Translational medicine, normally refers to a process for transitioning from the initial lab discovery to the patient＇s bedside with minimal disconnect comprehensive review of statistical and offers a design and metho...Translational medicine, normally refers to a process for transitioning from the initial lab discovery to the patient＇s bedside with minimal disconnect comprehensive review of statistical and offers a design and methodology. It has been advocated repeatedly by worldwide medical scientists as the new prospect highlighting the transition for scientific achievements from laboratory results to clinical application in recent years. As for neurosurgery, it is generally acknowledged that it has been improving in basic research and clinical practice by bounds and leaps; however, the achievements in basic and clinical neurosurgical studies seem to be parallel with no intersection for mutual interaction. Minimally invasive neurosurgery is aimed at serving as the intersection platform for translational medicine.展开更多
<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has ...<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. <strong>Methods: </strong>This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. <strong>Results:</strong> The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. <strong>Conclusions:</strong> The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.展开更多
Background In order to make posterior fossa decompression for the management of Chiari I malformation simple and less invasive while using direct visualization, a novel solely endoscopic procedure has been employed fo...Background In order to make posterior fossa decompression for the management of Chiari I malformation simple and less invasive while using direct visualization, a novel solely endoscopic procedure has been employed for the decompression of Chiari malformation type I. The objective of this study was to present neural endoscopic posterior fossa decompression and atlas laminectomy for Chiari type I patients. Methods Twenty-one patients with Chiari type I underwent neural endoscopic posterior fossa decompression and atlas laminectomy. We described the procedure for neural endoscopic posterior fossa decompression and atlas laminectomy. All patients in this series demonstrated cerebellar tonsil herniation below the foramen magnum in addition to syringomyelia. All patients in the reviewed study underwent preoperative MRI as well as 3-month postoperative MRI. Additional follow-up MRI varied but was usually repeated 12 months to 18 months after surgery. Postoperative MRI studies were retrospectively reviewed and compared with preoperative studies. Results All patients showed clinical improvements, and none had any complications. Patients with syringomyelia had symptoms entirely disappear. Eleven patients （52.4%） experienced radiographic improvement in syringomyelia （decreased size or resolution） during the follow-up period. Nine patients （42.8%） demonstrated decreased syrinx size and four （19%） demonstrated resolved syrinx. Of the 15 patients with symptomatic syringomyelia, 11 （73.3%） experienced symptomatic improvement. The median time to symptom improvement was four months after surgery. Post surgical MRI examinations indicated complete and sufficient decompression of foramen magnum region. Conclusions Endoscope atlanto-occipital decompression surgery is an innovative, safe and effective surgical procedure. It has similar results compared to traditional surgery, however with the added advantages of being minimal invasive, having fewer complications, decreased influence on stability of occipital bony structure, and a faster recovery as well as reduced hospital stay and expenses.展开更多
文摘Translational medicine, normally refers to a process for transitioning from the initial lab discovery to the patient＇s bedside with minimal disconnect comprehensive review of statistical and offers a design and methodology. It has been advocated repeatedly by worldwide medical scientists as the new prospect highlighting the transition for scientific achievements from laboratory results to clinical application in recent years. As for neurosurgery, it is generally acknowledged that it has been improving in basic research and clinical practice by bounds and leaps; however, the achievements in basic and clinical neurosurgical studies seem to be parallel with no intersection for mutual interaction. Minimally invasive neurosurgery is aimed at serving as the intersection platform for translational medicine.
文摘<strong>Background: </strong>Endoscopic third ventriculocisternostomy (ETV) is the most common neuroendoscopic technique in the treatment of noncommunicating hydrocephalus. Since its introduction, ETV has been a safe alternative to ventriculoperitoneal shunt (VP shunt), which has a high complication rate with significant socio-economic consequences. The authors report the results of ETV performed in the neurosurgical department of FANN teaching hospital in Dakar. <strong>Methods: </strong>This retrospective study presents the results of ETV performed in 513 patients with hydrocephalus of various etiologies, ranging from February 2010 to February 2018. We have included in our series from 2010 to 2016, all patients with clinically revealed non-communicating hydrocephalus followed by a brain computed tomography (CT) scan or brain magnetic resonance imaging (MRI) and who have benefited from an ETV, in which the ETV Success Score was evaluated. <strong>Results:</strong> The mean age of our patients was 14.10 years, with 298 (58%) males. The clinical symptomatology varied in both children and adults and manifested in children as macrocrania in 67.8% of the patients, while in adults, it manifested as raised intracranial pressure (ICP) in 87.5% of patients. A brain CT scan was performed in 461 (89.86%) of patients. The causes of hydrocephalus were dominated in 49% of patients by malformative pathologies, followed by tumors in 41% of patients, infections in 2.33% of patients, and normal-pressure hydrocephalus in 3.8% of patients. During the postoperative period, we found 21.41% of various complications. <strong>Conclusions:</strong> The findings in our series were compared to those in the literature and were satisfactory, thus proving the effectiveness and safety of ventriculocisternostomy in our department. In resource-limited countries, ETV can be performed with good results and less mortality and morbidity.
文摘Background In order to make posterior fossa decompression for the management of Chiari I malformation simple and less invasive while using direct visualization, a novel solely endoscopic procedure has been employed for the decompression of Chiari malformation type I. The objective of this study was to present neural endoscopic posterior fossa decompression and atlas laminectomy for Chiari type I patients. Methods Twenty-one patients with Chiari type I underwent neural endoscopic posterior fossa decompression and atlas laminectomy. We described the procedure for neural endoscopic posterior fossa decompression and atlas laminectomy. All patients in this series demonstrated cerebellar tonsil herniation below the foramen magnum in addition to syringomyelia. All patients in the reviewed study underwent preoperative MRI as well as 3-month postoperative MRI. Additional follow-up MRI varied but was usually repeated 12 months to 18 months after surgery. Postoperative MRI studies were retrospectively reviewed and compared with preoperative studies. Results All patients showed clinical improvements, and none had any complications. Patients with syringomyelia had symptoms entirely disappear. Eleven patients （52.4%） experienced radiographic improvement in syringomyelia （decreased size or resolution） during the follow-up period. Nine patients （42.8%） demonstrated decreased syrinx size and four （19%） demonstrated resolved syrinx. Of the 15 patients with symptomatic syringomyelia, 11 （73.3%） experienced symptomatic improvement. The median time to symptom improvement was four months after surgery. Post surgical MRI examinations indicated complete and sufficient decompression of foramen magnum region. Conclusions Endoscope atlanto-occipital decompression surgery is an innovative, safe and effective surgical procedure. It has similar results compared to traditional surgery, however with the added advantages of being minimal invasive, having fewer complications, decreased influence on stability of occipital bony structure, and a faster recovery as well as reduced hospital stay and expenses.
