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Controversial for congenital hydrocephalus

Neill R Graff-Radford, David T Jones
PURPOSE OF REVIEW: Since it was first described in 1965, normal pressure hydrocephalus (NPH) has been a controversial subject. New studies have shed light on its epidemiology and pathogenesis and provided objective ways to measure outcome in patients with NPH. Neuroimaging has improved and allows better recognition of both NPH and the presence of overlapping diseases RECENT FINDINGS: Several recent epidemiologic studies confirm that NPH is a rare disease, but the presence of large ventricles is a common finding with aging...
February 2019: Continuum: Lifelong Learning in Neurology
Markus Lenski, Annamaria Biczok, Jörg-Christian Tonn, Friedrich-Wilhelm Kreth
INTRODUCTION: Treatment of symptomatic intracranial cysts remains a controversial issue. We here present the risk/benefit profile of a minimally invasive not yet described stereotactic internal shunt implantation technique. The provided data might serve as a reference against which other treatment modalities can be compared. MATERIALS AND METHODS: From our prospective data base we identified a consecutive series of patients with symptomatic, so far untreated cysts undergoing internal shunting (2009-2017)...
December 18, 2018: World Neurosurgery
F Sharouf, M Zaben, A Lammie, P Leach, M I Bhatti
INTRODUCTION: Neurocutaneous melanosis (NCM) is a sporadic condition characterised by congenital melanocytic nevi and melanocytic thickening of the leptomeninges. It is believed to result from congenital dysplasia of melanin-producing cells within the skin and leptomeninges. The management of cutaneous manifestations remains controversial; for neurological manifestations, outcome remains poor even with the use of radiotherapy and chemotherapy. PATIENTS AND METHODS: We describe the case of a 5-month-old boy who presented with giant congenital melanocytic nevus and hydrocephalus...
August 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Shigeki Yamada, Masatsune Ishikawa, Kazuo Yamamoto
Objective: In spite of growing evidence of idiopathic normal-pressure hydrocephalus (NPH), a viewpoint about clinical care for idiopathic NPH is still controversial. A continuous divergence of viewpoints might be due to confusing classifications of idiopathic and adult-onset congenital NPH. To elucidate the classification of NPH, we propose that adult-onset congenital NPH should be explicitly distinguished from idiopathic and secondary NPH. Methods: On the basis of conventional CT scan or MRI, idiopathic NPH was defined as narrow sulci at the high convexity in concurrent with enlargement of the ventricles, basal cistern and Sylvian fissure, whereas adult-onset congenital NPH was defined as huge ventricles without high-convexity tightness...
2017: Frontiers in Neurology
Loubna Rifi, Amina Barkat, Abdeslam El Khamlichi, Malek Boulaadas, Abdessamad El Ouahabi
Anterior meningo-encephaloceles (AME) are congenital malformations characterized by herniation of brain tissue and meninges through a defect in the cranium, in frontal, orbital, nasal and ethmoidal regions. The management of this complex congenital malformation is controversial according to whether use, an intracranial, extra-cranial or combined approach. This is the first largest series published in Africa, in which we present our experience in the operative management of AME; we share our recommendation in technical consideration for surgical approach with review of the literature...
2015: Pan African Medical Journal
Tyler Auschwitz, Michael DeCuypere, Nickalus Khan, Stephanie Einhaus
Intracranial arachnoid cysts are a rare condition thought to be congenital in nature. Treatment of intracranial arachnoid cysts remains controversial based on their variable presentation. Treatment options include CSF shunting, endoscopic fenestration, or craniotomy and open fenestration for larger cysts. The complications of these procedures can include hydrocephalus, subdural hematomas, hygromas, and--more rarely--intraparenchymal hemorrhage. The authors found very few reports of hemorrhagic infarction as a complication of arachnoid cyst fenestration in the literature...
February 2015: Journal of Neurosurgery. Pediatrics
Sérgio F Salvador, Joana Oliveira, Josué Pereira, Henrique Barros, Rui Vaz
BACKGROUND: Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology. METHODS: Between 1998 and 2011, 168 consecutive procedures were performed in 164 patients, primarily children (56%<18 years of age and 35%<2 years of age). The causes of obstructive hydrocephalus included tumoural pathology, Chiari malformation, congenital obstruction of the aqueduct, post-infectious and post-haemorrhagic membranes, and ventriculo-peritoneal shunt (VPS) malfunctions...
November 2014: Clinical Neurology and Neurosurgery
Sameer H Halani, Mina G Safain, Carl B Heilman
Arachnoid cysts are common, accounting for approximately 1% of intracranial mass lesions. Most are congenital, clinically silent, and remain static in size. Occasionally, they increase in size and produce symptoms due to mass effect or obstruction. The mechanism of enlargement of arachnoid cysts is controversial. One-way slit valves are often hypothesized as the mechanism for enlargement. The authors present 4 cases of suprasellar prepontine arachnoid cysts in which a slit valve was identified. The patients presented with hydrocephalus due to enlargement of the cyst...
July 2013: Journal of Neurosurgery. Pediatrics
K Hosseinzadeh, J Luo, A Borhani, L Hill
OBJECTIVE: This manuscript reviews congenital anomalies and imaging findings associated with non-visualisation of the cavum septi pellucidi (CSP) found on prenatal sonogram. BACKGROUND: Observation of a normal cavum septi pellucidi (CSP) is an important landmark in the second and third trimester prenatal ultrasound evaluation of the fetal brain, and its visualisation provides reassurance of normal central forebrain development. Non-visualisation of the CSP is a prenatal sonographic finding, which in most cases is associated with neuroanatomical anomalies that include agenesis of the corpus callosum, schizencephaly, septo-optic dysplasia, holoprosencephaly, chronic hydrocephalus and acquired fetal brain injury...
June 2013: Insights Into Imaging
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
Orlando J Castejón
Cortical biopsies of patients with the diagnosis of complicated brain trauma, congenital hydrocephalus, brain vascular anomaly, and brain tumour are studied with the electron microscope using cortical biopsies of different cortical brain regions to analyze the alterations of endothelial junctions, and their participation in the pathogenesis of human brain oedema. In moderate oedema, most endothelial tight junctions are structurally closed and intact, while in some cases of severe oedema, the opening of tight endothelial junctions is observed...
2012: Folia Neuropathologica
N Akalan
Myelomeningocele has been recognized since ancient times although written descriptions began not before the 17th century. Among all serious congenital malformations, myelomeningocele is unique that is has a steady and considerable prevalence while being compatible with life. It has a dismal prognosis when left untreated where virtually all die within the first year while aggressive treatment have a profound effect on survival and quality of life. Effective surgical treatment became possible parallel to the treatment of hydrocephalus in the late 1950s...
2011: Advances and Technical Standards in Neurosurgery
Shizuo Oi
Classification of hydrocephalus is the most crucial but the most complicated academic challenge within the hydrocephalus research field. The major difficulty in this challenge arises from the fact that the classification is based on almost all subjects in hydrocephalus research, i.e., definition and terminology of hydrocephalus, pathophysiology, hydrocephalus chronology, specific forms of hydrocephalus, associated congenital anomalies/syndrome and underlying conditions, diagnostic procedures for hydrocephalus, and treatment modalities in hydrocephalus...
2010: Neurologia Medico-chirurgica
Hideki Ogiwara, Arthur J Dipatri, Tord D Alden, Robin M Bowman, Tadanori Tomita
PURPOSE: The outcome of endoscopic third ventriculostomy (ETV) is worse in children younger than 2 years old and especially in infants, and controversies still exist whether ETV might be superior to shunt placement in this age group. We retrospectively analyzed the data of 23 patients younger than 6 months of age treated with ETV and assessed its feasibility as a first choice of treatment for hydrocephalus. METHODS: Between 1994 and 2008 in our clinic, 23 patients younger than 6 months having presented with obstructive hydrocephalus were treated endoscopically...
March 2010: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ferdnand Osuagwu, Natasha Fagel, Noriko Salamon, Jorge Lazareff
BACKGROUND: Controversy still exists about the best management modality for congenital arachnoid cyst. Shunting procedures have been one of the treatment options offered to patients with this condition. Although arachnoid cysts shunting have been associated with a variety of clinical conditions, its relationship with flattened prepontine cistern has not been described. CASE DESCRIPTION: We describe two children with congenital arachnoid cyst managed with cystoperitoneal shunt, both of whom were later discovered to have developed flattened prepontine cistern and imaging findings of overcrowding of the posterior cranial fossa...
October 2009: Surgical Neurology
R Faggin, A Bernardo, P Stieg, G Perilongo, D d'Avella
OBJECTIVE: Although endoscopic third ventriculostomy (ETV) is a well established procedure for the treatment of congenital and acquired hydrocephalus, there is still a controversy with regard to the higher risk of failure in younger infants compared to older children after such a procedure. The aim of this article is to define the effectiveness of third ventriculostomy for hydrocephalus in infants less than 6 months of age better and to determine possible positive predictive factors. MATERIALS AND METHODS: In a series of 126 consecutive patients who underwent ETV between January 2000 and December 2002, 21 procedures were performed on infants ranging in age from 23 to 180 days, and without a previous history of shunting...
August 2009: European Journal of Pediatric Surgery
M Cabraja, U-W Thomale, P Vajkoczy
Tethered cord syndrome (TCS) and the Chiari malformation (CM) are generally related to congenital malformations, but both entities can be acquired.TCS often presents with progressing sensory and motor symptoms that can be attributed to increased tension of the spinal cord. Fixation of the spinal cord can occur congenitally (primary TCS) or in association with other intraspinal pathologies or postoperative scarring (secondary TCS). Exact diagnosis in the adult can be difficult if symptoms are interpreted as being related to degenerative disorders of the spine...
April 2008: Der Orthopäde
Jörg Baldauf, J Oertel, Michael R Gaab, Henry W S Schroeder
INTRODUCTION: Endoscopic third ventriculostomy (ETV) for the treatment of hydrocephalus of different etiologies is still controversial in children younger than 2 years of age. The success rate of ETV in this group of patients is analyzed in this study. MATERIALS AND METHODS: The series consisted of 21 patients treated with ETV. The mean age of the patients was 6.7 months, ranging from 9 days to 15 months (16 patients were younger than 1 year). The study included hydrocephalus due to idiopathic aqueductal stenosis (eight) and other congenital anomalies (four) as well as posthemorrhagic (three) and tumor-related occlusive hydrocephalus (three)...
June 2007: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Giuseppe Cinalli, Pietro Spennato, Christian Sainte-Rose, Eric Arnaud, Ferdinando Aliberti, Francis Brunelle, Emilio Cianciulli, Dominique Renier
INTRODUCTION: Chiari malformation (CM) is a frequent finding in multisutural and syndromic craniosynostosis, occurring in 70% of patients with Crouzon's syndrome, 75% with oxycephaly, 50% with Pfeiffer's syndrome and 100% with the Kleeblattschädel deformity. The pathogenesis of this condition and rationale for treatment are still controversial. DISCUSSION: Since its first description in 1972, several factors have been cited to play a role in inducing CM. In the light of recent publications, the roles of premature fusion of cranial vault and cranial base sutures, of congenital anomalies of the cerebellum and brain stem, of raised intracranial pressure, of venous hypertension and of hydrocephalus are reviewed...
October 2005: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
M Yoshioka, T Toda, S Kuroki, K Hamano
Fukuyama-type congenital muscular dystrophy, Walker-Warburg syndrome, and muscle-eye-brain disease are clinically similar autosomal-recessive diseases, characterized by congenital muscular dystrophy, cobblestone lissencephaly, and eye anomalies. The classification of these disorders remains controversial. We analyzed five patients with congenital muscular dystrophy from four families who had severe eye and brain anomalies, such as retinal dysplasia and hydrocephalus, using polymorphic microsatellite markers flanking the Fukuyama-type congenital muscular dystrophy locus on chromosome 9q31...
November 1999: Journal of Child Neurology
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