The Experts below are selected from a list of 87 Experts worldwide ranked by ideXlab platform
Fady T Charbel - One of the best experts on this subject based on the ideXlab platform.
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ct ventriculography for diagnosis of occult ventricular cysticerci
Surgical Neurology International, 2010Co-Authors: Sebastian R Herrera, Sergey Neckrysh, Fady T Charbel, Michael Chan, Ali Alaraj, Mmichael G Lemole, Konstantin V Slavin, Sepideh AminhanjaniAbstract:BACKGROUND: Neurocysticercosis is the most common parasitic infection of the central nervous system (CNS). Intraventricular lesions are seen in 7-20% of CNS cysticercosis. Intraventricular lesions can be missed by computed tomography (CT) and magnetic resonance imaging (MRI) as they are typically isodense/isointense to the cerebrospinal fluid. We present our experience with CT ventriculography to visualize occult cysts. CASE DESCRIPTION: Two patients presented with hydrocephalus and suspected neurocysticercosis were evaluated with CT and MRI with and without contrast failing to reveal intraventricular lesions. CT-ventriculography was used: 10 ml of cerebrospinal fluid was drained from the Ventriculostomy Catheter, and 10 ml of iohexol 240 diluted 1:1 with preservative-free saline was injected through the Ventriculostomy Catheter. Immediate CT of the brain was performed. The first patient had multiple cysts located throughout the body of the left lateral ventricle. The second patient had a single lesion located in the body of the lateral ventricle. The CT-ventriculography findings helped in identifying the lesions and plan the surgical intervention that was performed with the aid of an endoscope to remove the cysts. CONCLUSIONS: Intraventricular neurocysticercosis is a common parasitic disease which can be difficult to diagnose. We used CT-ventriculography with injection of contrast through the Ventriculostomy Catheter in two patients where CT and MRI failed to demonstrate the lesions. This technique is a safe and useful tool in the imaging armamentarium when intraventricular cystic lesions are suspected.
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Accuracy of Ventriculostomy Catheter placement using a head- and hand-tracked high-resolution virtual reality simulator with haptic feedback.
Journal of neurosurgery, 2007Co-Authors: Pat Banerjee, Cristian J. Luciano, G.michael Lemole, Fady T Charbel, Michael Y. OhAbstract:OBJECT: The purpose of this study was to evaluate the accuracy of Ventriculostomy Catheter placement on a head- and hand-tracked high-resolution and high-performance virtual reality and haptic technology workstation. METHODS: Seventy-eight fellows and residents performed simulated Ventriculostomy Catheter placement on an ImmersiveTouch system. The virtual Catheter was placed into a virtual patient's head derived from a computed tomography data set. Participants were allowed one attempt each. The distance from the tip of the Catheter to the Monro foramen was measured. RESULTS: The mean distance (+/- standard deviation) from the final position of the Catheter tip to the Monro foramen was 16.09 mm (+/- 7.85 mm). CONCLUSIONS: The accuracy of virtual Ventriculostomy Catheter placement achieved by participants using the simulator is comparable to the accuracy reported in a recent retrospective evaluation of free-hand Ventriculostomy placements in which the mean distance from the Catheter tip to the Monro foramen was 16 mm (+/- 9.6 mm).
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Virtual reality in neurosurgical education: Part-task Ventriculostomy simulation with dynamic visual and haptic feedback
Neurosurgery, 2007Co-Authors: G.michael Lemole, Sergey Neckrysh, P. Pat Banerjee, Cristian J. Luciano, Fady T CharbelAbstract:OBJECTIVE: Mastery of the neurosurgical skill set involves many hours of supervised intraoperative training. Convergence of political, economic, and social forces has limited neurosurgical resident operative exposure. There is need to develop realistic neurosurgical simulations that reproduce the operative experience, unrestricted by time and patient safety constraints. Computer-based, virtual reality platforms offer just such a possibility. The combination of virtual reality with dynamic, three-dimensional stereoscopic visualization, and haptic feedback technologies makes realistic procedural simulation possible. Most neurosurgical procedures can be conceptualized and segmented into critical task components, which can be simulated independently or in conjunction with other modules to recreate the experience of a complex neurosurgical procedure. METHODS: We use the ImmersiveTouch (ImmersiveTouch, Inc., Chicago, IL) virtual reality platform, developed at the University of Illinois at Chicago, to simulate the task of Ventriculostomy Catheter placement as a proof-of-concept. Computed tomographic data are used to create a virtual anatomic volume. RESULTS: Haptic feedback offers simulated resistance and relaxation with passage of a virtual three-dimensional Ventriculostomy Catheter through the brain parenchyma into the ventricle. A dynamic three-dimensional graphical interface renders changing visual perspective as the user's head moves. The simulation platform was found to have realistic visual, tactile, and handling characteristics, as assessed by neurosurgical faculty, residents, and medical students. CONCLUSION: We have developed a realistic, haptics-based virtual reality simulator for neurosurgical education. Our first module recreates a critical component of the Ventriculostomy placement task. This approach to task simulation can be assembled in a modular manner to reproduce entire neurosurgical procedures.
Cristian J. Luciano - One of the best experts on this subject based on the ideXlab platform.
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Percutaneous spinal fixation simulation with virtual reality and haptics
Neurosurgery, 2013Co-Authors: Cristian J. Luciano, Jeffery M. Sorenson, Leonard Kranzler, Silvioh Rizzi, P. Pat Banerjee, Pat Banerjee, Ben Roitberg, Sameer A. Ansari, Kevin T Foley, Prashant Chittiboina, Anand V. Germanwala, Ben Z. RoitbergAbstract:BACKGROUND: In this study, we evaluated the use of a part-task simulator with 3-dimensional and haptic feedback as a training tool for percutaneous spinal needle placement.\n\nOBJECTIVE: To evaluate the learning effectiveness in terms of entry point/target point accuracy of percutaneous spinal needle placement on a high-performance augmented-reality and haptic technology workstation with the ability to control the duration of computer-simulated fluoroscopic exposure, thereby simulating an actual situation.\n\nMETHODS: Sixty-three fellows and residents performed needle placement on the simulator. A virtual needle was percutaneously inserted into a virtual patient's thoracic spine derived from an actual patient computed tomography data set.\n\nRESULTS: Ten of 126 needle placement attempts by 63 participants ended in failure for a failure rate of 7.93%. From all 126 needle insertions, the average error (15.69 vs 13.91), average fluoroscopy exposure (4.6 vs 3.92), and average individual performance score (32.39 vs 30.71) improved from the first to the second attempt. Performance accuracy yielded P = .04 from a 2-sample t test in which the rejected null hypothesis assumes no improvement in performance accuracy from the first to second attempt in the test session.\n\nCONCLUSION: The experiments showed evidence (P = .04) of performance accuracy improvement from the first to the second percutaneous needle placement attempt. This result, combined with previous learning retention and/or face validity results of using the simulator for open thoracic pedicle screw placement and Ventriculostomy Catheter placement, supports the efficacy of augmented reality and haptics simulation as a learning tool.
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Accuracy of Ventriculostomy Catheter placement using a head- and hand-tracked high-resolution virtual reality simulator with haptic feedback.
Journal of neurosurgery, 2007Co-Authors: Pat Banerjee, Cristian J. Luciano, G.michael Lemole, Fady T Charbel, Michael Y. OhAbstract:OBJECT: The purpose of this study was to evaluate the accuracy of Ventriculostomy Catheter placement on a head- and hand-tracked high-resolution and high-performance virtual reality and haptic technology workstation. METHODS: Seventy-eight fellows and residents performed simulated Ventriculostomy Catheter placement on an ImmersiveTouch system. The virtual Catheter was placed into a virtual patient's head derived from a computed tomography data set. Participants were allowed one attempt each. The distance from the tip of the Catheter to the Monro foramen was measured. RESULTS: The mean distance (+/- standard deviation) from the final position of the Catheter tip to the Monro foramen was 16.09 mm (+/- 7.85 mm). CONCLUSIONS: The accuracy of virtual Ventriculostomy Catheter placement achieved by participants using the simulator is comparable to the accuracy reported in a recent retrospective evaluation of free-hand Ventriculostomy placements in which the mean distance from the Catheter tip to the Monro foramen was 16 mm (+/- 9.6 mm).
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Virtual reality in neurosurgical education: Part-task Ventriculostomy simulation with dynamic visual and haptic feedback
Neurosurgery, 2007Co-Authors: G.michael Lemole, Sergey Neckrysh, P. Pat Banerjee, Cristian J. Luciano, Fady T CharbelAbstract:OBJECTIVE: Mastery of the neurosurgical skill set involves many hours of supervised intraoperative training. Convergence of political, economic, and social forces has limited neurosurgical resident operative exposure. There is need to develop realistic neurosurgical simulations that reproduce the operative experience, unrestricted by time and patient safety constraints. Computer-based, virtual reality platforms offer just such a possibility. The combination of virtual reality with dynamic, three-dimensional stereoscopic visualization, and haptic feedback technologies makes realistic procedural simulation possible. Most neurosurgical procedures can be conceptualized and segmented into critical task components, which can be simulated independently or in conjunction with other modules to recreate the experience of a complex neurosurgical procedure. METHODS: We use the ImmersiveTouch (ImmersiveTouch, Inc., Chicago, IL) virtual reality platform, developed at the University of Illinois at Chicago, to simulate the task of Ventriculostomy Catheter placement as a proof-of-concept. Computed tomographic data are used to create a virtual anatomic volume. RESULTS: Haptic feedback offers simulated resistance and relaxation with passage of a virtual three-dimensional Ventriculostomy Catheter through the brain parenchyma into the ventricle. A dynamic three-dimensional graphical interface renders changing visual perspective as the user's head moves. The simulation platform was found to have realistic visual, tactile, and handling characteristics, as assessed by neurosurgical faculty, residents, and medical students. CONCLUSION: We have developed a realistic, haptics-based virtual reality simulator for neurosurgical education. Our first module recreates a critical component of the Ventriculostomy placement task. This approach to task simulation can be assembled in a modular manner to reproduce entire neurosurgical procedures.
Harold F Young - One of the best experts on this subject based on the ideXlab platform.
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factors affecting excitatory amino acid release following severe human head injury
Journal of Neurosurgery, 1998Co-Authors: Ross M Bullock, Alois Zauner, John J Woodward, John S Myseros, Sung C Choi, John D Ward, Anthony Marmarou, Harold F YoungAbstract:Object. Recent animal studies demonstrate that excitatory amino acids (EAAs) play a major role in neuronal damage after brain trauma and ischemia. However, the role of EAAs in patients who have suffered severe head injury is not understood. Excess quantities of glutamate in the extracellular space may lead to uncontrolled shifts of sodium, potassium, and calcium, disrupting ionic homeostasis, which may lead to severe cell swelling and cell death. The authors evaluated the role of EEAs in human traumatic brain injury. Methods. In 80 consecutive severely head injured patients, a microdialysis probe was placed into the gray matter along with a Ventriculostomy Catheter or an intracranial pressure (ICP) monitor for 4 days. Levels of EAAs and structural amino acids were analyzed using high-performance liquid chromatography. Multifactorial analysis of the amino acid pattern was performed and its correlations with clinical parameters and outcome were tested. The levels of EAAs were increased up to 50 times normal...
Eelco F M Wijdicks - One of the best experts on this subject based on the ideXlab platform.
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predictors of cerebral infarction in aneurysmal subarachnoid hemorrhage
Stroke, 2004Co-Authors: Alejandro A Rabinstein, Jonathan A Friedman, Stephen D Weigand, Robyn L Mcclelland, Jimmy R Fulgham, Edward M Manno, John L D Atkinson, Eelco F M WijdicksAbstract:Background— Clinical and radiologic predictors of cerebral infarction occurrence and location after aneurysmal subarachnoid hemorrhage have been seldom studied. Methods— We evaluated all patients admitted to our hospital with aneurysmal subarachnoid hemorrhage between 1998 and 2000. Cerebral infarction was defined as a new hypodensity located in a vascular distribution on computed tomography (CT) scan. Results— Fifty-seven of 143 patients (40%) developed a cerebral infarction. On univariate analysis, occurrence of cerebral infarction was associated with a worse World Federation of Neurological Surgeons grade (P=0.01), use of Ventriculostomy Catheter (P=0.01), preoperative vasospasm (P=0.03), surgical clipping (P=0.02), symptomatic vasospasm (P<0.01), and vasospasm on transcranial Doppler ultrasonography (TCD) or repeat angiogram (P<0.01). On multivariable analysis, only presence of symptoms ascribed to vasospasm (P<0.01) and evidence of vasospasm on TCD or angiogram predicted cerebral infarction (P<0.01)....
Kirby G Vosburgh - One of the best experts on this subject based on the ideXlab platform.
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smart stylet the development and use of a bedside external ventricular drain image guidance system
Stereotactic and Functional Neurosurgery, 2015Co-Authors: Vaibhav Patil, Rajiv Gupta, Raul San Jose Estepar, Ronilda Lacson, Arnold Cheung, Judith M Wong, John A Popp, Alexandra J Golby, Christopher S Ogilvy, Kirby G VosburghAbstract:Background: Placement accuracy of Ventriculostomy Catheters is reported in a wide and variable range. Development of an efficient image-guidance system may improve physician performance and patient safety. Objective: We evaluate the prototype of Smart Stylet, a new electromagnetic image-guidance system for use during bedside Ventriculostomy. Methods: Accuracy of the Smart Stylet system was assessed. System operators were evaluated for their ability to successfully target the ipsilateral frontal horn in a phantom model. Results: Target registration error across 15 intracranial targets ranged from 1.3 to 4.6 mm (mean 3.1 mm). Using Smart Stylet guidance, a test operator successfully passed a Ventriculostomy Catheter to a shifted ipsilateral frontal horn 20/20 (100%) times from the frontal approach in a skull phantom. Without Smart Stylet guidance, the operator was successful 4/10 (40%) times from the right frontal approach and 6/10 (60%) times from the left frontal approach. In a separate experiment, resident operators were successful 2/4 (50%) times when targeting the shifted ipsilateral frontal horn with Smart Stylet guidance and 0/4 (0%) times without image guidance using a skull phantom. Conclusions: Smart Stylet may improve the ability to successfully target the ventricles during frontal Ventriculostomy.
