scholarly journals Minimally invasive supratentorial neurosurgical approaches guided by Smartphone app and compass

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bruno Fernandes de Oliveira Santos ◽  
Daniel de Araujo Paz ◽  
Victor Miranda Fernandes ◽  
José Calasans dos Santos ◽  
Feres Eduardo Aparecido Chaddad-Neto ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Surgical Planning ◽  
Brain Injuries ◽  
Smartphone App ◽  
Less Invasive ◽  
Skin Marker ◽  
Average Accuracy ◽  
Intracerebral Hemorrhages ◽  
Intracranial Hematomas ◽  
Definition Of

AbstractThe precise location in the scalp of specifically planned points can help to achieve less invasive approaches. This study aims to develop a smartphone app, evaluate the precision and accuracy of the developed tool, and describe a series of cases using the referred technique. The application was developed with the React Native framework for Android and iOS. A phantom was printed based on the patient's CT scan, which was used for the calculation of accuracy and precision of the method. The points of interest were marked with an "x" on the patient's head, with the aid of the app and a compass attached to a skin marker pen. Then, two experienced neurosurgeons checked the plausibility of the demarcations based on the anatomical references. Both evaluators marked the frontal, temporal and parietal targets with a difference of less than 5 mm from the corresponding intended point, in all cases. The overall average accuracy observed was 1.6 ± 1.0 mm. The app was used in the surgical planning of trepanations for ventriculoperitoneal (VP) shunts and for drainage of abscesses, and in the definition of craniotomies for meningiomas, gliomas, brain metastases, intracranial hematomas, cavernomas, and arteriovenous malformation. The sample consisted of 88 volunteers who exhibited the following pathologies: 41 (46.6%) had brain tumors, 17 (19.3%) had traumatic brain injuries, 16 (18.2%) had spontaneous intracerebral hemorrhages, 2 (2.3%) had cavernomas, 1 (1.1%) had arteriovenous malformation (AVM), 4 (4.5%) had brain abscesses, and 7 (7.9%) had a VP shunt placement. In cases approached by craniotomy, with the exception of AVM, straight incisions and minicraniotomy were performed. Surgical planning with the aid of the NeuroKeypoint app is feasible and reliable. It has enabled neurological surgeries by craniotomy and trepanation in an accurate, precise, and less invasive manner.

MANAGEMENT OF MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

2020 ◽  
Vol 3 (1) ◽  
pp. 70-74
Author(s):  
Rustam Hazratkulov ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Surgical Treatment ◽  
Brain Injury ◽  
Hospital Stay ◽  
Treatment Outcomes ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Diagnostic Approach ◽  
Early Activation ◽  
Intracranial Hematomas

Multiple traumatic hematomas (MG) account for 0.74% of all traumatic brain injuries. A comprehensive diagnostic approach to multiple traumatic intracranial hematomas allows to establish a diagnosis in the early stages of traumatic brain injury and to determine treatment tactics. A differentiated approach to the choice of surgical treatment of multiple hematomas allows to achieve satisfactory results and treatment outcomes, which accordingly contributes to the early activation of the patient, a reduction in hospital stay, a decrease in mortality and disabilityin patients with traumatic brain injury

Intraoperative Ultrasonography for Definition of Less Invasive Surgical Technique in Patients with Chiari Type I Malformation

2017 ◽  
Vol 101 ◽  
pp. 466-475 ◽  
Author(s):  
Roger Schmidt Brock ◽  
Mario Augusto Taricco ◽  
Matheus Fernandes de Oliveira ◽  
Marcelo de Lima Oliveira ◽  
Manoel Jacobsen Teixeira ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intraoperative Ultrasonography ◽  
Type I ◽  
Chiari Type ◽  
Less Invasive ◽  
Chiari Type I Malformation ◽  
Definition Of ◽  
Chiari Type I

scholarly journals Sensorimotor conflict tests in an immersive virtual environment reveal subclinical impairments in mild traumatic brain injury

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hrishikesh M. Rao ◽  
Tanya Talkar ◽  
Gregory Ciccarelli ◽  
Michael Nolan ◽  
Anne O’Brien ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Virtual Environment ◽  
Mild Traumatic Brain Injury ◽  
Brain Injuries ◽  
Clinical Tests ◽  
Immersive Virtual Environment ◽  
Average Accuracy ◽  
Patient Reported ◽  
Huge Impact

Abstract Current clinical tests lack the sensitivity needed for detecting subtle balance impairments associated with mild traumatic brain injury (mTBI). Patient-reported symptoms can be significant and have a huge impact on daily life, but impairments may remain undetected or poorly quantified using clinical measures. Our central hypothesis was that provocative sensorimotor perturbations, delivered in a highly instrumented, immersive virtual environment, would challenge sensory subsystems recruited for balance through conflicting multi-sensory evidence, and therefore reveal that not all subsystems are performing optimally. The results show that, as compared to standard clinical tests, the provocative perturbations illuminate balance impairments in subjects who have had mild traumatic brain injuries. Perturbations delivered while subjects were walking provided greater discriminability (average accuracy ≈ 0.90) than those delivered during standing (average accuracy ≈ 0.65) between mTBI subjects and healthy controls. Of the categories of features extracted to characterize balance, the lower limb accelerometry-based metrics proved to be most informative. Further, in response to perturbations, subjects with an mTBI utilized hip strategies more than ankle strategies to prevent loss of balance and also showed less variability in gait patterns. We have shown that sensorimotor conflicts illuminate otherwise-hidden balance impairments, which can be used to increase the sensitivity of current clinical procedures. This augmentation is vital in order to robustly detect the presence of balance impairments after mTBI and potentially define a phenotype of balance dysfunction that enhances risk of injury.

Percival S. Bailey: eminent scholar of neurosciences who revealed the workings of the hypothalamus through clinicopathological research on craniopharyngiomas

2020 ◽  
Vol 133 (1) ◽  
pp. 197-209 ◽  
Author(s):  
Ruth Prieto ◽  
José M. Pascual
Keyword(s):  
Surgical Planning ◽  
Close Contact ◽  
Third Ventricle ◽  
Experimental Demonstration ◽  
Hypothalamic Nuclei ◽  
Eminent Scholar ◽  
Peter Bent Brigham Hospital ◽  
Definition Of

Percival S. Bailey (1892–1973) was a scholar, neuroscientist, neuropathologist, and neurosurgeon who made decisive contributions in the field of neuro-oncology. Far less known are his groundbreaking insights into understanding hypothalamic physiology through the study of craniopharyngiomas. As one of Harvey W. Cushing’s most talented trainees, Bailey was instrumental in developing Cushing’s project of a histologically based prognostic classification of brain tumors. He worked at Peter Bent Brigham Hospital on and off between 1919 and 1928, owing to frequent clashes with his mentor. A major cause of this long-term conflict was Bailey’s 1921 experimental demonstration of the hypothalamic origin of diabetes insipidus and Fröhlich’s syndrome. This finding challenged Cushing’s view that both alterations were due to pituitary gland insufficiency. In a seminal monograph written with John F. Fulton in 1929, both authors provided the first comprehensive account of the specific hypothalamic disturbances caused by tumors that originated within the infundibulum and third ventricle. The methodical study of Cushing’s craniopharyngioma specimens allowed Bailey to recognize the close contact between these lesions and hypothalamic nuclei, a key concept that Bailey originally advanced for proper surgical planning. This article aims to credit Bailey for his pioneering definition of craniopharyngiomas as tumors with a true intrahypothalamic position.

scholarly journals Spine–hip relations in patients with hip osteoarthritis

2018 ◽  
Vol 3 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Charles Rivière ◽  
Stefan Lazic ◽  
Louis Dagneaux ◽  
Catherine Van Der Straeten ◽  
Justin Cobb ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Surgical Planning ◽  
Imaging System ◽  
Hip Osteoarthritis ◽  
Acetabular Cup ◽  
Total Hip ◽  
Definition Of ◽  
The Individual ◽  
Cup Design ◽  
Cup Positioning

Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome. Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs. By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes. Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020

scholarly journals Correction of Pulmonary Arteriovenous Malformation Using Image-Based Surgical Planning

2009 ◽  
Vol 2 (8) ◽  
pp. 1024-1030 ◽  
Author(s):  
Kartik S. Sundareswaran ◽  
Diane de Zélicourt ◽  
Shiva Sharma ◽  
Kirk R. Kanter ◽  
Thomas L. Spray ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Surgical Planning ◽  
Pulmonary Arteriovenous Malformation

scholarly journals Radiological assessment of lower limb alignment

2021 ◽  
Vol 6 (6) ◽  
pp. 487-494
Author(s):  
Nuno Marques Luís ◽  
Ricardo Varatojo
Keyword(s):  
Lower Limb ◽  
Gold Standard ◽  
Surgical Planning ◽  
Preoperative Assessment ◽  
Radiological Assessment ◽  
Limb Alignment ◽  
Lower Limb Alignment ◽  
Definition Of ◽  
Torsional Malalignment ◽  
Tomography Scan

The full-length standing radiograph in an anteroposterior projection is the primary tool for defining and measuring limb alignment with definition of the physiological axes and mechanical and anatomic angles of the lower limb. We define the deformities of the lower limb and the importance of correct surgical planning and execution. For patients with torsional malalignment of the lower limb, computerized tomography scan evaluation is the gold standard for preoperative assessment. Cite this article: EFORT Open Rev 2021;6:487-494. DOI: 10.1302/2058-5241.6.210015

Cerebral microbleeds: Beyond the macroscope

2019 ◽  
Vol 14 (5) ◽  
pp. 468-475 ◽  
Author(s):  
Maud Pétrault ◽  
Barbara Casolla ◽  
Thavarak Ouk ◽  
Charlotte Cordonnier ◽  
Vincent Bérézowski
Keyword(s):  
Experimental Data ◽  
Natural History ◽  
Brain Cells ◽  
Biological Mechanisms ◽  
Clinical Routine ◽  
Therapeutic Decisions ◽  
Intracerebral Hemorrhages ◽  
Definition Of ◽  
Hemosiderin Deposits ◽  
Surrounding Parenchyma

While being increasingly recognized in clinical routine, brain microbleeds remain a puzzling finding for physicians. These small dot-like lesions are thought to be old perivascular collections of hemosiderin deposits. They can be found in different neurological settings such as cerebrovascular or neurodegenerative diseases. While their microscopic size would suggest considering these lesions as anecdotal, they are now regarded as biomarkers of severity of an underlying cerebrovascular disease. Their natural history and the interactions with surrounding brain cells remain unknown. However, their presence may impact therapeutic decisions. Deciphering the biological mechanisms leading to, or following microbleeds would enable us to address a key question: do microbleeds arise and impact the surrounding parenchyma like a miniature version of intracerebral hemorrhages or do they represent a different kind of injury? We hereby discuss, based on both clinical and experimental literature, the gap between the definition of microbleeds coming from neuroimaging and the pathophysiological hypotheses raised from histopathological and experimental data. Our analysis supports the need for a convergent effort from clinicians and basic scientists to go beyond the current “macro” view and disclose the cellular and molecular insights of these cerebral hemorrhagic microlesions.

Diffusion Tensor Imaging for Surgical Planning in Patients with Cervical Spondylotic Myelopathy

2019 ◽  
Vol 81 (01) ◽  
pp. 001-009 ◽  
Author(s):  
Karsten Schöller ◽  
Sebastian Siller ◽  
Christian Brem ◽  
Jürgen Lutz ◽  
Stefan Zausinger
Keyword(s):  
Diffusion Tensor Imaging ◽  
Cervical Spondylotic Myelopathy ◽  
Surgical Planning ◽  
Diffusion Tensor ◽  
Preoperative Evaluation ◽  
Cord Compression ◽  
Decompression Surgery ◽  
Characteristic Analysis ◽  
Less Invasive ◽  
Multilevel Cervical Spondylotic Myelopathy

Abstract Background and Study Aims/Objective Despite its invasiveness, computed tomography myelography (CTM) is still considered an important supplement to conventional magnetic resonance imaging (MRI) for preoperative evaluation of multilevel cervical spondylotic myelopathy (CSM). We analyzed if diffusion tensor imaging (DTI) could be a less invasive alternative for this purpose. Material and Methods In 20 patients with CSM and an indication for decompression of at least one level, CTM was performed preoperatively to determine the extent of spinal canal/cerebrospinal fluid (CSF) space and cord compression (Naganawa score) for a decision on the number of levels to be decompressed. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were correlated with these parameters and with MRI-based increased signal intensity (ISI). Receiver operating characteristic analysis was performed to determine the sensitivity to discriminate levels requiring decompression surgery. European Myelopathy Score (EMS) and neck/radicular visual analog scale (VAS-N/R) were used for clinical evaluation. Results According to preoperative CTM, 20 levels of maximum and 16 levels of relevant additional stenosis were defined and decompressed. Preoperative FA and particularly ADC showed a significant correlation with the CTM Naganawa score but also with the ISI grade. Furthermore, both FA and ADC facilitated a good discrimination between stenotic and nonstenotic levels with cutoff values < 0.49 for FA and > 1.15 × 10−9 m2/s for ADC. FA and especially ADC revealed a considerably higher sensitivity (79% and 82%, respectively) in discriminating levels requiring decompression surgery compared with ISI (55%). EMS and VAS-N/R were significantly improved at 14 months compared with preoperative values. Conclusion DTI parameters are highly sensitive at distinguishing surgical from nonsurgical levels in CSM patients and might therefore represent a less invasive alternative to CTM for surgical planning.

scholarly journals Title II: Improving Grants for States and Community Programs on Aging

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 715-715
Author(s):  
Jamie Kuhne
Keyword(s):  
Family Caregivers ◽  
Support Services ◽  
Brain Injuries ◽  
Supply And Demand ◽  
Traumatic Brain Injuries ◽  
Community Programs ◽  
Supportive Services ◽  
The Holocaust ◽  
Funding Programs ◽  
Definition Of

Abstract There are several noteworthy changes to the Improving Grants for States and Community Programs on Aging’s portion of the OAA. The reauthorization adds language requiring data collection on the needs of older adults and specifying additional populations on whom to focus outreach efforts, such as survivors of the Holocaust. The reauthorization also expands what States may fund with Supportive Services grants, adding screening for social isolation and traumatic brain injuries. The Act goes on extend Stated the option of funding programs to address both of these issues. The Act also requires the Assistant Secretary to study the supply and demand of home delivered and congregant meals and make recommendations to address the gap. Finally, there is expansion of the section on Caregiving, including a definition of caregiver assessment and the removal of a limit on funds States can use on support services to family caregivers.

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