Journal of neurosurgery
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Journal of neurosurgery · Mar 2020
Infection risk in endovascular neurointerventions: a comparative analysis of 549 cases with and without prophylactic antibiotic use.
A systematic analysis on the utility of prophylactic antibiotics for neuroendovascular procedures has not been performed. At the authors' institution there is a unique setup to address this question, with some attending physicians using prophylactic antibiotics (cefazolin or vancomycin) for all of their neurointerventions while others generally do not. ⋯ The risk of infection associated with endovascular neurointerventions with or without prophylactic antibiotic use was very low in this cohort. The data suggest that the routine use of antibiotic prophylaxis seems unnecessary and that to prevent antibiotic resistance and reduce costs antibiotic prophylaxis should be reserved for selected patients deemed to be at increased infection risk.
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Journal of neurosurgery · Mar 2020
Orbital reconstruction for tumor-associated proptosis: quantitative analysis of postoperative orbital volume and final eye position.
Surgical resection of sphenoid wing tumors and intraorbital pathology carries the dual goal of appropriately treating the target pathology as well as correcting proptosis. Residual proptosis following surgery can lead to cosmetic and functional disability. The authors sought to quantitatively assess the effect of orbital volume before and after reconstruction to determine the optimal strategy to achieve proptosis correction. ⋯ Proptosis associated with intracranial and orbital pathology represents a surgical challenge. The EI is a reliable and quantitative assessment of proptosis. For orbital reconstruction in cases of superior orbital fissure involvement, surgeons should consider rebuilding the orbit at slightly larger than anatomical volume.
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Journal of neurosurgery · Mar 2020
Accuracy of frameless image-guided implantation of depth electrodes for intracranial epilepsy monitoring.
Various techniques are available for stereotactic implantation of depth electrodes for intracranial epilepsy monitoring. The goal of this study was to evaluate the accuracy and effectiveness of frameless MRI-guided depth electrode implantation. ⋯ Despite modest accuracy, frameless depth electrode implantation was sufficient for seizure localization in the medial temporal lobe when using the orthogonal approach, but may not be adequate for occipital trajectories.