Neurosurgeons may find themselves in a precarious situation, while unable to secure haemostasis following tumour resection. We report intraoperative use of tranexamic acid to secure complete haemostasis as rescue measure in intracranial meningioma resection in uncontrollable bleeding.

Objective: To assess the outcome of micro vascular decompression (MVD) for trigeminal neuralgia (TN) in the initial experience.Methods: Between March 2016 and March 2018, 16 patients who were affected, by trigeminal neuralgia and underwent micro vascular decompression in the Department of Neurosurgery at tertiary centre were enrolled in the study. A Barrow Neurological Institute pain score was calculated pre and post-operatively for all patients. results: During a 24-month period, 16 patients underwent MVD for TN. All patients were operated on by the author. The patients included 11 females and 5 males, with a mean age of 50 years. The mean time from diagnosis to surgery was 3.5 years. The mean time from first neurosurgical clinic review and operation was 204 days, all the patients had a vascular loop identified on pre-operative MRI, all patients underwent micro vascular decompression. There was an average follow up of 16.37 months. A post-operative Barrow score of ≤3 was considered a satisfactory outcome, out of 16 patients 15 had satisfactory outcome. conclusions:We consider MVD to be gold standard treatment option in patients with TN, refractory to medical management.

IntroductionGestational diabetes mellitus (GDM) is an important risk factor for urinary incontinence (UI) two‐year post caesarean section (CS). Previous studies using rectus abdominis muscle (RAM) of pregnant rats with severe and moderate diabetes confirmed diabetic myopathy as a risk factor to UI. But the pathophysiological mechanisms of UI are not completely understood. Indeed, hyperglycemia can damage skeletal muscle with atrophy due to neuropathy or direct effect on muscle cell metabolism. In this context, this study evaluated for the first time the effects of hyperglycemia on the biomechanics of the RAM of pregnant women using Miography − an innovative technique, ex‐vivo, sensitive, that evaluates the function of the myocardial fiber through a controlled electrical stimulation.ObjectiveTo identify the possible deleterious effects of hyperglycemia on RAM functionality (ex vivo contractility) in pregnant women with and without GDM.MethodologyRAM of four primipara women with and without IU (three normoglycemic and one hyperglycemic) were collected during CS. The surgeon collected 1 cm in length of RAM and placed it in Krebs solution at 4°C. The changes in isometric tensile strength were recorded using LabChart software (LabChart 7 for Windows, AD Instruments) coupled to PowerLab (The PowerLab Data Acquisition System, AD Instruments) software for capturing and storing muscular responses. Muscle mechanical responses were expressed as a percentage of maximal contraction induced by electrical stimulation (Grass Model S48). We performed a multiple regression analysis adjusted to confounders using SPSS v21.o software. p < 0.05 was considered as statistically significant.Initial resultsWe obtained results of the RAM function after electrical stimulation during one hour of the four women. We noticed that the RAM of pregnant women does not sustain the electrical response during one hour of the experiment. We have not enough data to compare both groups, but I confirmed that the myography is effective to evaluate the RAM functionality.ConclusionThese initial results confirmed myography as a viable technique to analyze the functionally of the RAM in pregnant women, in a controlled way. The effects of hyperglycemia on the functionality of the RAM were identified.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

No abstract

Aim of this paper is to report a case of spontaneous externalization of Ventriculoperitoneal shunt tube through anus in an eighteen months female child (k/c/o Dandy-Walker malformation) treated with placement of ventriculoperitoneal shunt for hydrocephalus. The exact cause of such externalization is not known. Unusual migration of distal catheter tip of VP shunt is a rare and bowel perforation is reported to occur between 0.1% and 0.7%. In view of the potential risk for meningitis prompt and aggressive management is essential to avoid morbidity and mortality. Keywords: Transanal externalization; ventriculoperitoneal; Dandy-Walker; hydrocephalus