Dr. Hilary Nickols: neuropathologist and artist
Hilary Nickols, MD, PhDFrom time to time, I feature neuropathologists who exhibit talents beyond the strict confines of neuropathology. For example, I recently features the inimitableMark Cohen and his prodigious classical guitar skills. I discovered another neuropathologist/artist during the recent annual meeting of the American Association of Neuropathologists: Hilary Nickols, MD, PhD, of Norton Healthcare in Louisville, Kentucky. Dr. Nickols shared with me her detailed drawing of a craniotomy surgical field which she recently witnessed during a visit to the operating room.The scene in the operating room, including drains, reflected dura, etc.
CONCLUSIONS: The results of this study suggest that undiagnosed OSA, as assessed via the STOP-Bang questionnaire, is a significant predictor of patient health status and readmission risk in the brain tumor craniotomy population. Further investigations should be undertaken to apply this prediction tool in order to enhance postoperative patient care to reduce the need for unplanned readmissions. PMID: 31323636 [PubMed - as supplied by publisher]
CONCLUSIONS: Ultrasonographic ONSD is strongly correlated with invasive ICP measurements and may serve as a sensitive and noninvasive method for detecting elevated ICP in TBI patients after DC. PMID: 31323632 [PubMed - as supplied by publisher]
ConclusionConsidering patients with chronic subdural hematomas our study demonstrated that the significant variables predicting outcome are chronic subdural hematomas occurring secondary to an overdraining ventriculo-peritoneal shunt, a history of seizures, and a low level of consciousness measured by either the Markwalder or the Glasgow Coma Score. Interestingly all of these variables are determined prior to the patient arriving at hospital. Our study highlights the need for early presentation prior to clinical deterioration as the major determinant of outcome.
The objective of this study was to evaluate the gut microbiome in a preclinical TBI cortical impact model. Male rats underwent craniotomy and randomized to a sham group (n = 4), or a moderate TBI (n = 10) using a pneumatic impactor. MRI and behavioral assessments were performed pre-TBI and on days 2, 7, and 14 days thereafter. Microbiome composition was determined with 16s rRNA sequencing from fecal sample DNA pre-TBI and 2 hrs, 1, 3, and 7 days afterward. Alpha- and β-bacterial diversity, as well as organizational taxonomic units (OTUs), were determined. Significant changes in the gut microbiome were evident ...
Conclusions: Morphometry of the bony canal of MMA shall be important for safely expose and preserve the artery during craniotomy with careful drilling and shall be useful for those who have interest in this anatomical site.
CONCLUSIONS: This transmuscular technique for identification of the OA is a reliable method and may facilitate exposure and protection of the OA during a retrosigmoid approach. This technique may obviate the need for larger incisions when planning a bypass to nearby arteries in the posterior circulation via a retrosigmoid craniotomy. Additionally, the small skin incision can be enlarged when a different craniotomy and/or bypass is planned or when a greater length of the OA is needed to be harvested. PMID: 31299653 [PubMed - as supplied by publisher]
ConclusionsProlonged operative time can increase the SSI risk for neurosurgery patients. Intensive interventions should be taken to decrease operative duration.
ConclusionSpheno-orbital meningiomas are highly complex tumours. Surgical approaches should be tailored to the patient but good clinical and cosmetic outcomes may be achieved with a smaller craniotomy and custom-made implants, irrespective of whether the operation is the patient ’s first procedure.
ConclusionThis combined approach allows safe clipping of such PICA aneurysms.
This study aimed to evaluate the impact of a skull defect and the interpretation criteria of images on this diagnostic test. MATERIALS AND METHODS: A series of consecutive patients with a clinical diagnosis of brain death underwent CTA (case group), while the control group comprised patients with acute ischemic stroke in the same period. CTA criteria adopted to confirm brain death were the absence of opacification of the M4 branches and internal cerebral veins. The evaluation also included the presence of "stasis filling." Cases were stratified as intact skull, craniotomy, and craniectomy. Three neuroradiologist...