Neurochirurgie最新文献

英文中文

Operative versus non-operative management of posterior fossa epidural hematoma: A systematic review and meta-analysis 后窝硬膜外血肿的手术与非手术疗法：系统回顾与荟萃分析。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-28 DOI: 10.1016/j.neuchi.2024.101578

Suleiman S. Daoud , Mohammad A. Jamous , Mohammed M. Al Barbarawi , Sultan Jarrar , Amer Jaradat , Ahmed S. Aljabali , Mohammad K. Altal , Atef F. Hulliel , Ethar A. Hazaimeh , Omar F. Jbarah , Mohammad A. Alsharman , Adam Abdallah

Background

Posterior fossa epidural hematoma (PFEDH) is rare, occurring in less than 3% of head injuries. It can be managed either operatively or non-operatively. Management guidelines date from 2006, without recent updates providing class III evidence.

Method

We searched PubMed and other databases for English language observational studies up to 2021 that compared the two treatment approaches for PFEDH and.

Results

Twenty-four of the 350 references, for involving 874 patients, met the study criteria. Conservative management showed higher GOS 5 scores and lower mortality. GCS 13–15 patients were more prevalent in the conservative group. Surgical cases often involved ventriculomegaly/compression, hydrocephalus or contusion.

Conclusion

The study shed light on surgical versus conservative PFEDH management, although evidence is sparse. Generally, conservative methods showed better initial outcomes, and should be preferred. However, respect of individual patient traits and Brain Trauma Foundation guidelines is crucial: conservative management may not suit all cases. To enhance the evidence base, RCTs are important for optimal PFEDH management. Bridging this gap can substantially improve patient outcomes and clinical decision-making, emphasizing the need to consider both the available evidence and patient-specific factors for effective guidance.

背景：后窝硬膜外血肿（PFEDH）非常罕见，发生率不到头部损伤的 3%。可通过手术或非手术进行处理。处理指南是 2006 年制定的，最近没有更新提供 III 级证据：我们在PubMed和其他数据库中搜索了截至2021年比较PFEDH两种治疗方法的英文观察性研究：350篇参考文献中有24篇符合研究标准，涉及874名患者。保守治疗的 GOS 5 评分更高，死亡率更低。保守治疗组中 GCS 13-15 分的患者更多。手术病例通常涉及脑室肿大/压迫、脑积水或挫伤：该研究阐明了手术与保守治疗 PFEDH 的区别，但证据并不充分。一般来说，保守疗法的初期疗效较好，应优先考虑。然而，尊重患者的个体特征和脑外伤基金会的指导方针至关重要：保守治疗不一定适合所有病例。为了加强证据基础，研究性试验对于优化 PFEDH 管理非常重要。弥合这一差距可以大大改善患者的预后和临床决策，强调需要同时考虑现有证据和患者的特异性因素，以提供有效的指导。

{"title":"Operative versus non-operative management of posterior fossa epidural hematoma: A systematic review and meta-analysis","authors":"Suleiman S. Daoud , Mohammad A. Jamous , Mohammed M. Al Barbarawi , Sultan Jarrar , Amer Jaradat , Ahmed S. Aljabali , Mohammad K. Altal , Atef F. Hulliel , Ethar A. Hazaimeh , Omar F. Jbarah , Mohammad A. Alsharman , Adam Abdallah","doi":"10.1016/j.neuchi.2024.101578","DOIUrl":"10.1016/j.neuchi.2024.101578","url":null,"abstract":"<div><h3>Background</h3><p>Posterior fossa epidural hematoma (PFEDH) is rare, occurring in less than 3% of head injuries. It can be managed either operatively or non-operatively. Management guidelines date from 2006, without recent updates providing class III evidence.</p></div><div><h3>Method</h3><p>We searched PubMed and other databases for English language observational studies up to 2021 that compared the two treatment approaches for PFEDH and.</p></div><div><h3>Results</h3><p>Twenty-four of the 350 references, for involving 874 patients, met the study criteria. Conservative management showed higher GOS 5 scores and lower mortality. GCS 13–15 patients were more prevalent in the conservative group. Surgical cases often involved ventriculomegaly/compression, hydrocephalus or contusion.</p></div><div><h3>Conclusion</h3><p>The study shed light on surgical versus conservative PFEDH management, although evidence is sparse. Generally, conservative methods showed better initial outcomes, and should be preferred. However, respect of individual patient traits and Brain Trauma Foundation guidelines is crucial: conservative management may not suit all cases. To enhance the evidence base, RCTs are important for optimal PFEDH management. Bridging this gap can substantially improve patient outcomes and clinical decision-making, emphasizing the need to consider both the available evidence and patient-specific factors for effective guidance.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101578"},"PeriodicalIF":1.5,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A dead worm in the brain - a rare finding among the French population 脑中有一条死虫--这在法国人中实属罕见。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-28 DOI: 10.1016/j.neuchi.2024.101580

Charles Champeaux Depond , Dahmane Elhairech , Philippe Metellus , Pierre Dudouet

引用次数: 0

Safety of emergency extra-cranial surgery for life-threatening trauma lesions in patients suffering from traumatic brain injury 对脑外伤患者危及生命的外伤病灶进行颅外紧急手术的安全性。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-25 DOI: 10.1016/j.neuchi.2024.101579

Nathan Beucler

引用次数: 0

Predictors of functional outcomes following spinal meningioma surgery. A single-center retrospective experience of 59 cases 脊髓脑膜瘤术后功能预后的预测因素。单中心 59 例病例的回顾性经验。

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-22 DOI: 10.1016/j.neuchi.2024.101577

Meissa Hamza , Angela Elia , Luca Paun , Benoit Hudelist , Xavier Schumacher , Marco Demasi , Catherine Oppenheim , Fabrice Chretien , Marc Zanello , Alexandre Roux , Johan Pallud

Background

To better predict the postoperative functional outcomes of patients operated on for a spinal meningioma, we assessed: 1) the prevalence of good and poor postoperative functional outcomes following surgery; 2) the impact of age and frailty on postoperative functional outcomes.

Methods

In this retrospective cohort study, we screened adult patients operated on for a spinal meningioma from 2005 to 2022. Inclusion criteria were: 1) patients ≥18 years; 2) histopathological diagnosis of meningioma; 3) location to the cervical, thoracic or lumbar spine (foramen magnum meningioma excluded); 4) surgery as first-line treatment; and 5) available postoperative follow-up ≥1 year. Clinical outcomes were assessed using the modified McCormick scale preoperatively and at one-year of postoperative follow-up.

Results

In this single institution experience of 59 cases, we found that: 1) surgical resection positively impacts patients’ functional outcomes, 91.2% either showing an improved or maintained good postoperative neurological status defined by a modified McCormick scale score ≤ II; 2) a good modified McCormick scale status was achieved in 84.2% of patients at one postoperative year; 3) 87.5% of patients who were not improved postoperatively maintained an overall good neurological status defined by a modified McCormick scale score ≤ II; and 4) frail or aged patients were not at a higher risk of poor postoperative functional outcomes.

Conclusion

Surgical resection positively impacts outcomes of patients operated for a spinal meningioma. Sex, presence of a meningioma-related myelopathy, extent of resection, and occurrence of surgery-related postoperative complications, but not age or frailty, predict postoperative functional outcomes.

背景：为了更好地预测脊髓脑膜瘤手术患者的术后功能预后，我们对以下方面进行了评估：1）术后功能预后良好和不良的发生率；2）年龄和体弱对术后功能预后的影响：1）术后良好和不良功能预后的发生率；2）年龄和虚弱对术后功能预后的影响：在这项回顾性队列研究中，我们筛选了 2005 年至 2022 年期间接受脊髓脑膜瘤手术的成年患者。纳入标准为1）患者年龄≥18岁；2）组织病理学诊断为脑膜瘤；3）病变部位为颈椎、胸椎或腰椎（枕骨大孔脑膜瘤除外）；4）手术为一线治疗；5）术后随访时间≥1年。采用改良麦考密克量表评估术前和术后一年随访的临床结果：结果：在单个机构的 59 例病例中，我们发现1）手术切除对患者的功能预后有积极影响，91.2%的患者术后神经功能状况有所改善或保持良好，改良麦考密克量表评分≤II；2）84.2%的患者术后一年改良麦考密克量表评分达到良好。2%的患者在术后一年达到良好的改良麦考密克量表状态；3）87.5%术后未见好转的患者保持了总体良好的神经状态，定义为改良麦考密克量表评分≤II；4）体弱或高龄患者术后功能结果不佳的风险并不高：结论：手术切除对脊髓脑膜瘤患者的预后有积极影响。性别、是否存在与脑膜瘤相关的脊髓病变、切除范围以及术后相关并发症的发生情况都能预测术后功能预后，而年龄或体弱情况则不能预测术后功能预后。

{"title":"Predictors of functional outcomes following spinal meningioma surgery. A single-center retrospective experience of 59 cases","authors":"Meissa Hamza , Angela Elia , Luca Paun , Benoit Hudelist , Xavier Schumacher , Marco Demasi , Catherine Oppenheim , Fabrice Chretien , Marc Zanello , Alexandre Roux , Johan Pallud","doi":"10.1016/j.neuchi.2024.101577","DOIUrl":"10.1016/j.neuchi.2024.101577","url":null,"abstract":"<div><h3>Background</h3><p>To better predict the postoperative functional outcomes of patients operated on for a spinal meningioma, we assessed: 1) the prevalence of good and poor postoperative functional outcomes following surgery; 2) the impact of age and frailty on postoperative functional outcomes.</p></div><div><h3>Methods</h3><p>In this retrospective cohort study, we screened adult patients operated on for a spinal meningioma from 2005 to 2022. Inclusion criteria were: 1) patients ≥18 years; 2) histopathological diagnosis of meningioma; 3) location to the cervical, thoracic or lumbar spine (foramen magnum meningioma excluded); 4) surgery as first-line treatment; and 5) available postoperative follow-up ≥1 year. Clinical outcomes were assessed using the modified McCormick scale preoperatively and at one-year of postoperative follow-up.</p></div><div><h3>Results</h3><p>In this single institution experience of 59 cases, we found that: 1) surgical resection positively impacts patients’ functional outcomes, 91.2% either showing an improved or maintained good postoperative neurological status defined by a modified McCormick scale score ≤ II; 2) a good modified McCormick scale status was achieved in 84.2% of patients at one postoperative year; 3) 87.5% of patients who were not improved postoperatively maintained an overall good neurological status defined by a modified McCormick scale score ≤ II; and 4) frail or aged patients were not at a higher risk of poor postoperative functional outcomes.</p></div><div><h3>Conclusion</h3><p>Surgical resection positively impacts outcomes of patients operated for a spinal meningioma. Sex, presence of a meningioma-related myelopathy, extent of resection, and occurrence of surgery-related postoperative complications, but not age or frailty, predict postoperative functional outcomes.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101577"},"PeriodicalIF":1.5,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical effects of neuroendoscopic infratentorial supracerebellar approach surgical technique for resecting pineal tumors: a retrospective study 神经内镜下小脑上入路手术技术切除松果体肿瘤的临床效果：一项回顾性研究

IF 1.5 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-21 DOI: 10.1016/j.neuchi.2024.101576

Qiang Li , Kai Zhang , Hanruo Liu , Shijia Zhai , Yanfei Jia , Tian Li , Yawen Pan

Objective

Pineal tumors are relatively rare central nervous system lesions with a predilection for the pediatric population. This article aims to explore the clinical effects of neuroendoscopic infratentorial supracerebellar approach for resecting tumors in the pineal area.

Methods

This is a retrospective study that included patients who underwent neuroendoscopic infratentorial supracerebellar approach to resect nine tumors in the pineal area at the Department of Neurosurgery of the Second Hospital of Lanzhou University from December 2017 to October 2023.

Results

The results of postoperative MRI revealed that all tumors were resected. Five patients received postoperative radiotherapy, three patients received radiotherapy along with chemotherapy, and one patient received neither radiotherapy nor chemotherapy. The pathological results showed that four patients were diagnosed with germinoma, two patients with teratoma, two patients with mixed germ cell tumors, and one patient with central neurocytoma. After surgery, one patient developed psychiatric symptoms, two patients developed binocular upward vision and diplopia, and one patient developed unstable walking and diplopia. With a follow-up of 1.7–4.8 years, all nine patients lived normally. Furthermore, none of them had tumor recurrence or death.

Conclusion

The simple neuroendoscopic infratentorial supracerebellar approach has some safety and efficacy. It is suitable for tumors in the pineal region where the disease is mainly located below the Galen vein complex.

目的松果体肿瘤是一种相对罕见的中枢神经系统病变，好发于儿童群体。本文旨在探讨神经内镜下小脑幕上入路切除松果体区肿瘤的临床效果。方法这是一项回顾性研究，纳入了2017年12月至2023年10月兰州大学第二医院神经外科接受神经内镜下小脑幕上入路切除9例松果体区肿瘤的患者。结果术后MRI结果显示，所有肿瘤均被切除。5例患者接受了术后放疗，3例患者在放疗的同时接受了化疗，1例患者既没有接受放疗也没有接受化疗。病理结果显示，4 名患者被诊断为生殖细胞瘤，2 名患者为畸胎瘤，2 名患者为混合性生殖细胞瘤，1 名患者为中枢神经细胞瘤。手术后，1 名患者出现精神症状，2 名患者出现双眼上视和复视，1 名患者出现行走不稳和复视。经过 1.7-4.8 年的随访，9 名患者均正常生活。结论简易神经内镜下小脑幕上入路具有一定的安全性和有效性。结论简易神经内镜小脑下小脑上入路具有一定的安全性和有效性，适用于主要位于盖伦静脉复合体下方的松果体区肿瘤。

{"title":"Clinical effects of neuroendoscopic infratentorial supracerebellar approach surgical technique for resecting pineal tumors: a retrospective study","authors":"Qiang Li , Kai Zhang , Hanruo Liu , Shijia Zhai , Yanfei Jia , Tian Li , Yawen Pan","doi":"10.1016/j.neuchi.2024.101576","DOIUrl":"https://doi.org/10.1016/j.neuchi.2024.101576","url":null,"abstract":"<div><h3>Objective</h3><p>Pineal tumors are relatively rare central nervous system lesions with a predilection for the pediatric population. This article aims to explore the clinical effects of neuroendoscopic infratentorial supracerebellar approach for resecting tumors in the pineal area.</p></div><div><h3>Methods</h3><p>This is a retrospective study that included patients who underwent neuroendoscopic infratentorial supracerebellar approach to resect nine tumors in the pineal area at the Department of Neurosurgery of the Second Hospital of Lanzhou University from December 2017 to October 2023.</p></div><div><h3>Results</h3><p>The results of postoperative MRI revealed that all tumors were resected. Five patients received postoperative radiotherapy, three patients received radiotherapy along with chemotherapy, and one patient received neither radiotherapy nor chemotherapy. The pathological results showed that four patients were diagnosed with germinoma, two patients with teratoma, two patients with mixed germ cell tumors, and one patient with central neurocytoma. After surgery, one patient developed psychiatric symptoms, two patients developed binocular upward vision and diplopia, and one patient developed unstable walking and diplopia. With a follow-up of 1.7–4.8 years, all nine patients lived normally. Furthermore, none of them had tumor recurrence or death.</p></div><div><h3>Conclusion</h3><p>The simple neuroendoscopic infratentorial supracerebellar approach has some safety and efficacy. It is suitable for tumors in the pineal region where the disease is mainly located below the Galen vein complex.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101576"},"PeriodicalIF":1.5,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141438239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are name characteristics of UK neurosurgeons associated with their career success? 英国神经外科医生的姓名特征是否与其职业成功有关？

IF 1.6 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-18 DOI: 10.1016/j.neuchi.2024.101575

Marianna Evangelia Kapsetaki

引用次数: 0

Adult transverse sinus capillary hemangioma: case report and review of the literature 成人横窦毛细血管瘤：病例报告和文献综述

IF 1.6 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-08 DOI: 10.1016/j.neuchi.2024.101573

Lucas Ribeiro , Clément Dunoyer , Aude Trinquet , Federico Cagnazzo , Julien Boetto , Marine Le Corre

Background

Adult intracranial capillary hemangioma (ICH) is an extremely rare disease with very few cases reported in the literature. Natural history is poorly understood and therapeutic management has not been clearly defined.

Methods

Using PRISMA guidelines, we systematically reviewed all published adult cases of ICH, to which we added our own case.

Case presentation

A 24-year-old patient with intracranial hypertension underwent stenting for left transverse sinus ICH. Recurrence was managed by subtotal resection, and radiotherapy was undertaken after a second relapse. Radiotherapy achieved complete response at last follow-up.

Results

Among cases of ICH found in the literature, 36 concerned adults (55.3%), with clear female predominance, and only 2 cases affecting the transverse sinus (8.1%). Adult ICHs grew over time, and pregnancy seemed to accelerate natural progression. Complete resection was achieved in most cases, and radiotherapy was used in case of relapse, with high rates of tumor control.

Conclusion

Transverse sinus ICH is uncommon, and venous stenting is a suitable option in case of tumor invasion to treat intracranial hypertension. Surgery is the gold-standard treatment, and radiotherapy is a very effective alternative, with high rates of tumor control. Natural history is not benign, particularly in case of pregnancy.

背景成人颅内毛细血管瘤（ICH）是一种极为罕见的疾病，文献中报道的病例极少。病例介绍一位 24 岁的颅内高压患者因左侧横窦 ICH 接受了支架植入术。复发后进行了次全切除术，第二次复发后进行了放疗。结果在文献中发现的 ICH 病例中，36 例为成人（55.3%），女性明显占多数，只有 2 例影响横窦（8.1%）。成人 ICH 会随着时间的推移逐渐增大，而妊娠似乎会加速自然进展。结论：横窦 ICH 并不常见，在肿瘤侵犯的情况下，静脉支架植入术是治疗颅内高压的合适选择。手术是金标准治疗方法，放疗是非常有效的替代方法，肿瘤控制率高。自然病史并非良性，尤其是在妊娠的情况下。

{"title":"Adult transverse sinus capillary hemangioma: case report and review of the literature","authors":"Lucas Ribeiro , Clément Dunoyer , Aude Trinquet , Federico Cagnazzo , Julien Boetto , Marine Le Corre","doi":"10.1016/j.neuchi.2024.101573","DOIUrl":"https://doi.org/10.1016/j.neuchi.2024.101573","url":null,"abstract":"<div><h3>Background</h3><p>Adult intracranial capillary hemangioma (ICH) is an extremely rare disease with very few cases reported in the literature. Natural history is poorly understood and therapeutic management has not been clearly defined.</p></div><div><h3>Methods</h3><p>Using PRISMA guidelines, we systematically reviewed all published adult cases of ICH, to which we added our own case.</p></div><div><h3>Case presentation</h3><p>A 24-year-old patient with intracranial hypertension underwent stenting for left transverse sinus ICH. Recurrence was managed by subtotal resection, and radiotherapy was undertaken after a second relapse. Radiotherapy achieved complete response at last follow-up.</p></div><div><h3>Results</h3><p>Among cases of ICH found in the literature, 36 concerned adults (55.3%), with clear female predominance, and only 2 cases affecting the transverse sinus (8.1%). Adult ICHs grew over time, and pregnancy seemed to accelerate natural progression. Complete resection was achieved in most cases, and radiotherapy was used in case of relapse, with high rates of tumor control.</p></div><div><h3>Conclusion</h3><p>Transverse sinus ICH is uncommon, and venous stenting is a suitable option in case of tumor invasion to treat intracranial hypertension. Surgery is the gold-standard treatment, and radiotherapy is a very effective alternative, with high rates of tumor control. Natural history is not benign, particularly in case of pregnancy.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101573"},"PeriodicalIF":1.6,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flow alteration surgery using a radial artery graft for recurrent ruptured vertebral artery dissecting aneurysm after stent-assisted coil embolization: A case report 使用桡动脉移植物进行血流改变手术，治疗支架辅助线圈栓塞术后复发的椎动脉剥脱动脉瘤：病例报告

IF 1.6 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-06-08 DOI: 10.1016/j.neuchi.2024.101574

Masaru Abiko , Yukishige Hashimoto , Masakazu Mitsunobu , Nobutaka Horie

Background

Ruptured vertebral artery dissecting aneurysm (VADA) is often treated surgically with coil embolization and sometimes recurs. We herein report a case of recurrent ruptured VADA after stent-assisted coil embolization (SAC) that was successfully treated with flow alteration surgery using a radial artery (RA) graft.

Case Description

A 67-year-old woman presented with headache and coma. Enhanced CT revealed subarachnoid hemorrhage due to right VADA. Since the left VA was hypoplastic, the aneurysm was treated with SAC. However, follow-up angiography revealed recurrence of the aneurysm. Additional embolization was not considered due to the small size of the recurrent lesion and the presence of a stent; therefore, flow alteration surgery was performed using a RA graft. There were no neurological deficits after surgery or recurrence.

Conclusion

Flow alteration surgery using a RA graft is useful for recurrent VADA after SAC.

背景破裂的椎动脉剥脱性动脉瘤（VADA）通常采用线圈栓塞术进行手术治疗，但有时会复发。我们在此报告了一例支架辅助线圈栓塞术（SAC）后复发的椎动脉夹层动脉瘤，通过使用桡动脉（RA）移植物进行血流改变手术成功治疗了该患者。增强 CT 显示右侧 VADA 导致蛛网膜下腔出血。由于左侧 VA 发育不良，因此用 SAC 治疗了动脉瘤。然而，随访血管造影显示动脉瘤复发。由于复发病灶较小，且存在支架，因此没有考虑进行额外的栓塞治疗；因此，使用 RA 移植进行了血流改变手术。结论使用 RA 移植物进行血流改变手术对 SAC 后复发的 VADA 很有用。

引用次数: 0

Surgical management of a rare giant sacral meningocele in a child 罕见的儿童巨大骶骨脑膜瘤的手术治疗。

IF 1.6 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-05-30 DOI: 10.1016/j.neuchi.2024.101571

Adrien Chenneviere , Frederique Belloy , Aude Bessiere , Thierry Petit , Evelyne Emery , Alin Borha

Introduction

Anterior sacral meningocele is a rare congenital disorder, occurring isolated or in syndromic disease.

Case report

A 15-year-old patient who complained of abdominal pain and urinary dysfunction was managed surgically. Imaging diagnosed a giant presacral meningocele and agenesis of the coccyx.

Discussion

The presentation of sacral meningocele can be poorly symptomatic, which is why some patients are diagnosed late. Sometimes, diagnosis is suggested by non-specific abdominal symptoms or complications. Abdominal-pelvic radiological examination and lumbar spine MRI are essential, and treatment must be surgical. There are several surgical approaches, but currently no consensus.

Conclusion

An unusual huge presacral cystic mass in a young patient may be isolated or part of a syndrome, and can be asymptomatic for a long time, leading to late diagnosis. The surgical approach should be based on multidisciplinary discussion. We operated on a giant anterior sacral meningocele in a child using a posterior approach, with a satisfactory result.

导言：骶骨前脑膜囊肿是一种罕见的先天性疾病：骶骨前脑膜囊肿是一种罕见的先天性疾病，可单独或合并发生：一名 15 岁的患者主诉腹痛和排尿功能障碍，接受了手术治疗。影像学诊断为巨大骶前脑膜囊肿和尾骨发育不全：讨论：骶骨脑膜囊肿的症状不明显，这也是一些患者诊断较晚的原因。有时，非特异性腹部症状或并发症会提示诊断。腹盆腔放射学检查和腰椎核磁共振成像检查必不可少，治疗必须采用手术。目前有多种手术方法，但尚未达成共识：结论：年轻患者骶前异常巨大囊性肿块可能是孤立的，也可能是综合征的一部分，而且可能长期无症状，导致晚期诊断。手术方法应以多学科讨论为基础。我们采用后入路对一名儿童的巨大骶骨前脑膜囊肿进行了手术，结果令人满意。

{"title":"Surgical management of a rare giant sacral meningocele in a child","authors":"Adrien Chenneviere , Frederique Belloy , Aude Bessiere , Thierry Petit , Evelyne Emery , Alin Borha","doi":"10.1016/j.neuchi.2024.101571","DOIUrl":"10.1016/j.neuchi.2024.101571","url":null,"abstract":"<div><h3>Introduction</h3><p>Anterior sacral meningocele is a rare congenital disorder, occurring isolated or in syndromic disease.</p></div><div><h3>Case report</h3><p>A 15-year-old patient who complained of abdominal pain and urinary dysfunction was managed surgically. Imaging diagnosed a giant presacral meningocele and agenesis of the coccyx.</p></div><div><h3>Discussion</h3><p>The presentation of sacral meningocele can be poorly symptomatic, which is why some patients are diagnosed late. Sometimes, diagnosis is suggested by non-specific abdominal symptoms or complications. Abdominal-pelvic radiological examination and lumbar spine MRI are essential, and treatment must be surgical. There are several surgical approaches, but currently no consensus.</p></div><div><h3>Conclusion</h3><p>An unusual huge presacral cystic mass in a young patient may be isolated or part of a syndrome, and can be asymptomatic for a long time, leading to late diagnosis. The surgical approach should be based on multidisciplinary discussion. We operated on a giant anterior sacral meningocele in a child using a posterior approach, with a satisfactory result.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101571"},"PeriodicalIF":1.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Auditory brainstem implants: an analysis of adverse events in the MAUDE database 听性脑干植入：MAUDE 数据库中的不良事件分析。

IF 1.6 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie

Pub Date : 2024-05-28 DOI: 10.1016/j.neuchi.2024.101570

Olivia E. Speed , Soroush Farsi , Kaersti Rickels , Vijay A. Patel , Anna Bareiss , John Dornhoffer , Robert A. Saadi

Objective

Auditory Brainstem Implants (ABI) are used to restore hearing in patients lacking appropriate cochlear anatomy and/or cochlear nerve. The objective of this study was to examine the Manufacture and User Facility Device Experience (MAUDE) database to analyze adverse events.

Study design

This is a study of a multi-institutional database maintained by the US FDA.

Setting

A database analysis was performed via collaboration of multiple clinicians at tertiary referral centers.

Methods

The MAUDE database was queried for Medical Device Reports (MDRs) relating to ABIs. MDRs were identified using the advanced search term “Implant, Auditory Brainstem” and reviewing all reports with the basic search term “Brainstem Implant”. All collected reports were individually reviewed.

Results

A total of 265 individual patient reports were reviewed, of which 55 reports met inclusion criteria. Reports regarding audiologic outcome included failure to provide hearing benefit (n = 27), implant failure/device malfunction (n = 10), and device non-use (n = 6). Postoperative complications included local skin infection (n = 3), CSF leak (n = 3), elevated ICP (n = 1), surgical site dehiscence (n = 1), swelling (n = 1), seroma formation requiring drainage (n = 1), and meningitis (n = 2). Two patients had dislodged magnets during 1.5 Tesla MRI acquisition. There were 35 instances of full explantation of the device and 1 partial removal; 13 patients had a new device implanted following explantation.

Conclusions

Poor hearing results, device failure, and non-use were commonly reported causes for explanation in this analysis. This information can aid physicians in counseling patients and family members and managing device expectations.

目的：听性脑干植入体（ABI）用于恢复缺乏适当耳蜗解剖结构和/或耳蜗神经的患者的听力。本研究的目的是检查制造和用户设施设备经验（MAUDE）数据库，分析不良事件：研究设计：这是一项对美国 FDA 维护的多机构数据库的研究：通过三级转诊中心多位临床医生的合作进行数据库分析：在 MAUDE 数据库中查询与 ABI 相关的医疗器械报告 (MDR)。使用高级检索词 "植入物，听性脑干 "确定MDR，并使用基本检索词 "脑干植入物 "审查所有报告。对收集到的所有报告进行逐一审查：结果：共审查了 265 份患者报告，其中 55 份符合纳入标准。有关听力结果的报告包括未能提供听力益处（n = 27）、植入失败/设备故障（n = 10）和设备未使用（n = 6）。术后并发症包括局部皮肤感染（3 例）、CSF 泄漏（3 例）、ICP 升高（1 例）、手术部位开裂（1 例）、肿胀（1 例）、需要引流的血清肿形成（1 例）和脑膜炎（2 例）。两名患者在 1.5 特斯拉磁共振成像采集过程中磁铁脱落。有 35 例完全拆卸设备，1 例部分拆卸；13 例患者在拆卸设备后植入了新设备：结论：在本次分析中，听力效果不佳、装置故障和未使用是常见的解释原因。这些信息有助于医生为患者和家属提供咨询，并管理他们对装置的期望。

{"title":"Auditory brainstem implants: an analysis of adverse events in the MAUDE database","authors":"Olivia E. Speed , Soroush Farsi , Kaersti Rickels , Vijay A. Patel , Anna Bareiss , John Dornhoffer , Robert A. Saadi","doi":"10.1016/j.neuchi.2024.101570","DOIUrl":"10.1016/j.neuchi.2024.101570","url":null,"abstract":"<div><h3>Objective</h3><p>Auditory Brainstem Implants (ABI) are used to restore hearing in patients lacking appropriate cochlear anatomy and/or cochlear nerve. The objective of this study was to examine the Manufacture and User Facility Device Experience (MAUDE) database to analyze adverse events.</p></div><div><h3>Study design</h3><p>This is a study of a multi-institutional database maintained by the US FDA.</p></div><div><h3>Setting</h3><p>A database analysis was performed via collaboration of multiple clinicians at tertiary referral centers.</p></div><div><h3>Methods</h3><p>The MAUDE database was queried for Medical Device Reports (MDRs) relating to ABIs. MDRs were identified using the advanced search term “Implant, Auditory Brainstem” and reviewing all reports with the basic search term “Brainstem Implant”. All collected reports were individually reviewed.</p></div><div><h3>Results</h3><p>A total of 265 individual patient reports were reviewed, of which 55 reports met inclusion criteria. Reports regarding audiologic outcome included failure to provide hearing benefit (n = 27), implant failure/device malfunction (n = 10), and device non-use (n = 6). Postoperative complications included local skin infection (n = 3), CSF leak (n = 3), elevated ICP (n = 1), surgical site dehiscence (n = 1), swelling (n = 1), seroma formation requiring drainage (n = 1), and meningitis (n = 2). Two patients had dislodged magnets during 1.5 Tesla MRI acquisition. There were 35 instances of full explantation of the device and 1 partial removal; 13 patients had a new device implanted following explantation.</p></div><div><h3>Conclusions</h3><p>Poor hearing results, device failure, and non-use were commonly reported causes for explanation in this analysis. This information can aid physicians in counseling patients and family members and managing device expectations.</p></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"70 5","pages":"Article 101570"},"PeriodicalIF":1.6,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Neurochirurgie

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀