scholarly journals Technical Notes and Result of Stereotactic Evacuation of Hematoma in Spontaneous Supratentorial Intracerebral Hematoma

2018 ◽  
Vol 15 (3) ◽  
pp. 27-31
Author(s):  
Resha Shrestha ◽  
Pranaya Shrestha ◽  
Pravesh Rajbhandari ◽  
Samir Acharya ◽  
Sudan Dhakal ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Minimal Invasive ◽  
Technical Note ◽  
Stereotactic Surgery ◽  
Intracerebral Hematoma ◽  
Modified Rankin Scale ◽  
Hematoma Volume ◽  
Baseline Characteristics

Primary intracerebral hematoma constitutes about 10-15% of all strokes and is associated with high mortality and severe disability. Surgical treatment of intracerebral hemorrhage is quite controversial. It is believed that minimal invasive stereotactic surgery may reduce hematoma volume and decrease secondary neurotoxicity. The technical note of stereotactic surgery has been illustrated. A retrospective study from March 2016 to March 2018 has been conducted and all patients who underwent stereotactic evacuation of hematoma were included in this study. Baseline characteristics of patients and outcome in terms of Glasgow Coma Scale (GCS) and Modified Rankin Scale (mRS) have been shown. We have found significant improvement in GCS postoperatively, however mRS did not improve immediately but was significantly better in three months follow up period.

Intracerebral Hematoma, Perihemorrhagic Edema and Urinary Excreted Cysteinyl Leukotrienes Correlation Study

2014 ◽  
Vol 68 (2) ◽  
pp. 85-88
Author(s):  
Natalija Dolnenec-Baneva ◽  
Dijana Nikodijevic ◽  
Gordana Kiteva-Trenchevska ◽  
Igor Petrov ◽  
Dragana Petrovska-Cvetkovska ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Brain Edema ◽  
Correlation Study ◽  
Intracerebral Hematoma ◽  
Moderate Correlation ◽  
Hematoma Volume ◽  
Cysteinyl Leukotrienes ◽  
Edema Volume ◽  
Perihemorrhagic Edema

AbstractIntroduction.Several mechanisms in formation of perihemorrhagic edema are activated after contact of brain tissue-extravasated blood in intracerebral hemorrhage. Cysteinyl leukotrienes (cysLT) (C4, D4, E4) are included in this process as significant edema factors and they determine the neurological deficit and outcome. The study aim was a 5-day follow-up (admission/3 day/5 day) of urinary cysLT, hematoma volume, edema volume values and their correlation in patients after spontaneous, primary supratentorial intracerebral hemorrhage.Methods.An enzyme immunoassay was used for urinary cysLT measured in 62 patients and 80 healthy controls. Hematoma and edema volumes were visualized and measured by computed tomography and mathematically calculated with a special spheroid shape formula (V=AxBxC/2).Results.CysLT of hemorrhagic patients (1842.20±1413.2, 1181.54±906.2, 982.30±774.2pg/ml/mg creatinine) were significantly excreted (p<0.01). Brain edema (12.86±13.5, 22.38±21.1, 28.45±29.4cm3) was significantly increased (p<0.01). Hematoma volume values (13.05±14.5, 13.13±14.7, 12.99±14.7cm3) were not significant (p>0.05). A high correlation (multiple regression) between cysLT, hematoma and edema was found on the 3rdday (R=0.6) and a moderate correlation at admission (R=0.3) and on the 5thday (R=0.3).Conclusion.In our 5-day follow-up study a significant cysLT brain synthesis and significant brain edema progression versus constant hematoma volume values in hemorrhagic patients was found. A high correlation between cysLT, hematoma and edema volume was found on the 3rdday, a moderate correlation on admission and on the 5thday, which means that high cysLT and hematoma values were associated with high/moderate edema values.

Arytenoidopexy for bilateral vocal fold paralysis in young children

1996 ◽  
Vol 110 (11) ◽  
pp. 1027-1030 ◽  
Author(s):  
Jean-Michel Triglia ◽  
Jean-François Belus ◽  
Richard Nicollas
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Young Children ◽  
Vocal Fold ◽  
Good Health ◽  
Vocal Fold Paralysis ◽  
Airway Compromise ◽  
Bilateral Vocal Fold Paralysis ◽  
Life Threatening

AbstractThe purpose of this retrospective study was to describe and evaluate the results of arytenoidopexy performed by the external laterocervical approach in 15 consecutive children presenting bilateral vocal fold paralysis causing life-threatening airway compromise. Mean age at the time of surgery was 20 months and mean follow-up was 42 months. At the end of follow-up all patients were in good health and did not need special care for breathing. No abduction movement has been observed on the opposite vocal fold since arytenoidopexy. One failure subsequently required arytenoidectomy. The findings of this study suggest that arytenoidopexy is an effective surgical treatment for life-threatening bilateral vocal fold paralysis in young children.

Hypothenar Hammer Syndrome

1999 ◽  
Vol 24 (6) ◽  
pp. 731-734 ◽  
Author(s):  
D. DE MONACO ◽  
E. FRITSCHE ◽  
G. RIGONI ◽  
S. SCHLUNKE ◽  
U. VON WARTBURG
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Ulnar Artery ◽  
Dominant Hand ◽  
Middle Aged ◽  
Arterial Segment ◽  
Hypothenar Hammer Syndrome ◽  
Direct Anastomosis ◽  
Repetitive Trauma

The hypothenar hammer syndrome is an uncommon lesion of the ulnar artery caused by repetitive trauma to the ulnar portion of the hand. It characteristically occurs in the dominant hand of middle-aged craftsmen, but also in athletes practising various types of sports. We present a retrospective study of nine patients between 1988 and 1999. The follow-up ranged from 1 to 10 years. We recommend surgical treatment, by resection of the involved arterial segment and revascularization either by direct anastomosis or by means of a venous interpositional graft.

scholarly journals Quality of life following surgical treatment of lesions within the pineal region

2018 ◽  
Vol 130 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Stepan Fedorko ◽  
Klaus Zweckberger ◽  
Andreas W. Unterberg
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Neurological Outcome ◽  
Tumor Resection ◽  
Pineal Region ◽  
Subtotal Resection ◽  
Modified Rankin Scale ◽  
Tumor Patients

OBJECTIVEPineal region tumors are a rare and heterogeneous group of lesions. The optimal therapeutic approach is currently a topic of controversy, particularly in light of the potential operative risks and complications. The potential beneficial effects of surgery have already been described, but information about neurological outcome and, in particular, health-related quality of life (HRQOL) is still lacking in the literature. The aim of this study was to assess the therapeutic effect of resection of pineal region lesions, emphasizing grade of tumor resection, neurological outcome, quality of life, and the necessity of additional shunt procedures.METHODSThe authors performed a prospective study of HRQOL in 32 patients who had undergone surgical treatment of lesions in the pineal region (20 tumors and 12 cysts) between 2008 and 2014. All patients had at least 6 months of follow-up, with reexamination including standardized neurological assessment, an evaluation of dependency using the modified Rankin Scale, and an evaluation of HRQOL. The authors retrospectively examined patient charts and collected information regarding imaging studies, neurological status prior to surgery, surgical strategies used, any complications, and histological diagnoses.RESULTSIn this study, there was no surgery-associated mortality or major morbidity. Permanent minor morbidity was reported for 4 patients (13%). Comparing pre- and postoperative neurological symptoms, 75% of tumor patients had either complete resolution or improvement of preoperative symptoms; symptoms were unchanged in 10% of tumor patients and deteriorated in 15%. In patients with pineal cysts, long-term follow-up showed that 42% of patients were free of any symptoms and 58% experienced improvement of their preoperative symptoms. These outcomes were also reflected in the modified Rankin Scale scores, which demonstrated significant improvement following resection of pineal region lesions. Furthermore, significant improvements in HRQOL scores occurred in global health status, in all functional scales, and in pain, nausea and vomiting, fatigue, and insomnia (p < 0.0001). Moreover, a significant reduction in the necessity for permanent shunt procedures was observed after gross-total tumor resection compared with subtotal resection (p = 0.035) of pineal cysts.CONCLUSIONSDespite potential risks, (radical) surgery is a highly effective and safe treatment option for pineal region lesions and should be considered for the majority of patients.

scholarly journals Retrospective comparison of decompressive hemicraniectomy and hematoma evacuation for spontaneous supratentorial intracerebral hematoma

Pulse ◽  
2015 ◽  
Vol 7 (1) ◽  
pp. 16-21 ◽  
Author(s):  
MA Joarder ◽  
AKMB Karim ◽  
T Kamal ◽  
T Sujon ◽  
N Akhter ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Intracerebral Hematoma ◽  
Modified Rankin Scale ◽  
Hematoma Volume ◽  
Coma Scale ◽  
Decompressive Hemicraniectomy ◽  
Hematoma Evacuation ◽  
Retrospective Comparison ◽  
P 16 ◽  
Poor Outcomes

Objectives: The aim of this study was to test the hypothesis that decompressive hemicraniectomy (DHC), compared with craniotomy with evacuation of hematoma, and would improve clinical outcomes of patients with supratentorial intracerebral hemorrhage (SICH).Methods: We compared patients (November 2008–February 2014) with supratentorial ICH treated with DHC without hematoma evacuation and craniotomy with hematoma evacuation. DHC measured at least 150 mm and included opening of the dura. We analyzed clinical, radiological, and surgical characteristics. Outcome at 6 months was divided into good (modified Rankin Scale 0–4) and poor (modified Rankin Scale 5–6).Results: Fifteen patients (mean age 58 years) with ICH were treated by DHC. Median hematoma volume was 61 ml and mean preoperative Glasgow Coma Scale (GCS) was 7. Ten patients had good and five had poor outcomes. In hematoma evacuation group 29 patients were treated. Median hematoma volume was 55 ml and mean preoperative Glasgow Coma Scale (GCS) was 8. Seventeen patients had good and twelve had poor outcomes.Conclusions: DHC is more effective than hematoma evacuation in patients with SICH. Based on this small cohort, DHC may reduce mortality. Larger prospective study is warranted to assess safety and efficacy.Pulse Vol.7 January-December 2014 p.16-21

scholarly journals Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions

2019 ◽  
Vol 81 (06) ◽  
pp. 686-693
Author(s):  
Haiyong He ◽  
Meiqin Cai ◽  
Manting Li ◽  
Lei Wei ◽  
Lun Luo ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Optic Nerve ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Modified Rankin Scale ◽  
Pterional Approach ◽  
Total Resection ◽  
Significant Difference

Abstract Objectives Cranioorbital lesions present a great challenge for neurosurgeons and ophthalmologists. There is no consensus on the choice of surgical approach. The aims of this study were to investigate 49 cases of cranioorbital lesions and evaluate surgical approaches and outcomes. Patients and Methods A retrospective study was done on 49 patients (51 operations) from 2009 to 2018. Information about the lesion was used to decide whether the supraorbital eyebrow approach (SEA) or pterional approach (PA) was performed. Results Twenty-eight patients had surgical resection using SEA, 21 patients received PA, each group included one case of recurrence, who underwent reoperation via the same approach. SEA provided better cosmetic satisfaction, and a shorter incision than PA (p < 0.05). There was no significant difference in total resection rates, visual outcomes, recovery of ptosis, and other new surgical-related complications between SEA group and PA group (p > 0.05). Forty-nine cases of proptosis (94.1%, 49/51) were improved. Thirty-three patients (33/37, 89.2%) who underwent follow-up for longer than 12 weeks had a modified Rankin Scale (mRS) score ≤ 3. Conclusion Surgery is the preferred treatment for cranioorbital lesions, but total resection is difficult. SEA may be a more minimally invasive option for some more limited lesions superior to optic nerve. PA may be more reasonable for the lesion with obvious hyperostosis and more extensive lesions.

Cervical vertebral fractures in 56 dogs: a retrospective study

1999 ◽  
Vol 35 (2) ◽  
pp. 135-146 ◽  
Author(s):  
JC Hawthorne ◽  
WE Blevins ◽  
LJ Wallace ◽  
N Glickman ◽  
DJ Waters
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Functional Recovery ◽  
Vertebral Fractures ◽  
Perioperative Period ◽  
Clinicopathological Features ◽  
Neurological Deficits ◽  
Perioperative Mortality ◽  
Cervical Fractures

The clinicopathological features of cervical fractures in 56 dogs were reviewed. "Hit by car" (HBC) was the most common inciting cause, and the axis and atlas were the vertebrae most frequently affected. Surgical treatment was associated with high (36%) perioperative mortality. However, all dogs that survived the perioperative period achieved functional recovery. Functional recovery was achieved in 25 (89%) of 28 nonsurgically treated dogs with adequate follow-up. Overall, severity of neurological deficits (nonambulatory status) and prolonged interval (five days or longer) from trauma to referral were associated with poorer outcome. Nonsurgical treatment is a viable therapeutic approach for many dogs with cervical fractures. Early neck immobilization and prompt referral are recommended, because delay in referral decreases the likelihood of functional recovery.

Fixation of fifth metacarpal neck fractures: a comparison of medial locking plates with intramedullary K-wires

2020 ◽  
Vol 45 (6) ◽  
pp. 567-573 ◽  
Author(s):  
Kuan-Jung Chen ◽  
Jung-Pan Wang ◽  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Operative Time ◽  
Locking Plates ◽  
Level Of Evidence ◽  
Plate Group ◽  
Motion Time ◽  
Wire Fixation ◽  
K Wires

Surgical treatment for metacarpal neck fractures may be indicated for malrotation, palmar angulation exceeding 30° or metacarpal shortening exceeding 3 mm, although these thresholds have not been firmly established. In a retrospective study, we compared the clinical and radiographic results of 54 patients with displaced fifth metacarpal neck fractures who were treated with either medial locking plates (14 patients) or retrograde intramedullary K-wires (40 patients). At a mean follow-up of 26 months (range 12 to 62), metacarpal shortening and angulation were 2 mm greater and 4° greater, respectively, in the K-wire group. The plate group had an earlier return to work and greater aesthetic satisfaction, but operative time and complication incidence were higher. Range of motion, time to union, grip strength and Quick Disability of the Arm, Shoulder and Hand scores were similar. We conclude that medial plating offers no clear advantage over K-wire fixation in treating metacarpal neck fractures. Level of evidence: III

Cylinder-Shaped Bone Graft for Scaphoid Nonunion

2018 ◽  
Vol 23 (01) ◽  
pp. 96-101
Author(s):  
Hitoshi Hatanaka ◽  
Minoru Takasaki ◽  
Hiroko Furusho ◽  
Yasuhiro Omori
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Grafts ◽  
Scaphoid Nonunion ◽  
Wrist Motion ◽  
Operative Outcomes

Background: Wedge-shaped bone grafts that are internally fixed by a Herbert-type screw are a well-established surgical treatment for scaphoid nonunion. A procedure using cylinder-shaped bone grafts was also reported, but preoperative wrist functions were not assessed. In addition, it was not reported whether the humpback deformity of the scaphoid nonunion was corrected. The purpose of the current study was to compare preoperative wrist functions in cases of scaphoid nonunion with those observed at final follow-up, using cylinder-shaped bone grafts The humpback deformity of the scaphoid nonunion was also evaluated.Methods: We conducted a retrospective study to examine operative outcomes from 2008 to 2015. Twelve wrists in 12 patients (average age, 41 years; range, 17–67), with a mean follow-up of 19 months, were included in the current study. Cylinder-shaped bone grafts were obtained from the iliac crest with a newly designed trephine and fixed with a Herbert-type screw. We reviewed both the preoperative wrist functions and those obtained at final follow-up.Results: Union was achieved in 11 of 12 nonunion cases. Preoperative wrist functions, except for the range of wrist motion, significantly improved by final follow-up.Conclusions: We conclude that the use of cylinder-shaped bone grafts improves preoperative wrist functions in cases of scaphoid nonunion.

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