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Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
Kalyan B Bhattacharyya
Walter Edward Dandy did pioneering work in Neurosurgery in the early part of the 19th century. He worked all his life at the Johns Hopkins Hospital in USA and contributed extensively to research in hydrocephalus, the physiology of the cerebrospinal fluid and devised the technique of pneumoencephalography, apart from performing the first clipping operation in cerebral aneurysm and the division of the trigeminal nerve in neuralgic pain. This article summarizes his immense contributions in the field of Neurosurgery...
March 2018: Neurology India
Afroditi Despina Lalou, Marek Czosnyka, Joseph Donnelly, John D Pickard, FMedSci, Eva Nabbanja, Nicole C Keong, Matthew Garnett, Zofia H Czosnyka
OBJECTIVE Normal pressure hydrocephalus is not simply the result of a disturbance in CSF circulation, but often includes cardiovascular comorbidity and abnormalities within the cerebral mantle. In this study, the authors have examined the relationship between the global autoregulation pressure reactivity index (PRx), the profile of disturbed CSF circulation and pressure-volume compensation, and their possible effects on outcome after surgery. METHODS The authors studied a cohort of 131 patients in whom a clinical suspicion of normal pressure hydrocephalus was investigated...
March 16, 2018: Journal of Neurosurgery
Takuma Ohmichi, Masaki Kondo, Masahiro Itsukage, Hidetaka Koizumi, Shigenori Matsushima, Nagato Kuriyama, Kazunari Ishii, Etsuro Mori, Kei Yamada, Toshiki Mizuno, Takahiko Tokuda
OBJECTIVE The gold standard for the diagnosis of idiopathic normal pressure hydrocephalus (iNPH) is the CSF removal test. For elderly patients, however, a less invasive diagnostic method is required. On MRI, high-convexity tightness was reported to be an important finding for the diagnosis of iNPH. On SPECT, patients with iNPH often show hyperperfusion of the high-convexity area. The authors tested 2 hypotheses regarding the SPECT finding: 1) it is relative hyperperfusion reflecting the increased gray matter density of the convexity, and 2) it is useful for the diagnosis of iNPH...
March 16, 2018: Journal of Neurosurgery
Luis C Ascanio, Raghav Gupta, Nimer Adeeb, Justin M Moore, Christoph J Griessenauer, Julie Mayeku, Yaw Tachie-Baffour, Ranjit Thomas, Abdulrahman Y Alturki, Philip G R Schmalz, Christopher S Ogilvy, Ajith J Thomas
OBJECTIVE Currently, there is no established standard regarding the ideal number of external ventricular drain (EVD) clamp trials performed before ventriculoperitoneal (VP) shunt insertion following nontraumatic subarachnoid hemorrhage (SAH). In this study, the authors aimed to evaluate this relationship. METHODS A retrospective review of all patients presenting with SAH between July 2007 and December 2016 was performed. Patients with SAH who had received an EVD within the first 24 hours of hospital admission and had undergone at least 1 clamp trial prior to EVD removal were eligible for inclusion in the study...
March 16, 2018: Journal of Neurosurgery
Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: The variety of diagnostic characteristics associated with neurocysticercosis have been well studied, however, its potential to be implicated in other differential diagnosis has not been well demonstrated. CASE DESCRIPTION: We report the case of a 55-year-old Hispanic man who underwent a Chiari decompression surgery, which was complicated with hydrocephalus. Despite a ventriculoperitoneal (VP) shunt placement, he continued to have headaches and was soon found to have several skull base subarachnoid lesions, which were later diagnosed as the sequelae of an active neurocysticercosis infection...
March 12, 2018: World Neurosurgery
Morgan L Shannon, Ryann M Fame, Kevin F Chau, Neil Dani, Monica L Calicchio, Gwenaelle S Géléoc, Hart G W Lidov, Sanda Alexandrescu, Maria K Lehtinen
Choroid plexus tumors and ciliary body medulloepithelioma are predominantly pediatric neoplasms. Progress in understanding the pathogenesis of these tumors has been hindered by their rarity and lack of models that faithfully recapitulate the disease. Here, we find that endogenous c-Myc is down-regulated in the forebrain neuroepithelium, whose neural plate border domains give rise to anterior choroid plexus and ciliary body. To uncover the consequences of persistent MYC (c-Myc) expression, c-Myc expression was forced in multipotent neural precursors (Nestin-Cre:MYC), which produced a fully penetrant model of choroid plexus carcinoma and ciliary body medulloepithelioma...
March 12, 2018: American Journal of Pathology
Beth M Kline-Fath, Arnold C Merrow, Maria A Calvo-Garcia, Usha D Nagaraj, Howard M Saal
Fetal ventriculomegaly is a common referral for prenatal MRI, with possible etiologies being hydrocephalus and hydranencephaly. The underlying cause of hydranencephaly is unknown, but many have suggested that the characteristic supratentorial injury is related to idiopathic bilateral occlusions of the internal carotid arteries from an acquired or destructive event. Fowler syndrome is a rare genetic disorder that causes fetal akinesia and a proliferative vasculopathy that can result in an apparent hydranencephaly-hydrocephaly complex...
March 14, 2018: Pediatric Radiology
Sho Tamai, Yasuhiko Hayashi, Yasuo Sasagawa, Masahiro Oishi, Mitsutoshi Nakada
Background: Although it is well known that most choroid plexus cysts (CPCs) are asymptomatic, previous studies have reported that they can infrequently cause progressive hydrocephalus along with their increasing sizes. Among those cases, some patients needed cyst fenestration or cerebrospinal fluid (CSF) diversion to recover neurological deterioration. Meanwhile, some CPCs revealed spontaneous resolution, and in rare cases, they developed re-accumulation. Some reports have described series of radiological findings about their changes in location...
2018: Surgical Neurology International
Furkan Diren, Serra Sencer, Tayfun Hakan
Objective: Arteriovenous malformation (AVM) is the most common form of intracranial vascular malformations in adults. Intracranial pediatric AVMs are rare. AVM located in the vicinity of the brain stem in children are even more rare. Case report: This study reports a rare case of acute obstructive hydrocephalus following aqueductal stenosis caused by an unruptured grade IV perimesencephalic arteriovenous malformation. An 11-year-old boy admitted to the hospital with progressive headache, nausea and vomiting throughout a month...
2018: Open Neuroimaging Journal
Mohammad Vafaee Shahi, Samileh Noorbakhsh, Vida Zarrabi, Banafsheh Nourozi, Leila Tahernia
Background: Any mismatch between the production and absorption of CSF results in hydrocephalus. In most cases, the selected choice of treatment is the ventriculoperitoneal shunt insertion. Although, the surgery could have complications such as infection, shunt malfunction, subdural hematoma, seizure and Shunt immigration; so, the early and proper detection of these complications could result in better prognosis. The aim of this study was to evaluate and compare the efficacy of CT scan, CSF analysis and X-ray radiography in detection of shunt complications and problems in shunt placement and further follow-up in hospitalized children...
2018: Open Neuroimaging Journal
Dong Joon Kim, Dae Chul Suh, Byung Moon Kim, Dong Ik Kim
Purpose: Adjuvant coils may offer advantages in flow control during glue embolization of high flow vein of Galen aneurysmal malformation (VGAM) patients but involves specific issues such as feasibility, durability and coil mass effect. The purpose of this study is to assess the outcome of adjuvant coils in addition to transarterial glue embolization for treatment of these patients. Materials and Methods: Five pediatric VGAM patients (age range; 11 weeks to 2 yrs 2 mos) with high flow fistulous angioarchitecture were treated with adjuvant coils 1) in the distal feeding artery and/or 2) in the vein of Galen followed by glue embolization of the shunt...
March 2018: Neurointervention
Karl-Heinz Deeg
Prenatal, neonatal meningoencephalitis and infections of the brain in older infants are often associated with serious complications which can be diagnosed by sonography through the open fontanelles. Most frequently postmeningitic hydrocephalus and subdural effusions occur. Rarer complications are brain abscesses and ventriculitis which are caused by gram negative bacteria such as E. coli, Serratia marcescens, Proteus and Enterobacter. A serious complication after ventriculitis is the development of compartment hydrocephalus...
March 13, 2018: Ultraschall in der Medizin
Balagangadhar R Totapally, Ashish H Shah, Toba Niazi
OBJECTIVE: Posterior fossa tumor surgery in children poses a significant morbidity and mortality. Large multi-institutional datasets characterizing the epidemiology and morbidity of children undergoing posterior fossa tumor surgery are lacking. The objective of this study is to describe the epidemiology and short term surgical outcomes of children presenting with cerebellar tumors. PATIENTS AND METHODS: A retrospective review of the Kids Inpatient Database (KID) for all hospital discharges in 2012 with a diagnosis of cerebellar tumor (ICD-9 diagnosis code 191...
February 26, 2018: Clinical Neurology and Neurosurgery
Peter Y M Woo, James T F Zhuang, Jason M K Ho, Andrew Seto, Hoi-Tung Wong, Kwong-Yau Chan
Leptomeningeal spread and hydrocephalus are increasingly recognized as late disease complications of glioblastoma with almost a quarter of patients requiring early cerebrospinal fluid shunting. The neurosurgeon is challenged with maintaining shunt patency when tumor disease progression is rapid and adjuvant oncologic therapy has yet to be initiated. We describe our experience in treating a young female with diffuse glioblastoma leptomeningeal spread and communicating hydrocephalus who had several episodes of shunt obstruction due to intraluminal tumor cell-fibrin deposits...
March 13, 2018: Acta Neurochirurgica
Valentina Baro, Renzo Manara, Luca Denaro, Domenico d'Avella
PURPOSE: Dandy-Walker malformation is a rare condition due to imperforation of the Blake's pouch during intrauterine brain development, usually leading to early severe hydrocephalus. The association with holocord syringomyelia is rare, and from the Gardner's first report in 1957, only 23 cases have been described, mostly from autopsy series and pre-MRI period. Besides a worsening of clinical picture, its occurrence generates some concern about the best surgical treatment that varies widely among the literature reports...
March 12, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Mian Ma, Zhi-Liang Ding, Zhi-Qi Cheng, Gang Wu, Xiao-Yu Tang, Peng Deng, Jian-Dong Wu
OBJECTIVE: To explore the clinical characteristics of neurocutaneous melanosis (NCM) in adult patients in order to help improve diagnosis and treatment of this disease. METHODS: We present a rare case of an adult patient suffering from neurocutaneous melanosis with malignant melanoma as well as a review Chinese and English literature, and analyze their clinical features. RESULTS: There were thirty adult NCM patients, aged 19 to 65 years old, average 27...
March 9, 2018: World Neurosurgery
Shinjiro Fukami, Nobuyuki Nakajima, Hirofumi Okada, Jiro Akimoto, Tamotsu Miki, Hirokazu Fukuhara, Yukiko Shishido-Hara, Toshitaka Nagao, Masumi Tsuda, Michihiro Kohno
INTRODUCTION: Removal of midline paraventricular gliomas is difficult because of their deep localization and invasive character, requiring biopsy for pathological diagnosis. This study aimed to assess the pathological findings and clinical course of midline paraventricular gliomas diagnosed using a neuroendoscope. METHODS: This study was performed as a retrospective investigation of 26 patients whose tumors were diagnosed as midline paraventricular gliomas using a neuroendoscope...
March 9, 2018: World Neurosurgery
Li-Yuan Wang, Xiao-Tang Cai, Zhi-Ling Wang, Shun-Li Liu, Yong-Mei Xie, Hui Zhou
OBJECTIVE: To summarize the clinical features of Enterococcus faecium meningitis in children. METHODS: The clinical data of nine children with Enterococcus faecium meningitis were analyzed. RESULTS: In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
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