The short- and long-term efficacy analysis of stereotactic surgery combined external ventricular drainage in the treatment of the secondary intraventricular hemorrhage

Abstract BACKGROUND Pediatric and Young-Adult (AYA) brain tumors often present with hydrocephalus. As temporary cerebrospinal fluid (CSF) diversion procedure, we perform long-term indwelling external ventricular drainage (EVD) in the case of the management of CSF diversion more than two weeks presumably. The aim of this study is to investigate the initial management for hydrocephalus in pediatric /AYA patients with brain tumor, especially about long-term EVD. MATERIALS AND METHODS The patients less than 30 years of age diagnosed with brain tumor between 2005 and 2019 were retrospectively analyzed. Procedures of long-term EVD were similar to that of ventriculoperitoneal shunt (VPS) operation. Using flow-control VPS system, peritoneal catheter passed out of the body at the anterior chest, and distal end of the catheter was connected to standard EVD system. RESULTS In total of 345 patients with brain tumor, 109 had hydrocephalus at presentation. Among them, 25 patients (23%) underwent long-term EVD. The main reasons for selecting long-term EVD were to avoid intraperitoneal dissemination (n=13), and to maintain longer period of CSF diversion for the treatment of tumor (n=12). The median of long-term EVD was 38 days (range: 12 – 222 days). Although one case suffered from drainage tube occlusion at 59 days, there were no other complications such as infection or accidental evulsion. Eventually, 3 cases required permanent VPS for persistent hydrocephalus. CONCLUSION Long-term EVD is safe and effective option for CSF diversion. This procedure should be taken into consideration if patients have a risk of dissemination and may elude permanent VPS.

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Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series

International Surgery ◽

10.9738/intsurg-d-14-00222.1 ◽

2015 ◽

Vol 100 (6) ◽

pp. 1117-1123 ◽

Cited By ~ 1

Author(s):

Wei Zhang ◽

Lin Wei ◽

Gang Li ◽

Jinlong Sun ◽

Peng Jin ◽

...

Keyword(s):

Clinical Outcomes ◽

Intraventricular Hemorrhage ◽

Blood Clot ◽

Controlled Trial ◽

Case Series ◽

External Ventricular Drainage ◽

Therapeutic Effects ◽

Ventricular Drainage ◽

Drilling Technique ◽

Conventional Drilling

This study aimed to describe the technique details of rapid pore cranial drilling with external ventricular drainage and document its clinical outcomes by highlighting the advantages over the traditional and modified cranial drilling technique. Intraventricular hemorrhage is one of the most severe subtypes of hemorrhagic stroke with high mortality. The amount of blood in the ventricles is associated with severity of outcomes, and fast removal of the blood clot is the key to a good prognosis. Between 1977 and 2013, 3773 patients admitted for intraventricular hemorrhage underwent rapid pore cranial drilling drainage. The therapeutic effects and clinical outcomes were retrospectively analyzed. Of these patients, 1049 (27.8%) experienced complete remission, 1788 (47.4%) had improved condition, and 936 (24.8%) died. A total of 3229 (85.6%) patients gained immediate remission. One typical case was illustrated to demonstrate the efficacy of the rapid pore drilling technique. Rapid pore cranial drilling drainage in patients with intraventricular hemorrhage is fast, effective, and provides immediate relief in patients with severe conditions. It could be a better alternative to the conventional drilling approach for treatment of intraventricular hemorrhage. A randomized controlled trial for direct comparison between the rapid pore cranial drilling drainage and conventional drilling technique is in urgent need.

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18 Short- and long-term efficacy of intensive rehabilitation treatment on balance and gait in Parkinsonian patients: A pilot study with a 1-year follow-up

Basal Ganglia ◽

10.1016/j.baga.2012.04.019 ◽

2012 ◽

Vol 2 (4) ◽

pp. 262

Author(s):

G. Frazzitta ◽

G. Bertotti ◽

P. Balbi ◽

D. Uccellini ◽

N. Boveri ◽

...

Keyword(s):

Pilot Study ◽

Rehabilitation Treatment ◽

Term Efficacy ◽

Short And Long Term ◽

Intensive Rehabilitation

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Corticosteroid injection for coccydynia

Bone & Joint Open ◽

10.1302/2633-1462.111.bjo-2020-0146 ◽

2020 ◽

Vol 1 (11) ◽

pp. 709-714

Author(s):

Vilhjalmur Finsen ◽

Ante M. Kalstad ◽

Rainer G. Knobloch

Keyword(s):

Logistic Regression ◽

Confidence Interval ◽

Odds Ratio ◽

Corticosteroid Injection ◽

Term Efficacy ◽

Early Success ◽

Cortisone Injection ◽

Short And Long Term ◽

Regression Tests

Aims We aimed to establish the short- and long-term efficacy of corticosteroid injection for coccydynia, and to determine if betamethasone or triamcinolone has the best effect. Methods During 2009 to 2016, we treated 277 patients with chronic coccydynia with either one 6 mg betamethasone or one 20 mg triamcinolone cortisone injection. A susequent injection was given to 62 (26%) of the patients. All were reviewed three to four months after injection, and 241 replied to a questionnaire a mean of 36 months (12 to 88) after the last injection. No pain at the early review was considered early success. When the patient had not been subsequently operated on, and indicated on the questionnaire that they were either well or much better, it was considered a long-term success. Results At the three- to four-month review, 22 (9%) reported that they had no pain. The long-term success of one injection was 15% and rose to 29% after a second injection. Logistic regression tests showed that both early success (odds ratio (OR) 5.5, 95% confidence interval (CI) 2.1 to 14.4; p = 0.001) and late success (OR 3.7, 95% CI 1.7 to 8.3; p = 0.001) was greater with triamcinolone than with betamethasone. Late success was greater for patients with symptoms for less than 12 months (OR 3.0, 95% CI 1.4 to 6.7; p = 0.006). We saw no complications of the injections. Conclusion We conclude that the effect of corticosteroid injection for coccygodynia is moderate, possibly because we used modest doses of the drugs. Even so, they seem worthwhile as they are easily and quickly performed, and complications are rare. If the choice is between injections of betamethasone or triamcinolone, the latter should be selected. Cite this article: Bone Joint Open 2020;1-11:709–714.

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Endoscope-assisted microsurgical evacuation versus external ventricular drainage for the treatment of cast intraventricular hemorrhage: results of a comparative series

Neurosurgical Review ◽

10.1007/s10143-019-01110-7 ◽

2019 ◽

Vol 43 (2) ◽

pp. 695-708

Author(s):

Alessandro Di Rienzo ◽

Roberto Colasanti ◽

Domenic Esposito ◽

Martina Della Costanza ◽

Erika Carrassi ◽

...

Keyword(s):

Intraventricular Hemorrhage ◽

External Ventricular Drainage ◽

Ventricular Drainage

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Smartphone‑assisted endoscopic surgery via Kocher's point for intraventricular hemorrhage caused by thalamic hemorrhage: A comparison with external ventricular drainage

Experimental and Therapeutic Medicine ◽

10.3892/etm.2019.7740 ◽

2019 ◽

Author(s):

Xin Ge ◽

Xinhua Xu ◽

Xinguang Yu ◽

Xiaolei Chen ◽

Duo Li ◽

...

Keyword(s):

Endoscopic Surgery ◽

Intraventricular Hemorrhage ◽

External Ventricular Drainage ◽

Ventricular Drainage ◽

Thalamic Hemorrhage

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Fissurectomy combined with botulinum toxin A: a review of short- and long-term efficacy of this treatment strategy for chronic anal fissure; a consecutive proposal of a treatment algorithm for chronic anal fissure

coloproctology ◽

10.1007/s00053-020-00480-7 ◽

2020 ◽

Vol 42 (5) ◽

pp. 400-408

Author(s):

M. Trzpis ◽

J. M. Klaase ◽

R. H. Koop ◽

P. M. A. Broens

Keyword(s):

Botulinum Toxin ◽

Anal Fissure ◽

Recurrence Rate ◽

Treatment Strategy ◽

Chronic Anal Fissure ◽

Botulinum Toxin A ◽

Toxin A ◽

Term Efficacy ◽

Short And Long Term

Abstract Background Several studies have investigated the short- and long-term efficacy of fissurectomy combined with botulinum toxin A injection for patients with chronic anal fissure. Objective To evaluate the short- and long-term efficacy of the combined treatment strategy of fissurectomy with botulinum toxin A for chronic anal fissure and to discuss recurrence rates in the light of current theory on the aetiology of anal fissure. Materials and methods This is a narrative review. We conducted an article search using PubMed and calculated the means of the reported efficacy ranges. Results Fissurectomy combined with botulinum toxin A injections freed at least 78% of the patients from symptoms and yielded a fissure healing rate of up to 86%. Within 12 months after treatment a 3% recurrence rate was reported. On average, the long-term recurrence rate was 22%. One study reported a 50% recurrence rate 22 months after treatment. Conclusion The efficacy of fissurectomy combined with botulinum toxin A injection for chronic anal fissure is high. The short-term recurrence rate is low, while long-term recurrence is relatively high. Extended follow-up indicates that recurrence of chronic anal fissure is possibly caused by anal basal pressure building up steadily once again. If so, the cause of renewed increase of pressure should be addressed. Based on the literature and on our clinical experience, we assume that the underlying cause of increasing anal basal pressure is that patients use their pelvic floor muscles inadequately and this in turn leads to chronic anal fissure.

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