Abstract:
BACKGROUND:The semi-sitting position is preferred in some surgeries of the posterior fossa and the cervical spine. At the same time, it is associated with a risk of air embolism. In the presence of a patent foramen ovale (PFO) with an intracardial right-to-left shunt, an air embolism can result in a paradoxical embolism to the heart or brain. It is unclear whether the risk-benefit ratio favors the semi-sitting position in this scenario. METHODS:We conducted a systematic review of the relevant studies published after 2007 by searching the PubMed, Science Direct, and Cochrane Database of Systematic Reviews databases. Studies in which the presence of PFO was stated and the occurrence of paradoxical embolism was evaluated in patients who underwent neurosurgical procedures in the semi-sitting position were included in our analysis. RESULTS:We identified 4 observational studies with a total of 977 patients who underwent surgery of the posterior fossa or cervical spine in the semi-sitting position; among these, 82 had a PFO. Air embolism occurred in 33 of these 82 patients (40.2%). No paradoxical embolisms were detected. CONCLUSIONS:In experienced medical centers, neurosurgery in the semi-sitting position is feasible with acceptable risk even in patients with PFO. If the PFO is large, or if a permanent right-to-left shunt is present in a patient with a history of paradoxical embolism, it may be reasonable to repair the PFO before surgery if the semi-sitting position is strongly preferred. The risk analysis must be done on a case-by-case basis.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Klein J,Juratli TA,Weise M,Schackert Gdoi
10.1016/j.wneu.2018.04.114subject
Has Abstractpub_date
2018-07-01 00:00:00pages
196-200eissn
1878-8750issn
1878-8769pii
S1878-8750(18)30834-9journal_volume
115pub_type
杂志文章,评审abstract:BACKGROUND:This study sought to describe a patient with a slowly progressive cauda equina syndrome (CES) who had imaging findings of the CES that occurs as a rare complication of ankylosing spondylitis (AS), but whose spinal fusion was due to thoracolumbosacral instrumentation, not spondyloarthropathy. METHODS:A 53-ye...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2011.12.014
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Cushing disease, induced by a pituitary adrenocorticotropic hormone (ACTH)-secreting adenoma, is associated with high risk of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations. There...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.02.121
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Sex has been known to significantly affect postoperative complications and length of stay after elective anterior cervical fusions. Current evidence on lumbar spine surgery is limited. METHODS:The 2012-2016 American College of Surgeons National Surgical Quality Improvement Program database was queried using...
journal_title:World neurosurgery
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doi:10.1016/j.wneu.2018.08.097
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2020.06.213
更新日期:2020-10-01 00:00:00
abstract::The insula plays a crucial role in speech planning due to its connections with cortical and subcortical areas. Surgical management of cavernous malformation (CM) of the insula consists of total resection of the lesion and the surrounding gliosis to avoid or reduce seizures. When located in the dominant hemisphere, an ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.10.220
更新日期:2019-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.10.043
更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.11.033
更新日期:2018-03-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.07.163
更新日期:2017-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.043
更新日期:2018-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.05.011
更新日期:2019-08-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-02-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:World neurosurgery
pub_type:
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更新日期:2020-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.02.122
更新日期:2019-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.08.152
更新日期:2017-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 传,历史文章,杂志文章
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更新日期:2013-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.12.180
更新日期:2019-01-12 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.01.028
更新日期:2014-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.03.191
更新日期:2018-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.036
更新日期:2018-05-01 00:00:00