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2. CSF Rhinorrhoea After Endonasal Intervention to the Skull Base (CRANIAL) - Part 1: Multicenter Pilot Study

Author

Khan, Danyal Z., Marcus, Hani J., Horsfall, Hugo Layard, Bandyopadhyay, Soham, Schroeder, Benjamin E., Patel, Vikesh, O’Donnell, Alice, Ahmed, Shahzada, Alalade, Andrew F., Ali, Ahmad M.S., Allison, Callum, Al-Barazi, Sinan, Al-Mahfoudh, Rafid, Amarouche, Meriem, Bahl, Anuj, Bennett, David, Bhalla, Raj, Bhatt, Pragnesh, Boukas, Alexandros, Cabrilo, Ivan, Chadwick, Annabel, Chowdhury, Yasir A., Choi, David, Cudlip, Simon A., Donnelly, Neil, Dorward, Neil L., Dow, Graham, Fountain, Daniel M., Grieve, Joan, Giamouriadis, Anastasios, Gilkes, Catherine, Gnanalingham, Kanna, Halliday, Jane, Hanna, Brendan, Hayhurst, Caroline, Hempenstall, Jonathan, Henderson, Duncan, Hossain-Ibrahim, Kismet, Hirst, Theodore, Hughes, Mark, Javadpour, Mohsen, Jenkins, Alistair, Kamel, Mahmoud, Mannion, Richard J., Kolias, Angelos G., Khan, Mohammad Habibullah, Khan, Mohammad Saud, Lacy, Peter, Mahmood, Shumail, Maratos, Eleni, Martin, Andrew, Mathad, Nijaguna, McAleavey, Patrick, Mendoza, Nigel, Millward, Christopher P., Mirza, Showkat, Muquit, Sam, Murray, Daniel, Naik, Paresh P., Nair, Ramesh, Nicholson, Claire, Paluzzi, Alex, Pathmanaban, Omar, Paraskevopoulos, Dimitris, Pollock, Jonathan, Phillips, Nick, Piper, Rory J., Ram, Bhaskar, Robertson, Iain, Roman, Elena, Ross, Peter, Santarius, Thomas, Sayal, Parag, Shapey, Jonathan, Sharma, Rishi, Shaw, Simon, Shoakazemi, Alireza, Shumon, Syed, Sinha, Saurabh, Solomou, Georgios, Soon, Wai Cheong, Stapleton, Simon, Statham, Patrick, Stew, Benjamin, Thomas, Nick, Tsermoulas, Georgios, Tysome, James R., Varma, Adithya, Weir, Philip, Williams, Adam, and Youssef, Mohamed

Published
2021
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3. CSF Rhinorrhea After Endonasal Intervention to the Skull Base (CRANIAL) — Part 2: Impact of COVID-19

Author

Bandyopadhyay, Soham, Khan, Danyal Z., Marcus, Hani J., Schroeder, Benjamin E., Patel, Vikesh, O'Donnell, Alice, Ahmed, Shahzada, Alalade, Andrew F., Ali, Ahmad M.S., Allison, Callum, Al-Barazi, Sinan, Al-Mahfoudh, Rafid, Amarouche, Meriem, Bahl, Anuj, Bennett, David, Bhalla, Raj, Bhatt, Pragnesh, Boukas, Alexandros, Cabrilo, Ivan, Chadwick, Annabel, Chowdhury, Yasir A., Choi, David, Cudlip, Simon A., Donnelly, Neil, Dorward, Neil L., Dow, Graham, Fountain, Daniel M., Grieve, Joan, Giamouriadis, Anastasios, Gilkes, Catherine, Gnanalingham, Kanna, Halliday, Jane, Hanna, Brendan, Hayhurst, Caroline, Hempenstall, Jonathan, Henderson, Duncan, Hossain-Ibrahim, Kismet, Hirst, Theodore, Hughes, Mark, Javadpour, Mohsen, Jenkins, Alistair, Kamel, Mahmoud, Mannion, Richard J., Kolias, Angelos G., Khan, Mohammad Habibullah, Khan, Mohammad Saud, Lacy, Peter, Mahmood, Shumail, Maratos, Eleni, Martin, Andrew, Mathad, Nijaguna, McAleavey, Patrick, Mendoza, Nigel, Millward, Christopher P., Mirza, Showkat, Muquit, Sam, Murray, Daniel, Naik, Paresh P., Nair, Ramesh, Nicholson, Claire, Paluzzi, Alex, Pathmanaban, Omar, Paraskevopoulos, Dimitris, Pollock, Jonathan, Phillips, Nick, Piper, Rory J., Ram, Bhaskar, Robertson, Iain, Roman, Elena, Ross, Peter, Santarius, Thomas, Sayal, Parag, Shapey, Jonathan, Sharma, Rishi, Shaw, Simon, Shoakazemi, Alireza, Shumon, Syed, Sinha, Saurabh, Solomou, Georgios, Soon, Wai Cheong, Stapleton, Simon, Statham, Patrick, Stew, Benjamin, Thomas, Nick, Tsermoulas, Georgios, Tysome, James R., Varma, Adithya, Weir, Philip, Williams, Adam, Youssef, Mohamed, and Veljanoski, Damjan

Published
2021
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4. Primary pituitary granulomatosis with polyangiitis and the role of pituitary biopsy, case report and literature review.

Author

How Hong, Estelle, Shalid, Ahmed, Gatt, Daniel, Deepak, Srihari, and Bahl, Anuj

Subjects
LITERATURE reviews, GRANULOMATOSIS with polyangiitis, BIOPSY, PITUITARY gland, PITUITARY diseases
Abstract

Pituitary dysfunction (PD) in granulomatosis with polyangiitis (GPA) is a rare manifestation of the disease with an incidence of 2% and tends to occur as the disease progresses. On very rare occasions, PD can be the initial presentation of GPA. From our literature review, only 6 such cases were documented. We present a rare case of GPA in a 57-year-old female who primarily presented with PD and visual disturbance without any other systemic features of GPA. Her initial ANCA screen was negative and her MRI scan showed an enlarged pituitary gland with cystic changes. A pituitary biopsy confirmed the diagnosis and she was started on immunosuppressants. After completing her immunotherapy, her diabetic insipidus subsided and her vision markedly improved. A literature search on Pubmed, Cochrane, Open Grey, and SciELO with keywords 'granulomatosis', 'polyangiitis', and 'pituitary' was performed. A total of 72 articles were reviewed. 6 articles were identified where PD was the presenting complaint of GPA without other systemic involvement. Secondary hypophysitis in GPA indicates pituitary inflammation resulting from systemic disease or pituitary near-lying lesions. PD in GPA tends to occur with concomitant active disease at other sites. Headache seemed to be a common presenting feature with diabetic insipidus being the most common type of PD. Tissue biopsy is essential to confirm diagnosis. Pituitary biopsy is rarely required as other organ involvement is available for safer tissue sampling. However, in our case, pituitary biopsy had a role in confirming diagnosis and avoiding treatment delay. PD as a primary manifestation in GPA without systemic involvement is very rare and poses a diagnostic challenge. Pituitary biopsy can aid in diagnosis, allowing prompt treatment and prevention of long-term complications of untreated GPA such as permanent pituitary dysfunction. Nevertheless, the risk and benefit of pituitary surgery in each case should be weighted. [ABSTRACT FROM AUTHOR]

Published
2024
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5. A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom.

Author

Hall, Samuel, Abouharb, Ashraf, Anderson, Ian, Bacon, Andrew, Bahl, Anuj, Brydon, Howard, Dow, Graham, Fouyas, Ioannis, Galea, James, Ghosh, Anthony, Gurusinghe, Nihal, Kamel, Mahmoud, Minhas, Pawan, Mitchell, Patrick, Mowle, David, Mukerji, Nitin, Nair, Ramesh, Norris, John, Patel, Hiren, and Patel, Jash

Subjects
INTRACRANIAL aneurysms, DISEASE progression, SUBARACHNOID hemorrhage, NONPROBABILITY sampling, JUDGMENT sampling, INTRACRANIAL aneurysm ruptures, INTRACRANIAL arterial diseases
Abstract

Unruptured intracranial aneurysms (UIA) are common. For many the treatment risks outweigh their risk of subarachnoid haemorrhage and patients undergo surveillance imaging. There is little data to inform if and how to monitor UIAs resulting in widely varying practices. This study aimed to determine the current practice of unruptured UIA surveillance in the United Kingdom. A questionnaire was designed to address the themes of surveillance protocols for UIA including when surveillance is initiated, how frequently it is performed, and when it is terminated. Additionally, how aneurysm growth is managed and how clinically meaningful growth is defined were explored. The questionnaire was distributed to members of the British Neurovascular Group using probability-based cluster and non-probability purposive sampling methods. Responses were received from 30 of the 30 (100.0%) adult neurosurgical units in the United Kingdom of which 27 (90.0%) routinely perform surveillance for aneurysm growth. Only four units had a unit policy. The mean patient age up to which a unit would initiate follow-up of a low-risk UIA was 65.4 ± 9.0 years. The time points at which imaging is performed varied widely. There was an even split between whether units use a fixed duration of follow-up or an age threshold for terminating surveillance. Forty percent of units will follow-up patients more than 5 years from diagnosis. The magnitude in the change in size that was felt to constitute growth ranged from 1 to 3mm. No units routinely used vessel wall imaging although 27 had access to 3T MRI capable of performing it. There is marked heterogeneity in surveillance practices between units in the United Kingdom. This study will help units better understand their practice relative to their peers and provide a framework forplanning further research on aneurysm growth. [ABSTRACT FROM AUTHOR]

Published
2023
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8. A survey of the radiological follow-up of unruptured intracranial aneurysms in the United Kingdom

Author

Hall, Samuel, primary, Abouharb, Ashraf, additional, Anderson, Ian, additional, Bacon, Andrew, additional, Bahl, Anuj, additional, Brydon, Howard, additional, Dow, Graham, additional, Fouyas, Ioannis, additional, Galea, James, additional, Ghosh, Anthony, additional, Gurusinghe, Nihal, additional, Kamel, Mahmoud, additional, Minhas, Pawan, additional, Mitchell, Patrick, additional, Mowle, David, additional, Mukerji, Nitin, additional, Nair, Ramesh, additional, Norris, John, additional, Patel, Hiren, additional, Patel, Jash, additional, Patel, Krunal, additional, St George, Jerome, additional, Teo, Mario, additional, Toma, Ahmed, additional, Trivedi, Rikin, additional, Uff, Chris, additional, Visca, Anna, additional, Walsh, Daniel C., additional, White, Edward, additional, Whitfield, Peter, additional, and Bulters, Diederik, additional

Published
2021
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14. Global Perspectives on Task Shifting and Task Sharing in Neurosurgery

Author

Robertson, Faith C., primary, Esene, Ignatius N., additional, Kolias, Angelos G., additional, Khan, Tariq, additional, Rosseau, Gail, additional, Gormley, William B., additional, Park, Kee B., additional, Broekman, Marike L.D., additional, Rosenfeld, Jeffrey, additional, Balak, Naci, additional, Ammar, Ahmed, additional, Tisel, Magnus, additional, Haglund, Michael, additional, Smith, Timothy, additional, Mendez, Ivar, additional, Brennum, Jannick, additional, Honeybul, Stephen, additional, Matsumara, Akira, additional, Muneza, Severien, additional, Rubiano, Andres, additional, Kamalo, Patrick, additional, Fieggen, Graham, additional, Misra, Basant, additional, Bolles, Gene, additional, Adelson, David, additional, Dempsey, Robert, additional, Hutchinson, Peter, additional, Nikova, Alexandrina, additional, Ghazala, Osama, additional, Buno, Elubabor, additional, Bhattacharjee, Shibashish, additional, Iizuka, Takahiro, additional, Abdullah, Jafri Malin, additional, Chaurasia, Bipin, additional, Morgan, Eghosa, additional, Alcedo-Guardia, Rodolfo E., additional, Lucena, Lynne Lourdes N., additional, Oktay, Kadir, additional, AbdAllah, Omar Ibrahim, additional, Saihi, Ahlem, additional, Abdeldjalil, Gacem, additional, Asmaa, Mahi, additional, Yampolsky, Claudio, additional, Saladino, Laura P., additional, Mannara, Francisco, additional, Sachdev, Sonal, additional, Price, Benjamin, additional, Joris, Vincent, additional, Adeniran Bankole, Nourou Dine, additional, Carrasco, Edgar M., additional, Hodzic, Mirsad, additional, de Sousa Porto, Marcos Wagner, additional, Amorim, Robson, additional, Maldonado, Igor Lima, additional, Yves, Bizoza, additional, Suarez, Gonzalo, additional, Constanzo, Felipe, additional, Valdeblanquez Atencio, Johanna Cecilia, additional, Ruiz Mora, Karen Alexa, additional, Rodriguez Gil, Juan Manuel, additional, Paraskeva, Kiriakos, additional, Egemen, Emrah, additional, Ngamasata, Trevcsor, additional, Ntalaja, Jeff, additional, Beltchika, Antoine, additional, Ntsambi, Glennie, additional, Dunia, Goertz Mirenge, additional, Taha, Mahmoud M., additional, Arnaout, Mohamed, additional, Kirollos, Ramez, additional, Kassem, Mohamed, additional, Elwardany, Omar, additional, Negida, Ahmed, additional, Dolango, Birhanu, additional, Aseged, Mikael, additional, Mldie, Alemu Adise, additional, Laeke, Tsegazeab, additional, Aklilu, Abenezer, additional, Adefris, Esayas, additional, Luoto, Teemu, additional, Behnam, Rezai Jahromi, additional, De Schlichting, Emmanuel, additional, Nassim, Bougaci, additional, Bourdillon, Pierre, additional, Stienen, Martin N., additional, Lackermair, Stephan, additional, Schmidt, Franziska Anna, additional, Konczalla, Juergen, additional, Holzgreve, Adrien, additional, Sagerer, Andre, additional, Weinert, Dieter M., additional, Kumi, Paulette, additional, McLean, Aaron Lawson, additional, Loan, James, additional, Cahill, Julian, additional, Dockrell, Simon, additional, Afshari, Fardad T., additional, May, Paul, additional, Athanasiou, Alkinoos, additional, Papadopoulos, Steven, additional, Espinoza, Edroulfo-Georgios, additional, Chatzisotiriou, Athanasios, additional, Vlachogiannis, Pavlos, additional, Karabatsou, Konstantina, additional, Paschalis, Thanasis, additional, Tsitsipanis, Christos, additional, Longo Calderan, Gabriel Mauricio, additional, Leiva, Ronny, additional, Deora, Harsh, additional, Mukkamala, Sreenivas, additional, Batra, Dipesh, additional, Sukumaran, Arvind, additional, Parmar, Kanishk, additional, Bahl, Anuj, additional, Agrawal, Amit, additional, Dev, Nirankar, additional, Thakur, Nikhil, additional, Behari, Sanjay, additional, Yandrapati, Chandrasekhar B.V.K., additional, Bhoot, Ritesh, additional, Bhatt, Pragnesh, additional, Bhaumik, Uday, additional, Agrawal, Manish, additional, Thomas, Antony, additional, Chandrappa, Harish, additional, Mathur, Ankit, additional, Wahjoepramono, Petra, additional, Oswari, Selfy, additional, Al-Mahfoudh, Rafid, additional, Alnaji, Abbas, additional, Abuhadrous, Nidal, additional, Jarad, Bakr Abo, additional, Nour, Ibrahim, additional, Cohen-Inbar, Or, additional, Colasanti, Roberto, additional, Conti, Alfredo, additional, Raffa, Giovanni, additional, Castrioto, Corrado, additional, Baccanelli, Matteo M., additional, Tomasi, Santino Ottavio, additional, Zoli, Matteo, additional, Veroni, Andrea, additional, Di Cristofori, Andrea, additional, Giannachi, Luigi, additional, Lippa, Laura, additional, Sgubin, Donatella, additional, Broggi, Morgan, additional, Barbato, Marcello, additional, Restelli, Francesco, additional, Ganau, Mario, additional, Taddei, Graziano, additional, Albadawi, Hamzeh, additional, Salameh, Mohammed, additional, Gulmira, Madieyva, additional, Lashhab, Muffaq, additional, El Gaddafi, Walid, additional, Altoumi, Mohammad, additional, Manvinder, S.M., additional, Kanesen, Davendran, additional, Teo, Mario, additional, Sriram, Prabu Rau, additional, Zamri, Sarah Atiqah M., additional, Vinodh, Vayara Perumall, additional, Denou, Moussa, additional, Melhaoui, Adyl, additional, Outani, Oumaima, additional, Boutarbouch, Mahjouba, additional, Gretschel, Armin, additional, Yadav, Pradhumna, additional, Karmacharya, Balgopal, additional, Incekara, Fatih, additional, Boogert, Hugo den, additional, Lopez, Buccket Argvoello, additional, Amadou, Hassane Ali, additional, Sale, Danjuma, additional, Bello, Sanusi, additional, Edward, Poluyi, additional, Ukachukwu, Alvan-Emeka, additional, Nwaribe, Evaristus, additional, Aniaku, Ikechukwu, additional, Ndajiwo, Aliyu Baba, additional, Ayodele, Olabamidele, additional, Bot, Gyang Markus, additional, Ndubuisu Achebe, Sunday David, additional, Jamal, Bakht, additional, Tariq, Muhammad, additional, Farooq, Ghulam, additional, Khan, Danyal Zaman, additional, Khizar, Ahtesham, additional, Hussain, Zahid, additional, Nazir, Anisa, additional, Gonzales-Portillo, Marco, additional, Bautista, Jhosep Silvestre, additional, Torres, Roland A., additional, Javier-Lizan, Abigail, additional, de los Santos, Isagani Jodl G., additional, Morais, Nuno, additional, Dias, Lydia, additional, Noronha, Carolina, additional, Silva, Jovelo Monteiro, additional, Seromenho-Santos, Alexandra, additional, Lozanche, Kiril, additional, Negoi, Ionut, additional, Tascu, Alexandru, additional, Kozyrev, Danil A., additional, Nkeshimana, Menelas, additional, Karekezi, Claire, additional, Ndayishyigikiye, Marcel Didier, additional, Alabbass, Faisal, additional, Farrash, Faisal, additional, Alhazmi, Rawan, additional, Golubovic, Jagos, additional, Lepifá, Milan, additional, Ilifá, Rosanda, additional, Stanimirovifá, Aleksandar, additional, Garcia-Garcia, Sergio, additional, Rodriguez Arias, Carlos A., additional, Lau, Ruth, additional, Delgado-Fernandez, Juan, additional, Arraez, Miguel A., additional, Mateos, C. Fernandez, additional, Castano Leon, Ana M., additional, Wadanamby, Saman, additional, Bervini, David, additional, Shabani, Hamisi K., additional, Limpastan, Kriengsak, additional, Ayadi, Khalil, additional, Sencer, Altay, additional, Yalcinkaya, Ali, additional, Eren, Elif, additional, Basaran, Recep, additional, Gokoglu, Abdulkerim, additional, Mykola, Vyval, additional, Tayong, Felicita, additional, Zuccarello, Mario, additional, Quinsey, Carolyn, additional, Dewan, Michael C., additional, Young, Paul H., additional, Laws, Edward, additional, Rock, Jack, additional, Kurland, David B., additional, Muh, Carrie R., additional, Delgado Aguilar, Eri Dario, additional, Burns, Kenneth, additional, Low, Jacob, additional, Keogh, Conor, additional, Uff, Chris, additional, Spina, Alfio, additional, and Alelyani, Fayez, additional

Published
2020
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16. First Report of a Multicenter Prospective Registry of Cranioplasty in the United Kingdom and Ireland

Author

Fountain, Daniel M, Henry, Jack, Honeyman, Susan, O’Connor, Paul, Sekhon, Priya, Piper, Rory J, Edlmann, Ellie, Martin, Michael, Whiting, Gemma, Turner, Carole, Mee, Harry, Joannides, Alexis J, Kolias, Angelos G, Hutchinson, Peter J, Williams, Adam, Sinha, Ajay, Leggate, Alex, Belli, Antonio, Bahl, Anuj, McMahon, Catherine, Tolias, Christos, Holsgrove, Daniel, O’Brien, David, Bulters, Diederik, George, Edward St, Critchley, Giles, James, Greg, Akram, Harith, Pollock, Jonathan, Prasad, Manjunath, Ganau, Mario, Wilson, Mark, Hossain-Ibrahim, Mohammed, Bodkin, Peter, Whitfield, Peter, Mathew, Ryan K, Joshi, Shabin, Achawal, Shailendra, Harrisson, Stuart, Smith, Stuart, Lawrence, Tim, Al-Tamimi, Yahia, Committee, Steering, Bell, Anthony, Shaw, Simon, Brennan, Paul M, Anderson, Ian, Jamjoom, Aimun A B, Shoakazemi, Alireza, Khan, Amad, Kadhim, Ammar, Edwards-Bailey, Andrew, Bjornson, Anna, Roylance, Anthony, Zafar, Arif, Nabi, Asad, Baig Mirza, Asfand, Chari, Aswin, Yannoulias, Basil, Burford, Charlotte, Akhunbay-Fudge, Christopher, Millward, Christopher P, Hill, Ciaran, Barone, Damiano, Stastna, Daniela, Hajra, Debasish, Dasgupta, Debayan, Ferguson, Debbie, Viaroli, Edoardo, Toman, Emma, Solomou, Georgios, Jung, Josephine, Ekert, Justyna, Yakoub, Kamal M, Nozad, Lava, Haley, Mark, Petric, Marko, Khan, Mehdi, Akhbari, Melika, Amoo, Michael, Hollingworth, Milo, Naushahi, Mohammad, Fadelalla, Mohammed, Waqar, Mueez, Khan, Muhammad, El Sheikh, Mustafa, Abdulla, Mutwakil, McNulty, Nicola, Ghimire, Prajwal, Moon, Richard, Venturini, Sara, Lammy, Simon, Bandyopadhyay, Soham, Karavasili, Vanessa, SinghAlg, Varinder, Raptopoulos, Vasileios, Soon, Wai Cheong, and Singleton, Will

Abstract

Graphical Abstract

Published
2021
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17. Rapid brain shift, remote site hemorrhage, and a spinal hematoma after craniotomy for a large arachnoid cyst

Author

Bahl, Anuj, Connolly, Daniel, Sinha, Saurabh, Zaki, Hesham, and McMullan, John

Subjects
Hemorrhage -- Diagnosis -- Risk factors -- Case studies, Arachnoid cysts -- Care and treatment -- Patient outcomes -- Case studies, Craniotomy -- Usage -- Patient outcomes, Central nervous system diseases -- Diagnosis -- Risk factors -- Case studies, Health
Abstract

Byline: Anuj. Bahl, Daniel. Connolly, Saurabh. Sinha, Hesham. Zaki, John. McMullan Arachnoid cysts are prevalent among the general population. The management options of symptomatic arachnoid cysts each have their own [...]

Published
2012

27. CSF rhinorrhoea after endonasal intervention to the anterior skull base (CRANIAL): proposal for a prospective multicentre observational cohort study.

Author

Khan DZ, Bandyopadhyay S, Patel V, Schroeder BE, Cabrilo I, Choi D, Cudlip SA, Donnelly N, Dorward NL, Fountain DM, Grieve J, Halliday J, Kolias AG, Mannion RJ, O'Donnell A, Phillips N, Piper RJ, Ramachandran B, Santarius T, Sayal P, Sharma R, Solomou G, Tysome JR, Marcus HJ, Alalade AF, Ahmed S, Al-Barazi S, Al-Mahfoudh R, Bahl A, Bennett D, Bhalla R, Bhatt P, Dow G, Giamouriadis A, Gilkes C, Gnanalingham K, Hanna B, Hayhurst C, Hempenstall J, Hossain-Ibrahim K, Hughes M, Javadpour M, Jenkins A, Kamel M, Habibullah Khan M, Lacy P, Maratos E, Martin A, Mathad N, Mendoza N, Mirza S, Muquit S, Nair R, Nicholson C, Paluzzi A, Paraskevopoulos D, Pathmanaban O, Pollock J, Ram B, Robertson I, Ross P, Shaw S, Shoakazemi A, Sinha S, Stapleton S, Statham P, Stew B, Thomas N, Tsermoulas G, Weir P, and Williams A

Subjects
Cerebrospinal Fluid Leak, Cohort Studies, Humans, Postoperative Complications, Prospective Studies, Retrospective Studies, Skull Base surgery, Cerebrospinal Fluid Rhinorrhea epidemiology, Cerebrospinal Fluid Rhinorrhea etiology, Cerebrospinal Fluid Rhinorrhea surgery
Abstract

Background: The endonasal transsphenoidal approach (TSA) has emerged as the preferred approach in order to treat pituitary adenoma and related sellar pathologies. The recently adopted expanded endonasal approach (EEA) has improved access to the ventral skull base whilst retaining the principles of minimally invasive surgery. Despite the advantages these approaches offer, cerebrospinal fluid (CSF) rhinorrhoea remains a common complication. There is currently a lack of comparative evidence to guide the best choice of skull base reconstruction, resulting in considerable heterogeneity of current practice. This study aims to determine: (1) the scope of the methods of skull base repair; and (2) the corresponding rates of postoperative CSF rhinorrhoea in contemporary neurosurgical practice in the UK and Ireland., Methods: We will adopt a multicentre, prospective, observational cohort design. All neurosurgical units in the UK and Ireland performing the relevant surgeries (TSA and EEA) will be eligible to participate. Eligible cases will be prospectively recruited over 6 months with 6 months of postoperative follow-up. Data points collected will include: demographics, tumour characteristics, operative data), and postoperative outcomes. Primary outcomes include skull base repair technique and CSF rhinorrhoea (biochemically confirmed and/or requiring intervention) rates. Pooled data will be analysed using descriptive statistics. All skull base repair methods used and CSF leak rates for TSA and EEA will be compared against rates listed in the literature., Ethics and Dissemination: Formal institutional ethical board review was not required owing to the nature of the study - this was confirmed with the Health Research Authority, UK., Conclusions: The need for this multicentre, prospective, observational study is highlighted by the relative paucity of literature and the resultant lack of consensus on the topic. It is hoped that the results will give insight into contemporary practice in the UK and Ireland and will inform future studies.

Published
2021
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28. Blue rubber bleb naevus syndrome and Chiari malformation: high risk of peroperative haemorrhage.

Author

Bahl A, Raghavan A, and Sinha S

Subjects
Adolescent, Brain pathology, Female, Humans, Intracranial Hemorrhages etiology, Magnetic Resonance Imaging, Postoperative Hemorrhage etiology, Risk, Spine pathology, Syringomyelia pathology, Treatment Outcome, Arnold-Chiari Malformation complications, Arnold-Chiari Malformation surgery, Gastrointestinal Neoplasms complications, Gastrointestinal Neoplasms surgery, Intracranial Hemorrhages epidemiology, Intraoperative Complications etiology, Neurosurgical Procedures methods, Nevus, Blue complications, Nevus, Blue surgery, Postoperative Hemorrhage epidemiology, Skin Neoplasms complications, Skin Neoplasms surgery
Abstract

Blue rubber bleb naevus syndrome is an uncommon disorder whereby patients possess cutaneous vascular malformations. Cranial malformations have been rarely reported in the literature. We report the first ever case of a patient with blue rubber bleb naevus syndrome (BRBNS), who was found to have a symptomatic Chiari malformation and prominent subcutaneous vascular malformations in communication with the intracranial venous sinuses. In our case, a routine operation for Chiari malformation was complicated by significant blood loss. The operative hazards are presented along with suggested peri-operative management strategies when carrying out neurosurgical operations on patients with BRBNS. A brief literature review is included.

Published
2013
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