative indocyanine green angiography (ICGA), which is regularly used in microsurgical neurosurgery...
October 13, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Peter Milos, Kerstin Metcalf, Patrick Vigren, Hans Lindehammar, Malin Nilsson, Sverre Boström
Awake craniotomy for brain tumours  Awake neurosurgery is a useful method in lesions near eloquent brain areas, particularly low-grade gliomas.The aim is to maximise tumour resection and preserve neurological function. We performed 40 primary awake surgeries and 8 residual surgeries. Patients were operated awake throughout the procedure or with a laryngeal mask and general anaesthesia during the opening stage and then awake during intracerebral surgery. Language and motor function were mapped with direct cortical stimulation, motor evoked potential and standardised neurological testing...
October 11, 2016: Läkartidningen
Ryosuke Tomio, Takenori Akiyama, Masahiro Toda, Takayuki Ohira, Kazunari Yoshida
OBJECTIVE Transcranial motor evoked potential (tMEP) monitoring is popular in neurosurgery; however, the accuracy of tMEP can be impaired by craniotomy. Each craniotomy procedure and changes in the CSF levels affects the current spread. The aim of this study was to investigate the influence of several craniotomies on tMEP monitoring by using C3-4 transcranial electrical stimulation (TES). METHODS The authors used the finite element method to visualize the electric field in the brain, which was generated by TES, using realistic 3D head models developed from T1-weighted MR images...
October 7, 2016: Journal of Neurosurgery
Hongzhi Xu, Zhiyong Qin, Ming Xu, Chunjui Chen, Junjie Zhang, Xiancheng Chen
BACKGROUND: Intraoperative ultrasound is widely used in neurosurgery for the management of intracerebral hematoma and brain tumor. However, the clinical value of this method in the surgery of cerebral arteriovenous malformations (AVMs) has not been reported. In this study, the application of intraoperative ultrasound for AVMs surgery was evaluated prospectively. METHODS: This prospective clinical study comprised of 41 patients who underwent microsurgical resection of cerebral AVMs at our institute...
October 3, 2016: World Neurosurgery
Yu-Chen Ji, Yan Li, Jing-Xia Hu, Hong-Bo Zhang, Peng-Xiang Yan, Huan-Cong Zuo
Hemangioblastomas (HBMs) are highly vascular tumors of the central nervous system. Sporadic HBMs are nearly always solitary, and solitary HBMs are similar to intracranial arteriovenous malformations due to their highly vascular characteristics. However, to the best of our knowledge, cases of HBM in the cerebellum mimicking an aneurysm have never been reported in the literature. The present study reports a case of an HBM on the right cerebellar hemisphere mimicking an aneurysm, which originated from the right posterior inferior cerebellar artery, as determined using magnetic resonance angiography and digital subtraction angiography...
October 2016: Oncology Letters
Vijay Parihar, Y R Yadav, Yatin Kher, Shailendra Ratre, Ashish Sethi, Dhananjaya Sharma
CONTEXT: Steep learning curve is found initially in pure endoscopic procedures. Video telescopic operating monitor (VITOM) is an advance in rigid-lens telescope systems provides an alternative method for learning basics of neuroendoscopy with the help of the familiar principle of microneurosurgery. AIMS: The aim was to evaluate the clinical utility of VITOM as a learning tool for neuroendoscopy. MATERIALS AND METHODS: Video telescopic operating monitor was used 39 cranial and spinal procedures and its utility as a tool for minimally invasive neurosurgery and neuroendoscopy for initial learning curve was studied...
October 2016: Asian Journal of Neurosurgery
Vishal Kumar, Amarjeet Singh, Manoj K Tewari, Sukhpal Kaur
PROBLEM STATEMENT: Neurosurgical patients require special care not only in the hospital but also after their discharge from the hospital. Comprehension and compliance to the instructions given by the doctors/nurses at the time of discharge is important in home care of these patients. Many such patients suffer from various co-morbidities. Variable periods of convalescence affect health-related quality of life in these patients. PURPOSE OF THE STUDY: To determine the degree of compliance of neurosurgery patients and their family caregivers with the discharge advice given by the consultantsTo evaluate the quality of life of these patientsTo know the problems faced by these patients at home...
October 2016: Asian Journal of Neurosurgery
Sofiene Bouali, Nidhal Maatar, Asma Bouhoula, Khansa Abderrahmen, Imed Ben Said, Adnen Boubaker, Jalel Kallel, Hafedh Jemel
PURPOSE: The spinal epidural angiolipomas are rare expansive processes made of mature lipomatous and angiomatous elements. They often have a benign character. Their etiology, pathogenesis remains uncertain, and it is a cause of spinal cord compression. The magnetic resonance imaging is the most important neuroradiological examination. Histological examination is the only examination to confirm the diagnosis. Surgery is the treatment of choice. METHODS: A retrospective study of all patients operated on for a spinal epidural angiolipoma at the Department of Neurosurgery at the National Institute of Neurology of Tunis between January 2000 and December 2014 (15 years) was performed...
October 2016: Asian Journal of Neurosurgery
Ahmed Abdullah, Hisham El Shitany, Waleed Abbass, Amr Safwat, Amr K Elsamman, Ehab El Refaee
OBJECTIVES: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. MATERIALS AND METHODS: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas...
October 2016: Journal of Neurosciences in Rural Practice
Taopheeq Bamidele Rabiu, Edward Oluwole Komolafe
BACKGROUND: Africa has very few neurosurgeons. These are almost exclusively in urban centers. Consequently, people in rural areas, most of the African population, have poor or no access to neurosurgical care. We have recently pioneered rural neurosurgery in Nigeria. OBJECTIVES: This report details our initial experiences and the profile of neurosurgical admissions in our center. METHODS: A prospective observational study of all neurosurgical patients managed at a rural tertiary health institution in Nigeria from December 2010 to May 2012 was done...
October 2016: Journal of Neurosciences in Rural Practice
S F Chen, Y Kato, A Kumar, G W Tan, D Oguri, J Oda, T Watabe, S Imizu, H Sano, Z X Wang
Intraoperative rerupture (IOR) during clipping of cerebral aneurysms is a difficult complication of microneurosurgery. The aim of this study was to evaluate the incidence of IOR and analyze the strategies for controlling profound hemorrhage. A total of 165 patients with unruptured intracranial aneurysms and 46 patients with subarachnoid hemorrhage (SAH) treated surgically between April 2010 and March 2011, were reviewed. The data were collected with regard to age, sex, presence of symptoms, confounding factors and strategy for controlling intraoperative hemorrhage was analyzed in terms of location of aneurysms, timing of rupture and severity of IOR...
September 27, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Pietro Mortini, Filippo Gagliardi, Michele Bailo, Nicola Boari, Antonella Castellano, Andrea Falini, Marco Losa
Resection of large lesions growing into the third ventricle is considered nowadays still a demanding surgery, due to the high risk of severe endocrine and neurological complications. Some neurosurgical approaches were considered in the past the procedures of choice to access the third ventricle, however they were burden by endocrine and neurological consequences, like memory loss and epilepsy. We report here the endocrine and functional results in a series of patients operated with a recently developed approach specifically tailored for the resection of large lesions growing into the third ventricle...
September 29, 2016: Endocrine
Johannes Sarnthein, Lennart Stieglitz, Pierre-Alain Clavien, Luca Regli
BACKGROUND: To improve the transparency of the local health care system, treatment cost was recently referenced to disease related groups. Treatment quality must be legally documented in a patient registry, in particular for the highly specialized treatments provided by neurosurgery departments. METHODS: In 2013 we have installed a patient registry focused on cranial neurosurgery. Surgeries are characterized by indication, treatment, location and other specific neurosurgical parameters...
2016: PloS One
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