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sudden death in acute hydrocephalus

Geraint J Sunderland, Michael D Jenkinson, Rasheed Zakaria
The diagnosis of brain metastases is associated with a poor prognosis reflecting uncontrolled primary disease that has spread to the relative sanctuary of the central nervous system. 20 % of brain metastases occur in the posterior fossa and are associated with significant morbidity. The risk of acute hydrocephalus and potential for sudden death means these metastases are often dealt with as emergency cases. This approach means a full pre-operative assessment and staging of underlying disease may be neglected and a proportion of patients undergo comparatively high risk surgery with little or no survival benefit...
September 12, 2016: Journal of Neuro-oncology
Harrison J Westwick, Sami Obaid, Florence Morin-Roy, Pierre-Olivier Champagne, Alain Bouthillier
Intraventricular rupture of a colloid cyst is a rare phenomenon and has been proposed as a mechanism for sudden death in patients with colloid cysts. Imaging of a colloid cyst during rupture has been described in only one other instance. The authors report a highly unusual case of a 53-year-old man who presented with acute onset headaches and imaging findings of hydrocephalus caused by a colloid cyst originating from the septum pellucidum and superior surface of the roof of the third ventricle. Interestingly, the colloid cyst revealed imaging signs of intraventricular rupture characterized by a tail-like drainage of cystic contents into the occipital horn of the lateral ventricle...
July 8, 2016: Journal of Neurosurgery
Vijetha V Maller, Richard Ian Gray
Noncommunicating hydrocephalus is often referred to as obstructive hydrocephalus and is by definition an intraventricular obstruction of cerebrospinal fluid flow. Patient symptoms depend on the rapidity of onset. Acute obstructive hydrocephalus causes sudden rise in the intracranial pressure, which may lead to death, whereas in chronic hydrocephalus there may not be any symptoms. Computed tomography and magnetic resonance imaging play important roles in the diagnosis and management of hydrocephalus. Advances in magnetic resonance imaging such as the 3D sequences and phase-contrast imaging have revolutionized the preoperative and postoperative assessment of noncommunicating hydrocephalus...
April 2016: Seminars in Ultrasound, CT, and MR
Thomas L Beaumont, David D Limbrick, Keith M Rich, Franz J Wippold, Ralph G Dacey
OBJECTIVE Colloid cysts are rare, histologically benign lesions that may result in obstructive hydrocephalus and death. Understanding the natural history of colloid cysts has been challenging given their low incidence and the small number of cases in most reported series. This has complicated efforts to establish reliable prognostic factors and surgical indications, particularly for asymptomatic patients with incidental lesions. Risk factors for obstructive hydrocephalus in the setting of colloid cysts remain poorly defined, and there are no grading scales on which to develop standard management strategies...
March 11, 2016: Journal of Neurosurgery
Debora Martínez-Gómez, Vicente Joanes, Juan Manuel Herrera, Marlon Rivera-Paz, Vicente Vanaclocha
INTRODUCTION: Colloid cysts are benign tumors of the third ventricle. Most of them remain asymptomatic. However, some patients can develop since intermittent headaches to an acute deterioration and even sudden death. Several theories exist for which there would be a sudden death in these patients, among which include the rapid increase in size of the cyst, its rupture, the disturbance of hypothalamus-mediated cardiovascular reflex control and the unusual bleeding of the cyst, with only 15 cases described in the literature...
March 16, 2015: Revista de Neurologia
A M Cappellano, A A Senerchia, F Adolfo, P M Paiva, R Pinho, A Covic, S Cavalheiro, N Saba
PURPOSE: Tuberous sclerosis complex (TSC) is associated with hamartomatous growths including subependymal giant cell astrocytomas (SEGAs). Although, SEGAs are slow-growing glioneuronal tumors, they represent a significant cause of morbidity and mortality due to the risk of sudden death from acute hydrocephalus. Neurosurgical resection has been the mainstay of therapy, since radiotherapy and chemotherapy were proved inefficient in those tumors. Recent studies support the use of everolimus for subependymal giant cell astrocytomas associated with tuberous sclerosis and suggest it might represent a disease-modifying treatment for other aspects of tuberous sclerosis...
December 2013: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Hiromasa Inoue, Yasuhisa Nakagawa, Mayumi Ikemura, Eri Usugi, Yuma Kiyofuji, Masayuki Nata
A 77-year-old female in the hospital was found tachycardic and hypothermic by a nurse, and the patient's respiration subsequently ceased. Forensic autopsy revealed an intracranial cystic tumor that would have compressed the brainstem. On microscopic examination, the tumor was diagnosed as an Antoni A schwannoma growth, and recent multiple intratumoral hemorrhages in the intracranial schwannoma were observed, suggesting the sudden enlargement of the intracranial schwannoma due to intratumoral hemorrhaging. Accordingly, we diagnosed the cause of death as brainstem compression induced by the intratumoral hemorrhaging in the intracranial schwannoma...
September 2013: Legal Medicine
Neva Coce, Goran Pavliša, Sibila Nanković, Antonija Jakovčević, Marina Seronja-Kuhar, Gordana Pavliša
Colloid cysts are rare benign tumors of the third ventricle with diverse clinical presentation, which vary from incidentally found cysts to acute death. An uncommon hemorrhage in these cysts is a life threatening complication which can cause obstructive hydrocephalus with acute deterioration of the patient and sudden death. We present a case of 35-year-old man with large hemorrhagic colloid cyst of a third ventricle causing acute obstructive hydrocephalus even though magnetic resonance image with low T2 signal of the cyst suggested its clinically stable nature...
2012: Turkish Neurosurgery
Emanuela Turillazzi, Stefania Bello, Margherita Neri, Irene Riezzo, Vittorio Fineschi
UNLABELLED: Colloid cysts are rare congenital, intracranial neoplasms, commonly located in the third ventricle. Colloid cysts are endodermal congenital malformations. The cysts commonly range in size from 1-2 cm in diameter, although large cysts >3 cm in size have been reported. The components of the cyst include an outer fibrous capsule over an inner epithelium. The epithelium is usually a single layer of mucin-producing or ciliated cells. Such cysts contain mucoid and gelatinous material, which is positive for both Periodic acid Schiff (PAS) and mucicarmen staining...
2012: Diagnostic Pathology
Rodrigo Carrasco, José M Pascual, Diego Medina-López, Ana Burdaspal-Moratilla
BACKGROUND: Acute neurological deterioration and death in a patient harboring a colloid cyst of the third ventricle remains a poorly understood phenomenon. Sudden neurological derangement caused by spontaneous bleeding within a colloid cyst is a rare and potentially fatal event, usually requiring immediate diagnosis and emergency surgical treatment. CASE DESCRIPTION: A 47-year-old male presented with acute right-sided hemiparesis and speech impediment, followed by rapid deterioration of consciousness...
2012: Surgical Neurology International
Triantafyllos Bouras, Spyros Sgouros
INTRODUCTION: Endoscopic third ventriculostomy (ETV) is an established treatment for hydrocephalus. Most studies focus on success rates, and complications are insufficiently charted. The aim of this study was to perform a systematic review of ETV complications. METHODS: A Medline search discovered 24 series of ETV (seven in children, five in adults, and 12 in a mixed-age group) with detailed complications reports. RESULTS: The analysis included 2,672 ETVs performed on 2,617 patients...
2012: Acta Neurochirurgica. Supplement
Luca Massimi, Giuseppe Maria Della Pepa, Gianpiero Tamburrini, Concezio Di Rocco
Chiari malformation Type I (CM-I) is usually suspected in patients with slowly progressing neurological symptoms. However, in some instances, especially if syringomyelia is associated, an abrupt clinical onset is reported and is accompanied by an acknowledged risk of potentially severe clinical signs or even sudden death. Little is known about such a critical course in CM-I/syringomyelia complex. The authors describe 3 challenging cases of the abrupt onset of CM-I/syringomyelia to reveal more information on the clinical presentation and pathogenetic mechanisms of this sudden and potentially severe clinical phenomenon: a 38-year-old man experienced acute respiratory failure requiring intubation following acute decompensation of hydrocephalus associated with Noonan syndrome, a 1-year-old boy had sudden hemiparesis and Horner syndrome after a minor head/neck injury, and a 2...
November 2011: Journal of Neurosurgery. Pediatrics
Triantafyllos Bouras, Spyros Sgouros
OBJECT: Endoscopic third ventriculostomy (ETV) is an established treatment for hydrocephalus. Most studies focus on success rate, and complications are insufficiently documented. The aim of this study was to perform a systematic review of ETV complications. METHODS: A Medline search discovered 34 series of ETV with detailed complications reports (17 series involving exclusively pediatric patient populations, 6 series involving exclusively adults, and 11 series involving mixed adult and pediatric populations)...
June 2011: Journal of Neurosurgery. Pediatrics
M C Sharp, D C MacArthur
Colloid cysts are rare intracranial neoplasms which typically present with headaches. There is risk of neurological deterioration or death due to acute hydrocephalus. We report a case of colloid cyst presenting after a sudden acceleration/deceleration force from a theme park ride, highlighting the importance of lifestyle advice in these patients.
April 2011: British Journal of Neurosurgery
U Godano, R Ferrai, V Meleddu, M Bellinzona
BACKGROUND: Third ventricle colloid cysts are regarded as benign lesions. They may, however, present with dramatic and rapidly deteriorating neurological signs, leading to sudden death. Although the exact cause of this clinical course is unknown, acute hydrocephalus caused by occlusion of Monro's foramina has been suggested. This, in turn, may be the result of acute cyst swelling, which can exceptionally be due to an intralesional hemorrhage. CASE REPORT: This report illustrates the case of a young patient who deteriorated to sudden coma and was found to have a hemorrhagic colloid cyst of the third ventricle...
October 2010: Minimally Invasive Neurosurgery: MIN
Dong-Ri Li, Takaki Ishikawa, Dong Zhao, Tomomi Michiue, Li Quan, Bao-Li Zhu, Hitoshi Maeda
Intracranial chordoma is a locally invasive, relatively rare tumour at the base of the skull. The tumour usually grows slowly but there have been several case reports of sudden death, all of which were due to tumour-associated haemorrhages. We report an autopsy case of a sudden unexpected death due to clinically undiagnosed intracranial chordoma in the brainstem without haemorrhage. A 44-year-old man was found dead at home. The autopsy revealed two small gelatinous and semi-translucent greyish tumours on the ventral surface of the brainstem between the midbrain and pons...
July 15, 2010: Forensic Science International
Pippa Oakeshott, Gillian M Hunt, Alison Poulton, Fiona Reid
AIM: The aim of our study was to investigate survival and causes of death in a complete cohort of open spina bifida at the mean age of 40 years. METHOD: We conducted a community-based, prospective study of 117 consecutive infants (50 males, 67 females) with open spina bifida whose backs were closed non-selectively within 48 hours of birth between 1963 and 1971 at Addenbrooke's Hospital, Cambridge, UK. Of those who survived to age 1 year, 89% (82 out of 92) had a cerebrospinal fluid shunt...
August 2010: Developmental Medicine and Child Neurology
Tibor Hortobágyi, Ali Alhakim, Olaf Biedrzycki, Vesna Djurovic, Jeewan Rawal, Safa Al-Sarraj
A 15 years old girl of African origin was admitted with a history of headaches and a generalised tonic seizure. Her clinical examination including fundoscopy was normal. She claimed she had been assaulted. Within a few hours of her admission she was found dead in her bed during the ward round. Cardiopulmonary resuscitation was unsuccessful. At post-mortem, the major organs showed no pathological changes and neck dissection showed no abnormality. Neuropathological examination after formalin fixation revealed a cystic lesion in the fourth ventricle, ependymitis and acute hydrocephalus...
March 2009: Pathology Oncology Research: POR
Muhammad U Farooq, Archit Bhatt, Howard T Chang
Colloid cysts of the third ventricle are benign intracranial tumors that usually become symptomatic in adults, rather than in children. Rare hemorrhages in these cysts can cause acute obstructive hydrocephalus and sudden death. We report a novel pediatric case of hemorrhagic colloid cyst in a 9-year-old girl who presented with headaches, nausea, and had sudden deterioration of her mental status. The patient underwent emergent ventriculostomy and then craniotomy to resect the colloid cyst; she had an excellent recovery...
June 2008: Pediatric Neurology
Radim Lipina, Tomas Palecek, Stefan Reguli, Magdalena Kovarova
INTRODUCTION: Late failure of originally successful endoscopic third ventriculostomy (ETV) is considerably less common than failure of ventriculo-peritoneal (V-P) shunt in treatment of hydrocephalus. Death in consequence of late ETV failure is a very rare complication, so far having been mentioned in literature in 13 patients only. CASE REPORT: We present the case of an 11-year-old girl who died in consequence of ETV failure 26 months after the endoscopic procedure...
July 2007: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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