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To Investigate the Effect of Catheter Drainage and Urokinase Dissolution for Severe Ventricular System Hemorrhage
Zhang Yanping,
Zhang Pan,
Zhang Wei,
Wu Tiejun,
Zhu Guanglin,
Duan Qifeng
Issue:
Volume 5, Issue 2, December 2021
Pages:
57-61
Received:
15 June 2021
Accepted:
2 July 2021
Published:
15 July 2021
Abstract: Objective: To investigate the decrease of mortality and disability rate of severe ventricular system hemorrhage by catheter drainage and UK dissolution. Methods: From January 2015 to January 2020, 78 cases of primary severe ventricular hemorrhage and 47 cases of thalamic hematoma had broken into the ventricular system by admitted, all of which were caused by hypertension arteriosclerosis. A respectively adopt the double eminence F10 silicone tube line hemorrhage or hemorrhage drainage, drain and intraoperative all press automatic drainage device, and at the same time CT directional line thalamic hematoma drainage, pipe emptying and postoperative introcerebral hematoma and interior cavity at different times each injection urokinase solute 30000-50000 units, and lumbar puncture or with lumbar cistem catheter drainage, large cavity of thalamic hematoma and the original secondary intraventricular hemorrhage drainage time respectively for 3-4 d and 4-5 d, an average of 4.5 d extubation time. Results: After 6 months of follow-up, GOS and ADL grading were used to evaluate the recovery and self-care ability. GOS grading was 5points in 72 cases, 4 points in 41 cases, 3 points in 12 cases. ADL grading was Grade I in 69 cases, Grade II in 40 cases, Grade III in 5 cases, Grade IV in 6 cases, and Grade V in 5 cases (including 3 deaths). Among the 3 cases who died after operation, either 2 case suffered from primary whole ventricular hemorrhage combined with cerebral hernia, 1 case suffered from secondary hemorrhage combined with respiratory and circulatory failure caused by dilated hemocast of four ventricles. Sometime whith association communicating hydrocephalus in 3 cases that is underwent brain-peritoneal cerebrospinal fluid shunt. Conclusion: Empty and drainage of ventricular system hemorrhage and paraventricular thalamic hematoma which is can significantly reduce the morbidity and mortality.
Abstract: Objective: To investigate the decrease of mortality and disability rate of severe ventricular system hemorrhage by catheter drainage and UK dissolution. Methods: From January 2015 to January 2020, 78 cases of primary severe ventricular hemorrhage and 47 cases of thalamic hematoma had broken into the ventricular system by admitted, all of which were...
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Complications of Hydrocephalus Surgery in Children: Study of 18 Cases at the University Hospital Center of Conakry
Ibrahima Sory Souare,
Aminata Fofana,
Hugues Ghislain Atakla,
Ibrahima Sory Junior Souare,
Daniel Boubane Tama
Issue:
Volume 5, Issue 2, December 2021
Pages:
62-65
Received:
15 June 2021
Accepted:
26 June 2021
Published:
21 July 2021
Abstract: Context and Objective: Hydrocephalus is the active abnormal dilation of the cerebral ventricular cavities and leads to a disorder of cerebrospinal fluid dynamics. Ventriculoperitoneal shunt and ventriculocisternostomy shunt are the most frequently used techniques in our context. However, a number of complications can occur. Our goal is to contribute to the improvement of the prevention of complications in the surgical management of hydrocephalus. Patients and Method: This is an observational study, over a period of five years and six months, of children aged 0-15 years who have undergone hydrocephalus surgery. All these data and their correlations were analyzed on Excel and EPI Info tables in version 7.2.3.1. The study was previously submitted to the ethics committee for approval. Anonymity and compliance with ethical rules were the norm. Results: We collected 18 cases of complications, i.e. 11.92%. Infants were the most affected with 16.70%. Most of the patients had a risk factor of neighborhood skin lesions. These were mainly infectious complications 50% and mechanical complications 33.30%. For the management of complications, equipment removal and revision/replacement were the procedures most frequently adopted, with frequencies of 50% and 22.20%. 66.70% were improved. Conclusion: The management of hydrocephalus is essentially neurosurgical and involves ventriculoperitoneal shunt and ventriculocisternostomy shunt, which, despite their effectiveness, are sometimes accompanied by various complications, including infectious ones, which were found to be at the forefront of this study. Even if the evolution has been favorable for 2/3 of the children studied, we believe that the constant search for risk factors for complications and the education of the parents of the children will limit the occurrence of the complications found.
Abstract: Context and Objective: Hydrocephalus is the active abnormal dilation of the cerebral ventricular cavities and leads to a disorder of cerebrospinal fluid dynamics. Ventriculoperitoneal shunt and ventriculocisternostomy shunt are the most frequently used techniques in our context. However, a number of complications can occur. Our goal is to contribut...
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Cerebrospinal Fluid Leakage (Liquorrhea) Management in Heads Traumas
Zabsonre Denlewende Sylvain,
Yameogo Pacome,
Ouiminga Habib Abdoul Karim,
Sanou Abdoulaye,
Zida Ilyasse,
Thiombiano Abdoulaye,
Lankoande Henri,
Kinda Boureima,
Kabre Abel
Issue:
Volume 5, Issue 2, December 2021
Pages:
66-69
Received:
12 July 2021
Accepted:
30 July 2021
Published:
9 August 2021
Abstract: Introduction. Liquorrhea is a leakage of cerebrospinal fluid (CSF) into an air cavity of the skull base through an osteomeningeal breach which can exit through nos and / or ear. Highlighting the breach and closing it is sometimes very difficult. The aim of this work was to study cerebrospinal fluid liquorrhea management in our work environment. Method. This was a retrospective study over 05 years (2010-2014). We included any cases of liquorrhea managed in the neurosurgery department of Yalgado Ouédraaogo teaching hospital in Ouagadougou. Results. Thirty-five cases were included, they were 34 male and 1 female. The average age was 31.6 years. Liquorrhea was the reason for admission in 11 cases. Physical examination found rhinorrhea in 24 cases, otorrhea in 9 cases and oto-rhinorrhea in 2 cases. A fracture line was objectified one CT scan in all patients. This fracture line could explain the liquorrhea in 24 cases. Conservative treatment was performed in 33 cases. Two patients were opered. Outcome was favorable in 33 patients. One patient died of meningitis. Conclusion. Highlighting of the breach was difficult in our work context where CT-scan can provide good orientations. Treatment was essentially conservative; prognosis very often favorable except in the event of a complication such as meningitis.
Abstract: Introduction. Liquorrhea is a leakage of cerebrospinal fluid (CSF) into an air cavity of the skull base through an osteomeningeal breach which can exit through nos and / or ear. Highlighting the breach and closing it is sometimes very difficult. The aim of this work was to study cerebrospinal fluid liquorrhea management in our work environment. Met...
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Lumbar Canal Stenosis: Pre and Post Decompression laminectomy Outcomes in a Single Neurosurgery Private Practice
Satheesh Kumar Cheella Reddy
Issue:
Volume 5, Issue 2, December 2021
Pages:
70-74
Received:
30 August 2021
Accepted:
26 September 2021
Published:
5 October 2021
Abstract: Lumbar canal stenosis (LCS) or Lumbar Spinal Stenosis (LSS) is the most common degenerative condition affecting older adults. The clinical presentation of LCS includes lower back pain, radiating pain, tingling sensation, and numbness in the lower limbs, as well as nocturnal leg cramps, and bladder dysfunction due to neurological compression. Laminectomy is one of the most common procedures performed for the treatment of LCS. This study aimed to examine the pre-surgical presentations and post-surgical outcomes based on the available clinical records from a single neurosurgeon private practice based in Melbourne, Victoria, Australia. The clinical records of 166 patients were extracted and reviewed for clinical presentation notes, surgical notes, post-surgery follow-up letters between 2010 and 2019. Records without follow-up notes were excluded. The presurgical presentation symptoms included lower back pain, weakness, neurogenic claudication, pins and needles, and sensory and motor deficits. Post-surgical outcomes were evaluated based on the 1-month, 3-month, and 1-year follow up based on the notes and letters. Many patients mentioned significant improvement in symptoms immediately after the decompressive laminectomy. Descriptive analysis was performed; the results have been presented as percentages and charts. Post- laminectomy results reported that 87% improvement in back pain and 85% people reported improvements in neurogenic claudication. This study suggested that decompressive laminectomy was effective in the management of LCS. However, further studies are required due to the limitations, such as small population size, data availability, multiple re-presentations, and lack of proper follow-up.
Abstract: Lumbar canal stenosis (LCS) or Lumbar Spinal Stenosis (LSS) is the most common degenerative condition affecting older adults. The clinical presentation of LCS includes lower back pain, radiating pain, tingling sensation, and numbness in the lower limbs, as well as nocturnal leg cramps, and bladder dysfunction due to neurological compression. Lamine...
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Top 100 Most Cited Articles on Brain Tumors
George Thomas,
Ajay Chatim,
Eric Chalif,
Susan Koenig,
Neil Almeida,
Pritha Ghosh
Issue:
Volume 5, Issue 2, December 2021
Pages:
75-83
Received:
3 September 2021
Accepted:
22 September 2021
Published:
5 November 2021
Abstract: Background: A large number of published articles exist regarding intracranial tumors. This article aims to present the 100 most-cited articles on brain tumors and to perform a bibliometric analysis. Methods: In May 2021, the authors performed a title- focused search using Clarivate’s Web of Science database in order to identify the most cited articles centered on brain tumors. Results: Our search retrieved 99,652 articles on brain tumors. The top 100 most cited publications, published between 1979 and 2017, were identified by the number of times they were cited in other articles. The median number of citations for the top 100 articles was 726.5 citations. All of them combined have been cited 118,703 times, with an average citation per item of 24.84. The most cited article was from the European Organization for Research and Treatment of Cancer Brain Tumor and Radiotherapy groups in the New England Journal of Medicine, titled “Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma”. Conclusion: The aim of this study was to present analysis of the top 100 most cited articles regarding any tumor type of the brain. All 100 articles in our dataset had over 400 citations each and can thus be considered citation classics, publications in the field that are highly cited. The citation analysis of the top 100 articles regarding brain tumors shows the current landscape of noteworthy publications in the field of study. Clinician scientists entering the field would benefit from understanding the most prominent citation classics. The findings of this study should also be of importance to all individuals entering the field of neuro-oncology.
Abstract: Background: A large number of published articles exist regarding intracranial tumors. This article aims to present the 100 most-cited articles on brain tumors and to perform a bibliometric analysis. Methods: In May 2021, the authors performed a title- focused search using Clarivate’s Web of Science database in order to identify the most cited artic...
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Preoperative Head CT Assisted Prediction of Acute Encephalocele During Isolated Acute Subdural Hematoma Surgery
Jiandong Wu,
Gang Wu,
Xiao-Yu Tang,
Peng Deng,
Jin-hong Qian,
Zhi-Qi Cheng,
Mian Ma
Issue:
Volume 5, Issue 2, December 2021
Pages:
84-89
Received:
8 October 2021
Accepted:
2 November 2021
Published:
17 November 2021
Abstract: To investigate more predictors for acute encephalocele in patients during isolated acute subdural hematoma (ASDH) surgery by using clinical data combined with preoperative cranial computed tomography (CT) scan, so as to provide a basis for the development of a more scientific and reasonable treatment strategy. CT images and medical records of 46 patients who underwent neurosurgery for isolated traumatic acute subdural hematoma were collected. The patients with intra-operative acute encephalocele were grouped as the observation group (n=23), and the patients with no intra-operative acute encephalocele, whose age difference was within 5 years were included in the control group (n=23). The t-test and multivariate logistic regression analyses were carried out to evaluate the influence of clinical variables on acute encephalocele. Meanwhile, whether differences among Thickness of hematoma(TH), Midline shift (MLS), Hounsfield units of white matter (HU-WM), Hounsfield units of hematoma (HU-HT) and basal cistern effaced score (CES) measured by cranial CT could be used as predictors of outcomes in patients with acute encephalocele during subdural hematoma surgery was evaluated. There were no significant differences in age, sex, mechanism of injury, the time from trauma to decompression, and the MLS during surgery between the two groups. However, significant differences in preoperative Glasgow Coma Score (GCS), TH, HU-WM and HU-HT between the two groups were observed. The multivariate logistic regression analysis of radiographic data showed that HU-WM and CES were independent risk factors and strong predictors for intra-operative acute encephalocele. The areas under curve of CES and HU-WM were 0.8459 and 0.8336, respectively. The risk factors for acute encephalocele during ASDH operation are identified in this study. An increased risk of intra-operative acute encephalocele is found in patients with lower preoperative GCS, HU-WM, HU-HT and higher preoperative TH and CES, which should help clinicians to develop a more scientific treatment strategy and improve the survival of such kind of patients.
Abstract: To investigate more predictors for acute encephalocele in patients during isolated acute subdural hematoma (ASDH) surgery by using clinical data combined with preoperative cranial computed tomography (CT) scan, so as to provide a basis for the development of a more scientific and reasonable treatment strategy. CT images and medical records of 46 pa...
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Complications of Ventriculo-peritoneal Shunting: 13 Years of Experience in a Sub-saharan Paediatric Neurosurgery Unit
Alain Jibia,
Esperance Broalet,
Carine Kacou Tetchi,
Soress Dongo,
Sa’Deu Fondjo,
Aderehime Haidara
Issue:
Volume 5, Issue 2, December 2021
Pages:
90-93
Received:
24 October 2021
Accepted:
9 November 2021
Published:
24 December 2021
Abstract: Complications of ventriculoperitoneal shunting in hydrocephalus cure are countless and well known nowadays; depending on several factors. They are all more so screened in children whom are vulnerable and growing; more again in sub-Saharan area, suggesting a close follow-up and a paid attention on family balance. We emphasised on this surgical and social challenge to analyse the experience of a paediatric neurosurgical unit. A retrospective study has been performed to determine statistical data over 13 years of our practice in sub-Saharan hospital area, referring to international recommendations. It was of above 90 complications collected in 62 patients over 302 children operated, 20.52%. Complications were mechanic (58) and infectious (32). The mean age of appearance was 2 years 8 months, with an average of 6 months of follow-up. Malformative aetiologies were of 4 over 5 children, 80.65% and more than half were non-obstructive, 58%. The complications were unique, multiple or associated. The treatment was mainly surgical 88.7% on several modes. Sixteen children deceased during the study period. Post-shunting complications are the source of a compromised functional or even vital prognosis, sometimes in a psychosocial stress or low feel. The challenge in sub-Saharan area remains the efficient management of complications with limited resources or a sociocultural family uncertainty. Perioperative prevention must be the master words.
Abstract: Complications of ventriculoperitoneal shunting in hydrocephalus cure are countless and well known nowadays; depending on several factors. They are all more so screened in children whom are vulnerable and growing; more again in sub-Saharan area, suggesting a close follow-up and a paid attention on family balance. We emphasised on this surgical and s...
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