Interventional neurophysiologic monitoring.

Purpose Of Review: Intraoperative neurophysiologic monitoring provides useful information on the functional status of the nervous system. This review focuses on recently published data concerning the impact of monitoring on patient outcome.

Recent Findings: There is level I evidence to support the use of bispectral index monitoring to prevent awareness during anesthesia in high-risk patients.

The comparative impact of video consultation on emergency neurosurgical referrals.

Objective: Neurosurgical resources are concentrated in tertiary referral centers, whereas emergencies identified from district general hospitals are traditionally referred by telephone consultation (TC). Recent advances in communication technology offer the alternative options of teleradiology (TR) and video consultation (VC). This study aimed to determine the differences among these three consultation methods on the basis of their process-of-care indicators, clinical outcomes, and cost-effectiveness.

Tissue plasminogen activator expression in meningiomas and glioblastomas.

Objectives: Enzyme-linked immunosorbent assay (ELISA) and Western blotting techniques were used to investigate and compare the expression of tissue plasminogen activator (tPA) in benign (meningioma) and malignant (glioblastoma) human brain tumours.

Methods: A total of 22 tumour samples comprising 11 meningiomas and 11 glioblastomas with adjacent peritumoural tissue were analysed.

Results: The mean tPA content of meningiomas was approximately half that of glioblastomas (55.

Advanced "tactile" medical imaging for separation surgeries of conjoined twins.

Background: Understanding the anatomy of conjoined twins is difficult because of the rarity of this congenital malformation and the scarcity of reported cases in medical literature.

New Technology: Advances in radiologic imaging, computer modeling, and sophisticated manufacturing techniques enable medical imaging datasets to be translated into accurate, solid, life-size models. These models, which can be designed to include various combinations of anatomical features revealed by established imaging modalities, are important for pre-surgical assessments and planning, as well as for reference during the actual operative procedure.

Separation surgery for total vertical craniopagus twins.

Objective: A pair of conjoined twins aged 11 months underwent investigations, followed by surgical separation in Singapore General Hospital in April 2001. They were joined at the skull vertex and facing in opposite directions.

Methods: Radiological investigations including cerebral angiography, magnetic resonance imaging and computerized tomographic scans were performed, leading to the diagnosis of total vertical craniopagus.

How useful is glucose detection in diagnosing cerebrospinal fluid leak? The rational use of CT and Beta-2 transferrin assay in detection of cerebrospinal fluid fistula.

Background: This report describes the sensitivity and specificity of glucose detection using Glucostix test strips and computed tomography (CT) of the skull base for confirming cerebrospinal fluid (CSF) fistulae in patients with persistent rhinorrhoea or otorrhoea, and comparing them with the beta-2 transferrin assay as the gold standard for CSF detection.

Methods: Fluid samples from the nose were collected from 18 patients with suspected CSF fistulae. The samples were assayed for beta-2 transferrin using the Western blotting and immunostaining technique.