MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Neurosurgical Focus' source. Tue, 07 Feb 2012 03:15:44 +0100 http://www.medworm.com/index.php?rid=5659056&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22296678%26dopt%3DAbstract Authors: Dababneh H, Hedna VS, Ford J, Taimeh Z, Peters K, Mocco J, Waters MF Abstract The overall incidence of neurological complications due to infective endocarditis is as high as 40%, with embolic infarcts more common than hemorrhagic strokes. The standard of care for typical strokes does not apply to infective endocarditis because there is a substantial risk of hemorrhage with thrombolysis. In the last decade there have been multiple case reports of intravenous and intraarterial thrombolysis with successful outcomes for acute strokes with related infective endocarditis, but successful endovascular interventions for acute strokes associated with infective endocarditis are rarely reported. To the authors' knowledge, this report is the first case in the literature to use a mechan... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5659056 Wed, 01 Feb 2012 05:00:00 +0100 5659056 http://www.medworm.com/index.php?rid=5659055&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22296679%26dopt%3DAbstract Conclusions The authors demonstrated a linear correlation for frontal NIRS cerebral oxygenation measurements compared with regional CBF on CT perfusion imaging. Thus, frontal NIRS cerebral oxygenation measurement may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner. PMID: 22296679 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5659055 Wed, 01 Feb 2012 05:00:00 +0100 5659055 http://www.medworm.com/index.php?rid=5659054&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22296680%26dopt%3DAbstract Authors: Selman WR, Winn HR PMID: 22296680 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5659054 Wed, 01 Feb 2012 05:00:00 +0100 5659054 http://www.medworm.com/index.php?rid=5560131&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208894%26dopt%3DAbstract Conclusions The authors assert that tcMRgFUS represents a noninvasive, precise, and radiation-free neurosurgical technique for the treatment of neuropathic pain. The procedure avoids mechanical brain tissue shift and eliminates the risk of infection. The possibility of applying sonication thermal spots free from trajectory restrictions should allow one to optimize target coverage. The real-time continuous MR imaging and MR thermometry monitoring of targeting accuracy and thermal effects are major factors in optimizing precision, safety, and efficacy in an outpatient context. PMID: 22208894 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560131 Sun, 01 Jan 2012 05:00:00 +0100 5560131 http://www.medworm.com/index.php?rid=5560130&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208895%26dopt%3DAbstract Authors: Moser D, Zadicario E, Schiff G, Jeanmonod D Abstract The object of this study was to describe a method of measuring targeting accuracy in functional neurosurgery using MR imaging and the Stereotactic Atlas of the Human Thalamus and Basal Ganglia. This method should be useful for any functional procedure using these tools or similar ones, and is described here in the specific context of focused ultrasound surgery. The authors describe the atlas coordinate system used, the different relevant targeting and accuracy definitions, the tools used, the intraoperative target determination, the postoperative target reconstructions, and the calculation of the therapeutic lesion volume. The proposed method has been applied to the specific situation of measuring targeting accuracy in f... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560130 Sun, 01 Jan 2012 05:00:00 +0100 5560130 http://www.medworm.com/index.php?rid=5560129&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208896%26dopt%3DAbstract Authors: Etame AB, Diaz RJ, Smith CA, Mainprize TG, Hynynen K, Rutka JT Abstract Recent advances in molecular neurooncology provide unique opportunities for targeted molecular-based therapies. However, the blood-brain barrier (BBB) remains a major limitation to the delivery of tumor-specific therapies directed against aberrant signaling pathways in brain tumors. Given the dismal prognosis of patients with malignant brain tumors, novel strategies that overcome the intrinsic limitations of the BBB are therefore highly desirable. Focused ultrasound BBB disruption is emerging as a novel strategy for enhanced delivery of therapeutic agents into the brain via focal, reversible, and safe BBB disruption. This review examines the potential role and implications of focused ultrasound in mole... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560129 Sun, 01 Jan 2012 05:00:00 +0100 5560129 http://www.medworm.com/index.php?rid=5560128&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208897%26dopt%3DAbstract Authors: Liu HL, Yang HW, Hua MY, Wei KC Abstract Malignant glioma is a severe primary CNS cancer with a high recurrence and mortality rate. The current strategy of surgical debulking combined with radiation therapy or chemotherapy does not provide good prognosis, tumor progression control, or improved patient survival. The blood-brain barrier (BBB) acts as a major obstacle to chemotherapeutic treatment of brain tumors by severely restricting drug delivery into the brain. Because of their high toxicity, chemotherapeutic drugs cannot be administered at sufficient concentrations by conventional delivery methods to significantly improve long-term survival of patients with brain tumors. Temporal disruption of the BBB by microbubble-enhanced focused ultrasound (FUS) exposure can increas... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560128 Sun, 01 Jan 2012 05:00:00 +0100 5560128 http://www.medworm.com/index.php?rid=5560127&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208898%26dopt%3DAbstract Conclusions Despite the heterogeneity and the limitations of the reviewed studies, there is evidence that sonothrombolysis associated with tPA is a safe procedure and results in an increased rate of recanalization in the setting of acute ischemic stroke when wave frequencies and energy intensities of diagnostic ultrasound systems are used. PMID: 22208898 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560127 Sun, 01 Jan 2012 05:00:00 +0100 5560127 http://www.medworm.com/index.php?rid=5560126&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208899%26dopt%3DAbstract Authors: Kan P, Mokin M, Abla AA, Eller JL, Dumont TM, Levy EI, Siddiqui AH Abstract Intravascular ultrasound (IVUS) generates high-resolution cross-sectional images and sagittal reconstructions of the vessel wall and lumen. As a result, this imaging modality can provide accurate measurements of the degree of vessel stenosis, allow the detection of intraluminal thrombus, and analyze the plaque composition. The IVUS modality is widely used in interventional cardiology, and its use in neurointerventions has gradually increased. With case examples, the authors illustrate the utility of IVUS as an adjunct to conventional angiography for a wide range of intracranial and extracranial neurointerventions. PMID: 22208899 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560126 Sun, 01 Jan 2012 05:00:00 +0100 5560126 http://www.medworm.com/index.php?rid=5560125&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22208900%26dopt%3DAbstract Authors: Elias WJ, Kassell NF PMID: 22208900 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5560125 Sun, 01 Jan 2012 05:00:00 +0100 5560125 http://www.medworm.com/index.php?rid=5475408&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133167%26dopt%3DAbstract Conclusions Intracranial imaging is rarely performed in patients older than 90 years. In cases of suspected stroke, MR imaging findings may influence treatment decisions. Brain MR imaging studies ordered for other indications in this age group rarely influence treatment decisions. Incidentally discovered lesions in this age group are generally not treated. PMID: 22133167 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475408 Thu, 01 Dec 2011 05:00:00 +0100 5475408 http://www.medworm.com/index.php?rid=5475407&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133168%26dopt%3DAbstract Authors: Doe C, Jethwa PR, Gandhi CD, Prestigiacomo CJ Abstract The treatment of asymptomatic carotid artery stenosis (ACAS) has continued to evolve for the past 3 decades. With rapidly advancing technology, the results of old trials have become obsolete. While there has been little change in the efficacy of carotid endarterectomy, there have been vast improvements in both medical management and carotid angioplasty with stenting. Finding the best therapy for a given patient can therefore be difficult. In this article, the authors review the current literature regarding treatment options for ACAS and the methods available for stratifying patients who would benefit from surgical versus medical treatment. PMID: 22133168 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475407 Thu, 01 Dec 2011 05:00:00 +0100 5475407 http://www.medworm.com/index.php?rid=5475406&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133169%26dopt%3DAbstract Conclusions Treatment decisions for incidental LGG should be individualized based on presenting symptoms and radiological evidence of growth. The asymptomatic patient may be monitored safely with serial MR imaging and occasionally PET scanning before treatment is initiated. In patients presenting with nonspecific symptoms or concurrent symptomatic lesions, treatment may be initiated earlier to reduce potential morbidity. All treatment decisions must be tempered by patient factors and expectations of anticipated benefit. PMID: 22133169 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475406 Thu, 01 Dec 2011 05:00:00 +0100 5475406 http://www.medworm.com/index.php?rid=5475405&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133170%26dopt%3DAbstract Authors: Coumans JV, Walcott BP Abstract Incidental vertebral lesions on imaging of the spine are commonly encountered in clinical practice. Contributing factors include the aging population, the increasing prevalence of back pain, and increased usage of MR imaging. Additionally, refinements in CT and MR imaging have increased the number of demonstrable lesions. The management of incidental findings varies among practitioners and commonly depends more on practice style than on data or guidelines. In this article we review incidental findings within the vertebral column and review management of these lesions, based on available Class III data. PMID: 22133170 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475405 Thu, 01 Dec 2011 05:00:00 +0100 5475405 http://www.medworm.com/index.php?rid=5475404&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133171%26dopt%3DAbstract Conclusions Radiographic progression occurred in the majority of asymptomatic patients and generally heralded subsequent clinical symptoms. These data demonstrate that moyamoya is a progressive disorder, even in asymptomatic populations, and support the rationale of early surgical intervention to minimize morbidity from stroke. PMID: 22133171 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475404 Thu, 01 Dec 2011 05:00:00 +0100 5475404 http://www.medworm.com/index.php?rid=5475403&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133172%26dopt%3DAbstract Conclusions Syringomyelia often remains stable in patients receiving nonoperative treatment. However, given that 2 (12%) of 17 syringes in this series enlarged, it is likely appropriate to include periodic imaging in the follow-up of these cases. PMID: 22133172 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475403 Thu, 01 Dec 2011 05:00:00 +0100 5475403 http://www.medworm.com/index.php?rid=5475402&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133173%26dopt%3DAbstract Conclusions While the majority of pituitary incidentalomas can be managed conservatively, involvement of the optic apparatus, endocrine dysfunction, ophthalmological symptoms, and progressive increase in size represent the main indications for surgery. PMID: 22133173 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475402 Thu, 01 Dec 2011 05:00:00 +0100 5475402 http://www.medworm.com/index.php?rid=5475401&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133174%26dopt%3DAbstract Authors: Hervey-Jumper SL, McKeever PE, Gebarski SS, Muraszko KM, Maher CO Abstract Infantile hemangiomas are tumors commonly seen in children. Few authors have reported infantile hemangiomas affecting the CNS, and there are no prior reports detailing spontaneous resolution of a histologically proven juvenile hemangioma within a dorsal root ganglion. The authors report the case of a newborn boy with a large cutaneous hemangioma in the midline of his back. Spinal MR images were obtained to rule out associated spinal cord tethering, and an intradural spinal lesion was unexpectedly discovered. Biopsy revealed an intradural infantile hemangioma within the dorsal root ganglion, and, based on this diagnosis, no resection was performed. Sixteen months following the biopsy, the cutaneous h... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475401 Thu, 01 Dec 2011 05:00:00 +0100 5475401 http://www.medworm.com/index.php?rid=5475400&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133175%26dopt%3DAbstract Authors: Maher CO, Jr PK, Smith ER PMID: 22133175 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475400 Thu, 01 Dec 2011 05:00:00 +0100 5475400 http://www.medworm.com/index.php?rid=5475399&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133176%26dopt%3DAbstract Authors: Chalouhi N, Chitale R, Jabbour P, Tjoumakaris S, Dumont AS, Rosenwasser R, Gonzalez LF Abstract Given that relatives of patients with intracranial aneurysms (IAs) or subarachnoid hemorrhage have a greater risk of harboring an aneurysm, family screening has become a common practice in neurosurgery. Unclear data exist regarding who should be screened and at what age and interval screening should occur. Multiple factors including the natural history of IAs, the risk of treatment, the cost of screening, and the psychosocial impact of finding an aneurysm should be taken into account when family screening is considered. In this paper, the authors review the current literature regarding risk factors and natural history of sporadic and familial aneurysms. Based on these data the a... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475399 Thu, 01 Dec 2011 05:00:00 +0100 5475399 http://www.medworm.com/index.php?rid=5475398&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133177%26dopt%3DAbstract Authors: Dalyai RT, Ghobrial G, Awad I, Tjoumakaris S, Gonzalez LF, Dumont AS, Chalouhi N, Randazzo C, Rosenwasser R, Jabbour P Abstract Cavernous malformations (CMs) are angiographically occult vascular malformations that are frequently found incidentally on MR imaging. Despite this benign presentation, these lesions could cause symptomatic intracranial hemorrhage, seizures, and focal neurological deficits. Cavernomas can be managed conservatively with neuroimaging studies, surgically with lesion removal, or with radiosurgery. Considering recent studies examining the CM's natural history, imaging techniques, and possible therapeutic interventions, the authors provide a concise review of the literature and discuss the optimal management of incidental CMs. PMID: 22133177 [PubMed... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475398 Thu, 01 Dec 2011 05:00:00 +0100 5475398 http://www.medworm.com/index.php?rid=5475397&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133178%26dopt%3DAbstract Authors: Chalouhi N, Dumont AS, Randazzo C, Tjoumakaris S, Gonzalez LF, Rosenwasser R, Jabbour P Abstract With the widespread use of brain imaging studies, neurosurgeons have seen a marked increase in the number of incidental intracranial lesions, including vascular abnormalities. Specifically, the detection of incidentally discovered aneurysms, arteriovenous malformations, cavernous angiomas, developmental venous anomalies, and capillary telangiectasias has increased. The best management strategy for most of these lesions is controversial. Treatment options include observation, open surgery, endovascular procedures, and radiosurgery. Multiple factors should be taken into account when discussing treatment indications, including the natural history of the disease and the risk of the... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475397 Thu, 01 Dec 2011 05:00:00 +0100 5475397 http://www.medworm.com/index.php?rid=5475396&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133179%26dopt%3DAbstract Authors: Perret C, Boltshauser E, Scheer I, Kellenberger CJ, Grotzer MA Abstract Increasing use of neuroimaging in children has led to more incidental findings of CNS mass lesions, the management of which is uncertain. The authors' aims in this study are to describe these mass lesions and their evolution, as well as to discuss the management options and determine the prevalence of incidental CNS mass lesions at their pediatric clinic. A retrospective study was undertaken in children with primary CNS tumors who were younger than 18 years old and were admitted to the University Children's Hospital of Zurich, Switzerland, between January 1995 and December 2010. In 19 (5.7%) of 335 patients with newly diagnosed CNS tumors, the diagnosis of a CNS mass lesion was an incidental finding. R... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475396 Thu, 01 Dec 2011 05:00:00 +0100 5475396 http://www.medworm.com/index.php?rid=5475395&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133180%26dopt%3DAbstract Authors: Taussky P, Hanel RA, Meyer FB Abstract Incidental findings pose considerable management dilemmas for the treating physician and psychological burden for the respective patient. With an aging population, more patients will be diagnosed with asymptomatic internal carotid artery stenosis. Patients will have to be counseled with regard to treatment options according to their individual risk profile and according to professionals' knowledge of evidence-based data derived from large randomized control trials. Treatment consensus has long been lacking for patients with asymptomatic carotid artery stenosis prior to any randomized controlled trials. Additionally, an individual's risk profile may be hard to assess according to knowledge gained from randomized controlled trials. More... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475395 Thu, 01 Dec 2011 05:00:00 +0100 5475395 http://www.medworm.com/index.php?rid=5475394&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133181%26dopt%3DAbstract Authors: Lucantoni C, Than KD, Wang AC, Valdivia-Valdivia JM, Maher CO, La Marca F, Park P Abstract The primary aim of our study was to provide a comprehensive review of the clinical, imaging, and histopathological features of Tarlov cysts (TCs) and to report operative and nonoperative management strategies in patients with sacral TCs. A literature review was performed to identify articles that reported surgical and nonsurgical management of TCs over the last 10 years. Tarlov cysts are often incidental lesions found in the spine and do not require surgical intervention in the great majority of cases. When TCs are symptomatic, the typical clinical presentation includes back pain, coccyx pain, low radicular pain, bowel/bladder dysfunction, leg weakness, and sexual dysfunction. Tarlov... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475394 Thu, 01 Dec 2011 05:00:00 +0100 5475394 http://www.medworm.com/index.php?rid=5475393&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133182%26dopt%3DAbstract Authors: Chamoun R, Krisht KM, Couldwell WT Abstract With the increasing availability and use of modern brain diagnostic imaging modalities, discovery of incidental meningiomas has become fairly common. This creates a dilemma among neurosurgeons as to whether these lesions should be treated. Numerous natural history studies have been published in an effort to shed light on the potential for growth of incidental meningiomas. The available data appear to suggest that these tumors can fall into 1 of 3 main growth patterns: no growth, linear growth, or exponential growth. The therapeutic strategy selected should also consider several other factors, mainly the risk of complications from an eventual surgery, the possibility of malignancies and other pathological conditions that mimic men... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475393 Thu, 01 Dec 2011 05:00:00 +0100 5475393 http://www.medworm.com/index.php?rid=5475392&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133183%26dopt%3DAbstract Conclusions The precise etiology for idiopathic syringomyelia (IS) is still unclear, although conceptual advances have been made toward the overall understanding of the pathophysiology of IS. Various theories include the cerebellar piston theory, intramedullary pulse pressure theory, and increased spinal subarachnoid pressure. For most patients with IS, conservative management works well. Continued progression of symptoms, however, could be approached using decompressive strategies such as laminectomy, lysis of adhesions, and craniocervical decompression, depending on the level of pathology. Management for patients with progressive neurological dysfunction and the lack of flow disturbance is unclear, although syringosubarachnoid shunting can be considered. PMID: 22133183 [PubMed - in ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475392 Thu, 01 Dec 2011 05:00:00 +0100 5475392 http://www.medworm.com/index.php?rid=5475391&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133184%26dopt%3DAbstract Authors: Solomon RA PMID: 22133184 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475391 Thu, 01 Dec 2011 05:00:00 +0100 5475391 http://www.medworm.com/index.php?rid=5475390&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133185%26dopt%3DAbstract Authors: Klimo P, Coon V, Meyer DB Abstract Os odontoideum was first described in the late 1880s and still remains a mystery in many respects. The genesis of os odontoideum is thought to be prior bone injury to the odontoid, but a developmental cause probably also exists. The spectrum of presentation is striking and ranges from patients who are asymptomatic or have only neck pain to those with acute quadriplegia, chronic myelopathy, or even sudden death. By definition, the presence of an os odontoideum renders the C1-2 region unstable, even under physiological loads in some patients. The consequences of this instability are exemplified by numerous cases in the literature in which a patient with os odontoideum has suffered a spinal cord injury after minor trauma. Although there is l... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475390 Thu, 01 Dec 2011 05:00:00 +0100 5475390 http://www.medworm.com/index.php?rid=5475389&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133186%26dopt%3DAbstract Conclusions Small incidental UIAs are more commonly diagnosed in elderly individuals during imaging performed to investigate ill-defined spells or focal cerebrovascular ischemic symptoms, or during the evaluation of known or probable unrelated intracranial/neck pathology. Hypertension, smoking, and family history of aneurysms are common in this patient population, and the presence of these risk factors has important implications for treatment recommendations. Although paraclinoid aneurysms (excluding intracavernous aneurysms) are uncommon in patients with ruptured intracranial aneurysms, this location is very common in patients with small incidental UIAs. PMID: 22133186 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475389 Thu, 01 Dec 2011 05:00:00 +0100 5475389 http://www.medworm.com/index.php?rid=5475388&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22133187%26dopt%3DAbstract Conclusions A cautious and individualized approach to incidental UIAs is of utmost importance for formulation of a safe and effective treatment algorithm. Invasive treatment (either endovascular or surgery) can be considered in selected younger patients, certain "higher-risk" locations, expanding aneurysms, patients with a family history of aneurysmal hemorrhage, and in those who cannot live their lives knowing that they harbor the UIA. Although the complication rate of invasive treatment is very low, it is not negligible. The study confirms that small incidental UIAs deemed to be not in need of treatment have a very benign short-term natural history, which makes observation a reasonable approach in selected patients. PMID: 22133187 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5475388 Thu, 01 Dec 2011 05:00:00 +0100 5475388 http://www.medworm.com/index.php?rid=5379787&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044098%26dopt%3DAbstract Conclusions Trivial head injuries in soccer can have a long and complicated course. Nevertheless, the temporary disability is shorter in most cases than for players with injuries to other parts of the body. Modifying the rules of play would be necessary to reduce the incidence of head trauma. PMID: 22044098 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379787 Tue, 01 Nov 2011 04:00:00 +0100 5379787 http://www.medworm.com/index.php?rid=5379786&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044099%26dopt%3DAbstract Conclusions Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch-contusion injury. PMID: 22044099 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379786 Tue, 01 Nov 2011 04:00:00 +0100 5379786 http://www.medworm.com/index.php?rid=5379785&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044100%26dopt%3DAbstract Conclusions Traumatic knee-level peroneal nerve injury due to sports is usually associated with stretch/contusion, which more often requires graft repair. Graft length is the factor to be considered for the prognosis of nerve repair. PMID: 22044100 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379785 Tue, 01 Nov 2011 04:00:00 +0100 5379785 http://www.medworm.com/index.php?rid=5379784&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044101%26dopt%3DAbstract Authors: Dubourg J, Messerer M Abstract Traumatic brain injury (TBI) is recognized as a cause of hypopituitarism even after mild TBI. Although over the past decade, a growing body of research has detailed neuroendocrine changes induced by TBI, the mechanisms and risk factors responsible for this pituitary dysfunction are still unclear. Around the world, sports-especially combative sports-are very popular. However, sports are not generally considered as a cause of TBI in most epidemiological studies, and the link between sports-related head trauma and hypopituitarism has not been investigated until recently. Thus, there is a paucity of data regarding this important concern. Because of the large number of young sports participants with near-normal life expectancy, the implications of... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379784 Tue, 01 Nov 2011 04:00:00 +0100 5379784 http://www.medworm.com/index.php?rid=5379783&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044102%26dopt%3DAbstract Authors: Omalu B, Hammers JL, Bailes J, Hamilton RL, Kamboh MI, Webster G, Fitzsimmons RP Abstract Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379783 Tue, 01 Nov 2011 04:00:00 +0100 5379783 http://www.medworm.com/index.php?rid=5379782&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044103%26dopt%3DAbstract Authors: Curaudeau GA, Sharma N, Rovin RA Abstract Professional athletes are taking concussion very seriously, and missed play due to concussion is no longer stigmatized. One fortuitous consequence is increased awareness of the detrimental effects of concussion among student athletes. Whereas professional athletes have access to formal in-competition evaluation and out-of-competition monitoring programs, the majority of student athletes, especially at the middle school and high school levels, do not. The authors therefore set out to create an easy-to-use iPhone application for sideline concussion testing and serial monitoring of these at-risk athletes. PMID: 22044103 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379782 Tue, 01 Nov 2011 04:00:00 +0100 5379782 http://www.medworm.com/index.php?rid=5379781&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044104%26dopt%3DAbstract Authors: Appelboom G, Zoller SD, Piazza MA, Szpalski C, Bruce SS, McDowell MM, Vaughan KA, Zacharia BE, Hickman Z, D'Ambrosio A, Feldstein NA, Anderson RC Abstract Traumatic brain injury (TBI) is the current leading cause of death in children over 1 year of age. Adequate management and care of pediatric patients is critical to ensure the best functional outcome in this population. In their controversial trial, Cooper et al. concluded that decompressive craniectomy following TBI did not improve clinical outcome of the analyzed adult population. While the study did not target pediatric populations, the results do raise important and timely clinical questions regarding the effectiveness of decompressive surgery in pediatric patients. There is still a paucity of evidence regarding the ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379781 Tue, 01 Nov 2011 04:00:00 +0100 5379781 http://www.medworm.com/index.php?rid=5379780&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044105%26dopt%3DAbstract Conclusions Individuals with light weights and small wingspans, such as those in the pediatric population, are under considerable risk of injury when operating an ATV due to lateral, longitudinal, and vertical operational instability. PMID: 22044105 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379780 Tue, 01 Nov 2011 04:00:00 +0100 5379780 http://www.medworm.com/index.php?rid=5379779&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044106%26dopt%3DAbstract Authors: Clark AJ, Auguste KI, Sun PP Abstract Cervical cord neurapraxia is a common sports-related injury. It is defined as a transient neurological deficit following trauma localizing to the cervical spinal cord and can be caused by hyperextension, hyperflexion, or axial load mechanisms. Symptoms usually last less than 15 minutes, but can persist up to 48 hours in adults and as long as 5 days in children. While a strong causal relationship exists between cervical spine stenosis and cervical cord neurapraxia in adult patients, this association has not been observed in children. Likewise, while repeated episodes of neurapraxia can be commonplace in adult patients, recurrences have not been reported in the pediatric population. Treatment is usually supportive, but in adults with foc... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379779 Tue, 01 Nov 2011 04:00:00 +0100 5379779 http://www.medworm.com/index.php?rid=5379778&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044107%26dopt%3DAbstract Conclusions Skiers and snowboarders evaluated at the hospital are equally likely to sustain spine injuries. Additionally, participants in both sports have an increased incidence of SCI with cervical spine trauma. PMID: 22044107 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379778 Tue, 01 Nov 2011 04:00:00 +0100 5379778 http://www.medworm.com/index.php?rid=5379777&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044108%26dopt%3DAbstract Conclusions For a young athlete with a symptomatic pars defect, any of the described techniques of repair would probably produce acceptable results. An appropriate preoperative workup is important. The ideal candidate is younger than 20 years with minimal or no listhesis and no degenerative changes of the disc. Limited participation in sports can be expected from 5 to 12 months postoperatively. PMID: 22044108 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379777 Tue, 01 Nov 2011 04:00:00 +0100 5379777 http://www.medworm.com/index.php?rid=5379776&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22044109%26dopt%3DAbstract Authors: Bailes J, Maroon J, Robinson S PMID: 22044109 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5379776 Tue, 01 Nov 2011 04:00:00 +0100 5379776 http://www.medworm.com/index.php?rid=5297549&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961853%26dopt%3DAbstract Authors: Walcott BP, Coumans JV, Kahle KT Abstract Disorders of the spine are common in clinical medicine, and spine surgery is being performed with increasing frequency in the US. Although many patients with an established diagnosis of a true surgically treatable lesion are referred to a neurosurgeon, the evaluation of patients with spinal disorders can be complex and fraught with diagnostic pitfalls. While "common conditions are common," astute clinical acumen and vigilance are necessary to identify lesions that masquerade as surgically treatable spine disease that can lead to erroneous diagnosis and treatment. In this review, the authors discuss musculoskeletal, peripheral nerve, metabolic, infectious, inflammatory, and vascular conditions that mimic the syndromes produced by su... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297549 Sat, 01 Oct 2011 04:00:00 +0100 5297549 http://www.medworm.com/index.php?rid=5297546&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961854%26dopt%3DAbstract Conclusions Using a prospective methodology with a broad definition of complications, the authors report a significantly higher perioperative incidence of complications than previously indicated after spinal fusion procedures. Given the increased application of instrumentation, especially for degenerative disease, a better estimate of clinically relevant surgical complications could aid spine surgeons and patients in an individualized complication index to facilitate a more thorough risk-benefit analysis prior to surgery. PMID: 21961854 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297546 Sat, 01 Oct 2011 04:00:00 +0100 5297546 http://www.medworm.com/index.php?rid=5297544&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961855%26dopt%3DAbstract Conclusions Instrumentation of the C-2 vertebrae using the freehand technique for insertion of pedicle and intralaminar screws showed a high success rate with no critical violations. Pars screw insertion was not as reliable, with 2 critical violations from a total of 16 placements. The freehand technique appears to be a safe and reliable method for insertion of C-2 pedicle and intralaminar screws. PMID: 21961855 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297544 Sat, 01 Oct 2011 04:00:00 +0100 5297544 http://www.medworm.com/index.php?rid=5297543&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961856%26dopt%3DAbstract Conclusions Both ACCF and laminoplasty are effective treatments for patients with cervical stenosis. The authors found no difference in the rate of deltoid paresis between ACCF and laminoplasty to treat cervical stenosis. PMID: 21961856 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297543 Sat, 01 Oct 2011 04:00:00 +0100 5297543 http://www.medworm.com/index.php?rid=5297542&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961857%26dopt%3DAbstract Authors: Nagasawa DT, Smith ZA, Cremer N, Fong C, Lu DC, Yang I Abstract Spinal cord ependymomas are rare neoplasms, comprising approximately 5% of all CNS tumors and 15% of all spinal cord tumors. Although surgery was once reserved for diagnosis alone, the evolution of surgical practices has elevated resection to the treatment of choice for these lesions. While technological advances continue to improve the capacity for gross-total resections and thus decrease the risk of recurrence, ependymoma spinal surgery still contains a variety of potential complications. The presence of neurological deficits and deterioration are not uncommonly associated with spinal cord ependymoma surgery, including sensory loss, dorsal column dysfunction, dysesthetic syndrome, and bowel and bladder dysfu... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297542 Sat, 01 Oct 2011 04:00:00 +0100 5297542 http://www.medworm.com/index.php?rid=5297541&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961858%26dopt%3DAbstract Authors: Krisht KM, Mumert ML, Schmidt MH Abstract The thoracoscopic approach to the anterior spine is a practical and valuable means of approaching ventral spinal lesions but demands advanced technical skills and fine hand-eye coordination that is usually acquired with experience. A mutual understanding of all the ventilatory and surgical steps allows for an organized orchestration between the anesthesiologist and surgeon, which ultimately helps minimize potential complications. Despite a concerted effort by all involved to avoid risks, thoracoscopic surgery is associated with complications for which the surgical team should be cognizant. In this paper, the authors detail the operative technique of vertebral corpectomy and interbody fusion via the thoracoscopic approach for the tr... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297541 Sat, 01 Oct 2011 04:00:00 +0100 5297541 http://www.medworm.com/index.php?rid=5297540&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961859%26dopt%3DAbstract Conclusions In the authors' consecutive series of patients undergoing MISS, an unintended durotomy was associated with fewer complications than previously reported for open spinal surgery. The authors propose a simple management algorithm that includes early mobilization and results in excellent clinical outcomes with no incidence of postoperative cutaneous CSF fistula or other complications. PMID: 21961859 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297540 Sat, 01 Oct 2011 04:00:00 +0100 5297540 http://www.medworm.com/index.php?rid=5297539&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961860%26dopt%3DAbstract Authors: Shih P, Slimack NP, Roy A, Fessler RG, Koski TR Abstract Perioperative abdominal complications associated with spine surgery are rare. Although most known abdominal complications occur in conjunction with anterior spinal fusions, there is a paucity of reports reviewing abdominal complications occurring with posterior spinal fusions. The authors review 4 patients who experienced a perioperative abdominal complication following a posterior spinal fusion. In each of these patients, a history of abdominal surgery is present. Given the physiological changes that occur with surgery in the prone position, patients with previous abdominal surgeries are at risk for developing abdominal complications in the perioperative period. PMID: 21961860 [PubMed - in process] (Source: Neur... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297539 Sat, 01 Oct 2011 04:00:00 +0100 5297539 http://www.medworm.com/index.php?rid=5297538&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961861%26dopt%3DAbstract Conclusions AxiaLIF devices are safely retrieved using percutaneous technique. Both anterior and posterior revision strategies may be used to achieve anterior column fixation. PMID: 21961861 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297538 Sat, 01 Oct 2011 04:00:00 +0100 5297538 http://www.medworm.com/index.php?rid=5297537&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961862%26dopt%3DAbstract Conclusions Abdominal wall paresis is a rare but known potential complication of abdominal surgery. The authors report the first case series associated with the minimally invasive lateral transpsoas approach. PMID: 21961862 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297537 Sat, 01 Oct 2011 04:00:00 +0100 5297537 http://www.medworm.com/index.php?rid=5297536&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961863%26dopt%3DAbstract Authors: Sivakumar W, Elder JB, Bilsky MH Abstract Anterior cervical discectomy and fusion (ACDF) is a common neurosurgical procedure, and the benefits, long-term outcomes, and complications are well described in the literature. The development of a juxtafacet joint cyst resulting in radiculopathy is a rare outcome after ACDF and merits further description. The authors describe a patient in whom a juxtafacet joint cyst developed after ACDF procedures, resulting in surgical intervention. When a juxtafacet joint cyst develops after ACDF, symptoms can include radiculopathy, neck pain, and neurological symptoms such as paresthesias and motor weakness. The presence of a juxtafacet joint cyst implies instability in that region of the spine. Patients with this pathological entity may requ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297536 Sat, 01 Oct 2011 04:00:00 +0100 5297536 http://www.medworm.com/index.php?rid=5297535&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961864%26dopt%3DAbstract Authors: Hussain NS, Perez-Cruet MJ Abstract Spine surgery as we know it has changed dramatically over the past 2 decades. More patients are undergoing minimally invasive procedures. Surgeons are becoming more comfortable with these procedures, and changes in technology have led to several new approaches and products to make surgery safer for patients and improve patient outcomes. As more patients undergo minimally invasive spine surgery, more long-term outcome and complications data have been collected. The authors describe the common complications associated with these minimally invasive surgical procedures and delineate management options for the spine surgeon. PMID: 21961864 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297535 Sat, 01 Oct 2011 04:00:00 +0100 5297535 http://www.medworm.com/index.php?rid=5297534&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961865%26dopt%3DAbstract Authors: Kunes J, Thompson GH, Manjila S, Poe-Kochert C, Cohen AR Abstract Idiopathic intracranial hypertension (IIH) after pediatric spinal deformity surgery has not been previously reported. The authors conducted a retrospective analysis of more than 1500 pediatric spinal surgeries performed between 1992 and 2011. From their analysis, they report on 3 adolescent patients who underwent uncomplicated segmental spinal instrumentation for pediatric spinal deformity correction and subsequently developed features of IIH. The common variables in these 3 patients were adolescent age, spinal deformity, being overweight, symptom onset within 2 weeks postoperatively, significant estimated blood loss, and intraoperative use of ε-aminocaproic acid (antifibrinolytic) injection. The authors po... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297534 Sat, 01 Oct 2011 04:00:00 +0100 5297534 http://www.medworm.com/index.php?rid=5297533&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961866%26dopt%3DAbstract Conclusions Elderly patient outcomes were inconsistent in the published studies. Overall, most elderly patients obtained favorable outcomes with low operative mortality following surgery for adult spinal deformity. PMID: 21961866 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297533 Sat, 01 Oct 2011 04:00:00 +0100 5297533 http://www.medworm.com/index.php?rid=5297532&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961867%26dopt%3DAbstract Conclusions The minimally invasive, transpsoas muscle approach to the lumbar spine has a number of advantages. The data show that a percentage of the patients undergoing the transpsoas approach will have temporary sensory and motor symptoms related to this approach. The majority of the symptoms are thought to be related to psoas muscle inflammation and/or stretch injury to the genitofemoral nerve due to the surgical corridor traversed during the operation. No major injuries to the lumbar plexus were encountered. It is important to educate patients prior to surgery of the possibility of these largely transient symptoms. PMID: 21961867 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297532 Sat, 01 Oct 2011 04:00:00 +0100 5297532 http://www.medworm.com/index.php?rid=5297531&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961868%26dopt%3DAbstract Authors: Hsu W, Kretzer RM, Dorsi MJ, Gokaslan ZL Abstract Wrong-site surgery (WSS) is a rare occurrence that can have devastating consequences for patient care. There are several factors inherent to spine surgery that increase the risk of WSS compared with other types of surgery. Not only can a surgeon potentially operate on the wrong side of the spine or the wrong level, but there are unique issues related to spinal localization that can be challenging for even the most experienced clinicians. The following review discusses important issues that can help prevent WSS during spinal procedures. PMID: 21961868 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297531 Sat, 01 Oct 2011 04:00:00 +0100 5297531 http://www.medworm.com/index.php?rid=5297530&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961869%26dopt%3DAbstract Authors: Than KD, Wang AC, Rahman SU, Wilson TJ, Valdivia JM, Park P, La Marca F Abstract The goal of this study was to review the literature to compare strategies for avoiding and treating complications from anterior lumbar interbody fusion (ALIF), and thus provide a comprehensive aid for spine surgeons. A thorough review of databases from the US National Library of Medicine and the National Institutes of Health was conducted. The complications of ALIF addressed in this paper include pseudarthrosis and subsidence, vascular injury, retrograde ejaculation, ileus, and lymphocele (chyloretroperitoneum). Strategies identified for improving fusion rates included the use of frozen rather than freeze-dried allograft, cage instrumentation, and bone morphogenetic protein. Lower cage heights... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297530 Sat, 01 Oct 2011 04:00:00 +0100 5297530 http://www.medworm.com/index.php?rid=5297529&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961870%26dopt%3DAbstract Authors: Mazur MD, Mumert ML, Bisson EF, Schmidt MH Abstract Anterior screw fixation of Type II odontoid fractures provides immediate stabilization of the cervical spine while preserving C1-2 motion. This technique has a high fusion rate, but can be technically challenging. The authors identify key points that should be taken into account to maximize the chance for a favorable outcome. Keys to success include proper patient and fracture selection, identification of suitable screw entry point and correct screw trajectory, achieving bicortical purchase, and placing 2 screws when feasible and applicable. The authors review the operative technique and present guidance on appropriate patient selection and common pitfalls in anterior screw fixation, with strategies for avoiding complicat... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297529 Sat, 01 Oct 2011 04:00:00 +0100 5297529 http://www.medworm.com/index.php?rid=5297528&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961871%26dopt%3DAbstract Conclusions Pedicle screw placement in the thoracolumbar region is a safe procedure with an overall high accuracy and a very low rate of clinically relevant complications. PMID: 21961871 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297528 Sat, 01 Oct 2011 04:00:00 +0100 5297528 http://www.medworm.com/index.php?rid=5297527&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961872%26dopt%3DAbstract Conclusions Screw loosening in dynamic stabilization systems is not uncommon (4.7% screws in 19.8% patients). Patients of older age or those with diabetes have higher rates of screw loosening. Screw loosening can be asymptomatic and presents opportunity for osseous integration on later follow-up. Although adverse effects on clinical outcomes are rare, longer-term follow-up is required in cases in which screws become loose. PMID: 21961872 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297527 Sat, 01 Oct 2011 04:00:00 +0100 5297527 http://www.medworm.com/index.php?rid=5297526&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21961873%26dopt%3DAbstract Authors: Hsieh PC, Gokaslan ZL PMID: 21961873 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5297526 Sat, 01 Oct 2011 04:00:00 +0100 5297526 http://www.medworm.com/index.php?rid=5192990&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882906%26dopt%3DAbstract Authors: Schanker BD, Walcott BP, Nahed BV, Kahle KT, Li YM, Coumans JV Abstract Chiari malformations (Types I-IV) are abnormalities of the posterior fossa that affect the cerebellum, brainstem, and the spinal cord with prevalence rates of 0.1%-0.5%. Case reports of familial aggregation of Chiari malformation, twin studies, cosegregation of Chiari malformation with known genetic conditions, and recent gene and genome-wide association studies provide strong evidence of the genetic underpinnings of familial Chiari malformation. The authors report on a series of 3 family pairs with Chiari malformation Type I: 2 mother-daughter pairs and 1 father-daughter pair. The specific genetic causes of familial Chiari malformation have yet to be fully elucidated. The authors review the literature... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192990 Wed, 31 Aug 2011 23:00:00 +0100 5192990 http://www.medworm.com/index.php?rid=5192989&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882907%26dopt%3DAbstract Conclusions Chiari malformation is frequently seen in patients with both multi- and single-suture lambdoid craniosynostosis. Chiari malformation, and even a spinal cord syrinx, will occasionally resolve following craniofacial repair. De novo development of CM after craniosynostosis repair is not unusual. PMID: 21882907 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192989 Wed, 31 Aug 2011 23:00:00 +0100 5192989 http://www.medworm.com/index.php?rid=5192988&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882908%26dopt%3DAbstract Authors: Loukas M, Shayota BJ, Oelhafen K, Miller JH, Chern JJ, Tubbs RS, Oakes WJ Abstract A single pathophysiological mechanism of Chiari Type I malformations (CM-I) has been a topic of debate. To help better understand CM-I, the authors review disorders known to be associated with CM-I. The primary methodology found among most of them is deformation of the posterior cranial fossa, usually with subsequent decrease in volume. Other mechanisms exist as well, which can be categorized as either congenital or acquired. In understanding the relationship of such disorders with CM-I, we may gain further insight into the process by which cerebellar tonsillar herniation occurs. Some of these pathologies appear to be true associations, but many appear to be spurious. PMID: 21882908 [Pub... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192988 Wed, 31 Aug 2011 23:00:00 +0100 5192988 http://www.medworm.com/index.php?rid=5192987&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882909%26dopt%3DAbstract Conclusions Three-dimensional analysis of syringomyelia resolution over time enables the kinetics to be estimated. This technique is yet to be validated in a large cohort. Because syringomyelia is the final common pathway for a number of different pathological processes, it is possible that this exponential only applies to syringomyelia related to treatment of Chiari malformation Type I. PMID: 21882909 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192987 Wed, 31 Aug 2011 23:00:00 +0100 5192987 http://www.medworm.com/index.php?rid=5192986&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882910%26dopt%3DAbstract Conclusions The demonstration of CSF flow pulsation can contribute to assessments of surgical outcomes. The results presented here, however, raise doubts about current theories on the pathogenesis of syringomyelia. PMID: 21882910 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192986 Wed, 31 Aug 2011 23:00:00 +0100 5192986 http://www.medworm.com/index.php?rid=5192985&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21882911%26dopt%3DAbstract Authors: Proctor MR, Scott RM, Oakes WJ, Muraszko KM PMID: 21882911 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5192985 Wed, 31 Aug 2011 23:00:00 +0100 5192985 http://www.medworm.com/index.php?rid=5103642&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806340%26dopt%3DAbstract Authors: Szpalski C, Weichman K, Sagebin F, Warren SM Craniosynostosis is the premature fusion of one or more cranial sutures. When a cranial suture fuses prematurely, skull growth is altered and the head takes on a characteristic pathological shape determined by the suture(s) that fuses. Numerous treatment options have been proposed, but until recently there were no parameters or guidelines of care. Establishing such parameters was an important step forward in the treatment of patients with craniosynostosis, but results are still assessed using radiographic measurements, complication rates, and ad hoc reporting scales. Therefore, clinical outcome reporting in the treatment of craniosynostosis is inconsistent and lacks methodological rigor. Today, most reported evidence in the treatmen... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103642 Sun, 31 Jul 2011 23:00:00 +0100 5103642 http://www.medworm.com/index.php?rid=5103641&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806341%26dopt%3DAbstract Conclusions These findings raise concerns about intracranial and brain volume reduction in patients with sagittal and combined metopic and sagittal synostoses and the possibility that this volume reduction may be associated with brain dysfunction. Because the ICV reduction is greater in combined metopic and sagittal synostosis in patients older than 4.5 months of age than in sagittal synostosis in this age group, the potential for brain dysfunction may be particularly true for these younger infants. PMID: 21806341 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103641 Sun, 31 Jul 2011 23:00:00 +0100 5103641 http://www.medworm.com/index.php?rid=5103640&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806342%26dopt%3DAbstract Conclusions Patients with sagittal synostosis treated after 1 year of age demonstrate increased rates of ICH, warranting diligent evaluations and surveillance to detect it; rarely develop clinically significant cranial defects if appropriate bone grafting is performed at the time of surgery; and achieve acceptable improvements in head shape. PMID: 21806342 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103640 Sun, 31 Jul 2011 23:00:00 +0100 5103640 http://www.medworm.com/index.php?rid=5103639&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806343%26dopt%3DAbstract Conclusions Our study demonstrates that patients who undergo unicoronal plagiocephaly repair with a hypercorrection surgical technique avoid long-term relapse. Our results suggest that the surgical technique used in the correction of unilateral coronal synostosis is strongly associated with the prevention of postsurgical relapse and that the use of this novel method decreases the need for surgical revision. PMID: 21806343 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103639 Sun, 31 Jul 2011 23:00:00 +0100 5103639 http://www.medworm.com/index.php?rid=5103638&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806344%26dopt%3DAbstract Conclusions The authors' growing database of patients supports the experiences described by others that early treatment of craniosynostosis with an EASC + PHT is a safe and efficacious technique. In addition, cost reduction due to decreased hospital stay and limitation of blood transfusions are demonstrable benefits associated with the use of this technique. PMID: 21806344 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103638 Sun, 31 Jul 2011 23:00:00 +0100 5103638 http://www.medworm.com/index.php?rid=5103637&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806345%26dopt%3DAbstract Authors: Rivero-Garvía M, Márquez-Rivas FJ, García-Iglesias A, Gutiérrez-González R Craniometaphyseal dysplasia (CMD) is a very rare bone disorder characterized by abnormally developed metaphyses in long bones and sclerosis of the craniofacial bones. In this paper, the authors report 2 cases of children diagnosed with CMD and chronic intracranial hypertension with deletion in exon 9 of the human ANK gene (ANKH). After intracranial monitoring, a different treatment was chosen for each patient. One of the patients was treated using CSF shunting because ventriculomegaly in the absence of a Chiari malformation was also observed on cerebral MR imaging. The other patient underwent cranial expansion and decompressive craniotomy of the posterior fossa, because ventriculomegaly was exclude... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103637 Sun, 31 Jul 2011 23:00:00 +0100 5103637 http://www.medworm.com/index.php?rid=5103636&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806346%26dopt%3DAbstract Authors: Chim H, Manjila S, Cohen AR, Gosain AK The interplay of signals between dura mater, suture mesenchyme, and brain is essential in determining the fate of cranial sutures and the pathogenesis of premature suture fusion leading to craniosynostosis. At the forefront of research into suture fusion is the role of fibroblast growth factor and transforming growth factor-β, which have been found to be critical in the cell-signaling cascade involved in aberrant suture fusion. In this review, the authors discuss recent and ongoing research into the role of fibroblast growth factor and transforming growth factor-β in the etiopathogenesis of craniosynostosis. PMID: 21806346 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103636 Sun, 31 Jul 2011 23:00:00 +0100 5103636 http://www.medworm.com/index.php?rid=5103635&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21806347%26dopt%3DAbstract Authors: Persing J, Jane JA, Jane JA PMID: 21806347 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5103635 Sun, 31 Jul 2011 23:00:00 +0100 5103635 http://www.medworm.com/index.php?rid=5008972&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21721866%26dopt%3DAbstract Authors: Zada G The aim of this paper is to provide a comprehensive review of clinical, imaging, and histopathological features, as well as operative and nonoperative management strategies in patients with Rathke cleft cysts (RCCs). A literature review was performed to identify previous articles that reported surgical and nonsurgical management of RCCs. Rathke cleft cysts are often incidental lesions found in the sellar and suprasellar regions and do not require surgical intervention in the majority of cases. In symptomatic RCCs, the typical clinical presentation includes headache, visual loss, and/or endocrine dysfunction. Visual field testing and endocrine laboratory studies may reveal more subtle deficiencies associated with RCCs. When indicated, the transsphenoidal approach typical... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5008972 Thu, 30 Jun 2011 23:00:00 +0100 5008972 http://www.medworm.com/index.php?rid=5008971&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21721867%26dopt%3DAbstract Conclusions It appears that RCCs require repeat surgery in 13% of cases, and attempted GTR does not appear to reduce the overall rate of recurrence. However, more aggressive resections are associated with more complications in this series. PMID: 21721867 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5008971 Thu, 30 Jun 2011 23:00:00 +0100 5008971 http://www.medworm.com/index.php?rid=5008969&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21721868%26dopt%3DAbstract Conclusions The incidence of RCCs is much lower in the pediatric population; however, symptoms, imaging findings, and outcomes are similar, suggesting that pediatric RCCs arise from growth of remnants of the embryonic Rathke pouch earlier in life than adult RCCs but do not differ in any other way. It is important to consider RCCs in the differential diagnosis when pediatric patients present with visual impairment, unexplained headache, or hypopituitarism including growth delay. Although the average RCC size was similar in our pediatric and adult patient groups, the smaller size of the pituitary gland in pediatric patients suggests an increased relative RCC size. PMID: 21721868 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5008969 Thu, 30 Jun 2011 23:00:00 +0100 5008969 http://www.medworm.com/index.php?rid=5008967&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21721869%26dopt%3DAbstract Authors: Sivakumar W, Cole CD, Couldwell WT The authors report a case of Rathke cleft cyst presenting with severe hyponatremia. A 33-year-old man suffered sudden severe headaches, visual changes, dizziness, nausea, vomiting, and a metallic taste in his mouth. Initial laboratory values demonstrated severe hyponatremia. Magnetic resonance imaging revealed a cystic lesion with questionable intracystic hemorrhage, concerning for pituitary apoplexy. Transsphenoidal decompression and drainage of the cyst confirmed the diagnosis of Rathke cleft cyst and resolved the symptoms. Postoperative follow-up studies at 6 months demonstrated normal endocrine function and no evidence of a cyst. PMID: 21721869 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5008967 Thu, 30 Jun 2011 23:00:00 +0100 5008967 http://www.medworm.com/index.php?rid=5008965&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21721870%26dopt%3DAbstract Authors: Oyesiku NM, Post KD PMID: 21721870 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=5008965 Thu, 30 Jun 2011 23:00:00 +0100 5008965 http://www.medworm.com/index.php?rid=4912638&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631210%26dopt%3DAbstract Authors: Manjila S, Masri T, Shams T, Chowdhry SA, Sila C, Selman WR In this paper, the authors' aim is to provide an evidence-based review of primary and secondary ischemic stroke prevention guidelines covering most of the common risk factors and stroke etiologies for the practicing neurosurgeon. The key to stroke prevention is in the identification and treatment of the major risk factors for stroke. These include hypertension, heart disease, diabetes mellitus, dyslipidemia, and tobacco smoking. An updated approach to secondary prevention of stroke in the setting of intracranial and extracranial large vessel atherosclerosis and cardioembolism is provided along with a brief overview of pertinent clinical trials. Novel pharmacological options for prevention of cardioembolic strokes, suc... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912638 Tue, 31 May 2011 23:00:00 +0100 4912638 http://www.medworm.com/index.php?rid=4912637&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631211%26dopt%3DAbstract Conclusions The authors' institution performs endovascular stroke treatment with a safety and efficacy profile comparable to those of other major endovascular stroke therapy studies. Recanalization was associated with an improved clinical outcome. Protocols to maximize efficient triage of patients and better documentation of stroke treatments can assist in further studies. PMID: 21631211 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912637 Tue, 31 May 2011 23:00:00 +0100 4912637 http://www.medworm.com/index.php?rid=4912636&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631212%26dopt%3DAbstract Authors: Albuquerque FC PMID: 21631212 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912636 Tue, 31 May 2011 23:00:00 +0100 4912636 http://www.medworm.com/index.php?rid=4912635&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631213%26dopt%3DAbstract Conclusions Hemodynamic instability occurs frequently after CAS, but it seems to be a benign phenomenon and does not increase the risk of mortality or morbidity in the short term. A VR at rest less than 1.10, baseline autonomic dysfunction, and degree of carotid artery stenosis can be used as measures for predicting HI after CAS. PMID: 21631213 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912635 Tue, 31 May 2011 23:00:00 +0100 4912635 http://www.medworm.com/index.php?rid=4912634&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631214%26dopt%3DAbstract Authors: Ghobrial GM, Nair AK, Dalyai RT, Jabbour P, Tjoumakaris SI, Dumont AS, Rosenwasser RH, Gonzalez LF Multimodal endovascular intervention is becoming more commonplace for the acute intervention of ischemic stroke. Hyperdensity in a portion of the treated territory is a common finding on postthrombolytic noncontrast CT (NCCT), but its significance is poorly understood. The authors conducted a single-institution, retrospective chart review of patients who had intraarterial thrombolysis of the anterior circulation between 2010 and 2011 with evidence of hyperdensity on NCCT following recanalization. Eighteen patients had evidence of postoperative contrast stasis causing hyperdensity on NCCT. One hundred percent of the patients had MR imaging evidence of completed strokes postoperati... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912634 Tue, 31 May 2011 23:00:00 +0100 4912634 http://www.medworm.com/index.php?rid=4912633&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631215%26dopt%3DAbstract Authors: Vellimana AK, Ford AL, Lee JM, Derdeyn CP, Zipfel GJ Symptomatic intracranial arterial disease is associated with a high rate of recurrent ischemic events. The management of this condition is controversial, with some advocating medical therapy as a sole means of treatment and others recommending endovascular therapy in addition to best medical management. In rare cases, surgical intervention is considered. A thorough review of the available literature was performed, and treatment recommendations based on these data are provided. PMID: 21631215 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912633 Tue, 31 May 2011 23:00:00 +0100 4912633 http://www.medworm.com/index.php?rid=4912632&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631216%26dopt%3DAbstract Authors: Ding D, Liu KC Intracranial atherosclerosis presents a therapeutic challenge to medical and surgical physicians alike. Despite maximal medical therapy, the stroke rate from this disease is still high, especially when arterial stenosis is severe and patients are symptomatic. Open surgical therapy has yet to be shown to be a more efficacious treatment than medical therapy alone, largely due to the relatively high rates of perioperative complications. Angioplasty has a similar fate, with the risk of periprocedural complications outweighing the overall benefit of treatment. With the advent of stents for use in intracranial vasculature, new hope has arisen for the treatment of intracranial atherosclerosis. The NEUROLINK system, the drug-eluting stents Taxus and Cypher, the flexible... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912632 Tue, 31 May 2011 23:00:00 +0100 4912632 http://www.medworm.com/index.php?rid=4912631&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631217%26dopt%3DAbstract Conclusions The treatment of ICAD may be difficult in patients with subacute unstable neurological deficits related to symptomatic hypoperfusion, especially in the setting of a hemodynamically isolated hemisphere. Anticoagulation alone may be insufficient in these patients. Although there is no widely accepted guideline for the treatment of ICAD, the authors recommend stent-mediated endovascular recanalization in cases of symptomatic flow-limiting hemodynamic compromise, especially in cases of an isolated hemisphere lacking sufficient communicating artery compensatory perfusion. PMID: 21631217 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912631 Tue, 31 May 2011 23:00:00 +0100 4912631 http://www.medworm.com/index.php?rid=4912630&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631218%26dopt%3DAbstract Authors: Groysman LI, Emanuel BA, Kim-Tenser MA, Sung GY, Mack WJ Induced hypothermia has been used for neuroprotection in cardiac and neurovascular procedures. Experimental and translational studies provide evidence for its utility in the treatment of ischemic cerebrovascular disease. Over the past decade, these principles have been applied to the clinical management of acute stroke. Varying induction methods, time windows, clinical indications, and adjuvant therapies have been studied. In this article the authors review the mechanisms and techniques for achieving therapeutic hypothermia in the setting of acute stroke, and they outline pertinent side effects and complications. The manuscript summarizes and examines the relevant clinical trials to date. Despite a reasonable amount of e... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912630 Tue, 31 May 2011 23:00:00 +0100 4912630 http://www.medworm.com/index.php?rid=4912629&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631219%26dopt%3DAbstract Authors: Arnaout OM, Aoun SG, Batjer HH, Bendok BR Malignant middle cerebral artery stroke carries a very poor prognosis. Significant retrospective data support the hypothesis that decompressive hemicraniectomy decreases mortality rates due to this disease entity. Recently, 3 randomized controlled studies have been published and shed light on these issues and enhance the quality of evidence revolving around this procedure. In this review, the rationale, risks, benefits, and unanswered questions related to hemicraniectomy for acute ischemic stroke are reviewed with an emphasis on how 3 randomized trials have influenced knowledge on this life-saving yet controversial procedure. Further randomized studies are needed to clarify lingering questions regarding age indications and impact on qu... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912629 Tue, 31 May 2011 23:00:00 +0100 4912629 http://www.medworm.com/index.php?rid=4912628&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631220%26dopt%3DAbstract Conclusions Search engine query data analysis allows for the determination of relative stroke prevalence. Further investigation will reveal the reliability of this metric to determine temporal pattern analysis and prevalence in this and other symptomatic diseases. PMID: 21631220 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912628 Tue, 31 May 2011 23:00:00 +0100 4912628 http://www.medworm.com/index.php?rid=4912627&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631221%26dopt%3DAbstract Authors: Young KC, Jain A, Jain M, Replogle RE, Benesch CG, Jahromi BS Carotid atheromatous disease is an important cause of stroke. Carotid endarterectomy (CEA) is a well-established option for reducing the risk of subsequent stroke due to symptomatic stenosis (> 50%). With adequately low perioperative risk (< 3%) and sufficient life expectancy, CEA may be used for asymptomatic stenosis (> 60%). Recently, carotid angioplasty and stent placement (CAS) has emerged as an alternative revascularization technique. Trial design considerations are discussed in relation to trial results to provide an understanding of why some trials were considered positive whereas others were not. This review then addresses both the original randomized studies showing that CEA is superior to best med... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912627 Tue, 31 May 2011 23:00:00 +0100 4912627 http://www.medworm.com/index.php?rid=4912626&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631222%26dopt%3DAbstract Conclusions Moyamoya disease is characterized by the intimal thickening and media attenuation of the proximal vessels of the circle of Willis as well as the development of an aberrant distal vascular network. The primary proteins that are currently implicated in the pathophysiology of MMD include VEGF, bFGF, HGF, TGFβ(1), and G-CSF. Furthermore, the current literature on familial MMD has pointed to a low penetrance autosomal dominant or polygenic mode of transmittance at loci on chromosomes 3, 6, 8, 12, and 17. PMID: 21631222 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912626 Tue, 31 May 2011 23:00:00 +0100 4912626 http://www.medworm.com/index.php?rid=4912625&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631223%26dopt%3DAbstract Conclusions Moyamoya disease affects the cognition and daily function in pediatric patients to a greater extent than in adult patients. Due to the rarity of the disease, there is a distinct lack of high-level evidence regarding cognitive and clinical outcomes. PMID: 21631223 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912625 Tue, 31 May 2011 23:00:00 +0100 4912625 http://www.medworm.com/index.php?rid=4912624&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631224%26dopt%3DAbstract Authors: Dubourg J, Messerer M Nontraumatic intracerebral hemorrhage constitutes a major public health problem worldwide. Intracerebral hemorrhage leads to a high rate of morbidity and mortality. To date, no medical or surgical trials have clearly attested to the benefit of a particular therapy. The aim of this review was to summarize the best evidence for management decision-making in intracerebral hemorrhage. PMID: 21631224 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912624 Tue, 31 May 2011 23:00:00 +0100 4912624 http://www.medworm.com/index.php?rid=4912623&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631225%26dopt%3DAbstract Conclusions The present study shows that eNOS 27VNTR, T786C, and G894T polymorphisms cannot be used as indicators of the formation of intracranial aneurysms in Korean patients. To confirm these findings an additional analyses might need to be performed using a larger sample size. There were no differences in the genotypic distributions and allelic frequencies between similar races among patients with aneurysms, which were the same in previously reported normal populations. PMID: 21631225 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912623 Tue, 31 May 2011 23:00:00 +0100 4912623 http://www.medworm.com/index.php?rid=4912622&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631226%26dopt%3DAbstract Authors: Gross BA, Lin N, Du R, Day AL Literature reports on the natural history of cerebral cavernous malformations (CMs) are numerous, with considerable variability in lesion epidemiology, hemorrhage rates, and risk factors for hemorrhage. In this review, the authors performed a meta-analysis of 11 natural history studies. The overall male-to-female ratio was 1:1, and the mean age at presentation was 30.6 years. Overall, 37% of patients presented with seizures, 36% with hemorrhage, 23% with headaches, 22% with focal neurological deficits, and 10% were asymptomatic. Some patients had more than one symptom. Seizure presentation was most prevalent among supratentorial CMs, while focal neurological deficits were common in patients with infratentorial CMs. By location, CMs were in the cer... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912622 Tue, 31 May 2011 23:00:00 +0100 4912622 http://www.medworm.com/index.php?rid=4912621&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631227%26dopt%3DAbstract Authors: Mack WJ PMID: 21631227 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912621 Tue, 31 May 2011 23:00:00 +0100 4912621 http://www.medworm.com/index.php?rid=4912620&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631228%26dopt%3DAbstract Authors: Kan PT, Snyder KV, Yashar P, Siddiqui AH, Hopkins LN, Levy EI Computed tomography perfusion scanning generates physiological flow parameters of the brain parenchyma, allowing differentiation of ischemic penumbra and core infarct. Perfusion maps, along with the National Institutes of Health Stroke Scale score, are used as the bases for endovascular stroke intervention at the authors' institute, regardless of the time interval from stroke onset. With case examples, the authors illustrate their perfusion-based imaging guidelines in patient selection for endovascular treatment in the setting of acute stroke. PMID: 21631228 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912620 Tue, 31 May 2011 23:00:00 +0100 4912620 http://www.medworm.com/index.php?rid=4912619&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631229%26dopt%3DAbstract Authors: Duffis EJ, Al-Qudah Z, Prestigiacomo CJ, Gandhi C Early treatment of ischemic stroke with thrombolytics is associated with improved outcomes, but few stroke patients receive thrombolytic treatment in part due to the 3-hour time window. Advances in neuroimaging may help to aid in the selection of patients who may still benefit from thrombolytic treatment beyond conventional time-based guidelines. In this article the authors review the available literature in support of using advanced neuroimaging to select patients for treatment beyond the 3-hour time window cutoff and explore potential applications and limitations of perfusion imaging in the treatment of acute ischemic stroke. PMID: 21631229 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912619 Tue, 31 May 2011 23:00:00 +0100 4912619 http://www.medworm.com/index.php?rid=4912618&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631230%26dopt%3DAbstract Authors: Amenta PS, Ali MS, Dumont AS, Gonzalez LF, Tjoumakaris SI, Hasan D, Rosenwasser RH, Jabbour P Intravenous and intraarterial recombinant tissue plasminogen activator remains underutilized in the treatment of acute ischemic stroke, largely due to strict adherence to the concept of the therapeutic time window for administration. Recent efforts to expand the number of patients eligible for thrombolysis have been mirrored by an evolution in endovascular recanalization technology and techniques. As a result, there is a growing need to establish efficient and reliable means by which to select candidates for endovascular intervention beyond the traditional criteria of time from symptom onset. Perfusion imaging techniques, particularly CT perfusion used in combination with CT angiograp... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912618 Tue, 31 May 2011 23:00:00 +0100 4912618 http://www.medworm.com/index.php?rid=4912617&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631231%26dopt%3DAbstract Authors: Ishkanian AA, McCullough-Hicks ME, Appelboom G, Piazza MA, Hwang BY, Bruce SS, Hannan LM, Connolly ES, Lavine SD, Meyers PM Outcome after intraarterial therapy (IAT) for acute ischemic stroke remains variable, suggesting that improved patient selection is needed to better identify patients likely to benefit from treatment. The authors evaluate the predictive accuracies of the Houston IAT (HIAT) and the Totaled Health Risks in Vascular Events (THRIVE) scores in an independent cohort and review the existing literature detailing additional predictive factors to be used in patient selection for IAT. They reviewed their center's endovascular records from January 2004 to July 2010 and identified patients who had acute ischemic stroke and underwent IAT. They calculated individual HIA... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912617 Tue, 31 May 2011 23:00:00 +0100 4912617 http://www.medworm.com/index.php?rid=4912616&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631232%26dopt%3DAbstract Conclusions Standardization at all 3 stages of the CT perfusion study cycle is warranted. At present, caution should be exercised when interpreting CT perfusion results as these values may vary considerably depending on a variety of factors. Future research is needed to define the role of CT perfusion in clinical decision-making for acute stroke patients and to determine the clinically acceptable limits of variability in CT perfusion results. PMID: 21631232 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912616 Tue, 31 May 2011 23:00:00 +0100 4912616 http://www.medworm.com/index.php?rid=4912615&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631233%26dopt%3DAbstract Authors: Albuquerque FC PMID: 21631233 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912615 Tue, 31 May 2011 23:00:00 +0100 4912615 http://www.medworm.com/index.php?rid=4912614&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21631234%26dopt%3DAbstract Authors: Batjer HH, Dacey R, Lawton MT PMID: 21631234 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4912614 Tue, 31 May 2011 23:00:00 +0100 4912614 http://www.medworm.com/index.php?rid=4812203&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529165%26dopt%3DAbstract Conclusions In the majority of patients, the TCR provided complete resection of the tumor without compromising the safety of the procedure. In select cases of tumors with a reasonable size and location (midline and/or extending into the sphenoid sinus) as well as no involvement of inaccessible neurovascular and bony elements via this approach, the ETSA could also be a viable option. PMID: 21529165 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812203 Sat, 30 Apr 2011 23:00:00 +0100 4812203 http://www.medworm.com/index.php?rid=4812202&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529166%26dopt%3DAbstract Conclusions Hemangiopericytomas have been reclassified as mesenchymal nonmeningothelial tumors. They have an inevitable tendency to recur locally and metastasize distally. The mainstay of therapy remains an aggressive attempt to achieve gross-total resection at the initial surgery. Postoperative adjuvant radiotherapy should be offered to all patients, regardless of the degree of resection achieved. Diligent long-term follow-up is paramount as local recurrences and distal metastases can develop sometimes years after the initial treatment. PMID: 21529166 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812202 Sat, 30 Apr 2011 23:00:00 +0100 4812202 http://www.medworm.com/index.php?rid=4812201&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529167%26dopt%3DAbstract Conclusions Although no case of tumor regression was detected on MR imaging, the study results indicated that SST analogs can arrest the progression of unresectable or recurrent benign meningiomas of the skull base in some patients. It remains to be determined whether a controlled prospective clinical trial would be useful. PMID: 21529167 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812201 Sat, 30 Apr 2011 23:00:00 +0100 4812201 http://www.medworm.com/index.php?rid=4812200&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529168%26dopt%3DAbstract Conclusions Involvement of the optic canal in meningiomas is frequent. It occurs in a wide variety of anterior skull base meningiomas and it can be bilateral. It is a prominent factor that affects the preoperative visual status and postoperative recovery. Decompression of the optic canal and removal of the tumor inside is a crucial step in the surgical management of these tumors to optimize visual recovery and prevent tumor recurrence. PMID: 21529168 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812200 Sat, 30 Apr 2011 23:00:00 +0100 4812200 http://www.medworm.com/index.php?rid=4812199&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529169%26dopt%3DAbstract Authors: Gibbons BA, Miele WR, Florman JE, Heilman CB, Horgan MA Pneumosinus dilitans (PSD) is enlargement of the sinuses of the skull base and is frequently seen with meningiomas. Identifying PSD on imaging can assist with operative planning and preparation. Meningiomas associated with PSD are not more commonly high grade, and complete resection is frequently possible. PMID: 21529169 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812199 Sat, 30 Apr 2011 23:00:00 +0100 4812199 http://www.medworm.com/index.php?rid=4812198&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529170%26dopt%3DAbstract Conclusions The authors believe that proper selection of the approach favorably impacts functional outcome in patients undergoing surgery for the treatment of skull base tumors. In the authors' case series of posterior petrous bone meningiomas, Type P and most Type M tumors were safely managed through a regular retrosigmoid approach, whereas Type A tumors were optimally treated via an epidural anterior petrosectomy. PMID: 21529170 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812198 Sat, 30 Apr 2011 23:00:00 +0100 4812198 http://www.medworm.com/index.php?rid=4812197&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529171%26dopt%3DAbstract Conclusions Transnasal endoscopic resection of anterior cranial base meningiomas is feasible in selected cases. Reported resection rates are adequate, although the follow-up in the reported series is too short (mean 21 months) to make definitive conclusions regarding the long-term effectiveness. Cerebrospinal fluid leakage is a common complication, although it appears not to be associated with additional morbidity except for the need for reoperation. Long-term results are necessary before considering TNE resection as a valid alternative, in selected cases, to the more established transcranial techniques. PMID: 21529171 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812197 Sat, 30 Apr 2011 23:00:00 +0100 4812197 http://www.medworm.com/index.php?rid=4812196&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529172%26dopt%3DAbstract Authors: Fahlbusch R, Gerganov VM PMID: 21529172 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812196 Sat, 30 Apr 2011 23:00:00 +0100 4812196 http://www.medworm.com/index.php?rid=4812195&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529173%26dopt%3DAbstract In this report, the authors describe the operative nuances for removal of tuberculum sellae meningiomas with optic canal involvement using a purely endoscopic endonasal extended transsphenoidal (transplanum transtuberculum) approach. They specifically highlight the technique for endonasal bilateral optic nerve decompression and removal of intracanalicular tumor to improve postoperative visual function, as demonstrated in 2 illustrative cases. Special attention is also given to cranial base reconstruction to prevent CSF leakage using the vascularized pedicled nasoseptal flap. PMID: 21529173 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812195 Sat, 30 Apr 2011 23:00:00 +0100 4812195 http://www.medworm.com/index.php?rid=4812194&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529174%26dopt%3DAbstract In this report, we review the surgical technique and describe our operative nuances for removal of olfactory groove meningiomas, including recurrent tumors with extension into the nasal cavity, using a purely endoscopic endonasal transcribriform approach. In addition, we discuss the advantages, limitations, patient selection, and complications of this approach. We specifically highlight our technique for multilayer reconstruction of large anterior skull base dural defects using fascia lata and acellular dermal allograft supplemented by bilateral vascularized pedicled nasoseptal flaps. Three new cases of endoscopically resected olfactory groove meningiomas are also presented. PMID: 21529174 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812194 Sat, 30 Apr 2011 23:00:00 +0100 4812194 http://www.medworm.com/index.php?rid=4812193&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529175%26dopt%3DAbstract Authors: Couldwell WT PMID: 21529175 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812193 Sat, 30 Apr 2011 23:00:00 +0100 4812193 http://www.medworm.com/index.php?rid=4812192&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529176%26dopt%3DAbstract Conclusions Barrow classification is a simple and stepwise system to better understand the surgical anatomy and refine the techniques in performing these complex craniofacial approaches. On the other hand, thorough anatomical knowledge of the midline skull base and variations of the neurovascular structures is crucial to perform successful craniofacial approaches. PMID: 21529176 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812192 Sat, 30 Apr 2011 23:00:00 +0100 4812192 http://www.medworm.com/index.php?rid=4812191&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529177%26dopt%3DAbstract Authors: Choy W, Kim W, Nagasawa D, Stramotas S, Yew A, Gopen Q, Parsa AT, Yang I Meningiomas are mostly benign, slow-growing tumors of the CNS that originate from arachnoidal cap cells. While monosomy 22 is the most frequent genetic abnormality found in meningiomas, a multitude of other aberrant chromosomal alterations, signaling pathways, and growth factors have been implicated in its pathogenesis. Losses on 22q12.2, a region encoding the tumor suppressor gene merlin, represent the most common genetic alterations in early meningioma formation. Malignant meningioma progression, however, is associated with more complex karyotypes and greater genetic instability. Cytogenetic studies of atypical and anaplastic meningiomas revealed gains and losses on chromosomes 9, 10, 14, and 18, with a... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812191 Sat, 30 Apr 2011 23:00:00 +0100 4812191 http://www.medworm.com/index.php?rid=4812190&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529178%26dopt%3DAbstract Authors: Pham MH, Zada G, Mosich GM, Chen TC, Giannotta SL, Wang K, Mack WJ Although a majority of meningiomas are benign neoplasms, those occurring at the cranial base may be challenging tumors to treat because of extensive tissue invasion, an inability to achieve gross-total microscopic resection, and local tumor recurrence and/or progression. A more comprehensive understanding of the genetic abnormalities associated with meningioma tumorigenesis, growth, and invasion may provide novel targets for grading assessments and individualizing molecular therapies for skull base meningiomas. The authors performed a review of the current literature to identify genes that have been associated with the formation and/or progression of meningiomas. Mutations in the NF2 gene have been most commonl... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812190 Sat, 30 Apr 2011 23:00:00 +0100 4812190 http://www.medworm.com/index.php?rid=4812189&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529179%26dopt%3DAbstract Conclusions Fluorescence-guided resection may be a useful adjunct in the resection of skull base meningiomas. The use of a quantitative intraoperative probe to detect PpIX concentration allows more accurate determination of neoplastic tissue in meningiomas than visible fluorescence and is readily applicable in areas, such as the skull base, where complete resection is critical but difficult because of the vital structures surrounding the pathology. PMID: 21529179 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812189 Sat, 30 Apr 2011 23:00:00 +0100 4812189 http://www.medworm.com/index.php?rid=4812188&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529180%26dopt%3DAbstract Conclusions In this study, the incidence of communicating postoperative hydrocephalus was almost twice as high in patients with skull base lesions as in patients with meningiomas in other locations. Patient age, duration of surgery, duration of hospital stay, tumor volume, postoperative infection, and preoperative embolization were associated with the occurrence of hydrocephalus. In the statistical prediction model, patient age and duration of surgery were the most significant predictors of postoperative hydrocephalus after skull base meningioma surgery. PMID: 21529180 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812188 Sat, 30 Apr 2011 23:00:00 +0100 4812188 http://www.medworm.com/index.php?rid=4812187&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21529181%26dopt%3DAbstract Authors: Couldwell WT, Heros R, Dolenc V PMID: 21529181 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4812187 Sat, 30 Apr 2011 23:00:00 +0100 4812187 http://www.medworm.com/index.php?rid=4758573&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456920%26dopt%3DAbstract Conclusions Patients who undergo ETV for infective hydrocephalus and Dandy-Walker malformation should receive long-term follow-up, because late closure of the stoma may occur progressively and slowly. Intraoperative observation of thickened arachnoid membranes at the level of the interpeduncular cisterns at the first ETV and a progressive decreasing of CSF flow through the stoma on routine cine MR imaging should be considered unfavorable elements entailing a significant risk of deterioration. PMID: 21456920 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758573 Thu, 31 Mar 2011 23:00:00 +0100 4758573 http://www.medworm.com/index.php?rid=4758572&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456921%26dopt%3DAbstract Conclusions This paper reports benchmarks for endocrinological cure as well as complications in a large series of purely endoscopic pituitary surgeries by using the most recent consensus criteria. The advantages of extended endonasal approaches are most profound in tumors with suprasellar extension and CS invasion. PMID: 21456921 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758572 Thu, 31 Mar 2011 23:00:00 +0100 4758572 http://www.medworm.com/index.php?rid=4758571&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456922%26dopt%3DAbstract Conclusions In this large series of patients with NFPAs, endoscopy improved the quality of resection and endocrinological outcome. Larger studies focusing on the impact of these promising results on the long-term recurrence of NFPAs are warranted. PMID: 21456922 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758571 Thu, 31 Mar 2011 23:00:00 +0100 4758571 http://www.medworm.com/index.php?rid=4758570&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456923%26dopt%3DAbstract Conclusions Endoscopic transsphenoidal surgery is a well-tolerated minimally invasive procedure for pituitary fossa lesions. Overall patient-assessed nasal symptoms do not change, but some individual symptoms may show a mild worsening or overall improvement. PMID: 21456923 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758570 Thu, 31 Mar 2011 23:00:00 +0100 4758570 http://www.medworm.com/index.php?rid=4758569&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456924%26dopt%3DAbstract Conclusions The side-cutting tissue resector is a safe, easy to use, and effective tool for internal debulking and extracapsular dissection of nonvascularized tumors that are too firm for bimanual suction or blunt ring curette dissection. It is particularly useful when working through a deep and narrow corridor such as is encountered in endoscopic endonasal skull base surgery. PMID: 21456924 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758569 Thu, 31 Mar 2011 23:00:00 +0100 4758569 http://www.medworm.com/index.php?rid=4758568&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456925%26dopt%3DAbstract In this report the authors review the endoscopic endonasal extended transsphenoidal approach, with specific emphasis on technical operative nuances in removing retrochiasmatic craniopharyngiomas. An illustrative intraoperative video demonstrating the technique is also presented. PMID: 21456925 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758568 Thu, 31 Mar 2011 23:00:00 +0100 4758568 http://www.medworm.com/index.php?rid=4758567&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456926%26dopt%3DAbstract Conclusions The authors conclude that thoracoscopic discectomy and plate-instrumented fusion can be achieved with acceptable results and morbidity. Further studies should evaluate the role of instrumented fusions after thoracoscopic discectomy in larger groups of patients and during a longer follow-up period. PMID: 21456926 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758567 Thu, 31 Mar 2011 23:00:00 +0100 4758567 http://www.medworm.com/index.php?rid=4758566&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456927%26dopt%3DAbstract Authors: Hsieh PC PMID: 21456927 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758566 Thu, 31 Mar 2011 23:00:00 +0100 4758566 http://www.medworm.com/index.php?rid=4758565&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456928%26dopt%3DAbstract Conclusions Neuroendoscopic training has some specific requirements. A unique set of instruments is required, as is a model that can resemble real-life situations. The S.I.M.O.N.T. is a new alternative model specially designed for this purpose. Validation techniques followed by precision assessments attested to the model's feasibility. PMID: 21456928 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758565 Thu, 31 Mar 2011 23:00:00 +0100 4758565 http://www.medworm.com/index.php?rid=4758564&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456929%26dopt%3DAbstract Conclusions This is one of the largest series confirming the safety and validity of the neuroendoscopic biopsy procedure. Complications were relatively low (about 13%), and they were all reversible. Neuroendoscopic biopsy provided meaningful pathological data in 90% of patients, making subsequent tumor therapy feasible. Cerebrospinal fluid pathways can be restored by ETV or septum pellucidotomy (65%) to control intracranial hypertension. In light of the results obtained, a neuroendoscopic biopsy should be considered a possible alternative to the stereotactic biopsy in the diagnosis and treatment of ventricular or paraventricular tumors. Furthermore, it could be the only surgical procedure necessary for the treatment of selected tumors. PMID: 21456929 [PubMed - in process] (Source: Neur... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758564 Thu, 31 Mar 2011 23:00:00 +0100 4758564 http://www.medworm.com/index.php?rid=4758563&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456930%26dopt%3DAbstract Conclusions These data confirm the safety and diagnostic efficacy of simultaneous ETV and biopsy for tumors of the pineal region. Although no statistically significant differences were seen in the authors' recorded measurements, several trends suggest a role for a tailored approach to selecting a single or dual trajectory approach when using a rigid endoscope. PMID: 21456930 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758563 Thu, 31 Mar 2011 23:00:00 +0100 4758563 http://www.medworm.com/index.php?rid=4758562&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456931%26dopt%3DAbstract Conclusions Endoscopic biopsy sampling and a concurrent CSF diversion procedure through a single bur hole and trajectory can be considered for intraventricular tumors. The overall success rates of 83% for the biopsy procedure and 86% for the ETV indicate that the procedures are beneficial in the majority of cases. A concordance rate of 75% was found in patients who underwent an initial biopsy procedure and a subsequent microsurgical approach for tumor excision. PMID: 21456931 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758562 Thu, 31 Mar 2011 23:00:00 +0100 4758562 http://www.medworm.com/index.php?rid=4758561&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456932%26dopt%3DAbstract Authors: Kalhorn SP, Strom RG, Harter DH Hydrocephalus caused by stenosis of the foramen of Monro is rare. The authors describe a 28-year-old female patient with bilateral foraminal stenosis treated using endoscopic septostomy and unilateral foraminal balloon plasty (foraminoplasty). The patient's hydrocephalus and symptoms resolved postoperatively. Endoscopic strategies may be employed as first-line therapy in this condition. PMID: 21456932 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758561 Thu, 31 Mar 2011 23:00:00 +0100 4758561 http://www.medworm.com/index.php?rid=4758560&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456933%26dopt%3DAbstract Authors: Dlouhy BJ, Dahdaleh NS, Greenlee JD Improvement in fiber optics and imaging paved the way for tremendous advancements in neuroendoscopy. These advancements have led to increasingly widespread use of the endoscope in neurosurgical procedures, which in turn incited a technological revolution leading to new approaches, instruments, techniques, and a diverse armamentarium for the treatment of a variety of neurosurgical disorders. Soft-tissue removal is often a rate-limiting aspect to endoscopic procedures, especially when the soft tissue is dense or fibrous. The authors review a series of cases involving patients treated between August 2009 and October 2010 with a new device (the NICO Myriad), a non-heat-generating, oscillating, cutting, and tissue removal instrument that can be u... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758560 Thu, 31 Mar 2011 23:00:00 +0100 4758560 http://www.medworm.com/index.php?rid=4758559&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456934%26dopt%3DAbstract Conclusions Arachnoscopy is a helpful adjunct to microsurgery and can be performed safely and easily. It allows the surgeon to detect further adhesions in the subarachnoid space that would remain undetected by microscopy alone. PMID: 21456934 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758559 Thu, 31 Mar 2011 23:00:00 +0100 4758559 http://www.medworm.com/index.php?rid=4758558&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456935%26dopt%3DAbstract Authors: Schirmer CM, Heilman CB Neuroendoscopic treatment of colloid cysts is limited by the reach and flexibility of the instruments that can be passed through the working channels of the rigid neuroendoscope. The authors describe a case of a third ventricular colloid cyst where a large solid colloid fragment was recovered using a nitinol stone retrieval basket as a flexible wall-guided atraumatic salvage instrument. A flexible nitinol stone retrieval basket was successfully used through an endoscopic working channel to retrieve a large portion of the colloid cyst from the occipital horn of the lateral ventricle in a 70-year-old man who presented with progressive memory loss, urinary incontinence, and slowness of gait. A flexible nitinol stone retrieval basket can be safely and effec... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758558 Thu, 31 Mar 2011 23:00:00 +0100 4758558 http://www.medworm.com/index.php?rid=4758557&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456936%26dopt%3DAbstract Conclusions The data suggest that early endoscope-assisted ICH evacuation is safe and effective in the management of supratentorial ICH. The rebleeding, morbidity, and mortality rates are low compared with rates reported in the literature for the traditional craniotomy method. This study also showed that early and complete evacuation of ICH may lead to improved outcomes in selected patients. However, the safety and efficacy of endoscope-assisted ICH evacuation should be further investigated in a large, prospective, randomized trial. PMID: 21456936 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758557 Thu, 31 Mar 2011 23:00:00 +0100 4758557 http://www.medworm.com/index.php?rid=4758556&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456937%26dopt%3DAbstract Authors: Gross D, Schäfer G PMID: 21456937 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758556 Thu, 31 Mar 2011 23:00:00 +0100 4758556 http://www.medworm.com/index.php?rid=4758555&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21456938%26dopt%3DAbstract Authors: Cappabianca P, Jane JA, Souweidane M PMID: 21456938 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4758555 Thu, 31 Mar 2011 23:00:00 +0100 4758555 http://www.medworm.com/index.php?rid=4645773&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434816%26dopt%3DAbstract Authors: PMID: 21434816 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645773 Tue, 01 Mar 2011 00:00:00 +0100 4645773 http://www.medworm.com/index.php?rid=4645768&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434817%26dopt%3DAbstract Authors: Saetia K, Cho D, Lee S, Kim DH, Kim SD Ossification of the posterior longitudinal ligament (OPLL) is most commonly found in men, the elderly, and Asian patients. There are many diseases associated with OPLL, such as diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, and other spondyloarthropathies. Several factors have been reported to be associated with OPLL formation and progression, including genetic, hormonal, environmental, and lifestyle factors. However, the pathogenesis of OPLL is still unclear. Most symptomatic patients with OPLL present with neurological deficits such as myelopathy, radiculopathy, and/or bowel and bladder symptoms. There are some reports of asymptomatic OPLL. Both static and dynamic factors are related to the development of myelopathy. ... Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645768 Tue, 01 Mar 2011 00:00:00 +0100 4645768 http://www.medworm.com/index.php?rid=4645758&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434818%26dopt%3DAbstract Conclusions Patients who present without myelopathy have a high chance of remaining progression free. Those who already have signs of myelopathy at presentation may benefit from surgery due to a higher rate of progression over continued follow-up. PMID: 21434818 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645758 Tue, 01 Mar 2011 00:00:00 +0100 4645758 http://www.medworm.com/index.php?rid=4645757&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434819%26dopt%3DAbstract Conclusions Anterior cervical decompression and reconstruction is a safe and appropriate treatment for cervical spondylitic myelopathy in the setting of OPLL. For patients with maintained cervical lordosis, posterior cervical decompression and stabilization is advocated. The use of laminectomy or laminoplasty is indicated in patients with preserved cervical lordosis and less than 60% of the spinal canal occupied by calcified ligament in a "hill-shaped" contour. PMID: 21434819 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645757 Tue, 01 Mar 2011 00:00:00 +0100 4645757 http://www.medworm.com/index.php?rid=4645756&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434820%26dopt%3DAbstract Conclusions Ossification of the posterior longitudinal ligament in non-Asians demonstrates similar demographic and radiographic characteristics as in East Asians. The representation of different ethnic groups mirrors the demographics of the medical center population in general, showing no specific predilection for particular ethnic groups. Surgical decompression in appropriately selected patients results in similar rates of improvement when compared with the Japanese literature. PMID: 21434820 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645756 Tue, 01 Mar 2011 00:00:00 +0100 4645756 http://www.medworm.com/index.php?rid=4645755&cid=s_36716_153_f&fid=36716&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21434821%26dopt%3DAbstract Conclusions In a large cohort of the Chinese population, the incidence of cervical OPLL-related admission is 6.1 per 1 million person-years, and the prevalence rate is 7.7 per 100,000 person-years. Higher incidences are observed in elderly and male patients, which implies the disease's degenerative nature. After adjustments for demographics, the incidences and trends of OPLL-related comorbid disability are associated with age and surgical approaches. PMID: 21434821 [PubMed - in process] (Source: Neurosurgical Focus) Neurosurgical Focus journals http://www.medworm.com/rss/comments.php?id=4645755 Tue, 01 Mar 2011 00:00:00 +0100 4645755