Pub Date : 2021-12-21DOI: 10.33962/roneuro-2021-078
Mehmet Akif Ambarcioglu, İ. Atcı, Okan Türk, V. Antar, N. Demirel, N. Özdemir, Emre Eğilmez, A. Karaoğlu, Ö. Baran
Introduction: In this study, it is aimed to present a very rare liver subcapsular accumulation of a patient after ventriculoperitoneal shunt surgery who was diagnosed with Pseudotumor cerebri syndrome with progressive sight loss. Case: The patient is a 38-year-old female who was diagnosed with lomber spondylose and later operated with stabilization and fusion surgery. Seven days after the operation her headaches became clear and blackout in her left eye was seen and she was observed with medical treatment. CSF pressure of her was measured to be 25 cm/ water, so she was diagnosed as pseudotumour cerebri and taken to the operation immediately. On the 3rd day of post-operation, there occurred to be intense stomach ache and abdominal sensitivity of the case. After the scanning of abdominal CT, 7 cm of liquid collection was detected in the shunt distal of liver subcapsular area. Discussion: Liver pseudocyst should be considered, even if it is a rare complication when back striking abdominal pain and high liver enzymes are seen in patients with shunt dysfunction. USG and abdominal bt tests should be made for these patients. The drainage of the cyst and then the removal of the abdominal catheter should be applied.
{"title":"A very rare fact occurring after V/P shunt in the surgical treatment of Pseudotumor Serebri Syndrome","authors":"Mehmet Akif Ambarcioglu, İ. Atcı, Okan Türk, V. Antar, N. Demirel, N. Özdemir, Emre Eğilmez, A. Karaoğlu, Ö. Baran","doi":"10.33962/roneuro-2021-078","DOIUrl":"https://doi.org/10.33962/roneuro-2021-078","url":null,"abstract":"Introduction: In this study, it is aimed to present a very rare liver subcapsular accumulation of a patient after ventriculoperitoneal shunt surgery who was diagnosed with Pseudotumor cerebri syndrome with progressive sight loss. \u0000Case: The patient is a 38-year-old female who was diagnosed with lomber spondylose and later operated with stabilization and fusion surgery. Seven days after the operation her headaches became clear and blackout in her left eye was seen and she was observed with medical treatment. CSF pressure of her was measured to be 25 cm/ water, so she was diagnosed as pseudotumour cerebri and taken to the operation immediately. On the 3rd day of post-operation, there occurred to be intense stomach ache and abdominal sensitivity of the case. After the scanning of abdominal CT, 7 cm of liquid collection was detected in the shunt distal of liver subcapsular area. \u0000Discussion: Liver pseudocyst should be considered, even if it is a rare complication when back striking abdominal pain and high liver enzymes are seen in patients with shunt dysfunction. USG and abdominal bt tests should be made for these patients. The drainage of the cyst and then the removal of the abdominal catheter should be applied.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48344752","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 : 2021-12-21DOI: 10.33962/roneuro-2021-074
Anamaria-Alexandra Arsene, I. Gabriel, A. Ciurea
Background. Several causes that can trigger POD can be incriminated: the patient's immune status, surgical technical errors, intra-operative contamination, foreign materials microfilm. Extensive analysis is required to eradicate the limited or diffuse infection and manage the optimal therapeutic attitude conservative or by surgery to get: faster recovery time, to improve symptoms, to allow mobilization, to offer a good quality of life and to reduce the average length of hospital stay. Objectives. To perform a systematic review of POD outcomes via retrospective analysis of current studies based on the mechanism, the pathogenesis, the management of patient's immunological status, aetiology (microorganism involved, foreign material applied for hemostasis, application of spinal instrumentation, cement, screws, spinal devices), laboratory (TLC, ESR, CRP), MRI/CT-scan, antibiotherapy guidelines and the type of surgery performed: classical or minim-invasive, length of procedure, intraoperative accidents, the experience of the neurosurgeon, post-operative stay in ICU, etc. Methods. Several data were taken into account regarding lumbar infections using a comprehensive review of the literature published studies from 1998 to 2021. Demographic data, clinical variables, length of hospital stay, duration of antibiotic treatment, and post-treatment complications were assessed. Results. We performed a systematic review concerning 31 studies regarding clinical status, diagnosis and treatment. Conclusions. Based on our systematic analysis, training and continuous education in spine surgery are necessary to prevent POD. The diagnosis of lumbar POD is based on history and physical examination, biochemical markers, neuroradiologic studies, using appropriate MRI imaging. Most cases of lumbar POD can be managed by conservative treatment with antibiotics after causative germ isolation and antibiogram. Surgery is performed on patients with conservative treatment failure - resistant to antibiotic therapy, as those with neurological complications: acute paraplegia, pain resistance to analgetics, acute sepsis, abscesses, spinal instability, severe kyphosis. Early surgery with wound irrigation/debridement is more readily able to disrupt biofilm formation and facilitate penetration of systemic antimicrobials to allow for resolution of the infection, vacuum-assisted closure facilitates wound healing and eradicates spinal infections, decrease the rate of complications, permit rapid pain relief while preserving the instrumentation/stability, better clinical outcomes, infection control before extensive destruction of the vertebrae, spinal instability and kyphotic deformity appear. Instrumentation can usually be preserved in patients with early infections (e.g., <6 weeks), but instrumentation removal should be considered for infections presenting in a delayed fashion (e.g., >6 weeks to even years) PSII. Patients should be adequately followed for one postoperative year, to ensu
{"title":"Postoperative lumbar spondylodiscitis","authors":"Anamaria-Alexandra Arsene, I. Gabriel, A. Ciurea","doi":"10.33962/roneuro-2021-074","DOIUrl":"https://doi.org/10.33962/roneuro-2021-074","url":null,"abstract":"Background. Several causes that can trigger POD can be incriminated: the patient's immune status, surgical technical errors, intra-operative contamination, foreign materials microfilm. Extensive analysis is required to eradicate the limited or diffuse infection and manage the optimal therapeutic attitude conservative or by surgery to get: faster recovery time, to improve symptoms, to allow mobilization, to offer a good quality of life and to reduce the average length of hospital stay. \u0000Objectives. To perform a systematic review of POD outcomes via retrospective analysis of current studies based on the mechanism, the pathogenesis, the management of patient's immunological status, aetiology (microorganism involved, foreign material applied for hemostasis, application of spinal instrumentation, cement, screws, spinal devices), laboratory (TLC, ESR, CRP), MRI/CT-scan, antibiotherapy guidelines and the type of surgery performed: classical or minim-invasive, length of procedure, intraoperative accidents, the experience of the neurosurgeon, post-operative stay in ICU, etc. \u0000Methods. Several data were taken into account regarding lumbar infections using a comprehensive review of the literature published studies from 1998 to 2021. Demographic data, clinical variables, length of hospital stay, duration of antibiotic treatment, and post-treatment complications were assessed. \u0000Results. We performed a systematic review concerning 31 studies regarding clinical status, diagnosis and treatment. \u0000Conclusions. Based on our systematic analysis, training and continuous education in spine surgery are necessary to prevent POD. The diagnosis of lumbar POD is based on history and physical examination, biochemical markers, neuroradiologic studies, using appropriate MRI imaging. Most cases of lumbar POD can be managed by conservative treatment with antibiotics after causative germ isolation and antibiogram. Surgery is performed on patients with conservative treatment failure - resistant to antibiotic therapy, as those with neurological complications: acute paraplegia, pain resistance to analgetics, acute sepsis, abscesses, spinal instability, severe kyphosis. Early surgery with wound irrigation/debridement is more readily able to disrupt biofilm formation and facilitate penetration of systemic antimicrobials to allow for resolution of the infection, vacuum-assisted closure facilitates wound healing and eradicates spinal infections, decrease the rate of complications, permit rapid pain relief while preserving the instrumentation/stability, better clinical outcomes, infection control before extensive destruction of the vertebrae, spinal instability and kyphotic deformity appear. Instrumentation can usually be preserved in patients with early infections (e.g., <6 weeks), but instrumentation removal should be considered for infections presenting in a delayed fashion (e.g., >6 weeks to even years) PSII. Patients should be adequately followed for one postoperative year, to ensu","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42473282","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 : 2021-12-21DOI: 10.33962/roneuro-2021-068
A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, A. Iencean, I. Poeată
The advancement of intracranial stent technology and techniques has extended the applications of endovascular coiling methods for complex intracranial aneurysms. Coiling of wide-necked and complex bifurcation aneurysms usually requires double stent implantation. Different configurations for double stent-assisted coil embolization have been described. The T-configuration stent-assisted coiling procedure was recently described as a feasible, effective, and relatively safe endovascular technique used to treat wide-necked complex bifurcation aneurysms. In this article, we present the successful management of a complex wide-neck basilar tip aneurysm using a slightly modified T-configuration stent-assisted coiling technique.
{"title":"T- configuration stent assisted coiling treatment of a complex wide-necked basilar tip aneurysm","authors":"A. Chiriac, N. Dobrin, G. Ion, Z. Faiyad, A. Iencean, I. Poeată","doi":"10.33962/roneuro-2021-068","DOIUrl":"https://doi.org/10.33962/roneuro-2021-068","url":null,"abstract":"The advancement of intracranial stent technology and techniques has extended the applications of endovascular coiling methods for complex intracranial aneurysms. Coiling of wide-necked and complex bifurcation aneurysms usually requires double stent implantation. Different configurations for double stent-assisted coil embolization have been described. The T-configuration stent-assisted coiling procedure was recently described as a feasible, effective, and relatively safe endovascular technique used to treat wide-necked complex bifurcation aneurysms. In this article, we present the successful management of a complex wide-neck basilar tip aneurysm using a slightly modified T-configuration stent-assisted coiling technique.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48439730","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 : 2021-12-21DOI: 10.33962/roneuro-2021-076
M. Deniwar, M. Kassem, Ashraf Ezzeldin, J. Jafar
Background: The main treatment of cerebral aneurysms is direct surgical clipping or endovascular coil embolization. However, some cerebral aneurysms that we reviewed in the literature are still not susceptible to a single treatment approach. These aneurysms can be referred to as complex aneurysms. Objective: We aim to report these aneurysms and share our clinical experience with their treatment and diagnosis. Methods: All cases of cerebral aneurysms treated in New York University and in Mansoura University from 2010-2021 were retrospectively reviewed. Results: 18 patients with 21 cerebral aneurysms were treated by combined surgical and endovascular modalities. Aneurysms associated with arteriovenous malformations (AVMs) in 3 patients, associated with vasospasm in 7 patients, and 3 patients had double aneurysms. A total of 18 patients with aneurysms were treated with combined endovascular and microsurgical therapy. Early angiogram (< 1 week) revealed; complete obliteration of 19 aneurysms (90%) out of a total of 21 aneurysms, residual filling was observed in 2 aneurysms (10%). Late radiological follow up (> 3 months- 2 years) revealed; a stable residual filling in one and the other case underwent retreatment. Conclusions: The recalcitrant or complex cerebral aneurysms can be better referred to as diseases rather than lesions as many clinical and anatomical factors make their treatment difficult. Endovascular and microsurgery could be complementary to each other and create a multimodal approach for treating them.
{"title":"The complementary multimodal treatment of recalcitrant cerebral aneurysms","authors":"M. Deniwar, M. Kassem, Ashraf Ezzeldin, J. Jafar","doi":"10.33962/roneuro-2021-076","DOIUrl":"https://doi.org/10.33962/roneuro-2021-076","url":null,"abstract":"Background: The main treatment of cerebral aneurysms is direct surgical clipping or endovascular coil embolization. However, some cerebral aneurysms that we reviewed in the literature are still not susceptible to a single treatment approach. These aneurysms can be referred to as complex aneurysms. \u0000Objective: We aim to report these aneurysms and share our clinical experience with their treatment and diagnosis. \u0000Methods: All cases of cerebral aneurysms treated in New York University and in Mansoura University from 2010-2021 were retrospectively reviewed. \u0000Results: 18 patients with 21 cerebral aneurysms were treated by combined surgical and endovascular modalities. Aneurysms associated with arteriovenous malformations (AVMs) in 3 patients, associated with vasospasm in 7 patients, and 3 patients had double aneurysms. A total of 18 patients with aneurysms were treated with combined endovascular and microsurgical therapy. Early angiogram (< 1 week) revealed; complete obliteration of 19 aneurysms (90%) out of a total of 21 aneurysms, residual filling was observed in 2 aneurysms (10%). Late radiological follow up (> 3 months- 2 years) revealed; a stable residual filling in one and the other case underwent retreatment. \u0000Conclusions: The recalcitrant or complex cerebral aneurysms can be better referred to as diseases rather than lesions as many clinical and anatomical factors make their treatment difficult. Endovascular and microsurgery could be complementary to each other and create a multimodal approach for treating them.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46935758","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 : 2021-12-21DOI: 10.33962/roneuro-2021-070
Daniela C Bentia, A. Marinescu, F. Papagheorghe, Georgeta Popa, A. Ciurea
Introduction: Cavernomas are one of the four types of vascular malformations which develop in the central nervous system. From an imaging point of view, they are low flow small vessel malformations that cannot be seen on conventional angiography and are rarely visible on CT. They can be seen on MRI because of the para-magnetic haemoglobin break-down products within them. Case presentation: A 35 years old male presented at the emergency room following a tonic-clonic seizure, without urine emission. After a clinical exam, it was decided to perform a cerebral MRI with contrast substance and angiographic sequence. Clinical and imagistic results showed a superficial left temporal cavernoma, which showed signs of recent bleeding. After the surgery, the patient has no neurological deficits and is discharged afebrile and without any other symptoms. At 6 weeks after the surgery, the patients returned for neurosurgical reevaluation in perfect neurological condition, without motor deficit or intracranial hypertension. Conclusions: Cavernomas are angiographic cryptic vascular lesions that need an MRI investigation in order to appreciate them correctly.
{"title":"The importance of Nuclear Magnetic Resonance (MRI) in the diagnosis of cerebral cavernomas","authors":"Daniela C Bentia, A. Marinescu, F. Papagheorghe, Georgeta Popa, A. Ciurea","doi":"10.33962/roneuro-2021-070","DOIUrl":"https://doi.org/10.33962/roneuro-2021-070","url":null,"abstract":"Introduction: Cavernomas are one of the four types of vascular malformations which develop in the central nervous system. From an imaging point of view, they are low flow small vessel malformations that cannot be seen on conventional angiography and are rarely visible on CT. They can be seen on MRI because of the para-magnetic haemoglobin break-down products within them. \u0000Case presentation: A 35 years old male presented at the emergency room following a tonic-clonic seizure, without urine emission. After a clinical exam, it was decided to perform a cerebral MRI with contrast substance and angiographic sequence. Clinical and imagistic results showed a superficial left temporal cavernoma, which showed signs of recent bleeding. After the surgery, the patient has no neurological deficits and is discharged afebrile and without any other symptoms. At 6 weeks after the surgery, the patients returned for neurosurgical reevaluation in perfect neurological condition, without motor deficit or intracranial hypertension. \u0000Conclusions: Cavernomas are angiographic cryptic vascular lesions that need an MRI investigation in order to appreciate them correctly.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46414815","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 : 2021-12-21DOI: 10.33962/roneuro-2021-073
G. Popescu, F. Paslaru, A. Paslaru, M. Apostol, M. Zaharia, T. Corneliu, M. Mitrica, M. Popescu, R. M. Gorgan
Meningiomas are tumours of the meninges that arise primarily from arachnoidal cap cells, but they can also occur rarely as primary tumours in other localizations, such as within the ventricles. They stand for 24-30% of primary intracranial tumours and affect mostly women in their middle age or later adult life [1, 2]. Meningiomas can be classified, according to the World Health Organization (WHO) classification of Central Nervous System (CNS) tumours, as benign (grade I, most frequently encountered type), atypical (grade II) or anaplastic (grade III), based mostly on histopathological criteria known to be associated with tumour progression, recurrence risk and survival. Since meningioma grading based on the WHO classification is the most important factor determining therapeutic management and tumour prognosis, there has been an increasing interest in adding new criteria for better characterization of these tumours. Thus, the 2016 edition of the WHO classification recognized brain invasion as an independent criterion for atypical (grade II) meningioma diagnosis [3]. However, meningiomas that display aggressive features such as rapid growth and higher recurrence rate, can also involve blood vessels and bone. Hence, the authors aim to describe a different entity, aggressive meningiomas, not previously listed as a tumour phenotype in the WHO classification of meningothelial-cell tumours, with regard to pre-, intra- and postoperative methods for diagnosis and explore the implications on surgical strategies and adjuvant therapy.
{"title":"Imaging characteristics, histopathological features and surgical considerations regarding aggressive meningiomas","authors":"G. Popescu, F. Paslaru, A. Paslaru, M. Apostol, M. Zaharia, T. Corneliu, M. Mitrica, M. Popescu, R. M. Gorgan","doi":"10.33962/roneuro-2021-073","DOIUrl":"https://doi.org/10.33962/roneuro-2021-073","url":null,"abstract":"Meningiomas are tumours of the meninges that arise primarily from arachnoidal cap cells, but they can also occur rarely as primary tumours in other localizations, such as within the ventricles. They stand for 24-30% of primary intracranial tumours and affect mostly women in their middle age or later adult life [1, 2]. Meningiomas can be classified, according to the World Health Organization (WHO) classification of Central Nervous System (CNS) tumours, as benign (grade I, most frequently encountered type), atypical (grade II) or anaplastic (grade III), based mostly on histopathological criteria known to be associated with tumour progression, recurrence risk and survival. Since meningioma grading based on the WHO classification is the most important factor determining therapeutic management and tumour prognosis, there has been an increasing interest in adding new criteria for better characterization of these tumours. Thus, the 2016 edition of the WHO classification recognized brain invasion as an independent criterion for atypical (grade II) meningioma diagnosis [3]. However, meningiomas that display aggressive features such as rapid growth and higher recurrence rate, can also involve blood vessels and bone. Hence, the authors aim to describe a different entity, aggressive meningiomas, not previously listed as a tumour phenotype in the WHO classification of meningothelial-cell tumours, with regard to pre-, intra- and postoperative methods for diagnosis and explore the implications on surgical strategies and adjuvant therapy.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47327218","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 : 2021-12-21DOI: 10.33962/roneuro-2021-077
G. Jose, T. Abraham, P. Balakrishnan, Muhammed P.S. Irphan, T.P. Haris, Vala Parth Prakashbhai
Background: Posterior spine fixation and decompression for thoracic and lumbar spine fractures have the advantage of stabilization of the fracture, decompression of neural canal, early mobilization and rehabilitation of the patient. The study aimed to find out the postoperative outcome and complications following posterior spine surgery and the factors affecting the outcome. Methods: A retrospective study was carried out among 44 patients who underwent posterior spine decompression and fusion for thoracic and lumbar spine fracture. The data regarding patient presenting symptoms, comorbidity, associated injuries and imaging finding in CT and MRI were collected. The postoperative outcome of patients after surgery was assessed using ASIA impairment scale, KPS, VAS scale for pain are noted at the preoperative and postoperative period. Other factors like improvement of bowel and bladder symptoms, back stiffness and return to the job after surgery were also found out. Results: There was a significant improvement in ASIA impairment scale (mean =0.74 grade), KPS score (mean = 40) and VAS pain scale (mean = 6.7) at 6 months follow up after surgery. Improvement in ASIA impairment scale was more in the patient with severe canal compromise (mean = 1.62 grade), patients with translational/ distraction injuries (mean= 1.01grade) and patients with paraparesis (mean=1.06). Only one-third of patients with bowel and bladder involvement improved after surgery. Around 56.8% of patients were able to return to jobs at 6 months follow up. Patients who were paraplegic at the initial presentation were mostly not able to return to jobs. The most common reported complication in the study was intraoperative pedicle breakage. Conclusion: Decompression of the spinal cord plus posterior spine fixation is a safe, reliable and effective method in the management of thoracic and lumbar fractures with significant improvement in outcome in terms of motor power, pain and quality of life.
{"title":"Outcome of patients undergoing posterior spine fixation and decompression for posttraumatic thoracolumbar spine fractures and the factors predicting it","authors":"G. Jose, T. Abraham, P. Balakrishnan, Muhammed P.S. Irphan, T.P. Haris, Vala Parth Prakashbhai","doi":"10.33962/roneuro-2021-077","DOIUrl":"https://doi.org/10.33962/roneuro-2021-077","url":null,"abstract":"Background: Posterior spine fixation and decompression for thoracic and lumbar spine fractures have the advantage of stabilization of the fracture, decompression of neural canal, early mobilization and rehabilitation of the patient. The study aimed to find out the postoperative outcome and complications following posterior spine surgery and the factors affecting the outcome. \u0000Methods: A retrospective study was carried out among 44 patients who underwent posterior spine decompression and fusion for thoracic and lumbar spine fracture. The data regarding patient presenting symptoms, comorbidity, associated injuries and imaging finding in CT and MRI were collected. The postoperative outcome of patients after surgery was assessed using ASIA impairment scale, KPS, VAS scale for pain are noted at the preoperative and postoperative period. Other factors like improvement of bowel and bladder symptoms, back stiffness and return to the job after surgery were also found out. \u0000Results: There was a significant improvement in ASIA impairment scale (mean =0.74 grade), KPS score (mean = 40) and VAS pain scale (mean = 6.7) at 6 months follow up after surgery. Improvement in ASIA impairment scale was more in the patient with severe canal compromise (mean = 1.62 grade), patients with translational/ distraction injuries (mean= 1.01grade) and patients with paraparesis (mean=1.06). Only one-third of patients with bowel and bladder involvement improved after surgery. Around 56.8% of patients were able to return to jobs at 6 months follow up. Patients who were paraplegic at the initial presentation were mostly not able to return to jobs. The most common reported complication in the study was intraoperative pedicle breakage. \u0000Conclusion: Decompression of the spinal cord plus posterior spine fixation is a safe, reliable and effective method in the management of thoracic and lumbar fractures with significant improvement in outcome in terms of motor power, pain and quality of life.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41999253","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 : 2021-12-15DOI: 10.33962/roneuro-2021-088
O. Palamar, A. Huk, R. Aksyonov, D. Teslenko, D. Okonskyi, Nazarii V. Lazko
Neurosurgical approaches to lesions of the lateral and the third ventricles are divided into two fundamentally different groups: transcortical neurosurgical approaches, including - endoscopic and interhemispheric transcallosal microneurosurgical approaches. Complications in surgery of lateral and third ventricle tumours are often associated with the specific approach technique and could be transient. We analyzed postoperative neurological complications and the approach criteria on MRI or CT scans in postoperative period such as localization of corticotomy, distance from corticotomy to coronal suture, “angle of attack” after the frontal transcortical approach to the lateral and third ventricle based on 54 cases and presume transient nature of specific to approach complications and approaches’ factors that have role in postoperative mutism.
{"title":"Postoperative complications in endoscopic frontal transcortical surgery of lateral and third ventricle tumours","authors":"O. Palamar, A. Huk, R. Aksyonov, D. Teslenko, D. Okonskyi, Nazarii V. Lazko","doi":"10.33962/roneuro-2021-088","DOIUrl":"https://doi.org/10.33962/roneuro-2021-088","url":null,"abstract":"Neurosurgical approaches to lesions of the lateral and the third ventricles are divided into two fundamentally different groups: transcortical neurosurgical approaches, including - endoscopic and interhemispheric transcallosal microneurosurgical approaches. Complications in surgery of lateral and third ventricle tumours are often associated with the specific approach technique and could be transient. We analyzed postoperative neurological complications and the approach criteria on MRI or CT scans in postoperative period such as localization of corticotomy, distance from corticotomy to coronal suture, “angle of attack” after the frontal transcortical approach to the lateral and third ventricle based on 54 cases and presume transient nature of specific to approach complications and approaches’ factors that have role in postoperative mutism. ","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42968864","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 : 2021-12-15DOI: 10.33962/roneuro-2021-081
Adesh Shrivastava, N. Maria, Rakesh Mishra, W. Florez-Perdomo, A. Agrawal, L. Moscote-Salazar
Surgical smoke also referred to as cautery smoke is a gaseous mixture produced during surgical procedures where there is ablation, cutting, coagulation, desiccation or vaporization of the tissue. In a true sense "surgical smoke” refers to surgically generated gaseous contents. The surgical smoke results from the destruction of bones and tissues, causing microscopic particles to get suspended in the environment.
{"title":"Surgical smoke, neurosurgical practice and coronavirus","authors":"Adesh Shrivastava, N. Maria, Rakesh Mishra, W. Florez-Perdomo, A. Agrawal, L. Moscote-Salazar","doi":"10.33962/roneuro-2021-081","DOIUrl":"https://doi.org/10.33962/roneuro-2021-081","url":null,"abstract":"Surgical smoke also referred to as cautery smoke is a gaseous mixture produced during surgical procedures where there is ablation, cutting, coagulation, desiccation or vaporization of the tissue. In a true sense \"surgical smoke” refers to surgically generated gaseous contents. The surgical smoke results from the destruction of bones and tissues, causing microscopic particles to get suspended in the environment. ","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46346655","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 : 2021-12-15DOI: 10.33962/roneuro-2021-091
Randy Reina-Rivero, M. Rodríguez-Gutiérrez, Michael Gregorio Ortega Sierra, Diego Fernando Jamioy-Cabrera, Juan Felipe Villegas-Lora, Daniela Margoth Caycedo-Montiel, Juan David Balanta-Perea, Richard Adrian Vergara-Trujillo, Fernando Bellera, Y. Picón-Jaimes
Multimodal neuromonitoring is used as an adjunct to clinical neurological examination, imaging and other diagnostic studies to obtain the most detailed information about the physiology of the brain. Neuromonitoring has been a standard of care for patients presenting with traumatic brain injury in most critical care centres for the past several years. Neuromonitoring is composed of multiple variables, which not only provides a better dynamic of the pathophysiology of the compromised brain but also how it might respond to the corresponding management procedures. Although the clinical neurological examination is the standard for monitoring the neurocritical patient, the results obtained in the latter may be insufficient or inconclusive to detect or prevent secondary brain injury. Therefore, multiple neuromonitoring tools have been developed to measure different physiological variables that can contribute to a better follow-up of patients with traumatic brain injury. These variables include cerebral blood flow, cerebral electrical activity, cerebral metabolism, cerebral oxygenation and cerebral pressure. Thanks to monitoring as an adjuvant in critical care, it has been possible to avoid, identify and manage secondary brain injuries that commonly aggravate patients. This review aims to illustrate the main advantages and most recent recommendations regarding neuromonitoring based on the most current evidence.
{"title":"Multimodal neurological monitoring in neurotrauma","authors":"Randy Reina-Rivero, M. Rodríguez-Gutiérrez, Michael Gregorio Ortega Sierra, Diego Fernando Jamioy-Cabrera, Juan Felipe Villegas-Lora, Daniela Margoth Caycedo-Montiel, Juan David Balanta-Perea, Richard Adrian Vergara-Trujillo, Fernando Bellera, Y. Picón-Jaimes","doi":"10.33962/roneuro-2021-091","DOIUrl":"https://doi.org/10.33962/roneuro-2021-091","url":null,"abstract":"Multimodal neuromonitoring is used as an adjunct to clinical neurological examination, imaging and other diagnostic studies to obtain the most detailed information about the physiology of the brain. Neuromonitoring has been a standard of care for patients presenting with traumatic brain injury in most critical care centres for the past several years. Neuromonitoring is composed of multiple variables, which not only provides a better dynamic of the pathophysiology of the compromised brain but also how it might respond to the corresponding management procedures. Although the clinical neurological examination is the standard for monitoring the neurocritical patient, the results obtained in the latter may be insufficient or inconclusive to detect or prevent secondary brain injury. Therefore, multiple neuromonitoring tools have been developed to measure different physiological variables that can contribute to a better follow-up of patients with traumatic brain injury. These variables include cerebral blood flow, cerebral electrical activity, cerebral metabolism, cerebral oxygenation and cerebral pressure. Thanks to monitoring as an adjuvant in critical care, it has been possible to avoid, identify and manage secondary brain injuries that commonly aggravate patients. This review aims to illustrate the main advantages and most recent recommendations regarding neuromonitoring based on the most current evidence.","PeriodicalId":30188,"journal":{"name":"Romanian Neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49279672","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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