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Emergency decompressive surgery in patients with transtentorial brain herniation and pupillary abnormalities: the importance of improved pupillary response after osmotherapy and surgery
CONCLUSIONS: With aggressive medical and surgical management, patients with transtentorial brain herniation, including those with bilaterally fixed and dilated pupils, may have considerable rates of survival and functional recovery. Young age, less midline shift, and improved pupillary response following osmotic therapy or decompressive surgery are favorable prognosticators.PMID:37548576 | DOI:10.3171/2023.5.JNS23163
Source: Journal of Neurosurgery - August 7, 2023 Category: Neurosurgery Authors: Daniel W Griepp Aaron Miller Sahar Sorek Komal Naeem Stephanie Moawad David Klein Joseph A DeMattia Ralph Rahme Source Type: research

Ineffective triggering in patients with acute brain injury undergoing invasive mechanical ventilation
Conclusion: Ineffective triggering was found very common in patients with acute brain injury, especially those receiving craniotomy for brain tumor. Low respiratory drive was independently associated with severe ineffective triggering at expiratory phase.PMID:36997326 | DOI:10.4187/respcare.10596
Source: Respiratory Care - March 30, 2023 Category: Respiratory Medicine Authors: Xu-Ying Luo Xuan He Yi-Min Zhou Jian-Fang Zhou Guang-Qiang Chen Hong-Liang Li Yan-Lin Yang Linlin Zhang Jian-Xin Zhou Source Type: research

Management dilemma in a rare case of pituitary apoplexy with akinetic mutism in the setting of ruptured junctional brain aneurysm: A case report and literature review
CONCLUSION: Pituitary apoplexy with ruptured A1-Acom junction aneurysm with nonfunctioning pituitary macroadenoma is rare, and its presentation with akinetic mutism has not been reported. As there is scarce literature suggesting an association between pituitary apoplexy and ruptured aneurysm, it is challenging to comment regarding its pathogenesis. Although akinetic mutism generally has a poor prognosis, it may respond to Levodopa with a better outcome.PMID:36751455 | PMC:PMC9899474 | DOI:10.25259/SNI_942_2022
Source: Surgical Neurology International - February 8, 2023 Category: Neurosurgery Authors: Vikas Chandra Jha Mohammad Shahnawaz Alam Vivek Sharan Sinha Rahul Jain Source Type: research

A Stroke Alert With Unexpected Outcome
Conclusion: We report a case of thrombolysis administered in a patient with high-grade glioma with no apparent complications.
Source: The Neurologist - September 1, 2022 Category: Neurology Tags: Case Report/Case Series Source Type: research

Benzodiazepine Sedation and Postoperative Neurological Deficits after Awake Craniotomy for Brain Tumor – An Exploratory Retrospective Cohort Study
An awake craniotomy is a common neurosurgical procedure for excising brain tumor(s) located near or in eloquent areas. The use of benzodiazepine (BZD) for sedation in some patients with neuropathological conditions (e.g., stroke, brain tumors) has been previously linked with re-appearance of neurological deficits including limb incoordination, ataxia, and motor weakness, resulting in complications for the patient along with procedural challenges. Whether or not these findings can be extrapolated to patients undergoing brain tumor resection is largely unknown. The current work primarily sought to compare neurological outcom...
Source: Frontiers in Oncology - April 20, 2022 Category: Cancer & Oncology Source Type: research

Effect of Goal-Directed Intraoperative Fluid Therapy on Duration of Hospital Stay and Postoperative Complications in Patients Undergoing Excision of Large Supratentorial Tumors
Conclusions: This study did not show any benefit of GDFT over conventional intraoperative fluid therapy in terms of incidence of postoperative complications, hospital and ICU stay, and Glasgow outcome scores at-discharge in patients undergoing craniotomy for excision of large supratentorial tumors. However, the use of GDFT leads to better perioperative fluid management and brain relaxation scores. Clinical Trial Registry: CTRI/2016/10/007350.
Source: Neurology India - February 28, 2022 Category: Neurology Authors: Nitasha Mishra Girija P Rath Parmod K Bithal Arvind Chaturvedi P Sarat Chandra Sachin A Borkar Source Type: research

Use of Radiofrequency Technology in Endonasal Skull Base and Transcranial Procedures
Conclusion Initial experience with radiofrequency ablation showed that it was a safe technique to use in both endonasal skull-base and transcranial procedures. It seemed particularly useful for highly vascularized tumors but a greater experience is needed to further clarify its role in these procedures. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part B: Skull Base - March 9, 2021 Category: Neurosurgery Authors: Tish, Shahed Habboub, Ghaith Borghei-Razavi, Hamid Woodard, Troy D. Sindwani, Raj Kshettry, Varun R. Recinos, Pablo F. Tags: Original Article Source Type: research

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
AbstractSurgery of complex cranial base lesions carries a high risk of damage to main vessels, often resulting in life-changing or even life-threatening injuries. We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was open...
Source: Neurology and Therapy - November 30, 2019 Category: Neurology Source Type: research

Neuroanesthesia and outcomes: evidence, opinions, and speculations on clinically relevant topics
The objective of this review is to identify outstanding topics most relevant to neuroanesthesia practice and patient outcomes. We discuss the role of awake craniotomy, choice of general anesthetic agents, monitoring of anesthetic ‘depth’, mannitol-induced diuresis, neurophysiological monitoring, hyperventilation, and cerebral hypoperfusion. Recent findings Awake craniotomy, although a technique likely underused, is associated with enhanced recovery after surgery and prolonged survival after brain tumor resection compared with surgery under general anesthesia. The choice of general anesthetic must balance patient and...
Source: Current Opinion in Anaesthesiology - August 30, 2019 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Lingzhong Meng Source Type: research

Case Report of a Novel Technique for Repair of the Vertebral Artery During Cranial Surgery
We describe a rapid, effective, and noninvasive application of a collagen-based hemostatic patch to repair the vertebral artery during cranial surgery. A 61-year-old male patient underwent retrosigmoid craniotomy to remove a foramen magnum meningioma that encased the vertebral artery. A linear incision was made behind the ear and standard retrosigmoid craniotomy was performed with preservation of the transverse and sigmoid sinuses. The dura was opened in a Y-shaped fashion and the cerebellum was retracted with cerebrospinal fluid being released. Removing the exposed tumor from the artery resulted in a small arterial bleed....
Source: Neurology and Therapy - July 4, 2019 Category: Neurology Source Type: research

Prism Adaptation Treatment for Spatial Neglect Post Craniotomy in a Person With Brain Tumor
This study investigates the feasibility and potential effects of PAT in an individual with SN after brain tumor removal.
Source: Archives of Physical Medicine and Rehabilitation - October 1, 2018 Category: Rehabilitation Authors: Natalia Noce, Viktoriya Landar, Kimberly P. Hreha, Peii Chen Source Type: research

Management of concomitant metabolic encephalopathy and meningioma with vasogenic edema and impending herniation.
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 - March 3, 2018 Category: Neurosurgery Tags: Surg Neurol Int Source Type: research

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