المؤلفون: Sharouf, Feras^1,2 (AUTHOR), Hussain, Rahim N.³ (AUTHOR), Hettipathirannahelage, Sameera³ (AUTHOR), Martin, John¹ (AUTHOR), Gray, William^1,2 (AUTHOR), Zaben, Malik^1,2 (AUTHOR) zabenm@cardiff.ac.uk

المصدر: British Journal of Neurosurgery. Feb2020, Vol. 34 Issue 1, p46-50. 5p. 3 Charts, 4 Graphs.

مصطلحات موضوعية: *C-reactive protein, *LONGITUDINAL method, *SURGICAL site infections, *SCIENTIFIC observation, *LEUCOCYTES

مستخلص: Introduction: Post cranial surgery readmission, largely caused by surgical site infection (SSI), is a marker of patient-care quality requiring comprehensive discharge planning. Currently, discharge assessment is based on clinical recovery and basic laboratory tests, including C-reactive protein (CRP). Although CRP kinetics have been examined postoperatively in a handful of papers, the validity of CRP as a standalone test to predict SSI is yet to be explored. Methods: A prospective observational study was performed on adult patients undergoing elective cranial surgery over a 3-month period. Laboratory data; CRP, white cell count (WCC), neutrophil cell count (NCC), and clinical data were assessed pre and post-operatively and were evaluated as predictors for safe discharge. Readmission rates within 1 month were recorded. Results: In this study, 68 patients were included. About 8.6% were readmitted due to SSI. A postoperativepeak in CRP was seen on day 2 with a value of 57 in the non-readmitted group, and 115 in the readmitted group. CRP dropped gradually to normal levels by day 5 in the non-readmitted group. A secondary CRP rise at day 5 was noted in the readmitted group with a sensitivity, specificity, and negative predictive value of 71%, 90%, and 96%, respectively. Interestingly, our ROC analysis indicates that a CRP value of less than 65 predicts safe discharge with a sensitivity of 86%, specificity of 89% and negative predictive value of 98% of safe discharge (area under the curve, AUC: 0.782). No significant difference in other inflammatory markers was found between both groups. Conclusions: CRP increases postoperatively for 4–5 d which could be a physiological response to surgery, however, prolonged elevation or a secondary increase in CRP may indicate an ongoing infection. Our data validate the potential use of CRP levels to predict SSI. A multicentre study is warranted to investigate the role of CRP in predicting SSI. [ABSTRACT FROM AUTHOR]

المؤلفون: James, Lucy E., Roberts, Stuart A. G., Beltechi, Radu, Hussain, Rahim

المصدر: British Journal of Neurosurgery; Feb2021, Vol. 35 Issue 1, p32-34, 3p, 2 Black and White Photographs

مستخلص: Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies. We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient. Following eye patching and steroid treatment, at 6-week follow-up the patient's pain had significantly improved however the complete IIIrd nerve palsy remained. Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma. [ABSTRACT FROM AUTHOR]

: Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Hussain, Rahim A.¹ (AUTHOR) rahimhussain94@yahoo.com, Sainuddin, Sajid¹ (AUTHOR), Bhatti, I.¹ (AUTHOR), Leach, P.¹ (AUTHOR)

المصدر: British Journal of Neurosurgery. Aug2016, Vol. 30 Issue 4, p459-460. 2p.

مصطلحات موضوعية: *CEREBROSPINAL fluid shunts, *ESCHERICHIA coli, *GRAM-negative bacteria, *VENTRICULOCISTERNOSTOMY

مستخلص: We report a case of tumour-related hydrocephalus in a child treated with a ventriculo-peritoneal shunt which subsequently became infected with gram negative bacteria (Escherichia coli). After successful treatment of the infection the patient became shunt independent and has remained so for over 2 years. Gram negative ventriculitis is associated with diminished cerebro-spinal fluid production and we discuss the literature to date regarding this phenomenon. [ABSTRACT FROM AUTHOR]

المؤلفون: Jones, Huw M.¹ (AUTHOR) Huwmorganjones@doctors.org.uk, Hussain, Rahim¹ (AUTHOR), Leach, Paul¹ (AUTHOR)

المصدر: British Journal of Neurosurgery. Aug2015, Vol. 29 Issue 4, p587-588. 2p. 1 Black and White Photograph.

مصطلحات موضوعية: *SURGICAL anastomosis, *HYDROCEPHALUS, *SURGICAL complications, *THROMBOSIS, *PULMONARY hypertension, *CEREBROSPINAL fluid, *THERAPEUTICS

مستخلص: The insertion of ventriculo-atrial (VA) shunts has been performed for the treatment of hydrocephalus since the 1950s. Thrombosis, infection, pulmonary hypertension, tricuspid stenosis, shunt nephritis, intra-cardiac migration due to displacement or fracture are reported complications.1We present the case of a 49-year-old female who had a VA shunt as a baby, that was never revised, who presented with a neck abscess related to the shunt tubing. [ABSTRACT FROM AUTHOR]