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Antenatal management of fetal neurosurgical diseases.

The advance in the imaging tools during the pregnancy (ultrasound and magnetic resonance) allowed the early diagnose of many fetal diseases, including the neurological conditions. This progress brought the neurosurgeons the possibility to propose treatments even before birth. Myelomeningocele is the most recognized disease that can be treated during pregnancy with a high rate of success. Additionally, this field can be extended to other conditions such as hydrocephalus and encephaloceles. However, each one of these diseases has nuances in the diagnostic evaluation that should fit the requireme

Economic benefit of neurosurgical intervention for infant hydrocephalus in Haiti.

OBJECTIVE: Previous models have been utilized in other low- and middle-income countries (LMICs) to explore and assess the cost, sustainability, and effectiveness of infant hydrocephalus treatment. However, similar models have not been implemented in Haiti due to a paucity of data, epidemiology, and outcomes for hydrocephalus. Therefore, the authors utilized previously described economic modeling to estimate the annual cost and benefit of treating hydrocephalus in infants at a neurosurgery referral center, Hospital Bernard Mevs (HBM), in Port-au-Prince, Haiti. METHODS: The authors conducted a

An Unusual Case of Escherichia Coli Meningitis in an Immunocompetent Adult.

Spontaneous meningitis caused by Gram-negative bacilli is rare in adults. It typically occurs after a neurosurgical procedure or head injury but may also be related to the presence of a neurosurgical device, cerebrospinal fluid (CSF) leak syndrome, or seen in immunosuppressed patients. Escherichia coli (E. coli) is the leading cause of Gram-negative bacilli meningitis. We describe the case of a 47-year-old man who was hospitalized for spontaneous, community-acquired E. coli meningitis, which is unusual to see in an immunocompetent adult. CSF analysis was consistent with bacterial meningitis; h

A Comprehensive Review of the Role of the Latest Minimally Invasive Neurosurgery Techniques and Outcomes for Brain and Spinal Surgeries.

Minimally invasive neurosurgical techniques offer reduced surgical trauma, lower complication rates, and faster recovery compared to traditional open procedures. Approaches such as keyhole craniotomy, endoscopic skull base surgery, endovascular neurosurgery, and percutaneous spinal techniques have advanced the management of cranial and spinal pathologies. These methods aim to minimize tissue disruption, blood loss, and hospital stay while maintaining surgical efficacy. This narrative review explores their evolution, applications, and advantages in modern neurosurgery.

Совпадение в полном тексте источника
… Endaural Subtemporal Keyhole Approach to the Middle Cranial Fossa Past surgical approaches: At the end of the 20th century, craniotomy remained a standard approach in many neurosurgical procedures due to limitations in lighting, visualization, imaging accuracy, and the lack of specialized instruments …

Description and first clinical application of AirWay Scope for tracheal intubation.

We have developed a novel airway apparatus, AirWay Scope, which we have used in the orotracheal intubation of 10 consecutive patients requiring general anesthesia before neurosurgical procedures. The characteristic shape of the introducer (INTLOCK), the tube guiding function and the sighting device of the AirWay Scope has possibility to facilitate tracheal intubation. Here, we report the first clinical application of this system and describe potential advantages of the apparatus.

Deaths associated with anaesthesia.

The incidence of deaths associated with anaesthesia at Royal Prince Alfred Hospital for the period 1963-72 inclusive was 1:502. An analysis of the 408 deaths showed that more than half of them occurred in association with major cardiovascular and neurosurgical procedures. The number of deaths attributable to anaesthesia alone was 15 (3.7%). This was a marked reduction by comparison with the number in the previous decade (20.9%).

Surgical Site Infections After External Ventricular Drain Placement: Incidence, Patient-Related, and Periprocedural Risk Factors.

BACKGROUND AND OBJECTIVES: External ventricular drain (EVD) placement is a routine neurosurgical procedure for cerebrospinal fluid (CSF) diversion. Despite standardized procedures, a considerable risk of infection remains. While CSF EVD-related infections (EVD-RI) are common and have been extensively studied, surgical site infections (SSI) as a distinct subset are, at least when compared with CSF EVD-RI, relatively rare and remain poorly understood in the context of EVD placement. Hence, the aim of this study was to determine the incidence and risk factors of SSI after EVD placement. METHODS:

Persistent trigeminal artery communicating with a fetal posterior communicating artery: A case report.

A persistent trigeminal artery (PTA) is the most common carotid-vertebrobasilar anastomosis. PTA variants terminating on cerebellar arteries instead of the basilar artery have been reported previously. We present the first case of a PTA communicating with a fetal posterior communicating artery identified on a magnetic resonance angiogram. An understanding of these anatomical variants is important to clarify pathological processes that can help guide neurosurgical and endovascular procedures.

Intracranial metastatic adenocarcinoma of the prostate presenting as visual disturbance.

We report two cases of intracranial metastatic adenocarcinoma of the prostate that presented with visual disturbance. The two patients had no prior history of prostate cancer and both underwent invasive neurosurgical procedures. Progressive neurological decline mandated craniotomy in one patient and the other patient underwent transphenoidal surgery for biopsy. Androgen deprivation therapy was instituted postoperatively for both patients when prostate cancer was determined to be the source of the metastatic lesions.

Neurosurgical considerations of cranial base surgery.

Several craniotomies have been described that allow extensive resection of skull base and low-lying cranial tumors that involve little disfigurement to the patient. These techniques should be of interest to plastic surgeons as they may be called to aid their neurosurgical colleagues in exposing the anterior skull base or may be involved in combined procedures to resect tumors that involve the face, sinuses, orbit, and cranial vault.

[Transoral Robot-Assisted Surgery for Pituitary Gland].

Robotic surgery has been introduced into various surgical fields and is expected to be useful in neurosurgery. Robotic surgery is a technolo … operations in areas that are difficult to reach with tools; and 3)Aids to assist the surgeon. Many neurosurgical procedures have shifted from microscopy to endoscopy. One such case is pituitary lesions, where transsphenoidal sinus surgery is currently performed. Originally, Hardy's surgery using microscopy was performed, whereas now endoscopic surgery is mainstream, with …

Anatomical Triangles for Use in Skull Base Surgery: A Comprehensive Review.

Procedures performed along the skull base require technical prowess and a thorough knowledge of cranial anatomy to navigate the operative field. Anatomical triangles created by unique anatomical structures serve as landmarks to guide the surgeon during meticulous skull base procedures. The corridors rapidly orient the surgeon to the operative field and permit greater confidence regarding skull base position during dissection. A literature review was performed with use of the PubMed database and reference list searches from full-text reviewed articles, which resulted in the identification of 31

Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients.

A small number of patients with an apparently minor head injury will develop a life-threatening intracranial hematoma that must be rapidly detected and removed. To assess the risk of a significant intracranial neurosurgical complication after apparently minor head injury, the authors collected data prospectively on 610 patients who had sustained a transient posttraumatic loss of consciousness or other neurological function and who had a Glasgow Coma Scale (GCS) score of 13, 14, or 15 in the emergency room. Skull x-ray films were obtained in 583 patients, 66 of whom (10.8% of the study populati

[Surgical Site Infections in Hydrocephalus Surgery and Pediatric Neurosurgery].

Hydrocephalus surgery is one of the most frequently performed procedures in pediatric neurosurgery. The incidence of surgical site infections during this surgery is high. This complication has not improved with the evolution of neurosurgical procedures. This may be due to immature immune system and skin barrier function of children compared to adults and the fact that hydrocephalus surgery involves placement of an alien surgical device in the body. To overcome this issue, it is important to follow procedures that have been validated as beneficial for the prevention of infection in literature. …

Neurophysiologic intraoperative monitoring in children with Down syndrome.

OBJECTIVE: Neurophysiological monitoring during complex spine procedures may reduce risk of injury by providing feedback to the operating su … ntraoperative monitoring technique. CONCLUSIONS: Neurophysiologic intraoperative monitoring during neurosurgical procedures in children with Down syndrome may be reliably and safely implemented. Changes in neurophysiologic parameters during surgery must be carefully interpreted, and discussed with the neurosurgeon, neurophysiologist, and neuroanesthesiologist, and may no …

Etomidate infusion for neuro-anaesthesia. A case report.

The successful administration of an etomidate infusion as a supplement to droperidol, fentanyl, muscle relaxant, air and oxygen anaesthesia in an 8-hour neurosurgical procedure is described. The merits of this technique are discussed, with particular emphasis on the conduct of anaesthesia in a patient with raised intracranial pressure.

Postoperative infection in spine surgery: does the month matter?

OBJECT: The relationship between time of year and surgical site infection (SSI) following neurosurgical procedures is poorly understood. Authors of previous reports have demonstrated that rates of SSI following neurosurgical procedures performed during the summer months were higher compared with rates during other seasons. It is unclear, however, if this difference was related to climatological changes or inexperienced medical trainees (the July effect). The aim of this study was to evaluate for seasonal variation of SSI following spine surgery in a network of nonteaching community hospitals. …

Artificial intelligence and robotics in global neurosurgery: A scoping review.

OBJECTIVE: Artificial intelligence (AI) and robotics are transforming neurosurgical care; however, the application of these technologies in low- and middle-income countries (LMICs), where the burden of neurosurgical diseases is highest, is not well-characterized. In this scoping review, we sought to map the current landscape of AI and robotics in global neurosurgery to identify themes and gaps that can catalyze the expansion of safe neurosurgical care worldwide. METHODS: A systematic search was conducted across MEDLINE/PubMed, Embase, Web of Science, and IEEE Xplore. This review followed the

Optical coherence tomography in endovascular neurosurgery: current applications and future directions.

Optical Coherence Tomography (OCT), initially introduced in 1991, has demonstrated efficacy in diagnosing pathologies of the retina, optic nerve, and coronary vessels. Recently, there has been growing research interest in the application of OCT in endovascular neurosurgery, with studies exploring its utility across a range of intracranial and extracranial endovascular diseases. The current review aims to synthesize available literature on the use of OCT in endovascular neurosurgery, encompassing both clinical and preclinical models. 57 studies met the inclusion criteria and were included in th