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Article ; Online: A comparison of brain retraction mechanisms using finite element analysis and the effects of regionally heterogeneous material properties.

Griffiths, Emma / Jayamohan, Jayaratnam / Budday, Silvia

Biomechanics and modeling in mechanobiology

2024 Volume 23, Issue 3, Page(s) 793–808

Abstract: Finite element (FE) simulations of the brain undergoing neurosurgical procedures present us with the great opportunity to better investigate, understand, and optimize surgical techniques and equipment. FE models provide access to data such as the stress ... ...

Abstract	Finite element (FE) simulations of the brain undergoing neurosurgical procedures present us with the great opportunity to better investigate, understand, and optimize surgical techniques and equipment. FE models provide access to data such as the stress levels within the brain that would otherwise be inaccessible with the current medical technology. Brain retraction is often a dangerous but necessary part of neurosurgery, and current research focuses on minimizing trauma during the procedure. In this work, we present a simulation-based comparison of different types of retraction mechanisms. We focus on traditional spatulas and tubular retractors. Our results show that tubular retractors result in lower average predicted stresses, especially in the subcortical structures and corpus callosum. Additionally, we show that changing the location of retraction can greatly affect the predicted stress results. As the model predictions highly depend on the material model and parameters used for simulations, we also investigate the importance of using region-specific hyperelastic and viscoelastic material parameters when modelling a three-dimensional human brain during retraction. Our investigations demonstrate how FE simulations in neurosurgical techniques can provide insight to surgeons and medical device manufacturers. They emphasize how further work into this direction could greatly improve the management and prevention of injury during surgery. Additionally, we show the importance of modelling the human brain with region-dependent parameters in order to provide useful predictions for neurosurgical procedures.
MeSH term(s)	Finite Element Analysis ; Humans ; Brain/physiology ; Stress, Mechanical ; Computer Simulation ; Elasticity ; Neurosurgical Procedures ; Models, Biological
Language	English
Publishing date	2024-02-15
Publishing country	Germany
Document type	Journal Article ; Comparative Study
ZDB-ID	2093052-5
ISSN	1617-7940 ; 1617-7959
ISSN (online)	1617-7940
ISSN	1617-7959
DOI	10.1007/s10237-023-01806-2
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Zs.A 5966: Show issues

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Article ; Online: Letter to the Editor Regarding "Bone Flap Resorption After Cranioplasty: Risk Factors and Proposal of the Flap Integrity Score".

Lonigro, Sara / Magdum, Shailendra A / Jayamohan, Jayaratnam / Thomas, Gregory P L / Ganau, Mario

World neurosurgery

2024 Volume 185, Page(s) 477–479

MeSH term(s)	Humans ; Surgical Flaps ; Risk Factors ; Bone Resorption/etiology ; Plastic Surgery Procedures/methods ; Postoperative Complications/etiology ; Craniotomy/adverse effects ; Decompressive Craniectomy/adverse effects ; Decompressive Craniectomy/methods ; Skull/surgery
Language	English
Publishing date	2024-05-13
Publishing country	United States
Document type	Letter ; Comment ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.01.047
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Article: Septo-optic dysplasia.

Sataite, Ieva / Cudlip, Simon / Jayamohan, Jayaratnam / Ganau, Mario

Handbook of clinical neurology

2021 Volume 181, Page(s) 51–64

Abstract: Septo-optic dysplasia (SOD) or de Morsier's syndrome is a rare congenital disorder characterized by a classic triad of: (a) optic nerve hypoplasia, (b) agenesis of septum pellucidum and corpus callosum, and (c) hypoplasia of the hypothalamic-pituitary ... ...

Abstract	Septo-optic dysplasia (SOD) or de Morsier's syndrome is a rare congenital disorder characterized by a classic triad of: (a) optic nerve hypoplasia, (b) agenesis of septum pellucidum and corpus callosum, and (c) hypoplasia of the hypothalamic-pituitary axis. This chapter will outline the key information regarding the etiology and epidemiology of this syndrome with a focus on its comprehensive management. Particular attention will be paid to the diagnostic stage and the most relevant differential diagnosis, before moving to the complexities of its treatment. In fact, although SOD is not curable, many aspects of this syndrome can be improved through a tailored multidisciplinary approach consisting in hormonal replacement, corrective ophthalmological surgery, management of epileptic seizures, and active neuropsychological support.
MeSH term(s)	Diagnosis, Differential ; Humans ; Seizures ; Septo-Optic Dysplasia/diagnosis ; Septo-Optic Dysplasia/epidemiology ; Septo-Optic Dysplasia/therapy ; Septum Pellucidum ; Syndrome
Language	English
Publishing date	2021-07-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	0072-9752
ISSN	0072-9752
DOI	10.1016/B978-0-12-820683-6.00005-1
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Article ; Online: Neuroendoscopic lavage for the management of neonatal post-haemorrhagic hydrocephalus: a retrospective series.

Honeyman, Susan I / Boukas, Alexandros / Jayamohan, Jayaratnam / Magdum, Shailendra

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2021 Volume 38, Issue 1, Page(s) 115–121

Abstract: Introduction: Intraventricular haemorrhage (IVH) is a common complication of preterm birth, and optimal treatment remains uncertain. Neuroendoscopic lavage (NEL) has gained interest as a method for removal of intraventricular haematoma, with outcomes ... ...

Abstract	Introduction: Intraventricular haemorrhage (IVH) is a common complication of preterm birth, and optimal treatment remains uncertain. Neuroendoscopic lavage (NEL) has gained interest as a method for removal of intraventricular haematoma, with outcomes suggesting it to be safe and potentially effective. Methods: A retrospective review was carried identifying infants who underwent NEL for post-IVH hydrocephalus at our institution. Data was extracted on patient baseline demographics, comorbidities, complications, re-operation requirement, and neurodevelopmental outcomes. Results: Twenty-six patients (17 male) were identified, who underwent NEL at a mean age of 39 weeks and 4 days. Eighteen patients underwent simultaneous endoscopic third ventriculostomy (ETV). Mean patient follow-up was 57.7 months ± 11.8 months. A total of 17/26 patients went on to require a ventriculoperitoneal shunt (VPS). Nine patients did not require further surgical management of hydrocephalus; all had been managed with NEL + ETV. The relative risk of requiring VPS with NEL + ETV compared with NEL alone was 0.500 (CI: 0.315-0.794; p = 0.0033). The 24-month survival rate of VPS inserted following NEL was 64.7%. Exactly 5/26 (19.2%) had post-procedure complications: 2 CSF leaks (7.7%), 2 infections (7.7%), and 1 rebleed within 72 h of NEL (3.8%). On long-term follow-up, 22/25 patients achieved good motor outcome, either walking independently or with mobility aids. A total of 8/15 children attended mainstream schooling with adaption. Discussion: NEL is safe and potentially efficacious treatment for neonatal IVH. The procedure may reduce shunt dependence and, for those who require CSF diversion, improve shunt survival. Neurodevelopmentally, good motor and cognitive outcome can be achieved.
MeSH term(s)	Child ; Child, Preschool ; Female ; Humans ; Hydrocephalus/complications ; Hydrocephalus/surgery ; Infant ; Infant, Newborn ; Male ; Neuroendoscopy/methods ; Premature Birth ; Retrospective Studies ; Therapeutic Irrigation ; Third Ventricle/surgery ; Treatment Outcome ; Ventriculoperitoneal Shunt/adverse effects ; Ventriculostomy/methods
Language	English
Publishing date	2021-11-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-021-05373-8
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Zs.A 2036: Show issues

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Article ; Online: Speech and Language Development, Hearing, and Feeding in Patients With Genetically Confirmed Crouzon Syndrome With Acanthosis Nigricans: A 36-Year Longitudinal Retrospective Review of Patients at the Oxford Craniofacial Unit.

Kilcoyne, Sarah / Scully, Paula / Overton, Sarah / Brockbank, Sally / Thomas, Gregory P L / Ching, Rosanna C / Jayamohan, Jayaratnam / Ramsden, James D / Jones, Jon / Wilkie, Andrew O M / Johnson, David

The Journal of craniofacial surgery

2024

Abstract: Objective: Crouzon syndrome with acanthosis nigricans (CAN) is caused by the specific mutation c.1172C>A (p.Ala391Glu) in the fibroblast growth factor receptor 3 gene, and has an estimated prevalence of 1:1,000,000 births. Most cases occur de novo; ... ...

Abstract	Objective: Crouzon syndrome with acanthosis nigricans (CAN) is caused by the specific mutation c.1172C>A (p.Ala391Glu) in the fibroblast growth factor receptor 3 gene, and has an estimated prevalence of 1:1,000,000 births. Most cases occur de novo; however, autosomal dominant inheritance may occur. The clinical presentation typically includes craniosynostosis, midface and maxillary hypoplasia, choanal atresia/stenosis, hydrocephalus, and intracranial hypertension. Patients develop acanthosis nigricans, a hyperkeratotic skin disorder. The authors present the first known study to investigate the speech, language, hearing, and feeding of patients with CAN. Methods: A retrospective case-note review of patients with a genetically confirmed diagnosis of CAN attending the Oxford Craniofacial Unit during a 36-year period (1987-2023) was undertaken. Results: Participants were 6 patients with genetically-confirmed CAN (5 females, 1 male), all cases arose de novo. All patients had craniosynostosis (n = 5/6 multisuture synostosis, n = 1/6 left unicoronal synostosis). Hydrocephalus was managed through ventriculoperitoneal shunt in 67% (n = 4/6) of patients, and 67% (n = 4/6) had a Chiari 1 malformation. Patients had a complex, multifactorial feeding history complicated by choanal atresia/stenosis (100%; n = 6/6), and significant midface hypoplasia. All patients required airway management through tracheostomy (83%; n = 5/6); and/or continuous positive airway pressure (67%; n = 4/6). All patients underwent adenotonsillectomy (100%; n = 6/6). Initial failure to thrive, low weight, and/or height were seen in 100% (n = 6/6) patients; 80% (n = 4/5) had reflux; 100% (n = 6/6) had nasogastric, or percutaneous endoscopic gastrostomy based feeding during their treatment journey. All patients had hearing loss (100%; n = 6/6). Early communication difficulties were common: receptive language disorder (50%; n = 3/6); expressive language disorder (50%; n = 3/6); and speech sound disorder in 50% (n = 3/6)-necessitating the use of Makaton in 80% of patients (n = 3/5). Conclusions: Patients with CAN experience significant respiratory, neurological, and structural obstacles to hearing, speech, language, and feeding. The authors present a recommended pathway for management to support patients in these domains.
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000010085
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Zs.A 3761: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 175: Show issues

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Article ; Online: Decompressive surgery for Chiari I malformation in children without dural repair: a still effective and safe procedure?

Kurzbuch, Arthur R / Jayamohan, Jayaratnam / Magdum, Shailendra

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

2019 Volume 35, Issue 10, Page(s) 1839–1846

Abstract: Purpose: There are numerous publications about the technical aspects of decompressive surgery for Chiari I malformation highlighting many variations of this procedure. Each approach has its followers. Bony decompression of the foramen magnum alone or ... ...

Abstract	Purpose: There are numerous publications about the technical aspects of decompressive surgery for Chiari I malformation highlighting many variations of this procedure. Each approach has its followers. Bony decompression of the foramen magnum alone or with the removal of a portion of the posterior arch of C1, dural splitting with keeping arachnoid intact, and durotomy are described. Dural closure is done with various materials. We retrospectively reviewed foramen magnum decompression without dural repair (FMDWDR) following the technique used by Gardener and Williams as an option in pediatric patients with Chiari I malformation in terms of complication rate and clinical outcome. Methods: The surgical database of our unit identified 65 consecutive children who underwent FMDWDR surgery for Chiari I malformation between 2009 and 2016. The retrospective assessment included patient demographics, clinical data, surgical technique, revision rate, complications, and clinical outcome. Results: Durotomy without repair was performed in 65 patients. Complications included aseptic meningitis and subdural hematoma respectively in three cases, intradiploic CSF collections in three patients, and CSF leaks in six children. The CSF leak rate has reduced dramatically after introducing a technical modification. Revision surgery was performed in seven cases. None of the patients was identified with postoperative hydrocephalus or infection. There was no mortality and no long-term surgical morbidity. In terms of clinical outcome, 52 patients reported postoperative improvement, 10 were clinically unchanged, and three noticed worsening of symptoms. Conclusion: Applying a "T"-shaped fascial incision which allows a watertight closure of the fascia FMDWDR is still a safe and effective treatment option for Chiari I malformation in children.
MeSH term(s)	Adolescent ; Arnold-Chiari Malformation/diagnostic imaging ; Arnold-Chiari Malformation/surgery ; Child ; Child, Preschool ; Decompression, Surgical/methods ; Decompression, Surgical/trends ; Dura Mater/diagnostic imaging ; Dura Mater/surgery ; Female ; Foramen Magnum/diagnostic imaging ; Foramen Magnum/surgery ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2019-06-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	605988-0
ISSN	1433-0350 ; 0302-2803 ; 0256-7040
ISSN (online)	1433-0350
ISSN	0302-2803 ; 0256-7040
DOI	10.1007/s00381-019-04241-w
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Article ; Online: An Integrated Approach to the Management of Meningoencephalocoeles.

Roumeliotis, Grayson / Wiberg, Akira / Thomas, Gregory / Magdum, Shailendra / Jayamohan, Jayaratnam / Wall, Steven / Johnson, David

The Journal of craniofacial surgery

2021 Volume 32, Issue Suppl 3, Page(s) 1280–1284

Abstract: Abstract: Meningoencephalocoeles are congenital herniations of meningeal and cerebral tissues through a cranial defect. They occur most commonly in South-East Asia, and are relatively rare amongst European ancestry populations, with an estimated ... ...

Abstract	Abstract: Meningoencephalocoeles are congenital herniations of meningeal and cerebral tissues through a cranial defect. They occur most commonly in South-East Asia, and are relatively rare amongst European ancestry populations, with an estimated prevalence of 1/40,000 live births. The treatment of congenital meningoencephalocoeles is primarily surgical and are best managed by dedicated multi-disciplinary craniofacial teams. The authors performed a retrospective case review of all primary meningoencephalocoeles managed in the Oxford University Hospitals NHS Foundation Trust between 1986 and 2012. Twenty-nine cases (13 frontal, 9 occipital, 2 parietal, and 5 basal) were included in this study. The median age at presentation was 11 months (range 0-60 years). Twenty-five cases presented with an external mass; 3 with recurrent meningitis and 1 with otorrhoea. Twenty-six cases underwent surgery, and 17 of these were managed by an integrated approach between 2 or more surgical specialties. Twenty out of 26 operations were performed via a transcranial approach. The authors describe a particularly complex case in order to highlight the challenges associated with management of meningoencephalocoeles, the surgical technique employed, and the importance of a multidisciplinary surgical approach. This is the largest reported case series of meningoencephalocoeles managed in a single hospital in the United Kingdom. Designated craniofacial units with access to multidisciplinary surgical specialties provide a safe and optimal setting for the management of meningoencephalocoeles.
MeSH term(s)	Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; United Kingdom
Language	English
Publishing date	2021-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	1159501-2
ISSN	1536-3732 ; 1049-2275
ISSN (online)	1536-3732
ISSN	1049-2275
DOI	10.1097/SCS.0000000000007678
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Article: Neuro-Ophthalmological Manifestations Of Septo-Optic Dysplasia: Current Perspectives.

Ganau, Mario / Huet, Sibel / Syrmos, Nikolaos / Meloni, Marco / Jayamohan, Jayaratnam

Eye and brain

2019 Volume 11, Page(s) 37–47

Abstract: Septo-optic dysplasia (SOD), also known as de Morsier syndrome, is a rare congenital disorder belonging to the group of mid-line brain malformations. Despite the highly variable phenotypic penetration, its classical triad include a) optic nerve ... ...

Abstract	Septo-optic dysplasia (SOD), also known as de Morsier syndrome, is a rare congenital disorder belonging to the group of mid-line brain malformations. Despite the highly variable phenotypic penetration, its classical triad include a) optic nerve hypoplasia (ONH), b) agenesis of septum pellucidum and corpus callosum, and c) hypoplasia of the hypothalamo-pituitary axis. SOD has stringent diagnostic criteria requiring 2 or more features of the classic triad, therefore it represents a separate entity from other conditions such as ONH and achiasmia syndromes which share only some of these aspects, or SOD plus syndrome which is characterized by additional cortical abnormalities. Starting from its etiology and epidemiology, this narrative review focuses on the management of SOD patients, including their diagnosis, treatment and follow-up. To date, SOD is not curable; nonetheless, many of its symptoms can be improved through a tailored approach, consisting of hormonal replacement, corrective ophthalmological surgery and neuropsychological support.
Language	English
Publishing date	2019-10-18
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2587460-3
ISSN	1179-2744
ISSN	1179-2744
DOI	10.2147/EB.S186307
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Article ; Online: Does appendicitis in a child with a ventriculoperitoneal shunt necessitate shunt revision?

Johnstone, Peter D / Jayamohan, Jayaratnam / Kelly, Dominic F / Drysdale, Simon B

Archives of disease in childhood

2019 Volume 104, Issue 6, Page(s) 607–609

Language	English
Publishing date	2019-02-15
Publishing country	England
Document type	Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2018-316265
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Article ; Online: Intradiploic pseudomeningocele and ossified occipitocervical pseudomeningocele after decompressive surgery for Chiari I malformation: report of two cases and literature review.

Kurzbuch, Arthur R / Magdum, Shailendra / Jayamohan, Jayaratnam

Neurosurgical review

2017 Volume 40, Issue 2, Page(s) 345–350

Abstract: Intradiploic cerebrospinal fluid (CSF) collections are rare findings. The authors describe two pediatric patients with iatrogenically induced occipital CSF collections after decompressive surgery for Chiari I malformation. The first patient presents a ... ...

Abstract	Intradiploic cerebrospinal fluid (CSF) collections are rare findings. The authors describe two pediatric patients with iatrogenically induced occipital CSF collections after decompressive surgery for Chiari I malformation. The first patient presents a large occipital intradiploic pseudomeningocele and the second patient an intradiploic pseudomeningocele merging with an ossified occipitocervical pseudomeningocele. Though being rarities after decompression for Chiari I malformation, intradiploic fluid collection and ossified pseudomeningocele should be considered if patients represent with aggravating presurgical or new symptoms.
MeSH term(s)	Arnold-Chiari Malformation/diagnostic imaging ; Arnold-Chiari Malformation/surgery ; Cerebrospinal Fluid Leak/diagnostic imaging ; Cerebrospinal Fluid Leak/etiology ; Child ; Decompression, Surgical/adverse effects ; Female ; Foramen Magnum/surgery ; Humans ; Magnetic Resonance Imaging ; Meningocele/diagnostic imaging ; Meningocele/etiology ; Neurosurgical Procedures/adverse effects
Language	English
Publishing date	2017-04
Publishing country	Germany
Document type	Journal Article
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-017-0828-x
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