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[PMID]: 29452317
[Au] Autor:Rychen J; Croci D; Roethlisberger M; Nossek E; Potts M; Radovanovic I; Riina H; Mariani L; Guzman R; Zumofen DW
[Ad] Address:Department of Neurosurgery, Basel University Hospital, University of Basel, Spitalstrasse 21, CH4031 Basel, Switzerland.
[Ti] Title:The minimally invasive alternative approaches to the pterional craniotomy: A systematic review of the literature.
[So] Source:World Neurosurg;, 2018 Feb 13.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Minimally invasive alternatives to the pterional craniotomy include the minipterional and the supraorbital craniotomy (SOC). The latter is performed via either an eyebrow or an eyelid skin incision. The purpose of this systematic review was to analyze the type and the incidence of approach-related complications of these keyhole craniotomies. METHODS: We review pertinent publications retrieved by search in the PubMed/Medline database. Inclusion criteria were all full-text publications, abstracts, and posters in English, up to 2016, reporting clinical results. RESULTS: 105 publications containing data on 5837 surgeries performed via a minipterional or either of the two variants of the SOC met the eligibility criteria. Pain on mastication was the most commonly reported approach-related complication of the minipterional approach, where it occurred in 7.5% of cases. Temporary palsy of the frontal branch of the facial nerve and temporary supraorbital hypesthesia were associated with the SOC eyebrow variant, where it occurred in 6.5%, respectively in 4.6% of cases. Transient postoperative periorbital edema and transient ophthalmoparesis occurred in 36.8%, respectively in 17.4% of cases when the SOC was performed via an eyelid skin incision. The risk of occurrence of the latter two approach-related complications was related to the removal of the orbital rim, which is obligate part of the SOC through the eyelid approach but optional with the SOC eyebrow variant. CONCLUSION: Each of three "keyhole" approaches has a specific set and incidence of approach-related complications. It is essential to be aware of these complications to make the safest individual choice.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:Publisher

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[PMID]: 29394920
[Au] Autor:Vanikieti K; Poonyathalang A; Jindahra P; Cheecharoen P; Chokthaweesak W
[Ad] Address:Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.
[Ti] Title:Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.
[So] Source:BMC Ophthalmol;18(1):25, 2018 Feb 02.
[Is] ISSN:1471-2415
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. CASE PRESENTATION: An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. CONCLUSIONS: Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V ) and maxillary (V ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral posterior circulation cerebral infarction (i.e., occipital lobe infarction) can occur in CCA patients, presumably as a result of distal embolization through an ipsilateral, prominent PCOM. Spontaneous clinical improvement with stable radiographic support may occur.
[Mh] MeSH terms primary: Brain Infarction/diagnostic imaging
Carotid Artery Diseases/diagnostic imaging
Carotid Artery, Internal/diagnostic imaging
Cavernous Sinus Thrombosis/diagnostic imaging
Intracranial Aneurysm/diagnostic imaging
Occipital Lobe/diagnostic imaging
[Mh] MeSH terms secundary: Aged, 80 and over
Blepharoptosis/diagnosis
Carotid Artery, Internal/pathology
Diplopia/diagnosis
Female
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Occipital Lobe/pathology
Visual Fields
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[Js] Journal subset:IM
[Da] Date of entry for processing:180204
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0687-4

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[PMID]: 29390464
[Au] Autor:Zhang X; Li X; Meng M; Cao J; Song X; Liu K; Fang S
[Ad] Address:Department of Neurology, Neuroscience Centre, the First Teaching Hospital of Jilin University, Changchun, China.
[Ti] Title:Vascular spinal cord obstruction associated with superior vena cava syndrome: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9196, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Superior vena cava syndrome (SVCS) is the obstruction of blood flow through the SVC, causing complete or partial blockade of the collateral circulation of returning venous blood. SVCS is frequently presented with facial, neck, trunk, and upper limbs swelling and so on. However, to the best of our knowledge, the obstruction of the venous return in the spinal veins is rarely a manifestation of SVCS. PATIENT CONCERNS: We presented a rare case of a 52-year-old male patient with 2-month history of progressive right upper limb numbness and swelling and 10-day history of extremities malfunctioning. Cervical magnetic resonance imaging (MRI) detected obstruction of the spinal venous return. Lung computed tomography (CT) revealed lesions in the esophagus, which indicated esophageal cancer with mediastinal lymph nodes metastasis and signified SVCS. DIAGNOSES: With the results of laboratory findings, cervical MRI, lung CT findings, and physical examination, the patient was diagnosed with SVCS manifesting as spinal vein obstruction. INTERVENTIONS AND OUTCOMES: The family abandoned further treatment, and the patient passed away 2 months after discharge. LESSONS: The case indicates that SVCS can induce systemic and spinal cord diseases affecting the venous return. Further studies are necessary to reveal the mechanism for SVCS inducing spinal veins obstruction and to explore whether SVCS patients with and without vascular spinal cord obstruction have different prognoses.
[Mh] MeSH terms primary: Spinal Cord Compression/complications
Spinal Cord Compression/diagnostic imaging
Superior Vena Cava Syndrome/complications
Superior Vena Cava Syndrome/diagnostic imaging
Vascular Diseases/complications
[Mh] MeSH terms secundary: Disease Progression
Fatal Outcome
Humans
Hypesthesia/diagnosis
Hypesthesia/etiology
Magnetic Resonance Angiography/methods
Male
Middle Aged
Rare Diseases
Risk Assessment
Severity of Illness Index
Spinal Cord Compression/physiopathology
Superior Vena Cava Syndrome/physiopathology
Tomography, X-Ray Computed/methods
Upper Extremity
Vascular Diseases/diagnostic imaging
Vascular Diseases/physiopathology
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009196

  4 / 3253 MEDLINE  
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[PMID]: 28460850
[Au] Autor:Hu X; Heyn PC; Schwartz J; Roberts P
[Ti] Title:What Is Mild Stroke?
[So] Source:Arch Phys Med Rehabil;98(11):2347-2349, 2017 Nov.
[Is] ISSN:1532-821X
[Cp] Country of publication:United States
[La] Language:eng
[Mh] MeSH terms primary: Stroke/complications
[Mh] MeSH terms secundary: Emotions
Fatigue/etiology
Humans
Hypesthesia/etiology
Memory Disorders/etiology
Muscle Weakness/etiology
Severity of Illness Index
Stroke/diagnosis
Stroke/psychology
Symptom Assessment
[Pt] Publication type:JOURNAL ARTICLE; PATIENT EDUCATION HANDOUT
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170503
[St] Status:MEDLINE

  5 / 3253 MEDLINE  
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[PMID]: 29402815
[Au] Autor:Muhle P; Claus I; Marian T; Schröder JB; Wollbrink A; Pantev C; Warnecke T; Dziewas R; Suntrup-Krueger S
[Ad] Address:University Hospital Muenster, Department of Neurology, Muenster, Germany.
[Ti] Title:Introducing a Virtual Lesion Model of Dysphagia Resulting from Pharyngeal Sensory Impairment.
[So] Source:Neurosignals;26(1):1-10, 2018 Jan 25.
[Is] ISSN:1424-8638
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:BACKGROUND/AIMS: Performing neurophysiological and functional imaging studies in severely affected patients to investigate novel neurostimulation techniques for the treatment of neurogenic dysphagia is difficult. Therefore, basic research needs to be conducted in healthy subjects. Swallowing is a motor function highly dependent on sensory afferent input. Here we propose a virtual peripheral sensory lesion model to mimic pharyngeal sensory impairment, which is known as a major contributor to dysphagia in neurological disease. METHODS: In this randomized crossover study on 11 healthy volunteers, cortical activation during pneumatic pharyngeal stimulation was measured applying magnetoencephalography in two separate sessions, with and without pharyngeal surface anesthesia. RESULTS: Stimulation evoked bilateral event-related desynchronization (ERD) mainly in the caudolateral pericentral cortex. In comparison to the no-anesthesia condition, topical anesthesia led to a reduction of ERD in beta (13-30 Hz) and low gamma (30-60 Hz) frequency ranges (p<0.05) in sensory but also motor cortical areas. CONCLUSIONS: Withdrawal of sensory afferent information by topical anesthesia leads to reduced response to pneumatic pharyngeal stimulation in a distributed cortical sensorimotor network in healthy subjects. The proposed paradigm may serve to investigate the effect of neuromodulatory treatments specifically on pharyngeal sensory impairment as relevant cause of neurogenic dysphagia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180206
[Lr] Last revision date:180206
[St] Status:Publisher
[do] DOI:10.1159/000487037

  6 / 3253 MEDLINE  
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[PMID]: 28468199
[Au] Autor:Cho SE; Shin HS; Tak MS; Kang SG; Lee YS; Kim HS; Kim CH
[Ad] Address:*Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Seoul Hospital, Seoul †Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
[Ti] Title:A Rare Complication of Infraorbital Nerve Hyperesthesia in Surgically Repaired Orbital Fracture Patients.
[So] Source:J Craniofac Surg;28(3):e233-e234, 2017 May.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Injury to the peripheral sensory branches of the trigeminal nerve can follow a wide variety of craniofacial injuries. Many patients with facial fractures complain about the symptom of numbness to the distribution of injured nerve, which is indicative of hypoesthesia. Hyperesthesia involving the infraorbital nerve is rare in comparison to hypoesthesia secondary to facial trauma. The authors report on 2 patients with infraorbital nerve hyperesthesia in surgically repaired orbital fracture patients. Surgical decompression of the infraorbital nerve led to rapid resolution of hyperesthesia. To the best of our knowledge, these were rare cases of patients who presented with persistent hyperesthesia. Clinician should perform early surgical decompression of the infraorbital nerve in patient with persistent hyperesthesia of the infraorbital nerve.
[Mh] MeSH terms primary: Hyperesthesia/etiology
Maxillary Nerve/injuries
Orbital Fractures/complications
Orbital Fractures/surgery
[Mh] MeSH terms secundary: Adult
Decompression, Surgical
Humans
Hyperesthesia/diagnosis
Hyperesthesia/surgery
Hypesthesia/etiology
Hypesthesia/surgery
Male
Middle Aged
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180205
[Lr] Last revision date:180205
[Js] Journal subset:D
[Da] Date of entry for processing:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003439

  7 / 3253 MEDLINE  
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[PMID]: 29396071
[Au] Autor:Dillen WL; Hendricks BK; Mannas JP; Wheeler GR
[Ad] Address:University of Kentucky College of Medicine, Dept. of Neurosurgery, Lexington, KY, USA. Electronic address: william.dillen@uky.edu.
[Ti] Title:Surfer's myelopathy: A rare presentation in a teenage gymnast and review of the literature.
[So] Source:J Clin Neurosci;, 2018 Jan 26.
[Is] ISSN:1532-2653
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:This article describes a novel setting for a rare nontraumatic spinal cord injury referred to as Surfer's myelopathy. The patient is a 16 year-old female cheerleader who presented following a gymnastics practice where she was repeatedly performing back handsprings. She demonstrated progressively worsening midthoracic back pain and evolving paraplegia and hypesthesia of the lower extremities. Magnetic resonance imaging findings were consistent with T5-T7 spinal cord ischemia at 8 h and 16 h after symptom onset. The clinical and radiologic findings for this patient are consistent with previous case reports of Surfer's myelopathy. The authors also provide a summary of the current literature describing Surfer's myelopathy, which to date includes 64 reported cases. The diagnosis of nontraumatic spinal cord injury, referred to as Surfer's myelopathy, in a gymnast highlights the importance of greater physician and patient awareness of this rare condition.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180203
[Lr] Last revision date:180203
[St] Status:Publisher

  8 / 3253 MEDLINE  
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[PMID]: 29393814
[Au] Autor:Rennert RC; Hoshide R; Calayag M; Kemp J; Gonda DD; Meltzer HS; Fukushima T; Day JD; Levy ML
[Ad] Address:Department of Pediatric Neurosurgery, University of California, San Diego, California.
[Ti] Title:Extended middle fossa approach to lateralized pontine cavernomas in children.
[So] Source:J Neurosurg Pediatr;:1-5, 2018 Feb 02.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE Treatment of hemorrhagic cavernous malformations within the lateral pontine region demands meticulous surgical planning and execution to maximize resection while minimizing morbidity. The authors report a single institution's experience using the extended middle fossa rhomboid approach for the safe resection of hemorrhagic cavernomas involving the lateral pons. METHODS A retrospective chart review was performed to identify and review the surgical outcomes of patients who underwent an extended middle fossa rhomboid approach for the resection of hemorrhagic cavernomas involving the lateral pons during a 10-year period at Rady Children's Hospital of San Diego. Surgical landmarks for this extradural approach were based on the Fukushima dual-fan model, which defines the rhomboid based on the following anatomical structures: 1) the junction of the greater superficial petrosal nerve (GSPN) and mandibular branch of the trigeminal nerve; 2) the lateral edge of the porus trigeminus; 3) the intersection of the petrous ridge and arcuate eminence; and 4) the intersection of the GSPN, geniculate ganglion, and arcuate eminence. The boundaries of maximal bony removal for this approach are the clivus inferiorly below the inferior petrosal sinus; unroofing of the internal auditory canal posteriorly; skeletonizing the geniculate ganglion, GSPN, and internal carotid artery laterally; and drilling under the Gasserian ganglion anteriorly. This extradural petrosectomy allowed for an approach to all lesions from an area posterolateral to the basilar artery near its junction with cranial nerve (CN) VI, superior to the anterior inferior cerebellar artery and lateral to the origin of CN V. Retraction of the mandibular branch of the trigeminal nerve during this approach allowed avoidance of the region involving CN IV and the superior cerebellar artery. RESULTS Eight pediatric patients (4 girls and 4 boys, mean age of 13.2 ± 4.6 years) with hemorrhagic cavernomas involving the lateral pons and extension to the pial surface were treated using the surgical approach described above. Seven cavernomas were completely resected. In the eighth patient, a second peripheral lesion was not resected with the primary lesion. One patient had a transient CN VI palsy, and 2 patients had transient trigeminal hypesthesia/dysesthesia. One patient experienced a CSF leak that was successfully treated by oversewing the wound. CONCLUSIONS The extended middle fossa approach can be used for resection of lateral pontine hemorrhagic cavernomas with minimal morbidity in the pediatric population.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180202
[Lr] Last revision date:180202
[St] Status:Publisher
[do] DOI:10.3171/2017.10.PEDS17381

  9 / 3253 MEDLINE  
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[PMID]: 29172311
[Au] Autor:Rice N; Srinivasan B; Macpherson D
[Ti] Title:Case Report: Metastatic Infratemporal Soft Tissue Myeloma Presenting as a Numb Lower Lip.
[So] Source:Dent Update;44(1):53-4, 2017 Jan.
[Is] ISSN:0305-5000
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:This is a case of a patient presenting to his general dental practitioner (GDP) with altered sensation in his lower lip with no obvious cause. Due to a prompt referral, the patient was investigated and diagnosed with an extramedullary presentation of multiple myeloma. A numb lip can present in general dental practice, although this is not common. There are several causes, for example, dental infection or fractured mandible. Clinical relevance: It is very important for the dental practitioner to recognize when there could be a potential sinister underlying cause and prompt referral, under the two week rule referral system, is indicated
[Mh] MeSH terms primary: Multiple Myeloma/secondary
Soft Tissue Neoplasms/secondary
[Mh] MeSH terms secundary: Aged
Humans
Hypesthesia/etiology
Lip
Male
Mandible
Multiple Myeloma/complications
Multiple Myeloma/diagnosis
Soft Tissue Neoplasms/complications
Soft Tissue Neoplasms/diagnosis
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[Js] Journal subset:D
[Da] Date of entry for processing:171128
[St] Status:MEDLINE

  10 / 3253 MEDLINE  
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[PMID]: 29349997
[Au] Autor:Jiang Y; Zuo RJ; Wu L; Huang C; Shi Y; Song HW; Wang YW; Li B
[Ad] Address:Department of Orthopaedics, Haidian Hospital of Beijing, Beijing 100080, China; hdyyjy@vip.163.com.
[Ti] Title:[Surgical outcome of percutaneous endoscopic technique for highly migrated disc herniation via three different approaches].
[So] Source:Zhongguo Gu Shang;30(2):100-104, 2017 Feb 25.
[Is] ISSN:1003-0034
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:OBJECTIVE: To analyze the clinical effects of percutaneous endoscopic technique via three different approaches for highly migrated lumbar disc herniation. METHODS: The clinical data of 68 patients underwent percutaneous endoscopic technique from June 2011 to June 2014 were retrospectively analyzed. There were 43 males and 25 females, aged from 11 to 77 years old with an average of (42.29±15.92) years. The patients were divided into three groups according to different operative approaches, of them, 45 cases were by transforaminal approach (group A), 15 cases by translaminar approach (group B), and 8 cases by transpedicular approach (group C). There was 1 case in level L2,3, 12 cases in L3,4, 36 cases in L4,5, 19 cases in L5S1. The herniated disc was migrated superiorly in 23 patients, inferiorly in 45 patients. MRI were available to confirm migrated disc pre-and post-operatively. Operation time, loss blood volume, intraoperative and postoperative complications, time of back to work (postoperative recovery time) were recorded. Preoperative and postoperative VAS were used to evaluate low back pain and sciatica and JOA and MacNab criteria were used to evaluate functional recovery. RESULTS: All the operations were successful and all the patients were followed up from 12 to 40 months with an average of (18.0±15.9) months. Seven patients(3 cases in group A, 3 cases in group B, 1 case in group C) complicated with transient paraesthesia (hyperalgesia or hypesthesia), and the symptoms relieved after symptomatic treatment with neurotrophic medicine, at final follow-up, no symptoms were left. One case in group B complicated with dura mater tearing during operation and it was untreated, there was no resulted complications such as headache and sinus tract of skin. In group A, B, C, the mean VAS score of sciatica improved from preoperative 6.93±1.34, 6.33±1.23, 6.13±1.73 to 0.80±0.87, 0.73±0.70, 0.38±0.52 at final follow-up; and JOA score improved from preoperative 9.09±2.62, 9.80±2.31, 10.50±2.93 to 26.82±1.53, 25.93±1.58, 26.50±1.51 at final follow-up, respectively( <0.05). There was no significant difference among three groups( >0.05). There was no significant difference in loss blood volume, postoperative recovery time among three groups. But operation time of group B was shorter than other two groups. According to MacNab criterion to assess the clinical effects, 42 cases got excellent results, 21 good, 5 fair. CONCLUSIONS: Percutaneous endoscopic technique is a safe and effective method for surgical treatment of highly migrated herniation. The decision of operative approach should be made by characters of anatomy. By tanspedicular approach the lesion could be found directly. However, it depends on good skill and equipment.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:In-Process
[do] DOI:10.3969/j.issn.1003-0034.2017.02.002


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