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    Preferred view and transducer in lumbar ultrasound in overweight and obese patients.
    Ultrasound 2017 Feb 7;25(1):45-52. Epub 2017 Feb 7.
    Emergency Medicine Department, Tehran University of Medical Sciences, Tehran, Iran.
    Background: Ultrasound can be used to facilitate lumbar puncture, especially in obese patients.

    Methods: In this study, midline and paramedian approaches with curved and linear transducers were compared in patients with Body Mass Index (BMI) above 25 kg/m(2) for the identification of spinal landmarks. In each view, six major landmarks, including spinous process, ligamentum flavum, laminae, epidural space, subarachnoid space and posterior longitudinal ligament, were detected by emergency medicine residents and were then reviewed by radiologists. Read More

    Development of artificial tissue-like structures for a hybrid epidural anesthesia simulator.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2099-2102
    Puncturing the epidural space and lumbar puncture are common procedures in anesthesia. They are carried out blind, where a needle is advanced from posterior between two adjacent vertebrae. Two different approaches are common practice for this technique, the midline and the paramedian one. Read More

    Ultrasound as a safe and reliable guidance for subarachnoid puncture in rabbits.
    Acta Cir Bras 2017 Jan;32(1):14-21
    PhD, Full Professor, Department of Anesthesiology, UNESP, Botucatu-SP, Brazil. Intellectual and scientific content of the study, manuscript writing, critical revision.
    Purpose:: To evaluate a model for studying the toxicity in nervous tissue and meninges using ultrasound to guide needle insertion into the subarachnoid space of rabbits, with the objective of avoiding injuries triggered by the puncture and by intraneural injection of solutions.

    Methods:: Forty-five adult female rabbits were divided into 3 groups (G): G1 underwent subarachnoid puncture, G2 underwent subarachnoid injection of saline solution and G3 underwent subarachnoid injection of 0.5% hyperbaric bupivacaine. Read More

    Incidence and Outcomes of Central Nervous System Hemophagocytic Lymphohistiocytosis Relapse after Reduced Intensity Conditioning Hematopoietic Stem Cell Transplant.
    Biol Blood Marrow Transplant 2017 Feb 17. Epub 2017 Feb 17.
    Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center.
    Hemophagocytic Lymphohistiocytosis (HLH) is an immune regulatory disorder that commonly presents with CNS involvement. The only cure for genetic HLH is hematopoietic stem cell transplantation (HSCT), typically treated with reduced intensity conditioning (RIC) regimens. We sought to estimate the incidence of CNS relapse after RIC HSCT, determine risk factors, and evaluate outcomes. Read More

    Subdural hematoma occurred after spinal anesthesia in a human immunodeficiency virus-infected patient.
    Saudi J Anaesth 2017 Jan-Mar;11(1):102-105
    Department of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Seoul, Korea.
    A 25-year-old male patient who was infected with human immunodeficiency virus (HIV) underwent a condyloma excision under spinal anesthesia. The patient complained of suspicious postdural puncture headache. The patient did not respond to conservative management. Read More

    Automated pressure-controlled cerebrospinal fluid drainage during open thoracoabdominal aortic aneurysm repair.
    J Vasc Surg 2017 Feb 16. Epub 2017 Feb 16.
    Vascular Surgery Unit, San Raffaele Scientific Institute, "Vita-Salute" University, Milan, Italy.
    Objective: Perioperative cerebrospinal fluid (CSF) drainage is a well-established technique for spinal cord protection during thoracoabdominal aortic aneurysm (TAAA) open repair and is usually performed using dripping chamber-based systems. A new automated device for controlled and continuous CSF drainage, designed to maintain CSF pressure around the desired set values, thus avoiding unnecessary drainage, is currently available. The aim of our study was to determine whether the use of the new LiquoGuard automated device (Möller Medical GmbH, Fulda, Germany) during TAAA open repair was safe and effective in maintaining the desired CSF pressure values and whether the incidence of complications was reduced compared with a standard catheter connected to a dripping chamber. Read More

    A Rare Case of Pediatric Lumbar Spinal Ependymoma Mimicking Meningitis.
    World Neurosurg 2017 Feb 12. Epub 2017 Feb 12.
    Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address:
    Spontaneous acute subarachnoid hemorrhage (SAH) from lumbar ependymoma in children is rare. We report a case of a14-year-old boy who developed sudden radicular low back pain while playing baseball. He was initially managed conservatively in a local hospital for suspected lumbar disc herniation, but later developed meningeal symptoms and fever before being referred to our hospital. Read More

    Psychosis in the ED: A case of NMDA receptor antibody encephalitis.
    Am J Emerg Med 2017 Feb 6. Epub 2017 Feb 6.
    University of Arizona, College of Medicine, Department of Emergency Medicine, Tucson, AZ, USA.
    Anti-N-methyl-d-aspartate antibody receptor (NMDAR) encephalitis is a newly recognized disease increasing in diagnostic frequency. A 27-year-old female presented with symptoms of oral dyskinesia, tachycardia, and altered mental status following a three-month history of depression, lethargy, catatonia, and auditory hallucinations. We utilized our facilities neurology and psychiatry consult services, performed a lumbar puncture (LP), and requested NMDAR antibody titers. Read More

    Screening for asymptomatic neurosyphilis in HIV patients after treatment of early syphilis: an observational study.
    Sex Transm Infect 2017 Feb 14. Epub 2017 Feb 14.
    Department of Sexual Health and HIV, North Manchester General Hospital (Pennine Acute Hospitals NHS Trust), Crumpsall, Manchester, UK.
    Objective: To determine the prevalence of asymptomatic neurosyphilis (ANS) in HIV-positive individuals after treatment of early syphilis with single-dose benzathine penicillin G (BPG) or oral antibiotic alternatives.

    Methods: Patients at high risk of neurosyphilis (defined by serum rapid plasma reagin (RPR) titre ≥1:32 and/or peripheral blood CD4 lymphocyte count ≤350/μL) underwent lumbar puncture (LP) at a median time of 8.2 months post treatment. Read More

    In vivo images of the epidural space with two- and three-dimensional optical coherence tomography in a porcine model.
    PLoS One 2017 14;12(2):e0172149. Epub 2017 Feb 14.
    Department of Anesthesiology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
    Background: No reports exist concerning in vivo optical coherence tomography visualization of the epidural space and the blood patch process in the epidural space. In this study, we produced real-time two-dimensional and reconstructed three-dimensional images of the epidural space by using optical coherence tomography in a porcine model. We also aimed to produce three-dimensional optical coherence tomography images of the dura puncture and blood patch process. Read More

    Brief Report: Flow Rate of Cerebrospinal Fluid Through a Spinal Needle Can Accurately Predict Intracranial Pressure in Cryptococcal Meningitis.
    J Acquir Immune Defic Syndr 2017 Mar;74(3):e64-e66
    *Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; †Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and ‡Department of Medicine, Khayelitsha District Hospital, Cape Town, South Africa.
    Background: Patients with HIV-associated cryptococcal meningitis (CM) commonly present with raised intracranial pressure (ICP). Aggressive management of raised ICP reduces mortality but requires manometers, which are unavailable in most resource-limited settings. The law of Poiseuille states that the rate of flow of liquid through a tube is directly proportional to the difference in pressure between each end, and it may be possible to indirectly determine ICP by measuring flow of CSF through a spinal needle rather than using a manometer. Read More

    General anesthesia with a native airway for patients with mucopolysaccharidosis type III.
    Paediatr Anaesth 2017 Feb 8. Epub 2017 Feb 8.
    Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
    Background: Mucopolysaccharidosis type III is a progressive disease with worsening airway, pulmonary, and cardiac involvement that may complicate anesthetic care.

    Aim: To prospectively evaluate the incidence of airway issues and complications during magnetic resonance imaging (MRI) and lumbar puncture (LP) during general anesthesia with a native airway for patients with mucopolysaccharidosis type III.

    Method: The study was a part of the natural history study. Read More

    Management of a Ventral Cerebrospinal Fluid Leak With a Lumbar Transforaminal Epidural Blood Patch in a Child With Persistent Postdural Puncture Headache: A Case Report.
    Reg Anesth Pain Med 2017 Mar/Apr;42(2):263-266
    From the *Department of Anesthesiology, Perioperative and Pain Medicine, †Department of Pediatric Radiology, and ‡Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
    Objective: Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural blood patches fail to eliminate PDPH, diagnostic evaluation should be performed and alternative treatment sought. Read More

    Rosai-Dorfman disease of the subdural spine with a long segment lesion: A case report and literature review.
    J Int Med Res 2017 Jan 1:300060516687228. Epub 2017 Jan 1.
    1 Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
    Rosai-Dorfman disease (RDD) or sinus histiocytosis with massive lymphadenopathy is a rare benign disorder usually characterized by massive painless cervical lymphadenopathy and systemic manifestations. Extranodal involvement, especially spinal involvement, is extremely rare. We report a 41-year-old man who presented with only intermittent dorsodynia. Read More

    An algorithmic approach to the management of unrecognized hydrocephalus in pediatric candidates for intrathecal baclofen pump implantation.
    Surg Neurol Int 2016 20;7:105. Epub 2016 Dec 20.
    Department of Neurosurgery, Seattle Children's Hospital, Seattle, Washington, USA.
    Background: Complications of intrathecal baclofen (ITB) pump implantation for treatment of pediatric patients with spasticity and dystonia associated with cerebral palsy remain unacceptably high. To address the concern that some patients may have underlying arrested hydrocephalus, which is difficult to detect clinically because of a low baseline level of neurological function, and may contribute to the high rates of postoperative cerebrospinal fluid leak, wound breakdown, and infection associated with ITB pump implantation, the authors implemented a standardized protocol including mandatory cranial imaging and assessment of intracranial pressure (ICP) by lumbar puncture prior to ITB pump implantation.

    Methods: A retrospective case series of patients considered for ITB pump implantation between September 2012 and October 2014 at Seattle Children's Hospital is presented. Read More

    Analysis of serum interleukin-27 and interleukin-35 concentrations in patients with Guillain-Barré syndrome.
    Clin Chim Acta 2017 Feb 4;468:5-9. Epub 2017 Feb 4.
    Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China. Electronic address:
    Backgrounds: Guillain-Barré syndrome (GBS) is a postinfectious immune-mediated peripheral neuropathy. Interleukin (IL)-27 and IL-35 have been recognized as novel members of IL-12 family. We evaluated the serum and cerebral spinal fluid (CFS) concentrations of IL-27 and IL-35 in GBS and analyze their correlations with clinical characteristics. Read More

    Image-guided intrathecal baclofen pump catheter implantation: a technical note and case series.
    J Neurosurg Spine 2017 Feb 3:1-7. Epub 2017 Feb 3.
    Radiology, Boston Children's Hospital.
    OBJECTIVE Medically refractory spasticity and dystonia are often alleviated with intrathecal baclofen (ITB) administration through an indwelling catheter inserted in the lumbar spine. In patients with cerebral palsy, however, there is a high incidence of concomitant neuromuscular scoliosis. ITB placement may be technically challenging in those who have severe spinal deformity or who have undergone prior instrumented thoracolumbar fusion. Read More

    Sudden paraplegia after lumbar puncture as a clue in the diagnosis of a patient with spinal dural arteriovenous fistula.
    Eur Spine J 2017 Feb 1. Epub 2017 Feb 1.
    Neurology Department, Hospital Universitario Central de Asturias, Avenida de Roma S/N, 33011, Oviedo, Asturias, Spain.
    Purpose: Spinal dural arteriovenous fistula (SDAVF) is manifested as congestive myelopathy with progressive motor, sensory and urinary symptoms. Sometimes, clinical picture and magnetic resonance imaging of the spinal cord are not specific and the diagnosis becomes troublesome.

    Methods: We present a 68-year-old male with a progressive paraparesis of unknown etiology over the course of 12 months. Read More

    [In situ broken 27-gauge spinal needle in a repeated caesarean delivery : Case report and literature review].
    Anaesthesist 2017 Feb 24;66(2):115-121. Epub 2017 Jan 24.
    Klinik für Anästhesiologie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
    We report the rare case of an in situ fracture of a spinal needle within the setting of repeated caesarean delivery in a 28-year-old pregnant woman and discuss the responsible underlying factors. In particular, a wrong technique, limited experience, difficulties to identify the anatomical landmarks, as well as the use of spinal needles smaller than 25 G might promote such a complication. In order to ensure the stability of the spinal needle and to avoid an in situ fracture, the spinal needle should be never moved without the stylet. Read More

    Homovanillic acid in CSF of mild stage Parkinson's disease patients correlates with motor impairment.
    Neurochem Int 2017 Jan 18. Epub 2017 Jan 18.
    Movement Disorders Centre, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
    In Parkinson's disease (PD), several efforts have been spent in order to find biochemical parameters able to identify the progression of the pathological processes at the basis of the disease. It is already known that advanced PD patients manifesting dyskinesia are featured by the high homovanillic acid (HVA)/dopamine (DA) ratio, suggesting the increased turnover of DA in these patients. Less clear is whether similar changes affect mild and moderate stages of the disease (between 1 and 2. Read More

    Pseudotumour cerebri in children: Aetiology, clinical features, and progression.
    Neurologia 2017 Jan 9. Epub 2017 Jan 9.
    Unidad de Neuropediatría, Servicio de Pediatría, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
    Introduction: The definition, associated aetiologies, diagnosis, and treatment of idiopathic intracranial hypertension, or pseudotumour cerebri (PTC), are constantly being revised in the paediatric population.

    Objectives And Methods: Our study included children younger than 15 years old with PTC and attended at a reference hospital in the past 12 years. We analysed the clinical and epidemiological features of our sample and the diagnostic and treatment approaches. Read More

    Optimal Angle of Contralateral Oblique View in Cervical Interlaminar Epidural Injection Depending on the Needle Tip Position.
    Pain Physician 2017 Jan-Feb;20(1):E169-E175
    College of Medicine, Ulsan University, Seoul, Republic of Korea.
    Background: Chronic neck and upper extremity pain associated with cervical origin is common, and cervical interlaminar epidural steroid injections (CILESIs) are frequently used to manage the symptoms of cervical spinal disorders. However, CILESIs are associated with risks such as dural puncture and cord injury.

    Objectives: We aimed to determine the optimal needle tip visualization, in order to minimize CILESIs-induced complications. Read More

    Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques: A Randomized Clinical Trial.
    Anesth Analg 2017 Feb;124(2):560-569
    From the *Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada; †Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ‡Harvard Medical School, Boston, Massachusetts; §Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts; and [REPLACEMENT CHARACTER]Department of Anesthesiology, University of Texas Medical Branch, Galveston, Texas.
    Background: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques. Read More

    Should procedural skills be a part of the Acute Care Nurse Practitioner curriculum?
    Nurse Educ Today 2017 Mar 22;50:115-118. Epub 2016 Dec 22.
    Rutgers University School of Nursing, Newark, NJ 07107, United States.
    Invasive procedures are an integral component of the time sensitive management of the acute and critically ill patients. Acute Care Nurse Practitioner (ACNP) students aspiring to be employed in their roles in the acute care settings cannot be autonomous in their practices unless they have a minimum level of proficiency to perform life sustaining invasive procedures. Offering additional level of benefits of safety and quality in healthcare, simulation as a teaching method has grown in popularity among various levels of education among variety of disciplines. Read More

    Combined spinal-epidural anesthesia with hypobaric ropivacaine in sitting position significantly increases the incidence of hypotension in parturients undergoing cesarean section.
    J Obstet Gynaecol Res 2016 Dec 27. Epub 2016 Dec 27.
    Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
    Aim: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine.

    Methods: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups. Read More

    Impact of obesity on post-dural puncture headache.
    Int J Obstet Anesth 2016 Oct 29. Epub 2016 Oct 29.
    Department of Anesthesiology, Montefiore Medical Center, New York, NY, USA.
    Introduction: Previous studies have suggested an inverse relationship between obesity and development of dural puncture headache following spinal anesthesia. However, few have investigated the relationship between obesity and headaches after accidental dural puncture with an epidural needle. This study explored whether obesity has any association with headaches following an accidental dural puncture. Read More

    Spontaneous Spinal Subdural Hematoma.
    Neurologist 2017 Jan;22(1):34-39
    Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands.
    Objective: Spinal subdural hematomas (SSDHs) are rare. Causes are (1) posttraumatic, (2) iatrogenic (following surgery or lumbar puncture), (3) spontaneous including underlying malformations or coagulation deficits. With a systematic review of literature we want to shed light on the last group: symptomatology, etiology, treatment and outcome will we discussed. Read More

    Spinal anaesthesia in outpatient and conventional surgery: A point of view from experienced French anaesthetists.
    Anaesth Crit Care Pain Med 2016 Dec 19. Epub 2016 Dec 19.
    Department of Anaesthesiology and Critical Care, Nancy University Hospital, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France.
    Introduction: The objective of this investigation was to evaluate the practice of spinal anaesthesia among French anaesthetists in inpatient and outpatient settings.

    Methods And Materials: A questionnaire was sent to members of the French Association of Anaesthetists involved in regional anaesthesia during the first 4months of 2015. The questionnaire included items on the practice of spinal anaesthesia (type of needle, local anaesthetic available, puncture and disinfection techniques, etc. Read More

    Research Lumbar Punctures among African Americans and Caucasians: Perception Predicts Experience.
    Front Aging Neurosci 2016 2;8:296. Epub 2016 Dec 2.
    Department of Neurology, Emory University School of MedicineAtlanta, GA, USA; Center for Neurodegenerative Diseases Research, Emory University School of MedicineAtlanta, GA, USA; Alzheimer's Disease Research Center, Emory University School of MedicineAtlanta, GA, USA.
    African Americans are under-represented in Alzheimer's disease (AD)-related biomarker studies, and it has been speculated that mistrust plays a major factor in the recruitment of African Americans for studies involving invasive procedures such as the lumbar puncture (LP). We set out to determine factors associated with non-participation in a biomarker study aiming to explore cerebrospinal fluid (CSF) AD biomarker differences between older African Americans and Caucasians. We also surveyed participants' procedure-related perception (a standard medical procedure vs. Read More

    Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal-pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests.
    Eur J Neurol 2017 Mar 15;24(3):461-467. Epub 2016 Dec 15.
    Department of Neurology, Clinic for Neurological Rehabiliation II, University of Regensburg, Regensburg, Germany.
    Background And Purpose: Cerebrospinal fluid (CSF) removal improves clinical symptoms of many patients with idiopathic normal-pressure hydrocephalus (iNPH). The aim of this study was to investigate the correlation of changes in the optic nerve sheath diameter (ONSD) with patient responses to CSF removal.

    Methods: Transorbital ultrasonography was performed to obtain ONSD measurements in 31 patients with iNPH before and after lumbar puncture. Read More

    Translaminar pressure in Caucasian normal tension glaucoma patients.
    Acta Ophthalmol 2016 Dec 14. Epub 2016 Dec 14.
    Department of Ophthalmology, Cantonal Hospital Aarau, Aarau, Switzerland.
    Purpose: The aim of this study was to examine the translaminar pressure difference (TLP) in Caucasian patients with normal tension glaucoma (NTG) and its possible impact onto the pathogenesis of NTG.

    Methods: Retrospective analysis of medical records of patients with open-angle glaucoma (OAG) in the period from 2005 to 2015 from the Ophthalmology Department, Cantonal Hospital Aarau, Switzerland. A total of 67 eyes of 38 patients (mean age 68. Read More

    Transplantation of mesenchymal stromal cells in patients with amyotrophic lateral sclerosis: Results of Phase I/IIa clinical trial.
    Cell Transplant 2016 11 7. Epub 2016 Nov 7.
    Department of Neurology, Charles University, 2nd Medical School, University Hospital at Motol, Prague, Czech Republic
    Amyotrophic lateral sclerosis (ALS) is a progressive untreatable neurodegenerative disorder, leading to the death of the cortical and spinal motoneurons (MN). Bone marrow mesenchymal stem cells (BM-MSC) may represent a new approach to slowing down the progression of ALS, by providing neurotrophic support to host MN, and by having an antiinflammatory effect. We have designed a prospective, non-randomized, open-label clinical trial (phase I/IIa, EudraCT No. Read More

    Fluoroscopically Guided Epidural Injections of the Cervical and Lumbar Spine.
    Radiographics 2016 Dec 9:160043. Epub 2016 Dec 9.
    From the Department of Radiology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
    Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications. Read More

    How Much Cerebrospinal Fluid Should We Remove Prior to Measuring a Closing Pressure?
    J Child Neurol 2017 Mar 8;32(4):356-359. Epub 2016 Dec 8.
    1 Division of Pediatric Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
    Objective: The objective of this study was to identify a relationship between cerebrospinal fluid (CSF) volume removal and change in CSF pressure in children with suspected idiopathic intracranial hypertension (IIH).

    Methods: We performed a cross-sectional study of children 22 years and younger who underwent a lumbar puncture (LP) and had a documented opening pressure, closing pressure, and volume removed. Relationship between volume removal and pressure change was determined using a fractional polynomial regression procedure. Read More

    Outcomes of CSF spectrophotometry in cases of suspected subarachnoid haemorrhage with negative CT: two years retrospective review in a Birmingham hospital.
    Br J Neurosurg 2016 Dec 8:1-4. Epub 2016 Dec 8.
    a Queen Elizabeth Hospital , Birmingham , UK.
    Aim: The aim of this study was to evaluate the adherence to current guidelines for the investigation of suspected subarachnoid haemorrhage and the prevalence and outcome of computed tomography (CT)-negative aneurysmal subarachnoid haemorrhage.

    Design: A retrospective review in a single large tertiary referral centre.

    Subjects: A total of 796 patients, aged 16-90 years, who underwent lumbar puncture (LP) for suspected subarachnoid haemorrhage (SAH) following a negative or equivocal CT scan between January 2012 and November 2013 (23 months). Read More

    Primary central nervous system ALK-positive anaplastic large cell lymphoma in an adult: A rare case report.
    Medicine (Baltimore) 2016 Dec;95(49):e5534
    Department of Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Xicheng, Beijing, China.
    Rationale: Anaplastic large cell lymphoma (ALCL) is an aggressive non-Hodgkin lymphoma. It mostly invades lymph nodes with extranodal involvement observed in the soft tissue, bone, and skin.

    Patient Concerns: We report a 34-year-old Chinese male patient who presented with headache, diplopia, and vomit. Read More

    Chronic spinal subdural hematoma associated with antiplatelet therapy: a case report.
    World Neurosurg 2016 Dec 3. Epub 2016 Dec 3.
    Department of Neurosurgery, Sapporo Medical University, Sapporo 003-0804, Japan.
    Background: Spinal subdural hematoma is a rare clinical entity marked by the onset of pain and paralysis, which is usually associated with hemorrhagic disorders, trauma, and iatrogenic causes such as lumbar puncture or epidural anesthesia.

    Case Presentation: A 71-year-old male was admitted to our hospital with 2 weeks' history of bilateral lower leg pain, dysesthesia, paraparesis, and urinary disturbance. Magnetic resonance imaging revealed characteristic findings at the thoracolumbar spine, and surgical evacuation successfully treated this condition. Read More

    Risk factors for unsuccessful lumbar puncture in children.
    S Afr Med J 2016 Dec 1;106(12):1230-1235. Epub 2016 Dec 1.
    Red Cross War Memorial Children's Hospital, Cape Town, South Africa; Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, South Africa.
    Background: This descriptive study provides the first information on an association between the use of sedation and a reduction in the prevalence of unsuccessful lumbar puncture (LP) in African children of all races.

    Objective: Our hypothesis was that children who do not receive any procedural sedation are more likely to have unsuccessful LPs.

    Methods: A cross-sectional observational study examined LPs performed from February to April 2013, including details of the procedure, sedation or analgesia used, and techniques. Read More

    Pain Input Impairs Recovery After Spinal Cord Injury: Treatment With Lidocaine.
    J Neurotrauma 2016 Dec 2. Epub 2016 Dec 2.
    1 Behavioral and Cellular Neuroscience, Department of Psychology, Texas A&M University , College Station, Texas.
    More than 90% of spinal cord injuries are caused by traumatic accidents and are often associated with other tissue damage (polytrauma) that can provide a source of continued pain input during recovery. In a clinically relevant spinal cord contusion injury model, prior work has shown that noxious stimulation at an intensity that engages pain (C) fibers soon after injury augments secondary injury and impairs functional recovery. Noxious input increases the expression of pro-inflammatory cytokines (interleukin 1β and 18), cellular signals associated with cell death (caspase 3 and 8), and physiological signs of hemorrhage. Read More

    Successful Treatment of Postdural Puncture Headache Using Epidural Fibrin Glue Patch after Persistent Failure of Epidural Blood Patches.
    Pain Pract 2016 Dec 2. Epub 2016 Dec 2.
    Division of Anesthesiology, Geisinger Medical Center, Danville, PA, U.S.A.
    Objectives: Epidural blood patch is the gold standard for the treatment of postdural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Read More

    Epidural Blood Patch for the Treatment of Spontaneous and Iatrogenic Orthostatic Headache.
    Pain Physician 2016 Nov-Dec;19(8):E1115-E1122
    H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.
    Background: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. Read More

    Percutaneous vertebroplasty guided by preoperative computed tomography measurements.
    Indian J Orthop 2016 Nov-Dec;50(6):622-628
    Department of Interventional Radiology, The Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang, Jiangsu Province 212001, P. R. China.
    Background: Percutaneous vertebroplasty (PVP) is now widely performed to treat painful vertebral compression fractures. Previous researches have reported numerous advantages. However, it rarely reported that how to determine the feasibility of the unilateral or bilateral approach and how to decide the puncture angle, the skin insertion site before the procedure. Read More

    [Ultrasound imaging increases first-attempt success rate of neuraxial block in elderly patients].
    Zhonghua Yi Xue Za Zhi 2016 Nov;96(43):3459-3463
    Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.
    Objective: To verify whether preprocedural ultrasound of the lumbar spine could improve first-attempt success rate (defined as a successful neuraxial anesthesia with only one skin puncture) of neuraxial block in elderly patients. Methods: From septemble 2015 to February 2016, 200 elderly patients undergoing lower-limb surgery with neuraxial block at the Peking Universty Third Hospital were enrolled in this study.RandA 1. Read More

    Estimation of Skin to Subarachnoid Space Depth: An Observational Study.
    J Clin Diagn Res 2016 Oct 1;10(10):UC06-UC09. Epub 2016 Oct 1.
    Post Graduate Trainee, Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital , Guwahati, Assam, India .
    Introduction: In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. Read More

    [Alzheimer's disease cerebro-spinal fluid biomarkers: A clinical research tool sometimes useful in daily clinical practice of memory clinics for the diagnosis of complex cases].
    Rev Med Interne 2016 Nov 24. Epub 2016 Nov 24.
    Centre mémoire de recherches et de ressource Paris Nord Île-de-France, université Paris Diderot, Sorbonne Paris Cité, Inserm U942, groupe hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP, 75205 Paris, France.
    The role of biomarkers in clinical research was recently highlighted in the new criteria for the diagnosis of Alzheimer's disease. Cerebro-spinal fluid (CSF) biomarkers (total Tau protein, threonine 181 phosphorylated Tau protein and amyloid Aβ1-42 peptide) are associated with cerebral neuropathological lesions observed in Alzheimer's disease (neuronal death, neurofibrillary tangle with abnormal Tau deposits and amyloid plaque). Aβ1-40 amyloid peptide dosage helps to interpret Aβ1-42 results. Read More

    Early and delayed assessments of quantitative gait measures to improve the tap test as a predictor of shunt effectiveness in idiopathic normal pressure hydrocephalus.
    Fluids Barriers CNS 2016 Nov 22;13(1):20. Epub 2016 Nov 22.
    Department of Neurosurgery, Rakuwakai Otowa Hospital, 2 Chinjicho, Yamashinaku, Otowa, Kyoto, 607-8062, Japan.
    Background: To improve the diagnostic performance of the cerebrospinal fluid (CSF) tap test (TT), early and delayed assessments of gait were performed after the removal of 30 ml of CSF in patients with probable idiopathic normal pressure hydrocephalus. Assessments of gait included the 3-m timed up and go test (TUG), and the 10-m walk in time (10Ti) and in step (10St) tests.

    Methods: Quantitative data for the TUG, the 10Ti, and the 10St were obtained before CSF removal and on days 1 and 4 after removal of 30 ml CSF. Read More

    Intrapleural placement of a thoracic epidural catheter in a patient with spinal stenosis.
    J Clin Anesth 2016 Dec 7;35:195-197. Epub 2016 Sep 7.
    Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
    Due to the close proximity of the thoracic epidural space and parietal pleura, pleural puncture with intrapleural catheter placement is a potential complication of thoracic epidural anesthesia. The authors present a case of an obese patient with a history of spinal stenosis that underwent thoracotomy. Repeated failed attempts at epidural anesthesia were complicated by intrapleural placement of the catheter. Read More

    Feasibility of Lumbar Puncture in the Study of Cerebrospinal Fluid Biomarkers for Alzheimer's Disease in Subjects with Down Syndrome.
    J Alzheimers Dis 2017 ;55(4):1489-1496
    Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
    Background: Alzheimer's disease (AD) is the main medical problem in older adults with Down syndrome (DS). Studies of cerebrospinal fluid (CSF) AD biomarkers are limited and the feasibility of lumbar puncture (LP) is controversial in this population.

    Objective: To analyze the frequency of complications after a LP in DS. Read More

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