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Neurosurgical papers with practical application

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96 papers 100 to 500 followers
By Andreas Tarnaris Consultant Neurosurgeon
https://www.readbyqxmd.com/read/28302612/difficult-lumbar-puncture-pitfalls-and-tips-from-the-trenches
#1
REVIEW
P A Hudgins, A J Fountain, P R Chapman, L M Shah
Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat...
March 16, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28214798/intensive-blood-pressure-lowering-in-patients-with-acute-intracerebral-haemorrhage-clinical-outcomes-and-haemorrhage-expansion-systematic-review-and-meta-analysis-of-randomised-trials
#2
REVIEW
Gregoire Boulouis, Andrea Morotti, Joshua N Goldstein, Andreas Charidimou
INTRODUCTION: It is unclear whether intensive lowering of blood pressure (BP) at the acute phase of intracerebral haemorrhage (ICH) is beneficial. We performed a meta-analysis of randomised controlled trials (RCTs) to assess whether intensive BP lowering in patients with acute ICH is safe and effective in improving clinical outcomes. METHODS: We searched PubMed, EMBASE and the Cochrane databases for relevant RCTs and calculated pooled OR for 3-month mortality (safety outcome) and 3-month death or dependency (modified Rankin Scale (mRs) ≥3;efficacy outcome), in patients with acute ICH randomised to either intensive BP-lowering or standard BP-lowering treatment protocols...
April 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28217389/management-of-parturients-in-active-labor-with-arnold-chiari-malformation-tonsillar-herniation-and-syringomyelia
#3
Ramsis F Ghaly, Tatiana Tverdohleb, Kenneth D Candido, Nebojsa Nick Knezevic
BACKGROUND: Arnold-Chiari malformation Type 1 (ACM-1) in parturients is a topic of ongoing discussion between obstetricians and anesthesiologists. The primary unanswered question remains; How should the anesthesia provider proceed with labor analgesia and anesthesia for cesarean section when confronted with an advanced, asymptomatic, or minimally symptomatic case of ACM-1 during labor? CASE DESCRIPTION: A 24-year-old, ASA II, G1P0 full-term parturient presented to Labor and Delivery for vaginal delivery...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/27690656/stereotactic-laser-ablation-for-hypothalamic-and-deep-intraventricular-lesions
#4
Robert T Buckley, Anthony C Wang, John W Miller, Edward J Novotny, Jeffrey G Ojemann
OBJECTIVE Laser ablation is a novel, minimally invasive procedure that utilizes MRI-guided thermal energy to treat epileptogenic and other brain lesions. In addition to treatment of mesial temporal lobe epilepsy, laser ablation is increasingly being used to target deep or inoperable lesions, including hypothalamic hamartoma (HH), subependymal giant cell astrocytoma (SEGA), and exophytic intrinsic hypothalamic/third ventricular tumors. The authors reviewed their early institutional experience with these patients to characterize clinical outcomes in patients undergoing this procedure...
October 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27855720/pharmacological-interventions-for-agitation-in-patients-with-traumatic-brain-injury-protocol-for-a-systematic-review-and-meta-analysis
#5
David R Williamson, Anne Julie Frenette, Lisa Burry, Marc M Perreault, Emmanuel Charbonney, François Lamontagne, Marie-Julie Potvin, Jean-François Giguère, Sangeeta Mehta, Francis Bernard
BACKGROUND: Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI...
November 17, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27852691/medical-management-of-intracerebral-haemorrhage
#6
REVIEW
Floris H B M Schreuder, Shoichiro Sato, Catharina J M Klijn, Craig S Anderson
The global burden of intracerebral haemorrhage (ICH) is enormous. Developing evidence-based management strategies for ICH has been hampered by its diverse aetiology, high case fatality and variable cooperative organisation of medical and surgical care. Progress is being made through the conduct of collaborative multicentre studies with the large sample sizes necessary to evaluate therapies with realistically modest treatment effects. This narrative review describes the major consequences of ICH and provides evidence-based recommendations to support decision-making in medical management...
January 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27637674/spontaneous-subarachnoid-haemorrhage
#7
REVIEW
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
February 11, 2017: Lancet
https://www.readbyqxmd.com/read/27640182/the-critical-care-management-of-spontaneous-intracranial-hemorrhage-a-contemporary-review
#8
REVIEW
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27723170/systematic-review-of-patient-history-and-physical-examination-to-diagnose-chronic-low-back-pain-originating-from-the-facet-joints
#9
REVIEW
E T Maas, J N S Juch, R W J G Ostelo, J G Groeneweg, J W Kallewaard, B W Koes, A P Verhagen, F J P M Huygen, M W van Tulder
Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016...
March 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27469212/intracranial-vessel-wall-mri-principles-and-expert-consensus-recommendations-of-the-american-society-of-neuroradiology
#10
REVIEW
D M Mandell, M Mossa-Basha, Y Qiao, C P Hess, F Hui, C Matouk, M H Johnson, M J A P Daemen, A Vossough, M Edjlali, D Saloner, S A Ansari, B A Wasserman, D J Mikulis
Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging with CTA, MRA, or DSA. The technique has multiple potential uses in the context of ischemic stroke and intracranial hemorrhage. There remain gaps in our understanding of intracranial vessel wall MR imaging findings and research is ongoing, but the technique is already used on a clinical basis at many centers. This article, on behalf of the Vessel Wall Imaging Study Group of the American Society of Neuroradiology, provides expert consensus recommendations for current clinical practice...
February 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27408698/mechanisms-of-low-back-pain-a-guide-for-diagnosis-and-therapy
#11
REVIEW
Massimo Allegri, Silvana Montella, Fabiana Salici, Adriana Valente, Maurizio Marchesini, Christian Compagnone, Marco Baciarello, Maria Elena Manferdini, Guido Fanelli
Chronic low back pain (CLBP) is a chronic pain syndrome in the lower back region, lasting for at least 3 months. CLBP represents the second leading cause of disability worldwide being a major welfare and economic problem. The prevalence of CLBP in adults has increased more than 100% in the last decade and continues to increase dramatically in the aging population, affecting both men and women in all ethnic groups, with a significant impact on functional capacity and occupational activities. It can also be influenced by psychological factors, such as stress, depression and/or anxiety...
2016: F1000Research
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#12
REVIEW
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27366977/landmark-papers-in-cerebrovascular-neurosurgery-2015
#13
REVIEW
Justin M Moore, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Apar S Patel, Christopher S Ogilvy, Ajith J Thomas
The management of cerebrovascular disease has advanced considerably in 2015. Five randomized control trials have firmly established the role of endovascular thrombectomy for ischemic strokes due to large vessel occlusion. The randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN) (Berkhemer et al. NEJM 2015;372:11-20) was the first of a series on the topic. There was a total of 5 randomized controlled trials published showing benefit in terms of functional outcomes at 90days for mechanical thrombectomy including the Endovascular Therapy for Ischemic stroke with perfusion-imaging selection (EXTEND IA) (Campbell et al...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27368511/is-there-an-optimal-time-for-performing-cranioplasties-results-from-a-prospective-multinational-study
#14
Boon Leong Quah, Hu Liang Low, Mark H Wilson, Alexios Bimpis, Vincent D W Nga, Sein Lwin, Noor Hazlina Zainuddin, Nasser Abd Wahab, Md Al Amin Salek
BACKGROUND: The optimal timing of cranioplasty remains uncertain. OBJECTIVE: We hypothesized that the risk of infections after primary cranioplasty in adult patients who underwent craniectomies for non-infection-related indications are no different when performed early or delayed. We tested this hypothesis in a prospective, multicenter, cohort study. METHODS: Data were collected prospectively from 5 neurosurgical centers in the United Kingdom, Malaysia, Singapore, and Bangladesh...
October 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27367246/editorial-classes-of-evidence-in-neurosurgery
#15
James T Rutka
No abstract text is available yet for this article.
June 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27352276/imaging-of-degenerative-and-infectious-conditions-of-the-spine
#16
Lubdha M Shah, Jeffrey S Ross
UNLABELLED: : Imaging is important in the evaluation of patients with degenerative disease and infectious processes. There are numerous conditions that can manifest as low back pain (LBP) or neck pain in a patient, and in many cases, the cause may be multifactorial. Clinical history and physical examination are key components in the evaluation of such patients; however, physical examination has variable sensitivity and specificity. Although studies have demonstrated that uncomplicated acute LBP and/or radiculopathy are self-limited conditions that do not warrant any imaging, neuroimaging can provide clear anatomic delineation of potential causes of the patient's clinical presentation...
September 2016: Neurosurgery
https://www.readbyqxmd.com/read/27341047/incidence-of-intraoperative-seizures-during-motor-evoked-potential-monitoring-in-a-large-cohort-of-patients-undergoing-different-surgical-procedures
#17
Sedat Ulkatan, Ana Maria Jaramillo, Maria J Téllez, Jinu Kim, Vedran Deletis, Kathleen Seidel
OBJECTIVE The purpose of this study was to investigate the incidence of seizures during the intraoperative monitoring of motor evoked potentials (MEPs) elicited by electrical brain stimulation in a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. METHODS The authors retrospectively analyzed data from 4179 consecutive patients who underwent surgery or an interventional radiology procedure with MEP monitoring...
April 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27279946/a-case-of-bilateral-visual-loss-after-spinal-cord-surgery
#18
Jemal Shifa, Worknehe Abebe, Negussie Bekele, Dereje Habte
Visual loss is a rare but potentially devastating postoperative complication of prone spinal surgery with a reported incidence of 0.017 to 0.1 percent. We present a case of post-operative bilateral visual loss in a patient who had a laminectomy in prone position under general anesthesia. A 17-year-old male patient with large syringomyelia extending from C2 - T2 level had a surgical procedure done under general anesthesia (GA) in prone position that lasted four hours. After the surgical procedure, the patient presented to the Ophthalmology Clinic of Princess Marina Hospital, with a complaint of visual loss of the right eye followed by left, of one week duration...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/18249121/hypertension-induced-reversible-posterior-leukoencephalopathy-syndrome-causing-obstructive-hydrocephalus
#19
S Y Lee, S K Dinesh, J Thomas
Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized clinically by headache, altered mental status, abnormal visual perception and seizures. It is associated with neuroradiological findings characterized by reversible white matter abnormalities, predominantly in the parietal-occipital areas. Since the first description in 1996, it has been recognized in an increasing number of medical conditions, including hypertensive encephalopathy, eclampsia, and immunosuppressive treatment. The rapid resolution of clinical and neuroradiologic abnormalities suggests cerebral oedema, which is thought to result from impaired cerebrovascular autoregulation and endothelial injury...
April 2008: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27276340/the-sensory-motor-profile-awake-a-new-tool-for-pre-intra-and-postoperative-assessment-of-sensory-motor-function
#20
Juliane Becker, Margit Jehna, Elisabeth Steinmann, Hubertus M Mehdorn, Michael Synowitz, Gesa Hartwigsen
OBJECTIVES: Awake craniotomy is a well-established procedure in surgery of intracranial tumors in eloquent areas. However, sufficiently standardized instruments for the assessment of sensory-motor function before, during and after the operation are currently lacking, despite their importance for evaluation of operative outcome. PATIENTS AND METHODS: To address this issue, we designed a standardized assessment tool (the "sensory-motor profile awake scale"; SMP-a)...
August 2016: Clinical Neurology and Neurosurgery
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