Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
-
For the past decade, a screw-rod construct has been used commonly to stabilize the atlantoaxial joint, but the insertion of the screw through the C1 lateral mass (LM) can cause several complications. We evaluated whether using a higher screw entry point for C1 lateral mass (LM) fixation than in the standard procedure could prevent screw-induced occipital neuralgia. We enrolled 12 consecutive patients who underwent bilateral C1 LM fixation, with the modified screw insertion point at the junction of the C1 posterior arch and the midpoint of the posterior inferior portion of the C1 LM. ⋯ Twenty screws were positioned correctly through the intended entry points, but three screws were placed inferiorly (that is, below the arch), and one screw was inserted too medially. When performing C1-C2 fixation using the standard (Harms) construct, surgeons should be aware of the possible development of occipital neuralgia. A higher entry point may prevent this complication; therefore, we recommend that the screw should be inserted into the arch of C1 if it can be accommodated.
-
Acute subdural hematoma (ASDH) results in neuronal death due to mitochondrial dysfunction and a subsequent cascade of apoptotic and necrotic events. We previously demonstrated that mitochondrial ATP-dependent potassium (mitoK(ATP)) channels have a major role in cerebral ischemic preconditioning in vivo and in vitro. However, the role of the mitoK(ATP) channel has not been investigated in the context of ASDH. ⋯ Pretreatment with diazoxide significantly reduced infarct volume and brain edema formation after ASDH. However, the effects of diazoxide were abolished by co-treatment with 5-HD. 5-HD alone increased infarct volume. These data suggest that the mitoK(ATP) channel is an important mediator of the neuroprotective effects of cerebral preconditioning in a rat model of ASDH.
-
The presence of healthcare-related disparities is an ongoing, widespread, and well-documented societal and health policy issue. We investigated the presence of racial disparities among post-operative patients either with meningioma or malignant, benign, or metastatic brain tumors. We used the Medicaid component of the Thomson Reuter's MarketScan database from 2000 to 2009. ⋯ Patients of African-American ethnicity had significantly higher post-operative complications than those of Caucasian ethnicity. This higher rate of complications seems to have driven greater healthcare utilization, including greater LOS and total charges, among African-American patients. Interventions aimed at reducing complications among African-American patients with brain tumor may help reduce post-operative disparities.
-
This study examines electrocorticography (ECoG) signals in patients with supratentorial meningioma before and after tumor resection, and discusses its predictive value with regard to postoperative epilepsy. Ninety-one patients with supratentorial meningioma, who presented with seizures, were studied. Patients were followed-up for 2 to 5 years, and the occurrence rate of postoperative epilepsy in each group was compared. ⋯ Of the 29 patients with early postoperative seizures, seven (24.14%) also had late postoperative epilepsy. Of the 62 patients who did not experience early postoperative seizures, 10 (16.13%) also had late postoperative epilepsy (χ(2)=0.83, p>0.05). Thus, the change in ECoG before and after resection in patients with supratentorial meningioma has a predictive value for early postoperative seizures.
-
Historical Article
History of the Asian Australasian Society of Neurological Surgeons from 1964 to 2012: a personal account.
A steering committee of the Asian Australasian Society of Neurological Surgeons (AASNS) first met on 17 October, 1961, and between 29 and 31 October 1964, the First Congress was held in Canberra, Australia. A Constitution was accepted and Sir Ian (Douglas) Miller was elected as the first President. The Society was established "to facilitate personal association of neurosurgeons in the region" and to develop training programs and neurosurgical services. ⋯ Two special milestones have included the establishment of the Journal of Clinical Neuroscience in 1993 and the launching of the Asian Australasian Travelling Fellowship in 1987. The current President of the AASNS is Professor Andrew H. Kaye from Melbourne, Australia, and the President-elect of the WFNS is Professor Yong-Kwang Tu from Taipei, Taiwan.