bluuebunny/crossref_metadata_2025 huggingface dataset:
Nerve Conduction Study in Bell's Palsy
Authors: Shah Sanjib Kumar , Kothari R. P. , Bassi S. D.
Published: April 2019

Background: Nerve conduction study (NCS) is an important electrophysiological tool that can be used for the measurement of the latency and amplitude of the facial nerve. The NCS helps in predicting the prognosis of patients with Bell's palsy. Evaluation of NCS of patients with Bell's palsy may have contribution in counselling and management of the patient.

Objective: The study was aimed to study the state of nerve damage in patients with Bell's palsy. Methods: The latency and amplitude of facial nerve stimulating bilateral Orbicularis Oculi and Orbicularis Oris muscles were assessed and noted in 24 patients of Bell's palsy.

Results: 15(62.5%) of the patients had significant axonal injury affecting one side and only 1(4.16%) patient had demyelinating injury. The total of 8(33.33%) patients had insignificant axonal injury of the facial nerve in comparision with the normal side.

Conclusions: Nerve conduction study shows predominant axonal type of facial nerve injury in patients with Bell's palsy and hence provides valuable information regarding the prognosis and the state of nerve damage in patients with Bell's palsy.
Alteration of metabolic connectivity in a rat model of deafferentation pain: a 18F-FDG PET/CT study
Authors: Huo Bei-Bei , Shen Jun , Hua Xu-Yun , Zheng Mou-Xiong , Lu Ye-Chen , Wu Jia-Jia , Shan Chun-Lei , Xu Jian-Guang
Published: April 2019

OBJECTIVE

Refractory deafferentation pain has been evidenced to be related to central nervous system neuroplasticity. In this study, the authors sought to explore the underlying glucose metabolic changes in the brain after brachial plexus avulsion, particularly metabolic connectivity.

METHODS

Rats with unilateral deafferentation following brachial plexus avulsion, a pain model of deafferentation pain, were scanned by small-animal 2-deoxy-[18F]fluoro-d-glucose (18F-FDG) PET/CT to explore the changes of metabolic connectivity among different brain regions. Thermal withdrawal latency (TWL) and mechanical withdrawal threshold (MWT) of the intact forepaw were also measured for evaluating pain sensitization. Brain metabolic connectivity and TWL were compared from baseline to 1 week after brachial plexus avulsion.

RESULTS

Alterations of metabolic connectivity occurred not only within the unilateral hemisphere contralateral to the injured forelimb, but also in the other hemisphere and even in the connections between bilateral hemispheres. Metabolic connectivity significantly decreased between sensorimotor-related areas within the left hemisphere (contralateral to the injured forelimb) (p < 0.05), as well as between areas across bilateral hemispheres (p < 0.05). Connectivity between areas within the right hemisphere (ipsilateral to the injured forelimb) significantly increased (p = 0.034). TWL and MWT of the left (intact) forepaw after surgery were significantly lower than those at baseline (p < 0.001).

CONCLUSIONS

This study revealed that unilateral brachial plexus avulsion facilitates pain sensitization in the opposite limb. A specific pattern of brain metabolic changes occurred in this procedure. Metabolic connectivity reorganized not only in the sensorimotor area corresponding to the affected forelimb, but also in extensive areas involving the bilateral hemispheres. These findings may broaden our understanding of central nervous system changes, as well as provide new information and a potential intervention target for nosogenesis of deafferentation pain.
Safety and efficacy of anterior communicating artery compromise during endovascular coil embolization of adjoining aneurysms
Authors: Choi Hyun Ho , Cho Young Dae , Yoo Dong Hyun , Lee Su Hwan , Yeon Eung Koo , Kang Hyun-Seung , Cho Won-Sang , Kim Jeong Eun , Han Moon Hee
Published: April 2019

OBJECTIVE

In the presence of symmetric A1 flow, the safety and efficacy of compromising the anterior communicating artery (ACoA) during coil embolization of ACoA aneurysms has yet to be evaluated. Herein, the authors describe their experience, focusing on procedural safety.

METHODS

Between October 2012 and July 2017, 285 ACoA aneurysms with symmetric A1 flows were treated at the authors’ institution by endovascular coil embolization. Clinical and angiographic outcome data were subjected to binary logistic regression analysis.

RESULTS

ACoA compromise was chosen in the treatment of 71 aneurysms (24.9%), which were completely (n = 15) or incompletely (n = 56) compromised. In the remaining 214 lesions, the ACoA was preserved. Although 9 patients (3.2%) experienced procedure-related thromboembolisms (compromised, 4; preserved, 5), all but 1 patient (with ACoA compromise) were asymptomatic. In multivariate analysis, subarachnoid hemorrhage at presentation was the sole independent risk factor for thromboembolism (OR 15.98, p < 0.01), with ACoA compromise being statistically unrelated. In 276 aneurysms (96.8%) with follow-up of > 6 months (mean 20.9 ± 13.1 months, range 6–54 months), recanalization was confirmed in 21 (minor, 15; major, 6). A narrow (≤ 4 mm) saccular neck (p < 0.01) and ACoA compromise (p = 0.04) were independently linked to prevention of recanalization.

CONCLUSIONS

During coil embolization of ACoA aneurysms, the ACoA may be compromised without serious complications if A1 flows are symmetric. This approach may also confer some long-term protection from recanalization, serving as a valid treatment option for such lesions.
The striking effects of deep cerebellar stimulation on generalized fixed dystonia: case report
Authors: Horisawa Shiro , Arai Takashi , Suzuki Naoki , Kawamata Takakazu , Taira Takaomi
Published: April 2019

Cerebellar neuromodulation could influence the pathological abnormalities of movement disorders through several connections between the cerebellum and the basal ganglia or other cortices. In the present report, the authors demonstrate the effects of cerebellar deep brain stimulation (DBS) on a patient with severe generalized fixed dystonia (FD) that was refractory to bilateral pallidotomy and intrathecal baclofen therapy. A previously healthy 16-year-old girl presented with generalized FD. Bilateral pallidotomy and intrathecal baclofen therapy had failed to resolve her condition, following which she received DBS through the bilateral superior cerebellar peduncle (SCP) and dentate nucleus (DN). Ipsilateral stimulation of the SCP or DN improved the FD, and the ability of DBS administered via the SCP to relax muscles was better than that of DN DBS. A considerable improvement of generalized FD, from a bedridden state to a wheelchair-bound state, was observed in the patient following 6 months of chronic bilateral DBS via the SCP; moreover, the patient was able to move her arms and legs. The findings in the present case suggest that neuromodulation of deep cerebellar structures is a promising treatment for FD that is refractory to conventional treatments.
Clinical characteristics of and treatment protocol for trapped temporal horn following resection of lateral ventricular trigone meningioma: a single-center experience
Authors: Lin Zhiqin , Wang Chengjun , Gao Zhenwen , Li Xiangrong , Lan Folin , Liu Tianqing , Wang Yongzhi , Jiang Zhongli
Published: April 2019

OBJECTIVE

Trapped temporal horn (TTH) is a rare subtype of loculated hydrocephalus that is often managed surgically. The natural history of TTH is not well understood, and there are few data on the outcomes of conservative management of this condition. The aim of this study was to analyze the clinical features and outcomes of conservatively and surgically managed cases of TTH.

METHODS

The authors retrospectively reviewed the clinical data for 19 consecutive cases of TTH that developed after microsurgical resection of lateral ventricular trigone meningioma between 2011 and 2015.

RESULTS

The 19 cases involved 6 male and 13 female patients (mean age [± SD] 39.9 ± 13.8 years). The mean time interval from tumor resection to onset of TTH was 3.2 ± 3.0 months (range 3 days–10 months). Symptoms of intracranial hypertension were the most common complaints at presentation. The mean Karnofsky Performance Scale (KPS) score at onset was 52.1 ± 33.3 (range 10–90). Midline shift was observed in 15 cases (78.9%), and the mean amount of midline shift was 6.0 ± 4.8 mm (range 0–15 mm). Eleven cases (57.9%) were managed with surgical intervention, while 8 cases (42.1%) were managed conservatively. All patients (100%) showed improved clinical status over the course of 4.8 ± 1.0 years (range 2.8–6.3 years) of follow-up. The mean KPS score at last follow-up was 87.9 ± 11.3 (range 60–100). Eighteen patients (94.7%) showed signs of radiographic improvement, and 1 patient (5.3%) exhibited stable size of the temporal horn. Significant differences were observed between the surgical and nonsurgical cohorts for the following variables: KPS score at onset, presence of intracranial hypertension, and midline shift. The mean KPS score at onset was greater (better) in the nonsurgical group than in the surgical group (82.5 ± 8.9 vs 30 ± 25.7, p = 0.001). A greater proportion of patients in the surgical group presented with symptoms of intracranial hypertension (81.8% vs 0%, p = 0.001). The extent of midline shift was greater in the surgical group than in the nonsurgical group (9.0 ± 3.8 mm vs 2.0 ± 2.4 mm, p = 0.001).

CONCLUSIONS

The majority of patients with TTH presented in a delayed fashion. TTH is not always a surgical entity. Spontaneous resolution of TTH may be under-reported. Conservative management with clinical and radiological follow-up is effective in selected patients.
The influence of nimodipine and vasopressors on outcome in patients with delayed cerebral ischemia after spontaneous subarachnoid hemorrhage
Authors: Paľa Andrej , Schick Julia , Klein Moritz , Mayer Benjamin , Schmitz Bernd , Wirtz Christian Rainer , König Ralph , Kapapa Thomas
Published: April 2019

OBJECTIVE

Delayed cerebral ischemia (DCI) is a major factor contributing to the inferior outcome of patients with spontaneous subarachnoid hemorrhage (SAH). Nimodipine and induced hypertension using vasopressors are an integral part of standard therapy. Consequences of the opposite effect of nimodipine and vasopressors on blood pressure on patient outcome remain unclear. The authors report the detailed general characteristics and influence of nimodipine and vasopressors on outcome in patients with SAH.

METHODS

The authors performed a 2-center, retrospective, clinical database analysis of 732 SAH patients treated between 2008 and 2016. Demographic and clinical data such as age, sex, World Federation of Neurosurgical Societies (WFNS) grade, BMI, Fisher grade, history of arterial hypertension and smoking, aneurysm location, C-reactive protein (CRP) level, and detailed dosage of vasopressors and nimodipine during the treatment period were evaluated. Clinical outcome was analyzed using the modified Rankin Scale (mRS) 6 months after treatment. Univariate and multivariate regression analyses were performed. Additionally, mean arterial pressure (MAP), age, nimodipine, and vasopressor dose cutoff were evaluated with regard to outcome. The level of significance was set at ≤ 0.05.

RESULTS

Follow-up was assessed for 397 patients, 260 (65.5%) of whom achieved a good outcome (defined as an mRS score of 0–3). Univariate and multivariate analyses confirmed that nimodipine (p = 0.049), age (p = 0.049), and CRP level (p = 0.002) are independent predictors of good outcome. WFNS grade, Fisher score, hypertension, initial hydrocephalus, and total vasopressor dose showed significant influence on outcome in univariate analysis, and patient sex, smoking status, BMI, and MAP showed no significant association with outcome. A subgroup analysis of patients with milder initial SAH (WFNS grades I–III) revealed that initial hydrocephalus (p = 0.003) and CRP levels (p = 0.001) had significant influence on further outcome. When evaluating only patients with WFNS grade IV or V, age, CRP level (p = 0.011), vasopressor dose (p = 0.030), and nimodipine dose (p = 0.049) were independent predictors of patient outcome. Patients with an MAP < 93 mm Hg, a nimodipine cutoff dose of 241.8 mg, and cutoff total vasopressor dose of 523 mg had better outcomes.

CONCLUSIONS

According to the authors’ results, higher doses of vasopressors can safely provide a situation in which the maximum dose of nimodipine could be administered. Cutoff values of the total vasopressor dose were more than 3 times higher in patients with severe SAH (WFNS grade IV or V), while the nimodipine cutoff remained similar in patients with mild and severe SAH. Hence, it seems encouraging that a maximum nimodipine dosage can be achieved despite the need for a higher vasopressor dose in patients with SAH.
Dorsal component of the superior longitudinal fasciculus revisited: novel insights from a focused fiber dissection study
Authors: Komaitis Spyridon , Skandalakis Georgios P. , Kalyvas Aristotelis V. , Drosos Evangelos , Lani Evgenia , Emelifeonwu John , Liakos Faidon , Piagkou Maria , Kalamatianos Theodosis , Stranjalis George , Koutsarnakis Christos
Published: April 2019

OBJECTIVE

The aim of this study was to investigate the anatomical consistency, morphology, axonal connectivity, and correlative topography of the dorsal component of the superior longitudinal fasciculus (SLF-I) since the current literature is limited and ambiguous.

METHODS

Fifteen normal, adult, formalin-fixed cerebral hemispheres were studied through a medial to lateral fiber microdissection technique. In 5 specimens, the authors performed stepwise focused dissections of the lateral cerebral aspect to delineate the correlative anatomy between the SLF-I and the other two SLF subcomponents, namely the SLF-II and SLF-III.

RESULTS

The SLF-I was readily identified as a distinct fiber tract running within the cingulate or paracingulate gyrus and connecting the anterior cingulate cortex, the medial aspect of the superior frontal gyrus, the pre–supplementary motor area (pre-SMA), the SMA proper, the paracentral lobule, and the precuneus. With regard to the morphology of the SLF-I, two discrete segments were consistently recorded: an anterior and a posterior segment. A clear cleavage plane could be developed between the SLF-I and the cingulum, thus proving their structural integrity. Interestingly, no anatomical connection was revealed between the SLF-I and the SLF-II/SLF-III complex.

CONCLUSIONS

Study results provide novel and robust anatomical evidence on the topography, morphology, and subcortical architecture of the SLF-I. This fiber tract was consistently recorded as a distinct anatomical entity of the medial cerebral aspect, participating in the axonal connectivity of high-order paralimbic areas.
Preoperative MRI findings and prediction of diagnostic utility of foramen ovale electrodes
Authors: Bick Sarah K. , Dolatshahi Marjan S. , Grannan Benjamin L. , Cole Andrew J. , Hoch Daniel B. , Eskandar Emad N.
Published: April 2019

OBJECTIVE

Foramen ovale electrodes (FOEs) are a minimally invasive method to localize mesial temporal seizures in cases in which noninvasive methods are inconclusive. The objective of this study was to identify factors predicting the ability of FOEs to yield a diagnosis in order to determine optimal candidates for this procedure.

METHODS

All cases of diagnostic investigations performed with FOEs at the authors’ institution between 2005 and 2017 were reviewed. FOE investigation was defined as diagnostic if it led to a treatment decision. Demographic and clinical variables for diagnostic and nondiagnostic investigations were compared using a Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables.

RESULTS

Ninety-three patients underwent investigations performed with FOEs during the study period and were included in the study. FOE investigation was diagnostic in 75.3% of cases. Of patients who underwent anterior temporal lobectomy following diagnostic FOE evaluation, 75.9% were Engel class I at last follow-up (average 40.1 months). When the diagnostic and nondiagnostic FOE groups were compared, patients who had diagnostic investigations were more likely to be male (57.1% male vs 26.1% in the nondiagnostic group, p = 0.015). They were also more likely to have temporal lesions on preoperative MRI (p = 0.018).

CONCLUSIONS

FOEs are a useful, minimally invasive diagnostic modality resulting in a treatment decision in 75% of cases. Male patients and patients with temporal lesions on MRI may be most likely to benefit from FOE investigation.
Survival benefit of lobectomy over gross-total resection without lobectomy in cases of glioblastoma in the noneloquent area: a retrospective study
Authors: Roh Tae Hoon , Kang Seok-Gu , Moon Ju Hyung , Sung Kyoung Su , Park Hun Ho , Kim Se Hoon , Kim Eui Hyun , Hong Chang-Ki , Suh Chang-Ok , Chang Jong Hee
Published: April 2019

OBJECTIVE

Following resection of glioblastoma (GBM), microscopic remnants of the GBM tumor remaining in nearby tissue cause tumor recurrence more often than for other types of tumors, even after gross-total resection (GTR). Although surgical oncologists traditionally resect some of the surrounding normal tissue, whether further removal of nearby tissue may improve survival in GBM patients is unknown. In this single-center retrospective study, the authors assessed whether lobectomy confers a survival benefit over GTR without lobectomy when treating GBMs in the noneloquent area.

METHODS

The authors selected 40 patients who had undergone GTR of a histopathologically diagnosed isocitrate dehydrogenase (IDH)–wild type GBM in the right frontal or temporal lobe and divided the patients into 2 groups according to whether GTR of the tumor involved lobectomy, defined as a supratotal resection (SupTR group, n = 20) or did not (GTR group, n = 20). Progression-free survival (PFS), overall survival (OS), and Karnofsky Performance Status (KPS) scores were compared between groups (p ≤ 0.05 for statistically significant differences).

RESULTS

The median postoperative PFS times for each group were as follows: GTR group, 11.5 months (95% CI 8.8–14.2) and SupTR group, 30.7 months (95% CI 4.3–57.1; p = 0.007). The median postoperative OS times for each group were as follows: GTR group, 18.7 months (95% CI 14.3–23.1) and SupTR group, 44.1 months (95% CI 25.1–63.1; p = 0.040). The mean postoperative KPS scores (GTR, 76.5; SupTR, 77.5; p = 0.904) were not significantly different. In multivariate analysis, survival for the SupTR group was significantly longer than that for the GTR group in terms of both PFS (HR 0.230; 95% CI 0.090–0.583; p = 0.002) and OS (HR 0.247; 95% CI 0.086–0.704; p = 0.009).

CONCLUSIONS

In cases of completely resectable, noneloquent-area GBMs, SupTR provides superior PFS and OS without negatively impacting patient performance.
Positive and negative work events attributed to the spine 2 years after lumbar surgery among patients working preoperatively
Authors: Mancuso Carol A. , Duculan Roland , Cammisa Frank P. , Sama Andrew A. , Hughes Alexander P. , Girardi Federico P.
Published: April 2019

OBJECTIVE

Return to work after lumbar surgery is not synonymous with effective job performance, and it is likely that patients who undergo spine surgery experience both positive and negative events attributable to their spine after returning to work. The authors’ objectives were to measure work events attributable to the spine during the 2 years after lumbar surgery and to assess associated demographic and clinical characteristics.

METHODS

Employed patients scheduled for lumbar surgery were interviewed preoperatively and reported work characteristics, including amount of improvement in job performance that they expected from surgery. Clinical variables, such as comorbidities and surgical complexity, were collected using standard scales. Two years postoperatively patients completed the 22-item work domain of the Psychiatric Epidemiological Research Interview Life Events Scale (PERI) asking about major positive and negative events attributable to the spine that occurred since surgery. Event rates were assessed with logistic regression. Patients also reported the amount of improvement obtained in job performance, which was compared to the amount of improvement expected in bivariate analyses.

RESULTS

Two hundred seven working patients (mean age 53 years, 62% men) were interviewed preoperatively. At 2 years after surgery, 86% were working and 12% reported negative events attributable to the spine (e.g., reduced workload, retirement). In multivariable analysis, high school education or less (OR 4.6, CI 1.7–12.3, p = 0.003), another spine surgery (OR 3.4, CI 1.2–10.1, p = 0.03), and new/worse comorbidity (OR 3.3, CI 1.2–8.8, p = 0.02) remained associated. Seven percent reported positive events attributable to the spine; not having postoperative complications was associated (OR 24, CI 4–156, p = 0.001). Of 162 patients queried preoperatively about expectations, 120 expected improvement in work; postoperatively, 82% reported some improvement (42% reported less improvement than expected and 40% as much as or more improvement than expected), 18% reported no improvement. No improvement was associated with less education (OR 1.5, CI 1.0–2.1, p = 0.04), older age (OR 1.1, CI 1.0–1.1, p = 0.005), more complex surgery (OR 1.1, CI 1.0–1.1, p = 0.07), and another spine surgery (OR 6.1, CI 1.9–19.8, p = 0.003). In descriptive analyses for another sample of preoperatively work-disabled patients, most had physically demanding jobs and only 33% returned to work postoperatively.

CONCLUSIONS

Most preoperatively working patients were working postoperatively, reported spine-related improvement in job performance, and reported the occurrence of both positive and negative work events attributable to the spine. This study proposes novel work outcomes (i.e., positive and negative work events) and potential methods to measure them.
Enhanced perioperative care and decreased cost and length of stay after elective major spinal surgery
Authors: Carr Daniel A. , Saigal Rajiv , Zhang Fangyi , Bransford Richard J. , Bellabarba Carlo , Dagal Armagan
Published: April 2019

OBJECTIVE

The purpose of this study was to compare total cost and length of stay (LOS) between spine surgery patients enrolled in an enhanced perioperative care (EPOC) pathway and patients receiving traditional perioperative care (TRDC).

METHODS

All spine surgery candidates were screened for inclusion in the EPOC pathway. This cohort was compared to a retrospective cohort of patients who received TRDC and a concurrent group of patients who met inclusion criteria but did not receive the EPOC (no pathway care [NOPC] group). Direct and indirect costs as well as hospital and intensive care LOSs were analyzed between the 3 groups.

RESULTS

Total costs after pathway implementation decreased by $19,344 in EPOC patients compared to a historical cohort of patients who received TRDC and $5889 in a concurrent cohort of patients who did not receive EPOC (NOPC group). Hospital and intensive care LOS were significantly lower in EPOC patients compared to TRDC and NOPC patients.

CONCLUSIONS

The implementation of a multimodal EPOC pathway decreased LOS and cost in major elective spine surgeries.
Divergent network properties that predict early surgical failure versus late recurrence in temporal lobe epilepsy
Authors: Morgan Victoria L. , Rogers Baxter P. , Anderson Adam W. , Landman Bennett A. , Englot Dario J.
Published: April 2019

OBJECTIVE

The objectives of this study were to identify functional and structural network properties that are associated with early versus long-term seizure outcomes after mesial temporal lobe epilepsy (mTLE) surgery and to determine how these compare to current clinically used methods for seizure outcome prediction.

METHODS

In this case-control study, 26 presurgical mTLE patients and 44 healthy controls were enrolled to undergo 3-T MRI for functional and structural connectivity mapping across an 8-region network of mTLE seizure propagation, including the hippocampus (left and right), insula (left and right), thalamus (left and right), one midline precuneus, and one midline mid-cingulate. Seizure outcome was assessed annually for up to 3 years. Network properties and current outcome prediction methods related to early and long-term seizure outcome were investigated.

RESULTS

A network model was previously identified across 8 patients with seizure-free mTLE. Results confirmed that whole-network propagation connectivity patterns inconsistent with the mTLE model predict early surgical failure. In those patients with networks consistent with the mTLE network, specific bilateral within-network hippocampal to precuneus impairment (rather than unilateral impairment ipsilateral to the seizure focus) was associated with mild seizure recurrence. No currently used clinical variables offered the same ability to predict long-term outcome.

CONCLUSIONS

It is known that there are important clinical differences between early surgical failure that lead to frequent disabling seizures and late recurrence of less frequent mild seizures. This study demonstrated that divergent network connectivity variability, whole-network versus within-network properties, were uniquely associated with these disparate outcomes.
Subependymoma and dysembryoplastic neuroepithelial collision tumor in the foramen of Monro: case report
Authors: D’Agostino Erin , Calnan Daniel R. , Hickey William , Bauer David F.
Published: April 2019

Intracranial collision tumors have rarely been reported in the literature and generally include at least 1 malignant tumor component. Subependymoma with dysembryoplastic neuroepithelial tumor (DNET) is an as-yet unreported combination. Both components are uncommon tumors, and presentation in the foramen of Monro is even more unusual. A 16-year-old male patient with a past medical history significant for asthma presented with a 3-month history of headaches and radiographic evidence of mild obstructive hydrocephalus secondary to a nonenhancing ventricular lesion at the foramen of Monro. He underwent endoscopic biopsy and resection. Pathological analysis revealed distinct components of subependymoma and DNET. At the 1-year follow-up, the patient was doing well without regrowth of tumor. The authors describe a case of intracranial collision tumor demonstrating 2 grade I components: a novel combination of subependymoma and DNET.
Choroidal artery embolization in the management of cerebrospinal fluid overproduction: case report and review of the literature
Authors: Li Daphne , Shokuhfar Tahaamin , Pantalone Julia , Rothstein Brian , Alden Tord D. , Shaibani Ali , Saratsis Amanda M.
Published: April 2019

Diffuse villous hyperplasia of the choroid plexus (DVHCP) is a rare cause of communicating hydrocephalus. DVHCP may be diagnosed radiographically and through histological evaluation. It may be associated with genetic abnormalities, particularly involving chromosome 9. Due to CSF overproduction, patients with DVHCP often fail management with shunting alone and may require adjuvant interventions. The authors present the case of a child with partial trisomy 9p and delayed diagnosis of hydrocephalus with radiographic evidence of DVHCP who was successfully managed with ventriculoperitoneal shunt (VPS) placement, adjuvant bilateral endoscopic choroid plexus coagulation (CPC), and the novel application of anterior choroidal artery embolization. In addition, a systematic MEDLINE search was conducted using the keywords “diffuse villous hyperplasia,” “choroid plexus hypertrophy,” and “idiopathic cerebrospinal fluid overproduction.” Clinicopathological characteristics and outcomes of the present case were reviewed and compared to those in the literature.

A 14-month-old girl with partial trisomy 9p presented with macrocephaly and radiographic evidence of communicating hydrocephalus and DVHCP. Ventriculoperitoneal shunting resulted in distal failure due to inadequate CSF absorption, and ventriculoatrial shunt (VAS) placement was not possible due to multiple cardiac anomalies. Daily CSF production was reduced via endoscopic third ventriculostomy and bilateral CPC, followed by distal choroidal artery embolization, enabling VPS re-internalization. The embolization was complicated by radiographic evidence of an iatrogenic cerebral infarct, but this was clinically occult. Thirty-two additional cases of communicating hydrocephalus due to DVHCP are reported in the literature: 27 pediatric, 3 adult, and 2 postmortem. Genetic abnormalities were noted in 14, with 7 (50%) involving chromosome 9. Twelve patients underwent plexectomy (9 bilateral, 2 unilateral, 1 partial), and 10 underwent CPC (4 bilateral, 3 unilateral, and 3 unspecified), with or without shunting. Eight patients were successfully managed with shunting alone (6 VASs, 2 VPSs), and none underwent arterial embolization.

DVHCP is a rare cause of communicating hydrocephalus that may be associated with genetic abnormalities. A thorough review of the literature highlights diagnostic criteria and interventional options involved in managing this cause of CSF overproduction. The present case demonstrates that angiographic confirmation of prominent choroidal arteries may contribute to the diagnosis DVHCP. In addition, embolization of the distal choroidal arteries may be considered as a potential adjuvant treatment in patients for whom conventional treatments have failed or are not feasible.
Extended L5 pedicle subtraction osteotomy for neglected sacropelvic dissociation injury: case report
Authors: Singh Vishwajeet , Rustagi Tarush , Hart Robert
Published: April 2019

The sacrum forms the distal end of the spine and communicates with the pelvis. Fractures involving the sacrum are complex and may disrupt this vital communication. Neglecting these fractures may result in malunion, which often causes significant alteration in the pelvic parameters and sagittal balance. Management of ensuing deformities is complex and poorly described. The authors present a case of sacral malunion with sagittal imbalance treated with a low lumbar osteotomy.
Mini-pterional approach for clip ligation of ethmoidal dural arteriovenous fistula
Authors: Wicks Robert T. , Zhao Xiaochun , Hardesty Douglas A. , Liebelt Brandon D. , Nakaji Peter
Published: April 2019

Ethmoidal dural arteriovenous fistulas (DAVFs) have a near-universal association with cortical venous drainage and a malignant clinical course. Endovascular treatment options are often limited due to the high frequency of ophthalmic artery ethmoidal supply. A 64-year-old gentleman presented with syncope and was found to have a right ethmoidal DAVF. Rather than the traditional bicoronal craniotomy, an endoscope-assisted mini-pterional approach for clip ligation is demonstrated. The mini-pterional craniotomy allows a minimally invasive approach to ethmoidal DAVF via a lateral trajectory. The endoscope can help achieve full visualization in the narrow corridor.

The video can be found here: https://youtu.be/ZroXp-T35DI.
Right jugular foramen dural arteriovenous fistula Cognard IV
Authors: Peto Ivo , Abou-Al-Shaar Hussam , Dehdashti Amir R.
Published: April 2019

Posterior fossa dural arteriovenous fistulas (dAVFs) are rare vascular malformations. They carry a significant risk of hemorrhage if associated with cortical venous reflux. A 70-year-old man presented with right-sided medullary hemorrhage with pronounced Wallenberg syndrome. Angiography demonstrated right jugular foramen dAVF with direct brainstem venous reflux (Cognard IV). It was fed from multiple branches of the external carotid artery and the vertebral artery, and draining into the ascending pontomesencephalic vein. Primary two-stage transarterial embolization was performed with near-total occlusion of the fistula to prevent it from rebleeding in the acute phase. Because of the patient’s significant neurological deficit, the surgery was deferred to later and if the DAVF showed further progression. Follow-up angiography 8 months later demonstrated obvious recurrence and progression of the fistula from adjacent feeders. In the meantime, the patient had a remarkable recovery from the Wallenberg symptoms. To achieve complete occlusion of the fistula, a right far lateral approach was chosen with complete disconnection of the fistula. Postoperative angiography confirmed complete occlusion of the fistula, and the patient remained intact from the procedure.

The video can be found here: https://youtu.be/DJvpa8G4olc.
Application of the selective indocyanine green videoangiography in microsurgical treatment of a craniocervical junction dural arteriovenous fistula
Authors: Sun Liyong , Ren Jian , Zhang Hongqi
Published: April 2019

Craniocervical junction dural arteriovenous fistula (CCJDAVF) is a rare and unique type of intracranial DAVF with complex neurovascular anatomy, making it difficult to identify the arterialized vein during operation. The authors report the case of a 50-year-old male who presented with symptoms of venous hypertensive myelopathy. Angiography demonstrated a left CCJDAVF. The fistula was successfully disconnected via a suboccipital midline approach. The selective indocyanine green videoangiography (SICG-VA) technique was applied to distinguish the fistula site and arterialized vein from adjacent normal vessels. Favorable clinical and angiographic outcomes were attained. The detailed operative technique, surgical nuances, and utility of SICG-VA are illustrated in this video atlas.

The video can be found here: https://youtu.be/GJYl_jOJQqU.
Trans-superior ophthalmic vein approach for treatment of carotid-cavernous fistula
Authors: Srinivasan Visish M. , Sen Anish N. , Kan Peter
Published: April 2019

The authors present a case of a patient with a Barrow Type B carotid-cavernous fistula (CCF) who presented with severe symptoms of eye redness, diplopia, and proptosis. Due to the tortuosity and size of her angular vein and the lack of good flow/access via the inferior petrosal sinus, she was treated with a transvenous approach via a large, dilated superior ophthalmic vein for coil embolization of the CCF. The patient had a full angiographic and symptomatic cure. The authors present the treatment plan and strategy and the fluoroscopic recording of the treatment. Nuances of the technique are discussed.

The video can be found here: https://youtu.be/ABkGm17-cBU.
Prediksi Financial Distress Menggunakan Rasio Keuangan, Sensitivitas Makroekonomi, dan Intellectual Capital
Authors: Oktarina Dian
Published: April 2019

Penelitian ini bertujuan untuk melihat pengaruh rasio keuangan, indikator makroekonomi, dan intellectual capital terhadap financial distress. Rasio keuangan yang digunakan pada penelitian ini yaitu debt to equity ratio, total assets turnover ratio, current ratio, quick ratio, working capital ratio, net income to total assetsratio, dan cash ratio. Indikator makroekonomi yang digunakan pada penelitian ini adalah lending rate, Consumer Price Index (CPI), IHSG, inflasi, and kurs IDR/USD. Value Added Intellectual Coefficient (VAIC) digunakan untuk mengukur intellectual capital. Penelitian ini menggunakan sampel perusahaan manufaktur yang terdaftar di BEI mulai tahun 2012-2016. Penelitian ini menggunakan alat analisis regresi logistik untuk menguji hipotesis. Hasil penelitian ini menunjukkan bahwa inflasi, kurs IDR/USD, total assets turnover ratio, dan net income to total assets ratio berpengaruh negatif signifikan terhadap financial distress. Hal ini menunjukkan bahwa jika inflasi, kurs IDR/USD, total assets turnover ratio, dan net income to total assets ratio meningkat, maka financial distress menurun.
Pengaruh Ukuran KAP, Ukuran Perusahaan dan Manajemen Laba terhadap Integritas Laporan Keuangan
Authors: Lubis Intan Paulina , Fujianti Lailah , Amyulianthy Rafrini
Published: April 2019

This study aims to analyze the effect of KAP size, firm size and earnings management on the integrity of financial statements. The integrity of financial statements is the extent to which the financial statements presented indicate true and honest information. This study was taken because there are still contradictions from previous studies. This study uses secondary data. The population in this study is the consumer goods industry companies listed on the Indonesia Stock Exchange in 2012-2016. Determination of the sample by purposive sampling method, there are 13 samples from the total population of 40. The method used to analyze the data is panel data regression analysis, Eviews 9. Regression analysis results show that firm size negatively significant to the integrity of financial statements. While the size of KAP and earnings management have no significant effect on the integrity of financial statements.Keywords: Financial Statement Integrity, Company Size, Company Size and Earnings Management
Supply Chain Management Implementation on Snacks Production Process
Authors: Choeriyah Sahara Syarifatul , Setiawan Eko Budi
Published: April 2019

PQR’s company is a company that located in Citeureup Tasikmalaya. The company is engaged in the production of snacks such as mie lidi. The production strategy that used by this company is a make to stock. The company organizes activities from upstream to downstream. Activities that occur in the upstream is to procure raw materials to suppliers by purchasing department. However, some problem was found when the purchasing department has difficulty determining the amount of raw material for the procurement process. This is due to uncertain demand from distributors. While the activities in downstream is sending the product to distributor by shipping department. Some problem that occurs in the downstream were shipping department has difficulty to make schedule product shipments because there was a delay in the product delivery process. All problem occurs because there is no system that can manage supply chain information. So, the implementation of supply chain management by using the forecasting method of single moving average and calculation of sale limits of raw material and product inventory using safety stock method, it was expected to provide a solution to this problem.
Pengaruh Penerapan Model Latihan Terhadap Peningkatan Produktivitas Kerja Karyawan Pada PT. Okema Altra Perdana Manado
Authors: Egeten Angelina Ervina Jeanette
Published: April 2019

Dalam menjalankan suatu perusahaan, sumber daya manusia sangat berperan dalam kemajuan suatu bisnis. Pelatihan serta pengetahuan yang diberikan oleh perusahaan sangat menentukan kelancaran proses bisnis di suatu perusahaan. Dengan adanya pemberian variasi model latihan, bekal motivasi untuk karyawan, dan implementasi contoh yang diberikan oleh perusahaan kepada karyawan dapat meningkatkan produktivitas kerja karyawan. Dari hasil penelitian yang telah dilakukan maka dapat diketahui bahwa kontribusi latihan dapat memberikan pengaruh positif terhadap peningkatan produktivitas kerja karyawan dan hipotesis yang menyatakan terdapat hubungan yang tinggi antara kontribusi latihan dengan produktivitas kerja karyawan pada PT.Okema Altra Perdana dapat diterima.
Keputusan Mahasiswa Universitas “X” Bandung Untuk Merokok Di Lingkungan Kampus Yang Dipengaruhi Oleh Faktor Sosial
Authors: Hapsari Ayuningtyas , Muhammad Alfath Haikal
Published: April 2019

Indonesia is the country with the highest number of teen smokers in the world. About 80% of smokers in Indonesia start the habit before the age of 19 years. Based on the results of a pre-survey of 10 students that there are still many who violate the rules despite the existing prohibition to not smoke in public places at the University of "X". It also shows a lack of concern for smokers against others who do not smoke.

This study aims to look at the influence of social factors on the students decision at the University X Bandung to smoke on campus. This research uses descriptive verification method by distributing questionnaires to 30 students respondents of the University "X" Bandung, and use a Simple Linear Regression analysis methods.

Based on the results of regression calculations, the influence of social factors on smoking decisions on campus is very small that is equal to 37.9% while the remaining 62.1% influenced by other variables not examined in this study as a factor from the individual respective smokers, such as: lifestyle, psychological factors and cultural factors.          

 

Keywords: Social Marketing, Consumer Behavior, Social Factors and Consumer Buying Decision
Strategi Meningkatkan Daya Saing Industri Kreatif Indonesia: Studi Kasus Pengembangan Klaster Industri Alas Kaki Kecamatan Tamansari, Bogor
Authors: Putra Gema Setya Anggara , Maulana Noveri
Published: April 2019

Peningkatan daya saing industri kreatif Indonesia menjadi perbincangan sengit seiring pemberlakuan Masyarakat Ekonomi ASEAN (MEA) di penghujung tahun 2105 silam. Presiden Jokowi melalui Badan Ekonomi Kreatif (BEKRAF) selalu berupaya untuk mempercepat peningkatan daya saing industri kreatif sebagai kekuatan ekonomi baru di Indonesia. Namun, belum banyak industri kreatif yang mampu berkembang dan memiliki daya saing tinggi ketika berada di tengah pasar industri global. Penelitian ini diharapkan mampu menjadi salah satu alternatif solusi untuk menjawab permasalahan itu. Melalui kajian mendalam atas industri alas kaki di Kecamatan Tamansari, Bogor, penelitian ini diharapkan mampu merancang sebuah model strategi daya saing bagi industri kreatif tanah air. Menggunakan model porter diamond analysis, penelitian ini akan menyusun rancangan strategi bagi klaster industri alas kaki Tamansari serta mengkaji faktor peluang dan ancaman dalam mengembangkan industri kreatif. Penelitian kualitatif ini menggunakan pendekatan studi kasus dan teknik perolehan data menggunakan wawancara, observasi, FGD, dan analisis dokumen. Setelah data dianalisis melalui coding dan kategorisasi, maka dapat ditarik kesimpulan bahwa peningkatan daya saing industri kreatif sangat bergantung pada ketersedian modal, pembinaan kreatifitas pelaku usaha, serta aspek pemasaran yang terintegrasi teknologi. Perlu optimalisasi komponen pendukung industri kreatif model Porter Diamond agar daya saing industri kreatif Indonesia semakin meningkat di tengah pasar industri dunia.

 

Keywords:

Ekonomi kreatif, Industri kreatif, Bekraf, UKM, Daya saing, Sentra Industri, Tamansari, Bogor, Porter Diamond, Klaster Strategi
Analisis Tingkat Penerimaan Pengguna Layanan Music as a Service Berbayar dengan Metode Unifed Theory Acceptance and Use of Technology
Authors: Cristopher Jonathan , Indriana Marcelli
Published: April 2019

This study aims to determine the factors that influence the intentions of user behavior in using paid music as a service with the case studies of JOOX VIP apps. The framework of this research is UTAUT2 that has been modified by altering and adding existing constructs, perceived usefulness, effort expectancy, social influence, facilitating conditions, hedonic motivation, price value, habit, and search cost that will influence behavioral intention.Data was obtained by questionnaires collected from 155 respondents, whom use JOOX VIP. The collected data were analyzed by using the SEM method and the results indicates that hedonic motivation, habit, and search cost as a significant determinants of user’s behavior intention to use JOOX VIP.
Analisis Technology Acceptance Model Penggunaan E-Learning pada Mahasiswa
Authors: Lee Steventri Sontrust , Wella Wella
Published: April 2019

Penelitian ini bertujuan untuk mengetahui faktor yang memengaruhi penggunaan elearning.umn.ac.id pada mahasiswa melalui kerangka Technology Acceptance Model (TAM). Terdapat lima konstruk asli dari TAM yang digunakan dalam penelitian ini, antara lain persepsi kegunaan (PU), persepsi kemudahan penggunaan (PEOU), sikap terhadap penggunaan (ATU), minat perilaku (BI), dan penggunaan senyatanya (AU). Terdapat pula tiga konstruk eksternal yang digunakan dalam penelitian ini, antara lain keyakinan individu (SE), aksesibilitas sistem (SA), dan kualitas sistem (SQ). Hasil yang didapatkan pada penelitian ini menemukan tingkat penerimaan dan penggunaan e-learning UMN pada mahasiswa dengan menggunakan faktor internal (perceived usefulness, perceived ease of use, attitude toward using, behavioral intention, actual use) dan faktor eksternal (self-efficacy, system accessibility, system quality) TAM sudah tinggi. Perceived ease of use tidak memiliki hubungan apapun terhadap faktor-faktor yang lain, sehingga apabila faktor perceived ease of use ditingkatkan maka tidak akan terjadi pengaruh apapun terhadap actual use, meskipun didukung dengan faktor system accessibility. Adapun pengaruh positif signifikan yang dimiliki semua pasangan variabel memiliki sifat pengurangan nilai, sehingga jika sebuah faktor independen memiliki peningkatan skor sebanyak n, maka faktor dependen yang memiliki hubungan terhadap variabel independen tersebut ikut mengalami peningkatan skor namun mengalami penurunan nilai dengan besar n sejumlah dengan nilai koefisien total pengaruh yang dimilikinya.
Konversi Timbangan Digital untuk Pengukuran Volume pada Aplikasi Wadah Pintar
Authors: Astrid Marcella , Karyono Kanisius
Published: April 2019

Salah satu penerapan Internet of Things adalah wadah pintar. Wadah pintar yang dibuat memiliki fitur dapat mengirimkan informasi mengenai stok makanan atau bahan lainnya yang tersisa. Pengukuran volume stok dapat dilakukan dengan pengukuran berat. Akan tetapi, massa jenis setiap benda yang dapat ditampung di wadah dapat berbeda-beda sehingga diterapkan sistem persentase. Pengukuran berat dapat menggunakan strain gauge yang terdapat pada timbangan digital yang kemudian diolah dengan mikrokontroler ATMega8535. Batas bawah (nilai 0%) dan batas atas (nilai 100%) diinput oleh pengguna dengan external interrupt. Uji coba dilakukan dengan melihat keakuratan persentase bacaan yang tersimpan di database dengan persentase perhitungan. Hasil bacaan lebih akurat saat nilai 100% berada di tengah-tengah range strain gauge dibandingkan dengan yang berada di dekat batas bawah dan batas atas range strain gauge.
Identifikasi Tingkat Kematangan Buah Pisang Menggunakan Metode Ektraksi Ciri Statistik Pada Warna Kulit Buah
Authors: Limin Nina Sularida , Sari Jayanti Yusmah , Purnama Ika Purwanti Ningrum
Published: April 2019

Abstract—The Banana (musa paradical) is one of the national superior fruit production which is rich in vitamins. The level of banana production in Indonesia is above other fruit commodities. However, one of the postharvest problems for bananas produced on a large scale or industry is in the sorting of bananas. During this time the banana fruit is identified by the level of maturity based on the analysis of the skin color of the fruit visually the human eye that has limitations. The identification process like this has several disadvantages including requiring more energy to sort, and the level of perception of fruit maturity produced can be different because humans can experience fatigue, not always consistent, and human judgment is also subjective. To overcome this problem, this study builds a system to identify the maturity level of bananas using the extractive method of statistical features based on the skin color of bananas. The statistical feature extraction method used in this study is the maximum, minimum, and mean values ​​of pixels for RGB and HSV color spaces. The system built has been tested using 40 datasets of image of bananas and shows the results of good accuracy.

Index Terms—enter key words or phrases in alphabetical order, separated by commas