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postoperative meningitis

S Y Elhadji Cheikh Ndiaye, L Troude, M Al-Falasi, M Faye, A Melot, P-H Roche
BACKGROUND: The Chiari malformation type I (CM-I) is the most commonly found type in adults. The efforts to further improve the treatment offered for these malformations are hampered by the existence of controversial methods and the absence of a uniform scoring system to evaluate clinical outcomes. OBJECTIVES: The goal of our study is to analyze the clinical and radiological data concerning patients operated for CM and to expose surgical techniques. PATIENTS AND TREATMENT: This is a retrospective study concerning patients of more than 16 years of age, operated on (from 2000 to 2016) in our institution...
February 8, 2019: Neuro-Chirurgie
Jack Birkenbeuel, Kimberly Vu, Brandon M Lehrich, Mehdi Abouzari, Dillon Cheung, Pooya Khosravi, Ronald Sahyouni, Kasra Ziai, Omid Moshtaghi, Sammy Sahyouni, Hamid R Djalilian
OBJECTIVES: To analyze medical malpractice lawsuit trends pertaining to cases of vestibular schwannomas (VS). METHODS: Two major computerized legal databases (LexisNexis and WestLaw) were queried and reviewed for evaluation of all the US state and federal court records from civil trials alleging malpractice between 1976 and 2016. RESULTS: A total of 32 VS cases were identified. Allegations were divided into four categories: misdiagnosis/delayed diagnosis (47%), postoperative complications (44%), failure of informed consent or information sharing (16%), and other (3%)...
March 2019: Otology & Neurotology
Yoshiko Fujii, Masaya Nagaishi, Ryuta Nakae, Tomoji Takigawa, Yoshihiro Tanaka, Kensuke Suzuki
RATIONALE: Endodermal cysts are rare benign lesions in the central nervous system. Their common symptoms include headache and neck pain caused by mass effect or inflammatory reaction. We report the case of an elderly woman with intracranial endodermal cyst who presented with nonobstructive hydrocephalus. PATIENT CONCERNS: A 78-year-old woman presented with acute deterioration of consciousness caused by acute hydrocephalus. She subsequently underwent ventriculoperitoneal shunt placement...
February 2019: Medicine (Baltimore)
Hideaki Somura, Kei Furuya, Masahiro Kitahara, Junya Kondo, Yoshinari Maeda, Yukiko Nagashima, Noboru Yahara, Toshihiro Abe, Hiroto Hayashi
A 45-year-old man presented with the chief complaint of anal discomfort to a previous doctor. The symptoms remained after undergoing seton surgery following the diagnosis of intermuscular anal fistula. CT showed a tumor that was 3 cm in diameter on the right wall of the rectum, and he received a diagnosis of neuroendocrine carcinoma(NEC)based on a biopsy. Subsequently, he was admitted to our hospital. Liver metastasis accompanied NEC, and chemotherapy was performed for stage Ⅳ diagnosis. We detected tumor disappearance after administering 8 courses of CDDP plus CPT-11...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Bing Wang, Wen-Jia Dai, Xiao-Ting Cheng, Wen-Yi Liuyang, Ya-Sheng Yuan, Chun-Fu Dai, Yi-Lai Shu, Bing Chen
OBJECTIVE: To describe the characteristics of the clinical presentation, diagnosis, surgical methods, and outcomes of patients with otogenic cerebrospinal fluid (CSF) leakage secondary to congenital inner ear dysplasia. METHODS: A retrospective review was performed of 18 patients with otogenic CSF leakage secondary to inner ear dysplasia who underwent surgery in our group from 2007 to 2017 and had a follow-up of at least 4 months. The average length of follow-up was three years...
2019: Journal of Zhejiang University. Science. B
L Lemnos, K Aubry, J-J Moreau, F Caire, H Salle
INTRODUCTION: Vestibular neurotomy is a functional surgery for Meniere's disease in the event of medical treatment failure. The aim of the study was to assess the efficacy and complications of vestibular neurotomy, and to address the question of postoperative compensation. MATERIAL AND METHOD: All patients included in this retrospective study underwent a vestibular neurotomy at our center between 2009 and 2016. A preoperative evaluation was performed including MRI, audiometry, and videonystagmography...
January 15, 2019: Neuro-Chirurgie
Nicole A Silva, Blake E S Taylor, John S Herendeen, Renuka Reddy, Jean Anderson Eloy, James K Liu
BACKGROUND: Although reducing 30-day hospital readmission is now a priority in neurosurgical quality improvement, postoperative emergency room (ER) visits remain poorly understood, particularly in populations with limited access to outpatient care. After endoscopic transsphenoidal surgery (ETS), the unique pathologies treated may engender a variety of surgical and metabolic complications-often dangerous, delayed, and non-specific in presentation. OBJECTIVE: To characterize the causes and timing of ER visits-with or without readmission-in this socioeconomically disadvantaged population...
December 19, 2018: World Neurosurgery
Mu Zhang, Zhen-Li Tang, Li-Wen Wu, Li Yang, Xiao-Le Wang, Fei Yin, Jing Peng, Chen Chen
OBJECTIVE: To investigate the etiology and clinical features of epilepsia partialis continua (EPC) in children. METHODS: A retrospective analysis was performed for the clinical features, diagnosis and treatment of six children with EPC, and the clinical and laboratory features and prognosis were compared between the children with different etiologies. RESULTS: There were five girls and one boy, with an onset age ranging from one year and seven months to nine years...
December 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Yash Jobanputra, Purva Sharma, Sean J Martinez
We present a case of a 55-year-old lady with intermittent twitching of the left side of her face, involving her left eyelid and the angle of the mouth, ongoing for two years. She failed multiple trials of botulinum toxin injections as well as oral anti-spasmodic medications. The patient was diagnosed with an ectatic left vertebral artery, causing a compression of cranial nerve VII on the same side on magnetic resonance imaging (MRI) of the brain. She underwent neurosurgery with a microvascular decompression of the ectatic artery with a resolution of hemifacial spasms...
October 1, 2018: Curēus
Ziquan Li, Chengxian Yang, Xinjie Bao, Yong Yao, Ming Feng, Kan Deng, Xiaohai Liu, Bing Xing, Renzhi Wang
RATIONALE: The transsphenoidal surgical (TS) approach to sellar masses is the preferred surgical route in most cases. Secondary pituitary abscess (PA) following TS is an extremely rare but serious postoperative complication with potentially high disability and mortality. PATIENT CONCERNS: We describe an uncommon case of secondary PA in a 42-year-old woman, who underwent uncomplicated transsphenoidal procedures without cerebrospinal fluid leak, to treat primary Rathke cleft cyst...
November 2018: Medicine (Baltimore)
Kohei Tsuchimochi, Takato Morioka, Nobuya Murakami, Fumiya Yamashita, Nobuko Kawamura
BACKGROUND: Multiple spinal extradural meningeal cysts (SEMCs) are rare lesions. SEMCs communicate with the subarachnoid space through multiple dural defects and expand into the extradural space with progressive spinal cord compression. CASE PRESENTATION: We report a 5-month-old boy with hydronephrosis involving nine huge SEMCs that were distributed from the T1-L5 levels. Eight SEMCs, except for one small noncommunicating cyst, were exposed through laminoplastic laminotomy at the T10-L5 and T3-5 levels...
November 23, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Priyanka Misale, Anjali Lepcha
To report a series of adult patients diagnosed with congenital cholesteatoma (CC) with respect to symptoms, different varieties of presentation, surgical findings and approach used, complications and the postoperative results. A retrospective chart review of adult cases of CC who were treated in the period from January 2014-2017 was carried out in a tertiary care center. Levenson's criteria were used for diagnosis. Diagnosis was confirmed by imaging and intraoperatively. Postoperative results and complications were also analyzed...
December 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Kenny F Lin, Claire R Stewart, Philip E Steig, Cameron W Brennan, Philip H Gutin, Samuel H Selesnick
Objectives  To determine the incidence of prolonged postoperative systemic corticosteroid therapy after surgery for acoustic neuroma as well as the indications and associated risk factors that could lead to prolonged steroid administration, and the incidence of steroid-related adverse effects. Study Designs  Retrospective chart review. Methods  Retrospective chart review of patients undergoing resection of acoustic neuroma between 2010 and 2017 at two tertiary care medical centers. Patient and tumor characteristics, operative approach, hospital length of stay, initial postoperative taper length, number of discrete postoperative steroid courses, and postoperative complications were analyzed...
December 2018: Journal of Neurological Surgery. Part B, Skull Base
Victoria Chu, Diane M Carpenter, Kathleen Winter, Kathleen Harriman, Carol Glaser
In a case-control study within the Kaiser Permanente Northern California adult population, prior head or spine surgery (H/SS) was associated with increased Streptococcus pneumoniae meningitis outside of the postoperative period (no prior H/SS, odds ratio 6.0, 95% CI 1.9-18.6). Among the cases, only 33.3% had received any prior pneumococcal vaccinations.
November 19, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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
B Z Chel'diev, Yu V Kushel', M O Demin
Treatment of primary malignant neuroepithelial tumors of the posterior cranial fossa (PCF) in childhood includes surgical resection, radiation therapy (RT), and chemotherapy (CT). The radicalness of surgery is one of the most important prognostic factors of survival. Despite the significant advances in treatment, many of these tumors recur. Today, oncologists are increasingly recommending repeated surgery for recurrent malignant neuroepithelial tumors of the PCF to achieve gross total resection (GTR). Patients undergo this surgery after RT and palliative CT, which may increase surgical risks...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
O I Sharipov, M A Kutin, G A Polev, P L Kalinin
Meningoencephalocele is a hernial protrusion of the medulla and meninges through a defect in the skull bones. Due to poor accessibility of meningoencephalocele located in the lateral sphenoid recess region, modern surgical treatment of this pathology prefers to use endoscopic transsphenoidal approaches. MATERIAL AND METHODS: The study included 4 patients with meningoencephalocele of the lateral recess of the sphenoid sinus (1 male and 3 females; mean age, 46.8 years). All patients underwent resection of meningoencephalocele and repair of a skull base defect using the lateral extended transsphenoidal endoscopic approach through the pterygopalatine fossa (transpterygoid approach)...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Yu V Kushel', G V Danilov, A R Tekoev, B Z Chel'diev, Yu V Strunina
Wound liquorrhea is a serious and dangerous complication developing after neurosurgical interventions. The highest risk group includes patients operated on using approaches to the skull base. In pediatric neurosurgery, approaches to the posterior cranial fossa are some of the most common ones, with wound liquorrhea amounting to 33%. Studies devoted to the wound liquorrhea problem have been performed in heterogeneous patient groups, which complicates evaluation of the results and reduces their practical value...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Chuhua Fu, Ning Wang, Bo Chen, Pingli Wang, Huayun Chen, Wangwang Liu, Lijun Liu
OBJECTIVE: To date, no standard surgical procedure has been proven effective for intracerebral hemorrhage (ICH), particularly deep hematomas. This retrospective study evaluated the effectiveness and safety of endoscopic surgery, minimally invasive puncture and drainage, and craniotomy for treating moderate basal ganglia ICH. METHODS: Patients with basal ganglia ICH (N = 177) were divided into 3 groups based on therapeutic intervention as follows: endoscopic surgery group (n = 61), minimally invasive puncture and drainage group (n = 60), and craniotomy group (n = 56)...
November 4, 2018: World Neurosurgery
Patricia Ojeda, Derek Khorsand, Mazen Zawaideh, Orpheus Kolokythas
We present a case of an iatrogenic rectothecal fistula in a 34-year-old man who underwent repair of a congenital anterior sacral meningocele, intraoperatively complicated by rectal perforation. Postoperatively, the patient developed symptoms of meningitis prompting concern for the cerebrospinal fluid leak. Subsequent workup with computed tomography (CT) and magnetic resonance imaging demonstrated a postoperative pseudomeningocele and fistulization with an abdominal fluid collection. CT myelography confirmed the fistulous connection was between the pseudomeningocele and the rectum...
January 2019: Radiology Case Reports
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