World Neurosurg
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Venous thromboembolism is a well-known complication of Cushing syndrome. Deep vein thrombosis and pulmonary embolic events have been widely reported in patients with Cushing syndrome, but cerebral venous sinus thrombosis remains a much less common finding in these patients. ⋯ Previous studies have suggested that the coagulation profile of patients with Cushing syndrome normalizes when measured 12 months after correction of hypercortisolism, but these patients may remain hypercoagulable for an undefined period postoperatively, despite becoming adrenally insufficient. Although there have been scarce reports of cerebral venous sinus thrombosis in non-adrenocorticotrophic hormone-dependent Cushing syndrome, we report the first case of cerebral venous sinus thrombosis postoperatively in a patient with Cushing disease in remission.
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When medical devices and equipment in an operating room are connected to a network, vast amounts of data concerning the progress of the operation and the patient's condition can be comprehensively processed to improve the precision and safety of the surgical procedure. To make this possible, a next-generation networked operating room, "Smart Cyber Operating Theater" (SCOT), has been developed with medical-engineer cooperation. SCOT integrates stand-alone medical devices using the "OPeLiNK" communication interface. Using OPeLiNK, medical devices are connected and various data, such as intraoperative magnetic resonance imaging, neuromonitoring, biochemical monitoring, and navigation system, are integrated and displayed in the same timeline. ⋯ This is the first case report of endoscopic endonasal approach performed successfully in the SCOT. Further developments in this technology may lead to innovations in not only microscopic neurosurgery but also endoscopic neurosurgery.
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The development of infections such as urinary tract infections (UTIs) or pneumonia after a traumatic subdural hematoma (tSDH) can worsen patient outcomes and increase healthcare costs. We herein identify clinical parameters that influence the risk of infections after tSDH. ⋯ Patients with prolonged hospitalizations and/or intensive care unit stays were more likely to experience UTIs and pneumonia. Male gender and younger age were protective against UTI, and higher GCS was protective against pneumonia. These data may aid the identification and treatment of at-risk populations after admission for a tSDH.
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Case Reports
Delayed ureter stricture and kidney atrophy after oblique lumbar interbody fusion: a case report.
Oblique lumbar interbody fusion (OLIF) is a surgical technique for lumbar interbody fusion that allows surgeons to use a large cage while preserving the spine muscles. The surgical corridor of OLIF is close to the ureter in the retroperitoneal space and therefore entails a potential for injury to this organ. Although there are some published cases of ureteral injury that were identified during OLIF, to our knowledge, there have been no reports about delayed ureteral strictures and kidney atrophy after OLIF. We report a case of ureter stricture and ipsilateral kidney atrophy that was incidentally identified a few months postoperatively without signs of ureter injury during the operation. ⋯ Ureter injury may be observed with several months' delay after OLIF in patients without symptoms or laboratory abnormalities, even if no direct injury was noted during the procedure.