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Flexible endoscopically assisted evacuation of acute and subacute subdural hematoma through a small craniotomy: preliminary results

ConclusionsThe results reported here suggest that small craniotomy evacuation with a flexible endoscope is a safe, effective, and minimally invasive treatment for acute and subacute SDH in selected cases.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research

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This report documents the first case of generalized seizure that was caused by the accidental intracerebral injection of local anesthetics. Although the patient recovered completely, the clinical implications regarding the scalp infiltration technique in a patient with skull defects are discussed. PMID: 29739181 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Report Source Type: research
The development of postoperative functional dysfunction can have an impact on the length of hospital stay, total medical costs, and necessity of dependency. To maintain functional integrity, neuromonitoring including motor evoked potential (MEP), sensory evoked potential, and visual evoked potential, has been conducted during the operation. Anesthetic management is usually based on the maintenance of MEP, which is most susceptible to suppression by anesthetic agents. MEP is indicated for craniotomy, spine surgery and aortic surgery, in which the technique for stimulation and recording can vary on types of surgery.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
J Neurol Surg B DOI: 10.1055/s-0038-1641752 Objectives To determine the incidence of prolonged postoperative systemic corticosteroid therapy after surgery for acoustic neuroma as well as the indications and associated risk factors that could lead to prolonged steroid administration, and the incidence of steroid-related adverse effects. Study Designs Retrospective chart review. Methods Retrospective chart review of patients undergoing resection of acoustic neuroma between 2010 and 2017 at two tertiary care medical centers. Patient and tumor characteristics, operative approach, hospital length of stay...
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Original Article Source Type: research
The development of postoperative functional dysfunction can have an impact on the length of hospital stay, total medical costs, and necessity of dependency. To maintain functional integrity, neuromonitoring including motor evoked potential (MEP), sensory evoked potential, and visual evoked potential, has been conducted during the operation. Anesthetic management is usually based on the maintenance of MEP, which is most susceptible to suppression by anesthetic agents. MEP is indicated for craniotomy, spine surgery and aortic surgery, in which the technique for stimulation and recording can vary on types of surgery.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research
Conclusions: Our findings suggest that equivolemic, equiosmolar HTS and HTL solutions equally preserve perfusion of cortical brain microcirculation in a rabbit craniotomy model. The use of HTS was better in preventing the worsening of brain tissue oxygen tension.
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Investigations Source Type: research
Background: In the present study, we hypothesized that 3% hypertonic saline (HS) is more effective than 20% mannitol to reduce intracranial pressure (ICP) and to modify brain bulk in patients undergoing an elective supratentorial craniotomy. Materials and Methods: After institutional review board approval, patients scheduled to undergo supratentorial craniotomy were enrolled into this prospective, randomized, double-blind study. The patients were monitored for routine hemodynamic parameters, depth of anesthesia, and ICP. They received 5 mL/kg 20% mannitol (n=20) or 3% HS (n=19) as infusion for 15 minutes. The patients...
Source: Journal of Neurosurgical Anesthesiology - Category: Anesthesiology Tags: Clinical Investigations Source Type: research
Conclusion: The use of dexmedetomidine infusion with regional scalp block in patients undergoing awake craniotomy is safe and efficacious. The absence of major complications and higher PSS makes it close to an ideal agent for craniotomy in awake state.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusions: Management of concomitant metabolic encephalopathy and meningioma with vasogenic edema and impending herniation can be challenging. Correction of the encephalopathy is crucial to minimize perioperative morbidity and mortality. Awareness of metabolic causes of acute decompensation is critical for perioperative management, so a high index of clinical suspicion can make an important timely diagnosis for treatment initiation. Severely hypothyroid patients are sensitive to anesthetic agents and are at a high risk for perioperative complications. Prompt treatment prior to surgical intervention can help minimize peri...
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
Authors: Potters JW, Klimek M Abstract This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain. The only identified causative ...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
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