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Operative neurosurgery

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https://www.readbyqxmd.com/read/28424915/optimal-eye-movement-strategies-a-comparison-of-neurosurgeons-gaze-patterns-when-using-a-surgical-microscope
#1
Shahram Eivazi, Ahmad Hafez, Wolfgang Fuhl, Hoorieh Afkari, Enkelejda Kasneci, Martin Lehecka, Roman Bednarik
BACKGROUND: Previous studies have consistently demonstrated gaze behaviour differences related to expertise during various surgical procedures. In micro-neurosurgery, however, there is a lack of evidence of empirically demonstrated individual differences associated with visual attention. It is unknown exactly how neurosurgeons see a stereoscopic magnified view in the context of micro-neurosurgery and what this implies for medical training. METHOD: We report on an investigation of the eye movement patterns in micro-neurosurgery using a state-of-the-art eye tracker...
April 19, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#2
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28418345/cricotracheal-resection-in-a-patient-with-severe-subglottic-stenosis-advantages-of-a-temporary-non-cannulated-tracheostomy
#3
Todor Miroslavov Popov, Tzvetomir Marinov, Julian Rangachev, Dimitar Konov, Maya Belitova
BACKGROUND: Stenosis in the area of the cricotracheal segment is still a challenging problem to be dealt with. Post-intubational cases mark an increase in recent years due to the advances in intensive care, thoracic surgery and neurosurgery departments. CASE REPORT: This paper describes a case report of a patient with severe subglottic stenosis (grade III according to the Cotton-Myer scale), introduces a new option in cricotracheal resections - postoperative temporary non-cannulated tracheostomy and describes its advantages...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28415147/neurosurgical-laser-ablation-and-mr-thermometry-risks-of-multisite-workflow-pattern
#4
Paul S Larson, Sudhakar Vadivelu, Hooman Azmi-Ghadimi, Amy Nichols, Loretta Fauerbach, Helen Boehm Johnson
Neurosurgical laser ablation is a relatively new but rapidly growing application of stereotactic neurosurgery that allows neurosurgeons to treat many previously untreatable conditions with the added benefit of shorter hospitalizations and recovery times. The vast majority of these procedures, however, are performed using a multisite workflow pattern involving transport of the patient between the operating room (OR), the computed tomography (CT) suite, and the magnetic resonance imaging (MRI) suite, often necessitating patient transfer through public pathways and requiring multiple trips if laser fiber placement is not accurate...
April 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28413526/neuroendoscopy-is-it-safe
#5
Manas Panigrahi, Bharat Gupta, Rajesh Reddy
BACKGROUND: The effect of heat in endoscopic instruments used for laparoscopy and hysteroscopy has been well-studied. Reports of thermal injury from nasal endoscopes have also been reported. However, there are no experimental studies, which have objectively documented and provided recommendations for safe use of endoscopes in neurosurgery. OBJECTIVES: To study the heat generated at the tip of the endoscope and the subsequent thermal damage caused to a cotton drape placed in proximity, by varying the intensity of light delivered through different optical cables, ambient (operating room) temperatures and working distances...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28392319/diagnostic-accuracy-of-routine-blood-examinations-and-csf-lactate-level-for-post-neurosurgical-bacterial-meningitis
#6
Yang Zhang, Xiong Xiao, Junting Zhang, Zhixian Gao, Nan Ji, Liwei Zhang
OBJECTIVE: To evaluate the diagnostic accuracy of routine blood examinations and Cerebrospinal Fluid (CSF) lactate level for Post-neurosurgical Bacterial Meningitis (PBM) at a large sample-size post-neurosurgical patients. METHODS: The diagnostic accuracies of routine blood examinations and CSF lactate level to distinguish between PAM and PBM were evaluated with the values of the Area Under the Curve of the Receiver Operating Characteristic (AUC-ROC) by retrospectively analyzing the datasets of post-neurosurgical patients in the clinical information databases...
April 6, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28389649/recombinant-slit2-reduces-surgical-brain-injury-induced-blood-brain-barrier-disruption-via-robo4-dependent-rac1-activation-in-a-rodent-model
#7
Prativa Sherchan, Lei Huang, Onat Akyol, Cesar Reis, Jiping Tang, John H Zhang
Brain tissue surrounding surgical resection site can be injured inadvertently due to procedures such as incision, retractor stretch, and electrocauterization when performing neurosurgical procedures, which is termed as surgical brain injury (SBI). Blood brain barrier (BBB) disruption due to SBI can exacerbate brain edema in the post-operative period. Previous studies showed that Slit2 exhibited vascular anti-permeability effects outside the brain. However, BBB protective effects of Slit2 following SBI has not been evaluated...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28387618/effectiveness-of-endoscopic-surgery-for-supratentorial-hypertensive-intracerebral-hemorrhage-a-comparison-with-craniotomy
#8
Xinghua Xu, Xiaolei Chen, Fangye Li, Xuan Zheng, Qun Wang, Guochen Sun, Jun Zhang, Bainan Xu
OBJECTIVE The goal of this study was to investigate the effectiveness and practicality of endoscopic surgery for treatment of supratentorial hypertensive intracerebral hemorrhage (HICH) compared with traditional craniotomy. METHODS The authors retrospectively analyzed 151 consecutive patients who were operated on for treatment of supratentorial HICH between January 2009 and June 2014 in the Department of Neurosurgery at Chinese PLA General Hospital. Patients were separated into an endoscopy group (82 cases) and a craniotomy group (69 cases), depending on the surgery they received...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28385479/opportunity-to-reduce-transfer-of-patients-with-mild-traumatic-brain-injury-and-intracranial-hemorrhage-to-a-level-1-trauma-center
#9
Brian J Yun, Benjamin A White, H Benjamin Harvey, Anand M Prabhakar, Jonathan D Sonis, McKinley Glover, Emily Vallillo, Sun Choi, Pierre Borczuk, Ali S Raja
OBJECTIVE: Current guidelines do not address the disposition of patients with mild traumatic brain injury (TBI) and resultant intracranial hemorrhage (ICH). Emergency medicine clinicians working in hospitals without neurosurgery coverage typically transfer patients with both to a trauma center with neurosurgery capability. Evidence is accruing which demonstrates that the risk of neurologic decompensation depends on the type of ICH and as a result, not every patient may need to be transferred...
March 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#10
Matthew Piazza, Nikhil Nayak, Zarina Ali, Gregory Heuer, Matthew Sanborn, Sherman Stein, James Schuster, M Sean Grady, Neil R Malhotra
OBJECTIVE: The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). METHODS: The NIS was used to estimate the number of aneurysms treated with either surgical clipping and endovascular methods from 2002 through 2011 at teaching institutions...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28376692/neuroversion-using-electroconvulsive-therapy-as-a-bridge-to-deep-brain-stimulation-implantation
#11
Nolan R Williams, Greg Sahlem, Jaspreet Pannu, Istvan Takacs, Baron Short, Gonzalo Revuelta, Mark S George
Parkinson's disease (PD) is a movement disorder with significant neuropsychiatric comorbidities. Electroconvulsive therapy (ECT) is effective in treating these neuropsychiatric symptoms; however, clinicians are reluctant to use ECT in patients with deep brain stimulation (DBS) implantations for fear of damaging the device, as well as potential cognitive side effects. Right unilateral ultra-brief pulse (RUL UBP) ECT has a more favorable cognitive side-effect profile yet has never been reported in PD patients with DBS implants...
February 2017: Neurocase
https://www.readbyqxmd.com/read/28366755/postoperative-ptosis-and-diplopia-induced-by-the-intraoperative-application-of-bone-wax
#12
Yoshinori Maki, Ryota Ishibashi, Daisuke Yamada, Takumi Morita, Masaki Chin, Sen Yamagata
BACKGROUND: Bone wax is a hemostatic agent well used by neurosurgeons to prevent bleeding from bone. However, several complications involving bone wax have been reported, such as ptosis, infection, paraplegia, osteohypertrophy, edema, pain, granuloma formation, allergic reaction and thrombosis. CASE DESCRIPTION: A 47-year-old female patient presented to our neurosurgery department complaining of headache and vomiting. Subarachnoid hemorrhage from a ruptured aneurysm was detected on computed tomography (CT), and we performed emergent clipping of the ruptured aneurysm...
March 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28363833/postoperative-neurosurgical-infection-rates-after-shared-resource-intraoperative-magnetic-resonance-imaging-a-single-center-experience-with-195-cases
#13
Nikolaj Dinevski, Johannes Sarnthein, Flavio Vasella, Jorn Fierstra, Athina Pangalu, David Holzmann, Luca Regli, Oliver Bozinov
OBJECTIVE: To determine the rate of surgical site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database METHODS: All consecutive neurosurgical procedures that were performed with a high-field, two-room ioMRI between April 2013 and June 2016 were included (N=195; 109 craniotomies and 86 endoscopic transsphenoidal procedures)...
March 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#14
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28362185/reoperations-within-48-hours-following-7942-pediatric-neurosurgery-procedures
#15
Anil K Roy, Jason Chu, Caroline Bozeman, Samir Sarda, Michael Sawvel, Joshua J Chern
OBJECTIVE Various indicators are used to evaluate the quality of care delivered by surgical services, one of which is early reoperation rate. The indications and rate of reoperations within a 48-hour time period have not been previously reported for pediatric neurosurgery. METHODS Between May 1, 2009, and December 30, 2014, 7942 surgeries were performed by the pediatric neurosurgery service in the operating rooms at a single institution. Demographic, socioeconomic, and clinical characteristics associated with each of the operations were prospectively collected...
March 31, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28355734/-application-of-hybrid-operating-room-in-the-treatment-of-spinal-dural-arteriovenous-fistulas
#16
W Wang, Y Wang, D Wang, Y Zhao, H Liu, X Y Yang, S G Zhu, F S Xiao, W Wei, T Zhu, X J Yang, J N Zhang
Objective: To explore the experience in the treatment of spinal dural arteriovenous fistulas with application of hybrid operating room. Method: A retrospective analysis was performed among 22 patients with spinal dural arteriovenous fistulas admitted to Department of Neurosurgery of Tianjin Medical University General Hospital who received operation in the hybrid operating room from March 2011 to February 2016. Modified Aminoff-Logue scores (ALS) for myelopathy was used to evaluate the spinal function.All the 22 patients were followed up 6-12 months after the operation...
March 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28348939/radiolucent-skull-clamps-for-intra-operative-imaging-a-technical-note
#17
Neil Haranhalli, Hugo Zeberg, Patrick Lasala, David Altschul
Conventionally, surgery and procedural-based radiology are performed on different premises. With advances in imaging technology, the operating room is rapidly being transformed into an intraoperative imaging suite. Diagnostic imaging in conjunction with surgery has great utility and by all accounts has great future potential. During the last decade, cone beam computed tomography (CT) scanners have been introduced and have made intraoperative imaging more feasible because these scanners can be made less bulky...
February 10, 2017: Curēus
https://www.readbyqxmd.com/read/28346963/point-of-care-testing-in-neurosurgery
#18
Christopher Beynon, Lars Wessels, Andreas W Unterberg
Coagulation disorders can have a major impact on the outcome of neurosurgical patients. The central nervous system is located within the closed space of the skull, and therefore, intracranial hemorrhage can lead to intracranial hypertension. Acute brain injury has been associated with alterations of various hemostatic parameters. Point-of-care (POC) techniques such as rotational thromboelastometry are able to identify markers of coagulopathy which are not reflected by standard assessment of hemostasis (e.g...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#19
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#20
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
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