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Etiology, clinical presentation and treatment of congenital hydrocephalus

Kentaro Chiba, Yasuo Aihara, Takakazu Kawamata
OBJECTIVE: Endoscopic third ventriculostomy (ETV) remains the mainstay of treatment for noncommunicating hydrocephalus these days. However, there has been no adequate clue for the intraoperative assessment of ETV efficacy until now. This time, we propose a newly defined finding, "folding sign," which is visible and enables us to confirm penetration of both the third ventricle floor and the Liliequist membrane (LM) during operation. In this report, we describe consecutive ETV cases and discuss the mechanism of folding sign and its clinical meanings...
November 2018: World Neurosurgery
Gönül Çatlı, Ayhan Abacı, Ahmet Anık, Handan Güleryüz, Erdener Özer, Irfan Öcal, Nurullah Yüceer, Kamer Mutafoğlu
Central precocious puberty (CPP) is caused by premature activation of the hypothalamo-pituitary-gonadal axis. More than 50% of boys with CPP have an identifiable etiology. Hypothalamic hamartoma (HH), hydrocephalus, tumors, infections, congenital defects, ischemia, radiation, or injury of the brain are the most common causes of secondary CPP. In this report, we present the case of a 2 years and 9 months old male patient who had a 30x40 mm contrast-enhancing suprasellar mass and was histopathologically diagnosed with giant HH...
September 2014: Journal of Clinical Research in Pediatric Endocrinology
Hideki Ogiwara, Kodai Uematsu, Nobuhito Morota
OBJECT: Endoscopic choroid plexus coagulation (CPC) with or without endoscopic third ventriculostomy (ETV) has been shown to be effective for selected patients with hydrocephalus. However, whether the effect of the coagulation is temporary and the choroid plexus regenerates or can be obliterated has remained largely unknown. The authors evaluate the effectiveness of CPC and report 3 cases of obliteration demonstrated by direct endoscopic observation. METHODS: The authors retrospectively analyzed the surgical results of patients with hydrocephalus primarily treated by CPC with or without ETV...
September 2014: Journal of Neurosurgery. Pediatrics
Jaime Torres-Corzo, Juan Sánchez-Rodríguez, Dominic Cervantes, Roberto Rodríguez-Della Vecchia, Fernando Muruato-Araiza, Steven W Hwang, Leonardo Rangel-Castilla
BACKGROUND: Routinely, hydrocephalus related to fourth ventricular outlet obstruction (FVOO) has been managed with ventriculoperitoneal (VP) shunting or endoscopic third ventriculostomy (ETV). Few reports on Magendie foraminoplasty exist, and Luschka foraminoplasty has not been described. OBJECTIVE: To present an alternative technique in the management of FVOO via an endoscopic transventricular transaqueductal Magendie and Luschka foraminoplasty and to discuss the indications, technique, findings, and outcomes...
April 2014: Neurosurgery
Florian Baptist Freimann, Christian Sprung
OBJECT: Overdrainage of CSF remains an unsolved problem in shunt therapy. The aim of the present study was to evaluate treatment options on overdrainage-related events enabled by the new generation of adjustable gravity-assisted valves. METHODS: The authors retrospectively studied the clinical course of 250 consecutive adult patients with various etiologies of hydrocephalus after shunt insertion for different signs and symptoms of overdrainage. Primary and secondary overdrainage were differentiated...
December 2012: Journal of Neurosurgery
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
Radim Lipina, Stefan Reguli, Viera Dolezilová, Marie Kuncíková, Hana Podesvová
INTRODUCTION: Endoscopic third ventriculostomy (ETV) is considered a safe procedure and is a method of choice in treatment of obstructive hydrocephalus nowadays. In case of Sylvian aqueduct stenosis, the success rate reaches 90%. In children younger than 6 to 24 months, respectively, however, some authors report lower effectiveness ranging between 0% and 64%. The reasons of ETV failure are discussed: hyporesorption in patients with obstruction as a consequence of hemorrhage or infection, suboptimal ETV performance, especially in premature newborns, or the theory of different cerebrospinal fluid circulation in newborn babies...
September 2008: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Suzan Sacar, Huseyin Turgut, Semra Toprak, Bayram Cirak, Erdal Coskun, Ozlem Yilmaz, Koray Tekin
BACKGROUND: Ventriculoperitoneal (VP) shunts are used for intracranial pressure management and temporary cerebrospinal fluid (CSF) drainage. Infection of the central nervous system (CNS) is a major cause of morbidity and mortality in patients with CSF shunts. The aim of the present study was to evaluate the clinical features, pathogens, and outcomes of 22 patients with CSF shunt infections collected over 4 years. METHODS: The patients with shunt insertions were evaluated using; age, sex, etiology of hydrocephalus, shunt infection numbers, biochemical and microbiological parameters, prognosis, clinical infection features and clinical outcome...
March 8, 2006: BMC Infectious Diseases
John A Cowan, Matthew J McGirt, Graeme Woodworth, Daniele Rigamonti, Michael A Williams
OBJECTIVES: Currently, headache, nausea/vomiting, visual changes, and altered mental status are accepted as indications for the evaluation of hydrocephalus in children; while dementia, gait apraxia, and urinary incontinence remain indications in the elderly. The clinical presentation of hydrocephalus in young and middle-aged adults remains poorly described. Hence, middle-aged patients with mild gait, cognitive, or urinary symptoms unaccompanied by clear exam findings often remain undiagnosed and untreated...
July 2005: Neurological Research
A Bringas-Grande, A Fernández-Luque, C García-Alfaro, M Barrera-Chacón, M Toledo-González, J M Domínguez-Roldá
OBJECTIVE: To know the etiological factors of cerebral palsy (CP) incident during pregnancy and neonatal/perinatal periods. To know evolution of a child with a CP diagnosis. PATIENTS, MATERIAL AND METHODS: Bibliographical review of paediatric and rehabilitation texts and databases in Internet. Elaboration of a data collecting questionnaire for reviewing clinical records of patients treated in Paediatric Rehabilitation between 1996 and 2000. RESULTS: 250 patients records reviewed...
November 1, 2002: Revista de Neurologia
Mitchell E Geffner
BACKGROUND: Childhood hypopituitarism may be present at birth or may be acquired. Early diagnosis and treatment promote the best possible outcomes. METHODS: The anatomy, etiologies, clinical presentation, diagnostic testing strategies, and current treatments relevant to childhood hypopituitarism are reviewed. RESULTS: Children with congenital hypopituitarism may present with life-threatening hypoglycemia, abnormal serum sodium concentrations, shock, microphallus in males, and, only later, growth failure...
May 2002: Cancer Control: Journal of the Moffitt Cancer Center
Patrick Watts, Palanisamy Suresh, Eedy Mezer, Anna Ells, Manuela Albisetti, Lazlo Bajzar, Velma Marzinotto, Maureen Andrew, Patricia Massicotle, David Rootman
PURPOSE: The etiology of ligneous conjunctivitis is now known to be due to an underlying type 1 plasminogen deficiency. We hereby report the clinical features of three cases and their response to topically administered plasminogen. DESIGN: Observational case series. METHODS: Two Caucasian females aged 5 years and an 18-month male of north African descent presented with a membranous conjunctivitis, which recurred after surgical excision. Case 1 presented before the association with plasminogen deficiency was known with a bilateral chronic membranous mucopurulent conjunctivitis from the age of 14 months associated with bronchiolitis and gingival hyperplasia...
April 2002: American Journal of Ophthalmology
L Gómez López, C Luaces Cubells, J M Costa Clará, M T Palá Calvo, J M Martín Rodrigo, A Palomeque Rico, J Pou Fernández
OBJECTIVE: The objective of this study was to know the incidence, mode of presentation, clinical and microbiological aspects, as well as the management of ventriculo-peritoneal shunt malfunction. PATIENTS AND METHODS: A retrospective study was carried out where thirty-seven children with malfunctioning shunts were studied. The mechanical causes of shunt malfunction included disconnection, fracture and obstruction, while infection was considered as either a clinical or analytical change (blood and/or CSF)...
April 1998: Anales Españoles de Pediatría
S Aravabhumi, K L Izzo
The sensory and motor deficits of the CNS are varied, depending on the etiologic factors and the structures involved. Nevertheless, the clinical picture is predictable, provided one has an adequate knowledge of the neuroanatomy and the functions of the different fiber tracts, nuclei, and other specific regions of the brain and spinal cord. The purpose of this section is to provide an overall view of the sensory and motor deficits of the CNS, which will enable the clinician to treat these patients in a more objective and effective manner...
October 1989: Clinics in Podiatric Medicine and Surgery
P W Carmel, J L Antunes, S K Hilal, A P Gold
Eighteen cases of the Dandy-Walker syndrome are presented. The clinical manifestations are analyzed. Almost half of these children had associated congenital anomalies. Only four had the "characteristic" radiological findings. Direct surgical attack upon the cyst was not a successful form of treatment. Satisfactory treatment consisted of shunting of the ventricular system but the incidence of complications was high. There was a 27% mortality. The etiology and pathology are discussed.
August 1977: Surgical Neurology
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