Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
-
Neurocysticercosis (NCC) is an infection of the brain and its coverings by the larval stage of the tapeworm Taenia solium. It is the most common helminthic infestation of the central nervous system and a leading cause of acquired epilepsy worldwide. NCC induces neurological syndromes that vary from an asymptomatic infection to sudden death. ⋯ The selection of cases for medical or surgical treatments has improved and these two forms of therapy are complementary. In general, indications of surgery are: cysts that compress the brain and cranial nerves locally, intracranial hypertension or edema refractory to medical treatment, intraventricular NCC, spinal NCC with cord or root compression and ocular cysts. Recently, endoscopic approaches for ventricular NCC have been developed, which are now the treatment of choice for ventricular NCC with hydrocephalus.
-
The aim of the study was to report management and outcome of traumatic brain injury (TBI) in a Jakarta University hospital, and to determine prognostic factors. All consecutive patients with an Abbreviated Injury Score (AIS) head of >=4 or an AIS head score of >=3 combined with an AIS score of >=2 in any other body region were analyzed on patient characteristics and outcome. Prognostic factors evaluated were Glasgow Coma Scale (GCS) score, pupil reactions and probability of survival based on the Trauma and Injury Severity Score (TRISS) method. ⋯ Thus, TBI has a poor prognosis in the population under study. The TRISS has limitations in evaluating trauma care for this selected group of patients. GCS and pupil reactions are valuable and simple for usage as prognostic factors.
-
Although venous air embolism (VAE) in neurological surgery is mainly associated with posterior fossa procedures, this complication may also occur, with comparable severity, in the posterior cervical spine approach in patients who are semi-sitting. We report a patient with a massive VAE that occurred in the semi-sitting position during a posterior approach to an extended cervical-thoracic level (C3-T2) intramedullary tumor, which interrupted the surgical procedure. We discuss the possible causes of air embolism, the anatomic and pathogenetic mechanisms, treatment and preventive measures.
-
We aimed to evaluate the clinical utility and safety of the hook and rod method for occipitocervical fusion. Eleven consecutive patients (3 males, 8 females; 50-78 years old, average 63.8 years; 16-77 months follow-up, average 33.7 months) with unstable lesions at the craniocervical junction who underwent occipitocervical fusion using a hook and rod system were examined. A Compact Cotrel-Dubousset cervical system (Sofamor-Danek, Memphis TN, USA) was used in all patients. ⋯ No complications occurred during surgery. Solid bony fusion was obtained in all patients and no patient became clinically worse postoperatively. Occipitocervical fusion using a hook and rod system is a useful procedure that allows decompression of the spinal cord and secure spinal fusion at multiple levels simultaneously.
-
Cluster headache is a severely debilitating disorder that can remain unrelieved by current pharmacotherapy. Alongside ablative neurosurgical procedures, neuromodulatory treatments of deep brain stimulation (DBS) and occipital nerve simulation have emerged in the last few years as effective treatments for medically refractory cluster headaches. ⋯ Controversy remains over which surgical treatments are best and in which circumstances to intervene. Here we review current data on neurosurgical interventions for chronic cluster headache focusing upon DBS and occipital nerve stimulation, and discuss the indications for and putative mechanisms of DBS including translational insights from functional neuroimaging, diffusion weighted tractography, magnetoencephalography and invasive neurophysiology.