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Andreas Leidinger, Jose Piquer, Eliana E Kim, Hadia Nahonda, Mahmood M Qureshi, Paul H Young
BACKGROUND: Pediatric hydrocephalus is a health burden for East African countries with an estimated incidence of 6000 new cases per year. The objective of this study is to describe the epidemiology and surgical outcomes of patients treated for pediatric hydrocephalus in the single neurosurgical center of Zanzibar. MATERIAL AND METHODS: From December 2016 to December 2017, we prospectively collected data on all patients admitted with the diagnosis of hydrocephalus...
June 16, 2018: World Neurosurgery
Anna Nilsson, Erik Uvelius, David Cederberg, Erik Kronvall
BACKGROUND: Ventriculitis is a serious complication when using external ventricular drains (EVDs). Bactericidal silver coating has been reported to reduce the risk of infection. In the clinical setting, the diagnosis is often made based on symptoms and analyses of cerebrospinal fluid (CSF), with treatment initiated before infection is culture verified. Therefore, the bactericidal effect might not correlate with a reduced rate of clinically diagnosed infections. The present retrospective study was initiated to analyze if silver-coated EVDs is associated with a reduced rate of ventriculitis...
June 16, 2018: World Neurosurgery
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE Isolated subdural hematomas (iSDHs) are one of the most common intracranial hemorrhage (ICH) types in the population with mild traumatic brain injury (mTBI; Glasgow Coma Scale score 13-15), account for 66%-75% of all neurosurgical procedures, and have one of the highest neurosurgical intervention rates. The objective of this study was to examine how quantitative hemorrhage characteristics of iSDHs in patients with mTBI at admission are associated with subsequent neurosurgical intervention. METHODS This was a 3...
June 15, 2018: Journal of Neurosurgery
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE A paucity of studies have examined neurosurgical interventions in the mild traumatic brain injury (mTBI) population with intracranial hemorrhage (ICH). Furthermore, it is not understood how the dimensions of an ICH relate to the risk of a neurosurgical intervention. These limitations contribute to a lack of treatment guidelines. Isolated subdural hematomas (iSDHs) are the most prevalent ICH in mTBI, carry the highest neurosurgical intervention rate, and account for an overwhelming majority of all neurosurgical interventions...
June 15, 2018: Journal of Neurosurgery
Abigail S Cohen, Saef Izzy, Monisha A Kumar, Cara J Joyce, Stephen A Figueroa, Matthew B Maas, Christiana E Hall, David L McDonagh, David P Lerner, Paul M Vespa, Lori A Shutter, Eric S Rosenthal
OBJECTIVE: To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. METHODS: An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society...
June 12, 2018: Neurology
Nawaporn Techataweewan, Beatrix Dudzik, Amnat Kitkhuandee, Pichayen Duangthongphon, Nancy Tayles
No abstract text is available yet for this article.
June 8, 2018: World Neurosurgery
Sascha Marx, Joerg Baldauf, Marc Matthes, Michael R Gaab, Henry W S Schroeder
BACKGROUND: During the 1990s, endoscopic aqueductoplasty (AP) was considered to be a valuable alternative to endoscopic third ventriculostomy (ETV) in treating hydrocephalus related to idiopathic aqueductal stenosis (iAS), with promising short-term outcomes. OBJECTIVE: To evaluate the long-term outcome of AP in the treatment of iAS. METHODS: Long-term follow-up clinical examinations and magnetic resonance (MR) imaging were performed for patients treated by an AP for iAS in our department...
June 7, 2018: Neurosurgery
Alessandro Perin, Tommaso Francesco Galbiati, Cecilia Casali, Federico Giuseppe Legnani, Luca Mattei, Francesco Ugo Prada, Marco Saini, Andrea Saladino, Nicole Riker, Francesco DiMeco
BACKGROUND AND IMPORTANCE: Mesencephalic tectal gliomas represent a subset of midbrain tumors, which are more frequent in children than in adults. They usually become symptomatic when causing hydrocephalus by occluding the aqueduct. Because of their slow progression, due to their benign histology, they are characterized by a relatively good prognosis, although hydrocephalus might jeopardize patients' prognosis. Treatment is usually represented by cerebrospinal fluid diversion associated or not with biopsy...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Spiros L Blackburn, Christa B Swisher, Andrew W Grande, Alba Rubi, Laura Zitella Verbick, Aaron McCabe, Shivanand P Lad
BACKGROUND AND IMPORTANCE: The amount of subarachnoid blood and the presence of toxic blood breakdown products in the cerebrospinal fluid (CSF) have long been associated with poor outcomes in aneurysmal subarachnoid hemorrhage. The Neurapheresis™ system (Minnetronix Inc, St. Paul, Minnesota) has been developed to filter CSF and remove blood products, and is being investigated for safety and feasibility in the ExtracorPoreal FILtration of subarachnoid hemorrhage via SpinaL CAtheteR (PILLAR) study...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Enoch Ogbonnaya Uche, Chukwuemeka Okorie, Izuchukwu Iloabachie, Dubem S Amuta, Nkechinyere J Uche
BACKGROUND: Endoscopic third ventriculostomy (ETV) and ventriculo-peritoneal shunt (VPS) although recognized surgical options for non-communicating hydrocephalus have debatable applications. OBJECTIVE: We analysed a prospective cohort of age-matched children with non-tumor, non-communicating hydrocephalus treated with the two surgical modalities using clinically measurable parameters. METHODS: A single institution analysis of age-matched patients with non-communicating hydrocephalus treated with VPS or ETV over a 3-year period...
June 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Shaimaa Abdelsattar Mohammad, Noha Mohamed Osman, Reham M Khalil
BACKGROUND: Recently, most cases of hydrocephalus are related to obstruction. Accurate localization of the site of obstruction is crucial in determination of the treatment strategy. PURPOSE: To describe the phase-contrast and 3D-DRIVE findings in cases of obstructive hydrocephalus in paediatric patients and to determine their functional and anatomical correlates. MATERIAL AND METHODS: Brain MRIs of 25 patients (2 months to 11 years) with obstructive hydrocephalus were retrospectively reviewed...
May 30, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Petr Liby, V L Torres, J Taborsky, M Kyncl, M Tichy
INTRODUCTION: We present an infant with an expansive posterior fossa arachnoid cyst and severe clinical deterioration due to decompensated obstructive hydrocephalus. Given the dilated Sylvius aqueduct, we favoured the endoscopic transfrontal transaqueductal route to approach the cyst. CASE REPORT: A 12-month-old boy was acutely admitted for severe symptoms of intracranial hypertension. Imaging revealed spacious cystic formation in the posterior fossa with expansive behaviour towards the brain stem, fourth ventricle and cerebellum associated with obstructive triventricular hydrocephalus...
May 30, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mahmoud Abbassy, Khaled Aref, Ahmed Farhoud, Anwar Hekal
BACKGROUND: Tumors within the pineal region represent 1.5 to 8.5% of the pediatric brain tumors and 1.2% of all brain tumors. A management algorithm has been proposed in several publications. The algorithm includes endoscopic third ventriculostomy (ETV) and biopsy in cases presenting with hydrocephalus. In this series, we are presenting the efficacy of a single-trajectory approach for both ETV and biopsy. METHODS: Eleven cases were admitted to Alexandria main university hospital from 2013 to 2016 presenting with pineal region tumors and hydrocephalus...
May 28, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Sima Sayyahmelli, Ihsan Dogan, Mustafa K Baskaya
The posterior third ventricle and pineal region can harbor different pathologies. The supracerebellar infratentorial approach allows a direct access to the pineal region and posterior third ventricle and provides wide exposure of the arachnoid planes and deep venous system. In this 3-dimensional video, we present a patient with posterior third ventricular/pineal region tumor who underwent microsurgical resection via supracerebellar infratentorial approach. The patient is a 28-year-old woman with history of hydrocephalus who underwent endoscopic third ventriculostomy and biopsy at an outside hospital...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Kaveh Barami, Indro Chakrabarti, James Silverthorn, Jeremy Ciporen, Paul T Akins
OBJECTIVE: An enlarged fourth ventricle otherwise known as fourth ventriculomegaly (4th VM) has been previously reported in the pediatric population yet literature on adults is scant. We report our experience with 4th VM in adults over an 11 year period and review the literature. MATERIAL/METHODS: retrospective chart review of adult patients with the diagnosis of 4th VM admitted to the ICU in a tertiary care center RESULTS: 9 patients were identified with 4th VM...
May 17, 2018: World Neurosurgery
Zheng Wen-Jian, L I Liang-Ming, Hu Zi-Hui, Liao Wei, Lin Qi-Chang, Zhu Yong-Hua, Lin Shao-Hua
BACKGROUND: Ventriculostomy-associated cerebrospinal fluid infection (VAI) is a major complication limiting the use of an external ventricular drain (EVD) in intraventricular hemorrhage (IVH). Risk factors of VAI are still under wide discussion. METHODS: We performed a retrospective review of 84 IVH patients who underwent EVD at our center between January 2012 and January 2017. Preoperative clinical parameters, surgeon status, number of catheters and catheter-days, subgaleal tunneling distance, frequency of urokinase flush, and prophylactic antibiotics were compared between the infective and non-infective groups...
May 14, 2018: World Neurosurgery
Richard Justin Garling, Xin Jin, Jianzhong Yang, Ahmad H Khasawneh, Carolyn Anne Harris
OBJECTIVE Hydrocephalus affects approximately 1 in 500 people in the US, yet ventricular shunting, the gold standard of treatment, has a nearly 85% failure rate. Endoscopic third ventriculostomy (ETV) is an alternative surgical approach for a specific subset of hydrocephalic patients, but can be limited by the inability of neurosurgical residents to practice prior to patient contact. The goal of this study was to create an affordable ETV model and endoscope for resident training. METHODS Open-source software was used to isolate the skull and brain from the CT and MR images of a 2-year-old boy with hydrocephalus...
May 11, 2018: Journal of Neurosurgery. Pediatrics
Raja K Kutty, Sunilkumar Balakrishnan Sreemathyamma, Jyothish Sivanandapanicker, Prasanth Asher, Rajmohan Bhanu Prabhakar, Anilkumar Peethambaran, Gnanaseelan Kanakamma Libu
Introduction: Ventriculomegaly and hydrocephalus (HCP) are sometimes a bewildering sequela of decompressive craniectomy (DC). The distinguishing criteria between both are less well defined. Majority of the studies quoted in the literature have defined HCP radiologically, rather than considering the clinical status of the patient. Accordingly, these patients have been treated with permanent cerebrospinal fluid (CSF) diversion procedures. We hypothesize that asymptomatic ventriculomegaly following DC should undergo aspiration with cranioplasty and be followed up regularly...
April 2018: Journal of Neurosciences in Rural Practice
Mauro Dobran, Davide Nasi, Fabrizio Mancini, Maurizio Gladi, Massimo Scerrati
A 21-year-old male was admitted to our department with headache and drowsiness. CT scan and MRI revealed acute obstructive hydrocephalus caused by a pineal region mass. The serum and CSF levels of beta-human chorionic gonadotropin (beta-hCG) were 215 IU/L and 447 IU/L, respectively, while levels of alpha-fetoprotein (AFP) were normal. A germ cell tumor (GCT) was suspected, and the patient underwent endoscopic third ventriculostomy (ETV) with biopsy. After four days from surgery, the tumor bled with mass expansion and ETV stoma occlusion; thus, a ventriculoperitoneal shunt was positioned...
2018: Case Reports in Medicine
Soner Duru, Jose L Peiro, Marc Oria, Emrah Aydin, Canan Subasi, Cengiz Tuncer, Harold L Rekate
PURPOSE: Endoscopic third ventriculostomy (ETV) has become the method of choice in the treatment of hydrocephalus. Age and etiology could determine success rates (SR) of ETV. The purpose of this study is to assess these factors in pediatric population. METHODS: Retrospective study on 51 children with obstructive hydrocephalus that underwent ETV was performed. The patients were divided into three groups per their age at the time of the treatment: < 6, 6-24, and > 24 months of age...
April 25, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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