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Neurosurgical infection rates

Jiri Bartek, Petter Förander, Erik Thurin, Theresa Wangerid, Roger Henriksson, Göran Hesselager, Asgeir Store Jakola
Background: Vestibular Schwannoma (VS) is a benign neoplasm arising from the 8th cranial nerve, with surgery one of the treatment modalities. In a nation-wide registry study, we describe the baseline, treatment characteristics, and short-term outcome in patients surgically treated for VS. Methods: We performed a nationwide study with data from the Swedish Brain Tumor Registry (SBTR) for all adults diagnosed with VS 2009-2015. Patient symptoms, tumor characteristics, and postoperative complications were analyzed...
2019: Frontiers in Neurology
Joy Roach, Benjamin Gaastra, Diederik Bulters, Anan Shtaya
OBJECTIVE: External ventricular drain (EVD) placement is frequently required in neurosurgical patients to divert CSF and monitor intracranial pressure. The usual practise is the tunnelled EVD technique performed in operating theatres. EVD insertion through a bolt in intensive care is also described. We employ both practices in our institute. Herein, we compare the indications, accuracy, safety and costs of the two techniques. METHODS: Retrospective cohort study of a prospectively maintained EVD data-base of all patients undergoing first frontal EVD placement between Jan 2010-Dec 2015...
February 5, 2019: World Neurosurgery
Anna Bjornson, Tamara Tajsic, Angelos G Kolias, Adam Wells, Mohammad J Naushahi, Fahim Anwar, Adel Helmy, Ivan Timofeev, Peter J Hutchinson
BACKGROUND: Cranioplasty is an increasingly common procedure performed in neurosurgical centres following a decompressive craniectomy (DC), however, timing of the procedure varies greatly. OBJECTIVES: The aim of this study is to compare the surgical outcomes of an early compared to a late cranioplasty procedure. METHODS: Ninety adult patients who underwent a prosthetic cranioplasty between 2014 and 2017 were studied retrospectively. Timing of operation, perioperative complications and length of stay were assessed...
February 4, 2019: Acta Neurochirurgica
S Patel, D Thompson, S Innocent, V Narbad, R Selway, K Barkas
INTRODUCTION: Surgical site infections (SSIs) are of profound significance in neurosurgical departments, resulting in high morbidity and mortality. There are limited public data regarding the incidence of SSIs in neurosurgery. The aim of this study was to determine the rate of SSIs (particularly those requiring reoperation) over a seven-year period and identify factors leading to an increased risk. METHODS: An age matched retrospective analysis was undertaken of a series of 16,513 patients at a single centre...
January 30, 2019: Annals of the Royal College of Surgeons of England
Khoi D Nguyen, Vamsi Reddy, Scott Y Rahimi
OBJECT: Hemicraniectomy is a commonly performed neurosurgical procedure used in the setting of medically refractory malignant intracranial hypertension. Complications from cranioplasty following hemicraniectomy can be significant, including infection and wound issues. Difficulty with scar tissue during exposure for cranioplasty can be challenging and can lead to prolonged surgical time and increased bleeding. We describe a surgical technique, termed the "dural sandwich", that could provide a significant benefit during cranioplasty as compared to traditional single-layered dural closure...
January 11, 2019: World Neurosurgery
Stephanie Schipmann, Tobias Brix, Julian Varghese, Nils Warneke, Michael Schwake, Benjamin Brokinkel, Christian Ewelt, Martin Dugas, Walter Stummer
BACKGROUND: The aim of the study was to determine pre-operative factors associated with adverse events occurring within 30 days after neurosurgical tumor treatment in a German center, adjusting for their incidence in order to prospectively compare different centers. METHODS: Adult patients that were hospitalized due to a benign or malignant brain were retrospectively assessed for quality indicators and adverse events. Analyses were performed in order to determine risk factors for adverse events and reasons for readmission and reoperation...
January 11, 2019: Acta Neurochirurgica
A Candoni, N Klimko, A Busca, R De Blasi, O Shadrivova, S Cesaro, M E Zannier, L Verga, F Forghieri, E Calore, G Nadali, E Simonetti, P Muggeo, A M Quinto, C Castagnola, M Cellini, M I Del Principe, N Fracchiola, L Melillo, M Piedimonte, D Zama, F Farina, D Giusti, F Mosna, D Capelli, M Delia, M Picardi, N Decembrino, K Perruccio, S Vallero, F Aversa, R Fanin, L Pagano
Invasive Fungal Infections (IFI) of the Central Nervous System (IFI-CNS) and Paranasal Sinuses (IFI-PS) are rare, life-threatening infections in hematologic patients, and their management remains a challenge despite the availability of new diagnostic techniques and novel antifungal agents. In addition, analyses of large cohorts of patients focusing on these rare IFI are still lacking. Between January 2010 and December 2016, 89 consecutive cases of Proven (53) or Probable (36) IFI-CNS (71/89) and IFI-PS (18/89) were collected in 34 Hematological Centers...
December 19, 2018: Mycoses
Vita M Klieverik, Kai J Miller, Kuo Sen Han, Ash Singhal, Michael Vassilyadi, Charles J Touchette, Alexander G Weil, Peter A Woerdeman
OBJECTIVE: Complications following pediatric cranioplasty after craniectomy with either autologous bone flaps or cranial implants are reported to be common, particularly bone flap resorption. However, only sparse data are available regarding cranioplasty strategies, complications, and outcomes. This manuscript describes a Canadian-Dutch multicenter pediatric cohort study with autografts and cranial implant cranioplasties following craniectomies for a variety of indications. METHODS: The study included all children (< 18 years) who underwent craniectomy and subsequent cranioplasty surgeries from 2008 to 2014 (with a minimum of 1-year follow-up) at four academic hospitals with a dedicated pediatric neurosurgical service...
December 15, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Nadia Masroor, Jenika Ferretti-Gallon, Kaila Cooper, Kimberly Elgin, Kakotan Sanogo, Huong Jane Nguyen, Michelle Doll, Michael P Stevens, Gonzalo Bearman
BACKGROUND: Staphylococcal decolonization decreases the risk of Staphylococcus aureus surgical site infection. This study evaluates patient perceptions and barriers to a universal Staphylococcal decolonization (USD) protocol. METHODS: In October 2013, a protocol for the decolonization of Staphylococcal aureus in elective orthopedic, neurosurgical, and cardiac surgeries was implemented in an effort to further decrease post-operative infections rates. We surveyed patients undergoing these procedures between November 2014 and April 2015 using an anonymous, voluntary, Likert-scale survey; survey questions targeted compliance with the protocol as well as barriers to protocol completion...
December 11, 2018: American Journal of Infection Control
M Abbas, M E A de Kraker, E Aghayev, P Astagneau, M Aupee, M Behnke, A Bull, H J Choi, S C de Greeff, S Elgohari, P Gastmeier, W Harrison, M B G Koek, T Lamagni, E Limon, H L Løwer, O Lyytikäinen, K Marimuthu, J Marquess, R McCann, I Prantner, E Presterl, M Pujol, J Reilly, C Roberts, L Segagni Lusignani, D Si, E Szilágyi, J Tanguy, S Tempone, N Troillet, L J Worth, D Pittet, S Harbarth
BACKGROUND: Surveillance of surgical site infections (SSIs) is a core component of effective infection control practices, though its impact has not been quantified on a large scale. AIM: To determine the time-trend of SSI rates in surveillance networks. METHODS: SSI surveillance networks provided procedure-specific data on numbers of SSIs and operations, stratified by hospitals' year of participation in the surveillance, to capture length of participation as an exposure...
December 7, 2018: Journal of Hospital Infection
Lukas Grassner, Franz Marhold, Yousif Miron, Andreas Grillhösl, Karl Ungersboeck, Joachim Schulz, Martin Strowitzki
BACKGROUND: Decompressive craniectomy is a commonly performed procedure. It reduces intracranial pressure, improves survival, and thus might have a positive impact on several neurosurgical diseases and emergencies. Sometimes primary skin closure is not possible due to cerebral herniation or extensive skin defects. In order to prevent further restriction of the underlying tissue, a temporary skin expansion might be necessary. METHODS AND MATERIAL: We retrospectively reviewed patients in need for a temporary skin substitute because skin closure was not possible after craniectomy without violating brain tissue underneath in a time period of 6 years (2011-2016)...
December 4, 2018: Acta Neurochirurgica
Cagatay Calikoglu, Murteza Cakir
Objective: The aim of this study was to evaluate the outcomes of patients with lumbar disk hernia operated between 2012 January and 2017 August and to compare the differences between open discectomy (OD) and microdiscectomy (MD). Materials and Methods: Files of 519 patients who presented at our neurosurgical department with lumbar disk herniation were retrospectively reviewed and recorded. Preoperatively, all patients routinely underwent spinal lumbar magnetic resonance imaging (MRI) and anteroposterior as well as lateral lumbar vertebrae X-rays...
October 2018: Eurasian Journal of Medicine
Martin N Stienen, Nathalie Moser, Philipp Krauss, Luca Regli, Johannes Sarnthein
BACKGROUND: Today, there are only few reports on the incidence of surgical site infections (SSIs) in neurosurgery. The objective of this work was to determine the rate of SSI at a tertiary neurosurgical department for benchmarking purpose. METHODS: Data of consecutive patients undergoing neurosurgical treatment between January 2013 and December 2016 were prospectively entered into a registry. SSIs were diagnosed according to the 2017 Centers for Disease Control and Prevention criteria, with severity graded according to the Clavien-Dindo grade (CDG)...
November 27, 2018: Acta Neurochirurgica
Evgenii Belykh, Alessandro Carotenuto, Andrey A Kalinin, Serik K Akshulakov, Talgat Kerimbayev, Vladislav E Borisov, Marat A Aliyev, Peter Nakaji, Mark C Preul, Vadim A Byvaltsev
OBJECTIVE: To analyze the effects of a surgical protocol for infections, nonhealing wound prophylaxis, and analgesia among patients who underwent posterior spinal fusion at a single tertiary care neurosurgical center. METHODS: This prospective study was conducted in the neurosurgery department of a tertiary care neurosurgical center and compared a control group of patients who had posterior spinal fusion within 3 months before implementation of a surgical protocol with a study group of patients enrolled within 1 year after protocol implementation...
November 24, 2018: World Neurosurgery
Muhammad Adnan Khan, Syed Abdul Qader Quadri, Abdulmuqueeth Syed Kazmi, Vishal Kwatra, Anirudh Ramachandran, Aaron Gustin, Mudassir Farooqui, Sajid Sattar Suriya, Atif Zafar
Skull base osteomyelitis (SBO) is a complex and fatal clinical entity that is often misdiagnosed for malignancy. SBO is commonly a direct complication of otogenic, sinogenic, odontogenic, and rhinogenic infections and can present as central, atypical, or pediatric clival SBO. This review describes the clinical profile, investigational approach, and management techniques for these variants. A comprehensive literature review was performed in PubMed, MEDLINE, Research Gate, EMBASE, Wiley Online Library, and various Neurosurgical and Neurology journals with the keywords including: SBO, central or atypical SBO, fungal osteomyelitis, malignant otitis externa, temporal bone osteomyelitis, and clival osteomyelitis...
October 2018: Asian Journal of Neurosurgery
Vicente Pintado, Rosario Pazos, Manuel Enrique Jiménez-Mejías, Azucena Rodríguez-Guardado, Beatriz Díaz-Pollán, Carmen Cabellos, Juan Manuel García-Lechuz, Jaime Lora-Tamayo, Pere Domingo, Elena Muñez, Diego Domingo, Fernando González-Romo, José Antonio Lepe-Jiménez, Carlos Rodríguez-Lucas, Antonio Gil, Iván Pelegrín, Fernando Chaves, Virginia Pomar, Antonio Ramos, Teresa Alarcón, Elisa Pérez-Cecilia
BACKGROUND: Staphylococcus aureus meningitis is an uncommon nosocomial infection usually associated with neurosurgical procedures but spontaneous infections may occasionally appear. AIMS: To compare the features of meningitis caused by methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus and examine the prognostic factors for mortality, including MRSA infection and combined antimicrobial therapy. METHODS: Retrospective cohort study of 350 adults with S...
November 15, 2018: Journal of Hospital Infection
Orion P Keifer, Kate Zeising, Muhibullah S Tora, Melissa Campbell, Yarema B Bezchlibnyk, Nicholas Boulis
BACKGROUND AND IMPORTANCE: Trigeminal ganglion stimulation can be effective for trigeminal neuralgia. For patients who respond well to neurostimulation delivered percutaneously through the foramen ovale but require extensive revision and removal of instrumentation, a sub-temporal approach for stimulation of the trigeminal ganglion is an alternative option as a salvage procedure. CLINICAL PRESENTATION: Here we report a 47-year old woman who responded well to neurostimulation for trigeminal neuropathic pain over a one-year period from 2008-2009...
November 14, 2018: World Neurosurgery
Megan E H Still, Sara Venturini, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
BACKGROUND: Spine pathology is a common reason for admission to neurosurgical units in low- and middle- income countries (LMICs) and can have high morbidity rates from lack of specialized institutes. However, good surgical outcomes and quality of life scores have been reported in LMICs. OBJECTIVES: This study details the complication rates and predictive factors from spine surgery at a large hospital in Cambodia, aiming to identify high-risk patients to improve surgeon understanding of these complications for improved pre-operative planning and patient counseling...
November 14, 2018: World Neurosurgery
M Dedeciusová, T Tyll, V Beneš, D Netuka
Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%. The case report presents a patient with subdural empyema which resulted from sinusitis. The integral and first part of therapy was an urgent neurosurgical drainage of subdural empyema, followed by functional endoscopic sinus surgery performed by ENT surgeon...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Marija Stevic, Dusica Simic, Nina Ristic, Ivana Budic, Vesna Marjanovic, Marija Jovanovski-Srceva, Nikola Repac, Milica Rankovic-Janevski, Goran Tasic
Purpose: Preterm newborns, due to many factors, are at increased risk for poor neural development, intraventricular hemorrhages, infections, and higher rate of mortality. The aim of this study was to evaluate the risk factors associated with poor outcome in preterm neonates with late-onset neonatal sepsis (LONS) who had posthemorrhagic hydrocephalus and underwent neurosurgical procedures for treatment of the hydrocephalus. Patients and methods: Preterm neonates who had undergone insertion of ventriculoperitoneal shunt or Ommaya reservoir, during the 10-year period at University Children's Hospital, were retrospectively analyzed...
2018: Therapeutics and Clinical Risk Management
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