Lundgreenstrong8101
In case of elevated ICP, further progression of intracranial hypertension occurs in 100% of cases. Cerebral hyperthermia is followed by ICP elevation in both intact and impaired cerebral autoregulation.
Cerebral hyperthermia in patients with initially normal ICP results intracranial hypertension in 48% of cases. In case of elevated ICP, further progression of intracranial hypertension occurs in 100% of cases. Cerebral hyperthermia is followed by ICP elevation in both intact and impaired cerebral autoregulation.Background. Previously, treatment of women with brain metastases following reproductive system cancers was palliative and included whole brain radiotherapy. Currently, treatment approaches have changed and life expectancy has increased. Nevertheless, the role of surgical treatment in these patients is still discussed.
To demonstrate an appropriateness and role of neurosurgical care in the complex management of women with brain metastases following reproductive system cancers.
There were 78 women with brain metastases following reproductive system cancer. All patients were treated at the Blokhin National Cancer Medical Research Center for the period 2004-2019. We have also reviewed the literature data for the last 30 years.
Selective surgical approach should be essential in the treatment of patients with brain metastases following reproductive system cancer. A multidisciplinary approach ensures the best treatment outcomes.
Selective surgical approach should be essential in the treatment of patients with brain metastases following reproductive system cancer. A multidisciplinary approach ensures the best treatment outcomes.Background. Brain aneurysms are found in 1-2% of population and cause subarachnoid hemorrhage (SAH) in 80-85% of cases. In recent decades, the incidence of unruptured aneurysms has increased due to widespread availability of CT and MRI. WS6 order Microsurgery is still essential in the treatment of cerebral aneurysms.
To assess the effectiveness and safety of minimally invasive approaches in microsurgical treatment of brain aneurysms in comparison with traditional approaches, to clarify the indications and contraindications for minimally invasive approaches.
There were 394 patients with cerebral aneurysms for the period 2014-2019. All patients were divided into 2 groups depending on surgical approach traditional approach (TrA) (
=171, 43.4%) and minimally invasive approach (MiniAp) (
=223, 56.6%). In the TrA group, pterional (
=85), orbitozygomatic (
=23) and lateral supraorbital approaches (
=63) were used. In the MiniAp group, transbrow supraorbital (
=88), mini-pterional (
=62), transbrow transorbital (
=3 recommended only for experienced neurosurgeons in a specialized hospital. Safety and effectiveness of MiniAp are achieved by careful selection of patients, individual neuroimaging and preoperative planning.Minimally invasive procedures reduce the trauma of spine surgery. However, they are associated with high complexity of manipulations, long learning curve, need for expensive equipment for intraoperative navigation and significant irradiation. Various options for surgical approaches are being developed to reduce irradiation of medical staff and patients, surgery time and the number of drugs administered for general anesthesia. Simultaneous surgical interventions (SiSI) is one of these options.
To compare the effectiveness of simultaneous and staged minimally invasive dorsal decompression-stabilization procedures in patients with lumbar spine degenerative diseases.
A prospective study included 67 patients (41 men and 26 women) aged 48 (34; 56) years who underwent a single-level minimally invasive spinal root decompression and transforaminal interbody fusion via Wiltse posterior-lateral approach. Two study groups were distinguished group I (simultaneous surgical interventions, SiSI) (
=29), in which guide spparameters and adverse effects of anesthesia in patients with lumbar spine degenerative diseases. Nevertheless, there were similar clinical data and small incidence of surgical perioperative complications.The development of spine neurosurgery raises some questions concerning the methodology, practical significance, treatment and diagnosis of spinal diseases. In this regard, we inevitably turn to the methods of philosophical knowledge as a basis for analysis and synthesis of scientific information. This approach allows you to avoid mistakes in practice, which can have negative ethical and socio-economic consequences for society. Some controversial issues of spine surgery are discussed in the manuscript. Advisability of syndromic approach in the treatment of spine diseases, determining the length of spine fusion for injury, prediction of postoperative segmental instability due to osteoporosis and extrapolation of the principles of spine fusion surgery to arthroplasty are considered through the prism of philosophical categories.Smoking is an obvious risk factor of adverse events in early and long-term postoperative period after spine surgery including lumbar total disk arthroplasty. Objective. To study the effect of smoking on clinical and radiological outcomes after lumbar total disk arthroplasty.
A single-center retrospective observational cohort study was performed. We have analyzed medical records of patients who underwent single-level lumbar total disk arthroplasty for degenerative disease.
The study included 57 medical records of respondents. The examined medical records were divided into two groups - smokers (
=26) and non-smokers (
=31). There were no significant between-group differences in clinical outcomes. Incidence of adverse events was similar too. Kaplan-Meier event-free survival was similar in both groups. There were no significant between-group differences in X-ray data. Development of heterotopic ossification after lumbar total disk arthroplasty was more active in smokers.
Smoking has no significant effect on clinical and radiological outcomes in patients after single-level after lumbar total disk arthroplasty. link2 On the other hand, smoking significantly increases formation of heterotopic ossification after lumbar total disk arthroplasty.
Smoking has no significant effect on clinical and radiological outcomes in patients after single-level after lumbar total disk arthroplasty. On the other hand, smoking significantly increases formation of heterotopic ossification after lumbar total disk arthroplasty.One of the causes of syringomyelia is arachnopathy following an infectious or non-infectious inflammation of the arachnoid membrane. It is extremely rare that adhesive arachnoiditis develops within the occipital cistern and impairs cerebrospinal fluid flow from the foramen of Magendie, along posterior cerebellar surface and into spinal subarachnoid space. These process result syringomyelia.
To evaluate postoperative outcomes in patients with syringomyelia following arachnopathy at the craniovertebral level.
A retrospective analysis included 27 patients with syringomyelia and arachnopathy within the occipital cistern for the period from 2013 to 2018. Eight patients (29.6%) underwent primary surgery. link3 In this group, 2 patients had arachnopathy following post-traumatic subarachnoid hemorrhage, 1 - after non-traumatic subarachnoid hemorrhage in posterior cranial fossa, 2 - after bacterial meningitis, 3 - the cause was unclear. Nineteenth patients underwent redo surgery after previous procedures on posterior crar after surgery. Early postoperative complications occurred in 3 (11.1%) patients 1 (3.7%) had hydrocephalus and 2 (7.4%) had aseptic meningitis.
Modern diagnostic and surgical methods for syringomyelia ensure favorable outcomes in 77.7% of cases.
Modern diagnostic and surgical methods for syringomyelia ensure favorable outcomes in 77.7% of cases.
To summarize and analyze the results of minimally invasive spine surgery.
A retrospective quantitative analysis of surgical interventions for the period 2011-2018 was carried out. All procedures were performed at the neurosurgical department of the Neurology Research Center. Structure and effectiveness of minimally invasive interventions were reported.
There were over 800 endoscopic minimally invasive interventions on the lumbar spine and 127 procedures on the cervical spine. For the period from 2011 to 2018, we found an increase in the number of minimally invasive interventions (104 endoscopic discectomies in 2018), active use of percutaneous approaches (87 operations in 2018) along with microsurgical discectomy (81 operations in 2018). The total efficiency of the methods ranges from 91.42% to 95.69%.
Own results and literature data confirm the validity and expediency of surgical treatment of patients with degenerative-dystrophic spine diseases. Highly effective and safe minimally invasive surgery should be preferred in these cases.
Own results and literature data confirm the validity and expediency of surgical treatment of patients with degenerative-dystrophic spine diseases. Highly effective and safe minimally invasive surgery should be preferred in these cases.In many Dutch hospitals, treatment of spontaneous pneumothorax (SP) routinely consists of in-hospital chest tube drainage. Alternatives, such as ambulatory Heimlich valves or manual aspiration of the pneumothorax, have become available in recent years. Neither treatment requires patient hospitalisation and pneumothorax recurrence rate is the same as after in-hospital treatment. A recent study demonstrated the same results for conservative treatment of SP (no intervention at all, outpatient-based) compared to chest tube drainage. In the future, treatment of SP should be outpatient-based as much as possible. As a rule, patients should only be hospitalised for prevention of recurrence using thoracoscopy and talc poudrage or video-assisted thoracoscopic surgery. Chest tube drainage should no longer be the first choice for the treatment of patients with SP.Reconstruction of arm and hand function in patients with a cervical spinal cord injury can improve their quality of life. Elbow extension, wrist extension, grip function and opening of the hand can be reconstructed. Traditionally, this has been done through tendon transpositions. Nerve transfer is a new technique. A functioning motor nerve branch is moved and connected to a muscle or muscle group damaged by the spinal cord injury. This technique has several advantages. Multiple functions can be restored by one nerve transfer, no long-term hand-rehabilitation is required and there is no risk of adhesions of the transposition. The most important disadvantage is the recovery time, as a results of the slow ingrowth of the nerve transfer, which takes at least 12 to 18 months. For each spinal cord injury patient, an individual action plan must be made, because not every patient has the same options and these are sometimes very limited.Obesity is a complex endocrine disease, mainly caused by environmental, behavioral and biological factors. Maintaining weight loss is extremely difficult due to the neuro-endocrine dysregulations that stimulate the body to return to the previous, increased, weight. Identifying underlying weight-gaining factors is needed, including medication-related, psychological and endocrine factors, as well as monogenic obesity. The cornerstone of treatment is optimization of lifestyle and all other contributing factors. Achieving at least 5% weight loss already has important health benefits. If combined lifestyle intervention (CLI) alone is not successful, pharmacotherapy or bariatric surgery can be added for patients with increased weight-related health risks. Recently, novel pharmacotherapy became available, among which, liraglutide 3 mg and the combination therapy naltrexone/bupropion, which leads to an additional 5-6% mean weight loss compared to CLI alone. For rare forms of obesity there are specific drugs that target defects in the regulation of hunger and satiety.
