1,721,309 research outputs found
Repair of a spinal pseudomeningocele in a delayed postsurgical T cerebrospinal fluid leak using titanium U-clips: technical note
Full text linkIntroduction
Chronic cerebrospinal fluid leak (CCFL) represents a possible event following spine surgery, with an incidence rate ranging from 5 to 18%. In literature have been reported few modification techniques that involved the use of titanium U-clips with the aim to reduce dural traumatism during its closure but only after non-accidental durotomy.
Case illustration
We report the case of a 47-year-old female with history of L5-S1 microsurgical discectomy. After one year the patient was admitted to our unit because she presented progressive skin swelling in the lumbar region, intermittent headache and recurrent episodes of lipothymia. One-year MRI showed a voluminous subcutaneous cerebrospinal fluid (CSF)-like intensity collection in the T2-weighted sequences and communicating with the right L5-S1 interlaminar space. A second surgery revealed pseudomeningocele and a 5 mm dural defect is identified. At first, a tobacco pouch was created, and a suture with Prolene 6–0, a non-absorbable, synthetic monofilament, is made on the previously dissected tissue. In a second step, 2 medium/short non-penetrating titanium U-clips are applied with a multi-clip applier. There was no sign of recurrent pseudomeningocele in the 2-year follow-up.
Conclusion
The authors presented a novel use of titanium U-clips to manage an insidious and complex case of pseudomeningocele in a CCFL. U-clips represent a safe and effective tool in CCFL repair
In Reply: Rongeurs, neurosurgeons, and COVID-19: how do we protect health care personnel during neurosurgical operations in the midst of aerosol-generation from high-speed drills?
Full text linkTo the Editor:
We appreciated the manuscript by Chan et al,“Rongeurs, Neurosurgeons, and COVID-19: How Do We Protect Health Care Personnel During Neurosurgical Operations in the Midst of Aerosol-Generation From High-Speed Drills?” published April 2020 in Neurosurgery. We are grateful to the authors of the letter1 for their precise analysis and useful recommendations to fellow neurosurgeons and trainees to uphold the traditional craft of using hand drills and rongeurs in order to minimize aerosol generation from the neurosurgical-powered instruments during the COVID-19 pandemic. Nevertheless, we write in reply to present our surgical experience during the COVID-19 pandemic
Petro-Clival Tumours: Role and Indications of Transoral and Transsphenoidal Approaches Followed by Hypofractionated Stereotactic Radiotherapy
No full textLateral Transmaxillosphenoidal Approach to the Lateral Compartment of the Cavernous Sinus: Removal of a Dermoid Tumor
No full textGuida per posizionamento di cateteri cerebrali
No full textBackground: external ventricular drain (EVD) placement is mandatory for several pathologies. The misplacement rate of the EVD in the literature varies widely, ranging from 12.3% to 60%. The purpose of this study is to provide preliminary data about the possibility of increasing the safety of one of the most common life-saving procedures in neurosurgery by testing a new device for EVD placement.
Methods: we used a novel guide for positioning the ventricular catheter (patent RM2014A000376). The trajectory was assessed using 25 anonymized head CT scans of patients. The data set were used to con-duct three-dimensional computer-based and combined navigation and augmented reality-based simulations using plaster models. The data set inclusion criteria were volumetric head CT scan without midline shift of patients who are above 18 years old. Evans ratio was used to quantify the ventricle’s size. We excluded patients with slit ventricles, midline shift, skull fractures, and complex skull malformations. The proximal end of the device was tested on the cadaver.
Results: the cadaveric tests proved that only one surgeon could use the device. The multimodal simulation showed Kakarla grade 1 in all cases but one with grade 2, on both sides after right and left EVD placement. The mean Evans ratio was 0,28. The geometric principles that explain the device's efficacy can be summarized by studying the geometric properties of circumference and chord. The contact occurs for each section considered at the extreme points of the chord. Its axis, perpendicular to the plane tangent to the spherical surface at the entry point, corresponds to the direction of entry of the catheter guided by the instrument.
Conclusions: according to our multimodal simulation through cadaveric, 3D computer-based simulation, 3D plaster modeling, 3D neuronavigation, and augmented reality, the device will offer safer and effective EVD placements
The chemistry of star and planet formation with SKA
No full textIn this contribution, we aim to summarise the efforts of the Italian SKA scientific community in conducting surveys of star-forming regions within our Galaxy, in the development of astrochemical research on protostellar envelopes and disks, and in studying the planet formation process itself. The objective is dual: Firstly, to investigate the accumulation and development of dust throughout the formation of planets, and secondly, to chemically examine protoplanetary disks and protostellar envelopes by studying heavy molecules, such as chains and rings containing over seven carbon atoms, which exhibit significantly reduced strength at millimeter wavelengths
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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