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Search on : pneumocephalus [Words]
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[PMID]: 29477026
[Au] Autor:Khan K; Saeed S; Ramcharan A; Gray S
[Ad] Address:Department of Surgery, Harlem Hospital Columbia University Medical Center, New York, NY, USA. Electronic address: khank1@nychhc.org.
[Ti] Title:A case series of closed head trauma with pituitary stalk disruption resulting in hypopituitarism.
[So] Source:Int J Surg Case Rep;43:69-71, 2018 Feb 09.
[Is] ISSN:2210-2612
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Traumatic brain injury (TBI) is one of the main causes of morbidity and mortality in young trauma patients with resultant multi-organ effects. Hypopituitarism following TBI can be debilitating and life threatening. TBI which causes hypopituitarism may be characterized by a single head injury, such as from a motor vehicle accident, or by chronic repetitive head trauma, as seen in combative supports including boxing, kick-boxing, and football. In the majority of cases, a diagnosis of hypopituitarism can be entirely missed resulting in severe neuro-endocrine dysfunction. We present a case series of two patients diagnosed with hypopituitarism after TBI and treated appropriately with favorable outcome. CASE PRESENTATIONS: The first case is a 34 year-old male, who presented to the emergency department with blunt head trauma after a motor vehicle accident while riding his bicycle. He suffered from severe cranio-facial injuries, resulting in multifocal hemorrhagic contusions, epidural hematoma, and extensive cranio-facial fractures involving the sinuses. The patient developed persistent hypotension with a blood pressure as low as 60/40 mmHg on hospital day three. The second case is a 56 year-old male with a history of schizophrenia, who suffered traumatic brain injury after he was hit by a train. The patient sustained multiple facial fractures, pneumocephalus and C2/7 transverse processes fractures. He also had persistent hypotension, unresponsive to standard treatment. Investigation revealed a deficiency of anterior pituitary hormones resulting from pituitary axis disruption. DISCUSSION: Hypopituitarism is becoming an increasingly recognized complication following TBI, ranging from total to isolated deficiencies. Traumatic Brain Injury is a major public health problem and is one of the leading causes of disability. Understanding and recognizing pituitary dysfunction after TBI can lead to better outcomes and improved quality of life. CONCLUSION: Patients with major head injury and, in particular, those with fractures of the base of the skull, must be closely monitored for signs and symptoms of endocrine dysfunction. Appropriate dynamic pituitary-function screening should be performed.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:Publisher

  2 / 1707 MEDLINE  
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[PMID]: 29499423
[Au] Autor:Choque-Velasquez J; Colasanti R; Resendiz-Nieves JC; Gonzáles-Echevarría KE; Raj R; Jahromi BR; Goehre F; Lindroos AC; Hernesniemi J
[Ad] Address:Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland. Electronic address: johchove@hotmail.com.
[Ti] Title:Praying sitting position for pineal region surgery: an efficient variant of a classic positioning in Neurosurgery.
[So] Source:World Neurosurg;, 2018 Feb 27.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. Moreover, it may oblige the surgeon to a tiring posture. Herein, we describe our protocol for the "praying (steeper sitting) position" for pineal region surgery, a variant which may reduce some of the risks of the sitting position while providing a more ergonomic surgical position. METHODS: A retrospective review of 56 pineal lesions operated on using "praying position" between January 2008 and October 2015 was carried out. The "praying position" is essentially a steeper sitting position with the upper torso and the head bent forward and downward. The patient's head is tilted about 30° making the tentorium almost horizontal, thus providing good viewing angle. G-suit trousers or elastic bandage around the lower extremities are always used. RESULTS: Complete lesion removal was accomplished in 52 cases, subtotal in 4. VAE associated to persistent haemodinamic changes was non-existent in our series. When VAE was suspected, an inmediate reaction based on a good team work was imperative. No cervical spine cord injury nor peripheral nerve damage were reported. The microsurgical time was less than 45 minutes in most of the cases. Postoperative pneumocephalus was detected in all patients, but no case required surgical treatment. CONCLUSION: A protocolized steeper-sitting/praying position, which includes a proper team work management, may represent a simple, fast and safe manner for proper placement of the patient when approaching the pineal region.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher

  3 / 1707 MEDLINE  
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[PMID]: 29482118
[Au] Autor:Kutlay M; Durmaz A; Özer I; Kural C; Temiz Ç; Kaya S; Solmaz I; Daneyemez M; Izci Y
[Ad] Address:University of Health Sciences, Gulhane Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey.
[Ti] Title:Extended endoscopic endonasal approach to the ventral skull base lesions.
[So] Source:Clin Neurol Neurosurg;167:129-140, 2018 Feb 21.
[Is] ISSN:1872-6968
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVE: With the use of multiple endoscopic endonasal surgical corridors, extended endoscopic endonasal approaches (EEEAs) are now being used to treat a wide range of ventral skull base lesions. Our aim was to present our experience with EEEAs to the ventral skull base lesions. PATIENTS AND METHODS: The study group consisted of 106 patients (57 men and 49 women) who underwent surgery for skull base lesions using EEEAs from 2010 to 2017. The EEEA was most commonly used for giant pituitary macroadenomas, sinonasal malignancies, cerebrospinal fluid (CSF) leaks, meningiomas, craniopharyngiomas, and fibro-osseous lesions. Four different approaches were used including transtuberculum-transplanum, transethmoidal-transcribriform, transclival, and transmaxillary-transpterygoidal. RESULTS: The overall gross total resection (GTR) rate for these diverse pathologies was 75.0% in 88 patients (excluding the operations performed for non-neoplastic pathologies). GTR was achieved in 100%, 77.8%, 75%, 75%, 72.2%, 62.5%, 60% of fibro-osseous lesions, giant/large pitutary adenomas, meningiomas, esthesioneuroblastomas, sinonasal malignancies, craniopharyngiomas, and chordomas, respectively. The overall rate of improvement in visual fields was 86%. The overall rate of CSF leak was 8.4%. Other surgical complications included intracerebral hematoma and tension pneumocephalus. The mortality rate was 0.9%. CONCLUSION: EEEA is a safe, well-tolerated and effective surgical treatment modality in the management of ventral skull base lesions. It should be performed with close interdisciplinary collaboration. Appropriate case selection is mandatory. However, despite improved reconstruction techniques, postoperative CSF leakage still remains a challenge.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:Publisher

  4 / 1707 MEDLINE  
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[PMID]: 29408774
[Au] Autor:You CG; Zheng XS
[Ad] Address:Department of Neurosurgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Title:Postoperative pneumocephalus increases the recurrence rate of chronic subdural hematoma.
[So] Source:Clin Neurol Neurosurg;166:56-60, 2018 Mar.
[Is] ISSN:1872-6968
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Pneumocephalus is a common operative complication of chronic subdural hematoma. This study is to analyze the relationship between postoperative pneumocephalus and the recurrence and surgical outcomes. PATIENTS AND METHODS: This is a retrospective case-cohort study, including a pneumocephalus group (n = 46) and a control group (n = 181). Their recurrence rates, CT attenuation values, hospital stay, healing time and the neurological status were recorded and analyzed. RESULTS: The pneumocephalus group had a recurrence rate of 32.6%, significantly higher than the control (17.7%). In addition, the pneumocephalus group had a higher rate of postoperative epilepsy (21.7% vs 3.3%), longer hospital stay (11.5 ±â€¯2.8 vs 7.8 ±â€¯1.2 days), longer healing time (10.8 ±â€¯5.4 vs 6.5 ±â€¯2.3 months), and worse neurological scores than the control. CONCLUSION: Pneumocephalus increases the recurrence rate of chronic subdural hematoma, and it not only prolongs the hospital stay and healing time, but also leads to deterioration of the neurological status.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review

  5 / 1707 MEDLINE  
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[PMID]: 29453734
[Au] Autor:Patel KS; Dhawan S; Wang R; Carter BS; Chen JY; Chen CC
[Ad] Address:Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
[Ti] Title:Post-operative imaging assessment of non-functioning pituitary adenomas.
[So] Source:Acta Neurochir (Wien);, 2018 Feb 16.
[Is] ISSN:0942-0940
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:BACKGROUND: Non-functioning pituitary adenomas (NFAs) are the most common pituitary tumors. There is significant variability in clinical practice in terms of post-operative imaging evaluation. The objective of this manuscript is to provide an exhaustive review of published articles pertaining to the post-operative imaging evaluation of NFAs. METHODS: The MEDLINE database was queried for studies investigating imaging for the post-operative evaluation of pituitary adenomas. From an initial search of 5589 articles, 37 articles were evaluated in detail and included in this review. RESULTS: Magnetic resonance imaging (MRI) is the gold standard for post-operative monitoring of NFAs, although functional imaging modalities may improve identification of residual tumor in conjunction with MRI. The residual tumor can be distinguished from post-operative changes by experienced practitioners using high-resolution MRI in the immediate post-operative setting (within 1 week of surgery). However, continued imaging evolution in the appearance of residual tumor or resection cavity is expected up to 3 months post-operatively. CONCLUSIONS: Post-operative imaging appearance of the pituitary gland, optic apparatus, and pneumocephalus patterns, correlated with the clinical outcomes. Long-term, lifetime follow-up is warranted for NFA patients who underwent surgical resection.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180217
[Lr] Last revision date:180217
[St] Status:Publisher
[do] DOI:10.1007/s00701-018-3491-2

  6 / 1707 MEDLINE  
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[PMID]: 29174239
[Au] Autor:Metwali H; Gerganov V; Nery B; Aly A; Avila-Cervantes R; Samii M
[Ad] Address:International Neuroscience Institute, Hannover, Germany. Electronic address: drhussamm@yahoo.com.
[Ti] Title:Efficiency and Safety of Autologous Fat Grafts in Reconstructing Skull Base Defects After Resection of Skull Base Meningiomas.
[So] Source:World Neurosurg;110:249-255, 2018 Feb.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Reconstruction of the skull base after resection of skull base meningiomas is of paramount importance. Here we describe a safe and effective method of skull base reconstruction using autologous free fat grafts. METHODS: In this retrospective analysis of patients operated for skull base meningioma from 2007 to 2014. We analyzed the surgical technique, efficiency and safety as well as the graft-related complications. RESULTS: Autologous free fat grafts were used in 55 patients, including 39 patients with posterior fossa meningiomas related to the petrous bone and 16 patients with anterior fossa meningiomas related to the paranasal sinuses. Three patients experienced postoperative cerebrospinal fluid (CSF) leak and were managed with temporary continuous lumbar drainage. One patient developed pneumocephalus and required revision. The occurrence of CSF leak was related to aggressive resection with resulting large skull base defects, especially in anterior skull base meningiomas. There were no donor site-related complications. CONCLUSIONS: The use of autologous free fat grafts is an effective and safe technique for reconstructing skull base defects after microsurgical resection of skull base meningiomas.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Data-Review

  7 / 1707 MEDLINE  
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[PMID]: 29307024
[Au] Autor:Sachkova A; Schemmerling T; Goldberg M; Solomiichuk V; Rohde V; von Eckardstein KL; Schatlo B
[Ad] Address:Department of Neurosurgery, University Medicine Göttingen, Georg-August University Göttingen, Robert-Koch Str. 40, 37075, Göttingen, Germany.
[Ti] Title:Predictors of ventricular tension pneumocephalus after posterior fossa surgery in the sitting position.
[So] Source:Acta Neurochir (Wien);160(3):525-538, 2018 Mar.
[Is] ISSN:0942-0940
[Cp] Country of publication:Austria
[La] Language:eng
[Ab] Abstract:BACKGROUND: Ventricular pneumocephalus is a rare but potentially life-threatening complication of cranial surgery in the sitting position. OBJECTIVE: The objective of the study is to assess the incidence and risk factors of postoperative ventricular pneumocephalus. METHODS: We performed a retrospective chart review of 307 consecutive patients (147 men, 160 women) treated at our institution by intracranial surgery in the sitting position from January 2010 to October 2014. Ventricular air entrapment with lack of arousal or neurologic deterioration requiring external ventriculostomy (EVD) was defined as ventricular tension pneumocephalus (VTP). Demographic variables were recorded along with radiological and clinical data. The occurrence of pneumocephalus was correlated with patient-related and surgical variables. RESULTS: VTP was observed in 12 cases (3.9%). These patients had higher intraventricular air volumes (48.5 cm (CI 95% [29.06-67.86])) compared to asymptomatic patients (7.4 cm (CI 95% [5.43-9.48])). Opening of the fourth ventricle was the most potent predictor of VTP (OR = 34.7, CI 95% [4.4-273.5], p = 0.001). In patients undergoing no additional treatment for pneumocephalus, ventricular air volume declined to an average of 41.7% of the initial postoperative volume on postoperative day 3. CONCLUSIONS: Entrapment of intracranial and particularly ventricular air requiring emergent EVD occurred in 3.9% cases of intracranial surgery in the sitting position. Especially the opening of the fourth ventricle was associated with the development of VTP, which should warrant particularly diligent postoperative observation of these patients. In cases without neurological symptoms, the rate of spontaneous air resorption is sufficiently high to warrant expectant management.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[St] Status:In-Data-Review
[do] DOI:10.1007/s00701-017-3444-1

  8 / 1707 MEDLINE  
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[PMID]: 29194262
[Au] Autor:Fei X; Wan Y; Wang Z; Chen H; Jiang D
[Ad] Address:Department of Neurosurgery, Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou, China.
[Ti] Title:Application of YL-1 Needle in Chronic Subdural Hematoma Treatment for Super-Aged Patients.
[So] Source:J Craniofac Surg;29(1):e90-e94, 2018 Jan.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The proportion of the super-aged population (at the age of 80 or above) in patients with chronic subdural hematoma (CSDH) and the incidence of CSDH of the population have been increasing. Since it is widely accepted that YL-1 needle is effective in CSDH treatment, this paper aimed to probe into the efficacy of YL-1 needle in minimally invasive surgery for super-aged (at the age of 80-90) CSDH patients. METHODS: A retrospective analysis on the clinical information of 17 super-aged CSDH patients having received the YL-1 needle puncture treatment provided by the hospital from May 2012 to December 2016 was performed. At the same time, another 19 CSDH patients (ages 60-79) who were hospitalized during the same period were randomly selected to form a control group. The same surgical treatment was provided for both groups to observe and compare the treatment efficacy. RESULTS: The patients of both groups were cured and discharged. Among the super-aged patients, there was 1 patient with postoperative hematoma recurrence, 1 patient with pneumocephalus, and 1 patient with wound infection; among the aged patients, 1 reported postoperative recurrence and 2 had pneumocephalus; The average length of stay of the super-aged group was 9.235 ±â€Š2.948 days while that of the aged group was 7.316 ±â€Š3.660 days, which showed no statistical difference. CONCLUSION: The YL-1 needle puncture treatment is safe and efficacious for both the super-aged and the aged CSDH patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180204
[Lr] Last revision date:180204
[St] Status:In-Process
[do] DOI:10.1097/SCS.0000000000004198

  9 / 1707 MEDLINE  
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[PMID]: 29347913
[Au] Autor:Ansari AS; Dennis BB; Shah D; Baah W
[Ad] Address:Acute Medical Unit, Epsom and St. Helier University Hospital NHS Trust, London, England, UK.
[Ti] Title:An unusual case of infective pneumocephalus: case report of pneumocephalus exacerbated by continuous positive airway pressure.
[So] Source:BMC Emerg Med;18(1):2, 2018 Jan 18.
[Is] ISSN:1471-227X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Pneumocephalus, illustrated by air in the cranial vault is relatively infrequent and generally associated with neurosurgery, trauma, meningitis and barotrauma. However cases of spontaneous non-traumatic pneumocephalus remain rare. While the relationship between continuous positive airway pressure (CPAP) and atraumatic pneumocephalus has been previously reported, to our knowledge the rare presentation associated with sinus wall osteomyelitis has never been described. We summarize here the case of a 67-year-old woman's acute presentation of Streptococcus salvarius infection after a sudden drop in her consciousness. CASE PRESENTATION: The patient was brought to hospital by family reporting a one week history of sudden deterioration, cognitive decline, and lethargy. The patient presented with reduced arousal, cognitive function (Glasgow Coma Scale: 10, Abbreviated Mental Test Score:CS, 0 AMTS), and no history of trauma. Computed Tomography (CT) imaging was ordered and identified a significant pneumocephalus with no cranial defect. Further investigations acknowledged possible sinus or middle ear disease, which was highlighted by the discovery of S. salivarius by polymerase chain reaction (PCR) and potentially exacerbated by the use of nocturnal continuous positive airway pressure (CPAP). The patient made a complete recovery by eliminating likely causative factors and long term regimental antibiotics administration. CONCLUSION: This case highlights a rare neurological presentation of S. salivarius infection with a mixed aetiology of spontaneous pneumocephalus. This case features an atypical complication associated with CPAP use, and to our knowledge is the first case to be associated with sinus wall osteomyelitis. Recognition of the clinical features and risk factors for spontaneous pneumocephalus -while rare-serve to broaden our clinical index of suspicion when presented with patients experiencing neurological deficit. Information from this case may also aid in improving prevention, early diagnosis, and future management.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180128
[Lr] Last revision date:180128
[St] Status:In-Data-Review
[do] DOI:10.1186/s12873-018-0154-9

  10 / 1707 MEDLINE  
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[PMID]: 28468141
[Au] Autor:Wan Y; Fei X; Jiang D; Chen H; Shi L; Wang Z
[Ad] Address:*Department of Neurosurgery, Suzhou Kowloon Hospital Affiliated With Shanghai Jiao Tong University School of Medicine †Department of Neurosurgery, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China.
[Ti] Title:Clinical Observation of Treatment of Chronic Subdural Hematoma With Novel Double Needle Minimally Invasive Aspiration Technology.
[So] Source:J Craniofac Surg;28(3):646-649, 2017 May.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The aim of the present study was to explore the clinical effects, including the prevention of complications, of the treatment of chronic subdural hematoma with double needle aspiration. METHODS: The clinical data of 31 patients with chronic subdural hematoma treated by double YL-1 needle double skull drilling and 31 controls treated by traditional drilling and drainage were analyzed retrospectively. RESULTS: In the YL-1 needle group, only 1 patient was with hematoma recurrence, 1 patient was with intracranial pneumocephalus, and the remaining patients who were followed up for 3 months achieved a clinical cure. In the traditional drilling and drainage group, 13 patients were with hematoma recurrence within 3 months after the operation and 7 patients were with postoperative intracranial pneumocephalus. CONCLUSIONS: The method of double YL-1 needle is better than the traditional drilling and drainage method for the treatment of chronic subdural hematoma because it reduces the postoperative recurrence rate and complications.
[Mh] MeSH terms primary: Hematoma, Subdural, Chronic/surgery
Minimally Invasive Surgical Procedures/instrumentation
Needles
Paracentesis/standards
Trephining/instrumentation
Trephining/standards
[Mh] MeSH terms secundary: Aged
Aged, 80 and over
Drainage/methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pneumocephalus/etiology
Postoperative Complications/etiology
Recurrence
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180126
[Lr] Last revision date:180126
[Js] Journal subset:D
[Da] Date of entry for processing:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003462


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