Journal of neurosurgery
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Journal of neurosurgery · Mar 2013
Decreasing ventricular infections through the use of a ventriculostomy placement bundle: experience at a single institution.
Ventricular infection after ventriculostomy placement carries a high mortality rate. Responding to ventriculostomy infection rates, a multidisciplinary performance improvement team was formed, a comprehensive protocol for ventriculostomy placement was developed, and the efficacy was evaluated. ⋯ Bundle implementation including an antimicrobial-impregnated catheter dramatically decreased EVD-related infections. Training and situational awareness of appropriate practice, assisted by the checklist, plus use of the antibiotic-impregnated catheter resulted in sustained reduction in ventriculitis.
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Journal of neurosurgery · Mar 2013
Case ReportsHemorrhagic colloid cyst with intraventricular extension.
Colloid cysts of the third ventricle presenting with acute obstructive hydrocephalus due to intracystic and intraventricular hemorrhage are extremely rare. The authors report a case of a 43-year-old man with a hemorrhagic colloid cyst that was treated using endoscopic surgery. A small colloid cyst of the third ventricle was initially diagnosed in the patient, and he was treated conservatively at that time. ⋯ Only partial removal of the cyst was performed because of a tough cyst wall with highly viscous, hemorrhagic cystic contents. Histological examination revealed a typical colloid cyst wall and hemorrhage mixed within a mucinous substance. Postoperative serial neuroimaging demonstrated a gradual reduction in the residual cyst size and normalization in the lateral ventricle size.
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Journal of neurosurgery · Mar 2013
Case ReportsLack of functionality and need for revision of an Ommaya reservoir placed into a cavum septum pellucidum.
Ommaya reservoirs are routinely placed for the administration of intrathecal chemotherapy or antibiotics. There is scant literature that addresses the functionality of an Ommaya catheter placed exclusively within a cavum septum pellucidum (CSP). ⋯ The authors demonstrated failure of the system by injecting contrast agent into the reservoir and obtaining immediate and delayed CT scans that failed to demonstrate contrast dissemination into the ventricular system. An Ommaya reservoir placed exclusively within a CSP is potentially not functional, and can be dangerous if used for intrathecal drug therapy.
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Journal of neurosurgery · Mar 2013
Using a modified far-lateral approach to remove hypoglossal neurilemmomas: notes on technique.
In this paper the authors describe a modified far-lateral transcondylar approach to remove hypoglossal neurilemmomas (HGNs). ⋯ The modified far-lateral transcondylar approach is an effective treatment for HGNs, yielding a high total tumor removal rate with an acceptable rate of morbidity.
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Journal of neurosurgery · Mar 2013
Reanimation of elbow extension with medial pectoral nerve transfer in partial injuries to the brachial plexus.
Recent advancements in operative treatment of the brachial plexus authorized more extensive repairs and, currently, elbow extension can be included in the rank of desirable functions to be restored. This study aims to describe the author's experience in using the medial pectoral nerve for reinnervation of the triceps brachii in patients sustaining C5-7 palsies of the brachial plexus. ⋯ The medial pectoral nerve is a reliable donor for elbow extension recovery in patients who have sustained C5-7 nerve root injuries.