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Search Results: 1 - 10 of 5360 matches for " Single Burr Hole "
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A Novel Surgical Approach to Traumatic Intracranial Epidural Hematoma  [PDF]
David Shrestha, Liang Feng
Open Access Library Journal (OALib Journal) , 2017, DOI: 10.4236/oalib.1103820
Objective: Traumatic intracranial epidural hematoma is considered to be the serious complication of head injury requiring appropriate evaluation and surgical intervention. Although craniotomy provides an effective evacuation of the hematoma, there is an insufficient data to support one particular surgical treatment method. The objective of this study is to address the effectiveness of Urokinase instillation via single burr hole in different time interval. Method: Forty two patients with traumatic epidural hematoma, ranging between 15 and 71 years who meet the inclusion criteria were selected for the retrospective study. All the patients were surgically treated in the First Affiliated Hospital of Liaoning Medical University from January 2013 to June 2015. Result: The common complication encountered in this study was headache, dizziness, fever and re-bleeding. In Group-A, 4 (19%) patients complained of headache, 5 (23.8%) dizziness, 1 (4.7%) fever and re-bleeding occurred in 2 (9.5%) patients. In Group-B, 2 (9.5%) patients complained of headache, 1 (4.7%) dizziness, 1 (4.7%) fever and 1 (4.7%) re-bleeding. Out of forty two patients, 3 (7.1%) patients encountered re-bleeding and received craniotomy. In this study, Group B demonstrates better outcome than Group A (P < 0.028). Conclusion: Single burr hole with Urokinase instillation is safe, feasible and effective technique in the treatment of traumatic epidural hematoma in selected cases where close regular clinical and radiological monitoring is possible.
Multiple Density Subdural Hematomas  [PDF]
Divye Prakash Tiwari, Vivek Sharma, Janak Raj
Open Journal of Modern Neurosurgery (OJMN) , 2014, DOI: 10.4236/ojmn.2014.41004
Abstract: The chronic subdural hematoma is a well known entity in old age and the treatment is very challenging. Treatment protocol depends upon the radiological finding. The loculation and multilayering indicates the bleeding at multiple times and respectively found in 13.2% and 13.6%, which was more common in patients more than 75 years. Burr hole evacuation was the treatment of choice except in recurrent cases where craniotomy was performed.
Giant Brain Abscess in a Neonate Managed with External Drainage
G Sedain,N Ali,M Bhattachan,MS Sharma,SK Shilpakar
Journal of Nepal Paediatric Society , 2013, DOI: 10.3126/jnps.v33i1.7317
Abstract: Brain abscesses in neonates are extremely rare and usually occur in patients with certain risk factors. A 26 days child presented to the emergency with fever, irritability and not sucking well. CT revealed a large left frontal lobe abscess which was managed with burr hole and a drainage tube with concurrent intravenous antibiotics. DOI: http://dx.doi.org/10.3126/jnps.v33i1.7317 J Nepal Paediatr Soc. 2013;33(1):55-56
Emergency burr holes: "How to do it"
Mark H Wilson, David Wise, Gareth Davies, David Lockey
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-24
Abstract: No patients involvedThis paper describes a simple approach to emergency burr hole evacuation of extra-axial intracranial haematoma that can be used in the uncommon situation when life saving specialist neurosurgical intervention is not available.Rapidly expanding intracranial haematomas associated with fixed dilated pupils are rapidly fatal. A recently fixed dilated pupil with corresponding imaging evidence of an extra-axial haematoma is considered an indication for emergency targeted burr hole placement.Extra-axial haematomas (extradural/subdural) by definition are outside the brain and hence are not a primary brain injury. It is the delay in removing the compression of the brain by the clot that causes brain injury and death.Ideal treatment is provided by immediate specialist neurosurgical care. However in many parts of the world, this is not always available and the risks of delay associated with secondary transfer have to be balanced with the risks of the procedure being done by a non-specialist. At one UK neurosurgical centre, the median transfer time was 5.25 hours for patients with extradural haematoma and 6 hours for subdural haematoma [1]. The prolonged transfer of a patient with fixed/dilated pupils is unlikely to have a good outcome. Transfer of this type of patient is analogous to transferring a patient with other time critical but reversible pathology such as a tension pneumothorax. There are many reports of non-specialists successfully performing emergency burr holes [2]. These are often done with household drills and other makeshift tools which, when successful, has created media interest [3]. Although there have been significant technical advances in the safety of the procedure since the time of "exploratory" burr holes, there has simultaneously been a reduction in the number of surgeons either having experience in or being willing to perform the procedure. A number of general surgeons working in remote areas of Australia are more confident in perfor
Spectrum of intracranial subdural empyemas in a series of 45 patients: Current surgical options and outcome
Tewari Manoj,Sharma Rewati,Shiv Vinod,Lad Santosh
Neurology India , 2004,
Abstract: Background: The subject of subdural empyema (SDE) is reviewed on the basis of experience with 45 cases. Methods: Records of 45 patients with SDE were analyzed. There were 35 males and 10 females in the series. The majority of the patients were either infants (22.2%) or in their second and third decade of life (37.8%). For supratentorial SDE, craniotomy was done in 5 cases (11.1%). In six cases (13.3%) two burr-holes and in the rest of the cases multiple burrholes were done to evacuate the empyema. Craniectomy was done in three cases (6.7%), of which two had posterior fossa SDE. All patients received appropriate preoperative and postoperative broad-spectrum antibiotics. Results: There was good recovery in 35 (77.8%) patients, six patients (13.3%) had moderate disability, two patients (4.4%) had severe disability, and two (4.4%) died. Three patients who developed recollection at operation site required evacuation of residual SDE. Median follow-up was 3 years (range 4 months to 3 years). Conclusion: Emergent evacuation of SDE using multiple burr-holes and irrigation of the subdural cavity with saline for 24 hours results in a satisfactory outcome in cases with SDE.
Minimal Access Surgical Evacuation of Unilateral Chronic Subdural Hematoma  [PDF]
Hamdy Mohammed Behairy
World Journal of Neuroscience (WJNS) , 2018, DOI: 10.4236/wjns.2018.81007
Abstract: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions occurring mostly in elderly and ideally treated with surgical drainage. Many surgical techniques of different degrees of invasiveness have been proposed for its treatment with controversy about the best surgical procedure. The study aims to evaluate the efficacy of the minimal access technique of single burr-hole craniostomy and massive irrigation for treatment of unilateral CSDH. The study is a prospective descriptive study involved all patients with symptomatic radiologically proven unilateral CSDH admitted and treated surgically in department of Neurosurgery, Al-Hussein University hospital, Al-Azhar University, Cairo, Egypt, over 3 years, from January 2013 to January 2016. In the results we found that total 64 patients of CSDH, treated surgically by this procedure. Men formed 72% and women 28%. Age range was 51 to 82 years; the mean age was 65 years. Clinical presentation was impaired consciousness in 7%, headache (59%), right hemiparesis in 56% and left hemiparesis in 37%. CT was done for 91% and MRI 27% patients. The hematoma was left in 61% and right in 39%. Surgical evacuation utilizing this procedure was done in all patients. Complete recovery was obtained in 82% of patients and partial recovery in 11% of patients. Follow up for 4 months was done. Recurrence was detected in 6% of patients. We concluded that unilateral CSDH can be treated effectively by single nondependent burr-hole craniostomy and massive irrigation with excellent outcome.
Hematoma subdural cr?nico: análise de 35 casos
Araújo, Jo?o Flavio M.;Iafigliola, Maria Gracia;Balbo, Roque José;
Arquivos de Neuro-Psiquiatria , 1996, DOI: 10.1590/S0004-282X1996000100012
Abstract: thirty five patients with chronic subdural hematoma were treated surgically between 1988 and 1995. the patients, aged 19 to 80 years, were graded retrospectively according to the bender scale. the clots were removed via burr-holes with irrigation of the subdural space to ensure as complete an evacuation of subdural colletion, and craniotomy with membranectomy. the mortality rate was 16.6% with craniotomy and 0% with burr-hole. the patients who died, 80% were in grade iii or iv. the pathogenesis and surgical treatment of chronic subdural hematoma has been controversial, and still remains obscure.
A newly designed hydroxyapatite ceramic burr-hole button
Hiroshi Kashimura, Kuniaki Ogasawara, Yoshitaka Kubo, et al
Vascular Health and Risk Management , 2010, DOI: http://dx.doi.org/10.2147/VHRM.S8070
Abstract: newly designed hydroxyapatite ceramic burr-hole button Other (3468) Total Article Views Authors: Hiroshi Kashimura, Kuniaki Ogasawara, Yoshitaka Kubo, et al Published Date March 2010 Volume 2010:6 Pages 105 - 108 DOI: http://dx.doi.org/10.2147/VHRM.S8070 Hiroshi Kashimura, Kuniaki Ogasawara, Yoshitaka Kubo, Kenji Yoshida, Atsushi Sugawara, Akira Ogawa Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan Abstract: Conventional burr-hole buttons sometimes do not fit the burr hole well due to the curvature of the surrounding bone. An irregular surface at the border between the button and the surrounding skull may appear unaesthetic. The major problem is the difference between the curvature radius of the skull and the burr-hole button in contact with the skull. To solve this problem, the authors designed a button made of hydroxyapatite ceramic to snugly fit the burr hole. The specifications of this device and its clinical application are described here.
Comparison of Burr Hole Irrigation and Closed System Drainage Methods After Burr Hole Irrigation in The Treatment of Chronic Subdural Hematoma
Mehmet SE?ER,Niyazi KALYONCU,Murat GüNAL,Enis KURUO?LU
Journal of Neurological Sciences , 2012,
Abstract: Objective: Comparison of evacuation of hematoma through burr hole irrigation (BHI) and closed system drainage (CSD) after burr hole irrigation in the treatment of chronic subdural hematoma (CSDH) in terms of relapse.Materials and Methods: 32 patients who were operated with CSDH diagnosis between 2001 and 2008 were retrospectively evaluated with respect to clinical features, etiologic factors, surgical technique and recurrence. Of the 5 recurrent cases in BHI group, 2 (20%) received tap and 3 received excision of hematoma via craniotomy. No pathology requiring additional surgery was detected in the follow-up of the patients who underwent BHI-CSD.Conclusion: Closed system drainage through burr hole irrigation in CSDH cases is a simple and reliable method which reduces the risk for recurrence and reoperation and enables evacuation of anticoagulants such as plasminogen and thrombomodulin, products of impaired coagulation- anticoagulation balance.
Variabilidade horizontal da fertilidade do solo de uma unidade de amostragem em sistema plantio direto
Alvarez V., V. H.;Guar?oni M., A.;
Revista Brasileira de Ciência do Solo , 2003, DOI: 10.1590/S0100-06832003000200010
Abstract: sampling soil with the auger hole is simpler and faster than with the cutting shovel. the last is frequently used in no till systems to obtain soil samples for fertility analyses. this study had the following objectives: comparison of two different localized soil sampling systems concerning the horizontal variability of chemical soil characteristics; determination of the necessary unit number to compose a representative sample of the area, and the demonstration that mean fertility values obtained from the composite sample are the same as the obtained from the arithmetic mean of single samplings. the study was carried out in an area under no till system since 15 years. the localized sampling systems were: cutting shovel (24 single samples collected perpendicularly to the furrow and in the middle of the space between two furrows) and auger hole (20 single samples collected in the planting furrow (ts), 20 single samples collected 10 cm beside the furrow (t10), and 20 single samples collected 40 cm beside the furrow (t40).representative sub-samples of both methods were randomly chosen from the single ones, and mixed to make up respective composite samples. p, k, ca2+, mg2+, and al3+, and the values of ph, h + al, and p-rem were determined in the single and composite samples, and their means, standard deviation, and variation coefficient calculated. data means were compared by the student test. only k, mg2+, and h + al values differed according to the employed sampling system. when the auger hole was used, the variability of all studied characteristics and the necessary number of single samples to compose a representative sample were higher than for sampling with the cutting shovel. the variability was low for ph, p-rem, and h + al, and high for p, al3+, mg2+, k, and ca2+. ten single samples collected with the cutting shovel or 27 single samples collected by the auger hole (five samples collected in the furrow, nine collected 10 cm beside the furrow, and 13 collected in
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