journal
https://read.qxmd.com/read/36857794/incidence-and-management-of-postoperative-pseudomeningocele-and-cerebrospinal-fluid-leak-after-chiari-malformation-type-i-decompression
#1
JOURNAL ARTICLE
Travis J Atchley, Yasaman Alam, Evan Gross, Nicholas M B Laskay, Dagoberto Estevez-Ordonez, Philip G R Schmalz, Winfield S Fisher
OBJECTIVE: The optimal surgical management of Chiari malformation type I (CM-I) remains controversial and heterogeneous. The authors sought to investigate patient-specific, technical, and perioperative features that may affect the incidence of CSF-related complications including pseudomeningocele and CSF leak at their institution. METHODS: The authors performed a single-center, retrospective review of all adult patients with CM-I who underwent posterior fossa decompression...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857793/risk-factors-for-clinical-and-radiological-worsening-following-chiari-malformation-type-i-surgery-in-the-pediatric-population
#2
JOURNAL ARTICLE
Nida Fatima, Dale M Swift, Eric Y Montgomery, Bradley E Weprin, Angela V Price, Brett A Whittemore, Bruno P Braga
OBJECTIVE: Foramen magnum (FM) decompression with or without duraplasty is considered a common treatment strategy for Chiari malformation type I (CM-I). The authors' objective was to determine a predictive model of risk factors for clinical and radiological worsening after CM-I surgery. METHODS: A retrospective review of electronic health records was conducted at an academic tertiary care hospital from 2001 to 2019. A multivariable Cox proportional hazards regression model was used to determine the risk factors...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857792/thirty-day-outcomes-for-suboccipital-decompression-in-adults-with-chiari-malformation-type-i-a-frailty-driven-perspective-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#3
MULTICENTER STUDY
Alexander J Kassicieh, Emily M Estes, Kavelin Rumalla, Syed Faraz Kazim, Rohini G McKee, Meic H Schmidt, Christian A Bowers
OBJECTIVE: When indicated, patients with symptomatic Chiari malformation type I (CM-I) may benefit from suboccipital decompression (SOD). Although SOD is considered a lower-risk neurosurgical procedure, preoperative risk assessment and careful surgical patient selection remain critical. The objectives of the present study were twofold: 1) describe 30-day SOD outcomes for CM patients with attention to the impact of preoperative frailty and 2) design a predictive model for the primary endpoint of nonhome discharge (NHD)...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857791/long-term-outcomes-of-foramen-magnum-decompression-with-duraplasty-for-chiari-malformation-type-i-in-adults-a-series-of-297-patients
#4
JOURNAL ARTICLE
Bo Wang, Chong Wang, Yao-Wu Zhang, Yu-Chao Liang, Wei-Hao Liu, Jun Yang, Yu-Lun Xu, Yong-Zhi Wang, Wen-Qing Jia
OBJECTIVE: Foramen magnum decompression with duraplasty (FMDD) is one of the most frequently utilized surgical treatments for Chiari malformation type I (CMI) in adults. However, its long-term outcomes remain controversial. The object of this study was to evaluate the long-term outcomes of FMDD in adults with CMI. METHODS: In total, 297 adults with CMI who had undergone FMDD at the authors' institution between 2011 and 2020 were included in this retrospective study...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857790/prognostic-analysis-of-posterior-fossa-decompression-with-or-without-cerebellar-tonsillectomy-for-chiari-malformation-type-i-a-multicenter-retrospective-study
#5
MULTICENTER STUDY
Yuankun Cai, Chaobin Wang, Songshan Chai, Guo Li, Tingbao Zhang, Zheng Liu, Dongye Yi, Jincao Chen, Juntao Hu, Kui Liu, Nanxiang Xiong
OBJECTIVE: The purpose of this study was to compare the prognosis of patients with Chiari malformation type I (CM-I) treated with posterior fossa decompression with duraplasty (PFDD) and posterior fossa decompression with resection of tonsils (PFDRT). METHODS: The clinical data of patients with CM-I treated using these two procedures in three medical centers between January 2016 and June 2021 were retrospectively analyzed and divided into PFDD and PFDRT groups according to the procedures...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857789/external-validation-of-the-chicago-chiari-outcome-scale-in-adults-with-chiari-malformation-type-i
#6
JOURNAL ARTICLE
Lukasz Antkowiak, Piotr Stogowski, Tomasz Klepinowski, Tristan Balinski, Hubert Mado, Piotr Sumislawski, Marcin Niedbala, Michalina Rucinska, Zuzanna Nowaczyk, Marta Rogalska, Damian Kocur, Anna Kasperczuk, Ryszard Sordyl, Wojciech Kloc, Wojciech Kaspera, Gertrud Kammler, Leszek Sagan, Adam Rudnik, Pawel Tabakow, Manfred Westphal, Marek Mandera
OBJECTIVE: The Chicago Chiari Outcome Scale (CCOS) serves as a standardized clinical outcome evaluation tool among patients with Chiari malformation type I (CM-I). While the reliability of this scale has been proven for pediatric patients, the literature lacks CCOS validation when used solely in adults. Therefore, this study aimed to determine the validity of the CCOS in an external cohort of adult patients. METHODS: The authors retrospectively analyzed the medical records of symptomatic patients with CM-I who underwent posterior fossa decompression between 2010 and 2018 in six neurosurgical departments...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857788/reappraisal-of-intradural-findings-in-chiari-malformation-type-i
#7
JOURNAL ARTICLE
Belinda Shao, Daniel Wojcik, Kevin L Ma, Natalie Amaral-Nieves, Jonathan A Poggi, Owen P Leary, Petra M Klinge
OBJECTIVE: Management of Chiari malformation type I (CM-I) requires the functional restoration of an obstructed cisterna magna. In posterior fossa decompression with duraplasty (PFDD), various intradural pathologies are suggested to alter CSF flow at the craniocervical junction and require surgical correction. However, reports of the spectrum of intraoperative intradural findings and their nuances are scarce, especially those characterizing rarer findings pertaining to the vascular structures and vascular compression...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857787/minimally-invasive-modification-of-the-goel-harms-atlantoaxial-fusion-technique-a-case-series-and-illustrative-guide
#8
JOURNAL ARTICLE
Aaron Gelinne, Martin Piazza, Deb A Bhowmick
OBJECTIVE: The Goel-Harms atlantoaxial screw fixation technique for the treatment of atlantoaxial instability and unstable odontoid fractures is reliable and reproducible for a variety of anatomies. The drawbacks of the technique are the potential for significant bleeding from the C2 nerve root venous plexus and the risks associated with posterior midline exposure and retraction, such as pain and wound complications. The authors developed a minimally invasive surgical (MIS) modification of the Goel-Harms technique using intra-articular grafting to facilitate placement of percutaneous lateral mass and pars screws with extended tabs for minimally invasive subfascial rod placement...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857786/central-or-axial-atlantoaxial-dislocation-and-craniovertebral-junction-alterations-a-review-of-393-patients-treated-over-12-years
#9
JOURNAL ARTICLE
Abhidha Shah, Ravikiran Vutha, Apurva Prasad, Atul Goel
OBJECTIVE: The authors reviewed their scientific publications and updated their clinical material obtained over the last 12 years for cases of central or axial atlantoaxial dislocation (CAAD) identified in the presence of craniovertebral musculoskeletal and/or neural alteration(s). The management implications of diagnosing and treating CAAD are highlighted. METHODS: During a 12-year period, CAAD was diagnosed in 393 patients with craniovertebral junction-related musculoskeletal and neural alterations who underwent atlantoaxial fixation...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857785/single-institution-comparative-analysis-for-odontoid-resection-posterior-transaxis-versus-anterior-transnasal-approach
#10
JOURNAL ARTICLE
İhsan Doğan, Eyüp Bayatli, Halit Anil Eray, Koral Erdogan, Macit Terzi, Savas Hasimoglu, Ozan Tekneci, Suha Beton, Umit Eroglu, Onur Ozgural, Gokmen Kahilogullari, Yusuf Sukru Caglar
OBJECTIVE: The resection of an upwardly migrated odontoid is most widely performed via an anterior endoscopic endonasal approach after the addition of posterior occipitocervical instrumentation. In patients with craniovertebral junction (CVJ) anomalies like basilar invagination (BI), surgery is usually achieved in two separate stages. However, the authors have recently introduced a novel posterior transaxis approach in which all the therapeutic goals of the surgery can be safely and effectively accomplished in a single-stage procedure...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857784/surgery-for-basilar-invagination-with-and-without-chiari-i-malformation
#11
JOURNAL ARTICLE
Jörg Klekamp
OBJECTIVE: The surgical treatment for Chiari I malformation and basilar invagination has been discussed with great controversy in recent years. This paper presents a treatment algorithm for these disorders based on radiological features, intraoperative findings, and analyses of long-term outcomes. METHODS: Eight-five operations for 82 patients (mean ± SD age 40 ± 18 years; range 9-75 years) with basilar invagination were evaluated, with a mean follow-up of 57 ± 55 months...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857783/fourth-ventricular-subarachnoid-stent-for-chiari-malformation-type-i-associated-persistent-syringomyelia
#12
JOURNAL ARTICLE
Rachael K Han, Mauricio P Medina, Alexandra M Giantini-Larsen, John K Chae, Amanda Cruz, Andrew L A Garton, Jeffrey P Greenfield
OBJECTIVE: Syringomyelia (syrinx) associated with Chiari malformation type I (CM-I) is commonly managed with posterior fossa decompression, which can lead to resolution in most cases. A persistent syrinx postdecompression is therefore uncommon and challenging to address. In the setting of radiographically adequate decompression with persistent syrinx, the authors prefer placing fourth ventricular subarachnoid stents that span the craniocervical junction particularly when intraoperative observation reveals arachnoid plane scarring...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857782/introduction-stability-and-motion-addressing-the-pathology-of-chiari-malformation-and-craniocervical-junction
#13
JOURNAL ARTICLE
David D Limbrick, Douglas L Brockmeyer, Atul Goel, Jennifer M Strahle
No abstract text is available yet for this article.
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36857781/intraoperative-neuromonitoring-for-pediatric-chiari-decompression-when-is-it-useful
#14
JOURNAL ARTICLE
Rajeev D Sen, Vicente Martinez, Jessica Eaton, Robert N Holdefer, Richard G Ellenbogen
OBJECTIVE: Surgical treatment for symptomatic Chiari I malformation involves surgical decompression of the craniovertebral junction. Given the proximity of critical brainstem structures, intraoperative neuromonitoring (IONM) is employed for safe decompression in some institutions. However, IONM adds time and cost to the operation, and the benefit to the patient has not been defined. Given the diversity in surgical practices, there is no evidence-based standard of care regarding when to use IONM and which modalities are most helpful...
March 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724525/neurosurgery-for-psychiatric-disorders-reviewing-the-past-and-charting-the-future
#15
REVIEW
Luke Bauerle, Charles Palmer, Claudia A Salazar, Thomas Larrew, Suzanne E Kerns, E Baron Short, Mark S George, Nathan C Rowland
Surgical techniques targeting behavioral disorders date back thousands of years. In this review, the authors discuss the history of neurosurgery for psychiatric disorders, starting with trephination in the Stone Age, progressing through the fraught practice of prefrontal lobotomy, and ending with modern neurosurgical techniques for treating psychiatric conditions, including ablative procedures, conventional deep brain stimulation, and closed-loop neurostimulation. Despite a tumultuous past, psychiatric neurosurgery is on the cusp of becoming a transformative therapy for patients with psychiatric dysfunction, with an ever-increasing evidence base suggesting reproducible and ethical therapeutic benefit...
February 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724524/schizophrenia-and-neurosurgery-systematic-review-and-theories
#16
JOURNAL ARTICLE
Rajeev R Dutta, Bryce Picton, Nolan J Brown, Chenyi Yang, Maxwell Lee, Hana Sung, Alexander M Lopez, Michelle Paff
OBJECTIVE: Despite its relatively low prevalence, schizophrenia has a high burden of illness due to its lifelong effects and the fact that it is often refractory to psychotropic treatment. This review investigated how neurosurgical interventions, primarily neuromodulation through deep brain stimulation (DBS), can mitigate treatment-refractory schizophrenia. Pathophysiological data and ongoing clinical trials were reviewed to suggest which targets hold promise for neurosurgical efficacy...
February 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724523/novel-psychiatric-disorders-following-mild-traumatic-brain-injury-a-retrospective-multivariable-analysis-with-screening-recommendations
#17
JOURNAL ARTICLE
Alexander M Ballatori, Ariana Zargarian, Alison Haddad, Shane Shahrestani
OBJECTIVE: Concussions are a form of mild traumatic brain injury (mTBI) that most commonly occur after blunt trauma to the head and may result in temporary loss of consciousness. These patients are typically comanaged by neurocritical care specialists, neurologists, and neurosurgeons depending on the severity of disease. The purpose of this study was twofold: 1) evaluate how patient demographic characteristics impact the development of novel psychiatric disorders (NPDs) after mTBI; and 2) develop screening recommendations to identify patients with NPDs...
February 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724522/efficacy-of-deep-brain-stimulation-for-the-treatment-of-anorexia-nervosa-a-systematic-review-and-network-meta-analysis-of-patient-level-data
#18
JOURNAL ARTICLE
Annabelle Shaffer, Anant Naik, Maria Bederson, Paul M Arnold, Wael Hassaneen
OBJECTIVE: Deep brain stimulation (DBS) has been approved as a therapy for movement disorders and obsessive-compulsive disorder. Recently, DBS has been studied in patients with anorexia nervosa (AN), which is a debilitating and life-threatening psychiatric disorder. Several stimulation locations have been tested without a clear indication of the best region. In this systematic review and network meta-analysis, the authors used patient-level data to identify stimulation targets with the greatest evidence for efficacy in increasing body mass index (BMI)...
February 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724521/stereotactic-electroencephalography-in-epilepsy-patients-for-mapping-of-neural-circuits-related-to-emotional-and-psychiatric-behaviors-a-systematic-review
#19
JOURNAL ARTICLE
Christian G Lopez Ramos, Hao Tan, Erin A Yamamoto, Daniel R Cleary, David J Mazur-Hart, Maryam N Shahin, Ahmed M Raslan
OBJECTIVE: Stereotactic electroencephalography (sEEG) is an increasingly utilized method for identifying electrophysiological processes underlying sensorimotor, cognitive, and emotional behaviors. In this review, the authors outline current research using sEEG to investigate the neural activity underlying emotional and psychiatric behaviors. Understanding the current structure of intracranial research using sEEG will inform future studies of psychiatric disease and therapeutics for effective neuromodulation...
February 2023: Neurosurgical Focus
https://read.qxmd.com/read/36724520/intracranial-subsecond-dopamine-measurements-during-a-sure-bet-or-gamble-decision-making-task-in-patients-with-alcohol-use-disorder-suggest-diminished-dopaminergic-signals-about-relief
#20
JOURNAL ARTICLE
Brittany Liebenow, Angela Jiang, Emily DiMarco, Thomas Wilson, Mustafa S Siddiqui, Ihtsham Ul Haq, Adrian W Laxton, Stephen B Tatter, Kenneth T Kishida
OBJECTIVE: To the authors' knowledge, no data have been reported on dopamine fluctuations on subsecond timescales in humans with alcohol use disorder (AUD). In this study, dopamine release was monitored in 2 patients with and 2 without a history of AUD during a "sure bet or gamble" (SBORG) decision-making task to begin to characterize how subsecond dopamine responses to counterfactual information, related to psychological notions of regret and relief, in AUD may be altered. METHODS: Measurements of extracellular dopamine levels were made once every 100 msec using human voltammetric methods...
February 2023: Neurosurgical Focus
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