Browsing by Author "Taylor, Allan"

Now showing 1 - 6 of 6
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    Brain arteriovenous malformations presenting with haemorrhage
    (2012) Mjoli, Ntethelelo; Taylor, Allan; Feuvre, David Le
    Includes bibliographical references.
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    The endovascular treatment of traumatic cranio-cervical vascular injuries
    (2013) Ssenyonga, Peter Kato; Taylor, Allan; Feuvre, David Le
    Includes abstract. Includes bibliographical references.
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    How has the OSD affected our state hospitals?
    (2009) Parkes, Jeannette; Abratt, Raymond; Taylor, Allan; Le Feuvre, David; Murray, Elizabeth; Robertson, Barbara; Kotze, Tessa; Marais, David; Khan, Del; Kilborn, Tracy; Wieselthaler, Nicky; Gajjar, Himal; Handler, Lenny; Fagan, Johan; Spitaels, Ariane; Morrison, Adrian; Davidson, Alan; Salie, Shamiel; Urban, Mike; Rajkumar, Ash; Pretorius, Vincent; van Niekerk, Magriet; Ferreira, Germaine; Wolmerans, Marli; Cyster, Lyall; King, Darren; Okwuosa, Sebastian; van Staden, Sanet; van Niekerk, Margarethe; Winckler, Jana; Meissenheimer, Heinrich; Botes, Annie; Tait, Deon; Visagie, Jodine; Swarts, Steve; Klocke, Marina; Lomas, Vanessa; Marais, Ilke; Vijoen, Werner; Perry, Jennie; Nkosi, Nokwazi; Stuve, Katrin
    The long-awaited occupation-specific dispensation (OSD) process for state-employed doctors has now been concluded. The final offer, signed and accepted in the bargaining chamber despite being rejected by 92% of doctors in a SAMA survey, has not received much attention or fanfare. At the conclusion of this process, which has been drawn out over several years, many points have emerged that are extremely worrying for the future of health care in this country.
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    Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital
    (2019) Wegoye, Emmanuel; Parkes, Jeannette; Taylor, Allan
    Objective. Over the last two decades there has been increasing evidence that radiosurgery and radiotherapy management of skull-base paragangliomas is as effective as microsurgical resection and carries less morbidity. This 10 year retrospective review of 24 patients in a single institution, treated over 10 years assesses tumour control rates and morbidity associated with radiosurgery and radiotherapy treatment. Method. Patients with a radiological diagnosis of skull-base paragangliomas were treated with different techniques of stereotactic and image-guided radiotherapy delivering hypo fractionated irradiation. Techniques used included conventional radiotherapy or intensity modulated radiotherapy (IMRT), dynamic arc (DA) and volumetric modulated arc therapy (VMAT). Analysis of local tumour control was performed using RECIST criteria and the KaplanMeier method. 69% of patients received 14-16gy in 1-3 fractions while 31% received 48- 50gy in 25 fractions. Radiation-associated toxicity was graded according to the commonly used Radiation therapy Oncology group (RTOG) toxicity criteria. Results. 24 patients with skull-base paragangliomas were treated with a median follow up of 43 months. One patient lost to follow up and was excluded. Tumour control was achieved in 96% of patients. 76% of patients treated reported no radiation associated toxicity. 24% of patients had some radiation associated toxicity: the conventional group 12%, stereotactic radiosurgery 8% and stereotactic radiotherapy 4%. 43% of patients in the conventional group had progression of hearing loss in the affected ear. One patient in the radiosurgery group developed osteonecrosis of the temporal bone at 5 year follow up. Conclusion. Radiosurgery and radiotherapy are efficacious in achieving tumour control with minimal morbidity. Tumour control rates in the study are similar to control rates in literature. Radiation associated toxicities are mainly minor. Study is limited by the retrospective nature and limited duration of follow up.
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    Surgical site infections in Neurosurgery
    (2022) Tromp, Sean Andrew; Taylor, Allan
    Background Surgical site infection (SSI) is associated with a high morbidity and mortality. We sought to define the incidence of SSI at our institution and examine the risk factors for infection. Methods An observational, retrospective cross-sectional review of 676 patients older than 13 years old treated at Groote Schuur Hospital in 2019 yielded 842 neurosurgical operations. These were analysed individually to determine SSI rate as well as risk factors globally, and in pathology groups and wound classes. The SSI cases then had further review of microbiology, laboratory markers of infection, clinical, and outcome data. Results The overall incidence of SSI was 4,9% per patient. Of these 33 cases, the majority were deep infections (n=28). The incidence was similar across pathology groups, and scheduling status, but operations starting at night had increased risk of infection. Infected wounds had the highest risk for SSI (8,7%) with external ventricular drain (EVD) insertion carrying the highest risk in clean operations (6,5%). Age was a risk factor for superficial SSI, while operative time and cerebro-spinal fluid (CSF) leak were risk factors for deep infection. 36,4% of SSI cases were culture negative. C-reactive protein (CRP) and change in white cell count (WCC) predict deep infection, functional outcome, and hospital length of stay (LOS). The deep SSI group outcomes were 53,6% functionally impaired, and mortality was 21,4%. Conclusion The SSI rate of 4,9% compares well with previous studies. Advanced age, contaminated wounds, and EVD's are high risk for later infection. Operative time and CSF leak are potentially modifiable risk factors for SSI. CRP and change in WCC are useful markers for diagnosis and predicting outcome. 75% of deep SSI cases had a poor outcome.
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    Symptomatic developmental venous anomalies
    (2016) Ben Husien, Mohammed; Le Feuvre, David Edmond John; Taylor, Allan
    Developmental Venous Anomalies are a normal variant that may be associated with other cerebral vascular malformation. They have bean previously referred to Venous angiomas. DVAs are the most frequently encountered cerebral vascular malformation and their incidence is reported to be high as2.6%. DVAs are classified into two types based on draining veins. Either deep or superficial. Those that drain into sub-ependymal veins are classified as deep and those that drain into cortical pial veins are classified as superficial. The trans-cerebral veins join either the deep or superficial venous systems by crossing a varying length of the brain parenchyma. Controversy surrounds their exact clinical significance, as DVAs are rarely symptomatic. The symptoms displayed by a patient can be related to a lesion that is associated with DVAs, such as a cavernoma. To describe the patients presenting to a single unit over a 10-year period with symptoms attributable to aDVA. Out of 19 patients in the database with the diagnosis of DVA, 10 were identified where the clinical presentation was directly related to the DVA. Seven of the patients presented with haemorrhage, 6 had parenchymal bleeds and one was intraventricular. Two patients had neurological deficit, 1 was transient and one was progressive. One patient had sudden severe headache with no evidence of haemorrhage on CT scan. The age range was from 14 to 55 with a mean of 32,7 years. Four patients were male and 6 were female. Of the patients that presented with haemorrhage only one had a fistula, three other patients with haemorrhage had evidence on DSA of stenosis of the large collector vein, In the remaining 3 patients no reason for the bleed could be detected. One patient presented with left hemianopia that resolved after several hours, DSA showed minimal caput medusa with delayed filling of the collector vein. The other patient that presented with progressive neurological deficit in the form of progressive leg spasticity and dysarthria, Angiography showed a large collecting vein that drains in the jugular bulb was stenosed. The last patient that presented with sudden severe headaches, with no haemorrhage identified on CT scan, On DSA there was early filling of the DVA veins compared to other cerebral veins and two prominent posterior communicating thalamoperforating vessels were seen.