Towards improved outcome in children treated surgically for spontaneous intracranial suppuration in South Wales.

Introduction: Spontaneous central nervous system (CNS) infections in children are rare. Treatment involves surgical intervention and antibiotic therapy. We describe a single centre experience of managing this condition in South Wales.

The Risk of Spread of Infection During Craniotomy/Craniostomy on Patients with Active Coronavirus Disease 2019 (COVID-19) Infection: Myth or Fact?

Objectives: Craniotomies/craniostomies have been categorized as aerosol-generating procedures and are presumed to spread coronavirus disease 2019 (COVID-19). However, the presence of severe acute respiratory distress syndrome coronavirus 2 virus in the generated bone dust has never been proved. Our objective is to evaluate the presence of virus in the bone dust (aerosol) generated during emergency neurosurgical procedures performed on patients with active COVID-19.

One case report of delayed severe intracerebral and intraventricular hemorrhage after cranioplasty.

Background: Cranioplasty is a relatively simple neurosurgical procedure, and common complications of cranioplasty include dural tears, CSF leakage, infection, epilepsy, epidural hematoma and bone flap resorption. Intracerebral hemorrhage as a complication of cranioplasty is rare, and it is often fatal. The report describes one case of delayed severe intracerebral and intraventricular hemorrhage after an uneventful cranioplasty.

[Technical "Tips" for Epidural Tenting Using DuraGen for Surgical Management of Large Dural Defects:A Technical Note].

DuraGen, an absorbable, engineered collagen-based artificial graft was introduced in Japan in September 2019 for cranial, transsphenoidal, and spinal surgeries. In addition to its efficacy and safety profile, owing to sutureless dural repair, DuraGen is widely accepted by neurosurgeons. Direct tenting with DuraGen is occasionally required in patients with large dural defects, particularly in cases of tumors adherent to the dura.

Advantages of using a prophylactic epidural closed drain and non-watertight dura suture in a craniotomy near the "parietal site".

Background: In neurosurgery, the necessity of having a drainage tube is controversial. Subgaleal fluid collection (SFC) often occurs, especially in a craniotomy near the "parietal site".This study aimed to reassess the benefit of using a prophylactic epidural drainage (ED) and non-watertight dura suture in a craniotomy near the parietal site.

Cranioplasty following ventriculoperitoneal shunting: lessons learned.

Objective: Cranioplasty (CP) is considered as a straightforward and technically unchallenging operation; however, complication rates are high reaching up to 56%. Presence of a ventriculoperitoneal shunt (VPS) and timing of CP are reported risk factors for complications. Pressure gradients and scarring at the site of the cranial defect seem to be critical in this context.

Suppurative Intracranial Complications of Pediatric Sinusitis: A Single-Center Experience.

Background: Suppurative intracranial complications of sinusitis are rare events in children and can lead to harmful neurologic sequelae and significant morbidity. We sought to review the presentation and management of patients admitted at our hospital with these conditions.

Methods: This was a retrospective study of pediatric patients admitted to a quaternary children's hospital from 2007 to 2019 for operative management of sinusitis with intracranial extension.

Efficacy of high-dose versus low-dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial.

Background: Traumatic brain injury (TBI) is the most common trauma worldwide and is a leading cause of injury-related death and disability. Inflammation is initiated as a result of the TBI, which is in association with severity of illness and mortality in brain trauma patients, especially in subdural hemorrhage and epidural hemorrhage cases. A high percentage of adults admitted to the intensive care unit with TBI are diagnosed with vitamin D deficiency; this deficiency may induce impaired immune responses and increase the risk of infections.

Immediate replacement of bone flap after craniotomy for empyema in children.

Purpose: Optimal management of the bone flap after craniotomy for intracranial infection has not been well defined in the pediatric population. This study reviewed the outcomes of a single Canadian center where immediate replacement of the bone flap was standard practice.

Methods: This is a retrospective study of all patients who underwent craniotomies for evacuation of epidural or subdural empyema at a single center from 1982 to 2018.

Spontaneous acute epidural hematoma associated with chronic subdural hematoma due to dural metastasis of gastric carcinoma: a case report and literature review.

Non-traumatic spontaneous acute epidural hematoma (EDH) happening to chronic subdural hematoma (SDH) caused by dural metastases is a rare entity. Pathogenesis can be derived from infection, coagulopathy, and inflammation. Malignant tumors metastasize to dura mater is one of the most infrequent causes.

Treatment of CSF leakage and infections of dural substitute in decompressive craniectomy using fascia lata implants and related anatomopathological findings.

Purpose: Decompressive craniectomy (DC) is widely used to treat raised intracranial pressure (ICP) in cranial trauma and stroke. It is accompanied by numerous complications. The aim of our study is to assess the surgical treatment of infections related to the use of a dural substitute with concurrent CSF leakage performed at our institution.

Neuronavigation-Guided Endoscopic Endonasal Drainage of Pediatric Anterior Cranial Base Epidural and Subdural Empyema.

In children, epidural and/or subdural intracranial empyema can complicate frontal sinusitis or pansinusitis. The standard transcranial approach used to treat epidural or subdural empyema has many drawbacks, but these can be avoided with an endoscopic expanded endonasal approach (EEA). To support the feasibility and advantages of this approach, we report the successful drainage through endoscopic EEA of a bifrontal empyema caused by an intracranial extension of pansinusitis.

Intracranial complications of pediatric rhinosinusitis: Identifying risk factors and interventions affecting length of hospitalization.

Objective: To identify risk factors and interventions affecting length of hospitalization (LOH) and clinical outcome in children with intracranial complications of rhinosinusitis.

Methods: Retrospective chart review of 12 children hospitalized at 2 academic medical centers for intracranial complications of rhinosinusitis over the past 5 years.

Results: 12 patients were identified with an average age at presentation of 13 years old.

What's around the spinal cord? Imaging features of extramedullary diseases.

Diagnosis of extramedullary spinal diseases is often complex, firstly requiring a good anatomic knowledge for a precise localization of pathologies. The spinal canal, a tubular space delimited by vertebral bodies and neural arches, contains the spinal cord, nerve roots and cauda equina. Neural structures are surrounded and supported, from outer to inner, by meninges: dura, arachnoid and pia mater; meningeal layers divide extramedullary spaces in epidural, subdural and subarachnoid.

Complications of Otitis Media and Sinusitis Caused by Streptococcus anginosus Group Organisms in Children.

Background: The Streptococcus anginosus group (SAG, S. anginosus, S. intermedius and S.

Successful surgical management of an Escherichia coli epidural-subdural abscess secondary to sino-rhinotomy.

Objective: To describe a case of successful management of epidural-subdural abscess and severe meningitis with secondary brain herniation in a dog.

Case Summary: A rhino-sinusotomy was performed in a 3-year-old mixed-breed dog for management of refractory sinonasal aspergillosis. Initial recovery was good, but the dog became acutely stuporous 36 hours after surgery.

Excision and Primary Reanastomosis of the Anterior Inferior Cerebellar Artery for Treatment of a Ruptured Mycotic Aneurysm: 2-Dimensional Operative Video.

Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions with a predisposition for distal location and non-saccular morphology.1,2 These aneurysms are less amenable to clipping and may instead require aneurysm trapping with bypass.3 This video reports a novel bypass for a ruptured, fusiform distal AICA aneurysm.

Intracranial subdural empyemas and epidural abscesses in children.

Objective: The authors conducted a retrospective analysis of a consecutive series of children with intracranial subdural empyemas (SEs) and epidural abscesses (EAs) to highlight the important clinical difference between these two entities. They describe the delays and pitfalls in achieving accurate diagnoses and make treatment recommendations based on clinical and imaging findings.

Methods: They reviewed their experience with children who had presented with intracranial SE and/or EA in the period from January 2013 to May 2018.

Dural Reconstruction Using Laparoscopic Gastro-omental Free Flap in Refractory Cranial Infections.

Background: Epidural abscesses and subdural empyema after craniotomy are potentially lethal complications in neurosurgery. Patients with recalcitrant cranial wound infections may be difficult to manage, and dural reconstruction in these patients is challenging.

Methods: A total of 14 patients presented with recurrent intracranial infection after craniotomy.

Treatment of Traumatic Depressed Compound Skull Fractures.

Background: A skull fracture widely occurs in patients with traumatic brain injury, leading to intracranial hematoma, brain contusion, and intracranial infection. It also influences the prognosis and death of patients. This study aimed to discuss cases of patients with comminuted skull fractures.

Thirty-Day Hospital Readmission and Surgical Complication Rates for Shunting in Normal Pressure Hydrocephalus: A Large National Database Analysis.

Background: Research on age-related complications secondary to shunts in normal pressure hydrocephalus (NPH) is primarily limited to single-center studies and small cohorts.

Objective: To determine the rates of hospital readmission and surgical complications, and factors that predict them, following shunt surgery for NPH in a large healthcare network.

Methods: Surgical procedures, complications, and readmissions for adults undergoing ventricular shunting for NPH were determined using de-identified claims from a privately insured United States healthcare network in years 2007-2014.