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105 full-text articles. Page 1 of 6.

Endovascular Treatment Of Cervical Myelopathy From Brachiocephalic Venous Stenosis., Craig Schreiber, Alex Anavim, Mark Kotapka, Paul Brady 2020 Philadelphia College of Osteopathic Medicine

Endovascular Treatment Of Cervical Myelopathy From Brachiocephalic Venous Stenosis., Craig Schreiber, Alex Anavim, Mark Kotapka, Paul Brady

Neurosurgery Resident Research

Central venous stenosis is a rare cause of neurologic pathology. Here we present a case of brachiocephalic vein stenosis causing cervical myelopathy through venous engorgement. Our patient was a 51-y/o male who presented with ambulatory dysfunction so he was evaluated for cervical myelopathy. Imaging revealed cord compression from venous engorgement and brachiocephalic vein stenosis. He was treated with angioplasty and vessel stenting which significantly improved flow on postintervention imaging. In conclusion, preoperative vascular imaging should be considered in myelopathic patients as it can detect this rare but dangerous etiology.


Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin 2020 University of Massachusetts Medical School

Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin

GSBS Dissertations and Theses

Background: Mechanical thrombectomy is the gold standard for treating patients with certain acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, even with major advancements and increasing procedural volumes, acute endovascular therapy remains a high-risk procedure with a considerable 90-day mortality rate, affected by a variety of factors.

Purpose: To investigate various clinical and procedural factors associated with 90-day mortality in patients undergoing mechanical thrombectomy for emergent treatment of AIS and determine which of these factors made unique contributions to post-thrombectomy prognosis.

Methods: We examined a prospective registry of 323 patients treated with endovascular thrombectomy for AIS between ...


Improving Patient Safety Through A Postoperative Debriefing Initiative, Ellina Hattar, MD, Monica Young, DNP, MBA, RN, CNOR, Erin Leonetti, RN, Omaditya Khanna, MD, Anthony Stefanelli, MD, James Harrop, MD, Ashwini Sharan MD 2020 Thomas Jefferson University

Improving Patient Safety Through A Postoperative Debriefing Initiative, Ellina Hattar, Md, Monica Young, Dnp, Mba, Rn, Cnor, Erin Leonetti, Rn, Omaditya Khanna, Md, Anthony Stefanelli, Md, James Harrop, Md, Ashwini Sharan Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

Effective and clear communication in the operating room is a necessary aspect of any surgery. Every member of the operative team is integral in fostering an environment focused on patient safety. As such, the institution of a postoperative debrief session may allow for feedback from every member of the team that will ultimately aid in improving a patient’s experience.


Standardizing Postoperative Handoffs Using The Evidence-Based Ipass Framework Improves Handoff Communication For Postoperative Neurosurgical Patients In The Neuro-Intensive Care Unit, Richard F. Schmidt, MD, Matthew D. Vibbert, MD, Coleen A. Vernick, DO, Andrew M. Mendelson, DO, Caitlin Harley, MSN, Giuliana Labella, MSN, Jessica Houser, BSN, Patrick Becher, BSN, Erin Simko, BSN, Pascal M. Jabbour, MD, Stavropoula I. Tjoumakaris, MD, M. Reid Gooch, MD, Ashwini D. Sharan, MD, Christopher J. Farrell, MD, James S. Harrop, MD, Robert H. Rosenwasswer, MD, Rebecca C. Jaffe, MD, Jack Jallo, MD 2020 Thomas Jefferson University

Standardizing Postoperative Handoffs Using The Evidence-Based Ipass Framework Improves Handoff Communication For Postoperative Neurosurgical Patients In The Neuro-Intensive Care Unit, Richard F. Schmidt, Md, Matthew D. Vibbert, Md, Coleen A. Vernick, Do, Andrew M. Mendelson, Do, Caitlin Harley, Msn, Giuliana Labella, Msn, Jessica Houser, Bsn, Patrick Becher, Bsn, Erin Simko, Bsn, Pascal M. Jabbour, Md, Stavropoula I. Tjoumakaris, Md, M. Reid Gooch, Md, Ashwini D. Sharan, Md, Christopher J. Farrell, Md, James S. Harrop, Md, Robert H. Rosenwasswer, Md, Rebecca C. Jaffe, Md, Jack Jallo, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

Within one year of initiation of the process improvement plan, we wanted to improve:

  • Direct communication of airway and hemodynamic concerns
  • Direct communication of operative events, complications, and perioperative management goals.
  • Attendance at postoperative handoffs
  • Confirmation of information by receiving teams
  • Staff perceptions of handoff efficacy and teamwork.


Implementing A Surgical Pre-Operative Checklist: Improving Transparency & Communication, Ritam Ghosh, MD, James Harrop, MD, Jesse Edwards, MD 2020 Thomas Jefferson University

Implementing A Surgical Pre-Operative Checklist: Improving Transparency & Communication, Ritam Ghosh, Md, James Harrop, Md, Jesse Edwards, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Our goal was to first analyze what the current practice was and if there was a need for improvement. To our knowledge, each surgical service has its own preop protocol and this is not standardized across the hospital. Furthermore, very few services have EPIC based protocols that allow for documentation and information sharing. For example, the neurosurgery service uses paper checklists, a style that is effective yet outdated.

A survey was sent out to multiple departments in order to gauge the current landscape of pre-operative care. Questions were posed to analyze if there was a need for improved documentation by ...


Improving Serial Imaging Protocols In Spontaneous Intracerebral Hemorrhage, Kevin Hines, MD, Nikolaos Mouchtouris, MD, Fadi al-Saiegh, MD, Karim Hafazalla, Jacob Mazza, Giuliana Labella, Muhammad K. Athar, MD, Adam Flanders, MD, M. Reid Gooch, MD, Stavropoula Tjoumakaris, MD, Robert H. Rosenwasswer, MD, Pascal Jabbour, MD 2020 Thomas Jefferson University

Improving Serial Imaging Protocols In Spontaneous Intracerebral Hemorrhage, Kevin Hines, Md, Nikolaos Mouchtouris, Md, Fadi Al-Saiegh, Md, Karim Hafazalla, Jacob Mazza, Giuliana Labella, Muhammad K. Athar, Md, Adam Flanders, Md, M. Reid Gooch, Md, Stavropoula Tjoumakaris, Md, Robert H. Rosenwasswer, Md, Pascal Jabbour, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

Aim to decrease unnecessary use of serial imaging in sICH patients.

  • This project plans to decrease the number of scans in this patient population while increasing faculty/staff satisfaction and efficiency of resource utilization.
  • The goal is to decrease HCT utilization by 20% without compromising patient care or decision making.
  • After finalizing and approving the HCT protocol, implementation of a trial period for two


The Utility Of Cervical Spine Bracing As A Postoperative Adjunct To Multilevel Anterior Cervical Spine Surgery, Ian F. Caplan, Saurabh Sinha, Benjamin Osiemo, Scott McClintock, James M. Schuster, Harvey Smith, Gregory Glauser, Nikhil Sharma, Ali K. Ozturk, Zarina S. Ali, Neil R. Malhotra 2020 University of Pennsylvania

The Utility Of Cervical Spine Bracing As A Postoperative Adjunct To Multilevel Anterior Cervical Spine Surgery, Ian F. Caplan, Saurabh Sinha, Benjamin Osiemo, Scott Mcclintock, James M. Schuster, Harvey Smith, Gregory Glauser, Nikhil Sharma, Ali K. Ozturk, Zarina S. Ali, Neil R. Malhotra

Mathematics Faculty Publications

Background: Use of cervical bracing/collar subsequent to anterior cervical spine discectomy and fusion (ACDF) is variable. Outcomes data regarding bracing after ACDF are limited. Here, we study the impact of bracing on short-term outcomes related to safety, quality of care, and direct costs in multilevel ACDF.

Methods: Retrospective cohort analyses of all consecutive patients undergoing multilevel ACDF with or without bracing from 2013 to 2017 was undertaken (n = 616). Patient demographics and comorbidities were analyzed. Tests of independence and logistic regressions were used to assess differences in length of stay (LOS), discharge disposition (home, assisted rehabilitation facility [ARF], or ...


Expression Of Cytokines And Chemokines As Predictors Of Stroke Outcomes In Acute Ischemic Stroke, Sarah R. Martha, Qiang Cheng, Justin F. Fraser, Liyu Gong, Lisa A. Collier, Stephanie M. Davis, Doug Lukins, Abdulnasser Alhajeri, Stephen Grupke, Keith R. Pennypacker 2020 University of Washington

Expression Of Cytokines And Chemokines As Predictors Of Stroke Outcomes In Acute Ischemic Stroke, Sarah R. Martha, Qiang Cheng, Justin F. Fraser, Liyu Gong, Lisa A. Collier, Stephanie M. Davis, Doug Lukins, Abdulnasser Alhajeri, Stephen Grupke, Keith R. Pennypacker

Institute for Biomedical Informatics Faculty Publications

Introduction: Ischemic stroke remains one of the most debilitating diseases and is the fifth leading cause of death in the US. The ability to predict stroke outcomes within the acute period of stroke would be essential for care planning and rehabilitation. The Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC; clinicaltrials.gov NCT03153683) study collects arterial blood immediately distal and proximal to the intracranial thrombus at the time of mechanical thrombectomy. These blood samples are an innovative resource in evaluating acute gene expression changes at the time of ischemic stroke. The purpose of this study was to identify inflammatory genes ...


Pediatric Brainstem Gliomas: An Institutional Experience, Altaf Ali Laghari, Mirza Zain Baig, Muhammad Ehsan Bari, Aneela Darbar, Naureen Mushtaq, Umme e Hani Abdullah, Daniya Aziz Khan 2019 Aga Khan University

Pediatric Brainstem Gliomas: An Institutional Experience, Altaf Ali Laghari, Mirza Zain Baig, Muhammad Ehsan Bari, Aneela Darbar, Naureen Mushtaq, Umme E Hani Abdullah, Daniya Aziz Khan

Section of Neurosurgery

Objective: The aim of this study was to analyze the clinical profiles and outcomes of pediatric brainstem gliomas treated at our institute.
Methodology: We reviewed the files of 18 pediatric age group patients diagnosed with brainstem glioma at our institution. The following variables were recorded: age, sex, duration of symptoms, date of diagnosis, main clinical symptoms, Karnofsky performance status score, magnetic resonance imaging findings, histopathology findings, details of the treatment given, disease progression, and date of mortality/last follow-up. This data were then transferred to SPSS version 23 which was used for further analysis.
Results: The mean age of our ...


Current Management Of Glioma In Pakistan, Umme e Hani Abdullah, Altaf Ali Laghari, Muhammad Usman Khalid, Huzaifa Bin Rashid, Fatima Ali, Adnan Jabbar, Asim Hafiz, Muhammad Shahzad Shamim, Ather Enam 2019 Aga Khan University

Current Management Of Glioma In Pakistan, Umme E Hani Abdullah, Altaf Ali Laghari, Muhammad Usman Khalid, Huzaifa Bin Rashid, Fatima Ali, Adnan Jabbar, Asim Hafiz, Muhammad Shahzad Shamim, Ather Enam

Section of Neurosurgery

To date, information on the management of specific neurosurgical tumors, such as glioma, in Pakistan remains scattered and scarce. Our review synthesizes the predicaments of glioma management routinely presented to the neurosurgery, medical oncology, radiation oncology, and radiology departments in Pakistan. Expert opinions were integrated from each of the relevant fields in the form of personal citations. The data presented in our review were collected from various PubMed and non-PubMed indexed articles, coupled with various health reports from the Government of Pakistan along with the World Health Organization. Through these data, it was postulated that the utilization of innovative and ...


Pituitary Adenoma With Calcifications: A Case Report, Yakoot Khan, Noor Malik, Saba Iqbal Awan, Syed Hassan Khalid, Altaf Ali Laghari 2019 Aga Khan University

Pituitary Adenoma With Calcifications: A Case Report, Yakoot Khan, Noor Malik, Saba Iqbal Awan, Syed Hassan Khalid, Altaf Ali Laghari

Section of Neurosurgery

Pituitary adenomas and Rathke’s cleft cyst with calcification are rarely seen and craniopharyngioma still remains the common sellar suprasellar space occupying lesion with calcification. Presence of calcification is reported in pituitary adenoma in only 0.2% to 8% cases. The pituitary adenoma with calcification is a rare radiological finding and it must be distinguished from other lesions of the pituitary gland as the management and prognosis differs significantly. We report a case of a 29-year-old gentleman presented electively with the complaints of deterioration of vision for four months. CT-scan without contrast examination revealed pituitary adenoma with calcification. The patient ...


Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak 2019 Aga Khan University

Timing Of Postoperative Magnetic Resonance Imaging (Mri) Following Glioma Resection: Shattering The 72 Hour Window, Syed Sarmad Bukhari, Muhammad Shahzad Shamim, Fatima Mubarak

Section of Neurosurgery

Extent of enhancing tumour resection is correlated with progression free survival following glioma surgery. Historically, a contrast enhanced MRI has been recommended within 72 hours following surgery to evaluate for residual disease. This theoretical window was established amidst conflicting evidence to avoid reactive enhancement. Recent studies with better designs and better imaging quality have sought to challenge this window with a more pragmatic method of evaluating residual disease.


Emergency Care Surveillance And Emergency Care Registries In Low-Income And Middle-Income Countries: Conceptual Challenges And Future Directions For Research, Hani Mowaf, Christine Ngaruiya, Gerard O'Reilly, Olive Kobusingye, Vikas Kapil, Andres Rubiano, Marcus Ong, Juan Carlos Puyana, AKM Fazlur Rahman, Rashid Jooma, Blythe Beecrof, Junaid Razzak 2019 Yale University School of Medicine, New Haven, Connecticut, USA.

Emergency Care Surveillance And Emergency Care Registries In Low-Income And Middle-Income Countries: Conceptual Challenges And Future Directions For Research, Hani Mowaf, Christine Ngaruiya, Gerard O'Reilly, Olive Kobusingye, Vikas Kapil, Andres Rubiano, Marcus Ong, Juan Carlos Puyana, Akm Fazlur Rahman, Rashid Jooma, Blythe Beecrof, Junaid Razzak

Section of Neurosurgery

Despite the fact that the 15 leading causes of global deaths and disability-adjusted life years are from conditions amenable to emergency care, and that this burden is highest in low-income and middle-income countries (LMICs), there is a paucity of research on LMIC emergency care to guide policy making, resource allocation and service provision. A literature review of the 550 articles on LMIC emergency care published in the 10-year period from 2007 to 2016 yielded 106 articles for LMIC emergency care surveillance and registry research. Few articles were from established longitudinal surveillance or registries and primarily composed of short-term data collection ...


Endoscopic Transsphenoidal Surgery For Cushing's Disease: A Review, Mirza Zain Baig, Altaf Ali Laghari, Aneela Darbar, Umme e Hani Abdullah, Sumiya Abbasi 2019 Ruggles Biomedical Research Institute, Danbury, USA.

Endoscopic Transsphenoidal Surgery For Cushing's Disease: A Review, Mirza Zain Baig, Altaf Ali Laghari, Aneela Darbar, Umme E Hani Abdullah, Sumiya Abbasi

Section of Neurosurgery

Ever since the 1960s, transsphenoidal surgery has been the modality of choice for treating Cushing's disease. Subsequent visualization of the pituitary fossa and sphenoid sinus may be done either with the operating microscope or with the relatively new endoscope. The endoscope due to its panoramic view allows greater visualization as compared to the operating microscope. It confers greater access to the cavernous sinus, sella, suprasellar, and parasellar regions and accommodates higher magnifications. It is bi-dimensional, however as opposed to the operating microscope that provides a three-dimensional view and allows greater depth perception. This article provides a comprehensive review of ...


Effect Of Pregnancy On Growth Of Intracranial Meningiomas, Ayesha Quddusi, Muhammad Shahzad Shamim, Quratulain Virani 2019 Aga Khan University

Effect Of Pregnancy On Growth Of Intracranial Meningiomas, Ayesha Quddusi, Muhammad Shahzad Shamim, Quratulain Virani

Section of Neurosurgery

Meningiomas are the most common benign primary intracranial tumours in adults. Their rapid growth during pregnancy has been well reported. Moreover, the relationship of increased progesterone expression during pregnancy and extensive tumour growth has been debated. In this review, we discuss not only the effect of progesterone on meningiomal growth but also other mechanisms involved in gestational meningiomas.


Serum Biomarkers For Glioblastoma Multiforme, Ayesha Quddusi, Muhammad Shahzad Shamim 2019 Aga Khan University

Serum Biomarkers For Glioblastoma Multiforme, Ayesha Quddusi, Muhammad Shahzad Shamim

Section of Neurosurgery

A number of different serum biomarkers are currently being evaluated for their potential use as diagnostic and prognostic biomarkers in Glioblastoma Multiforme. Amongst these, a vast number of different microRNAs have been studied, that are up-regulated or downregulated in relation to Glioblastoma Multiforme. Different studies have found numerous associations of these different microRNAs with recurrence, Karnofsky Performance Score, Progression Free Survival and Overall Survival. Other than microRNAs, serum Glial Fibrillary Acid Protein, cytokines and YLK-40, as well as a number of other candidate serum biomarkers are being studied.More studies, with larger sample sizes are required before these serum biomarkers ...


Early Versus Delayed Flow Diversion For Ruptured Intracranial Aneurysms: A Meta-Analysis, Rimal Hanif Dossani, Devi P. Patra, Jennifer Kosty, Fareed Jumah, Okkes Kuybu, Nasser Mohammed, Muhammad Waqas, Muhammad Riaz, Hugo Cuellar 2019 Louisiana State University Health Sciences Center, Louisiana, USA.

Early Versus Delayed Flow Diversion For Ruptured Intracranial Aneurysms: A Meta-Analysis, Rimal Hanif Dossani, Devi P. Patra, Jennifer Kosty, Fareed Jumah, Okkes Kuybu, Nasser Mohammed, Muhammad Waqas, Muhammad Riaz, Hugo Cuellar

Section of Neurosurgery

Objective: The use and timing of flow diversion for aneurysmal subarachnoid hemorrhage is controversial. The objective of this study is to perform a meta-analysis and systematic review to compare overall complication rate between early versus delayed flow diversion for ruptured aneurysms.
Methods: A literature search for all eligible articles was performed using PubMed, Cochrane, and Web of Science databases. The primary outcome was the overall complication rate (any complication in the perioperative period), and secondary outcomes were 1) hemorrhage and 2) stroke/death (all hemorrhagic/ischemic strokes and/or death).
Results: Thirteen articles including 142 patients met inclusion criteria. Eighty-nine ...


Need Of Physical And Chemical Restraints: Experiences At Inpatient Psychiatric Ward In A Tertiary Care Hospital In Karachi, Pakistan, Humera Saeed, M. Shameel Khan, Syeda Maheen Batool, Asma Akbar Ladak, Nadia Karim, Rabeeka Aftab 2019 Aga Khan University

Need Of Physical And Chemical Restraints: Experiences At Inpatient Psychiatric Ward In A Tertiary Care Hospital In Karachi, Pakistan, Humera Saeed, M. Shameel Khan, Syeda Maheen Batool, Asma Akbar Ladak, Nadia Karim, Rabeeka Aftab

Department of Psychiatry

In psychiatry, agitated / aggressive patients are often treated with de-escalation techniques. If this does not work, physical or chemical restrains are required; but in the event of resistance, seclusion is applied. We report the findings of baseline study of experiences of physical and chemical restraints in a tertiary care hospital in Karachi, where 104 files were evaluated retrospectively. The mean age of patients was 32.5 ±14.3 years with 54.8% men, while the average length of stay was 11.5 ±9.3 days. Agitation, violent behaviour, and aggression were the most common indications for restraints. In total, 94 ...


Freehand Pedicle Screw Fixation: A Safe Recipe For Dorsal, Lumbar And Sacral Spine, Muhammad Junaid, Ali Afzal, Anisa Kalsoom, Syed Sarmad Bukhari 2019 PNS Shifa Hospital, Karachi

Freehand Pedicle Screw Fixation: A Safe Recipe For Dorsal, Lumbar And Sacral Spine, Muhammad Junaid, Ali Afzal, Anisa Kalsoom, Syed Sarmad Bukhari

Section of Neurosurgery

Objective: To determine outcome of freehand pedicle screw fixation for dorsal, lumbar and sacral fractures at a tertiary care centre in the developing world.
Methods: A retrospective review was performed of 150 consecutive patients who underwent pedicle screw fixation from January 1, 2012 to 31st December 2017. A total of 751 pedicle screws were placed. Incidence and extent of cortical breach by misplaced pedicle screw was determined by review of intra-operative and post-operative radiographs and/or computed tomography.
Results: Among the total 751 free hand placed pedicle screws, four screws (0.53%) were repositioned due to a misdirected trajectory ...


Enhanced Recovery After Elective Craniotomy For Brain Tumours, Ummey Hani, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim 2019 Aga Khan University

Enhanced Recovery After Elective Craniotomy For Brain Tumours, Ummey Hani, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Enhanced recovery after surgery (ERAS) is aimed at accelerated rehabilitation after surgery, and involves a multidisciplinary approach. Significant work has been published on this concept with regards to abdominal surgeries, however, the idea is relatively new for those undergoing neurosurgical procedures. We have reviewed literature on ERAS in patients undergoing craniotomy for brain tumours.


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