Asian Journal of Neurosurgery最新文献

{"title":"Nurse Practitioners (NPs) as Game Changers in Tanzania Health Delivery System: Lessons Learnt from Fujita Bantane Hospital in Japan","authors":"Grace Emmanuel Kombe, Jumaa Tram Almasi, Yoko Kato, B. Liew","doi":"10.1055/s-0044-1788681","DOIUrl":"https://doi.org/10.1055/s-0044-1788681","url":null,"abstract":"Shortage of physicians/doctors in the primary health care system has been evidenced in various countries. Among other things, these countries deployed nurse practitioners (NPs) in the health care delivery system to address this shortage. Countries in America, Europe, and Asia use NPs to address physicians/doctors shortage in the primary health care delivery systems. Various studies have shown that NPs have been deployed in primary health care facilities to curb these shortages.While in Tanzania shortage of physicians/doctors and other health professionals is evidenced in every sector of the health care system, nurses play a crucial role to cover this shortage by providing care and support for individuals and communities. Nurses work in various settings from being a nurse, counselor, laboratory technologist, social worker, educationist, and physician, to name a few. Nurses play a key role in preventing, diagnosing, and attending to common health problems. The question is, “When will the Tanzanian health delivery system recognize the pivotal role of these nurses and upgrade them to NPs?” This study suggests that deployment of NPs in Tanzania's health care systems could be a “game changer.” As a fellow on Critical Care Nursing Course at Fujita Health University Bantane Hospital in Japan, witnessed deployment of NPs in health care delivery and the reaped benefits are enormous; increased access to health care services, reduction in health care costs, reduced hospital stays, and customer satisfaction through client empowerment and comfort. This is an observational study of tasks performed by NPs in Fujita Health University Bantane Hospital and their relevance as a positive innovation to curb physician shortages for effective health care delivery. The duration of the study at Bantane Hospital was 2 months from January 15 to March 16, 2024. One-to-one interviews with NPs on duty were conducted. Also, collected and reviewed information from Tanzanian government Web sites, published government documents, and academic literature. Results show that NPs perform a lot of procedures that physicians/doctors were supposed to do. In the wards, theater, laboratories, and clinics, they play a pivotal role to curb shortage of physicians/doctors in health settings. NPs are an effective addition to medical facilities. They perform various procedures in the absence of the doctors. The findings from this study have important implications for improving health care delivery in Tanzania. NPs could be “game changers” in the health care landscape in Tanzania. Investment on nurses' education, proper training, and policy changes in nurse practice regulations are key for this to succeed.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"34 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800728","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":"Prediction of Intraoperative Blood Loss during Surgery of Brain Meningiomas","authors":"Gayrat Eshkuvvatov, Ulugbek Asadullayev, Jakhongir Yakubov, Dilshod Khodjimetov, Khabibullo Khasanov","doi":"10.1055/s-0044-1788682","DOIUrl":"https://doi.org/10.1055/s-0044-1788682","url":null,"abstract":"\u0000 Background The utilization of preoperative embolization is a well-established method for reducing intraoperative blood loss during surgery of meningiomas. However, the exact indications and contraindications for this technique remain controversial.\u0000 Objective The objective of this study is to determine the indications for preoperative embolization of brain meningiomas.\u0000 Materials and Methods A retrospective analysis of 46 patients who underwent surgical resection of intracranial meningioma from 2020 to the end of 2022 was conducted. Preoperative magnetic resonance imaging (MRI) and computed tomography (CT) data were studied to assess their relationship with the volume of intraoperative blood loss.\u0000 Results Invasive tumor growth and bone involvement (erosion, hyperostosis) were found to be the most significant factors influencing intraoperative blood loss (p = 0.001).\u0000 Conclusion This study clearly demonstrates an association between preoperative imaging data and intraoperative blood loss, which may be useful in predicting massive bleeding during surgery.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"61 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141808214","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":"Application of Using Gore Preclude MVP Dura Substitute for Intraoperative Durotomy Repair in Lumbar Spine Surgery: Case Series and A Technical Note","authors":"Yoshinori Maki, Toshinari Kawasaki, Kota Nakajima, Mitsushige Ando, Tamaki Kobayashi, Yoshihiko Ioroi, M. Takayama","doi":"10.1055/s-0044-1788634","DOIUrl":"https://doi.org/10.1055/s-0044-1788634","url":null,"abstract":"Durotomy is an intraoperative complication in lumbar surgery, which can result in refractory cerebrospinal leakage. Therefore, intraoperative durotomy in lumbar surgery should be appropriately repaired. The aim of the study was to describe our method to repair intraoperative durotomy using the Gore Preclude MVP Dura Substitute (MVP). The MVP is an artificial dural substitute of three layers. Its surfaces are composed of expanded polytetrafluoroethylene, and the intermittent layer is made of a proprietary fluoroelastomer. After an incidental durotomy during surgery, the MVP was cut and designed bigger than the size of the durotomy site. The MVP was inserted into the space between the dura and the arachnoid membrane. The MVP was unfolded in the inserted space and fixed to the dura using four nodes of 6–0 nylon yarn. Intraoperative dural repair was achieved, and cerebrospinal fluid leakage did not persist. No complications were observed. Our method to repair intraoperative durotomy using the MVP can be simple and useful.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815394","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":"Into the Neuroscape: Perceptions of Pakistani Medical Students and Recent Graduates toward Neurosurgery","authors":"Muhammad Shakir, Hammad Atif Irshad, Akmal Shahzad, Eisha Abid Ali, Aly Hamza Khowaja, Areesha Ahmer, S. Enam","doi":"10.1055/s-0044-1788617","DOIUrl":"https://doi.org/10.1055/s-0044-1788617","url":null,"abstract":"\u0000 Introduction Neurosurgery receives several applicants every year, but the decreasing size of the neurosurgery workforce in Pakistan despite evidence of initial student interest is perplexing. Therefore, it is vital to evaluate the perspective of medical students and recent graduates to get a holistic view of perceptions toward neurosurgery.\u0000 Materials and Methods A nationwide cross-sectional study was conducted on a sample of medical students and recent graduates from different medical colleges. Their perceptions were gauged by multiple choice questions and barriers identified using Likert scale questions. Statistical analyses were carried out using the IBM Statistical Package for Social Sciences (SPSS) version 26.\u0000 Results A total of 2,481 responses were recorded from study participants. Neurosciences and neurosurgery were a part of a medical school curriculum for the majority (64.9%) of the participants. However, a significant number (65.4%) of the participants do not have the opportunity to rotate in the field of neurosurgery. The respondents' perception of neurosurgery is shaped by various factors, such as university lectures (21.9%), digital media (16.7%), and social media (15.2%). Known patients (5.7%) and known neurosurgeons (4.8%) were considered the least influential sources. The top three characteristics associated with neurosurgery were consistent for both male and female students: difficult, interesting, and brain. Male respondents (25.22%) predominantly described neurosurgery as difficult, while female respondents (21.98%) found it interesting. Many females perceived neurosurgery as a male-dominated specialty, with 64% female participants agreeing with gender bias compared to 36% of males.\u0000 Conclusion This study uncovers that medical students' views on neurosurgery are shaped by lectures, digital media, and social media, leading to preconceived ideas. These notions, including extended working hours, limited work–life balance, competition, gender bias, and stereotypes, impede their interest and comprehension of neurosurgery as a profession. To address this, students should have more opportunities to familiarize themselves with the field, allowing them to challenge these misconceptions and discover the captivating world of neurosurgery.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"15 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816112","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":"Successful Rectification of Cervical Nerve Root Irritation with Sequential Surgical Maneuvers during Posterior Cervical Instrumentation","authors":"Balaji Vaithialingam, Ramachandran Govindasamy, S. Gopal, S. Rudrappa","doi":"10.1055/s-0044-1788632","DOIUrl":"https://doi.org/10.1055/s-0044-1788632","url":null,"abstract":"Posterior cervical instrumentation is used to treat a variety of cervical pathologies, including cervical spondylotic myelopathy, severe canal stenosis, and degenerative diseases. A 55-year-old man with severe cervical canal stenosis underwent a C3–C6 laminectomy and lateral mass screw fixation under general anesthesia. After lateral mass screw fixation and rod placement on the right side, raw electromyography (EMG) revealed irritative discharges in the right biceps brachii muscle. Following a suspicion of irritation/mechanical stretching of the C5–C6 nerve root, a posterior foraminotomy was performed on the right side as a rescue measure. The amplitude of raw EMG irritative discharges in the right biceps brachii muscle decreased significantly after posterior foraminotomy. Following rod reapplication with decreased rod lordosis, the irritative EMG discharges were eliminated. Before implementing further measures, posterior foraminotomy can be a crucial initial intervention for minimizing nerve root irritation due to mechanical factors after cervical lateral mass screw fixation.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":" 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827492","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":"Clinical Outcome and Predictors of Traumatic Cervical Injury: A Prospective Observational Study","authors":"Suresh Kumar Jaiswal, B. K. Ojha, Somil Jaiswal, Ankur Bajaj","doi":"10.1055/s-0044-1788062","DOIUrl":"https://doi.org/10.1055/s-0044-1788062","url":null,"abstract":"\u0000 Introduction Traumatic cervical spine injuries (CSIs) have an incidence of 1.7 to 8% among traumatic brain injury (TBI) patients and should be a pivotal part of its neurological examination. Prognosis of cervical spine insult in TBI depends on several epidemiological and clinical factors which need to be considered during the management of these injuries. This study aims to analyze the outcomes of patients with CSI and its associated predictors.\u0000 Material and Methods A prospective observational study was conducted among 63 patients of traumatic CSI admitted at a tertiary care center of Lucknow, Uttar Pradesh, India. All patients underwent a clinical assessment using the American Spinal Injury Association, Functional Independence Measure (FIM), and Barthel Index scoring and grading at admission, 1, and 4 months, respectively. All patients at the facility underwent magnetic resonance imaging (MRI). Midsagittal T1- and T2-weighted sequences were used to measure the degree of spinal cord injury (SCI) impairment. Patients were followed for outcome assessment.\u0000 Results There was a significant difference in the median values of Barthel Index and mean values of FIM preoperatively and at 4 months' follow-up. There was a significant improvement in the neurological outcome of the patients after admission, at 1, and 4 months' follow-up. Out of the 30 patients who had improvement in the neurological outcome, majority (26) had edema present in less than equal to 2 segments and this was statistically significant. The overall FIM score was significantly higher among those with ≤ 2 segment edema as compared with those with > 2 segments.\u0000 Conclusion The study concludes that incomplete injury, edema on MRI imaging less than equal to 2 segments, and no listhesis are predictors of neurological and functional improvement in patients with traumatic cervical spinal injuries.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"135 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656387","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":"Traumatic Brain Injury and Guillain-Barré Syndrome: Tale of an Illicit Affair—Case Report and Brief Review of Literature","authors":"V. Harsh, Hemant Alda, Saurav Besra, Ujjawal Roy, Anil Kumar","doi":"10.1055/s-0044-1788063","DOIUrl":"https://doi.org/10.1055/s-0044-1788063","url":null,"abstract":"Guillain-Barré syndrome (GBS) is a common entity in neurology clinics. A variety of etiologies have been implicated in the presentation of GBS. Although rarely reported, traumatic brain injury (TBI) has also been reported to cause GBS. In this article, we report a similar case of GBS that occurred following TBI and the patient presented with acute flaccid paraparesis with intact strength in upper limbs. Paraparesis progressed to quadriparesis simulating a case of spinal injury, without any correlating imaging findings. Nerve conduction study findings, cerebrospinal fluid studies, and clinical examination led to the diagnosis of post-TBI GBS. A review of similar cases reported in literature is also attached. High index of suspicion should be maintained for GBS in all cases of imaging-negative post-TBI limb weakness which may simulate acute spinal injury.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"116 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657487","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":"Efficacy of Ventriculoperitoneal Shunt for Postoperative Central Nervous System Infection Complicated with Hydrocephalus","authors":"Fumei Chen, Na Wang, Li Wang, ZhiYang He, KangLi Xu, Tianxiang Zhan, Qian Zhou, Hao Wang, XiaoFeng Yang","doi":"10.1055/s-0042-1757727","DOIUrl":"https://doi.org/10.1055/s-0042-1757727","url":null,"abstract":"\u0000 Objective Our aim was to assess the efficacy of ventriculoperitoneal shunt (VPS) for treating postoperative central nervous system infection (PCNSI) complicated with hydrocephalus and to identify factors associated with treatment failure.\u0000 Methods We conducted a retrospective analysis of PCNSI patients with hydrocephalus treated by VPS at the Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, between December 2012 and January 2020. Functional recovery was evaluated during follow-up using the Glasgow Outcome Scale.\u0000 Results A total of 29 patients (21 males, 8 females) were enrolled in the study (mean age: 56.4 ± 12.0 years, range: 18.0–77.0 years). Seventeen patients were treated successfully by VPS (58.6%). Among the 11 patients with shunt complications (37.9%), 8 (27.6%) presented with fever, 3 (10.3%) with shunt infection, and 3 (10.3%) with shunt obstruction. Univariate analysis identified low Glasgow Coma Scale (GCS) score (3–8) at the time of VPS and post-treatment fever as predictive of shunt failure.\u0000 Conclusion VPS was effective for treating PCNSI complicated with hydrocephalus. However, patients with low GCS score at the time of VPS or fever post-treatment were at greater risk of shunt failure and poor outcome.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"134 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656400","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":"Symptomatic Cerebellar Cyst Formation after Foramen Magnum Meningioma Removal: A Case Report","authors":"Shoichiro Hanai, K. Yanaka, Kuniyuki Onuma, Kazuhiro Nakamura, Michihide Kajita, Hitoshi Aiyama, Eiichi Ishikawa","doi":"10.1055/s-0043-1776300","DOIUrl":"https://doi.org/10.1055/s-0043-1776300","url":null,"abstract":"\u0000 Background Symptomatic cerebellar cyst formation after surgery is rare and the mechanism remains unknown. We describe a cerebellar cyst that gradually expanded, becoming symptomatic, after the removal of a foramen magnum meningioma and discuss the mechanism of cyst formation.\u0000 Case Description A 76-year-old woman with a tumor at the foramen magnum was treated by posterior fossa craniotomy and C1 hemilaminectomy. The patient suddenly developed cerebellar symptoms and consciousness disturbance approximately 1 week into an otherwise good postoperative course. Imaging showed a subcutaneous pseudomeningocele in the occipital region and cerebellar cyst formation. After resolution by fenestration of the cerebellar cyst and duraplasty, the patient's symptoms gradually improved. No tumor or cerebellar cyst recurrence has been detected in over 5 years since the surgery.\u0000 Conclusion Postoperative pseudomeningocele appeared crucial for cerebellar cyst formation. Postoperative development of symptomatic cerebellar cysts is rare but should be recognized as a serious, sometimes life-threatening, postoperative complication of posterior fossa surgery.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"134 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141656402","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":"Applications of Augmented Reality in Neuro-Oncology: A Case Series","authors":"M. Dellaretti, Hian Penna Gavazza Figueiredo, André G. Soares, Luiz E.V. Froes, Fernando Cotrim Gomes, Franklin Faraj","doi":"10.1055/s-0044-1788064","DOIUrl":"https://doi.org/10.1055/s-0044-1788064","url":null,"abstract":"Augmented reality (AR) is a technological tool that superimposes two-dimensional virtual images onto three-dimensional real-world scenarios through the integration of neuronavigation and a surgical microscope. The aim of this study was to demonstrate our initial experience with AR and to assess its application in oncological neurosurgery. This is a case series with 31 patients who underwent surgery at Santa Casa BH for the treatment of intracranial tumors in the period from March 4, 2022, to July 14, 2023. The application of AR was evaluated in each case through three parameters: whether the virtual images auxiliated in the incision and craniotomy and whether the virtual images aided in intraoperative microsurgery decisions. Of the 31 patients, 5 patients developed new neurological deficits postoperatively. One patient died, with a mortality rate of 3.0%. Complete tumor resection was achieved in 22 patients, and partial resection was achieved in 6 patients. In all patients, AR was used to guide the incision and craniotomy in each case, leading to improved and precise surgical approaches. As intraoperative microsurgery guidance, it proved to be useful in 29 cases. The application of AR seems to enhance surgical safety for both the patient and the surgeon. It allows a more refined immediate operative planning, from head positioning to skin incision and craniotomy. Additionally, it helps decision-making in the intraoperative microsurgery phase with a potentially positive impact on surgical outcomes.","PeriodicalId":505649,"journal":{"name":"Asian Journal of Neurosurgery","volume":"9 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668091","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}