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cerebrospinal fluid drainage

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https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#1
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation and only six cases have been reported in the literature so far(17). We present a unique case of a 64-year-old lady who presented with 2 years history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 and suffered from meningitis. She had MRI, CT cisternogram as well as CT of brain and that showed clival defect with CSF leak into the sphenoid sinus. She underwent trans-sphenoidal repair of the clival defect with concurrent lumbar drain insertion for CSF drainage...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28699153/-hydrocephalus-due-to-hyperplasia-of-the-choroid-plexuses-in-a-patient-with-trisomy-9-mosaicism-a-real-diagnostic-and-therapeutic-challenge
#2
P Puerta-Roldan, A Guillen-Quesada, R Carrasco, J Muchart, M Serrano, E Ferrer
INTRODUCTION: Trisomy 9 is an unusual chromosome abnormality in live-born patients, which is frequently accompanied by functional and structural anomalies of the central nervous system. Among many other alterations, several studies have been published in the English-speaking literature that show an association between chromosome 9 abnormality and pathologies affecting the choroid plexuses. CASE REPORT: We report the case of a 4-month-old male with trisomy 9 mosaicism associated to hydrocephalus secondary to choroid plexus hyperplasia, who was referred due to a clinical picture of intracranial hypertension...
August 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28698085/modified-park-bench-position-for-superior-vermian-arteriovenous-malformations-and-dural-fistulas
#3
Rouzbeh Motiei-Langroudi, Christoph J Griessenauer, Abdulrahman Y Alturki, Paul H Chapman, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVES: Arteriovenous malformations (AVMs) of the superior cerebellar vermis and dural arteriovenous fistulas (dAVFs) draining into tentorial venous structures are uncommon lesions. Various surgical approaches and positions have been used to gain access. METHODS: We present our experience with 10 superior vermian AVMs and 3 dAVFs with retrograde transverse sinus or torcular drainage, each resected through a supracerebellar infratentorial approach in park bench position with modification of the neck and head position (vertex tilt-up instead of down)...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28680734/hydroxyapatite-bone-cement-application-for-the-reconstruction-of-retrosigmoid-craniectomy-in-the-treatment-of-cranial-nerves-disorders
#4
Nouman Aldahak, Derrick Dupre, Mohamed Ragaee, Sebastien Froelich, Jack Wilberger, Khaled M Aziz
BACKGROUND: Retromastoid craniectomy (RSC) is a cardinal surgical approach used to access the posterior fossa. Hydroxyapetite bone cement (HBC) is frequently employed for cranioplasty in efforts to prevent cerebrospinal fluid (CSF) leak, whilst maintaining low complication rates and good cosmetic satisfaction. The authors aim to determine the safety and effectiveness of HBC for reconstruction RSC used for treatment of various cranial nerves disorders. METHODS: The authors conducted a retrospective one-center two surgeons review of 113 patients who underwent RSC filled with HBC for the treatment of cranial nerve disorders...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28676314/cerebrospinal-fluid-leaks-after-transsphenoidal-surgery-effect-of-a-polyethylene-glycol-hydrogel-dural-sealant
#5
REVIEW
Erlick A C Pereira, Carly A Grandidge, Victoria A Nowak, Simon A Cudlip
To investigate cerebrospinal fluid (CSF) leak rates after mainly endoscopic endonasal transsphenoidal surgery with and without polyethylene glycol hydrogel dural sealant (DuraSeal®), we prospectively collected data from a single-centre consecutive case series over four years from January 2007 to December 2010 inclusive. 250 patients were identified (135 male, 115 female; median age 52years, range 14-83). 180 patients received DuraSeal® (72%). 85 (34%) had intra-operative dural breach and 13 (5.2%) developed post-operative CSF leaks (3 without intra-operative dural breach) requiring lumbar drainage or formal repair...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28672999/continuous-intrathecal-administration-of-liposomal-amphotericin-b-for-treatment-of-refractory-cryptococcus-neoformans-encephalitis-a-case-report
#6
Haiting Xie, Peng Luo, Zhongli Li, Rui Li, Haitao Sun, Duobin Wu
The aim of the present study was to investigate the treatment of refractory Cryptococcus neoformans encephalitis with continuous administration of liposomal amphotericin B (AmB). Liposomal AmB was administered to a 28-year-old male by intravenous injection, with daily increasing dosages up to 150 mg per day and combined use of fluconazole (0.4 g per day) and oral flucytosine tablets (1.5 g per day). Following 5 months of treatment, C. neoformans could still be detected in the ink stain of cerebrospinal fluid, but the patient could not tolerate a further increase in the dosage of liposomal AmB...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28665386/-modern-diagnosis-and-treatment-in-children-with-congenital-basal-encephalocele
#7
A V Sakharov, V V Roginskiy, D N Kapitanov, A L Ivanov, E V Shelesko, S K Gorelyshev, A A Evteev, N V Lemeneva, D N Zinkevich, Yu A Kochkin, V I Ozerova, L A Satanin
Basal encephalocele is a rare disease that predominantly occurs in children. Its most common symptoms include nasal liquorrhea, difficulty in nasal breathing, and deformity of the naso-orbital region. MATERIAL AND METHODS: The study group included 19 patients with basal encephalocele, aged 2 months to 18 years. Ten (59%) patients were operated on through a transnasal endoscopic approach; 3 (17.5%) patients were operated on through a transcranial approach; 4 (23.5%) patients were operated on using a combined approach: the patients underwent simultaneous elimination of a cranio-orbital region deformity using the basal transcranial approach as well as hernial sac resection and hernioplasty using the transnasal endoscopic approach...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28661942/nursing-management-of-lumbar-drainage-in-cryptococcal-meningitis-a-case-report
#8
Ling Ling, Lu Guo, Jingjuan Wang, Lili Zhang, Jie Zhu, Zhiyu Huang
Raised intracranial pressure is a hallmark of cryptococcal meningitis and is associated with increased mortality. Continuous drainage of lumbar cerebrospinal fluid is suggested to control intracranial pressure. The complications induced by this treatment have been described. However, nursing care associated with identification and management of complications is less well known. We encountered a patient with human immunodeficiency virus-negative cryptococcal meningitis who developed increasing cerebrospinal fluid pressure, hearing impairment, and limb weakness...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#9
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28648385/fluorescence-imaging-of-lymphatic-outflow-of-cerebrospinal-fluid-in-mice
#10
Sunkuk Kwon, Christopher F Janssen, Fred Christian Velasquez, Eva M Sevick-Muraca
Cerebrospinal fluid (CSF) is known to be reabsorbed by the lymphatic vessels and drain into the lymph nodes (LNs) through peripheral lymphatic vessels. In the peripheral lymphatics, the contractile pumping action of lymphangions mediates lymph drainage; yet it is unknown whether lymphatic vessels draining cranial and spinal CSF show similar function. Herein, we used non-invasive near-infrared fluorescence imaging (NIRFI) to image (i) indocyanine green (ICG) distribution along the neuraxis and (ii) routes of ICG-laden CSF outflow into the lymphatics following intrathecal lumbar administration...
June 22, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#11
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28629679/how-to-address-cerebrospinal-fluid-leakage-following-ossification-of-the-posterior-longitudinal-ligament-surgery
#12
Jung Hyeon Moon, Sungjoon Lee, Chun Kee Chung, Chi Heon Kim, Won Heo
BACKGROUND: Primary dural repair in ossification of posterior longitudinal ligament (OPLL) surgery via anterior is challenging because of limited space. Based on several years of our experiences, we present our concept for addressing cerebrospinal fluid (CSF) leakage following dural tear during anterior OPLL surgery. METHODS: We reviewed the medical records of 65 patients who underwent anterior OPLL surgery from 2003 to 2014. We included 7 patients whose operation records described dural tear followed by CSF leakage...
June 16, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28627088/astrogliosis-and-impaired-aquaporin-4-and-dystrophin-systems-in-idiopathic-normal-pressure-hydrocephalus
#13
Per Kristian Eide, Hans-Arne Hansson
AIMS: Idiopathic normal pressure hydrocephalus (iNPH) is one subtype of dementia that may improve following drainage of cerebrospinal fluid (CSF). This prospective observational study explored whether expression of the water channel aquaporin-4 (AQP4) and the anchoring molecule dystrophin 71 (Dp71) are altered at astrocytic perivascular endfeet and in adjacent neuropil of iNPH patient. Observations were related to measurements of pulsatile and static intracranial pressure (ICP). METHODS: The study included iNPH patients undergoing overnight monitoring of the pulsatile/static ICP, in whom a biopsy was taken from the frontal cerebral cortex during placement of the ICP sensor...
June 19, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#14
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28605565/puncture-of-cerebellar-horizontal-fissure-for-retrosigmoid-approach-a-prospective-and-quantitative-analysis
#15
Chang Kyu Park, Sung Ho Lee, Bong Arm Rhee, Seok Keun Choi
BACKGROUND: Cerebrospinal fluid (CSF) drainage is important in retrosigmoid approached surgery; however, in some cases, it is not feasible due to cerebellar swelling. OBJECTIVE: To introduce a method, puncture of the horizontal fissure of the cerebellum, which can reduce the cerebellum to easily obtain a good operative corridor and slowly drain CSF. METHODS: Between January and December 2014, we estimated the precise location of the horizontal fissure in 56 patients who underwent surgery via a retrosigmoid approach...
June 10, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28598276/risk-factors-associated-with-postoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-skull-base-surgery
#16
Shannon Fraser, Paul A Gardner, Maria Koutourousiou, Mark Kubik, Juan C Fernandez-Miranda, Carl H Snyderman, Eric W Wang
OBJECTIVE The aim in this paper was to determine risk factors for the development of a postoperative CSF leak after an endoscopic endonasal approach (EEA) for resection of skull base tumors. METHODS A retrospective review of patients who underwent EEA for the resection of intradural pathology between January 1997 and June 2012 was performed. Basic demographic data were collected, along with patient body mass index (BMI), tumor pathology, reconstruction technique, lumbar drainage, and outcomes. RESULTS Of the 615 patients studied, 103 developed a postoperative CSF leak (16...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28589166/elevated-glutamate-and-lactate-predict-brain-death-after-severe-head-trauma
#17
Marco A Stefani, Rafael Modkovski, Gisele Hansel, Eduardo R Zimmer, Afonso Kopczynski, Alexandre P Muller, Nathan R Strogulski, Marcelo S Rodolphi, Randhall K Carteri, André P Schmidt, Jean P Oses, Douglas H Smith, Luis V Portela
OBJECTIVE: Clinical neurological assessment is challenging for severe traumatic brain injury (TBI) patients in the acute setting. Waves of neurochemical abnormalities that follow TBI may serve as fluid biomarkers of neurological status. We assessed the cerebrospinal fluid (CSF) levels of glutamate, lactate, BDNF, and GDNF, to identify potential prognostic biomarkers of neurological outcome. METHODS: This cross-sectional study was carried out in a total of 20 consecutive patients (mean [SD] age, 29 [13] years; M/F, 9:1) with severe TBI Glasgow Coma Scale ≤ 8 and abnormal computed tomography scan on admission...
June 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28578713/delayed-onset-haematoma-formation-after-cochlear-implantation
#18
W-K Low, S Xu
OBJECTIVE: This paper presents our experience on delayed-onset haematoma formation after cochlear implantation, a topic which has not been well discussed in the literature. METHOD: Retrospective case review study. RESULTS: Five children who had undergone cochlear implant surgery at 1.5 to 4 years of age (median, 2.5 years) were studied. The haematoma episodes occurred 2-12 years (median, 6 years) after cochlear implantation. Two patients had recurrent episodes...
June 5, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28553388/penetrating-vertebral-and-spinal-trauma-complicated-by-meningitis-in-a-2-year-old-child-a-rare-clinical-case
#19
Larkin Igor Ivanovich, Larkin Valery Ivanovich, Aleksandr Sergeevich Preobrazhensky
The selection of a treatment approach for a 2-year-old child with penetrating vertebral and spinal trauma, complicated by meningitis, is presented here. This pathology occurs rather rarely, which complicates the development of a uniform approach for the management of such patients. After surgical treatment of the wound in the lumbar region at L5-S1 level due to trauma, the leakage of a transparent discharge had been observed, the nature of which was unclear; it was considered at this treatment stage to be injury to the right ureter...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28533993/bilateral-external-ventricular-drain-placement-and-intraventricular-irrigation-combined-with-concomitant-serial-prone-patient-positioning-a-novel-treatment-for-gravity-dependent-layering-in-bacterial-ventriculitis
#20
Andrew K Chan, Harjus S Birk, John K Yue, Ethan A Winkler, Michael W McDermott
A feared complication of ventricular access for drainage or shunting is ventriculitis. Early diagnosis and treatment is vital to prevent morbidity and mortality. Efficacy of directed antibiotic therapy in ventriculitis is limited by increasing multidrug resistant microorganisms and insufficient systemic antibiotic absorption into the cerebrospinal fluid. Treatment may involve intravenous and/or intrathecal antibiotics as well as external ventricular drainage. We present the first case report suggesting a potential role of a novel technique - direct ventricular catheter-mediated continuous saline irrigation and serial prone patient positioning - to treat a fulminant bacterial ventriculitis...
April 18, 2017: Curēus
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