Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Apr 2018
Optic nerve sheath diameter based on preoperative brain computed tomography and intracranial pressure are positively correlated in adults with hydrocephalus.
The usefulness of optic nerve sheath diameter (ONSD) in predicting increased intracranial pressure (ICP) is not well established in adults with hydrocephalus. In this retrospective study, we evaluated the correlation between ONSD measured on brain computed tomography (CT) and ICP in adults with hydrocephalus. ⋯ ONSD measured on preoperative brain CT was linearly correlated with ICP in adult patients with communicating and non-communicating hydrocephalus, and it was a predictor of increased ICP with good discrimination and high inter-observer reliability. These results suggest that preoperative ONSD measurement on brain CT can be helpful to safely manage such patients by providing information about ICP.
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Clin Neurol Neurosurg · Apr 2018
The surgical management of dysphagia secondary to diffuse idiopathic skeletal hyperostosis.
This study reviews the management pathway and surgical outcomes of patients referred to and operated on at a tertiary neurosurgical centre, for dysphagia associated with anterolateral cervical hyperostosis (ACH) in diffuse idiopathic skeletal hyperostosis (DISH). ⋯ All our patients experienced significant and sustained clinical improvement. Anterior cervical osteophytectomy consistently leads to improvement in symptomatic ACH patients without recurrence. Early referral to a neurosurgical multi-disciplinary team (MDT) is indicated in ACH related dysphagia, once conservative management has failed.
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Clin Neurol Neurosurg · Apr 2018
Outcomes following minimally invasive lateral transpsoas interbody fusion for degenerative low grade lumbar spondylolisthesis: A systematic review.
A variety of surgical approaches have been described to treat low grade lumbar degenerative spondylolisthesis (DS). Minimally invasive spinal fusion techniques were first introduced to minimize morbidities associated with invasive surgical treatments. Minimally invasive lateral transpsoas interbody fusion, also known as lateral lumbar interbody fusion (LLIF), is a relatively new method of lumbar arthrodesis that avoids various approach related complications compared to its posterior and anterior counterparts. ⋯ Three studies also reported that patient satisfaction and willingness to undergo the procedure again approached 90%. Minimally invasive transpsoas interbody fusion possibly leads to favorable clinical and radiological outcomes while avoiding the possible complications of its more traditional open and minimally invasive counterparts. Further studies are needed to better establish its role in the management of low grade degenerative lumbar spondylolisthesis.
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Clin Neurol Neurosurg · Apr 2018
Clinically aggressive phenotype: A clinicopathological case series of atypical pituitary adenomas.
Atypical pituitary adenomas were relatively more malignant lesions defined by WHO criteria. However, not all of them show clinically aggressive behavior. Thus, the current WHO criteria of atypical adenoma didn't seem to be enough to distinguish clinically aggressive adenoma. Therefore, we would like to identify other clinical factors in a cohort of atypical pituitary adenomas to a better identification of clinical aggressiveness. ⋯ Gender, functional status, tumor size and Ki-67 index ≥4.45% were associated with clinical aggressiveness. A clinicopathological classification of pituitary adenomas may be useful to determine who should be under closer radiological follow-up or followed multimodal treatment strategy.
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Clin Neurol Neurosurg · Apr 2018
Results of interdisciplinary management of 693 patients with aneurysmal subarachnoid hemorrhage: Clinical outcome and relevant prognostic factors.
Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of morbidities and fatalities. The continuous evolution of neurosurgical, endovascular and neuro-intensive cares has improved the overall mortality. In this study we sought to evaluate the clinical outcome after aSAH from a single tertiary center. ⋯ The management of aSAH remains challenging but good clinical outcome can be achieved in a substantial subset of patients. Age, initial clinical condition, early aneurysm re-rupture, PH and MCA-aneurysm are important prognostic factors. Early detection and appropriate treatment of CVS are crucial for successful management.