Pub Date : 2021-09-15DOI: 10.33962/roneuro-2021-052
Ivan David Lozada Marintez, M. G. Ortega-Sierra, María Daniela Del Pilar Zambrano-Arenas, Natalia Páez-Escallón, Darwin Gabriel Perea-Martínez, Yuly Sofia Caldera-Arrautt, Kevin Solis-Bazza, D. A. Betancourt-Cundar, Hernando Jose Gonzalez-Garces, Andrés Mauricio Manríque-Gualdron, Feraz Fady Zaghab-Zgieb, L. Moscote-Salazar
Fat embolism syndrome typically appears after an asymptomatic period of 24 to 72 hours and is typically manifested by the clinical triad of respiratory failure, neurological manifestations and petechiae, together with analytical alterations such as anaemia and thrombopenia. Respiratory distress is the most common symptom. Cerebral fat embolism is an incomplete form of fat embolism, which does not meet all the diagnostic criteria; in fact, it may appear without the presence of respiratory failure; Therefore, its early diagnosis is a challenge in the trauma patient
{"title":"Essentials of cerebral fat embolism syndrome","authors":"Ivan David Lozada Marintez, M. G. Ortega-Sierra, María Daniela Del Pilar Zambrano-Arenas, Natalia Páez-Escallón, Darwin Gabriel Perea-Martínez, Yuly Sofia Caldera-Arrautt, Kevin Solis-Bazza, D. A. Betancourt-Cundar, Hernando Jose Gonzalez-Garces, Andrés Mauricio Manríque-Gualdron, Feraz Fady Zaghab-Zgieb, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-052","DOIUrl":"https://doi.org/10.33962/roneuro-2021-052","url":null,"abstract":"Fat embolism syndrome typically appears after an asymptomatic period of 24 to 72 hours and is typically manifested by the clinical triad of respiratory failure, neurological manifestations and petechiae, together with analytical alterations such as anaemia and thrombopenia. Respiratory distress is the most common symptom. Cerebral fat embolism is an incomplete form of fat embolism, which does not meet all the diagnostic criteria; in fact, it may appear without the presence of respiratory failure; Therefore, its early diagnosis is a challenge in the trauma patient","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41726793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-15DOI: 10.33962/roneuro-2021-058
S. Mass-Ramirez, Ivan David Lozada Marintez, Jose Bohorquez-Rivero, E. García-Ballestas, D. Bustos, Ingrith Tatiana Poveda-Castillo, R. D. Delgado-Marrugo, V. J. Daza-Martínez, Andrés David Sastre-Martínez, M. G. Ortega-Sierra, Tariq Janjua, M. Bolaño-Romero, L. Moscote-Salazar
Patients with acute neurological diseases (traumatic brain injury, hemorrhagic or ischemic stroke, spinal cord injury or tumour) may present with various systemic alterations such as changes in cardiovascular and respiratory response, gastrointestinal function disorders, metabolic and endocrinological abnormalities, coagulopathies, among others. Head injury increases the risk of malnutrition due to multiple factors related to nutrient intake, abnormalities in energy expenditure, eating behaviour disorders, gastrointestinal changes, and medication side effects. Gastrointestinal conditions include gastroparesis, which is defined as a delay in gastric emptying in the absence of mechanical obstruction. These patients often report nausea, vomiting, pain, postprandial fullness and abdominal swelling. Although the exact mechanism by which it occurs in traumatic brain injury is not known, it is related to complications such as intracranial hypertension, so it is most often seen in cases of severe trauma. Therefore, the objective of this review is to expose basic and practical concepts about gastroparesis and its approach.
{"title":"Gastroparesis as a complication in the patient with traumatic brain injury","authors":"S. Mass-Ramirez, Ivan David Lozada Marintez, Jose Bohorquez-Rivero, E. García-Ballestas, D. Bustos, Ingrith Tatiana Poveda-Castillo, R. D. Delgado-Marrugo, V. J. Daza-Martínez, Andrés David Sastre-Martínez, M. G. Ortega-Sierra, Tariq Janjua, M. Bolaño-Romero, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-058","DOIUrl":"https://doi.org/10.33962/roneuro-2021-058","url":null,"abstract":"Patients with acute neurological diseases (traumatic brain injury, hemorrhagic or ischemic stroke, spinal cord injury or tumour) may present with various systemic alterations such as changes in cardiovascular and respiratory response, gastrointestinal function disorders, metabolic and endocrinological abnormalities, coagulopathies, among others. Head injury increases the risk of malnutrition due to multiple factors related to nutrient intake, abnormalities in energy expenditure, eating behaviour disorders, gastrointestinal changes, and medication side effects. Gastrointestinal conditions include gastroparesis, which is defined as a delay in gastric emptying in the absence of mechanical obstruction. These patients often report nausea, vomiting, pain, postprandial fullness and abdominal swelling. Although the exact mechanism by which it occurs in traumatic brain injury is not known, it is related to complications such as intracranial hypertension, so it is most often seen in cases of severe trauma. Therefore, the objective of this review is to expose basic and practical concepts about gastroparesis and its approach.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49363555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-15DOI: 10.33962/roneuro-2021-063
A. Sachan, Prakrati Sachan, Sateesh Chandra
Context: Traumatic brain injury is a major public health problem worldwide with increasing incidence and severity in developing countries. In India, it becomes a huge burden on society with a lack of proper preventive measures, public awareness, traffic sense and pre-hospital care. Therefore we studied the epidemiological profile and factors predicting outcome. Aims: To study the epidemiological, demographic profile of TBI patients to help to improve the healthcare facilities. Setting and design: It is an observational prospective study. Methods and materials: Overall 2134 patients with TBI were enrolled. The data was collected according to the predesigned proforma. The demographic, epidemiological, clinical variables were analysed to determine the current trends and outcomes. Result: The male: female ratio was 2.21:1 with most cases from the age group of 21-30 years ( 29.42%). RTA was the mode of injury in 64.48% of cases. Overall mortality was 10.91%. Overall descriptive data was suggestive of poor outcome in old patients, referred cases, acute SDH and brainstem lesions, hypoxic and hypotensive patients, associated injuries, pre-existing disease and with higher Rotterdam and ISS scores. Conclusion: The outcome is dependent on factors like geographical, demographic, pre-hospital, and patient-related. With knowledge about the causes, patterns, and distribution the prognosis of TBI patients can be improved.
{"title":"Epidemiological, demographic and clinical profile of traumatic brain injury patients","authors":"A. Sachan, Prakrati Sachan, Sateesh Chandra","doi":"10.33962/roneuro-2021-063","DOIUrl":"https://doi.org/10.33962/roneuro-2021-063","url":null,"abstract":"Context: Traumatic brain injury is a major public health problem worldwide with increasing incidence and severity in developing countries. In India, it becomes a huge burden on society with a lack of proper preventive measures, public awareness, traffic sense and pre-hospital care. Therefore we studied the epidemiological profile and factors predicting outcome.\u0000Aims: To study the epidemiological, demographic profile of TBI patients to help to improve the healthcare facilities.\u0000Setting and design: It is an observational prospective study.\u0000Methods and materials: Overall 2134 patients with TBI were enrolled. The data was collected according to the predesigned proforma. The demographic, epidemiological, clinical variables were analysed to determine the current trends and outcomes.\u0000Result: The male: female ratio was 2.21:1 with most cases from the age group of 21-30 years ( 29.42%). RTA was the mode of injury in 64.48% of cases. Overall mortality was 10.91%. Overall descriptive data was suggestive of poor outcome in old patients, referred cases, acute SDH and brainstem lesions, hypoxic and hypotensive patients, associated injuries, pre-existing disease and with higher Rotterdam and ISS scores.\u0000Conclusion: The outcome is dependent on factors like geographical, demographic, pre-hospital, and patient-related. With knowledge about the causes, patterns, and distribution the prognosis of TBI patients can be improved.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46711651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-025
R. Misra, Sushil Kumar, Sandeep Sharma
An eighteen-month-old child presented with vomiting, fever and altered sensorium of two days duration. He had anaemia and computed tomography of head revealed hyper-dense internal cerebral veins, vein of Galen and inferior sagittal sinus and bilateral thalamic hypo-density. The child improved with anti-coagulants and packed cell transfusion.
{"title":"Deep cerebral vein thrombosis due to anaemia in a child","authors":"R. Misra, Sushil Kumar, Sandeep Sharma","doi":"10.33962/roneuro-2021-025","DOIUrl":"https://doi.org/10.33962/roneuro-2021-025","url":null,"abstract":"An eighteen-month-old child presented with vomiting, fever and altered sensorium of two days duration. He had anaemia and computed tomography of head revealed hyper-dense internal cerebral veins, vein of Galen and inferior sagittal sinus and bilateral thalamic hypo-density. The child improved with anti-coagulants and packed cell transfusion.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46188203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-027
Deepak Kumar Singh, V. Agrahari, M. Kaif, Rakesh Kumar, Kuldeep Yadav
Background: In the past, there were studies done to assess visual outcomes like visual acuity, fundoscopic findings and visual field mainly in pediatric patients with posterior fossa tumours (PFT). We assessed the above parameters pre- and post-operatively in all age group patients including both extra and intra-axial PFT. We also assessed visual outcome in patients with or without hydrocephalus. Objectives: To analyze “visual outcomes in patients with posterior fossa tumours undergoing surgical treatment”. The effect of hydrocephalus on the visual outcome was also analyzed. Materials and Methods: This prospective study including 107 patients with PFT undergoing definitive surgery was conducted in the Department of Neurosurgery at Dr Rmlims, Lucknow. Pre-op and post-op (six weeks after tumour resection) visual examinations were done and compared. Results: A shifting trend towards normalization of visual acuity (VA) was seen post-surgery in all age groups. Overall improvement was seen in the majority of cases having pupil normal size sluggish reactive (NSSR) after surgery. Papilledema improved in the majority of patients in all age groups and patients having hydrocephalus. Colour vision and night vision also improved in the majority. The field of vision cut was not improved postoperatively in the majority. Conclusion: Visual parameters like visual acuity, pupil size and reactivity to light; colour vision and night vision were improved significantly after surgery whereas cut field of vision did not improve. All fundoscopic findings like papilledema, retinal venous dilation and retinal splinters haemorrhage disappeared in a significant number of patients post-operatively. In cases with obstructive hydrocephalus, these parameters also improved significantly after Ventriculo-peritoneal shunt/ ETV or definitive surgery.
{"title":"Visual outcome analysis in patients with posterior fossa tumours undergoing surgical treatment","authors":"Deepak Kumar Singh, V. Agrahari, M. Kaif, Rakesh Kumar, Kuldeep Yadav","doi":"10.33962/roneuro-2021-027","DOIUrl":"https://doi.org/10.33962/roneuro-2021-027","url":null,"abstract":"Background: In the past, there were studies done to assess visual outcomes like visual acuity, fundoscopic findings and visual field mainly in pediatric patients with posterior fossa tumours (PFT). We assessed the above parameters pre- and post-operatively in all age group patients including both extra and intra-axial PFT. We also assessed visual outcome in patients with or without hydrocephalus.\u0000Objectives: To analyze “visual outcomes in patients with posterior fossa tumours undergoing surgical treatment”. The effect of hydrocephalus on the visual outcome was also analyzed.\u0000Materials and Methods: This prospective study including 107 patients with PFT undergoing definitive surgery was conducted in the Department of Neurosurgery at Dr Rmlims, Lucknow. Pre-op and post-op (six weeks after tumour resection) visual examinations were done and compared.\u0000Results: A shifting trend towards normalization of visual acuity (VA) was seen post-surgery in all age groups. Overall improvement was seen in the majority of cases having pupil normal size sluggish reactive (NSSR) after surgery. Papilledema improved in the majority of patients in all age groups and patients having hydrocephalus. Colour vision and night vision also improved in the majority. The field of vision cut was not improved postoperatively in the majority.\u0000Conclusion: Visual parameters like visual acuity, pupil size and reactivity to light; colour vision and night vision were improved significantly after surgery whereas cut field of vision did not improve. All fundoscopic findings like papilledema, retinal venous dilation and retinal splinters haemorrhage disappeared in a significant number of patients post-operatively. In cases with obstructive hydrocephalus, these parameters also improved significantly after Ventriculo-peritoneal shunt/ ETV or definitive surgery.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48791177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-021
A. Cucu, M. Coșman, B. Dobrovat, C. Dascălu, I. Jitaru, R. Sandu, A. Tudor, C. Costea, M. Turliuc, G. Dumitrescu, A. Sava, I. Poeată
Objective: The aim of this study was to evaluate the possible relationship between the appearance of tumour margins of atypical meningiomas and the risk of tumour recurrence, as well as progression-free survival. We also evaluated the correlations between the tumour margins and the neuroimaging characteristics (e.g. brain oedema and contrast enhancement) along with pathological features (e.g. brain invasion and mean value of Ki-67 LI). Material and methods: In our study, we included 81 patients diagnosed with atypical meningioma (grade II meningioma), who have undergone surgery at the "Prof. Dr N. Oblu" Emergency Clinical Hospital Iasi, between January 1, 2010, and December 31, 2019. We followed the MRI imaging characteristics (e.g. tumour margins patterns, contrast enhancement, oedema grading and tumour volume), but also the pathological characteristics such as brain invasion and the mean value of the Ki-67 labelling index. The assessment of tumour recurrence was made using MRI imaging (T1+ contrast), over a follow-up period of 5 years after the surgery. Results: In our study, we observed that 59.3% (n=48) of meningiomas had an irregular appearance. The irregular margins predominated in the male population (65.1%) and were statistically significantly correlated with brain oedema (p<0.001), contrast enhancement (p<0.01), anatomical location (p<0.014) and the mean value of the Ki-67 labelling index (p<0.01). The tumour margins were not correlated with brain invasion or volume of meningiomas. Conclusion: In our series of patients we found that the irregular margin was not a prognostic factor for tumour recurrence over a period of 5 years or for progression-free survival.
{"title":"Meningioma in shape","authors":"A. Cucu, M. Coșman, B. Dobrovat, C. Dascălu, I. Jitaru, R. Sandu, A. Tudor, C. Costea, M. Turliuc, G. Dumitrescu, A. Sava, I. Poeată","doi":"10.33962/roneuro-2021-021","DOIUrl":"https://doi.org/10.33962/roneuro-2021-021","url":null,"abstract":"Objective: The aim of this study was to evaluate the possible relationship between the appearance of tumour margins of atypical meningiomas and the risk of tumour recurrence, as well as progression-free survival. We also evaluated the correlations between the tumour margins and the neuroimaging characteristics (e.g. brain oedema and contrast enhancement) along with pathological features (e.g. brain invasion and mean value of Ki-67 LI). \u0000Material and methods: In our study, we included 81 patients diagnosed with atypical meningioma (grade II meningioma), who have undergone surgery at the \"Prof. Dr N. Oblu\" Emergency Clinical Hospital Iasi, between January 1, 2010, and December 31, 2019. We followed the MRI imaging characteristics (e.g. tumour margins patterns, contrast enhancement, oedema grading and tumour volume), but also the pathological characteristics such as brain invasion and the mean value of the Ki-67 labelling index. The assessment of tumour recurrence was made using MRI imaging (T1+ contrast), over a follow-up period of 5 years after the surgery. \u0000Results: In our study, we observed that 59.3% (n=48) of meningiomas had an irregular appearance. The irregular margins predominated in the male population (65.1%) and were statistically significantly correlated with brain oedema (p<0.001), contrast enhancement (p<0.01), anatomical location (p<0.014) and the mean value of the Ki-67 labelling index (p<0.01). The tumour margins were not correlated with brain invasion or volume of meningiomas. \u0000Conclusion: In our series of patients we found that the irregular margin was not a prognostic factor for tumour recurrence over a period of 5 years or for progression-free survival.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45401737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-031
S. Jain, G. Jaiswal, T. Gupta, K. Lodha, Vishnu Kumar Lohar, K. Yadav
Introduction: Brain parenchymal abscesses are relatively infrequent but potentially serious infections in the paediatric population. Surgical intervention in addition to a prolonged administration of antibiotics is generally appropriate management. Aims and objective: We performed this study to assess the clinical profile, aetiology and outcome of paediatric brain abscess which are treated surgically only by aspiration in the tribal region of Rajasthan. Material and method: A single-centre retrospective study was conducted over a 5 year period (2014–2019) in the department of neurosurgery in RNT medical college, Udaipur, Rajasthan. We treated approx 60 patients of which 25 patients treated conservatively and 5 patient treated by craniotomy and abscess excision. So only 30 patient included in our study in which abscess treated by aspiration only. Patients<18 years of age with a confirmed intra-parenchymal abscess were included. Patient records were reviewed for abscess location, microbiology results, Clinical features, Surgical intervention, and outcome using the Glasgow Outcome Score at 3 months. Result: 11 patients had an abscess in the temporal lobe and Streptococcus was the most common causative micro-organism (n¼15). 25 patients (80%) had an identifiable source which included: ENT infections, congenital cardiac malformations, recent dental surgery and meningitis. The most common symptom is fever f/b headache, seizure and vomiting. But despite previous studies seizure (10/30) presentation is comparatively more. All 30 patients underwent aspiration. Conclusion: In tribal regions of India ENT infections are a more common source of brain abscess because of poor hygiene and illiteracy and their ignorance of ENT infections and also not taking seriously to fever, headache and other health issues. But at present, there are also decreasing trends of brain abscess by ENT infections and rising trends by congenital heart disease which is a good sign that the health and educational infrastructure is strengthening in the tribal region also.
{"title":"Paediatric brain abscesses in tribal region of India","authors":"S. Jain, G. Jaiswal, T. Gupta, K. Lodha, Vishnu Kumar Lohar, K. Yadav","doi":"10.33962/roneuro-2021-031","DOIUrl":"https://doi.org/10.33962/roneuro-2021-031","url":null,"abstract":"Introduction: Brain parenchymal abscesses are relatively infrequent but potentially serious infections in the paediatric population. Surgical intervention in addition to a prolonged administration of antibiotics is generally appropriate management.\u0000Aims and objective: We performed this study to assess the clinical profile, aetiology and outcome of paediatric brain abscess which are treated surgically only by aspiration in the tribal region of Rajasthan.\u0000Material and method: A single-centre retrospective study was conducted over a 5 year period (2014–2019) in the department of neurosurgery in RNT medical college, Udaipur, Rajasthan. We treated approx 60 patients of which 25 patients treated conservatively and 5 patient treated by craniotomy and abscess excision. So only 30 patient included in our study in which abscess treated by aspiration only. Patients<18 years of age with a confirmed intra-parenchymal abscess were included. Patient records were reviewed for abscess location, microbiology results, Clinical features, Surgical intervention, and outcome using the Glasgow Outcome Score at 3 months.\u0000Result: 11 patients had an abscess in the temporal lobe and Streptococcus was the most common causative micro-organism (n¼15). 25 patients (80%) had an identifiable source which included: ENT infections, congenital cardiac malformations, recent dental surgery and meningitis. The most common symptom is fever f/b headache, seizure and vomiting. But despite previous studies seizure (10/30) presentation is comparatively more. All 30 patients underwent aspiration.\u0000Conclusion: In tribal regions of India ENT infections are a more common source of brain abscess because of poor hygiene and illiteracy and their ignorance of ENT infections and also not taking seriously to fever, headache and other health issues. But at present, there are also decreasing trends of brain abscess by ENT infections and rising trends by congenital heart disease which is a good sign that the health and educational infrastructure is strengthening in the tribal region also.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49583293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-039
R. Aksyonov, O. Palamar, A. Huk, D. Teslenko, D. Okonskyi
Pituitary adenomas are one of the most common primary central nervous system tumours and have an estimated prevalence of 17%. Management of hormone-secreting pituitary adenomas involves a multidisciplinary approach that can incorporate surgical, medical, and/or radiation therapies. Acromegaly is a rare, chronic disorder that mostly results from growth hormone (GH)-secreting pituitary adenoma. We analyzed the outcomes of surgical treatment for growth hormone (GH) pituitary adenomas based on 28 cases and determine factors that lead to biochemical remission.
{"title":"Possibilities of endoscopic endonasal transsphenoidal surgery in treatment of growth-hormone pituitary adenomas","authors":"R. Aksyonov, O. Palamar, A. Huk, D. Teslenko, D. Okonskyi","doi":"10.33962/roneuro-2021-039","DOIUrl":"https://doi.org/10.33962/roneuro-2021-039","url":null,"abstract":"Pituitary adenomas are one of the most common primary central nervous system tumours and have an estimated prevalence of 17%. Management of hormone-secreting pituitary adenomas involves a multidisciplinary approach that can incorporate surgical, medical, and/or radiation therapies. Acromegaly is a rare, chronic disorder that mostly results from growth hormone (GH)-secreting pituitary adenoma. We analyzed the outcomes of surgical treatment for growth hormone (GH) pituitary adenomas based on 28 cases and determine factors that lead to biochemical remission.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42160262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-038
Neha Singh, Deepak Kumar Singh
Introduction: Craniovertebral junction is the “zone of transition” between the skull and cervical spine so its detailed discussion is lacking in so many standard textbooks addressing these regions. These anomalies are especially common in the Indian subcontinent. Accurate diagnosis, probable aetiology and pre-treatment evaluation considerably affect the prognosis of patients. The aim of this study was to classify various Craniovertebral junction disorders according to their aetiology and to correlate the imaging findings with the clinical profile of the patients and histopathology whenever possible. Methods: This prospective observational study was done in our department over the period of one year from August 2016 to July 2017. 57 North Indian patients from all age groups and both sex, who had imaging features suggesting craniovertebral junction pathology were selected for the study. Results: Our study group comprised 34 males and 23 females with a male to female ratio of 1.47: 1. The most common age group was 11-20 years and the most common aetiology being developmental followed by infective, autoimmune and inflammatory disorders. Conclusions: CVJ abnormalities are a group of treatable neurological disorders, and are approached with much caution by clinicians. Thus, it is crucial that radiologists should be able to make a precise diagnosis, categorize them into etiological groups, and give precise anatomical information on MDCT and/or MRI, as this information ultimately helps determine the management of such abnormalities and their prognosis.
{"title":"Spectrum of non-traumatic craniovertebral junction disorders","authors":"Neha Singh, Deepak Kumar Singh","doi":"10.33962/roneuro-2021-038","DOIUrl":"https://doi.org/10.33962/roneuro-2021-038","url":null,"abstract":"Introduction: Craniovertebral junction is the “zone of transition” between the skull and cervical spine so its detailed discussion is lacking in so many standard textbooks addressing these regions. These anomalies are especially common in the Indian subcontinent. Accurate diagnosis, probable aetiology and pre-treatment evaluation considerably affect the prognosis of patients. The aim of this study was to classify various Craniovertebral junction disorders according to their aetiology and to correlate the imaging findings with the clinical profile of the patients and histopathology whenever possible. \u0000Methods: This prospective observational study was done in our department over the period of one year from August 2016 to July 2017. 57 North Indian patients from all age groups and both sex, who had imaging features suggesting craniovertebral junction pathology were selected for the study. \u0000Results: Our study group comprised 34 males and 23 females with a male to female ratio of 1.47: 1. The most common age group was 11-20 years and the most common aetiology being developmental followed by infective, autoimmune and inflammatory disorders. \u0000Conclusions: CVJ abnormalities are a group of treatable neurological disorders, and are approached with much caution by clinicians. Thus, it is crucial that radiologists should be able to make a precise diagnosis, categorize them into etiological groups, and give precise anatomical information on MDCT and/or MRI, as this information ultimately helps determine the management of such abnormalities and their prognosis.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44610328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-18DOI: 10.33962/roneuro-2021-023
A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, I. Poeată
The stent-assisted coil-jailing technique was initially introduced as an effective and secure method in the treatment of large wide-necked intracranial aneurysms. Later on, this technique has proved its efficiency in the safety and optimal treatment of very small aneurysms. In this article, we will present the successful treatment of a very small middle cerebral artery aneurysm using the stent-assisted coil-jailing technique and review the current trends in this type of treatment.
{"title":"The stent-assisted coil-jailing technique for very small intracranial aneurysm treatment","authors":"A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, I. Poeată","doi":"10.33962/roneuro-2021-023","DOIUrl":"https://doi.org/10.33962/roneuro-2021-023","url":null,"abstract":"The stent-assisted coil-jailing technique was initially introduced as an effective and secure method in the treatment of large wide-necked intracranial aneurysms. Later on, this technique has proved its efficiency in the safety and optimal treatment of very small aneurysms. In this article, we will present the successful treatment of a very small middle cerebral artery aneurysm using the stent-assisted coil-jailing technique and review the current trends in this type of treatment.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48800825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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