Search

Objective: To systematically review the evidence for intrathecal or intraventricular plus intravenous administration of antibiotics compared with standard management for postsurgical meningitis or ventriculitis. Methods: The following databases were searched: MEDLINE, the Central Register of Controlled Trials (CENTRAL); PubMed, EMBASE; and reference list of articles. Results: Administration of intrathecal/intraventricular antibiotics was associated with decreased mortality (OR 0.27 [95% CI 0.15–0.49] p = < 0.00001), increased cure rate (OR 3.4 [95% CI 1.6–7.22] p = 0.001). There was no difference in the occurrence of reinfection rate, and in poor functional outcome (OR 0.57 [95% CI 0.21–1.60] p = 1.6 p = 0.29; OR 0.43 [95% CI 0.11–1.68] p = 0.22). Conclusions: Intrathecal/intraventricular plus intravenous administration of antibiotics improves survival and cure rate in patients with postoperative meningitis or ventriculitis. More high-quality studies are needed. [ABSTRACT FROM AUTHOR]

Background: Stroke is a neurological emergency that tends to be the first cause of death in many countries. Atmospheric variables are strongly associated with stroke, in which subarachnoid hemorrhage (SAH) has been associated in many studies to meteorological risk factors such as air pollution, air pressure, weather changes, and ambient temperature. These characteristics may influence the brain circulation and cause SAH, being diagnosed as idiopathic SAH or SAH with unknown cause. Objective: The main objective of this review is to present the most relevant meteorological risk factors that may develop subarachnoid hemorrhage according to the current evidence that supports the strong association. Conclusion: Brain vessel circulation may be influenced by atmospheric variables such as air pollution and weather changes, generating intrinsic changes in the intima of the vessels which leads to vasospasm and with comorbidities associated may develop SAH. [ABSTRACT FROM AUTHOR]

Background: Collateral circulation is a vascular network which maintains the blood flow after the partial blockage of primary vascular pathways. This acts as potential vascular supplementary system and plays important role in the cerebral ischemia. Main body: Collateral circulation has implications in the management especially related to cerebral endovascular treatment and thrombolytic therapy. It is considered as subsidiary network of vascular channels, which is highly variable. Insufficient arterial supply is due to the hemodynamic compromise because of thromboembolism. Apart from the collaterals, there is additional existence of a group of vessels known as venous collaterals. Their function is variable and they contribute to the augmentation of venous drainage in venous ischemias. Various pharmacological interventions are used to modulate the collaterals, these can prove to be a complementary alternative to the invasive intracerebral interventions. Conclusions: The aim of this review article is to highlight the importance of cerebral collateral circulation and to discuss the various available pharmacological alternatives available and their current relevance in the management of various neurovascular pathologies. [ABSTRACT FROM AUTHOR]

Surgery is the most common cause of spinal cord ischemia; it is also caused by hemodynamic changes, which disrupt the blood flow. Direct ligation of the spinal arteries, especially the Adamkiewicz artery is involved as well. Other causes of spinal cord ischemia include arteriography procedures, thoracic surgery, epidural and rachianesthesia, foraminal infiltration, arterial dissection, systemic hypotension, emboligenic heart disease, thoracic disc herniation, and compression. Understanding the vascular anatomy of the spinal cord is essential to develop optimal strategies for preventing ischemic injuries to the spinal cord. During ischemia, a rich network of intra and paraspinal collaterals allow enough blood flow to compensate the intensity of spinal cord ischemia. In case of interruption of flow of a main artery, the collateral artery increases its flow to maintain perfusion to the tissues. Avoiding spinal cord ischemia by using collateral circulation is necessary to prevent the establishment of hypovolemia, hyperthermia and elevations in venous pressures. The objective of this narrative review is to present the current concepts of spinal collateral circulation and its role in the setting of ischemic events, affecting the vascular supply of the spinal cord. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) is largely (70-80%) produced by the choroids plexus of the ventricles and is considered as the plasma ultrafiltrate. While CSF formation, circulation, and composition appear to be physiological and physical, its absorption appears to be mainly physical. The formation, composition, circulation, absorption, and changes in pathological conditions of CSF are discussed briefly in this review article. The CSF pressure dynamics studies provide information about the tightness, elastance, or outflow resistance of the CSF in the CNS. We believe that the present study shall help to provide essential details of CSF physiology which are important to many disciplines including radiology, neurology, and neurosurgery. [ABSTRACT FROM AUTHOR]

Multilocular hydrocephalus is an entity that occurs relatively frequently in neurosurgical practice. We are present an editorial letter with a mini-review of the pathophysiology, surgical, and medical treatment. [ABSTRACT FROM AUTHOR]

THIEME 98 Hope or Hype: Beta-Blockers in Traumatic Brain Injury Luis Rafael Moscote-Salazar 1,2 Tariq Janjua 3 William A Florez-Perdomo 4, Harold Vasquez 4,5 1 Paracelsus Medical University, Salzburg, Austria 2 Department of Neurosurgery, Center of Biomedical Research, University of Cartagena, Cartagena de Indias, Colombia 3 Neurocritical Care Unit, Regions Hospital, Saint Paul, Minnesota, United States 4 Latinamerican Council of Neurocritical Care, Colombia 5 Department of Medicine, Universidad del Sinu, Cartagena, Colombia published online September 29, 2020 Address for correspondence Luis Rafael Moscote-Salazar, MD, Department of Neurosurgery, University of Cartagena, Cra. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Traumatic brain injury (TBI) has significant consequences for patients, families, and healthcare systems worldwide. [Extracted from the article]