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Clinical study of hydrocephalus

Marie Cantier, Adeline Morisot, Emmanuel Guérot, Bruno Megarbane, Keyvan Razazi, Damien Contou, Eric Mariotte, Emmanuel Canet, Etienne De Montmollin, Vincent Dubée, Eric Boulet, Stéphane Gaudry, Guillaume Voiriot, Julien Mayaux, Frédéric Pène, Mathilde Neuville, Bruno Mourvillier, Stéphane Ruckly, Lila Bouadma, Michel Wolff, Jean-François Timsit, Romain Sonneville
BACKGROUND: Tuberculous meningitis (TBM) is a devastating infection in tuberculosis endemic areas with limited access to intensive care. Functional outcomes of severe adult TBM patients admitted to the ICU in nonendemic areas are not known. METHODS: We conducted a retrospective multicenter cohort study (2004-2016) of consecutive TBM patients admitted to 12 ICUs in the Paris area, France. Clinical, biological, and brain magnetic resonance imaging (MRI) findings at admission associated with a poor functional outcome (i...
August 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
Hassan Fadel, Seong-Jin Moon, Neil V Klinger, Parthasarathi Chamiraju, Hazem A Eltahawy, Marc D Moisi, Murali Guthikonda
Candida parapsilosis is an incredibly rare cause of ventriculoperitoneal (VP) shunt infections, with only one adult case reported in the literature to date. We describe the case of a 45-year-old man admitted for a traumatic fall and subsequently treated with VP shunt placement for obstructive hydrocephalus secondary to a cerebellar contusion and intraventricular hemorrhage. Eight months following VP shunt placement, the patient presented with a two-month history of clear fluid leakage through a dehiscent surgical abdominal wound overlying the distal VP shunt...
August 13, 2018: World Neurosurgery
Tong Sun, Yikai Yuan, Qiuming Zhang, Meng Tian, Xuepei Li, Yicheng Zhou, Hang Yu, Junwen Guan
BACKGROUND: Lumboperitoneal shunt (LPS) attracts increasing number of research interest in the treatment of hydrocephalus due to minimal invasiveness. However, the outcome of LPS-treated posttraumatic hydrocephalus (PTH) is poorly learnt, remaining unknown to date. METHODS: We retrospectively analyzed adult patients with PTH treated by LPS in our department between May 2013 and Apr 2017. Baseline characteristics, preoperative clinical features, symptomatic and imageologic improvement, and postoperative complications were synchronously investigated...
August 14, 2018: Acta Neurochirurgica
Ernest J Barthélemy, Yannis K Valtis, Maggie F Cochran, Louine Martineau, Kee Park, Jeffrey B Mendel, Benjamin Warf, Aaron L Berkowitz
INTRODUCTION: /Objective: Hydrocephalus is a common neurosurgical disorder that can lead to significant disability or death if not promptly identified and treated. Data on the burden of hydrocephalus in low-income countries is limited given lack of radiological resources for the diagnosis of this condition. Here, we present an analysis of patterns of hydrocephalus from a large sample of head CTs performed at a public hospital in rural Haiti, a low-income country in the Caribbean. METHODS: We analyzed reports from 3614 head CTs performed between July 2013 and January 2016 for findings that were consistent with a diagnosis of hydrocephalus (report indicating "hydrocephalus," "ventriculomegaly," or "enlargement of the ventricles")...
August 7, 2018: World Neurosurgery
Pavlina Lenga, Christian Hohaus, Bujung Hong, Adisa Kursumovic, Nicolai Maldaner, Jan-Karl Burkhardt, Philippe Bijlenga, Daniel A Rüfenacht, Nils O Schmidt, Peter Vajkoczy, Julius Dengler
OBJECTIVE Giant posterior circulation aneurysms (GPCirAs) usually cause substantial mass effect on the brainstem, which may lead to neurological deficits. So far, there has been no systematic investigation of factors associated with such deficits in GPCirA. The authors aim to examine the risk factors for cranial nerve deficit (CND), motor deficit, and disability in patients with GPCirA. METHODS Using MR images obtained in 30 patients with unruptured GPCirA, the authors examined GPCirA volume, presence of hydrocephalus or partial thrombosis (PT) of the aneurysm, and the degree of brainstem displacement measured by the distance between the McRae line and the tip of the GPCirA (∆MT)...
August 10, 2018: Journal of Neurosurgery
Pradyumna Pan
Aim: To study the clinical outcome of shunt surgeries in children with hydrocephalus and evaluate the risk factors for ventriculoperitoneal (VP) shunt failure. Materials and Methods: Patients who underwent VP shunt surgery for hydrocephalus were included. Medical charts, operative reports, imaging studies, and clinical follow-up evaluations were reviewed and analyzed retrospectively. Results: A total of 137 patients with the average age of 20...
April 2018: Journal of Pediatric Neurosciences
Rajendra K Diwakar, Omesh Khurana
Background: Premature newborn infants are exposed to a wide spectrum of brain lesions which are clinically silent supporting a possible role of cerebral ultrasound screening. Aim of the study is to describe the pattern of cranial ultrasound abnormalities in preterm infants defining the short term and long term neurologic outcomes. Material and Methods: A hospital-based bedside cranial ultrasound was carried out at day 1, 3, 7 and follow-up scan at 3-6 months in the Department of Radio-diagnosis...
April 2018: Journal of Pediatric Neurosciences
Fen Wang, Dongmei Guo, Zheng Liu, Aihong Zhou, Cuibai Wei, Jianping Jia
Neurosarcoidosis is relatively rare and has diverse manifestations. The clinical characteristics, diagnosis, treatment, and outcome for neurosarcoidosis in China are poorly understood. We retrospectively analyzed the clinical features, laboratory and imaging results, treatment, and outcomes in patients who met the criteria for definite or probable neurosarcoidosis in Xuan Wu Hospital of Capital Medical University from 2000 to 2015. Eight patients were included in this study, accounting for 5.84% of all cases with sarcoidosis...
August 7, 2018: Neurological Sciences
Hussein A Zeineddine, Wesley Jones, Christopher R Conner, Brett Simpson, Spiros Blackburn, Arthur L Day
BACKGROUND: Blood blister-like aneurysms (BBAs) are an uncommon group of arterial aneurysms with a high risk of rupture, progression, and re-rupture. The best intervention is unclear, but their clinical behavior typically requires urgent intervention. We describe a BBA managed conservatively with complete resolution on follow-up. CASE: A 50 year-old female presented as a Hunt-Hess grade 2 Fisher grade 3 subarachnoid hemorrhage (SAH). CT revealed mild hydrocephalus with thick basal SAH eccentric to the left...
July 31, 2018: World Neurosurgery
Zhuo-Wei Lei, Shi-Qiang Wu, Zhuo Zhang, Yang Han, Jun-Wen Wang, Feng Li, Kai Shu
A growing number of children and adolescents are being diagnosed as Chiari malformation type I (CM-I) for behavioral disorders, developmental delay, seizures, or abnormal orpharyngeal function. The aim of this study was to compare the clinical characteristics, imaging findings and surgical outcomes of CM-I in pediatric and adult patients. Between January 2014 and June 2017, 84 patients with CM-I underwent surgical treatment in our department. We divided the patients into two groups: pediatric group (n=11, age <18 years) and adult group (n=73, age ≥18 years)...
April 2018: Current medical science
Thantrira Porntaveetus, Thanakorn Theerapanon, Chalurmpon Srichomthong, Vorasuk Shotelersuk
Cole-Carpenter syndrome (CCS), commonly classified as a rare type of osteogenesis imperfecta, is a disorder with severe bone fragility, craniosynostosis, and distinct facial features. Recently, the heterozygous missense mutation, c.1178A>G, p.Tyr393Cys, in exon 9 of P4HB which encodes protein disulfide isomerase, has been found in three Caucasian patients with CCS. Ethnic background is known to affect clinical manifestations, especially facial features of dysmorphic syndromes. Here, we describe the first Asian CCS patient possessing the recurrent mutation in P4HB...
July 31, 2018: American Journal of Medical Genetics. Part A
Chen Liang, Ling Yang, Shiwen Guo
The present study aimed to compare the complications and clinical outcomes of serial lumbar puncture (LP) and lumbar cerebrospinal fluid (CSF) drainage (LD) of patients with aneurysmal subarachnoid hemorrhage and provide more evidence to guide clinical management. In this retrospective study, 41 and 39 aneurysmal subarachnoid hemorrhage patients were enrolled in the LP and LD group, respectively. Clinical outcomes, including CSF infection, intracerebral hemorrhage, vasospasm, hydrocephalus, death, length of stay, duration of drainage and the Glasgow Outcome Scale score were compared between the two groups...
July 23, 2018: Journal of Biomedical Research
Wan-Chen Tsai, Chia-Yi Lien, Jun-Jun Lee, Wei-Che Lin, Che-Wei Hsu, Chi-Ren Huang, Nai-Wen Tsai, Chiung-Chih Chang, Cheng-Hsien Lu, Wen-Neng Chang
The prognostic significance of clinical characteristics and neuroimaging features, especially cranial magnetic resonance imaging (MRI)-based neuroimaging features, in patients with human immunodeficiency virus (HIV)-negative cryptococcal meningitis (CM) has rarely been examined in the literature. We analyzed the clinical characteristics and MRI findings of 65 HIV-negative patients (43 men, 22 women, age 19-86 years) collected during a study period of 15 years (January 2001-December 2015). Their underlying conditions included diabetes mellitus, liver cirrhosis, hematologic disorders, autoimmune disorders, malignancy, chronic obstructive pulmonary disease, adrenal insufficiency and organ transplantation, and their clinical presentations included headache, altered consciousness, fever, seizure, visual disturbance and hearing impairment...
July 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Peter Wostyn, Debby Van Dam, Peter Paul De Deyn
Primary open-angle glaucoma is one of the leading causes of irreversible blindness worldwide. Raised intraocular pressure is the most important modifiable risk factor and lowering it remains the mainstay therapeutic approach for slowing optic nerve damage and visual field progression in glaucoma patients. An intriguing finding of clinical retrospective and prospective studies is that intracranial pressure is lower in patients with glaucoma. Furthermore, in a recent study on monkeys subjected to an implantation of a lumboperitoneal cerebrospinal fluid shunt to lower intracranial pressure, chronic reduction in intracranial pressure was associated with the development of glaucoma-like pathology in half of the monkeys...
September 2018: Medical Hypotheses
Muhammad Junaid, Mamoon Ahmed, Mamoon Ur Rashid
Objective: This study was conducted to assess outcomes in patients with hydrocephalus who underwent ventriculoperitoneal shunting at Keen's point. Methods: This retrospective study was conducted in Combined Military Hospital (CMH) Peshawar. Time frame was four years from January 2011 to January 2015. The presenting complaints, clinical findings, investigations, treatment plans and surgical outcomes were noted. Ventriculo-Peritoneal (VP) shunting was done at Keen's point...
May 2018: Pakistan Journal of Medical Sciences Quarterly
Bartosz Polis, Lech Polis, Krzysztof Zeman, Jarosław Paśnik, Emilia Nowosławska
PURPOSE: The aim of the article is to describe an immunological reaction to shunt infection in children with hydrocephalus. The main cause of shunt infection involves methicillin resistant Staphylococcus epidermidis (Bhatia et al. Indian J Med Microbiol 35:120-123, 2017; Hayhurst et al. Childs Nerv Syst 24:557-562, 2008; Martínez-Lage et al. Childs Nerv Syst 26: 1795-1798, 2010; Simon et al. PLoS One, 2014; Snowden et al. PLoS One 8:e84089, 2013; Turgut et al. Pediatr Neurosurg 41:131-136, 2005), a bacterial strain which is responsible for the formation of biofilm on contaminated catheters (Snowden et al...
July 21, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
A Beaufrère, B Bessières, M Bonnière, M Driessen, C Alfano, T Couderc, M Thiry, N Thelen, M Lecuit, T Attié-Bitach, M Vekemans, Y Ville, L Nguyen, M Leruez-Ville, F Encha-Razavi
BACKGROUND: The recent outbreak of Zika virus (ZIKV) infection and the associated increased prevalence of microcephaly in Brazil underline the impact of viral infections on embryo-fetal development. The aim of the present study is to provide a detailed clinical and histopathological study of the fetal disruption caused by the ZIKV, with a special focus on the associated neuropathological findings. METHODS: A detailed feto-placental examination, as well as neuropathological and neurobiological studies were performed on three fetuses collected after pregnancy termination between 22 to 25 weeks of gestation (WG), because brain malformations associated with a maternal and fetal ZIKV infection was diagnosed...
July 18, 2018: Brain Pathology
Josef Finsterer, Sinda Zarrouk-Mahjoub
There is no comprehensive overview concerning the phenotypic variability in patients carrying SLC25A4 mutations available. Therefore, the aim of the present review was to summarise and discuss recent findings concerning the clinical presentation and phenotypic heterogeneity of SLC25A4 mutations. The study was conducted by systematically reviewing the literature using the search terms 'mitochondrial', "myopathy', 'nuclear DNA', 'mitochondrial DNA', in combination with 'SLC25A4' or 'AAC1'. The results indicated that the phenotypic heterogeneity in patients carrying a SLC25A4 mutation is broader than so far anticipated...
August 2018: Biomedical Reports
Ryan Gallagher, Jodie Marquez, Peter Osmotherly
BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is treated by insertion of a ventricular peritoneal (VP) shunt. To help identify who would benefit from a VP shunt, patients undergo a tap test (TT). Several measures can identify change from a TT, but the magnitude of change and the combination of measures that indicate the improvement from a TT is unclear. OBJECTIVE: To develop minimal clinically important differences (MCIDs) for a battery of gait, balance, and cognitive measures in relation to improvement from the TT, and to identify which combination of measures best identifies when improvement has occurred...
July 12, 2018: Neurosurgery
Danielle Houlden, Dmitriy Khodorskiy, Sandra Miller-Portman, Maria Li
Introduction  Unlike low-pressure hydrocephalus, very low pressure hydrocephalus (VLPH) is a rarely reported clinical entity previously described to be associated with poor outcomes and to be possibly refractory to treatment with continued cerebrospinal fluid (CSF) drainage at subatmospheric pressures. 1, 2 We present four cases of VLPH following resection of suprasellar lesions and hypothesize that untreatable patients can be identified early, thereby avoiding futile prolonged external ventricular drainage in ICU...
August 2018: Journal of Neurological Surgery. Part B, Skull Base
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