Nitin Agarwal, Sharath Kumar Anand, Enyinna L Nwachuku, Tiffany E Wilkins, Hanna Algattas, Rohit Prem Kumar, Hansen Deng, Yue-Fang Chang, Ava Puccio, David O Okonkwo
PURPOSE: The Rotterdam Scoring System (RSS) attempts to prognosticate early mortality and early functional outcome in patients with traumatic brain injury (TBI) based on non-contrast head computed tomography (CT) imaging findings. The purpose of this study was to identify the relationship between RSS scores and long-term outcomes in patients with severe TBI. METHODS: Consecutively treated patients with severe TBI enrolled between 2008 and 2011, in the prospective, observational, Brain Trauma Research Center database were included...
May 17, 2024: British Journal of Neurosurgery
Ashwin Kumaria, Alex J Leggate, Graham R Dow, Harshal A Ingale, Iain J A Robertson, Paul O Byrne, Surajit Basu, Donald C Macarthur, Stuart J Smith
Although glioblastoma is the commonest primary brain tumour in adults, its location in the cerebellum is extremely rare. We present thirteen cases (3 female, 10 male; median age at presentation 56 [age range 21-77]) of surgically managed, histologically confirmed, primary cerebellar glioblastoma (cGB) over a 17 year period (2005-2022). Pre-operative radiological diagnosis was challenging given cGB rarity, although MRI demonstrated ring enhancement in all cases. Surgical management included posterior fossa craniectomy and debulking in 11 cases and burr hole biopsy in two...
May 14, 2024: British Journal of Neurosurgery
Elika Karvandi, Liam Barrett, Virginia Newcombe, Peter Hutchinson, Adel Helmy
BACKGROUND: After a mild traumatic brain injury (mild TBI,) a significant number of patients may experience persistent symptoms and disabilities for months to years. Early identification and timely management of persistent symptoms may help to reduce the long-term impacts of mild TBIs. There is currently no formalised method for identifying patients with persistent symptoms after mild TBI once they are discharged from emergency department. OBJECTIVE: Assess the feasibility of a remote monitoring tool for early identification of persistent symptoms after mild TBI in the outpatient setting using digital tools...
May 6, 2024: British Journal of Neurosurgery
Siddharth Vankipuram, Pratipal Kalsi, Zhengyue Grace Yang, Vittorio M Russo, Antonino Russo
BACKGROUND: Sacropelvic fractures with multidirectional instability require complex reduction and stabilisation techniques. Triangular osteosynthesis reconstruction is an established technique but hardware failure rates remain high and screw trajectories unfamiliar to spine surgeons. Our technique allows de-rotation of the pelvis, fracture reduction in both vertical and transverse planes, immediate weight bearing and is more reproducible for complex spine surgeons. OBJECTIVE: To describe our case series of dual triangular osteosynthesis reduction and stabilisation for complex sacropelvic fractures...
May 2, 2024: British Journal of Neurosurgery
Balint Zoltan Borbas, Peter Whitfield, Nicola King
INTRODUCTION: In patients with traumatic intracranial haemorrhage (tICH) there is significant risk of both venous thromboembolism (VTE) and haemorrhage progression. There is a paucity of literature to inform the timing of pharmacological thromboprophylaxis (PTP) initiation. AIM: This meta-analysis aims to summarise the current literature on the timing of PTP initiation in tICH. METHODS: This meta-analysis followed the Methodological Expectations of Cochrane Intervention Reviews checklist and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines...
April 30, 2024: British Journal of Neurosurgery
Edward Goacher, Stefan Yardanov, Richard Phillips, Alexandru Budu, Edward Dyson, Marcel Ivanov, Gary Barton, Mike Hutton, Adrian Gardner, Nasir A Quraishi, Gordan Grahovac, Josephine Jung, Andreas K Demetriades, Pierluigi Vergara, Erlick Pereira, Vasileios Arzoglou, Jibin Francis, Rikin Trivedi, Benjamin M Davies, Mark R N Kotter
PURPOSE: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK. MATERIALS AND METHODS: Incidence of DCM was identified from the Hospital Episode Statistics (HES) database for a single year using five ICD-10 diagnostic codes to represent DCM...
April 26, 2024: British Journal of Neurosurgery
Riccardo Serra, Timothy Chryssikos
INTRODUCTION: Decompressive craniectomy and craniotomy are among the most common procedures in Neurosurgery. In recent years, increased attention has focused on the relationships between incision type, extent of decompression, vascular supply to the scalp, cosmetic outcomes, and complications. Here, we review the current literature on scalp incisions for large unilateral front-temporo-parietal craniotomies and craniectomies. METHODS: Publications in the past 50 years on scalp incisions used for front-temporo-parietal craniectomies/craniotomies were reviewed...
April 23, 2024: British Journal of Neurosurgery
Daniel Thompson, Adam Williams, Peter C Whitfield, Peter Hutchinson, Nicholas Phillips, David Cromwell, Adel Helmy
OBJECTIVES: The COVID-19 pandemic required a change in resource priority from Neurosurgical care in order to treat medically unwell patients suffering from the complications of COVID-19 infections. We demonstrate the impact of COVID-19 on total bed days in 24 Neurosurgical centres in England offering adult Neurosurgery as well as the total spells (single inpatient episodes) for operative Neurosurgical patients between 2020 and 2022 when compared with 2019. METHODS: We used Capse Healthcare Knowledge System software iCompare in order to show the change in total spells for patients undergoing a primary or secondary Neurosurgical procedure as defined using the National Neurosurgical Audit Programme (NNAP) OPCS-4 coding framework between 2019 and 2022...
April 19, 2024: British Journal of Neurosurgery
Omar Atallah, Kathreena M Kurian, Mario Teo
BACKGROUND AND IMPORTANCE: Calcifying pseudoneoplasms of the neuraxis (CAPNON) is an extremely rare tumor, with nearly 150 cases have been reported in the literature. We present a case of CAPNON at foramen magnum (cervicomedullary junction). We also discuss the histological and radiological features of this rare pathology. CLINICAL PRESENTATION: A 35-year-old male patient presented to our center complaining of neck pain for the last 6 months and for the last 3 months has had headaches associated with nausea, blurred vision and papilledema...
April 14, 2024: British Journal of Neurosurgery
Alisa Arnautovic, Joseph Mijares, Emir Begagić, Adi Ahmetspahić, Mirza Pojskić
OBJECTIVE: The primary objective of this investigation is to systematically scrutinize extant surgical studies delineating Four-Level Anterior Cervical Discectomy and Fusion (4L ACDF), with a specific emphasis on elucidating reported surgical indications, clinical and radiological outcomes, fusion rates, lordosis correction, and the spectrum of complication rates. METHODS: The literature review was conducted in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, employing the MEDLINE (PubMed), Embase, and Scopus databases...
April 12, 2024: British Journal of Neurosurgery
Jamie F M Brannigan, Conor S Gillespie, Gideon Adegboyega, Matthew Watson, Keng Siang Lee, Adele Mazzoleni, Edward Goacher, Orla Mantle, Vian Omar, Githmi Gamage, Alvaro Yanez Touzet, Oliver Mowforth, Will Thomas, James Uprichard, Peter J Hutchinson, Daniel J Stubbs, Benjamin M Davies
A chronic subdural haematoma (CSDH) is a collection of aged blood between the dura and the brain, typically treated with surgical evacuation. Many patients with CSDH have comorbidities requiring the use of antithrombotic medications. The optimal management of these medications in the context of CSDH remains unknown, as the risk of recurrence must be carefully weighed against the risk of vaso-occlusive events. To better understand these risks and inform the development of clinical practice guidelines, we conducted a systematic review and meta-analysis...
April 8, 2024: British Journal of Neurosurgery
Takafumi Kawasaki, Taishi Nakamura, Makoto Ohtake, Taisuke Akimoto, Hiroshi Manaka, Koichi Hamada, Katsumi Sakata, Masayuki Iwashita, Ichiro Takeuchi, Tetsuya Yamamoto
BACKGROUND: Takotsubo cardiomyopathy (TC) is a well-known complication of subarachnoid haemorrhage (SAH), often accompanied by neurogenic myocardial dysfunction. Although TC has been reported to be associated with higher morbidity and mortality among patients with aneurysmal SAH (aSAH), some patients have been reported to recover, the profiles and follow-up outcomes of these survivors remain unclear. MATERIALS AND METHODS: To characterize the profiles of patients with aSAH complicated by TC who experienced favourable outcomes using long-term follow-up data, a consecutive series of patients with aSAH were enrolled and TC diagnosis was based on the revised version of the Mayo Clinic criteria...
April 3, 2024: British Journal of Neurosurgery
Nithish Jayakumar, Aasim Hagroo, Oliver Kennion, Damian Holliman
BACKGROUND: The National Neurosurgical Audit Programme (NNAP) publishes mortality outcomes of consultants and neurosurgical units across the United Kingdom. It is unclear how useful outcomes data is for patients and whether it influences their decision-making process. Our aim was to identify patients' perceptions and understanding of the NNAP data and its influences. MATERIALS AND METHODS: This single-centre study was conducted in the outpatient neurosurgery clinics at a regional neurosurgical centre...
April 2, 2024: British Journal of Neurosurgery
Danilo Di Giorgio, Filippo Giovannetti, Paolo Priore, Mirko Scagnet, Federico Mussa, Ingrid Raponi, Valentino Valentini, Lorenzo Genitori
INTRODUCTION: Skull base pathologies in the paediatric population are rare and require treatment by multiple qualified specialists. The endoscopic endonasal approach has revolutionized surgical treatment because it is less invasive than existing treatments.The goal of this study was to retrospectively review our experience with the reconstruction of paediatric skull middle base defects and associated complications. MATERIALS AND METHODS: We analysed medical records from patients aged ≤ 18 years who were treated at our centre between 2013 and 2021...
March 28, 2024: British Journal of Neurosurgery
Rosa Sun, Marina Pitsika, Sheikh Momin, Zenab Sher, Donald Macarthur
PURPOSE: Neurosurgery training in the UK has undergone significant changes over the past few years, including the new competency-based curriculum and a reduction of elective operating due to the pandemic. We conducted a comprehensive survey to assess UK neurosurgical trainees' experiences and perceptions to develop targeted action plans. METHODS: An online anonymised survey was developed and distributed amongst the BNTA mailing list. Question types included 10-point Likert scales and free text options...
March 27, 2024: British Journal of Neurosurgery
Nitin Mukerji
No abstract text is available yet for this article.
April 2024: British Journal of Neurosurgery
Marek Baláž, Pavel Filip, Martina Bočková, Věra Feitová, Ivo Říha, Dušan Hrabovský, Jan Chrastina
PURPOSE: Despite the best efforts of neurologists, the results of pharmacotherapy in the late stages of Parkinson's disease are often disappointing and accompanied by debilitating side effects. Under these circumstances, deep brain stimulation is a viable treatment option. The aim of the meticulous pre-surgical planning is not only precise electrode implantation, but also the avoidance of intraoperative vascular conflicts potentially causing intracerebral bleeding. MATERIAL AND METHODS: In this report, we present a patient with early-onset Parkinson's disease whose cerebral vascular anatomy precluded standard bilateral subthalamic nucleus electrode implantation...
April 2024: British Journal of Neurosurgery
Melissa Gough, Russell Mills, Una Brechany, Claire Nicholson, Alistair Jenkins, Mohammed Akbar Hussain
BACKGROUND: Deep brain stimulation (DBS) surgery targeting the ventral intermediate thalamic nucleus (Vim) has proven efficacy in the treatment of tremor. AIMS: The primary aim is to investigate whether there is a statistically significant difference in patient outcomes when CT-guided targeting of the Vim is compared with MRI-guided targeting. METHODS: This is a retrospective study concerning patients undergoing Vim-targeted DBS at the Department of Neurosurgery, Royal Victoria Infirmary in Newcastle (9th August 2012 to 4th January 2019)...
February 19, 2024: British Journal of Neurosurgery
Stephan Lackermair, Adolf Müller, Hannes Egermann, Rainer Hahne
Background: Surgical treatment of intracranial arachnoid cysts (iACs) is challenging. Microsurgical resection, endoscopic fenestration and cysto-peritoneal shunting are the most frequently used methods, each implying their own drawbacks. Stereotactic-guided cysto-ventricular drainage has been described as an alternative method. Here we describe our experience with this technique and how we conducted volumetric measurements to evaluate the effect of permanent drainage. Methods: Standardized stereotactic planning was performed...
February 7, 2024: British Journal of Neurosurgery
Andrew Brian O'Keeffe, Anca Merla, Keyoumars Ashkan
Deep brain stimulation has been in clinical use for 30 years and during that time it has changed markedly from a small-scale treatment employed by only a few highly specialized centers into a widespread keystone approach to the management of disorders such as Parkinson's disease. In the intervening decades, many of the broad principles of deep brain stimulation have remained unchanged, that of electrode insertion into stereotactically targeted brain nuclei, however the underlying technology and understanding around the approach have progressed markedly...
February 7, 2024: British Journal of Neurosurgery
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