Turk Neurosurg
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Some restriction and complications, such as progression of kyphosis, incidence of axial neck pain and decrease of postoperative cervical range of motion are concern. We designed this retrospective clinical study to evaluate the effect of laminoplasty by preserving the muscle attachments of C2 and C7 spinous processes on range of motion (ROM), axial neck pain and cervical lordosis. ⋯ Protection of the anatomic structures around the cervical spine such as the muscles and ligaments provides us better results regarding ROM and cervical axial pain.
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Shunt-dependent hydrocephalus (SDH) is a relatively common complication following aneurysmal subarachnoid hemorrhage (aSAH). Delay in diagnosis and treatment may worsen neurological outcome. This study was conducted to identify early clinical factors associated with SDH following aSAH. ⋯ Overall, 33 patients (36.2%) developed SDH following aSAH after definitive treatment. Univariate analysis revealed age, emergency department (ED) white blood cell (WBC) count, hypernatremia, Hunt & Hess Grade, modified Fisher"s Grade, presentation of acute hydrocephalus, initial placement of external ventriculostomy, and post-operative central nervous system infection were clinically significant factors. Multivariate logistic regression showed ED WBC count > 14,500/?L (OR 5.096, 95% CI 1.332 to 19.499, p=0.017), poor Hunt&Hess Grade (III, IV & V) (OR 3.562, 95% CI 1.081 to 11.737, p=0.037), and initial placement of external ventriculostomy (OR 4.294, 95% CI 1.125 to 16.393, p=0.033) were independent factors. < p < CONCLUSION: Three early independent predictors of SDH were identified including poor Hunt&Hess Grade, initial placement of external ventriculostomy and ED leukocytosis. Early placement of a ventricular-peritoneal shunt after aSAH may shorten length of stay in hospital and in intensive care unit.
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To evaluate iatrogenic vascular injuries in the craniocervical region and their endovascular management. ⋯ Although iatrogenic vascular injuries are rare, early diagnosis and management may be lifesaving. Endovascular techniques are reliable and safe in most of the patients.
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Observational Study
Motor Evoked Potentials and Bispectral Index-Guided Anaesthesia in Image-Guided Mini-Invasive Neurosurgery of Supratentorial Tumors Nearby the Cortico-Spinal Tract.
To describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. ⋯ BIS-guided general anaesthesia within a 40-60 interval, with low Ce of Propofol (≤2 μ/ml) and high analgesic regime allow reliable tMEP measurements, avoiding postoperative neurological impairment and major adverse outcomes, such as seizure and awareness.
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To investigate the costs of treating the infection with antibiotics only with the risk of surgery when unsuccessful versus immediate removal followed by re-implantation in patients with deep brain stimulation (DBS) hardware infection. ⋯ Treatment with antibiotics with the risk of a later removal when unsuccessful was a more valuable strategy in terms of costs when compared to immediate surgical intervention in cases of hardware-related infections in DBS surgeries.