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Neurosurgical complications

Sasha Vaziri, Joseph M Abbatematteo, Max S Fleisher, Alexander B Dru, Dennis T Lockney, Paul S Kubilis, Daniel J Hoh
OBJECTIVEThe American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online surgical risk calculator uses inherent patient characteristics to provide predictive risk scores for adverse postoperative events. The purpose of this study was to determine if predicted perioperative risk scores correlate with actual hospital costs.METHODSA single-center retrospective review of 1005 neurosurgical patients treated between September 1, 2011, and December 31, 2014, was performed. Individual patient characteristics were entered into the NSQIP calculator...
February 15, 2019: Journal of Neurosurgery
Liezel Ulloque-Caamaño, Joulen Mo-Carrascal, Johana Maraby, Alexis Narvaez-Rojas, Loraine Quintana-Pajaro, Yancarlos Ramos-Villegas, Luis R Moscote-Salazar
Ventriculitis after extraventricular drainage is a very important neurosurgical complication in neurocritical care units. It is necessary to make an early diagnosis, given that the morbidity and mortality secondary to it can be variable, and complicate the evolution of neurocritical patients. Despite this, ventriculostomy continues to be an important pillar in monitoring and treatment. Given the urgency of ventriculitis associated with multiresistant germs, new antimicrobial drugs have emerged as part of the treatment, as intraventricular routes have been proposed within the new investigations...
2019: Cirugia y Cirujanos
Michael S Rallo, Michael Nosko, Richard L Agag, Zhenggang Xiong, Fawaz Al-Mufti, Sudipta Roychowdhury, Anil Nanda, Gaurav Gupta
Cutis verticis gyrata (CVG) is a rare condition of the scalp in which thickening of the dermis induces rigid folds and furrows resembling the cerebral cortex. Two forms of primary CVG exist, essential in which CVG is the only presenting problem and non-essential in which the scalp condition occurs along with neuropsychiatric ailments. CVG can also occur secondary to a variety of causes including inflammatory, neoplastic, and metabolic conditions or drug use. Despite its rarity, CVG is an important issue for neurosurgeons to understand as it can present complications in performing craniotomy, most notably during the scalp exposure and closure...
February 11, 2019: World Neurosurgery
Nauman S Chaudhry, Wenya Linda Bi, Saksham Gupta, Abhishek Keraliya, Naomi Shimizu, E Antonio Chiocca
BACKGROUND: Pneumoperitoneum after surgical manipulation of the abdomen implies a perforation. Rare cases of non-operated cancer patients, largely with gastrointestinal or genitourinary cancers, have been noted to have radiological findings of pneumatosis intestinalis and/or pneumoperitoneum as a complication of molecular-targeted therapy (MTT) without confounding factors for perforation. We present a patient with a cranial malignancy treated with bevacizumab who subsequently manifested with pneumatosis intestinalis...
February 11, 2019: World Neurosurgery
Matthew A Haber, Muhammad Abd-El-Barr, William Gormley, Srinivasan Mukundan, Aaron D Sodickson, Christopher A Potter
Visits to the emergency department by patients who have recently undergone neurosurgery are a common occurrence, and these patients frequently receive emergent cross-sectional head imaging in order to evaluate for complications. Different neurosurgical approaches may have typical postoperative imaging findings that can be confused with pathology. Furthermore, particular abnormal postoperative imaging findings may signal an evolving complication. It is essential for the radiologist to understand common neurosurgical procedures and their potential complications in order to provide proper diagnostic evaluation of the postoperative neurosurgical patient...
February 13, 2019: Emergency Radiology
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
Mithun Sattur, Clayton Korson, Fraser Henderson, Stephen Kalhorn
Occipital spur is an abnormal bony outgrowth of the external occipital protuberance (EOP). We describe an interesting and previously unreported case of fracture of an occipital spur following trauma. Our 20-year-old male patient was treated in the emergency department (ED) and discharged home without complication. Neurosurgical consultation was obtained but is not requisite for these injuries. Greater awareness of this unique presentation may help to expedite future emergency department treatment.
January 24, 2019: American Journal of Emergency Medicine
James L West, Michael H Soike, Jaclyn J Renfrow, Michael D Chan, Adrian W Laxton, Stephen B Tatter
OBJECTIVERathke's cleft cysts (RCCs) are benign lesions of the sella turcica that usually come to neurosurgical attention due to compression of the optic apparatus (OA) and headaches. Treatment options for these lesions include observation, aspiration of cyst contents, or open resection of the cyst with the cyst wall. All of these options involve the potential for cyst recurrence or enlargement. In this study the authors report on a potential new therapeutic option for RCCs, i.e., stereotactic radiosurgery (SRS)...
February 1, 2019: Journal of Neurosurgery
Theodore H Schwartz, Peter F Morgenstern, Vijay K Anand
OBJECTIVEEndoscopic skull base surgery (ESBS) is a relatively recent addition to the neurosurgical armamentarium. As with many new approaches, there has been significant controversy regarding its value compared with more traditional approaches to ventral skull base pathology. Although early enthusiasm for new approaches that appear less invasive is usually high, these new techniques require rigorous study to ensure that widespread implementation is in the best interest of patients.METHODSThe authors compared surgical results for ESBS with transcranial surgery (TCS) for several different pathologies over two different time periods (prior to 2012 and 2012-2017) to see how results have evolved over time...
February 1, 2019: Journal of Neurosurgery
Megan Obi, Kaine Onwuzulike
BACKGROUND: Hyponatremia in the neonatal population is an uncommon occurrence and can be associated with significant increase in morbidity and mortality. In the neonatal population, it is typically associated with an excess of antidiuretic hormone (ADH) and rarely has been found to be associated with hydrocephalus short of being caused by the subsequent treatment of hydrocephalus. CASE: Description: We present a case report of a patient with neonatal hydrocephalus, secondary to intraventricular hemorrhage in the setting of prematurity, treated at our institution, in whom sodium levels reached a nadir as head circumference peaked and subsequent treatment of hydrocephalus resolved the associated hyponatremia...
February 1, 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
Christa Morrison, Mary Claire Avanis, Susanna Ritchie-McLean, Colleen Woo, Jane Herod, Reema Nandi, Dominic Thompson
BACKGROUND: Craniocervical immobilisation using halo body orthoses may be required in the management of children with craniocervical junction pathology. To date, the effect of such immobilisation on perioperative anaesthetic management has not been addressed in large series. AIM: To review the airway management of children requiring halo body orthoses undergoing general anaesthesia. METHODS: The study was a retrospective case note review from a single institution...
February 1, 2019: Paediatric Anaesthesia
Flavio Vasella, Julia Velz, Marian C Neidert, Stephanie Henzi, Johannes Sarnthein, Niklaus Krayenbühl, Oliver Bozinov, Luca Regli, Martin N Stienen
The aim of the present study was to assess the safety of microsurgical resection of intracranial tumors performed by supervised neurosurgical residents. We analyzed prospectively collected data from our institutional patient registry and dichotomized between procedures performed by supervised neurosurgery residents (defined as teaching procedures) or board-certified faculty neurosurgeons (defined as non-teaching procedures). The primary endpoint was morbidity at discharge, defined as a postoperative decrease of ≥10 points on the Karnofsky Performance Scale (KPS)...
January 30, 2019: Scientific Reports
Malik Zaben, S Manivannan, C Petralia, P Leach
PURPOSE: Subdural haematoma (SDH) is a recognised complication of forceps-assisted delivery (FAD). There are no guidelines regarding its management. This study aims to provide a better insight into the management and outcomes of neonatal SDH post-FAD. METHODS: Retrospective review of our neonatal database and systematic review of the literature for neonatal cases that presented with SDH after FAD. Retrospective neurosurgical database search for cases of neonatal SDH post-FAD managed in our unit between January 2007 and January 2017...
January 28, 2019: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
R Sathyanarayanan, K Raghu, S Deepika, K Sarath
Purpose: The purpose of the present study is to report an overview of fracture patterns and surgical approaches for 15 patients who were treated in our Indhira Gandhi Institute of Dental Sciences, Pondicherry, India from 2010 to 2015. Method and Material: Fifteen people were included in the study, which were diagnosed with anterior table fracture of the frontal sinus and were randomly admitted in our institution. All patients were evaluated preoperatively with axial and coronal computed tomography scans before operating...
July 2018: Annals of Maxillofacial Surgery
Anette Storesund, Arvid Steinar Haugen, Hilde Valen Wæhle, Rupavathana Mahesparan, Marja A Boermeester, Monica Wammen Nortvedt, Eirik Søfteland
Introduction: Surgical safety checklists may contribute to reduction of complications and mortality. The WHO's Surgical Safety Checklist (WHO SSC) could prevent incidents in operating theatres, but errors also occur before and after surgery. The SURgical PAtient Safety System (SURPASS) is designed to intercept errors with use of checklists throughout the surgical pathway. Objective: We aimed to validate a Norwegian version of the SURPASS' preoperative and postoperative checklists for use in combination with the already established Sign In, Time Out and Sign Out parts of the WHO SSC...
2019: BMJ Open Quality
Xiaoxi Zhang, Yu Zhou, Guoli Duan, Haishuang Tang, Qiao Zuo, Pengfei Yang, Yi Xu, Bo Hong, Qinghai Huang, Jianmin Liu
OBJECTIVE: Endovascular treatment for ruptured middle cerebral artery (MCA) aneurysms, which were more likely to be recommended for neurosurgical clipping because of complex anatomic configuration, still remain controversial. In this study, angiographic and clinical outcomes ofendovacularly treated ruptured MCA aneurysms were systematically reviewed. MATERIALS AND METHODS: Online database including Cochrane, Medline, web of science and Embase were retrospectively and systematically searched...
January 24, 2019: World Neurosurgery
J Shetty, J Kandasamy, D Sokol, P Gallo
INTRODUCTION: Neurosurgical treatment is recommended for symptomatic syringomyelia and the post-operative radiological resolution of the syringomyelia is associated with an improvement or at least stability of the patient's pre-operative symptoms. METHODS: We reviewed syringomyelia treatment in our centre over the last five years for clinical outcome, surgical complications, post operative MRI and long term symptom resolution. RESULTS: 50 cases of symptomatic syringomyelia underwent foramen magnum decompression and expansile watertight duroplasty...
January 14, 2019: European Journal of Paediatric Neurology: EJPN
Julius Höhne, Karl-Michael Schebesch, Camilla de Laurentis, Mehmet Osman Akçakaya, Christian Bonde Pedersen, Alexander Brawanski, Frantz Rom Poulsen, Talat Kiris, Claudio Cavallo, Morgan Broggi, Paolo Ferroli, Francesco Acerbi
BACKGROUND: Glioblastoma multiforme (GBM) is the most common primary brain tumor and has a high recurrence rate. Maximizing the extent of resection (EOR) in recurrent GBM has proved to be the cornerstone of neurosurgical re-treatment. The development of surgical microscopes fitted with fluorescein-specific filters has facilitated fluorescein-guided microsurgery and the identification of tumor tissue. Use of fluorescein sodium (FL) in primary high-grade glioma resection has shown promising results...
January 22, 2019: World Neurosurgery
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