المؤلفون: Julie Woodfield, Boris Krischek, Giles Critchley, Damian Holliman, Angelos Kolias, Thomas Santarius, Ola Rominiyi, Michael McDermott, Michael D Jenkinson, Jörg-Christian Tonn, Mohsen Javadpour, Andrea Saladino, Tiit Illimar Mathiesen, Rory Piper, Michael Vogelbaum, Chaya Brodie, Sara Venturini, Daniel M Fountain, Roland Goldbrunner, Elliot Tilling, Felix Sahm, Priscilla Brastianos, Rory J Piper, Antonio Santoro, Sylvia Kurz, Pierfrancesco Lapolla, Andrea Mingoli, Jennifer Brown, Debraj Mukherjee, Simon Walling, Andrew Morokoff, Patrick Wen, Ghazaleh Tabatabai, Jill Barnholtz-Sloan, Ryan K Mathew, Alexander Smedley, Helen Shih, William Taylor, Minh Nguyen, Bryony Ford, Samantha J Mills, Tamara Ali, Ruwanthi Kolamunnage-Dona, Josephine Jung, Muhammed Elhadi, Erminia Albanese, Aswin Chari, David Rowland, Melissa Gough, Michael Cearns, Simon Lammy, Yasir Chowdhury, Christian Mawrin, Mahmoud Saleh, Jens Schittenhelm, Farshad Nassiri, Raymond Huang, Pietro Familiari, Manfred Westphal, Warren Selman, Daniel Brown, Nathan McSorley, Oliver Hanemann, Richard Pullicino, Francesco Gaillard, Mirjam Renovanz, Chris Barrett, Christine Jungk, Aaron Cohen-Gadol, Javier Martín-Alonso, Gelareh Zadeh, Hytham Hamid, Abdurrahman I Islim, Christopher P Millward, Shaveta Mehta, Usama Ali, Shelli Diane Koszdin, Theo Georgious, Andrew R Brodbelt, Mohamed Abdelsadg, Suhaib Abualsaud, Amro Abuleil, Kevin Agyemang, Hanan Akbari, Likhith Alakandy, Clarissa Alfonso, Arousa Ali, Michael Amoo, Mohamed A. R. Arbab, Mutiu Asha, Kareem Austin, Khaled Badran, Jarnail Bal, Parameswaran Bhattathiri, Paul M. Brennan, Andrew R. Brodbelt, Ferran Brugada-Bellsolà, Placido Bruzzaniti, Annabel Butcher, Rory S. Cairns, Michael Canty, Sachiv Chakravarti, Rebecca Chave-Cox, Anna Craig-McQuade, Peter Crossley, Elizabeth Culpin, Alessia D'Amico, Bassam Dabbous, Pedro David Delgado-López, Mohamed Draz, Katharine J. Drummond, Rusiru T. Ekanayaka, Ibrahim Elmaadawi, Omar Elmandouh, Mazin Elsharif, Daisy Evans, Andreas Fahlström, Fleur L. Fisher, Daniel M. Fountain, Keiko Fox, Chloé Gelder, Shamayitri Ghosh, Aimee Goel, Athanasios Grivas, Andrew Gvozdanovic, Allan Hall, Liv Hartrick, Samih Hassan, Jack Henry, Abdurrahman I. Islim, Asgeir S. Jakola, Michael D. Jenkinson, Sanjeeva Jeyaretna, Adrian Jimenez, Andranik Kahramanian, Neeraj Kalra, David O. Kamson, Oliver Kennion, Adham M. Khalafallah, Sarah Kingdon, Howra Ktayen, Aditaya Kumar, Jun Yi Lau, Jing Xian Lee, Ryan Leyden, Patricia Littlechild, Sophie Liu, Darmanin Lora-Kay, Vivia Lung, Stephen T. Magill, Hani J. Marcus, Fawaz E. Marhoom, Ryan K. Mathew, Calan Mathieson, Tobias Mederer, Torstien R. Meling, Samantha J. Mills, Christopher P. Millward, Mujtaba Mohammad, Amir H. Zamanipoor Najafabadi, Olivia Näslund, Imran Noorani, Gildas Patet, Omar N. Pathmanaban, Andrea Perera, Amit Persad, See Yung Phang, Rory J. Piper, Jonathan Pollock, Benjamin Price, Martin Proescholdt, James Robins, Bobby Sachdev, Fozia Saeed, Ieva Sataite, Antony Kevin Scafa, Verena Schadewaldt, Syed Wajahat Shah, Mustafa El Sheikh, Zenab Sher, Bente Sandvei Skeie, Agbolahan Sofela, Jerome St George, Torbjørn Strømsnes, Nigel Suttner, Philip Theodosopoulos, Manjul Tripathi, Ismail Ughratdar, James Ulrich, Adithya Varma, Anil Varma, Maria Velicu, Esther Wu, Jacob Young, Giuseppa Zancana, Catherine Zhang, Karolyn Au, Felix Behling, Linda Bi, Nicholas Butowski, Ana Castro, Marta Couce, Francesco Dimeco, Katherine J. Drummond, Ian Dunn, Craig Erker, Michelle Felicella, Eva Galanis, Norbert Galldiks, Caterina Giannini, Christel Herold-Mende, Luke Hnenny, Craig Horbinski, Gerhard Jungwirth, Timothy Kaufmann, Daniel Lachance, Christian Lafougere, Katrin Lamszus, Serge Makarenko, Tathiana Malta, Jennifer Moliterno-Gunel, HK Ng, Houtan Noushmehr, Arie Perry, Laila Poisson, Bianco Pollo, Aditya Ragunathan, David Raleigh, Franz Ricklefs, Antonio Santacroce, Christian Schichor, Nils Schimdt, Andrew Sloan, Matija Snuderl, Jim Snyder, Erik Sulman, Suganth Suppiah, Marcos Tatagiba, Marco Timmer, Andreas Von Deimling, Tobias Walbert, Justin Z. Wang, Stephen Yip, Gabriel Zada, Viktor Zherebitskiy, Michael T.C. Poon

المصدر: BMJ Open, Vol 12, Iss 1 (2022)

مصطلحات موضوعية: Medicine

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/12/1/e052705.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/0926b56220df490c910070692f8601b3Test

المؤلفون: Luke Hnenny, Neil Roundy, Victor Zherebitskiy, Marjorie Grafe, Atiya Mansoor, Aclan Dogan

المصدر: Journal of Neurological Surgery Reports, Vol 76, Iss 02, Pp e216-e221 (2015)

مصطلحات موضوعية: aneurysmal bone cyst, pregnancy, skull base, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Background and Purpose Aneurysmal bone cysts (ABCs) rarely involve the cranium and have seldom been reported in pregnancy. Clinical Presentation We describe a case of a 28-year-old woman who presented at 37 weeks of gestation with 3 months of gradually worsening vision, 10 months of proptosis, and restricted ocular motility on the left. Brain imaging revealed a multicystic enhancing mass measuring 5.9 × 5.3 × 3.7 cm, centered on the cribriform plate on the left, extending into the anterior cranial fossa superiorly as well as the left nasal cavity, maxillary, sphenoid, and frontal sinuses. Her clinical course is described in detail; 3-month postoperative imaging demonstrated no residual mass. Conclusion A literature review revealed five previous cases of ABCs associated with pregnancy. We report a rare case of a giant ABC of fibrous dysplasia involving the paranasal sinuses and anterior cranial fossa. We postulate on the possible influence of pregnancy on the clinical course.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2193-6358Test; https://doaj.org/toc/2193-6366Test

الوصول الحر: https://doaj.org/article/8f53f5d5e4c84b31a12a9b16ec0787afTest

المؤلفون: Islim, Abdurrahman I, Millward, Christopher P, Piper, Rory J, Fountain, Daniel M, Mehta, Shaveta, Kolamunnage-Dona, Ruwanthi, Ali, Usama, Koszdin, Shelli Diane, Georgious, Theo, Mills, Samantha J, Brodbelt, Andrew R, Mathew, Ryan K, Santarius, Thomas, Jenkinson, Michael D, Mohamed Abdelsadg, Suhaib Abualsaud, Amro Abuleil, Kevin Agyemang, Hanan Akbari, Likhith Alakandy, Erminia Albanese, Clarissa Alfonso, Usama Ali, Arousa Ali, Tamara Ali, Michael Amoo, Mohamed A R Arbab, Mutiu Asha, Kareem Austin, Khaled Badran, Jarnail Bal, Chris Barrett, Parameswaran Bhattathiri, Paul M Brennan, Andrew R Brodbelt, Jennifer Brown, Daniel Brown, Ferran Brugada-Bellsolà, Placido Bruzzaniti, Annabel Butcher, Rory S Cairns, Michael Canty, Michael Cearns, Sachiv Chakravarti, Rebecca Chave-Cox, Yasir Chowdhury, Anna Craig-McQuade, Giles Critchley, Peter Crossley, Elizabeth Culpin, Alessia D'Amico, Bassam Dabbous, Pedro David Delgado-López, Mohamed Draz, Katharine J Drummond, Rusiru T Ekanayaka, Muhammed Elhadi, Ibrahim Elmaadawi, Omar Elmandouh, Mazin Elsharif, Daisy Evans, Andreas Fahlström, Pietro Familiari, Fleur L Fisher, Bryony Ford, Daniel M Fountain, Keiko Fox, Francesco Gaillard, Chloé Gelder, Theo Georgious, Shamayitri Ghosh, Aimee Goel, Melissa Gough, Athanasios Grivas, Andrew Gvozdanovic, Allan Hall, Hytham Hamid, Liv Hartrick, Samih Hassan, Jack Henry, Damian Holliman, Abdurrahman I Islim, Asgeir S Jakola, Mohsen Javadpour, Michael D Jenkinson, Sanjeeva Jeyaretna, Adrian Jimenez, Josephine Jung, Andranik Kahramanian, Neeraj Kalra, David O Kamson, Oliver Kennion, Adham M Khalafallah, Sarah Kingdon, Ruwanthi Kolamunnage-Dona, Shelli Diane Koszdin, Howra Ktayen, Aditaya Kumar, Simon Lammy, Pierfrancesco Lapolla, Jun Yi Lau, Jing Xian Lee, Ryan Leyden, Patricia Littlechild, Sophie Liu, Darmanin Lora-Kay, Vivia Lung, Stephen T Magill, Hani J Marcus, Fawaz E Marhoom, Javier Martin-Alonso, Ryan K Mathew, Calan Mathieson, Nathan McSorley, Tobias Mederer, Shaveta Mehta, Torstien R Meling, Samantha J Mills, Christopher P Millward, Andrea Mingoli, Mujtaba Mohammad, Debraj Mukherjee, Amir H Zamanipoor Najafabadi, Olivia Näslund, Minh Nguyen, Imran Noorani, Gildas Patet, Omar N Pathmanaban, Andrea Perera, Amit Persad, See Yung Phang, Rory J Piper, Jonathan Pollock, Benjamin Price, Martin Proescholdt, Richard Pullicino, James Robins, Ola Rominiyi, David Rowland, Bobby Sachdev, Fozia Saeed, Mahmoud Saleh, Thomas Santarius, Antonio Santoro, Ieva Sataite, Antony Kevin Scafa, Verena Schadewaldt, Syed Wajahat Shah, Mustafa El Sheikh, Zenab Sher, Bente Sandvei Skeie, Alexander Smedley, Agbolahan Sofela, Jerome St George, Torbjørn Strømsnes, Nigel Suttner, William Taylor, Philip Theodosopoulos, Elliot Tilling, Manjul Tripathi, Ismail Ughratdar, James Ulrich, Adithya Varma, Anil Varma, Maria Velicu, Sara Venturini, Esther Wu, Jacob Young, Giuseppa Zancana, Catherine Zhang, Karolyn Au, Jill Barnholtz-Sloan, Felix Behling, Linda Bi, Priscilla Brastianos, Chaya Brodie, Nicholas Butowski, Ana Castro, Aaron Cohen-Gadol, Marta Couce, Francesco Dimeco, Katherine J Drummond, Ian Dunn, Craig Erker, Michelle Felicella, Eva Galanis, Norbert Galldiks, Caterina Giannini, Roland Goldbrunner, Oliver Hanemann, Christel Herold-Mende, Luke Hnenny, Craig Horbinski, Raymond Huang, Christine Jungk, Gerhard Jungwirth, Timothy Kaufmann, Boris Krischek, Sylvia Kurz, Daniel Lachance, Christian Lafougere, Katrin Lamszus, Serge Makarenko, Tathiana Malta, Tiit Illimar Mathiesen, Christian Mawrin, Michael McDermott, Jennifer Moliterno-Gunel, Andrew Morokoff, Farshad Nassiri, H K Ng, Houtan Noushmehr, Arie Perry, Laila Poisson, Bianco Pollo, Aditya Ragunathan, David Raleigh, Mirjam Renovanz, Franz Ricklefs, Felix Sahm, Andrea Saladino, Antonio Santacroce, Christian Schichor, Nils Schimdt, Jens Schittenhelm, Warren Selman, Helen Shih, Andrew Sloan, Matija Snuderl, Jim Snyder, Erik Sulman, Suganth Suppiah, Ghazaleh Tabatabai, Marcos Tatagiba, Marco Timmer, Jorg-Christian Tonn, Michael Vogelbaum, Andreas Von Deimling, Tobias Walbert, Simon Walling, Justin Z Wang, Patrick Wen, Manfred Westphal, Stephen Yip, Gabriel Zada, Gelareh Zadeh, Viktor Zherebitskiy, Michael T C Poon, Angelos Kolias, Julie Woodfield, Rory Piper, Aswin Chari

المساهمون: Abdurrahman I, Islim, Christopher P, Millward, Rory J, Piper, Daniel M, Fountain, Shaveta, Mehta, Ruwanthi, Kolamunnage-Dona, Usama, Ali, Shelli Diane, Koszdin, Theo, Georgiou, Samantha J, Mill, Andrew R, Brodbelt, Ryan K, Mathew, Thomas, Santariu, Jenkinson, D, Michael, Abdelsadg, Mohamed, Abualsaud, Suhaib, Abuleil, Amro, Agyemang, Kevin, Akbari, Hanan, Alakandy, Likhith, Albanese, Erminia, Alfonso, Clarissa, Ali, Usama, Ali, Arousa, Ali, Tamara, Amoo, Michael, R Arbab, Mohamed A, Asha, Mutiu, Austin, Kareem, Badran, Khaled, Bal, Jarnail, Barrett, Chri, Bhattathiri, Parameswaran, M Brennan, Paul, R Brodbelt, Andrew, Brown, Jennifer, Brown, Daniel, Brugada-Bellsolà, Ferran, Bruzzaniti, Placido, Butcher, Annabel, S Cairns, Rory, Canty, Michael, Cearns, Michael, Chakravarti, Sachiv, Chave-Cox, Rebecca, Chowdhury, Yasir, Craig-McQuade, Anna, Critchley, Gile, Crossley, Peter, Culpin, Elizabeth, D'Amico, Alessia, Dabbous, Bassam, David Delgado-López, Pedro, Draz, Mohamed, J Drummond, Katharine, T Ekanayaka, Rusiru, Elhadi, Muhammed, Elmaadawi, Ibrahim, Elmandouh, Omar, Elsharif, Mazin, Evans, Daisy, Fahlström, Andrea, Familiari, Pietro, L Fisher, Fleur, Ford, Bryony, M Fountain, Daniel, Fox, Keiko, Gaillard, Francesco, Gelder, Chloé, Georgious, Theo, Ghosh, Shamayitri, Goel, Aimee, Gough, Melissa, Grivas, Athanasio, Gvozdanovic, Andrew, Hall, Allan, Hamid, Hytham, Hartrick, Liv, Hassan, Samih, Henry, Jack, Holliman, Damian, I Islim, Abdurrahman, S Jakola, Asgeir, Javadpour, Mohsen, D Jenkinson, Michael, Jeyaretna, Sanjeeva, Jimenez, Adrian, Jung, Josephine, Kahramanian, Andranik, Kalra, Neeraj, O Kamson, David, Kennion, Oliver, M Khalafallah, Adham, Kingdon, Sarah, Kolamunnage-Dona, Ruwanthi, Diane Koszdin, Shelli, Ktayen, Howra, Kumar, Aditaya, Lammy, Simon

مصطلحات موضوعية: neurological oncology, neuroradiology, neurosurgery, oncology

الوصف: Introduction: Due to the increased use of CT and MRI, the prevalence of incidental findings on brain scans is increasing. Meningioma, the most common primary brain tumour, is a frequently encountered incidental finding, with an estimated prevalence of 3/1000. The management of incidental meningioma varies widely with active clinical-radiological monitoring being the most accepted method by clinicians. Duration of monitoring and time intervals for assessment, however, are not well defined. To this end, we have recently developed a statistical model of progression risk based on single-centre retrospective data. The model Incidental Meningioma: Prognostic Analysis Using Patient Comorbidity and MRI Tests (IMPACT) employs baseline clinical and imaging features to categorise the patient with an incidental meningioma into one of three risk groups: low, medium and high risk with a proposed active monitoring strategy based on the risk and temporal trajectory of progression, accounting for actuarial life expectancy. The primary aim of this study is to assess the external validity of this model. Methods and analysis: IMPACT is a retrospective multicentre study which will aim to include 1500 patients with an incidental intracranial meningioma, powered to detect a 10% progression risk. Adult patients ≥16 years diagnosed with an incidental meningioma between 1 January 2009 and 31 December 2010 will be included. Clinical and radiological data will be collected longitudinally until the patient reaches one of the study endpoints: intervention (surgery, stereotactic radiosurgery or fractionated radiotherapy), mortality or last date of follow-up. Data will be uploaded to an online Research Electronic Data Capture database with no unique identifiers. External validity of IMPACT will be tested using established statistical methods. Ethics and dissemination: Local institutional approval at each participating centre will be required. Results of the study will be reported through peer-reviewed articles and conferences and disseminated ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/35042706; info:eu-repo/semantics/altIdentifier/wos/WOS:000753380800001; volume:12; issue:1; numberofpages:9; journal:BMJ OPEN; http://hdl.handle.net/11573/1604639Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85123660462

الإتاحة: https://doi.org/10.1136/bmjopen-2021-052705Test
http://hdl.handle.net/11573/1604639Test

المؤلفون: Persad, Amit R., Rosalie, Mercure-Cyr, Spiess, Michael S., Allan, Woo, Zane, Tymchak, Adam, Wu, Luke, Hnenny, Fourney, Daryl R.

المصدر: European Spine Journal ; volume 31, issue 12, page 3330-3336 ; ISSN 0940-6719 1432-0932

مصطلحات موضوعية: Orthopedics and Sports Medicine, Surgery

الإتاحة: https://doi.org/10.1007/s00586-022-07423-4Test

المؤلفون: Daryl R. Fourney, Shandy Fox, Michael Spiess, Luke Hnenny

المصدر: Global Spine Journal

مصطلحات موضوعية: tumor, medicine.medical_specialty, business.industry, General surgery, Spinal instability, Original Articles, Surgery, instability, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, oncology, Orthopedic surgery, Medicine, Orthopedics and Sports Medicine, neurosurgery, Neurology (clinical), Neurosurgery, orthopedic, metastases, business, 030217 neurology & neurosurgery, Reliability (statistics)

الوصف: Study Design: Reliability analysis. Objectives: The Spinal Instability Neoplastic Score (SINS) was developed for assessing patients with spinal neoplasia. It identifies patients who may benefit from surgical consultation or intervention. It also acts as a prognostic tool for surgical decision making. Reliability of SINS has been established for spine surgeons, radiologists, and radiation oncologists, but not yet among spine surgery trainees. The purpose of our study is to determine the reliability of SINS among spine residents and fellows, and its role as an educational tool. Methods: Twenty-three residents and 2 spine fellows independently scored 30 de-identified spine tumor cases on 2 occasions, at least 6 weeks apart. Intraclass correlation coefficient (ICC) measured interobserver and intraobserver agreement for total SINS scores. Fleiss’s kappa and Cohen’s kappa analysis evaluated interobserver and intraobserver agreement of 6 component subscores (location, pain, bone lesion quality, spinal alignment, vertebral body collapse, and posterolateral involvement of spinal elements). Results: Total SINS scores showed near perfect interobserver (0.990) and intraobserver (0.907) agreement. Fleiss’s kappa statistics revealed near perfect agreement for location; substantial for pain; moderate for alignment, vertebral body collapse, and posterolateral involvement; and fair for bone quality (0.948, 0.739, 0.427, 0.550, 0.435, and 0.382). Cohen’s kappa statistics revealed near perfect agreement for location and pain, substantial for alignment and vertebral body collapse, and moderate for bone quality and posterolateral involvement (0.954, 0.814, 0.610, 0.671, 0.576, and 0.561, respectively). Conclusions: The SINS is a reliable and valuable educational tool for spine fellows and residents learning to judge spinal instability.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c7b65bb31659cfdfbcf9b927d383d413Test
https://doi.org/10.1177/2192568217697691Test

المؤلفون: Uzair Ahmed, Shandy Fox, Michael Kelly, Kotoo Meguro, Luke Hnenny

المصدر: Spinal Cord Series and Cases. 3

مصطلحات موضوعية: medicine.medical_specialty, business.industry, Fistula, medicine.medical_treatment, Arteriovenous fistula, Case Report, Dermatology, medicine.disease, Spinal cord, Hyperintensity, 030218 nuclear medicine & medical imaging, Surgery, Pseudomeningocele, 03 medical and health sciences, Myelopathy, 0302 clinical medicine, medicine.anatomical_structure, Neurology, Pathognomonic, medicine, Radiology, Embolization, business, 030217 neurology & neurosurgery

الوصف: Spinal dural arteriovenous fistulae (sdAVF) are rare lesions. Patients typically present with slowly progressive myelopathy that is often mistaken for degenerative cervical or lumbar stenosis. On spinal magnetic resonance imaging (MRI), multisegmental T2 hyperintensities along with associated flow voids are pathognomonic of sdAVF. However, diagnosis can be difficult. Definitive diagnosis and localization is achieved with complete spinal angiography. Treatment options include open surgical ligation, endovascular embolization or multimodality treatment. The purpose of this study is to present a series of cases to aid in the assessment, diagnosis and treatment of this unusual pathology. We present 10 cases of sdAVF treated at our center over an 8-year period. Seventy percent of patients were male. The mean age of presentation was 62.6 years. The most common lesion was a dorsal dural AVF with single feeder. All patients underwent open surgical ligation, six having preoperative coil embolization of the radicular artery to allow for intraoperative localization of the fistula. Eight patients showed improvement following treatment as graded by the Nurick system. Two patients failed to improve. None of the patients worsened. One patient had a radiation burn from the spinal angiogram requiring secondary closure and one patient had a pseudomeningocele at the site of surgery that resolved. The successful treatment of sdAVF requires a detailed understanding of clinical presentation and imaging findings to allow for precise treatment. Owing to the rarity of the condition, clinicians must continue to share their experiences to advance our knowledge.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7e50ee8eea732a86ac92b0c4836c183eTest
https://doi.org/10.1038/scsandc.2017.24Test

المؤلفون: Hatem Sabry, Neil Roundy, Jesse J. Liu, Luke Hnenny, Aclan Dogan, Jeffrey S. Raskin

المصدر: Journal of neurosurgery. Spine. 22(1)

مصطلحات موضوعية: Male, medicine.medical_specialty, Subarachnoid hemorrhage, Catheters, Photophobia, Nausea, Lumbar, Foreign-Body Migration, Vertebrobasilar Insufficiency, Medicine, Humans, Foramen Magnum, Failed Back Surgery Syndrome, Injections, Spinal, Aged, Neck pain, Lumbar Vertebrae, Morphine, business.industry, General Medicine, Infusion Pumps, Implantable, Silastic, Subarachnoid Hemorrhage, medicine.disease, Surgery, Analgesics, Opioid, Catheter, Anesthesia, medicine.symptom, Presentation (obstetrics), business, Tomography, X-Ray Computed

الوصف: Intrathecal catheter placement into the lumbar cistern has varied indications, including drug delivery and CSF diversion. These Silastic catheters are elastic and durable; however, catheter-associated malfunctions are well reported in the literature. Fractured catheters are managed with some variability, but entirely intradural retained fragments are often managed conservatively with observation. The authors describe a case of a 70-year-old man with an implanted intrathecal morphine pump for failed back surgery syndrome who presented to an outside hospital with a history of headache, neck pain, nausea, and photophobia of 3 days' duration. He also described mild weakness and intermittent numbness of both legs. Unenhanced head CT demonstrated subarachnoid hemorrhage (SAH). A right C-5 hemilaminectomy was performed. This case is unique in that there was no indication that the lumbar intrathecal catheter had fractured prior to the patient's presentation with SAH. This case demonstrates that intrathecal catheter fragments are mobile and can precipitate intracranial morbidity. Extrication of known fragments is safe and should be attempted to prevent further neurosurgical morbidity.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1698ebce3265b37aae23319ca0f912d2Test
https://pubmed.ncbi.nlm.nih.gov/25360531Test

المؤلفون: D Fiorella, Luke Hnenny, Michael Kelly

المصدر: Journal of NeuroInterventional Surgery. 4:A68.3-A69

مصطلحات موضوعية: Intracerebral hemorrhage, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Transverse sinuses, General Medicine, medicine.disease, Surgery, Venous thrombosis, medicine.anatomical_structure, Angiography, Cerebrospinal fluid diversion, Dural venous sinuses, Medicine, Neurology (clinical), Radiology, medicine.symptom, business, Papilledema, Superior sagittal sinus

الوصف: Background Cerebral venous thrombosis is a potentially devastating condition. Predisposing factors include hypercoagulable state, infection, pregnancy, oral contraceptive use and female sex. Symptoms may include headache, nausea, vomiting, and visual changes. Papilledema, focal neurologic deficits, strokes, and seizures may occur. Treatment consists of systemic anticoagulation and management of the underlying process. Acetazolamide and cerebrospinal fluid diversion are reserved for cases with refractory, severe intracranial hypertension. Recently, neurointerventional techniques have shown promise in the treatment of this condition. Case report We report the case of a 47-year-old male who presented with seizures and intracerebral hemorrhage. CT angiography showed near-complete occlusion of the superior sagittal sinus and occlusion of both transverse sinuses. Anticoagulation was initiated, but he continued to have seizures and his level of consciousness deteriorated. He was therefore taken to angiography and mechanical thrombectomy of his sagittal sinus was performed with the Penumbra device (Penumbra Inc., Alameda, California, USA). Flow was markedly improved in the superior sagittal sinus, and he recovered well post-operatively. He was discharged home on antiepileptic medication with no neurologic deficits. Conclusion Mechanical thrombectomy is a viable option for revascularization of the dural venous sinuses in the setting of cerebral venous thrombosis. Competing interests L Hnenny: None. D Fiorella: Codman and Shurtleff, Covidien ev3, NFocus Medical, Cordis, Micrus Endovascular. M Kelly: None.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::91fe6dd68f539e9b3123a8a7c1865ed3Test
https://doi.org/10.1136/neurintsurg-2012-010455c.52Test