Abstract:
OBJECTIVE:External ventricular drains (EVDs) historically have a high rate of infection, and EVD infections are a cause of significant morbidity and mortality. We have shown previously that a simple infection control protocol reduced the rate of EVD infections during a 3-year period, and the present study examines whether infection rates were durably reduced over an additional 4 years. METHODS:Retrospective analysis of EVDs placed in the intensive care unit of a tertiary neurosurgical center over an additional 4 year follow-up period. RESULTS:In the 4-year follow-up period, 189 EVDs were placed in 173 patients. The previously observed decrease in cerebrospinal fluid culture positivity from 9.8% in the baseline period to 0.8% in the first 3 years of the protocol period continued in the 4-year follow-up period (0%, 0 of 189 EVD placements, 0 per 1000 catheter-days; P < 0.001 compared with baseline). The previously observed decrease in the rate of ventriculitis from 6.3% to 0.8% also continued in the follow-up period (0%, 0 of 189 EVD placements, 0 per 1000 catheter-days; P < 0.001 compared with baseline). Over the total 7 years of protocol use, the rate of culture positivity was 0.3% (1 of 308 EVD placements, 0.29 per 1000 catheter-days) and the rate of ventriculitis was 0.3% (1 of 308 EVD placements, 0.29 per 1000 catheter-days). The only observed infection over 7 years occurred in a patient who removed their own EVD. CONCLUSIONS:A straightforward EVD infection control protocol substantially and durably reduces EVD infections to a near-zero rate.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Flint AC,Toossi S,Chan SL,Rao VA,Sheridan Wdoi
10.1016/j.wneu.2016.12.042subject
Has Abstractpub_date
2017-03-01 00:00:00pages
518-523eissn
1878-8750issn
1878-8769pii
S1878-8750(16)31354-7journal_volume
99pub_type
杂志文章abstract:BACKGROUND:Spinal cord herniation (SCH) is rare, is mostly idiopathic, and occurs predominantly in the thoracic spine. SCH is less common in the cervical spine and has been reported after posterior cervical spine surgery associated with the development of pseudomeningoceles. Two cases of SCH have been reported after an...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.078
更新日期:2017-04-01 00:00:00
abstract::The Foundation for International Education in Neurological Surgery (FIENS) was established in 1969 for the purpose of promoting neurosurgical education and patient care in the developing world. Ghana, the first African site, was adopted in 1989. In 2005 a neurosurgical training program was developed for Ethiopia, Keny...
journal_title:World neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.wneu.2010.03.007
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:The primary treatment for patients with sacral chordoma is en bloc surgical resection with negative margins, which has been shown to reduce local recurrence and tumor-related morbidity. Here we describe the use of intraoperative neuronavigation using preoperative spine magnetic resonance imaging fused to i...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.01.257
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Spinal dural arteriovenous fistulas (SDAVFs) are rare vascular spinal malformations. According to the reported data, surgery seems to result in better occlusion rates than endovascular treatment. However, the post-treatment evolution of neurological symptoms stratified by the treatment remains unknown. The ma...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.005
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Spinal myxopapillary ependymoma (SME), generally considered a benign entity, can exhibit brain and whole-spine metastases as well as local recurrence after surgery. However, the presence of preoperative retrograde intracranial dissemination at the time of diagnosis is very rare. CASE DESCRIPTION:We report a...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.08.169
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Vasospasm developing after subarachnoid hemorrhage (SAH) is an important cause of mortality and morbidity. Lutein is a carotenoid with antioxidant and anti-inflammatory properties. The aim of present study was to investigate effects of lutein on the basilar artery and nerve tissues. METHODS:Wistar rats were ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.07.186
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Ventriculostomy-related infection (VRI) is associated with potential serious morbidity, extended hospitalization duration, increased health care costs, and mortality. We assessed the effectiveness of a pragmatic risk-stratification pathway for external ventricular drain (EVD) management, allowing for surgical...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.11.070
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:The purpose of the present study was to assess for gender-based differences in the usage and cost of maximal nonoperative therapy before spinal fusion surgery in patients with symptomatic lumbar stenosis or spondylolisthesis. METHODS:A large insurance database was queried for patients with symptomatic lumbar...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.08.131
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The mortality index, or the ratio of observed to expected mortality, is a reported quality metric that has been assumed to directly reflect patient care. However, documentation and coding that does not use knowledge of how a reported mortality index is derived could reflect poorly on a hospital or service li...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.10.022
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Congenital spondylolytic spondylolisthesis of C2 vertebra resulting from deficient posterior element of the axis is rarely described in the literature. CASE DESCRIPTION:We describe a unique case of agenesis of posterior elements of C2 with craniovertebral junction anomalies consisting of osseous, vascular, ...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.08.010
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Intracranial mycotic aneurysms are uncommon. They can occur due to extravascular extension or intravascular seeding of the vessel wall. They often result in subarachnoid hemorrhage with poor prognosis. We present a rare case of subarachnoid hemorrhage due to vertebral artery dissection with aproximal anterio...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.06.090
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Nontraumatic carotid artery injury with active extravasation, or carotid blowout syndrome (CBS), is relatively rare and highly difficult to treat because it is difficult to approach the lesions owing to anatomic factors. It also involves quick progression and a risk of cerebral embolization caused by thrombi...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.076
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Recurrence is a major problem in craniopharyngioma (CP) management. Recent study shows that high FABP5/CRABPII may be related to tumor growth and that all-trans retinoic acid (ATRA) may suppress primary CP growth. We studied the expression profile of FABP5 and CRABPII in recurrent CP tissue and...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.05.063
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The anterior-only surgical procedure, including discectomy, open reduction, fusion, and fixation, is a recommended approach in the treatment of cervical facet dislocations. This approach has a reduction failure rate of up to 40%. When it fails, a posterior approach is usually required. OBJECTIVE:To report a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.153
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Middle cerebral artery aneurysms (MCAAs) are regularly treated by both microsurgical clipping and endovascular coiling. We performed a systematic meta-analysis to compare the safety and efficacy of these 2 methods. METHODS:Literature was reviewed for all studies reporting angiographic occlusion and/or functi...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2015.05.073
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Atlanto-occipital transarticular screw fixation (AOTSF) has rarely been reported for fixation of the craniovertebral junction (CVJ). METHODS:A retrospective chart review of all pediatric patients (less than 18 years of age) with an attempt of AOTSF for fixation of traumatic CVJ instability was conducted. R...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.04.129
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Obese and morbidly obese patients undergoing lumbar spinal fusion surgery are a challenge to the operating surgeon. Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open-TLIF have been performed for many years with good results; however, functional outcomes after lumbar spine surgery ...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2014.12.034
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Reports of tuberculosis involving ≥4 contiguous spinal levels are rare. Surgery is often required in this population for neurological decompression and stabilization. These patients appear to be particularly predisposed to complications that include incomplete recovery of neurological function after decompre...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2016.02.026
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:Thrombectomy with aspiration catheters has shown to be effective for treatment of intracranial large vessel occlusion (LVO). We present preclinical evaluation of the safety and efficacy of React68 and React71 (Medtronic PLC, Irvine, CA) catheters in animal models of LVO. METHODS:In vivo evaluation of cathete...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.08.131
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Cervical laminectomy has 2 major disadvantages: postlaminectomy adhesion of dural membrane and lack of a fusion bed. The objective of this study was to determine whether simultaneous cervical laminoplasty with fusion (CLPF) might overcome these unwanted outcomes. METHODS:Patients who underwent CLPF for trea...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.018
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Indications for reconstruction of the common carotid artery (CCA) include trauma, iatrogenic injury, neoplastic growth (such as invasive neck carcinomas), postoperative infection, and cervical carotid aneurysm. Although various techniques and conduits have been described, the clinical scenario may preclude t...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2019.05.215
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Thalamic glioma is a type of midline glioma with poor outcomes. In the present study, we investigated the clinical and molecular features of thalamic gliomas in Chinese patients. METHODS:The data from 26 patients with thalamic glioma who had undergone surgery at Shanghai Huashan Hospital from January 2011 to...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.061
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Currently, no spinal classification system has achieved universal acceptance. Therefore, it is important to choose a reliable classification within clinical practice. The objective of this study was to determine and compare the intraobserver and interobserver agreement of the Load Sharing Classification (LSC)...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.138
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:The pathophysiology of spinal cord injury (SCI) with the information obtained to date has not been elucidated fully. A safe drug or treatment protocol that results in cell regeneration for SCI remains unknown. Neuroprotective and neuroregenerative effects of riluzole, administered after a SCI, have been shown...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.171
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:The endoscopic endonasal approach (EEA) has been increasing in popularity as an alternative to traditional transcranial and transorbital approaches in the treatment of orbital pathological entities. The purpose of the present study was to examine the outcomes of patients who had undergone EEA resection of or...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.04.050
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Patients with intracranial meningiomas can experience neurocognitive dysfunctions in specific cognitive domains depending on tumor location and size. The literature regarding cognitive function surrounding the resection of frontal meningiomas is sparse. METHODS:We performed a prospective matched-control stud...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.10.095
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Granular cell tumor (GCT) is a relatively uncommon predominantly benign lesion that usually presents as a solitary, painless cutaneous or submucosal nodule. Most of these tumors are found in the tongue. Although GCT is believed to have a Schwann cell origin, reports of GCT in peripheral and spinal nerves are...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.10.012
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The growing interest in minimally invasive approaches to the thoracic and lumbar spine is mostly secondary to the high surgical morbidity and complication rates associated with conventional open approaches. The objective was to report the largest series of patients with thoracic and lumbar vertebral osteomye...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.03.172
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Recently, the neuronavigation system (NS) has become an essential intraoperative tool for many neurosurgical procedures, allowing for precise lesion localization. It is particularly important to avoid errors during the navigation process. Here we report a novel technique using palatal positioning of the patie...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.221
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:An increasing body of literature describing use of high-fidelity surgical training models is challenging long-held dogma that cadavers provide the best medium for postgraduate surgical skills training. The purpose of this study was to describe a surgical skills course comprising entirely synthetic training m...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.230
更新日期:2019-07-01 00:00:00