Abstract:
:Neurosurgical registrars are frequently called upon by A&E staff and physicians to interpret emergency head CT (computed tomography) scans out of hours. This appears to reflect the reduced threshold for scanning patients and the nonavailability of a radiologist to report these scans. This study was undertaken to assess the safety of such practices. Five neurosurgical registrars, blinded to each other and to the radiology reports, interpreted 50 consecutive emergency head CT scans (both trauma and nontrauma) from the hospital's imaging system as a pilot study. These were initially graded as normal or abnormal. Abnormal scans were assessed for the presence of an intracranial bleed, pneumocephalus, skull fractures, cerebral contusions, mass effect, midline shift, ischaemia or hydrocephalus. The agreement of the observers' recordings with the report issued or approved by a consultant radiologist was evaluated using SPSS Version 13.0. Four of the five registrars assessed a further 150 scans in a similar manner to complete the study. There was a good general agreement between the formal reports and the neurosurgical registrars' identification of normal scans (average Kappa 0.79). The radiology reports and the registrars also agreed well on the presence or absence of intracranial blood, contusions and pneumocephalus (Kappa value > 0.70). The agreement was poorer for ischaemia, mass lesions (other than intracranial haematomas), grey white differentiation, evidence of raised intracranial pressure and midline shift (Kappa < 0.5). Neurosurgical registrars compared well with radiologists when it came to assessing emergency head CT scans as normal or detecting a surgical lesion. The agreement was poorer on subtle abnormalities. The practice of neurosurgical registrars informally 'reporting' on emergency head CT scans cannot be recommended.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Mukerji N,Cahill J,Paluzzi A,Holliman D,Dambatta S,Kane PJdoi
10.1080/02688690902730723subject
Has Abstractpub_date
2009-04-01 00:00:00pages
158-61issue
2eissn
0268-8697issn
1360-046Xpii
909741264journal_volume
23pub_type
杂志文章abstract::Background: Bow hunter's syndrome (BHS), also known as rotational vertebral artery occlusion syndrome, is rare. Occasionally, it combines with dissection/pseudoaneurysm of the ipsilateral VA.Methods: We report a case of BHS combined with ipsilateral VA dissection/pseudoaneurysm and review eight similar cases reported ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1718604
更新日期:2020-02-03 00:00:00
abstract::Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1617407
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:Extra-ventricular neurocytoma (EVN) is rare, mainly described within the cerebral hemispheres or spinal cord. We report a case of sellar neurocytoma presenting with chiasmal compression. CLINICAL PRESENTATION:A 50-year-old woman presented with decreasing vision and a bitemporal field deficit. CT and MRI demo...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.633635
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Our aim was to evaluate the routine use of a pedicled nasoseptal flap (NSF) as a primary repair for intra-operative CSF leaks compared with fat/fascia lata graft and lumbar drain insertion by performing a retrospective review of elective patients undergoing primary trans-sphenoidal surgery from January 200...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.795525
更新日期:2013-12-01 00:00:00
abstract::A process has been developed by which ventriculoperitoneal hydrocephalus shunts, which are prone to bacterial colonisation, can be impregnated with antimicrobials in order to confer antibacterial activity. Concern that their use might be associated with an increased risk of postoperative seizures has been addressed he...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409101187
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:There is a high rate of IDH1/2 mutations in low grade gliomas and in high grade gliomas deriving from them. IDH analysis of gliomas is a novel method of classification and an independent prognostic marker. We compared antibody and sequencing methods for the detection of IDH mutations. METHOD:88 samples fr...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.771139
更新日期:2013-08-01 00:00:00
abstract::We report our experience with five lesions exclusively involving the entire cavernous sinus in which an essentially extradural surgical approach was used. There were two cases of cavernous haemangioma, two cases of meningioma and one case of fungal granuloma. The dural cover of the superior orbital fissure, and mandib...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699746483
更新日期:1997-04-01 00:00:00
abstract::Neurosurgical shunts occasionally act as a conduit for seeding of central nervous system tumours to the abdomen. Retrograde spread of extra-neural tumours to the central nervous system is exceedingly rare. We report the first case of an abdominal primary tumour spreading to the spinal cord via a lumbo-peritoneal shunt...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1679353
更新日期:2020-12-01 00:00:00
abstract::Continuous infusion of intrathecal baclofen (ITB) via a subcutaneously implanted pump has developed over the last 20 years as a powerful tool in the management of spasticity in various adult and paediatric neurological conditions. Acting more focally on spinal GABA receptors, ITB causes fewer systemic side effects tha...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690802233364
更新日期:2008-08-01 00:00:00
abstract::A patient with von Recklinghausen's disease presented with a right sixth nerve palsy. Investigations demonstrated unilateral dolichoectasia of the intracranial carotid artery and sphenoid wing dysplasia. This case demonstrates an association not previously documented, that of unilateral fusiform dilatation of the caro...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409027975
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less po...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.1003026
更新日期:2015-06-01 00:00:00
abstract::Two cases of vertigo with subclavian artery stenosis are presented. In both cases, the angiograms revealed left subclavian artery stenosis at the middle portion of the clavicle as well as kinked origin of the vertebral artery. After resection of the anterior scalene muscle, the stenosis and the vertigo resolved. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688699008992713
更新日期:1990-01-01 00:00:00
abstract::Our aim is to present a typical case of IgG4-related hypophysitis, which will offer insight into the aetiology and pathogenesis of this relatively newly described disease. IgG4 Related Disease is a protean systemic condition that mimics inflammatory, infectious, and malignant processes. Biopsy of affected organs will ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1416061
更新日期:2020-02-01 00:00:00
abstract::Analysis of the management of 7 cases of extradural arachnoid cyst is presented. A brief review of the literature on the subject is presented. Seven cases of extradural arachnoid cysts were treated surgically between the years 1996 to 2002. These patients were analysed retrospectively. The average follow-up period was...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690400012368
更新日期:2004-10-01 00:00:00
abstract::Early changes of the activity of enzymes such as creatine kinase in the cerebrospinal fluid (CSF) or serum are often investigated after head injuries to assess the extent of brain damage and establish a reliable prognosis. The purpose of the present study was to determine levels of creatine kinase isoenzyme CK-BB in t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698808992666
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify independent anatomic, morphologic and hemodynamic features of the ACoA (anterior communicating artery) complex that serve as risk factors for the occurrence of ACoA aneurysms. METHODS:Fifteen consecutive patients with 15 ACoA aneurysms were included. Computational fluid ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1821867
更新日期:2020-09-29 00:00:00
abstract::Background: Cranioplasty (CP) of autologous bone flap after decompressive craniectomy (DC) is known to be associated with a high complication rate, particularly bone flap resorption (BFR). In a retrospective study, we used a novel virtual reality (VR) visualisation technique to identify and evaluate risk factors assoc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1661962
更新日期:2019-12-01 00:00:00
abstract::We have studied 139 cases of intracranial germ cell tumours up to the beginning of 1993, 63.3% of which showed monotypic histological patterns and 36.7% were shown to be mixed tumours. All these cases underwent surgery followed by radiation and/or chemotherapy. All cases of choriocarcinoma died within 2 years. Cases o...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688699550041395
更新日期:1995-01-01 00:00:00
abstract:AIM:To investigate inefficiencies during patients' stay in neurosurgical beds. METHODS:A prospective audit of neurosurgical inpatients was conducted over approximately 2 months. We recorded the causes and duration of inappropriate delays, defined as actions requiring more that 24 h from initiation until completion. R...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701649488
更新日期:2007-12-01 00:00:00
abstract::A case of spontaneous haemorrhage in a cerebellar abscess is reported. Only two reports of this complication have been found in the literature. An incidental acoustic schwannoma was also found close to the abscess. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699008992729
更新日期:1990-01-01 00:00:00
abstract::In March 2015, the Supreme Court's landmark ruling on the common law case of Montgomery vs Lanarkshire Health Board established the doctrine of informed patient consent, setting the legal standards that doctors should abide by. In this review, our primary aim has been to establish whether, despite the well-publicised ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1519111
更新日期:2018-12-01 00:00:00
abstract::A retrospective study was performed to evaluate the rate of infection in free and osteoplastic bone flaps after craniotomy. Two hundred and two craniotomies were performed in 98 cases of tumour, 35 cases of trauma and 69 cases of vascular disease. The overall incidence of infection was 6.4% (13 cases). The infectious ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699008993798
更新日期:1990-01-01 00:00:00
abstract::In this study occipital lobectomies were carried out on 12 foetal lambs on about the 100th day of gestation. Three lambs were born alive and had computed tomographic (CT) scans performed on the 13th or 18th day of life. One lamb was found to have hydrocephalus due to ventriculitis. All three lambs had low attenuation ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698709023777
更新日期:1987-01-01 00:00:00
abstract::The water content of samples of normal and oedematous brain in lobectomy specimens from 16 patients with cerebral tumours has been measured by gravimetry and by wet and dry weighing. Uncorrected gravimetry underestimated the water content of oedematous peritumoural cortex by a mean of 1.17%, and of oedematous peritumo...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688698708999634
更新日期:1987-01-01 00:00:00
abstract::Objective: Mixed growth hormone (GH) and prolactin (PRL) secreting adenomas are the most common type of plurihormonal pituitary adenomas. We assessed the clinical presentations and impacts of transsphenoidal surgery (TS) on patients with mixed GH and PRL adenomas including surgical outcomes, complications, and prognos...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1713989
更新日期:2020-04-01 00:00:00
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journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2013.847172
更新日期:2014-06-01 00:00:00
abstract::We report three patients who deteriorated after lumbar puncture (LP). Two patients were later found to have type іі (a + b) dural arteriovenous fistulas (DAVF) with high flow retrograde venous drainage on cerebral angiography. The third had a type II (a) DAVF. All patients recovered at least partially after DAVF treat...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1639619
更新日期:2019-07-09 00:00:00
abstract::Existing techniques for lengthening a peritoneal catheter require a formal laparotomy, and exploration for the catheter which is then extended by the addition of a necessary length. We describe a simplified technique which is quicker and which in co-operative patients can be done under local anaesthesia on an out-pati...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699208995037
更新日期:1992-01-01 00:00:00
abstract::A case report of a patient who developed cauda equina syndrome following pelvic traction for acute sciatica is presented. A good outcome was obtained with prompt surgical decompression. This case illustrates the potential dangers of traction, which is frequently employed in the management of acute back pain. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/0268869021000007696
更新日期:2002-08-01 00:00:00
abstract::The authors report a case of Paget's disease involving the skull with the rare but severe complications of hydrocephalus and syringomyelia related to basilar impression. Complications of Paget's disease of the skull are briefly discussed and current treatment strategies outlined. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/026886902320909178
更新日期:2002-10-01 00:00:00