Pediatric Neurosurgery

2016 ◽  
pp. 135-152
Author(s):  
Jodi L. Smith
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Intraventricular Hemorrhage ◽  
Intractable Epilepsy ◽  
Pediatric Neurosurgery ◽  
Test Results ◽  
Board Examination ◽  
Clinical Vignettes ◽  
Spinal Infections ◽  
Spinal Malformations

Common pediatric neurosurgical problems treated by neurosurgeons will be included on the American Board of Neurological Surgeons (ABNS) Oral Board Examination. Therefore, the candidate should be familiar with the neurosurgical management of such problems, which include disorders of cerebrospinal fluid (CSF) dynamics, congenital cranial and spinal malformations, tumors, vascular congenital and acquired disorders, intracranial and spinal infections, and intractable epilepsy. Neurological disorders that mimic pediatric neurosurgical conditions may also be on the examination. In this chapter, clinical vignettes of common pediatric neurosurgical conditions are presented, including hydrocephalus, myelomeningocele, intraventricular hemorrhage (IVH) of prematurity, craniosynostosis, and posterior fossa tumors. The examinee will be given the history, physical examination, pertinent imaging studies, and test results and will then be expected to provide a rational differential diagnosis and plan of management, outline the risks of surgery and describe the operation if proposed, and handle intraoperative and postoperative complications that occur.

Pediatric Neurosurgery

2020 ◽  
pp. 161-186
Author(s):  
Jodi L. Smith
Keyword(s):  
Intractable Epilepsy ◽  
Pediatric Neurosurgery ◽  
Oral Examination ◽  
Oral Exam ◽  
Cerebrospinal Fluid Dynamics ◽  
Clinical Vignettes ◽  
Independent Practitioner ◽  
Neurological Surgery ◽  
Spinal Infections ◽  
Spinal Malformations

The ABNS Oral Examination evaluates an applicant’s knowledge and judgment in clinical neurosurgical practice after an applicant has been an independent practitioner. With the new format, the oral exam is divided into 3 sessions, each consisting of 5 questions. Questions in the first session deal with general neurosurgery, questions in the second session focus on the preidentified area of practice chosen by the applicant (e.g., pediatric neurosurgery), and questions in the third session are based on cases submitted by the applicant. Common pediatric neurosurgical problems treated by neurosurgeons may be included on the American Board of Neurological Surgery Oral Examination in the general neurosurgery session. Therefore, one should be familiar with the neurosurgical management of pediatric cases, including disorders of cerebrospinal fluid dynamics, congenital cranial and spinal malformations, tumors, vascular congenital and acquired disorders, intracranial and spinal infections, and intractable epilepsy. In this chapter, clinical vignettes of common pediatric neurosurgical conditions will be presented including (a) myelomeningocele, (b) craniosynostosis, (c) hydrocephalus, (d) posterior fossa tumors, and (e) moyamoya disease, with the cases subdivided into those that may be seen in the general session (1 to 3) and those more likely to be seen in the subspecialty specific session (4 and 5). The applicant will be given the history, physical examination, pertinent imaging studies, and test results and will then be expected to provide a rational differential diagnosis and plan of management, outline the risks of surgery, and describe the operation, if proposed, and handle intraoperative and postoperative complications that occur.

Event-related Potentials Improve the Efficiency of Cerebrospinal Fluid Biomarkers for Differential Diagnosis of Alzheimer’s Disease

2018 ◽  
Vol 15 (13) ◽  
pp. 1244-1260 ◽  
Author(s):  
Mirjana Babić Leko ◽  
Magdalena Krbot Skorić ◽  
Nataša Klepac ◽  
Fran Borovečki ◽  
Lea Langer Horvat ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Tau Protein ◽  
Strong Correlation ◽  
Event Related Potentials ◽  
P300 Latency ◽  
Protein Biomarkers ◽  
Related Potentials ◽  
T Tau

Introduction: The pathological process of Alzheimer's disease (AD) in the brain likely begins 20-30 years earlier than the emergence of its first clinical symptoms and symptoms of AD often overlap with the symptoms of other primary causes of dementia. Therefore, it is crucially important to improve early and differential diagnosis of the disease. Event-related potentials (ERP) measured non-invasively by electroencephalography have shown diagnostic potential in AD. Aims: The aim of this study was to compare the efficiency of P300 and N200 potentials and reaction time (RT) with commonly used protein biomarkers measured in the cerebrospinal fluid (CSF), including amyloid β peptide (β1-42), total tau (t-tau), tau protein phosphorylated at threonine 181 (p-tau181), tau protein phosphorylated at serine 199 (p-tau199), tau protein phosphorylated at threonine 231 (p-tau231), and visinin-like protein 1 (VILIP-1) in differential diagnosis of AD in mild cognitive impairment (MCI) and AD patients. Subjects: The study involved 49 AD patients, 28 patients with MCI, 4 healthy control subjects and 16 patients with other primary causes of dementia. Results: ERP (P300RT, N200RT, P300 counting and N200 counting) showed a moderate to strong correlation with protein CSF biomarkers. We confirmed previous observations of moderate to strong correlation between ERP and neuropsychological testing and showed that P300 latency and RT are shortened in AD patients on therapy with acetylcholinesterase inhibitors. Using ERP and RT, a predictive model for determination of AD likelihood in MCI patients was developed, detecting 56.3% of MCI patients with high risk for development of AD in our cohort. MCI patients with pathological levels of Aβ1-42 had prolonged P300 latency, indicating that a combination of ERP and CSF protein biomarkers could improve the differential diagnosis of AD in MCI patients. Additionally, the results suggested the potential of P300 latency in differentiating AD and FTD patients. Conclusion: Our data provide possible solutions for improvement of differential diagnosis of AD, and reveal that the diagnostic efficiency of CSF protein biomarkers t-tau, p-tau181, p-tau199, p-tau231 and VILIP-1 could be improved by adding ERP in clinical practice.

scholarly journals Early Inflammatory Cytokine Expression in Cerebrospinal Fluid of Patients with Spontaneous Intraventricular Hemorrhage

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1123
Author(s):  
Wendy C. Ziai ◽  
Adrian R. Parry-Jones ◽  
Carol B. Thompson ◽  
Lauren H. Sansing ◽  
Michael T. Mullen ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intraventricular Hemorrhage ◽  
Inflammatory Responses ◽  
Obstructive Hydrocephalus ◽  
External Ventricular Drainage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Injury Reduction ◽  
Positive Correlations ◽  
Factor Α ◽  
Perihematomal Edema

We investigated cerebrospinal fluid (CSF) expression of inflammatory cytokines and their relationship with spontaneous intracerebral and intraventricular hemorrhage (ICH, IVH) and perihematomal edema (PHE) volumes in patients with acute IVH. Twenty-eight adults with IVH requiring external ventricular drainage for obstructive hydrocephalus had cerebrospinal fluid (CSF) collected for up to 10 days and had levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), and C-C motif chemokine ligand CCL2 measured using enzyme-linked immunosorbent assay. Median [IQR] ICH and IVH volumes at baseline (T0) were 19.8 [5.8–48.8] and 14.3 [5.3–38] mL respectively. Mean levels of IL-1β, IL-6, IL-10, TNF-α, and CCL2 peaked early compared to day 9–10 (p < 0.05) and decreased across subsequent time periods. Levels of IL-1β, IL-6, IL-8, IL-10, and CCL2 had positive correlations with IVH volume at days 3–8 whereas positive correlations with ICH volume occurred earlier at day 1–2. Significant correlations were found with PHE volume for IL-6, IL-10 and CCL2 at day 1–2 and with relative PHE at days 7–8 or 9–10 for IL-1β, IL-6, IL-8, and IL-10. Time trends of CSF cytokines support experimental data suggesting association of cerebral inflammatory responses with ICH/IVH severity. Pro-inflammatory markers are potential targets for injury reduction.

Folate analysis for the differential diagnosis of profound cerebrospinal fluid folate deficiency

2011 ◽  
Vol 44 (8-9) ◽  
pp. 719-721 ◽  
Author(s):  
Aida Ormazábal ◽  
Belén Perez-Dueñas ◽  
Cristina Sierra ◽  
Roser Urreitzi ◽  
Julio Montoya ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Folate Deficiency

scholarly journals The Susceptibility of Meningococci to the Antimicrobial Agents in Moscow 2006 - 2015

2016 ◽  
Vol 15 (3) ◽  
pp. 7-14 ◽  
Author(s):  
M. A. Koroleva ◽  
I. S. Koroleva ◽  
I. M. Zakroeva ◽  
I. M. Gruber
Keyword(s):  
Cerebrospinal Fluid ◽  
Continuous Monitoring ◽  
Antimicrobial Agents ◽  
Meningococcal Infection ◽  
Test Results ◽  
Prognostic Criteria ◽  
Comparison Results ◽  
Moderately Resistant ◽  
First Time

Relevance. One of the prognostic criteria meningococcal infection (MI) epidemic status process is the increasing number of resistant to antibiotics meningococcal strains. Aim of this study was to investigate the dynamics of invasive strains of N. meningitidis susceptibility to antibiotics in Moscow in 2006 - 2015. Materials and methods. Studied 98 strains of N. meningitidis, isolated from blood and cerebrospinal fluid of patients with MI. The study changes of sensitivity N. meningitidis to antibiotics was occured in two periods: first -2006 - 2011 and second - 2012 - 2015. The MIC was determined by E-test. Results. In the present study revealed for the first time the Russian strains of N. meningitidis, moderately resistant to penicillin (5 strains) and resistant to rifampicin (3 strains). Among the studied strains were not found resistant to ceftriaxone, ciprofloxacin, tetracycline and chloramphenicol. Discussion. Comparison results two study periods allowed to reveal the dynamics of increasing the sensitivity of N. meningitidis to antibiotics, which confirms the decline in meningococcal virulence, and as a result, continued interepidemic MI period. Conclusions. Despite the decline antibakterial resistance is required continuous monitoring.

Fatal cerebral and cerebellar hemorrhagic infarction after thoracoscopic microdiscectomy

2007 ◽  
Vol 6 (3) ◽  
pp. 276-279 ◽  
Author(s):  
Erwin M. J. Cornips ◽  
Julie Staals ◽  
Angela Stavast ◽  
Kim Rijkers ◽  
Robert J. Van Oostenbrugge
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Venous Thrombosis ◽  
Intracranial Hypotension ◽  
Rare Case ◽  
Pathophysiological Mechanism ◽  
Thoracic Cavity ◽  
Hemorrhagic Infarction ◽  
Severe Manifestation ◽  
Cortical Venous Thrombosis

✓ The authors present a rare case of fatal cerebral and cerebellar hemorrhagic infarction following an uneventful thoracoscopic microdiscectomy. They hypothesize that this complication was associated with cortical venous thrombosis secondary to intracranial hypotension, which was caused by an unnoticed leak of cerebrospinal fluid (CSF) into the thoracic cavity. Cortical venous thrombosis and intrathoracic CSF were confirmed at autopsy. The former disorder is the most severe manifestation of the pathophysiological mechanism occurring to a lesser degree in patients affected by mild intracranial hypotension, and occurs more frequently in these patients. Intracranial hypotension (of an orthostatic nature or not) must be considered in the differential diagnosis of every patient who complains of headaches after thoracoscopic or open transthoracic microdiscectomy.

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