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He C, Yang G, Zhao M, Wu Q, Wang L, Sharma HS. A clinical study of high-dose urokinase for the treatment of the patients with hypertension induced ventricular hemorrhage. PROGRESS IN BRAIN RESEARCH 2021; 266:349-355. [PMID: 34689863 DOI: 10.1016/bs.pbr.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study discusses the therapeutic effect of high-dose urokinase treatment for hypertension ventricular hemorrhage. METHODS A total of 60 patients with hypertension ventricular hemorrhage were randomly assigned to two groups: treatment group (n=30) and control group (n=30). Both groups received bilateral external ventricular drain. The treatment group was injected with 50,000IU urokinase to the lateral ventricle every day; the total injection volume per day was 100,000IU. The control group was injected with 20,000IU urokinase to the lateral ventricle every day with a total injection volume per day of 40,000IU. Lumbar puncture was performed in both groups after the later ventricular drain was removed to release cerebrospinal fluid (CSF). Head Computed tomography(CT) examination was performed regularly to observe changes in the ventricular hematoma as well as the occurrence of complications such as intracranial infection and hydrocephalus. Patient prognosis 6 weeks after surgery was compared between the two groups. RESULTS In the treatment group, the intraventricular hemorrhage clearance time and the number of instances of urokinase treatment were significantly less than those of the control group (P<0.05). The total urokinase dosage of the treatment group was significantly higher than that of the control group (P<0.05). With respect to post-surgery complications, in the treatment group, there were three cases of hydrocephalus and one case of intracranial infection. In the control group, there were four cases of hydrocephalus and three cases of intracranial infection. Intraventricular re-hemorrhage was not observed in either group. Intracranial infection was relieved after strengthened anti-infective therapy and continuous drainage. There was a statistically significant difference in the occurrence of complications between the treatment group and the control group (P<0.05). The rate of good prognosis in the treatment group was higher than that of the control group (P<0.05), and the inefficiency rate was lower (P<0.05). CONCLUSIONS High-dose urokinase treatment produces a significant therapeutic effect in hypertension ventricular hemorrhage. This treatment can quickly eliminate intraventricular hemorrhage, shorten the ventricular drain tube indwelling time, decrease the occurrence of intracranial infection, and increase the likelihood of a good prognosis.
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Affiliation(s)
- Chao He
- Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China
| | - Gang Yang
- Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China.
| | - Ming Zhao
- Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China
| | - Qilin Wu
- Department of Neurosurgery, Zhuji People' Hospital of Zhejiang Province, Zhuji Affiliated Hospital of Shaoxing University, Zhuji, Zhejiang, China
| | - Lin Wang
- Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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Torres-Corzo JG, Rangel-Castilla L, Islas-Aguilar MA, Vecchia RRD. A Novel Approach of Navigation-Assisted Flexible Neuroendoscopy. Oper Neurosurg (Hagerstown) 2018; 14:E33-E37. [PMID: 28521036 DOI: 10.1093/ons/opx118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 04/17/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Neuronavigation-assisted endoscopy is commonly used for skull base and intraventricular surgery. Flexible neuroendoscopy offers certain advantages over rigid endoscopy; however, a major disadvantage of the flexible endoscope has been easy disorientation in the flexed position. Neuronavigation-assisted flexible neuroendoscopy was not available until now. This is the first report of the use of navigation-assisted flexible neuroendoscopy in a patient with hydrocephalus. CLINICAL PRESENTATION A 10-mo-old girl presented with irritability and vomiting to the emergency department and was found to have severe hydrocephalus. The patient underwent successful endoscopic third ventriculostomy and exploration of the ventricles (lateral, third, cerebral aqueduct, fourth) and basal cisterns with the flexible neuroendoscopy assisted with electromagnetic neuronavigation. CONCLUSION As demonstrated by this initial experience, neuronavigation-assisted flexible neuroendoscopy is a feasible and safe tool, endoscopic procedures with the flexible endoscope may be possible in a safer manner. We report the first use of neuronavigation-assisted flexible neuroendoscopy to perform an ETV and exploration of the entire ventricular system. Further evaluation will be necessary to define and expand its applications in neurosurgery.
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Affiliation(s)
- Jaime G Torres-Corzo
- Department of Neurosurgery, Hospital Central, Faculty of Medicine, San Luis Potosí, México
| | - Leonardo Rangel-Castilla
- Department of Neurosurgery, Hospital Central, Faculty of Medicine, San Luis Potosí, México.,Department of Neuro-surgery, Wayne State University, Detroit, Michigan
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Asano K, Katayama K, Kakuta K, Oyama K, Ohkuma H. Assessment of the Accuracy and Errors of Head-Up Display by an Optical Neuronavigation System in Brain Tumor Surgery. Oper Neurosurg (Hagerstown) 2016; 13:23-35. [DOI: 10.1093/ons/opw001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 01/20/2016] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND: A head-up display (HUD) in which navigational information is projected into the microscope view may enable surgeons to perform operations more efficiently. Projecting depictions of both tumor and important intracranial structures on the HUD may facilitate safe surgery.
OBJECTIVE: To investigate accuracy and errors regarding important intracranial structures, errors due to brain shifts, and preservation rates for important intracranial structures.
METHODS: A total of 184 surgeries in 172 patients were performed using this operation system. Postoperatively, we determined accuracy and errors for actual structures and virtual reality on the HUD and performed statistical analyses.
RESULTS: Preresection accuracy for important intracranial structures was highest for the internal carotid artery (ICA; 90.4%) and lowest for the posterior inferior cerebellar artery (53.6%). Differences between pre- and postresection accuracy were greatest, in descending order, for the cortical vein (P < .0001), V4 segment of vertebral artery (P < .0001), and anterior inferior cerebellar artery (P = .00780), whereas differences between pre- and postresection errors were smallest for the cranial nerve V (P = .500), middle cerebral artery (P = .0313), and ICA (P = .0313). Cases of poor preresection accuracy and large differences in pre- to postresection accuracy were seen in the prone position.
CONCLUSION: A reliable surgical resection rate was achieved using the HUD, and reliable preservation of important intracranial structures was also possible. Accuracy was concluded to be within an acceptable range.
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Transjugular Endoscopic Approach to Inframeatal Space: A Theoretical Approach. ARCHIVES OF NEUROSCIENCE 2016. [DOI: 10.5812/archneurosci.34030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sammartino F, Feletti A, Fiorindi A, Mazzucco GM, Longatti P. Aspiration of parafalcine empyemas with flexible scope. Childs Nerv Syst 2016; 32:1123-9. [PMID: 27075188 DOI: 10.1007/s00381-016-3082-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Accepted: 04/04/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Subdural empyemas are considered neurosurgical emergencies, and the parafalcine location is particularly insidious. We revised the experience of general surgeons who are used to manage chronic pleural purulent collections with video-assisted thoracoscopy. METHODS With a similar technique, we successfully aspirated a parafalcine empyema using a flexible scope avoiding a more invasive craniotomy. A review of the treatment options of empyematous collections is also provided, focusing particularly on the hazardous parafalcine location. RESULTS The management of subdural empyemas poses different decision-making problems compared to common brain abscesses, urging a more rapid and holistic surgical treatment with minimally invasive approach. Endoscopic aspiration of parafalcine empyema was followed by complete recovery in our patient. CONCLUSIONS Flexible endoscopy is a promising method to obtain complete pus removal even from loculated collections through a bur hole, avoiding large craniotomies and consequent potential complications.
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Affiliation(s)
- Francesco Sammartino
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy
| | - Alberto Feletti
- Neurosurgery Unit, Department of Neurosciences, NOCSAE Modena Hospital, Via Giardini 1355, 41126 Baggiovara, Modena, Italy.
| | - Alessandro Fiorindi
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy
| | - Grazia Marina Mazzucco
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy
| | - Pierluigi Longatti
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Treviso, Italy
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A Journey into the Technical Evolution of Neuroendoscopy. World Neurosurg 2014; 82:e777-89. [DOI: 10.1016/j.wneu.2014.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 06/21/2014] [Accepted: 09/04/2014] [Indexed: 11/24/2022]
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Yoshida K, Kawa G, Taniguchi H, Inoue T, Mishima T, Yanishi M, Sugi M, Kinoshita H, Matsuda T. Novel ureteroscopic navigation system with a magnetic tracking device: a preliminary ex vivo evaluation. J Endourol 2014; 28:1053-7. [PMID: 24866091 DOI: 10.1089/end.2013.0757] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Examination of the pyelocaliceal system using a flexible ureteroscope necessitates accurate orientation of the tip of the instrument. This study assessed the use of a novel real-time ureteroscopic navigation system in a pyelocaliceal phantom. MATERIALS AND METHODS The navigation system used a magnetic tracking device to determine the position of the ureteroscope in a pyelocaliceal phantom and displayed the position of the endoscope on a three-dimensional image that could be rotated. Twenty-eight urologists were divided into group A and group B (seven novice surgeons and seven experienced surgeons in each group). All participants were asked to examine the phantom and identify the positions of three designated calices, without the navigation system (Task 1) and with the navigation system (Task 2). In group A, participants performed Task 1 followed by Task 2. In group B, participants performed Task 2 followed by Task 1. The accuracy rate (AR) of identifying the calices, migration length (ML) of the tip of the ureteroscope, and time (T) taken to complete the task were recorded. The results were compared between Task 1 and Task 2, and between novice and experienced surgeons. RESULTS The AR for Task 2 was 100% in both group A and group B. The AR was significantly lower in Task 1 than in Task 2 for both novice and experienced surgeons in both groups (group A: novice P=0.016, experienced P=0.034; group B: novice P=0.015, experienced P=0.015; Wilcoxon test). In Group A, T was significantly longer in Task 1 than in Task 2 for experienced surgeons. There were no significant differences in ML or T between novice and experienced surgeons. CONCLUSIONS Our novel ureteroscopic navigation system improved the accuracy of ureteroscopic maneuvers. Further development of this system for use in clinical ureteroscopic procedures is planned.
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Affiliation(s)
- Kenji Yoshida
- Department of Urology and Andrology, Kansai Medical University , Osaka, Japan
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Du C, Chen X, Wang Y, Li J, Yu D. An adaptive 6-DOF tracking method by hybrid sensing for ultrasonic endoscopes. SENSORS 2014; 14:9961-83. [PMID: 24915179 PMCID: PMC4118391 DOI: 10.3390/s140609961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/15/2014] [Accepted: 05/27/2014] [Indexed: 11/16/2022]
Abstract
In this paper, a novel hybrid sensing method for tracking an ultrasonic endoscope within the gastrointestinal (GI) track is presented, and the prototype of the tracking system is also developed. We implement 6-DOF localization by sensing integration and information fusion. On the hardware level, a tri-axis gyroscope and accelerometer, and a magnetic angular rate and gravity (MARG) sensor array are attached at the end of endoscopes, and three symmetric cylindrical coils are placed around patients' abdomens. On the algorithm level, an adaptive fast quaternion convergence (AFQC) algorithm is introduced to determine the orientation by fusing inertial/magnetic measurements, in which the effects of magnetic disturbance and acceleration are estimated to gain an adaptive convergence output. A simplified electro-magnetic tracking (SEMT) algorithm for dimensional position is also implemented, which can easily integrate the AFQC's results and magnetic measurements. Subsequently, the average position error is under 0.3 cm by reasonable setting, and the average orientation error is 1° without noise. If magnetic disturbance or acceleration exists, the average orientation error can be controlled to less than 3.5°.
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Affiliation(s)
- Chengyang Du
- Key Laboratory of Opto-Electronics Information Technology of Ministry of Education, College of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China.
| | - Xiaodong Chen
- Key Laboratory of Opto-Electronics Information Technology of Ministry of Education, College of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China.
| | - Yi Wang
- Key Laboratory of Opto-Electronics Information Technology of Ministry of Education, College of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China.
| | - Junwei Li
- Key Laboratory of Opto-Electronics Information Technology of Ministry of Education, College of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China.
| | - Daoyin Yu
- Key Laboratory of Opto-Electronics Information Technology of Ministry of Education, College of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin 300072, China.
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