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The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review

Chinese Neurosurgical Journal 2020年第4期6卷 230-234页

作者： Zahraa F.Al-Sharshahi Samer S.Hoz Mohammed A.Alrawi Mohammed A.Sabah Saja A.Albanaa luis rafael moscote-salazar Department of Neurosurgery Neurosurgery teaching HospitalBaghdadIraq College of Medicine University of BaghdadBaghdadIraq RED LATINO Latin American Trauma&Intensive Neuro-Care OrganizationBogotáColombia

Simulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety.Several models have been used for simulation purposes.Non-living animal models offer a range of benefits,including affordability,availability,biological texture,and a comparable similarity to human anatomy.In this paper,we review the available literature on the use of non-living animals in neurosurgical simulation training.We aim to answer the following questions:(1)what animals have been used so far,(2)what neurosurgical approaches have been simulated,(3)what were the trainee tasks,and(4)what was the experience of the authors with these models.A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020.Our initial search yielded a total of 70 results.After careful screening,we included 22 articles for qualitative analysis.We compared the reports in terms of the(1)animal used,(2)type of surgery,and(3)trainee tasks.All articles were published between 2003 and 2019.These simulations were performed on three types of animals,namely sheep,cow,and swine.All authors designed specific,task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches.Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training.Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training.These models enable the acquisition and refinement of surgical skills,with the added benefits of accessibility and cost-effectiveness.To date,16 different microneurosurgical cranial approaches have been replicated on three non-living animal models,including sheep,cows,and swine.This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training,with particular attention to the se

关键词： Neurosurgery Cranial Simulation Non-living Sheep Swine Cow

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Intracranial hematoma development following thrombolysis inpatients suffering with acute myocardial infarction: Management strategy

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Journal of Acute Disease 2018年第5期7卷 217-219页

作者： luis rafael moscote salazar Amit Agrawal Guru Dutta Satyarthee George Chater Cure Alfonso Pacheco-Hernandez Universidad de Cartagena Cartagena de IndiasColombia Department of Neurosurgery Narayna Medical College HospitalChinthareddypalemNellore-524003Andhra PradeshIndia All India Institute of Medical Sciences New DelhiIndia Clinica General de Norte BarranquillaColombia

Intracerebral hemorrhage secondary to thrombolysis in patients with acute myocardial infarction is a catastrophic condition.Several factors predispose to intracranial bleeding including low body weight,female sex,advanced age,use of oral anticoagulants prior to the administration of fibrinolytic therapy,diastolic blood pressure (greater than 110 mm Hg),among others.Optimal medical management involves multidisciplinary roles of hematology,neurosurgery and critical medicine.In this illustrative case,a classification and management algorithm were proposed for patients with complications hemorrhage associated with thrombolysis after myocardial infarction.

关键词： Acute myocardial infarction Thrombolysis Intracranial hematoma Management Outcome

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Neuroprotective effects of progesterone in acute brain trauma and its physiological mechanism

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Journal of Acute Disease 2018年第1期7卷 20-25页

作者： luis rafael moscote-salazar Alexis Narvaez-Rojas Amit Agrawal Guru Dutta Satyarthee Samer Hoz Johana Maraby-Salgado Andrei FJoaquim Cartagena Neurotrauma Research Group Universidad de Cartagena CartagenaColombia Universidad Nacional Autonoma de Nicaragua Managua Cartagena Neurotrauma Research GroupUniversidad de CartagenaCartagenaColombia Department of Neurosurgery Narayna Medical College Hospital ChinthareddypalemNellore-524003Andhra PradeshIndia All India Institute of Medical Science New DelhiIndia Teaching Neurosurgery Hospital Bagdad-Iraq Universidad de Cartagena CartagenaColombia Department of Neurology Neurosurgery DivisionState University of CampinasCampinas-Sao PauloBrazil

Traumatic brain injury (TBI) is the leading cause of death and neurological disability in young adults worldwide. This work aims to review the role of progesterone in traumatic brain injury and the usefulness as a possible treatment. We searched pubmed database (2000-2017) for articles containing 'progesterone and brain traumatic injury'. Basic science studies have advanced knowledge of the mechanisms of secondary brain injury, creating prospects for the medical and pharmacological management of TBI. Although several comparative studies evaluated both the efficacy and safety of several groups of drugs, in which, corticosteroids, tranexamic acid, βreceptor antagonists, erythropoiesis-stimulating agents, reductase inhibitorsinclude hydroxymethyl glutaryl-CoA inhibitors (statins), among others. Several studies even evaluated the role of progesterone in the treatment of TBI, which is providing growing evidence about its potential neuroprotective mechanisms during the acute phase of trauma. Despite recent advances in the field of management of TBI care in the emergency units, intensive care and the multiple trials for more than 20 years to find useful pharmacological treatments, most of these efforts failed in pre-clinical stages (II and III).

关键词： Head trauma Progesterone Neural trauma Hormones

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Cardiovascular complications associated with spinal cord injury

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Journal of Acute Disease 2018年第4期7卷 139-144页

作者： Roberto Fabio Calvo-Infante Alexis Narvaez-Rojas Huber Padilla-Zambrano Samer S.Hoz Amit Agrawal luis rafael moscote-salazar University of Cartagena Cartagena de IndiasColombia Universidad Nacional Autonoma de Nicaragua Nicaragua Neurosurgeon Department of NeurosurgeryNeurosurgery teaching Hospital-BaghdadIraq Department of Neurosurgery Narayna Medical College HospitalChinthareddypalemNellore-524003Andhra PradeshIndia Neurosurgery-Critical Care Cartagena Neurotrauma Research GroupUniversidad de CartagenaCartagena de IndiasColombia

Spinal cord injury can lead to important functional, psychological and social sequelae. Despite the progress in medicine and greater understanding of the pathophysiological events associated with a traumatic spinal cord injury, spinal cord injury is still associated with a high morbidity and mortality. The involvement of the autonomic nervous system has implications in acute and chronic stages of the injured spinal cord patients. The most frequent cardiovascular complications in the acute phase of the traumatic spinal lesions are bradyarrhythmia, hypotension, increased vasovagal reflexes, ventricular and supraventricular ectopic beats, venous stasis, and vasodilation. In the chronic phase, we find orthostatic hypotension, alteration of the arterial pressure and the regulation of the body temperature as well as alteration of the blood volume. The knowledge of the cardiovascular alterations is of vital importance for the management and rehabilitation of the patients with spinal cord injury. In this article, we present a critical review of medical literature.

关键词： Complications Spinal cord trauma Spinal cord

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Acute intra-operative brain swelling managed effectively with emergency basal cisternostomy: A case report

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Journal of Acute Disease 2018年第1期7卷 43-44页

作者： Muthanna Noman Abdulqader Ahmed Hamid Al-Tameemi Hayder Salih Samer SHoz Abdullah HAl Ramadan luis rafael moscote salazar Department of Neurosurgery Neurosurgery Teaching HospitalBaghdadIraq Department of Neurosurgery King Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia Department of Neurosurgery Red-Latino-Colombia

The cisternostomy is a novel technique for the management of intracranial hypertension. Intracranial hypertension is the most frequent cause of mortality in patients with acute brain injury. The availability of a less aggressive technique compared to decompressive craniectomy is an advantage for neurosurgeons. We presented a case that demonstrates the successful use of this technique.

关键词： Neurosurgery Cysternostomy Stroke

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Cranio-cervical bone hyperpneumatization: An overview and illustrative case

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Journal of Acute Disease 2018年第4期7卷 145-148页

作者： Mohammed Maan AbdulAzeez Padilla-Zambrano Huber Salima B.Alsaadi Cabreras-Nanclares B.Vladimir luis rafael moscote salazar Samer S.Hoz College of Medicine Baghdad UniversityBaghdadIraq College of Medicine University of CartagenaCartagena de IndiasColombia Neuroradiology Department Neurosurgery Teaching HospitalBaghdadIraq Department of Neurosurgery Red-Latino-Colombia Neurosurgery Department Neurosurgery Teaching HospitalBaghdadIraq

The pneumatization of regions such as the apex of the temporal crag, the mastoid cells and the perilaberytic region is considered physiological in adults. The process of craniocervical pneumatization in unhealthy adults derives from a dysfunction at the level of the eustachian tube, which provides a valve effect causing an increase in pressure at the level of the middle ear, forcing the entry of air into the dome of the skull through the opening of the occipitomastoidal suture. The process of standard pneumatization of the temporal bones, begins in the final weeks preceding birth, characterized by a decrease in the embryonic mesenchyme at the antrum level and progresses through childhood until adolescence, when the stone portion at the level of the rock is pneumatized;Normal variants have been reported, such as pneumatization that extends from the temporal scale to behind the sigmoid sinus. With regard to the process of hyperneumatization, several etiologies have been proposed that a congenital process versus an acquired process to develop this condition should be compared. The present illustrative case is a seventy-three years old male presented to the outpatient clinic with chronic recurrent occipital headache, already investigated by general practitioner for elevated blood pressure which was excluded. We had checked him to exclude the cervical spinal origin of the occipital headache which was then excluded too. This case scenario demonstrates the debate about how to deal with such cases and thus the review will bring the attention of those who take care of such radiological findings to keep in mind the possible causes and complications according to the reported cases till now. We concluded that the hyperpneumatization of the craniocervical junction is an uncommon radiological finding that is usually asymptomatic although it can entail serious complications in some instances, especially when it enlarges progressively, which may be due to an acquired process. Thus, craniocervical hyperpneumatization deserves hig

关键词： Craniocervical bone Hyperpneumatization of cranial bones

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Use of antiepileptic drugs in children with brain tumors: A review for acute management

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Journal of Acute Disease 2018年第5期7卷 181-185页

作者： Jennifer Herrera-Bejarano Amit Agrawal Claudia Marcela Navas Valbuena Guru Dutta Satyarthee Chandramouli Balasubramanian Andrei F.Joaquim George Chater Cure luis rafael moscote-salazar Physician Universidad del RosarioBogotaColombia Professor of Neurosurgery MM Institute of Medical Sciences&ResearchMaharishi Markandesh(w)ar UniversityMullana-Ambala133-207.HaryanaIndia Physician Universidad Industrial de SantanderUISBucaramangaColombia Assistant Professor of Neurosurgery All India Institute of Medical SciencesNew DelhiIndia Department of Neurosurgery Birmingham Children's HospitalBirminghamUK Department of Neurology Neurosurgery DivisionUniversity of Campinas(UNICAMP)Campinas-SPBrazil Neurosurgeon Clinica General del NorteBarranquillaColombia Neurosurgeon-Critical Care University of CartagenaCartagena de IndiasColombia

Patients with primary or secondary tumors in the central nervous system may have seizures resulting from direct tissue damage,metabolic abnormalities,infection,or toxic side effects of medications.In pediatric patients,it is more frequent to use drugs to control secondary epilepsy.In this article,we discuss the main nuances of antiepileptic drugs for the proper management of children with central nervous system tumors.

关键词： Antiepileptic drugs Brain tumors Neuro oncology Seizures

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Hyponatremia in the acute phase of spinal cord trauma: Review

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Journal of Acute Disease 2018年第3期7卷 103-107页

作者： luis rafael moscote salazar Amit Agrawal Guru Dutta Satyarthee Huber S.Padilla-Zambrano Boris Vladimir Cabrera-Nanclares Romario Mendoza-Flórez Samer Hoz Alexis Narvaez-Rojas Universidad de Cartagena Cartagena de IndiasColombia Department of Neurosurgery Narayna Medical College HospitalChinthareddypalemNellore-524003Andhra PradeshIndia All India Institute of Medical Sciences New DelhiIndia School of Medicine.Centro de Investigaciones Biomédicas(CIB).Cartagena Neurotrauma Research Group research line.Faculty of Medicine-University of Cartagena CartagenaColombia Neurosurgery Teaching Hospital BaghdadIraq Universidad Nacional Autonoma de Managua Nicaragua

Hyponatremia is a common electrolyte disturbance usually observed in neurosurgical patients undergoing surgical management of traumatic, as well as, nontraumatic intracranial pathology. The spinal cord trauma is also associated with occasional development of such hyponatremia;it usually occurs within the first two-weeks of the injury. Hyponatremia can lead to alterations of consciousness, convulsions, coma, cardiac arrhythmias and on rare occasions, death. Authors present a practical oriented review of the literature.

关键词： Hyponatremia Serum sodium Spinal cord trauma Neurotrauma Injury

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Preoperative embolization of skull-base tumors: Indications, utility, and concerns

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Journal of Acute Disease 2019年第3期8卷 89-94页

作者： luis rafael moscote-salazar Ali Adnan Dolachee Alexis Narvaez-Rojas Hayder Ali Al-Saadi Arjan A.Najim Aysar Khudhair jassam Alyaa Khadim Abdulreda Ali Odai Mahmood Haya Jasim Mohammed Samer S.Hoz University of Cartagena Cartagena de IndiasColombia Department of Surgery College of MedicineUniversity of Al-QadisiyahIraq Department of Neurosurgery Universidad Nacional Autonoma de NicaraguaManaguaNicaragua Department of Neurosurgery Neurosurgery Teaching HospitalBaghdadIraq

Skull-base tumors are generally difficult to access compared with many other cranial lesions. Usually surgery remains the gold standard treatment for the majority of these tumors. However, in many cases, surgical resection is a challenge because the disease usually is already in the advanced stage by the time of diagnosis. Additionally, there are hypervascular lesions which cause excessive loss of blood, then results in multiple blood transfusions and prolonged operative time, increases the risk of neural injury and prevents complete excision. In order to reduce blood loss intraoperatively, many alternatives were available with the neurosurgical armamentarium, such as head elevation, intravenous use of tranexamic acid, total intravenous anesthesia and even preoperative embolization of tumors. However, preoperative embolization carries variable results, potentially aggravating edema and increasing tumor size. To ascertain the current status and the up-to-date indications, an evaluation of the therapeutic role of preoperative embolization was performed in the current study.

关键词： Pre-operative Embolization Skull-base tumors

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Pharmacological potential of acetazolamide in traumatic intracranial hypertension

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Journal of Acute Disease 2018年第4期7卷 149-151页

作者： López-Cepeda Daniela Ramos-Villegas Yancarlos Padilla-Zambrano Huber S. Andrade-López Andrea Quintana-Pájaro Loraine Corrales-Santander Hugo Samer S.Hoz luis rafael moscote-salazar 无 University of Cartagena Cartagena de IndiasBolivarColombia Center for Biomedical Research Faculty of Medicine-University of CartagenaCartagena Colombia Cartagena Neurotrauma Research Group Universidad de CartagenaColombia Coordinator Center for Biomedical Research(CIB) Faculty of Medicine-University of CartagenaCartagena Colombia Medicine Program-rafael Nú?ez University Corporation CartagenaColombia Specialist in Neurosurgery Faculty of Medicine-University of CartagenaCartagena de IndiasBolívarColombia Department of Neurosurgery Neurosurgery teaching Hospital-BaghdadIraq

Traumatic brain injuries are an important cause of morbidity and mortality around the world. These types of lesions are often associated with increased intracranial pressure and cerebral edema, proper management of this can reduce tissue damage of the brain and improve brain perfusion. The use of acetazolamide is not indicated in guidelines for the management of intracranial hypertension, which is used to a great extent for the management of idiopathic intracranial hypertension. However, it is not yet known in the management of traumatic intracranial hypertension.

关键词： Brain injuries Intracranial hypertension Acetazolamide

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