Operative neurosurgery (Hagerstown, Md.)
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Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. ⋯ Tarlov cysts of the sacrum can lead to significant bone erosion and subsequent insufficiency fractures, requiring fenestration and in some cases, complex sacropelvic fixation.
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Oper Neurosurg (Hagerstown) · Apr 2017
Randomized Controlled Trial Multicenter StudyA Pivotal Randomized Clinical Trial Evaluating the Safety and Effectiveness of a Novel Hydrogel Dural Sealant as an Adjunct to Dural Repair.
A watertight dural repair is critical to minimizing the risk of postoperative complications secondary to cerebrospinal fluid (CSF) leaks. ⋯ The test sealant, Adherus Dural Sealant, is a practical, safe, and effective adjunct to achieving a watertight dural closure after primary dural closure in cranial procedures.
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Oper Neurosurg (Hagerstown) · Feb 2017
Initial Single-Center Technical Experience With the BrainPath System for Acute Intracerebral Hemorrhage Evacuation.
Surgical intervention has been proposed as a means of reducing the high morbidity and mortality associated with acute intracerebral hemorrhage (ICH), but many previously reported studies have failed to show a clinically significant benefit. Newer, minimally invasive approaches have shown some promise. ⋯ Evacuation of ICH using the BrainPath system is safe and technically effective. The volume of clot removed compares favorably with other published studies. Early improved clinical outcomes are suggested by improvement in Glasgow Coma Score and reduced 30-day mortality. Ongoing analysis is necessary to elucidate long-term clinical outcomes and the subsets of patients who are most likely to benefit from surgery.
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Oper Neurosurg (Hagerstown) · Feb 2017
A Simplified Method of Accurate Postprocessing of Diffusion Tensor Imaging for Use in Brain Tumor Resection.
Use of diffusion tensor imaging (DTI) in brain tumor resection has been limited in part by a perceived difficulty in implementing the techniques into neurosurgical practice. ⋯ Accurate DTI is easily obtained, postprocessed, and implemented into neuronavigation within routine neurosurgical workflow. This information aids in resecting tumors while preserving eloquent cortices and subcortical networks.
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Oper Neurosurg (Hagerstown) · Feb 2017
Validity Evidence for the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT).
Growing demand for transparent and standardized methods for evaluating surgical competence prompted the construction of the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). ⋯ This study provides validity evidence for the NEVAT to support its use as a standardized method of evaluating neuroendoscopic competence during simulation-based training.