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Biomedical subjects

Neil Buxton

Publications and source records attributed to Neil Buxton.

7 recordsLinked to original sources
PubMed2006

Outcome predictors in the management of spinal cord ependymoma.

The aim of this study was to determine predictors of functional outcome and survival in a retrospective cohort of spinal cord ependymomas treated at a single institution. Twenty-six patients who underwent treatment of spinal cord ependymoma at a single institution were retrospectively analysed. The clinicopathological features were reviewed and correlated with functional outcome (measured using the Frankel grade), recurrence (clinical or radiological), progression-free survival (PFS) and overall survival (OS). Seventy-nine percent of patients with complete excision had maintained or improved functional outcome, compared to 75% in the incomplete resection plus radiotherapy group. Patients with a good pre-operative Frankel grade tended to maintain their functional status, though this did not reach statistical significance (Fisher's Exact test, P = 0.090). Univariate analysis revealed that longer symptom duration prior to treatment was associated with poorer functional outcome (P = 0.006). Extent of resection and the use of adjuvant radiotherapy did not influence PFS or OS; however, early diagnosis and treatment are paramount in the management of spinal ependymoma if a good functional outcome is to be achieved.

Adult↗
PubMed2006

Injuries caused by parachute risers during foreign military parachuting.

OBJECTIVE: The objective was to study the injuries from the deployment of military parachutes when parachuting with foreign armies. METHODS: The number and nature of injuries sustained while military parachuting with domestic and foreign parachute systems and techniques was compared. RESULTS: Of a total of 370 parachutists, 41 (11.1%) suffered minor injuries following two descents on the British parachute, 20 (5.4%) of these were classified as riser injuries. Thirty-eight (25.9%) of 147 British parachutists sustained riser injuries following two descents with the French parachute. Thirty-four (89.5%) of these injuries were minor posterior-auricular bruises and abrasions not requiring treatment. Four (10.5%) were extensive posterior-auricular abrasions that required treatment. Two soldiers (5.3%) suffered lacerations of the attachment of the pinna to the head. There were no riser injuries and no other injuries when the soldiers parachuted with their own countries parachutes in the proceeding two descents. CONCLUSION: Failure to adhere to drills led to injuries with foreign parachute systems.

Accidents, Aviation↗
PubMed2005

Traumatic cerebral aneurysm formation following ventriculoperitoneal shunt insertion.

INTRODUCTION: Iatrogenic intracranial aneurysms are rare in children. CASE REPORT: A 15-year-old girl presented in coma with a fixed dilated left pupil six weeks following removal of a long-standing left-sided ventriculoperitoneal shunt. Computed tomography (CT) and cerebral angiography revealed a left temporoparietal intracerebral haemorrhage with a fusiform distal middle cerebral artery aneurysm. The patient underwent image-guided localisation of the aneurysm to enable evacuation of the haemorrhage and resection of the fusiform aneurysm. CONCLUSION: A high index of suspicion is required for diagnosis and early treatment to prevent unnecessary morbidity and mortality.

Adolescent↗
PubMed2005

External ventricular drains: is there a time limit in children?

BACKGROUND/PURPOSE: The time limit for the use of external ventricular drains (EVDs) has always been controversial. The purpose of this study is to find out if there is a time limit with regard to infection of EVDs and their duration of use in children. METHODS: The records of 28 patients who had a total of 46 EVDs over a 4-year period at the Regional Paediatric Neurosurgical Centre at the Royal Liverpool Children's Hospital, Alder Hey, Liverpool, UK, were retrieved. The cerebrospinal fluid (CSF) white cell counts, CSF Gram stains and the CSF culture results were analysed. CONCLUSION: There is no time limit for EVDs in children. They can be left as long as clinically indicated provided strict protocols are followed in the handling of the set.

Bacterial Infections↗
PubMed2003

Neuroendoscopic third ventriculostomy for failed shunts.

BACKGROUND: Neuroendoscopic third ventriculostomy has increased in frequency for the management of hydrocephalus. The objective of this paper is to study the outcome in patients with hydrocephalus whose shunt subsequently failed and who were treated with neuroendoscopic third ventriculostomy (NTV). METHOD: The departmental prospectively acquired database, kept since 1994, was researched to identify those patients who underwent NTV, having presented with a failed shunt. Subsequent failure of the NTV occurs when further treatment for the hydrocephalus is required. RESULTS: There were 88 patients identified, 45(51%) male and 43(49%) female. Median age at time of NTV was 14 years (range 1 day to 69 years). Median time from last shunt to NTV was 8 years (1 week to 35 years). Follow-up was for a median of 3 years (1 month to 6 years) after their NTV. Overall 42 (48%) failed and 46 (52%) were successful. In those with noncommunicating causes the success rate was 73%. Median time to failure was 1 month (immediate to 5 years) Median age of failed patients at time of NTV was 7 years. Serious complications occurred in 5 (5.6%). CONCLUSION: NTV in patients having previously been shunted for their hydrocephalus is safe and as successful as in primary NTV. Failure can be expected to occur with greater frequency in communicating than noncommunicating types of hydrocephalus. The fact that they have a malfunctioning shunt in situ is not a contraindication to this procedure. In cases of infected shunts it is a useful adjunct to the treatment of the infection.

Adolescent↗