{"title":"Case Report: Signal Drop on MRA Imaging of the Internal Carotid Artery after Neuroform Stent Placement","authors":"A. Pandey, Meryl A. Severson Iii, R. Rosenwasser","doi":"10.29046/JHNJ.004.1.004","DOIUrl":"https://doi.org/10.29046/JHNJ.004.1.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130470587","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}
Y. Ooi, J. Malone, Rn Cnrn Teresita DeVera Bsn, Rn Carol Blyzniuk Bsn, A. Sharan
1Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 2Department of Neurological Surgery, Jefferson University Physicians, Philadelphia, PA 3Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA An intrathecal delivery system allows direct infusion of analgesics and antispasmodic drugs into the cerebral spinal fluid in patients with chronic intractable pain or spasticity. Intrathecal therapy effective but any surgical intervention carries the risk of complications. Complications encountered with this therapy include wound dehiscence (spontaneous reopening) and infection, which often lead to explanation of the intrathecal pump. Later re-implanation is feasible, but there is limited information regarding successful retention of the device after re-implantation. A recurring problem with generating reliable guidelines in neurosurgery is that some situations occur too rarely for evidence to be much more than anecdotal.
{"title":"Successful Re-implantation of Intrathecal Delivery System after Removal Secondary to Infection or Wound Dehiscence","authors":"Y. Ooi, J. Malone, Rn Cnrn Teresita DeVera Bsn, Rn Carol Blyzniuk Bsn, A. Sharan","doi":"10.29046/JHNJ.005.1.005","DOIUrl":"https://doi.org/10.29046/JHNJ.005.1.005","url":null,"abstract":"1Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 2Department of Neurological Surgery, Jefferson University Physicians, Philadelphia, PA 3Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA An intrathecal delivery system allows direct infusion of analgesics and antispasmodic drugs into the cerebral spinal fluid in patients with chronic intractable pain or spasticity. Intrathecal therapy effective but any surgical intervention carries the risk of complications. Complications encountered with this therapy include wound dehiscence (spontaneous reopening) and infection, which often lead to explanation of the intrathecal pump. Later re-implanation is feasible, but there is limited information regarding successful retention of the device after re-implantation. A recurring problem with generating reliable guidelines in neurosurgery is that some situations occur too rarely for evidence to be much more than anecdotal.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125511211","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}
{"title":"Surgeon Opinions on Use of Epidural Steroids in Treatment of Lumbar Disk Disease: Results of an Online Survey","authors":"J. Ratliff, M. Maltenfort, Bryan Lebude","doi":"10.29046/JHNJ.004.2.001","DOIUrl":"https://doi.org/10.29046/JHNJ.004.2.001","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121105211","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}
B. Daou, E. Atallah, Bs Evan Fitchett, N. Chalouhi, R. Starke, B. J. Oliver, Bs Maria Montano, P. Jabbour, Md Mba Facs Faha Robert H. Rosenwasswer, Md Faans Stavropoula Tjoumakaris
{"title":"Clinical Applications of the Pipeline Embolization Device","authors":"B. Daou, E. Atallah, Bs Evan Fitchett, N. Chalouhi, R. Starke, B. J. Oliver, Bs Maria Montano, P. Jabbour, Md Mba Facs Faha Robert H. Rosenwasswer, Md Faans Stavropoula Tjoumakaris","doi":"10.29046/jhnj.013.2.004","DOIUrl":"https://doi.org/10.29046/jhnj.013.2.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121801001","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}
Trauma Several years ago, every patient that was brought to Thomas Jefferson University Hospital with a closed head injury would receive a CT scan — regardless of whether or not that patient already had a scan performed at an outside institution. If the scan demonstrated any intracranial pathology, then a repeat CT scan was performed 12 hours after the initial scan as long as the patient remained neurologically stable. Ultimately, every patient received two CT scans at our institution separated by 12 hours. Now, each patient is followed by a total of three CT scans. If a patient had undergone a CT scan at an outside institution, this scan was loaded onto the Jefferson system and was considered their first CT scan. A follow-up CT scan was to be performed 6 hours after the initial scan if any intracranial pathology was noted. As long as the patient remained neurologically stable, a third and final CT scan was to be performed sometime between 12 to 24 hours after the initial scan. Therefore, patients with non-operative intracranial hemorrhage received two or three CT scans at our institution and were observed for at least 24 hours. In both situations, routine follow-up imaging was performed on all patients with an initial intracranial lesion resulting from head trauma. This practice is founded on the recommendation that " early imaging, rather than awaiting neurological deterioration, reduces the delay in detection and treatment of acute intracranial injury. " This is based largely on the existing literature regarding epidural hematomas (EDH) and severe head injury. More than 50% of patients with severe head injuries have progression of findings on CT scan that otherwise would go undetected due to their poor initial clinical status. 1 Case reports have illustrated the need for repeat imaging in the setting of " ultra-early " CT scans, which may not capture a developing hematoma. 2 In addition, EDHs have been reported to be more likely to enlarge if captured within 6 hours of injury 3 — again enforcing the importance of repeat imaging for these patients. At the same time, while such case reports and small case series have demonstrated the importance of imaging at least 6 hours after the initial injury, patients who have already had a negative CT scan generally do not get a repeated scan, — even if the negative scan was performed within 6 hours of their injury. Overall, …
{"title":"Developing a Clinical Guideline for CT Scans in Closed Head Injury","authors":"Chengyuan Wu, J. Jallo","doi":"10.29046/JHNJ.006.1.002","DOIUrl":"https://doi.org/10.29046/JHNJ.006.1.002","url":null,"abstract":"Trauma Several years ago, every patient that was brought to Thomas Jefferson University Hospital with a closed head injury would receive a CT scan — regardless of whether or not that patient already had a scan performed at an outside institution. If the scan demonstrated any intracranial pathology, then a repeat CT scan was performed 12 hours after the initial scan as long as the patient remained neurologically stable. Ultimately, every patient received two CT scans at our institution separated by 12 hours. Now, each patient is followed by a total of three CT scans. If a patient had undergone a CT scan at an outside institution, this scan was loaded onto the Jefferson system and was considered their first CT scan. A follow-up CT scan was to be performed 6 hours after the initial scan if any intracranial pathology was noted. As long as the patient remained neurologically stable, a third and final CT scan was to be performed sometime between 12 to 24 hours after the initial scan. Therefore, patients with non-operative intracranial hemorrhage received two or three CT scans at our institution and were observed for at least 24 hours. In both situations, routine follow-up imaging was performed on all patients with an initial intracranial lesion resulting from head trauma. This practice is founded on the recommendation that \" early imaging, rather than awaiting neurological deterioration, reduces the delay in detection and treatment of acute intracranial injury. \" This is based largely on the existing literature regarding epidural hematomas (EDH) and severe head injury. More than 50% of patients with severe head injuries have progression of findings on CT scan that otherwise would go undetected due to their poor initial clinical status. 1 Case reports have illustrated the need for repeat imaging in the setting of \" ultra-early \" CT scans, which may not capture a developing hematoma. 2 In addition, EDHs have been reported to be more likely to enlarge if captured within 6 hours of injury 3 — again enforcing the importance of repeat imaging for these patients. At the same time, while such case reports and small case series have demonstrated the importance of imaging at least 6 hours after the initial injury, patients who have already had a negative CT scan generally do not get a repeated scan, — even if the negative scan was performed within 6 hours of their injury. Overall, …","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133665715","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 Thoracic spinal cord stimulation (tSCS) is a therapeutic option for the treatment of neuropathic pain, such as that generated from post-laminectomy syndrome, reflex sympathetic dystrophy, or neuritis. Two variables that have scarcely been examined in relation to effective stimulation are the electrode type used and the method of intraoperative confirmation of paresthesia employed. We compared the effective paresthesia distribution of 3 distinct configurations of thoracic spinal cord stimulator electrodes and the 2 different neurophysiological techniques of intraoperative paresthesia confirmation.
{"title":"An Outcome Comparison of Electrode Configurations and Intraoperative Testing Techniques for Thoracic Spinal Cord Stimulators for Chronic Neuropathic Pain","authors":"Angud Mehdi, D. Penn, Chengyuan Wu, A. Sharan","doi":"10.29046/JHNJ.007.2.001","DOIUrl":"https://doi.org/10.29046/JHNJ.007.2.001","url":null,"abstract":"INTRODUCTION Thoracic spinal cord stimulation (tSCS) is a therapeutic option for the treatment of neuropathic pain, such as that generated from post-laminectomy syndrome, reflex sympathetic dystrophy, or neuritis. Two variables that have scarcely been examined in relation to effective stimulation are the electrode type used and the method of intraoperative confirmation of paresthesia employed. We compared the effective paresthesia distribution of 3 distinct configurations of thoracic spinal cord stimulator electrodes and the 2 different neurophysiological techniques of intraoperative paresthesia confirmation.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131926036","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}
Peter G. Campbell, L. Tartaglino, H. Dayoub, P. Jabbour, A. Dumont, L. Gonzalez, R. Rosenwasser, S. Tjoumakaris
Introduction Spinal arteriovenous malformations (SAVMs) are rare and under-diagnosed entities. If untreated, SAVMs can lead to progressive spinal cord myelopathy. The diversion of arterial blood through dorsal and/or medullary veins can lead to a vascular steal phenomena often accompanying highflow lesions, or venous hypertension and congestion which ultimately reduces intramedullary blood flow in lower flow malformations1. Therefore, timely diagnosis and a precise understanding of these lesions can determine surgical strategies and prevent delays in treatment.
{"title":"Emerging Clinical Imaging Techniques for Spinal Arteriovenous Malformations","authors":"Peter G. Campbell, L. Tartaglino, H. Dayoub, P. Jabbour, A. Dumont, L. Gonzalez, R. Rosenwasser, S. Tjoumakaris","doi":"10.29046/JHNJ.006.1.006","DOIUrl":"https://doi.org/10.29046/JHNJ.006.1.006","url":null,"abstract":"Introduction Spinal arteriovenous malformations (SAVMs) are rare and under-diagnosed entities. If untreated, SAVMs can lead to progressive spinal cord myelopathy. The diversion of arterial blood through dorsal and/or medullary veins can lead to a vascular steal phenomena often accompanying highflow lesions, or venous hypertension and congestion which ultimately reduces intramedullary blood flow in lower flow malformations1. Therefore, timely diagnosis and a precise understanding of these lesions can determine surgical strategies and prevent delays in treatment.","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114862586","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}
{"title":"Minimally Invasive Surgery for Skull Base Tumors","authors":"James J. Evans, M. Rosen","doi":"10.29046/jhnj.004.2.004","DOIUrl":"https://doi.org/10.29046/jhnj.004.2.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123103477","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}
A. Tracy, Joseph I. Cn, G. Doucet, X. He, D. Pustina, K. Osipowicz
{"title":"Advances in Clinical Neuroimaging","authors":"A. Tracy, Joseph I. Cn, G. Doucet, X. He, D. Pustina, K. Osipowicz","doi":"10.29046/jhnj.011.2.009","DOIUrl":"https://doi.org/10.29046/jhnj.011.2.009","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123347369","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}
{"title":"Spinal Metastasis – Diagnosis, Management, and the Role of the Hospitalist","authors":"B. Ganesh, C. Harrop, J. Edwards","doi":"10.29046/jhnj.015.1.004","DOIUrl":"https://doi.org/10.29046/jhnj.015.1.004","url":null,"abstract":"","PeriodicalId":355574,"journal":{"name":"JHN Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123635928","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：