The Internet Journal of Neurosurgery最新文献

{"title":"Evaluation of Cerebral Microembolic Signals in Patients with Mechanical Aortic Valves","authors":"K. Ghandehari, Zahra Izadimoud","doi":"10.5580/1d69","DOIUrl":"https://doi.org/10.5580/1d69","url":null,"abstract":"Background and Purpose: Microembolic Signals (MES) are frequently observed in Transcranial Doppler (TCD) recordings of patients with Mechanical Heart Valve (MHV).We hypothesized that number of MES produced by MHV could be reduced with oxygen inhalation, if gaseous bubbles are the underlying cause. Methods: All consecutive patients with St Jude aortic valves visiting the cardiology clinic were refered to the neurosonology unit, Valie Asr Hospital, Khorasan during August 2003 to August 2004. TCD monitoring of MES was performed with an ultrasound device (Vingmed 800 Oslo,Norway) and a 2 MHz probe. The MES counts were recorded during 30 minutes breathing room air and thereafter 30 minutes breathing through a facial mask with reservior bag (6 liter O2 per minute). The criteria of MES detection were characteristic chrip sound, unidirectional signal, random appearance within cardiac cycle and intensity increase 3dB above background. The MES counts in two periods of monitoring were compared with paired T test and significance was declared at P < 0.05. Results: Twelve patients (8 females and 4 males) were investigated. Oxygen ventilation caused a significant decrease of MES counts in the patients in comarison to breathing room air, P = 0.001. Thus MES in patients with MHV are mainly gaseous bubbles caused by blood agitation with MHV. Conclusion: The quantity of MES in patients with MHV is not related to the risk of thromboembolic complications in these patients.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127747706","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":"Current intervention strategies for Cerebral Venous Sinus Thrombosis","authors":"Andre des Etages, H. Chan","doi":"10.5580/bb1","DOIUrl":"https://doi.org/10.5580/bb1","url":null,"abstract":"Intravenous heparin infusion has been the mainstay of treatment for cerebral venous sinus thrombosis (CVST). Surgical and neuroradiological treatment was once an uncommon occurrence. Recent trends, however, have been to employ endovascular or surgical intervention strategies in carefully selected cases and the combined use of these modalities is on the rise. These strategies include endovascular thrombolysis, mechanical thrombectomy to remove the clot and operative neurosurgery to treat raised intracranial pressure. We review the literature and present an update on current treatment strategies.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126526540","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":"Intradural Extramedullary Spinal Cord Tumors: A Retrospective Study of Tumor Types, Locations, and Surgical Outcomes","authors":"S. P. Stawicki, J. Guarnaschelli","doi":"10.5580/ae8","DOIUrl":"https://doi.org/10.5580/ae8","url":null,"abstract":"Introduction: Intradural extramedullary spinal cord tumors (IESCT) account for approximately two thirds of all intraspinal neoplasms. The purpose of this report was to determine shortand long-term outcomes of surgical patients with IESCT, and to examine clinical features that could be helpful in management of patients with these lesions. Methods: A retrospective review of 67 operative IESCT cases between 1974 and 2001 was performed. Outcomes were scored at one month and at mean follow-up of 8.5 months postoperatively. In addition, patient demographics, tumor types and locations were also collected. Statistical analysis was conducted utilizing Chi-square and Student's t-tests. Results: There were 31 men and 36 women (mean age 48 y/o, range 18-87 y/o). Men presented at a younger age than women (44 vs 53 y/o, P<0.02). Fifty-seven (85%) patients presented with severe radiculopathy and/or myelopathy. The remaining 10 (15%) had symptoms typical of disc herniation. Mean duration of symptoms prior to diagnosis was 11 months. Schwannomas (36 patients) had the longest mean duration of symptoms (14.9 months), followed by meningiomas (21 patients, 8.4 months), and ependymomas (10 patients, 2 months). Sixty-three (94%) of patients demonstrated significant improvement at one-month and 62 (92%) at 8.5-month mean follow-up as compared to the index exam. Only 13/67 (19.4%) patients had residual focal deficits on long term follow-up. Conclusions: Surgery for IESCT should be expected to produce significant and dramatic improvement in great majority of patients. Demographic, tumor-specific and anatomic considerations may be clinically useful when approaching IESCT.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125111433","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":"Motorized bed artifact in the Intensive Care Unit","authors":"N. Sethi, J. Torgovnick, P. Sethi","doi":"10.5580/689","DOIUrl":"https://doi.org/10.5580/689","url":null,"abstract":"Continuous Video-EEG monitoring (CCTV) was initiated on a 63-year-old male admitted to the neurological intensive care unit (NICU) with sub-arachnoid hemorrhage due to rupture of a right posterior communicating artery aneurysm. During review of the overnight record a sudden change in the baseline record occurred with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads ( Fig 1 and 2). This electrographic discharge was correctly recognized to be a non-physiological (non-cerebral) artifact generated by the to and fro rocking motion of the motorized bed on visual inspection of the concurrent video record. This motorized bed artifact further disappeared when the bed was switched off thus confirming its non-cerebral origin. With continuous EEG monitoring becoming increasingly common in the intensive care unit, correct identification of artifacts generated by the patient's surroundings is of paramount importance to prevent misinterpretation of the EEG and inadvertent over treatment. Figure 1 Figures 1 and 2. EEG record showing a sudden change in the baseline record with appearance of a rhythmic theta frequency sharply contoured waveform best visualized in the left para-sagittal and central ( Cz and Pz) leads.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114253151","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":"Telephone artifact in EEG recordings","authors":"N. Sethi, P. Sethi, J. Torgovnick, E. Arsura","doi":"10.5580/27e2","DOIUrl":"https://doi.org/10.5580/27e2","url":null,"abstract":"The electroencephalogram (EEG) is meant to record cerebral activity but it also picks up electrical signals arising from extracerebral sites. The EEG record is frequently contaminated by electrical signals arising from the immediate patient environment giving rise to nonphysiological artifacts. Non-physiological artifacts commonly arise from monitoring devices like infusion pumps and suctioning devices though electrical devices like mobile phones may also contaminate the EEG record 1. During inpatient video EEG recording of a patient, intermittent 30 Hz sharply contoured waveforms lasting 2 seconds were visualized (Fig 1,2) . Figure 1 Figures 1 & 2: EEG recording showing low amplitude sharply contoured waveforms lasting on an average 2 seconds and corresponding to the frequency of the telephone ring. Figure 2 Upon viewing the video image these sharply contoured waveforms were correctly identified as a non-physiological artifact generated by the telephone ringing in the patient's room. Further more the frequency of the artifact matched the frequency of the telephone ring. Recognition of these artifacts is important to avoid misinterpretation of the EEG and erroneous treatment decisions. CORRESPONDENCE TO Nitin Sethi, MD Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68th Street New York, NY 10021 e-mail: sethinitinmd@hotmail.com References 1. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8):1876-8. Telephone artifact in EEG recordings 2 of 2 Author Information N. K. Sethi, M.D. Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P. K. Sethi, M.D. Department of Neurology, Sir Ganga Ram Hospital J. Torgovnick, M.D. Department of Neurology, Saint Vincent's Hospital and Medical Centers E. Arsura, M.D. Department of Medicine, Saint Vincent's Hospital and Medical Center,","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121395463","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":"Spinal Osteoblastoma In A Pediatric Patient: Case Report With Review Of Literature","authors":"R. Agrawal, S. Chauhan, N. Gopal, R. Mehrotra","doi":"10.5580/166f","DOIUrl":"https://doi.org/10.5580/166f","url":null,"abstract":"We present a pediatric patient with osteoblastoma of D1 vertebra. Neck trauma occurred 11/2 year before the onset of symptoms. Patient presented with Neck-pain for one-year. Cure was provided by complete surgical excision. We highlight the rarity of the site of occurrence of osteoblastoma and the fact that a radical treatment needs to be performed.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125735964","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":"Periodic Sharp Wave Complexes in Patient with Creutzfeldt-Jakob Disease","authors":"N. Sethi, P. Sethi, J. Torgovnick","doi":"10.5580/2348","DOIUrl":"https://doi.org/10.5580/2348","url":null,"abstract":"Creutzfeldt- Jakob disease (CJD) is included under the umbrella of prior related neurodegenerative diseases. Other prior related diseases include Gerstmann-Str‰usslerScheinker (GSS), fatal familial insomnia (FFI), Kuru and new variant CJD (BSE) in humans, chronic wasting disease (CWD) in deer and scrapie in sheep. Sporadic CJD presents with rapidly progressive dementia and myoclonus. Diagnosis is typically clinical and supplemented by electroencephalography (EEG) and analysis of cerebrospinal fluid. During the course of sporadic CJD, most patients develop a characteristic picture on EEG with one second periodic or pseudoperiodic sharp waves complexes (PSWC) or spikes superimposed on a slow background (Fig 1 and 2).","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131817083","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":"Abnormal Pattern Of Brachial Plexus Formation: An Original Case Report","authors":"K. A. Oluyemi, O. A. Adesanya, D. Ofusori, Christina U. Okwuonu, V. Ukwenya, F. Om'iniabohs, Blessing I. Odion","doi":"10.5580/3d1","DOIUrl":"https://doi.org/10.5580/3d1","url":null,"abstract":"We encountered a brachial plexus with two cords (Medial & Lateral) and three abnormal communications. The lateral cord sent an abnormal branch to the medial cord as the medial root of median nerve emerged from the latter. A branch from the posterior aspect of the medial cord divided into the radial and axillary nerves. The musculocutaneous nerve sent an abnormal branch to the Median nerve at the level of mid-arm. There was also an abnormal communication between the ulnar and radial nerve at the mid-arm region. Knowledge of these variations is important in nerve entrapment syndromes involving different branches of brachial plexus.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133450040","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":"Laptop artifact during electroencephalography","authors":"N. Sethi, N. Schaul, D. Kolesnik, D. Labar, P. Sethi","doi":"10.5580/1994","DOIUrl":"https://doi.org/10.5580/1994","url":null,"abstract":"Artifacts are signals recorded on the electroencephalogram (EEG) that are not cerebral in origin and can be divided into physiological and non-physiological artifacts. Physiological artifacts are generated from the patient itself and include cardiac, glossokinetic, muscle, eye movement, respiratory and pulse artifact among many others. Numerous nonphysiological artifacts generated from the immediate patient surroundings can contaminate EEG recordings. Common non-physiological artifacts include those generated by monitoring devices, infusion pumps, suctioning devices and chest physiotherapy 1. Lately artifacts generated by electronic devices like mobile phones have been reported 2. During inpatient video EEG recording of a patient, rhythmic highly sharply contoured 14-16 Hz waveforms were visualized in all the leads (Fig 1,2). Figure 1 Figure 1: EEG record showing onset of 14-16 cycles per second rhythmic highly sharply contoured waveforms in all leads. Figure 2 Figure 2: EEG record showing 14-16 cycles per second rhythmic highly sharply contoured waveforms. This artifact occurred whenever the patient touched the laptop pad. Upon viewing the video images, this sharply contoured discharge was noted to occur whenever the patient touched the laptop pad in front of her. We tried to cross and uncross the wire of the laptop AC adaptor with the EEG head box but were unable to isolate what exactly generated these waveforms. The patient was using a wireless PC card to access the Internet. Recognition of non-physiological artifacts like these is important to avoid misinterpretation of the EEG and erroneous treatment decisions. It also highlights the point that medical devices may fail to operate correctly due to interference from various emitters of radiofrequency energy. CORRESPONDENCE TO NK Sethi, MD Department of Neurology Comprehensive Epilepsy Center NYP-Weill Cornell Medical Center 525 East, 68 Street New York, NY 10021(U.S.A.) E-mail: sethinitinmd@hotmail.com Laptop artifact during electroencephalography 2 of 3 References 1. Sethi NK, Torgovnick J, Sethi PK. Chest percussion artifact. Clin Neurophysiol. 2007; 118 (2): 475-6. 2. Sethi PK, Sethi NK, Torgovnick J. Mobile phone artifact. Clin Neurophysiol. 2006; 117(8): 1876-8. Laptop artifact during electroencephalography 3 of 3 Author Information N.K. Sethi Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center N. Schaul Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Kolesnik Department of Neurology, Comprehensive Epilepsy Center, New York Hospital D. Labar Department of Neurology, Comprehensive Epilepsy Center, NYP-Weill Cornell Medical Center P.K. Sethi Department of Neurology, Sir Ganga Ram Hospital","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126773539","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":"Gram Negative Bacillary Brain Abscess: Clinical Features And Therapeutic Outcome","authors":"Fakhrul Huda, Vivek Sharma, W. Ali, M. Rashid","doi":"10.5580/2863","DOIUrl":"https://doi.org/10.5580/2863","url":null,"abstract":"Background: :This study was conducted to analyze the clinical features and therapeutic outcome for brain abscesses caused by gram negative bacilli. Methods: 41 patients with gram negative bacillary brain abscess, out of a total of 278 cases, 25 males and 16 female aged 2-72 years were reviewed at IMS, BHU and JN Medical College Hospital AMU, over a 17 year period for Predisposing factors, clinical feature and therapeutic outcome. Results: The most common presenting symptoms were headache, vomiting, fever and altered sensorium. At the time of admission 26.10% had GCS <9. Temporal and temporoparietal was the commonest site and 14.6% had multiple abscesses. The common predisposing factors were otic infection, penetrating trauma and chest infections with diabetes mellitus being the main underlying disease. CT and MRI facilitated early diagnosis. Surgical intervention was done in 97.1% cases. The most common pathogen isolated was pseudomonas in otogenic group, E. coli in head injury group and Klebsiella in hematogenous spread. 39.04% cases were multidrug resistant with pseudomonas being the main culprit. The overall mortality was 26.8% with the presence of septic shock and multidrug resistance being the poor prognostic factors. Conclusion: Brain abscesses caused by gram negative bacilli are not rare and often have a high prevalence of septic shock, multidrug resistance and death. Clinical presentation and therapeutic outcomes vary according to different pathogenic species. In light of high mortality rate an early diagnosis and prompt management is essential to maximize the chance for survival.","PeriodicalId":326784,"journal":{"name":"The Internet Journal of Neurosurgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132420184","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}