Background and Purpose: Microembolic Signals (MES) are frequently observed in Transcranial Doppler (TCD) recordings of patients with Mechanical Heart Valve (MHV).We hypothesized that number of MES produced by MHV could be reduced with oxygen inhalation, if gaseous bubbles are the underlying cause. Methods: All consecutive patients with St Jude aortic valves visiting the cardiology clinic were refered to the neurosonology unit, Valie Asr Hospital, Khorasan during August 2003 to August 2004. TCD monitoring of MES was performed with an ultrasound device (Vingmed 800 Oslo,Norway) and a 2 MHz probe. The MES counts were recorded during 30 minutes breathing room air and thereafter 30 minutes breathing through a facial mask with reservior bag (6 liter O2 per minute). The criteria of MES detection were characteristic chrip sound, unidirectional signal, random appearance within cardiac cycle and intensity increase 3dB above background. The MES counts in two periods of monitoring were compared with paired T test and significance was declared at P < 0.05. Results: Twelve patients (8 females and 4 males) were investigated. Oxygen ventilation caused a significant decrease of MES counts in the patients in comarison to breathing room air, P = 0.001. Thus MES in patients with MHV are mainly gaseous bubbles caused by blood agitation with MHV. Conclusion: The quantity of MES in patients with MHV is not related to the risk of thromboembolic complications in these patients.
{"title":"Evaluation of Cerebral Microembolic Signals in Patients with Mechanical Aortic Valves","authors":"K. Ghandehari, Zahra Izadimoud","doi":"10.5580/1d69","DOIUrl":"https://doi.org/10.5580/1d69","url":null,"abstract":"Background and Purpose: Microembolic Signals (MES) are frequently observed in Transcranial Doppler (TCD) recordings of patients with Mechanical Heart Valve (MHV).We hypothesized that number of MES produced by MHV could be reduced with oxygen inhalation, if gaseous bubbles are the underlying cause. Methods: All consecutive patients with St Jude aortic valves visiting the cardiology clinic were refered to the neurosonology unit, Valie Asr Hospital, Khorasan during August 2003 to August 2004. TCD monitoring of MES was performed with an ultrasound device (Vingmed 800 Oslo,Norway) and a 2 MHz probe. The MES counts were recorded during 30 minutes breathing room air and thereafter 30 minutes breathing through a facial mask with reservior bag (6 liter O2 per minute). The criteria of MES detection were characteristic chrip sound, unidirectional signal, random appearance within cardiac cycle and intensity increase 3dB above background. The MES counts in two periods of monitoring were compared with paired T test and significance was declared at P < 0.05. Results: Twelve patients (8 females and 4 males) were investigated. Oxygen ventilation caused a significant decrease of MES counts in the patients in comarison to breathing room air, P = 0.001. Thus MES in patients with MHV are mainly gaseous bubbles caused by blood agitation with MHV. Conclusion: The quantity of MES in patients with MHV is not related to the risk of thromboembolic complications in these patients.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127747706","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}
Intravenous heparin infusion has been the mainstay of treatment for cerebral venous sinus thrombosis (CVST). Surgical and neuroradiological treatment was once an uncommon occurrence. Recent trends, however, have been to employ endovascular or surgical intervention strategies in carefully selected cases and the combined use of these modalities is on the rise. These strategies include endovascular thrombolysis, mechanical thrombectomy to remove the clot and operative neurosurgery to treat raised intracranial pressure. We review the literature and present an update on current treatment strategies.
{"title":"Current intervention strategies for Cerebral Venous Sinus Thrombosis","authors":"Andre des Etages, H. Chan","doi":"10.5580/bb1","DOIUrl":"https://doi.org/10.5580/bb1","url":null,"abstract":"Intravenous heparin infusion has been the mainstay of treatment for cerebral venous sinus thrombosis (CVST). Surgical and neuroradiological treatment was once an uncommon occurrence. Recent trends, however, have been to employ endovascular or surgical intervention strategies in carefully selected cases and the combined use of these modalities is on the rise. These strategies include endovascular thrombolysis, mechanical thrombectomy to remove the clot and operative neurosurgery to treat raised intracranial pressure. We review the literature and present an update on current treatment strategies.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126526540","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}
Introduction: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two thirds of all intraspinal neoplasms. The purpose of this report was to determine shortand long-term outcomes of surgical patients with IESCT, and to examine clinical features that could be helpful in management of patients with these lesions. Methods: A retrospective review of 67 operative IESCT cases between 1974 and 2001 was performed. Outcomes were scored at one month and at mean follow-up of 8.5 months postoperatively. In addition, patient demographics, tumor types and locations were also collected. Statistical analysis was conducted utilizing Chi-square and Student's t-tests. Results: There were 31 men and 36 women (mean age 48 y/o, range 18-87 y/o). Men presented at a younger age than women (44 vs 53 y/o, P<0.02). Fifty-seven (85%) patients presented with severe radiculopathy and/or myelopathy. The remaining 10 (15%) had symptoms typical of disc herniation. Mean duration of symptoms prior to diagnosis was 11 months. Schwannomas (36 patients) had the longest mean duration of symptoms (14.9 months), followed by meningiomas (21 patients, 8.4 months), and ependymomas (10 patients, 2 months). Sixty-three (94%) of patients demonstrated significant improvement at one-month and 62 (92%) at 8.5-month mean follow-up as compared to the index exam. Only 13/67 (19.4%) patients had residual focal deficits on long term follow-up. Conclusions: Surgery for IESCT should be expected to produce significant and dramatic improvement in great majority of patients. Demographic, tumor-specific and anatomic considerations may be clinically useful when approaching IESCT.
{"title":"Intradural Extramedullary Spinal Cord Tumors: A Retrospective Study of Tumor Types, Locations, and Surgical Outcomes","authors":"S. P. Stawicki, J. Guarnaschelli","doi":"10.5580/ae8","DOIUrl":"https://doi.org/10.5580/ae8","url":null,"abstract":"Introduction: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two thirds of all intraspinal neoplasms. The purpose of this report was to determine shortand long-term outcomes of surgical patients with IESCT, and to examine clinical features that could be helpful in management of patients with these lesions. Methods: A retrospective review of 67 operative IESCT cases between 1974 and 2001 was performed. Outcomes were scored at one month and at mean follow-up of 8.5 months postoperatively. In addition, patient demographics, tumor types and locations were also collected. Statistical analysis was conducted utilizing Chi-square and Student's t-tests. Results: There were 31 men and 36 women (mean age 48 y/o, range 18-87 y/o). Men presented at a younger age than women (44 vs 53 y/o, P<0.02). Fifty-seven (85%) patients presented with severe radiculopathy and/or myelopathy. The remaining 10 (15%) had symptoms typical of disc herniation. Mean duration of symptoms prior to diagnosis was 11 months. Schwannomas (36 patients) had the longest mean duration of symptoms (14.9 months), followed by meningiomas (21 patients, 8.4 months), and ependymomas (10 patients, 2 months). Sixty-three (94%) of patients demonstrated significant improvement at one-month and 62 (92%) at 8.5-month mean follow-up as compared to the index exam. Only 13/67 (19.4%) patients had residual focal deficits on long term follow-up. Conclusions: Surgery for IESCT should be expected to produce significant and dramatic improvement in great majority of patients. Demographic, tumor-specific and anatomic considerations may be clinically useful when approaching IESCT.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125111433","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}
Continuous Video-EEG monitoring (CCTV) was initiated on a 63-year-old male admitted to the neurological intensive care unit (NICU) with sub-arachnoid hemorrhage due to rupture of a right posterior communicating artery aneurysm. During review of the overnight record a sudden change in the baseline record occurred with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads ( Fig 1 and 2). This electrographic discharge was correctly recognized to be a non-physiological (non-cerebral) artifact generated by the to and fro rocking motion of the motorized bed on visual inspection of the concurrent video record. This motorized bed artifact further disappeared when the bed was switched off thus confirming its non-cerebral origin. With continuous EEG monitoring becoming increasingly common in the intensive care unit, correct identification of artifacts generated by the patient's surroundings is of paramount importance to prevent misinterpretation of the EEG and inadvertent over treatment. Figure 1 Figures 1 and 2. EEG record showing a sudden change in the baseline record with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads.
{"title":"Motorized bed artifact in the Intensive Care Unit","authors":"N. Sethi, J. Torgovnick, P. Sethi","doi":"10.5580/689","DOIUrl":"https://doi.org/10.5580/689","url":null,"abstract":"Continuous Video-EEG monitoring (CCTV) was initiated on a 63-year-old male admitted to the neurological intensive care unit (NICU) with sub-arachnoid hemorrhage due to rupture of a right posterior communicating artery aneurysm. During review of the overnight record a sudden change in the baseline record occurred with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads ( Fig 1 and 2). This electrographic discharge was correctly recognized to be a non-physiological (non-cerebral) artifact generated by the to and fro rocking motion of the motorized bed on visual inspection of the concurrent video record. This motorized bed artifact further disappeared when the bed was switched off thus confirming its non-cerebral origin. With continuous EEG monitoring becoming increasingly common in the intensive care unit, correct identification of artifacts generated by the patient's surroundings is of paramount importance to prevent misinterpretation of the EEG and inadvertent over treatment. Figure 1 Figures 1 and 2. EEG record showing a sudden change in the baseline record with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114253151","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}
The electroencephalogram (EEG) is meant to record cerebral activity but it also picks up electrical signals arising from extracerebral sites. The EEG record is frequently contaminated by electrical signals arising from the immediate patient environment giving rise to nonphysiological artifacts. Non-physiological artifacts commonly arise from monitoring devices like infusion pumps and suctioning devices though electrical devices like mobile phones may also contaminate the EEG record 1. During inpatient video EEG recording of a patient, intermittent 30 Hz sharply contoured waveforms lasting 2 seconds were visualized (Fig 1,2) . Figure 1 Figures 1 & 2: EEG recording showing low amplitude sharply contoured waveforms lasting on an average 2 seconds and corresponding to the frequency of the telephone ring. Figure 2 Upon viewing the video image these sharply contoured waveforms were correctly identified as a non-physiological artifact generated by the telephone ringing in the patient's room. Further more the frequency of the artifact matched the frequency of the telephone ring. Recognition of these artifacts is important to avoid misinterpretation of the EEG and erroneous treatment decisions. CORRESPONDENCE TO Nitin Sethi, MD Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68th Street New York, NY 10021 e-mail: sethinitinmd@hotmail.com References 1. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8):1876-8. Telephone artifact in EEG recordings 2 of 2 Author Information N. K. Sethi, M.D. Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P. K. Sethi, M.D. Department of Neurology, Sir Ganga Ram Hospital J. Torgovnick, M.D. Department of Neurology, Saint Vincent's Hospital and Medical Centers E. Arsura, M.D. Department of Medicine, Saint Vincent's Hospital and Medical Center,
脑电图(EEG)是用来记录大脑活动的，但它也可以接收来自脑外部位的电信号。脑电图记录经常受到来自患者周围环境的电信号的污染，从而产生非生理性伪影。非生理性伪影通常来自输液泵和吸引装置等监测设备，尽管手机等电子设备也可能污染脑电图记录1。在住院患者的视频脑电图记录中，可以看到持续2秒的间歇性30hz尖锐轮廓波形(图1,2)。图1和图2:脑电图记录显示平均持续2秒的低幅值尖锐轮廓波形，与电话铃声的频率相对应。在观看视频图像后，这些轮廓清晰的波形被正确地识别为由患者房间的电话铃声产生的非生理性伪影。此外，伪影的频率与电话铃声的频率相匹配。识别这些伪影对于避免对脑电图的误解和错误的治疗决定是很重要的。Nitin Sethi, MD综合癫痫中心NYP-Weill康奈尔医疗中心525 East, 68街纽约，NY 10021电子邮件:sethinitinmd@hotmail.comSethi PK, Sethi NK, Torgovnick J.手机制品。临床神经生理学杂志2006;117(8): 1876 - 8。N. K. Sethi，医学博士，综合癫痫中心，nypp - weill Cornell医学中心P. K. Sethi，神经内科博士，Sir Ganga Ram医院J. Torgovnick，神经内科博士，圣文森特医院和医疗中心E. Arsura，医学博士，圣文森特医院和医疗中心，
{"title":"Telephone artifact in EEG recordings","authors":"N. Sethi, P. Sethi, J. Torgovnick, E. Arsura","doi":"10.5580/27e2","DOIUrl":"https://doi.org/10.5580/27e2","url":null,"abstract":"The electroencephalogram (EEG) is meant to record cerebral activity but it also picks up electrical signals arising from extracerebral sites. The EEG record is frequently contaminated by electrical signals arising from the immediate patient environment giving rise to nonphysiological artifacts. Non-physiological artifacts commonly arise from monitoring devices like infusion pumps and suctioning devices though electrical devices like mobile phones may also contaminate the EEG record 1. During inpatient video EEG recording of a patient, intermittent 30 Hz sharply contoured waveforms lasting 2 seconds were visualized (Fig 1,2) . Figure 1 Figures 1 & 2: EEG recording showing low amplitude sharply contoured waveforms lasting on an average 2 seconds and corresponding to the frequency of the telephone ring. Figure 2 Upon viewing the video image these sharply contoured waveforms were correctly identified as a non-physiological artifact generated by the telephone ringing in the patient's room. Further more the frequency of the artifact matched the frequency of the telephone ring. Recognition of these artifacts is important to avoid misinterpretation of the EEG and erroneous treatment decisions. CORRESPONDENCE TO Nitin Sethi, MD Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68th Street New York, NY 10021 e-mail: sethinitinmd@hotmail.com References 1. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8):1876-8. Telephone artifact in EEG recordings 2 of 2 Author Information N. K. Sethi, M.D. Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P. K. Sethi, M.D. Department of Neurology, Sir Ganga Ram Hospital J. Torgovnick, M.D. Department of Neurology, Saint Vincent's Hospital and Medical Centers E. Arsura, M.D. Department of Medicine, Saint Vincent's Hospital and Medical Center,","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121395463","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}
We present a pediatric patient with osteoblastoma of D1 vertebra. Neck trauma occurred 11/2 year before the onset of symptoms. Patient presented with Neck-pain for one-year. Cure was provided by complete surgical excision. We highlight the rarity of the site of occurrence of osteoblastoma and the fact that a radical treatment needs to be performed.
{"title":"Spinal Osteoblastoma In A Pediatric Patient: Case Report With Review Of Literature","authors":"R. Agrawal, S. Chauhan, N. Gopal, R. Mehrotra","doi":"10.5580/166f","DOIUrl":"https://doi.org/10.5580/166f","url":null,"abstract":"We present a pediatric patient with osteoblastoma of D1 vertebra. Neck trauma occurred 11/2 year before the onset of symptoms. Patient presented with Neck-pain for one-year. Cure was provided by complete surgical excision. We highlight the rarity of the site of occurrence of osteoblastoma and the fact that a radical treatment needs to be performed.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125735964","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}
Creutzfeldt- Jakob disease (CJD) is included under the umbrella of prior related neurodegenerative diseases. Other prior related diseases include Gerstmann-Str‰usslerScheinker (GSS), fatal familial insomnia (FFI), Kuru and new variant CJD (BSE) in humans, chronic wasting disease (CWD) in deer and scrapie in sheep. Sporadic CJD presents with rapidly progressive dementia and myoclonus. Diagnosis is typically clinical and supplemented by electroencephalography (EEG) and analysis of cerebrospinal fluid. During the course of sporadic CJD, most patients develop a characteristic picture on EEG with one second periodic or pseudoperiodic sharp waves complexes (PSWC) or spikes superimposed on a slow background (Fig 1 and 2).
{"title":"Periodic Sharp Wave Complexes in Patient with Creutzfeldt-Jakob Disease","authors":"N. Sethi, P. Sethi, J. Torgovnick","doi":"10.5580/2348","DOIUrl":"https://doi.org/10.5580/2348","url":null,"abstract":"Creutzfeldt- Jakob disease (CJD) is included under the umbrella of prior related neurodegenerative diseases. Other prior related diseases include Gerstmann-Str‰usslerScheinker (GSS), fatal familial insomnia (FFI), Kuru and new variant CJD (BSE) in humans, chronic wasting disease (CWD) in deer and scrapie in sheep. Sporadic CJD presents with rapidly progressive dementia and myoclonus. Diagnosis is typically clinical and supplemented by electroencephalography (EEG) and analysis of cerebrospinal fluid. During the course of sporadic CJD, most patients develop a characteristic picture on EEG with one second periodic or pseudoperiodic sharp waves complexes (PSWC) or spikes superimposed on a slow background (Fig 1 and 2).","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131817083","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}
K. A. Oluyemi, O. A. Adesanya, D. Ofusori, Christina U. Okwuonu, V. Ukwenya, F. Om'iniabohs, Blessing I. Odion
We encountered a brachial plexus with two cords (Medial & Lateral) and three abnormal communications. The lateral cord sent an abnormal branch to the medial cord as the medial root of median nerve emerged from the latter. A branch from the posterior aspect of the medial cord divided into the radial and axillary nerves. The musculocutaneous nerve sent an abnormal branch to the Median nerve at the level of mid-arm. There was also an abnormal communication between the ulnar and radial nerve at the mid-arm region. Knowledge of these variations is important in nerve entrapment syndromes involving different branches of brachial plexus.
{"title":"Abnormal Pattern Of Brachial Plexus Formation: An Original Case Report","authors":"K. A. Oluyemi, O. A. Adesanya, D. Ofusori, Christina U. Okwuonu, V. Ukwenya, F. Om'iniabohs, Blessing I. Odion","doi":"10.5580/3d1","DOIUrl":"https://doi.org/10.5580/3d1","url":null,"abstract":"We encountered a brachial plexus with two cords (Medial & Lateral) and three abnormal communications. The lateral cord sent an abnormal branch to the medial cord as the medial root of median nerve emerged from the latter. A branch from the posterior aspect of the medial cord divided into the radial and axillary nerves. The musculocutaneous nerve sent an abnormal branch to the Median nerve at the level of mid-arm. There was also an abnormal communication between the ulnar and radial nerve at the mid-arm region. Knowledge of these variations is important in nerve entrapment syndromes involving different branches of brachial plexus.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133450040","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}
N. Sethi, N. Schaul, D. Kolesnik, D. Labar, P. Sethi
Artifacts are signals recorded on the electroencephalogram (EEG) that are not cerebral in origin and can be divided into physiological and non-physiological artifacts. Physiological artifacts are generated from the patient itself and include cardiac, glossokinetic, muscle, eye movement, respiratory and pulse artifact among many others. Numerous nonphysiological artifacts generated from the immediate patient surroundings can contaminate EEG recordings. Common non-physiological artifacts include those generated by monitoring devices, infusion pumps, suctioning devices and chest physiotherapy 1. Lately artifacts generated by electronic devices like mobile phones have been reported 2. During inpatient video EEG recording of a patient, rhythmic highly sharply contoured 14-16 Hz waveforms were visualized in all the leads (Fig 1,2). Figure 1 Figure 1: EEG record showing onset of 14-16 cycles per second rhythmic highly sharply contoured waveforms in all leads. Figure 2 Figure 2: EEG record showing 14-16 cycles per second rhythmic highly sharply contoured waveforms. This artifact occurred whenever the patient touched the laptop pad. Upon viewing the video images, this sharply contoured discharge was noted to occur whenever the patient touched the laptop pad in front of her. We tried to cross and uncross the wire of the laptop AC adaptor with the EEG head box but were unable to isolate what exactly generated these waveforms. The patient was using a wireless PC card to access the Internet. Recognition of non-physiological artifacts like these is important to avoid misinterpretation of the EEG and erroneous treatment decisions. It also highlights the point that medical devices may fail to operate correctly due to interference from various emitters of radiofrequency energy. CORRESPONDENCE TO NK Sethi, MD Department of Neurology Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68 Street New York, NY 10021(U.S.A.) E-mail: sethinitinmd@hotmail.com Laptop artifact during electroencephalography 2 of 3 References 1. Sethi NK, Torgovnick J, Sethi PK. Chest percussion artifact. Clin Neurophysiol. 2007; 118 (2): 475-6. 2. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8): 1876-8. Laptop artifact during electroencephalography 3 of 3 Author Information N.K. Sethi Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center N. Schaul Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Kolesnik Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Labar Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P.K. Sethi Department of Neurology, Sir Ganga Ram Hospital
伪影是记录在脑电图(EEG)上的非脑源信号，可分为生理性和非生理性伪影。生理伪影是由患者自身产生的，包括心脏、舌动、肌肉、眼动、呼吸和脉搏等。患者周围环境产生的许多非生理性伪影会污染脑电图记录。常见的非生理性伪影包括由监测装置、输液泵、吸引装置和胸部物理治疗产生的伪影1。最近，像手机这样的电子设备产生的人工制品也有报道。在住院患者的视频脑电图记录中，在所有导联中都可以看到有节奏的高度清晰轮廓的14- 16hz波形(图1,2)。图1:脑电图记录显示，在所有导联中，每秒钟有14-16个周期的节律性高轮廓波形。图2:脑电图记录显示每秒14-16个周期的节律性高轮廓波形。每当患者触摸笔记本电脑时，就会出现这种现象。在观看视频图像时，每当患者触摸她面前的笔记本电脑时，就会出现这种明显的轮廓放电。我们试图将笔记本电脑交流适配器与脑电图头盒的电线交叉或分开，但无法分离出究竟是什么产生了这些波形。该患者使用无线PC卡访问互联网。识别像这样的非生理性伪影对于避免对脑电图的误解和错误的治疗决定是很重要的。它还强调，由于各种射频能量发射器的干扰，医疗设备可能无法正常运行。NK Sethi医学博士神经内科综合癫痫中心NYP-Weill Cornell医疗中心525 East, 68 Street New York, NY 10021(美国)电子邮件:sethinitinmd@hotmail.com脑电图期间的笔记本电脑伪影2 / 3参考文献1。Sethi NK, Torgovnick J, Sethi PK。胸部敲击神器。临床神经生理学杂志2007;118(2): 476 - 476。2. Sethi PK, Sethi NK, Torgovnick J.手机制品。临床神经生理学杂志2006;117(8): 1876 - 8。脑电图中的笔记本电脑图像3 / 3作者信息N.K. Sethi神经内科，综合癫痫中心，nypp - weill Cornell医学中心N. Schaul神经内科，综合癫痫中心，纽约医院D. Kolesnik神经内科，综合癫痫中心，纽约医院D. Labar神经内科，综合癫痫中心，nypp - weill Cornell医学中心P.K. Sethi神经内科，Sir Ganga Ram医院
{"title":"Laptop artifact during electroencephalography","authors":"N. Sethi, N. Schaul, D. Kolesnik, D. Labar, P. Sethi","doi":"10.5580/1994","DOIUrl":"https://doi.org/10.5580/1994","url":null,"abstract":"Artifacts are signals recorded on the electroencephalogram (EEG) that are not cerebral in origin and can be divided into physiological and non-physiological artifacts. Physiological artifacts are generated from the patient itself and include cardiac, glossokinetic, muscle, eye movement, respiratory and pulse artifact among many others. Numerous nonphysiological artifacts generated from the immediate patient surroundings can contaminate EEG recordings. Common non-physiological artifacts include those generated by monitoring devices, infusion pumps, suctioning devices and chest physiotherapy 1. Lately artifacts generated by electronic devices like mobile phones have been reported 2. During inpatient video EEG recording of a patient, rhythmic highly sharply contoured 14-16 Hz waveforms were visualized in all the leads (Fig 1,2). Figure 1 Figure 1: EEG record showing onset of 14-16 cycles per second rhythmic highly sharply contoured waveforms in all leads. Figure 2 Figure 2: EEG record showing 14-16 cycles per second rhythmic highly sharply contoured waveforms. This artifact occurred whenever the patient touched the laptop pad. Upon viewing the video images, this sharply contoured discharge was noted to occur whenever the patient touched the laptop pad in front of her. We tried to cross and uncross the wire of the laptop AC adaptor with the EEG head box but were unable to isolate what exactly generated these waveforms. The patient was using a wireless PC card to access the Internet. Recognition of non-physiological artifacts like these is important to avoid misinterpretation of the EEG and erroneous treatment decisions. It also highlights the point that medical devices may fail to operate correctly due to interference from various emitters of radiofrequency energy. CORRESPONDENCE TO NK Sethi, MD Department of Neurology Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68 Street New York, NY 10021(U.S.A.) E-mail: sethinitinmd@hotmail.com Laptop artifact during electroencephalography 2 of 3 References 1. Sethi NK, Torgovnick J, Sethi PK. Chest percussion artifact. Clin Neurophysiol. 2007; 118 (2): 475-6. 2. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8): 1876-8. Laptop artifact during electroencephalography 3 of 3 Author Information N.K. Sethi Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center N. Schaul Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Kolesnik Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Labar Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P.K. Sethi Department of Neurology, Sir Ganga Ram Hospital","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126773539","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}
Background: :This study was conducted to analyze the clinical features and therapeutic outcome for brain abscesses caused by gram negative bacilli. Methods: 41 patients with gram negative bacillary brain abscess, out of a total of 278 cases, 25 males and 16 female aged 2-72 years were reviewed at IMS, BHU and JN Medical College Hospital AMU, over a 17 year period for Predisposing factors, clinical feature and therapeutic outcome. Results: The most common presenting symptoms were headache, vomiting, fever and altered sensorium. At the time of admission 26.10% had GCS <9. Temporal and temporoparietal was the commonest site and 14.6% had multiple abscesses. The common predisposing factors were otic infection, penetrating trauma and chest infections with diabetes mellitus being the main underlying disease. CT and MRI facilitated early diagnosis. Surgical intervention was done in 97.1% cases. The most common pathogen isolated was pseudomonas in otogenic group, E. coli in head injury group and Klebsiella in hematogenous spread. 39.04% cases were multidrug resistant with pseudomonas being the main culprit. The overall mortality was 26.8% with the presence of septic shock and multidrug resistance being the poor prognostic factors. Conclusion: Brain abscesses caused by gram negative bacilli are not rare and often have a high prevalence of septic shock, multidrug resistance and death. Clinical presentation and therapeutic outcomes vary according to different pathogenic species. In light of high mortality rate an early diagnosis and prompt management is essential to maximize the chance for survival.
{"title":"Gram Negative Bacillary Brain Abscess: Clinical Features And Therapeutic Outcome","authors":"Fakhrul Huda, Vivek Sharma, W. Ali, M. Rashid","doi":"10.5580/2863","DOIUrl":"https://doi.org/10.5580/2863","url":null,"abstract":"Background: :This study was conducted to analyze the clinical features and therapeutic outcome for brain abscesses caused by gram negative bacilli. Methods: 41 patients with gram negative bacillary brain abscess, out of a total of 278 cases, 25 males and 16 female aged 2-72 years were reviewed at IMS, BHU and JN Medical College Hospital AMU, over a 17 year period for Predisposing factors, clinical feature and therapeutic outcome. Results: The most common presenting symptoms were headache, vomiting, fever and altered sensorium. At the time of admission 26.10% had GCS <9. Temporal and temporoparietal was the commonest site and 14.6% had multiple abscesses. The common predisposing factors were otic infection, penetrating trauma and chest infections with diabetes mellitus being the main underlying disease. CT and MRI facilitated early diagnosis. Surgical intervention was done in 97.1% cases. The most common pathogen isolated was pseudomonas in otogenic group, E. coli in head injury group and Klebsiella in hematogenous spread. 39.04% cases were multidrug resistant with pseudomonas being the main culprit. The overall mortality was 26.8% with the presence of septic shock and multidrug resistance being the poor prognostic factors. Conclusion: Brain abscesses caused by gram negative bacilli are not rare and often have a high prevalence of septic shock, multidrug resistance and death. Clinical presentation and therapeutic outcomes vary according to different pathogenic species. In light of high mortality rate an early diagnosis and prompt management is essential to maximize the chance for survival.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132420184","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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