{"title":"Predominance of neurologic diseases in international aeromedical transportation","authors":"Wan-Lin Chen MD , Yu-Ming Lin MD , Hong-Ping Ma MD , Wen-Ta Chiu MD, PhD , Shin-Han Tsai MD, PhD","doi":"10.1016/j.surneu.2009.04.021","DOIUrl":"10.1016/j.surneu.2009.04.021","url":null,"abstract":"<div><h3>Background</h3><p>International travel industry in Taiwan is expanding. The number of people traveling abroad was approximately 480 000 people in 1980; 2 940 000 in 1990; 7 320 000 in 2000, and in 2007, it has reached 8 960 000, which was more than one third of total population. Air medical transportation will be necessary when local medical facilities do not approximate the international standards. No previous study on epidemiology in Taiwan on patients received international medical repatriation. This is the first report to discuss the epidemiology of Taiwan's international aeromedical transportation and its focus on neurologic diseases.</p></div><div><h3>Method</h3><p>Retrospective analysis of all international aeromedical transports on Taiwanese patients from October 2005 to September 2007 was performed. All materials were collected from the databank of International SOS, Taipei. The data were analyzed with Microsoft Excel and SPSS v. 11.0 software (SPSS, Chicago, Ill).</p></div><div><h3>Results</h3><p>A total of 416 patients were transported. Excluding expatriates transported outbound and 2-stage inbound transports, the Taiwanese patient number with international aeromedical transport was 379; 51 by air ambulance and 328 commercially. There were 271 male (72%) and 108 female patients (18%). Of the 379 patients, 178 (47%) were neurologic diseases. Two hundred ninety-five (78%) patients were transported from China. Patient transports peaked in autumn by 105 (28%). Of all 33 ventilated patients, 12 (36%) were neurologic diseases. In-flight complications occurred in 10% of neurologic and 2% of nonneurologic cases. No in-flight mortality occurred in both groups.</p></div><div><h3>Conclusion</h3><p>Neurologic diseases comprise most of the Taiwanese patients that requires medical transportation. With relatively suboptimal medical standard and high medical expenses in China, patients with neurologic conditions need timely and safe aeromedical transport than those with other diseases. Transport of patients with neurologic diseases, either by air ambulance or commercial flights, can only be safely performed by well-trained medical escorts and comprehensive logistic arrangements.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S47-S49"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.04.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40020075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.05.031
Mark Garrett MD, Robert F. Spetzler MD
{"title":"Surgical treatment of brainstem cavernous malformations","authors":"Mark Garrett MD, Robert F. Spetzler MD","doi":"10.1016/j.surneu.2009.05.031","DOIUrl":"10.1016/j.surneu.2009.05.031","url":null,"abstract":"<div><h3>Background</h3><p>The contemporary neurosurgeon is often confronted by cavernous malformations. Those located in the brainstem are particularly challenging</p></div><div><h3>Methods</h3><p>This article reviews published series on the natural history and surgical outcomes of these lesions and discusses the surgical approaches used at our institution for their resection.</p></div><div><h3>Results</h3><p>Despite their challenging location in the brainstem, appropriately selected lesions can be resected surgically with acceptable rates of morbidity and mortality.</p></div><div><h3>Conclusions</h3><p>Our institutional philosophy on the surgical treatment of brainstem cavernous malformations reflects the substantial surgical experience of the senior author.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 ","pages":"Pages S3-S9"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.05.031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40020895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Attempting homicide by inserting sewing needle into the brain","authors":"Abbas Amirjamshidi MD, MPH , Arman Rakan Ghasvini MD , Maysam Alimohammadi MD , Kazem Abbassioun MD","doi":"10.1016/j.surneu.2009.02.029","DOIUrl":"10.1016/j.surneu.2009.02.029","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Child abuse with sewing needle is a rare but well-known homicide attempt threatening the life of victims. Information about diagnosis and treatment of such cases either in the acute or chronic phases is lacking and ambiguous in the literature. This study intends to report the experience of 6 victims of homicide attempt who presented to the authors in different decades of life and were managed in different ways. This may deliver some evidences to the literature regarding management of further cases encountered by neurosurgeons.</p></div><div><h3>Material and methods</h3><p>The authors had the chance of managing 6 patients referred to their trauma center harboring one or more sewing needles within their cranium. There were 3 male and 3 female patients, with 2 patients in their first decade of life, and the others, each in either decade of life. The youngest was 6, and the eldest 51 year old. The elder patients were having vague headaches, for which a plain skull x-ray or CT of the brain lead to the diagnosis of persisting intracranial foreign bodies. Chronic headache was the main complaint of the patients. Four patients underwent surgical removal of the sewing needle, and 2 are being followed.</p></div><div><h3>Results</h3><p>Among the 4 patients who underwent surgery, 1 died after a short period of ‘akinetic mutism.’ Headache and limb paresthesia improved 6 months after the operation in 2 cases, and the other 1 remained unchanged. The cases under observation have been doing well. Biochemical analysis of the rusted needle showed a composite of oxidant form of some of the elements of needle such as Fe, Mn, and Cr.</p></div><div><h3>Conclusion</h3><p>In spite of standard algorithms proposed for management of penetrating head wounds, selection of the best treatment in the victims harboring sewing needles in their brain needs close cooperation between neurosurgeons, pediatricians, psychiatrists, and social workers. Furthermore, there is no absolute indication for removing sewing intracranial needles detected in the later decades of life.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 635-641"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.02.029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40021330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.03.016
Scott D. Simon MD , Arthur J. Ulm MD , Antonio Russo MD , Erminia Albanese MD , Robert A. Mericle MD
{"title":"Distal intracranial catheterization of patients with tortuous vascular anatomy using a new hybrid guide catheter","authors":"Scott D. Simon MD , Arthur J. Ulm MD , Antonio Russo MD , Erminia Albanese MD , Robert A. Mericle MD","doi":"10.1016/j.surneu.2009.03.016","DOIUrl":"10.1016/j.surneu.2009.03.016","url":null,"abstract":"<div><h3>Background</h3><p>A hybrid guide catheter mates the traditional strong guide catheter with a thin, soft distal tip, allowing placement further into the distal cervical or proximal cranial circulation.</p></div><div><h3>Case Description</h3><p>We present 5 cases in which traditional guide catheters were unable to successfully navigate tortuous anatomy or provide stable support for intervention.</p></div><div><h3>Conclusion</h3><p>Hybrid guide catheters provided safe, stable support for successful treatment. Hybrid guide catheters allow for treatment for patients who previously were not candidates for neuroendovascular surgery.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 737-740"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.03.016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9161475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.03.029
Emily Bell PhD , Ghislaine Mathieu MA , Eric Racine PhD
{"title":"Preparing the ethical future of deep brain stimulation","authors":"Emily Bell PhD , Ghislaine Mathieu MA , Eric Racine PhD","doi":"10.1016/j.surneu.2009.03.029","DOIUrl":"10.1016/j.surneu.2009.03.029","url":null,"abstract":"<div><h3>Background</h3><p>Deep brain stimulation is an approved and effective neurosurgical intervention for motor disorders such as PD and ET. Deep brain stimulation may also be effective in treating a number of psychiatric disorders, including treatment refractory depression and OCD. Although DBS is a widely accepted therapy in motor disorders, it remains an invasive and expensive procedure. The ethical and social challenges of DBS need further examination, and discussion and emerging applications of DBS in psychiatry may also complicate the ethical landscape of DBS.</p></div><div><h3>Methods</h3><p>To identify and characterize current and emerging issues in the use of DBS, we reviewed the neurosurgical literature on DBS as well as the interdisciplinary medical ethics and relevant psychological and sociological literatures. We also consulted the USPTO database, FDA regulations and report decisions, and the business reports of key DBS manufacturers.</p></div><div><h3>Results</h3><p>Important ethical and social challenges exist in the current and extending practice of DBS, notably in patient selection, informed consent, resource allocation, and in public understanding. These challenges are likely to be amplified if emerging uses of DBS in psychiatry are approved.</p></div><div><h3>Conclusions</h3><p>Our review of ethical and social issues related to DBS highlights that several significant challenges, although not insurmountable, need much closer attention. A combination of approaches previously used in neuroethics, such as expert consensus workshops to establish ethical guidelines and public engagement to improve public understanding, may be fruitful to explore.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 577-586"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.03.029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28309976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Surgical NeurologyPub Date : 2009-12-01DOI: 10.1016/j.surneu.2009.03.036
Krishna Prabhu MCh , Roy Thomas Daniel MCh , Sunithi Mani MD , Ari G. Chacko MCh
{"title":"Dermoid tumor with diastematobulbia","authors":"Krishna Prabhu MCh , Roy Thomas Daniel MCh , Sunithi Mani MD , Ari G. Chacko MCh","doi":"10.1016/j.surneu.2009.03.036","DOIUrl":"10.1016/j.surneu.2009.03.036","url":null,"abstract":"<div><h3>Background</h3><p>Dermoid tumors are rare congenital lesions and account for 0.2% to 1.8% of all intracranial tumors. Dermoid tumor with diastematobulbia is very rare.</p></div><div><h3>Case description</h3><p>We report a dermoid tumor in an adult female with an unusual location and morphology. The lesion had 2 major components with different material within the cysts. The posterior part of the dermoid had presented on the floor of the fourth ventricle and had split the pons into 2 distinct halves. The anterior part of the lesion was situated in the prepontine cistern and encircling the anterior half of the brainstem. The lesion was radically excised, and the postoperative images showed return of the 2 halves of the pons to appose each other in the midline.</p></div><div><h3>Conclusion</h3><p>This case report demonstrates the anatomical peculiarities of this extremely unusual presentation of a dermoid cyst with diastematobulbia. Total excision of the lesion through a dorsal approach resulted in a good outcome.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 717-721"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.03.036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28309978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical technique for a cystic-type metastatic brain tumor: transformation to a solid-type tumor using hydrofiber dressing","authors":"Takeshi Okuda MD , Yoshifumi Teramoto MD , Haruki Yugami MD , Kazuo Kataoka MD , Amami Kato MD","doi":"10.1016/j.surneu.2009.07.045","DOIUrl":"10.1016/j.surneu.2009.07.045","url":null,"abstract":"<div><h3>Background</h3><p>Many metastatic brain tumors have a distinct border with normal brain tissue, which facilitates tumor removal. However, residual tumor tissue may be present after surgery when metastatic brain tumors are of cystic type. We have developed a method using hydrofiber dressing to transform cystic-type into solid-type tumors.</p></div><div><h3>Methods</h3><p>Hydrofiber dressing is a sodium carboxymethylcellulose hydrocolloid polymer with high fluid-absorptive capacity. This material was originally used as a dressing for exudative wounds. Hydrofiber dressing was used for 8 patients with cystic-type metastatic brain tumor. Tumor removal was performed after hydrofiber dressing was inserted into the cyst cavity to transform the tumor into a solid-type tumor.</p></div><div><h3>Results</h3><p>Transformation of cystic-type metastatic brain tumors into smaller solid-type tumors using hydrofiber dressing facilitated en bloc resection of tumor. The dressing also absorbed residual cyst fluid and was thus also effective in preventing intraoperative dissemination of tumor cells. This approach enabled ideal en bloc resection in all patients. There were no adverse events.</p></div><div><h3>Conclusions</h3><p>These findings suggest hydrofiber dressing may be useful in surgery for cystic-type metastatic brain tumors.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 703-706"},"PeriodicalIF":0.0,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.07.045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28441283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
