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  • 1
    Online Resource
    Online Resource
    Rationale and design of the peripheral nerve tumor registry: an observational cohort study
    Informa UK Limited ; 2023
    In:  Neurological Research Vol. 45, No. 1 ( 2023-01-02), p. 81-85
    Details
    In: Neurological Research, Informa UK Limited, Vol. 45, No. 1 ( 2023-01-02), p. 81-85
    Type of Medium: Online Resource
    ISSN: 0161-6412 , 1743-1328
    URL: Article
    DOI: 10.1080/01616412.2022.2129762
    RVK:
    XA 10000
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2023
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  • 2
    Online Resource
    Online Resource
    Clinical evaluation of the safety and efficacy of lumbar cerebrospinal fluid drainage for the treatment of refractory increased intracranial pressure : Clinical article
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2009
    In:  Journal of Neurosurgery Vol. 110, No. 6 ( 2009-06), p. 1200-1208
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 110, No. 6 ( 2009-06), p. 1200-1208
    Abstract: Several approaches have been established for the treatment of intracranial hypertension; however, a considerable number of patients remain unresponsive to even aggressive therapeutic strategies. Lumbar CSF drainage has been contraindicated in the setting of increased intracranial pressure (ICP) because of possible cerebral herniation. The authors of this study investigated the efficacy and safety of controlled lumbar CSF drainage in patients suffering from intracranial hypertension following severe traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (SAH). Methods The authors prospectively evaluated 100 patients—45 with TBI and 55 with SAH—having a mean age of 43.7 ± 15.7 years (mean ± SD) and suffering from refractory intracranial hypertension (ICP 〉 20 mm Hg). Intracranial pressure and cerebral perfusion pressure (CPP) before and after the initiation of lumbar CSF drainage as well as related complications were documented. Patient outcomes were assessed 6 months after injury. Results The application of lumbar CSF drainage led to a significant reduction in ICP from 32.7 ± 10.9 to 13.4 ± 5.9 mm Hg (p 〈 0.05) and an increase in CPP from 70.6 ± 18.2 to 86.2 ± 15.4 mm Hg (p 〈 0.05). Cerebral herniation with a lethal outcome occurred in 6% of patients. Thirty-six patients had a favorable outcome, 12 were severely disabled, 7 remained in a persistent vegetative state, and 45 died. Conclusions Lumbar drainage of CSF led to a significant and clinically relevant reduction in ICP. The risk of cerebral herniation can be minimized by performing lumbar drainage only in cases with discernible basal cisterns.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2008.10.JNS08293
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2009
    detail.hit.zdb_id: 2026156-1
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  • 3
    Online Resource
    Online Resource
    Spinal navigation for posterior instrumentation of C1–2 instability using a mobile intraoperative CT scanner
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2017
    In:  Journal of Neurosurgery: Spine Vol. 27, No. 3 ( 2017-09), p. 268-275
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 27, No. 3 ( 2017-09), p. 268-275
    Abstract: Spinal navigation techniques for surgical fixation of unstable C1–2 pathologies are challenged by complex osseous and neurovascular anatomy, instability of the pathology, and unreliable preoperative registration techniques. An intraoperative CT scanner with autoregistration of C-1 and C-2 promises sufficient accuracy of spinal navigation without the need for further registration procedures. The aim of this study was to analyze the accuracy and reliability of posterior C1–2 fixation using intraoperative mobile CT scanner–guided navigation. METHODS In the period from July 2014 to February 2016, 10 consecutive patients with instability of C1–2 underwent posterior fixation using C-2 pedicle screws and C-1 lateral mass screws, and 2 patients underwent posterior fixation from C-1 to C-3. Spinal navigation was performed using intraoperative mobile CT. Following navigated screw insertion in C-1 and C-2, intraoperative CT was repeated to check for the accuracy of screw placement. In this study, the accuracy of screw positioning was retrospectively analyzed and graded by an independent observer. RESULTS The authors retrospectively analyzed the records of 10 females and 2 males, with a mean age of 80.7 ± 4.95 years (range 42–90 years). Unstable pathologies, which were verified by fracture dislocation or by flexion/extension radiographs, included 8 Anderson Type II fractures, 1 unstable Anderson Type III fracture, 1 hangman fracture Levine Effendi Ia, 1 complex hangman-Anderson Type III fracture, and 1 destructive rheumatoid arthritis of C1–2. In 4 patients, critical anatomy was observed: high-riding vertebral artery (3 patients) and arthritis-induced partial osseous destruction of the C-1 lateral mass (1 patient). A total of 48 navigated screws were placed. Correct screw positioning was observed in 47 screws (97.9%). Minor pedicle breach was observed in 1 screw (2.1%). No screw displacement occurred (accuracy rate 97.9%). CONCLUSION Spinal navigation using intraoperative mobile CT scanning was reliable and safe for posterior fixation in unstable C1–2 pathologies with high accuracy in this patient series.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2017.1.SPINE16859
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2017
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  • 4
    Online Resource
    Online Resource
    High frequency of low-virulent microorganisms detected by sonication of pedicle screws: a potential cause for implant failure
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2019
    In:  Journal of Neurosurgery: Spine Vol. 31, No. 3 ( 2019-09), p. 424-429
    Details
    In: Journal of Neurosurgery: Spine, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 31, No. 3 ( 2019-09), p. 424-429
    Abstract: Loosening of pedicle screws is a frequent complication after spinal surgery. Implant colonization with low-virulent microorganisms forming biofilms may cause implant loosening. However, the clinical evidence of this mechanism is lacking. Here, the authors evaluated the potential role of microbial colonization using sonication in patients with clinical pedicle screw loosening but without signs of infection. METHODS All consecutive patients undergoing hardware removal between January 2015 and December 2017, including patients with screw loosening but without clinical signs of infection, were evaluated. The removed hardware was investigated using sonication. RESULTS A total of 82 patients with a mean (± SD) patient age of 65 ± 13 years were eligible for evaluation. Of the 54 patients with screw loosening, 22 patients (40.7%) had a positive sonication result. None of the 28 patients without screw loosening who served as a control cohort showed a positive sonication result (p 〈 0.01). In total, 24 microorganisms were detected in those 22 patients. The most common isolated microorganisms were coagulase-negative staphylococci (62.5%) and Cutibacterium acnes (formerly known as Propionibacterium acnes ) (25%). When comparing only the patients with screw loosening, the duration of the previous spine surgery was significantly longer in patients with a positive microbiological result (288 ± 147 minutes) than in those with a negative result (201 ± 103 minutes) (p = 0.02). CONCLUSIONS The low-virulent microorganisms frequently detected on pedicle screws by using sonication may be an important cause of implant loosening and failure. Longer surgical duration increases the likelihood of implant colonization with subsequent screw loosening. Sonication is a highly sensitive approach to detect biofilm-producing bacteria, and it needs to be integrated into the clinical routine for optimized treatment strategies.
    Type of Medium: Online Resource
    ISSN: 1547-5654
    URL: Article
    DOI: 10.3171/2019.1.SPINE181025
    RVK:
    XA 55270.1
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2019
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  • 5
    Online Resource
    Online Resource
    Characterization of Cortical Microvascularization in Adult Moyamoya Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Stroke Vol. 39, No. 6 ( 2008-06), p. 1703-1709
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 6 ( 2008-06), p. 1703-1709
    Abstract: Background and Purpose— Increased cortical microvascularization has been proposed to be a Moyamoya disease (MMD)–specific characteristic. It was the aim of our study to characterize the anatomic pattern and microhemodynamics of cortical microvascularization in MMD. Methods— Intraoperative indocyanine green videoangiography was performed in 16 adult MMD patients, 15 patients with atherosclerotic cerebrovascular disease (ACVD), and 10 control patients. Cortical microvascularization and microvascular hemodynamics were categorized and analyzed according to anatomic and functional indocyanine green angiographic aspects. Anatomic analysis included microvascular density, microvascular diameter, and microvascular surface per analyzed area. Microhemodynamic analysis included microvascular transit time, arterial microvascular transit time, and venous microvascular transit time. Results— Microvascular density and diameter were significantly increased in MMD patients (1.8±0.2 mm/mm 2 and 0.24±0.03 mm, respectively) compared with those in ACVD patients (1.5±0.2 mm/mm 2 and 0.20±0.02 mm, respectively) and controls (1.5±0.1 mm/mm 2 and 0.19±0.03 mm, respectively). This resulted in significantly increased microvascular surface per analyzed area in MMD (67±13%) vs ACVD patients (47±7%) and controls (45±6%). Anatomic changes were paralleled by significantly increased microvascular and arterial microvascular transit times in MMD patients (11.55±3.50 and 6.79±2.96 seconds, respectively) compared with those in ACVD patients (8.13±1.78 and 4.34±1.30 seconds, respectively) and controls (8.04±2.16 and 4.50±1.87 seconds, respectively). Conclusion— Cortical microvascularization in MMD is characterized by significantly increased microvascular density and microvascular diameter, leading to increased microvascular surface. These anatomic alterations are accompanied by prolonged microvascular hemodynamics. These observations might represent an MMD-specific compensation mechanism for impaired cerebral blood flow.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.107.501759
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 1467823-8
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