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Useful ‘sliding-lock-knot’ technique for suturing dural patch to prevent cerebrospinal fluid leakage after extended transsphenoidal surgery
Date of publication: 20-Feb-2013
Background:Postoperative cerebrospinal fluid (CSF) leakage is a major problematic complication after extended transsphenoidal surgery (TSS). Watertight closure of the sellar dura with a fascial patch graft is a method of choice for preventing CSF leakage; however, suturing and knotting in a deep and narrow operative field is technically challenging and time consuming. To present a simple and effective knotting technique named the ‘sliding-lock-knot’ technique, in which the knot can easily be slid to the suturing point and tied automatically using only a single string, without loosening.
Sinking of bone flap-looking beyond cosmesis and costs
Date of publication: 20-Feb-2013
Chronic calcified subdural hematoma: Case report and review of the literature
Date of publication: 20-Feb-2013
Background:Calcified chronic subdural hematoma is a rare but known entity, estimated to represent 0.3-2.7% of chronic subdural hematomas. Although surgical treatment is unanimous for chronic subdural hematomas, therein lies some doubt on it being applied to calcified chronic subdural hematomas.
Immunoexcitatory mechanisms in glioma proliferation, invasion and occasional metastasis
Date of publication: 29-Jan-2013
Abstract
There is increasing evidence of an interaction between inflammatory cytokines and glutamate receptors among a number of neurological diseases including traumatic brain injuries, neurodegenerative diseases and central nervous system (CNS) infections. A number of recent studies have now suggested a strong relation between inflammatory mechanisms and excitatory cascades and these may play a role in glioma invasiveness and proliferation.
Chronic inflammation appears to be a major initiating mechanism in most human cancers, involving cell-signaling pathways, which are responsible for cell cycling, cancer cell migration, invasion, tumor aggressiveness, and angiogenesis. It is less well appreciated that glutamate receptors also play a significant role in both proliferation and especially glioma invasion. There is some evidence that sustained elevations in glutamate may play a role in initiating certain cancers and new studies demonstrate an interaction between inflammation and glutamate receptors that may enhance tumor invasion and metastasis by affecting a number of cell-signaling mechanisms. These mechanisms are discussed in this paper as well as novel treatment options for reducing immune-glutamate promotion of cancer growth and invasion.
A case of unilateral moyamoya disease suffered from intracerebral hemorrhage due to the rupture of cerebral aneurysm, which appeared seven years later
Date of publication: 29-Jan-2013
Background:Whether unilateral moyamoya disease (MMD), confirmed by steno-occlusive lesion at the terminal portion of internal carotid artery with formation of moyamoya vessels unilaterally and normal or equivocal findings contralaterally, is an early form of definite (bilateral) MMD remains controversial. It is well-known that adult patients with MMD tend to suffer from cerebral hemorrhage, occasionally due to the rupture of aneurysm arising from moyamoya vessel.
Shooting rampages, mental health, and the sensationalization of violence
Date of publication: 29-Jan-2013
Abstract
Gun violence and, most recently, senseless shooting rampages continue to be sensitive and emotional points of debate in the American media and the political establishment. The United Nations is already set to commence discussing and approving its Small Arms Treaty in March 2013. And following the Newtown, Connecticut tragedy in the United States this past December, American legislators are working frantically to pass more stringent gun control laws in the U.S. Congress.
The American media and proponents of gun control assert that the problem lies in the “easy availability of guns” and “too many guns” in the hand of the public. Second Amendment and gun rights advocates, on the other hand, believe the problem lies elsewhere, including a permissive criminal justice system that panders to criminals; the failure of public education; the fostering of a culture of dependence, violence, and alienation engendered by the welfare state; and the increased secularization of society with children and adolescents growing up devoid of moral guidance. I cannot disagree with the latter view, but I believe there are additional, contributing, and more proximate causes — e.g., failures of the mental health system and the role of the media and popular culture in the sensationalization of violence — that also need to be specifically pointed out and discussed in the medical literature, as I have set out to do in this review article.
A case of ecchordosis physaliphora presenting with an abducens nerve palsy: A rare symptomatic case managed with endoscopic endonasal transsphenoidal surgery
Date of publication: 28-Jan-2013
Background:Ecchordosis physaliphora (EP) is a benign notochordal remnant that is usually asymptomatic; symptomatic cases are extremely rare. Most of the reported symptomatic cases were managed by resection via craniotomy.
Enterprise stent for waffle-cone stent-assisted coil embolization of large wide-necked arterial bifurcation aneurysms
Date of publication: 28-Jan-2013
Background:Large wide-necked arterial bifurcation aneurysms present a unique challenge for endovascular coil embolization treatment. One technique described in the literature deploys a Neuroform stent into the neck of the aneurysm in the shape of a waffle-cone, thereby acting as a scaffold for the coil mass. This case series presents four patients with large wide-necked bifurcation aneurysms treated with the closed-cell Enterprise stent using the waffle-cone technique.
Reasons, procedures, and outcomes in ventriculoatrial shunts: A single-center experience
Date of publication: 28-Jan-2013
Background:Ventricular shunts are used to drain cerebrospinal fluid into extra-cranial spaces. Ventriculoatrial (VA) shunts are provided to transfer cerebrospinal fluid from the cerebral ventricle into the right atrium of the heart. A single center experience of indications, procedure, and clinical outcomes in VA shunt was presented in current study.
Windows 8: A promise for tablet computers in the hospital?
Date of publication: 28-Jan-2013
