Traumatic retroclival epidural hematoma in pediatric patient–Case report and review of literature

June 15, 2011, 0:00

Muhammad Zubair Tahir, SA Quadri, Sonia Hanif, Gohar JavedSurgical Neurology International 2011 2(1):78-78Background: Retroclival epidural hematoma (REDH) is a very rare entity in the practical field of neurosurgery. Only a few cases have been reported...

A proposed definition of symptomatic vasospasm based on treatment of cerebral vasospasm after subarachnoid hemorrhage in Japan: Consensus 2009, a project of the 25 th Spasm Symposium

June 9, 2011, 0:00

Satoshi Shirao, Hiroshi Yoneda, Hideyuki Ishihara, Koji Kajiwara, Michiyasu Suzuki, Survey Study Members of Japan Neurosurgical Society

Surgical Neurology International 2011 2(1):74-74

Background : There is a lack of unified information on diagnosis and treatment of cerebral vasospasm (CV) after subarachnoid hemorrhage (SAH) among the hospitals in Japan. Thus, the aim of the study was to define the current practice in this area based on a survey by Japanese neurosurgeons. Methods : A survey on diagnosis and treatment of CV was sent to 414 hospitals each of which performs >100 neurosurgeries annually. Results : Responses were received from 240 hospitals (58.0%). Because accurate criteria for diagnosis of symptomatic vasospasm (SVS) were used in only 33.8% of the hospitals, we proposed a clinical definition of SVS that was approved at the 25 th Spasm Symposium (Consensus 2009). This definition is simplified as follows: (1) the presence of neurological worsening; (2) no other identifiable cause of neurological worsening; and (3) confirmation of vasospasm by medical examinations. The results also showed that the Fisher CT scale is used differently for patients with ICH or IVH, with 41.3% of cases with ICH/IVH based on SAH that met Fisher criteria classified into Fisher group 1, 2 or 3, and 46.3% classified into Fisher group 4. There were no major differences in prophylactic therapies of CV and therapy for cerebral ischemia among the hospitals. Endovascular treatment for vasospasm was performed in most hospitals (78.7%); however, the criteria differed among the hospitals: (1) angiographic vasospasm and SVS appeared (37.9%), (2) only when aggressive therapy was ineffective (41.4%). Conclusion : We established a clinical definition of SVS based on the results of this survey (Consensus 2009).

Neurocirugía Hoy, Vol. 3, Numero 9

June 2, 2011, 21:39

Note: To view this in full-screen, click the Menu button below, and then View Fullscreen; press Esc to exit full-screen mode. To view this presentation on a mobile device, click the link below. Neurocirugía Hoy, Vol. 3, Numero 9 View more presentations from Surgical Neurology International

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Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall-Experience with 75 cases in a post-war country Kosova

May 28, 2011, 0:00

Arsim Morina, Fatos Kelmendi, Qamile Morina, Shefki Dragusha, Feti Ahmeti, Dukagjin Morina, Kushtrim GashiSurgical Neurology International 2011 2(1):72-72Background : The study is to show the advantages of preservation of a calvarial bone flap in the a...

WFNS 2017 bid from Madrid

May 12, 2011, 10:29

The Spanish Society for Neurosurgery invites you to take a look at their bid to organize the 16th WFNS World Congress of Neurosurgery in Madrid. You can visit WFNSMadrid2017.com for more information.

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Sociedad Española de Neurocirugía

May 12, 2011, 10:25

We are happy to announce the collaboration between Surgical Neurology International and the Sociedad Española de Neurocirugía, the official Spanish society for neurosurgery. You can find them at our site under Societies > Collaborations.

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Harbor UCLA Neuro-Radiology Case 4

May 10, 2011, 19:43

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Expression of thioredoxin-1 and hypoxia inducible factor-1α in cerebral arteriovenous malformations: Possible role of redox regulatory factor in neoangiogenic property

April 30, 2011, 0:00

Yasushi Takagi, Ken-ichiro Kikuta, Takuya Moriwaki, Tomohiro Aoki, Kazuhiko Nozaki, Nobuo Hashimoto, Susumu Miyamoto

Surgical Neurology International 2011 2(1):61-61

Background: Recently it is reported that proliferative activity remains in vascular walls of cerebral arteriovenous malformations (AVMs). These reports indicate that endothelial cells in AVMs have the neoangiogenic property. In this study, we assess the role of thioredoxin-1 (Trx-1) and hypoxia-inducible factor 1a (HIF-1α) in AVMs. These factors are reported to play a role in neoangiogenesis. Methods: We analyzed the expressions of Trx1 in the specimens of human cerebral AVMs. In addition, we also analyzed the expression of HIF-1α in these specimens by immunohistochemical method and RT-PCR. Furthermore, we assessed the effect of redox state and expression of Trx-1 during neoangiogenesis using in vitro angiogenesis assay. Findings: Trx-1 and HIF-1α immunoreactivity was detected in almost all 17 specimens of AVMs. Trx-1 and HIF-1α immunoreactive cells were distributed mainly endothelium of intranidal arteries and enlarged veins with thickened vascular walls. Double staining shows that Trx-1 and VEGF (vascular endothelial growth factor) immunoreactivity were colocalized in the same cells. These cells were considered to be endothelial cells. HIF-1α immunoreactivity was also colocalized with VEGF immunoreactivity in endothelium. As for influencing factors, the presence of deep drainers and convulsion significantly associated with HIF-1α expression. Trx-1 assessed by western blotting decreased at 6 hours and 12 hours after plating on Matrigel, which is a model of angiogenesis. Conclusions: We have shown that the endothelial induction of Trx-1 and HIF-1α in cerebral AVMs. Based on all findings obtained in this study, Trx-1 may affect the neoangiogenic property of cerebral AVMs. Key Words: Angiogenesis, cerebral arteriovenous malformations, HIF-1α, Trx-1

Endovascular stenting of an extracranial-intracranial saphenous vein high-flow bypass graft: Technical case report

April 19, 2011, 0:00

Giuliano Maselli, Claudio De Tommasi, Alessandro Ricci, Massimo Gallucci, Renato J Galzio

Surgical Neurology International 2011 2(1):46-46

Background : The authors describe a case of endovascular stenting of an extracranial-intracranial saphenous vein high-flow bypass graft in the management of a complex bilateral carotid aneurysm case. Case Description : A 43-year-old woman was admitted with progressive visual field restriction and headache. Imaging studies revealed bilateral supraclinoid carotid aneurysms. The right carotid aneurysm was clipped and the left one was treated by an endovascular procedure, after performing an internal carotid artery-middle cerebral artery (ICA-MCA) saphenous vein bypass graft. A few months following the bypass procedure, a 70-80% stenosis of the graft was discovered and treated endovascularly with a stenting procedure. Follow-up at 36 months after the first operation showed the patency of the venous graft and no neurological deficits. Conclusions : Endovascular stenting of the extracranial-intracranial saphenous vein high-flow bypass graft is technically feasible when postoperative graft occlusion is discovered.

From medical knowledge to practical healthcare

April 10, 2011, 6:46

Pieter Kubben, Information Technology editor for Surgical Neurology International, recently spoke on TEDxMaastricht on knowledge management in medicine, in particular on clinical decision supporting systems. His presentation is now available online on the official TEDxTalks YouTube channel.