Clinical neurology and neurosurgery
-
Clin Neurol Neurosurg · Feb 2016
The diagnostic performance of ultrasonographic optic nerve sheath diameter and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure.
To assess the diagnostic accuracy of ultrasonographic optic nerve sheath diameter (ONSD) measurement and color Doppler indices of the ophthalmic arteries in detecting elevated intracranial pressure (ICP). ⋯ While the ultrasonographic mean binocular ONSD (>4.53 mm) was completely accurate in detecting elevated ICP, color Doppler indices of the ophthalmic arteries were of limited value.
-
Clin Neurol Neurosurg · Feb 2016
Observational StudyDevelopment, validation and psychometric properties of a diagnostic/prognostic tool for breakthrough pain in mixed chronic-pain patients.
Breakthrough pain (BTP) shows variable prevalence in different clinical contexts of cancer and non-cancer patients. BTP diagnostic tools with demonstrated reliability, validation and prognostic capability are lacking. We report the development, psychometric and validation properties of a diagnostic/prognostic tool, the IQ-BTP, for BTP recognition, its likelihood and clinical features among chronic-pain (CP) patients. ⋯ The IQ-BTP showed satisfactory psychometric and validation properties. With adequate feasibility it enabled the allocating of cancer/non-cancer CP patients in three prognostic classes. Results are sufficient to warrant a subsequent impact study of the IQ-BTP as prognostic model and screening tool for BTP in both CP populations.
-
Clin Neurol Neurosurg · Jan 2016
Surgical complications following malignant brain tumor surgery: An analysis of 2002-2011 data.
To estimate the incidence of surgical complications and associated in-hospital morbidity and mortality following surgery for malignant brain tumors. ⋯ In this study of an administrative database, patients undergoing surgery for a malignant brain tumor who suffered from a surgical complication had significantly longer lengths of stay, total hospital charges, and complication rates. Having a surgical complication was also an independent risk factor for in-hospital mortality. Nonetheless, it is unclear whether all surgical complications were clinically relevant, and further research is encouraged.
-
Clin Neurol Neurosurg · Jan 2016
Review Meta Analysis Comparative StudyLaparotomy vs minimally invasive laparoscopic ventriculoperitoneal shunt placement for hydrocephalus: A systematic review and meta-analysis.
Ventriculoperitoneal shunt (VPS) surgery is the most commonly used method for the treatment of hydrocephalus. Traditionally, distal catheters in the VPS surgery have been placed either through a standard small open laparotomy or via a laparoscopic technique. Although there are many studies demonstrating the benefits of a minimally invasive approach, limited research has directly compared the two techniques used in VPS surgery. ⋯ There was no difference between the laparotomic and laparoscopic approaches in the length of hospital stay, complication rate, proximal shunt failure or infection rate. The present systematic review and meta-analysis demonstrated that the laparoscopic technique in VPS surgery is associated with reduced shunt failure and abdominal malposition compared to the open laparotomy technique, with no significant difference in rates of infection or other complications. The lack of studies with high levels of evidence may contribute to bias in our conclusions and the long-term relative merits require validation by further prospective, randomized studies.
-
Clin Neurol Neurosurg · Jan 2016
En bloc spondylectomy combined with chest wall excision for spinal tumor via a modified posterior approach: a retrospective study on 21 patients.
This study was to investigate the feasibility and efficacy of total en bloc spondylectomy (TES) combined with chest wall excision through a modified posterior approach in treating the patients with thoracic spinal tumor and posterior chest wall invasion. ⋯ The results suggest that the combined TES with chest wall excision via a modified posterior approach seems feasible and effective for treating patients with thoracic spinal tumor and posterior chest wall invasion.