Identifying Factors Associated With a Poor Outcome Following External Ventricular Drain Insertion for Spontaneous Intraparenchymal Haemorrhage.

Introduction: External ventricular drains (EVDs) are used in the management of spontaneous intraparenchymal haemorrhage (ICH) to divert cerebrospinal fluid and reduce intracranial pressure. Despite being a recognised treatment, there remains a lack of data on outcomes after surgery.

Methods: Data was collected for all EVDs inserted from 2010 to 2022 at a tertiary neurosurgery centre in Sydney.

Cerebrospinal fluid white cell count to red cell count ratio as a predictor of ventriculitis in patients with external ventricular drains.

Introduction: External ventricular drain (EVD) associated ventriculitis is a complication of EVD placement associated with significant morbidity and mortality. Gold-standard for EVD associated bacterial ventriculitis diagnosis involves cerebrospinal fluid (CSF) sampling from the EVD with microscopy, culture and sensitivity testing. The ratio of white blood cells to red blood cells has anecdotally been considered a predictive factor in diagnosing EVD associated ventriculitis, however no study has been done demonstrating this.

Is neurotrauma training in rural New South Wales still required following the implementation of the New South Wales State Trauma Plan?

Background: In New South Wales (NSW), Australia, trauma accounts for 6% of deaths. Trauma patients receiving definitive care in regional trauma centres are 34% more likely to have a fatal outcome compared to level 1 centres. Following the implementation of the NSW State Trauma Plan where patients with major trauma are fast tracked to regional trauma services, should NSW rural surgeons and retrieval doctors continue to receive surgical training in neurotrauma?

Methods: The study's primary objective was to ascertain which NSW regional and rural hospitals have the equipment to perform neurotrauma and when it was last used.

Transcranial Doppler-derived indices of cerebrovascular haemodynamics are independent of depth and angle of insonation.

Continuous measurement of cerebral blood flow velocity (CBFV) of the middle cerebral artery (MCA) using transcranial Doppler (TCD) and arterial blood pressure (ABP) monitoring enables assessment of cerebrovascular haemodynamics. Further indices describing cerebrovascular function can be calculated from ABP and CBFV, such as the mean index (Mxa) of cerebrovascular autoregulation, the 'time constant of the cerebral arterial bed' (tau), the 'critical closing pressure' (CrCP) and a 'non-invasive estimator of ICP' (nICP). However, TCD is operator-dependent and changes in angle and depth of MCA insonation result in different readings of CBFV.

Dynamic myelopathy as a result of C1 posterior arch aplasia and os odontoideum. A case report.

The atlas (C1) and axis (C2) have distinct morphologies to support the skull and facilitate head rotation and neck flexion. Congenital defects of C1 posterior arch are rare. We present a case of a 59-year-old man with both an absent C1 posterior arch with concomitant os odontoideum.

Expression of Components of the Renin-Angiotensin System by the Putative Stem Cell Population Within WHO Grade I Meningioma.

We have recently demonstrated a putative stem cell population within WHO grade I meningioma (MG) that expressed embryonic stem cell (ESC) markers OCT4, NANOG, SOX2, KLF4 and c-MYC, localized to the endothelial and pericyte layers of the microvessels. There is increasing recognition that the renin-angiotensin system (RAS) plays a critical role in stem cell biology and tumorigenesis. This study investigated the expression of components of the RAS: pro-renin receptor (PRR), angiotensin converting enzyme (ACE), angiotensin II receptor 1 (ATIIR1), and angiotensin II receptor 2 (ATIIR2) on the putative stem cell population on the microvessels of WHO grade I MG.

Expression of Embryonic Stem Cell Markers on the Microvessels of WHO Grade I Meningioma.

The presence of cells within meningioma (MG) that express embryonic stem cell (ESC) markers has been previously reported. However, the precise location of these cells has yet to be determined. 3,3-Diaminobenzidine (DAB) immunohistochemical (IHC) staining was performed on 11 WHO grade I MG tissue samples for the expression of the ESC markers OCT4, NANOG, SOX2, KLF4 and c-MYC.

An unusual presentation of cerebellar lymphoma.

We report a case of a 40 year old female who presented with a three month history of headaches with a background of Myasthenia Gravis (MG), treated with azathioprine. MRI brain demonstrated a rim-enhancing lesion in the left posterior fossa. CT scan of the chest abdomen and pelvis revealed no other lesion.

Tumour stem cells in meningioma: A review.

Meningioma is a common intracranial and intraspinal neoplasm accounting for 25-30% of all primary neurological tumours. It is associated with high rates of recurrence especially in higher-grade tumours and lesions located at the skull base. Cancer stem cells are increasingly recognised as the origin of cancer and are attributed to loco-regional recurrence, metastasis and treatment resistance.

Metastatic thymoma presenting as spontaneous epidural lumbar haematoma.

We report the case of a 44-year-old man who was found to have metastatic thymoma to his lumbar spine presenting as a spontaneous epidural haematoma. The man presented with back pain and cauda equina like symptoms in the absence of trauma, antiplatelet or anticoagulant agents. Following a laminectomy and excision of the epidural collection he made a full neurological recovery.

Spinal intradural myxoid chondrosarcoma.

The authors present a rare case of intradural extramedullary spinal chondrosarcoma. This 38-year-old man presented with urinary retention and lower-limb weakness. Magnetic resonance imaging demonstrated a thoracic intradural extramedullary spinal tumor, which was resected.

Using smart phone video to supplement communication of radiology imaging in a neurosurgical unit: technical note.

Background: The use of smart phones within medicine continues to grow at the same rate as mobile phone technology continues to evolve. One use of smart phones within medicine is in the transmission of radiological images to consultant neurosurgeons who are off-site in an emergency setting. In our unit, this has allowed quick, efficient, and safe communication between consultant neurosurgeon and trainees, aiding in rapid patient assessment and management in emergency situations.

Use of a synthetic dural substitute to prevent ventral retethering in the management of diastematomyelia.

Diastematomyelia is a congenital condition where the spinal cord is split by a bony or cartilaginous septum. Neurological signs and symptoms arise when this septum tethers the spinal cord. Surgical detethering often improves symptoms; however, recurrent tethering of the cord is increasingly recognised as a long-term complication.

Luteal phase defect: part of the infertility zeitgeist or relic from the past?

Luteal phase defect (LPD) or short luteal phase is a controversial entity that has been variously defined over the years. There are a number of potential causes for LPD all of which are associated with inadequate progesterone secretion throughout the luteal phase which impairs endometrial development and is thus thought to cause infertility. However, the relationship between LPD and infertility is complex, with LPD found in both fertile and infertile women.