scholarly journals SURG-27. TREATING HYDROCEPHALUS IN DIFFUSE MIDLINE GLIOMAS WITH AN H3 K27M MUTATION

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii209-ii209
Author(s):  
L Coombs ◽  
R LaRocca ◽  
Jessica Hata ◽  
H Nickols ◽  
A Spalding ◽  
...  
Keyword(s):  
Chart Review ◽  
Obstructive Hydrocephalus ◽  
Malignant Gliomas ◽  
Retrospective Chart Review ◽  
Third Ventriculostomy ◽  
Tumor Patients ◽  
Initial Management ◽  
Mutation Status ◽  
Characteristic Imaging ◽  
H3k27m Mutation

Abstract BACKGROUND Diffuse midline gliomas (DMG) are a subset of malignant gliomas that share a characteristic Histone H3K27M mutation. These tumors are centrally located and may cause hydrocephalus on initial presentation. DMG lack characteristic imaging that distinguish from other primary brain tumors in the midline. We conducted this retrospective chart review of 43 consecutive patients presenting with midline tumors to determine: how many had a DMG; whether DMG patients with hydrocephalus were candidates for resection; and what the outcomes of endoscopic third ventriculostomy (ETV) versus ventriculoperitoneal shunt (VPS) placement were, as compared to wild type (WT) tumors. METHODS We conducted an IRB approved retrospective chart review of patients presenting with midline tumors from 9/2016-3/2020 to determine H3K27M mutation status, hydrocephalus, and neurosurgery intervention. RESULTS The median age of all midline tumor patients was 19.1 years (range 1.1-80.1). 26% (11/43) of midline tumors presented with H3K27M mutation, with a higher rate of hydrocephalus compared to patients without mutation [7/11 (65%) for DMG vs. 6/32 (19%) for WT, p< 0.05]. Of the seven H3K27M patients presenting with hydrocephalus, none were candidates for resection, 5 underwent ETV, and 2 underwent VPS placement as initial management. 4 out of these 5 ETVs failed within an average of 24 days (6-42 days). 2 patients then underwent VP shunt placement; the other 2 underwent secondary ETV but both failed and required VP shunting as well. All 6 WT tumor patients had one procedure (1 ETV, 5 resection) to relieve hydrocephalus, and no patients had recurrent hydrocephalus. CONCLUSIONS Both pediatric and adult patients may present with DMG associated with a higher rate of unresectable tumors and hydrocephalus on presentation. Furthermore, these data suggest that neuroendoscopic third ventriculostomy and septum pellucidum fenestration for the management of obstructive hydrocephalus in patients with DMG may be less robust than shunting.

Clinical presentation and optimal management for intramedullary cavernous malformations

2006 ◽  
Vol 21 (1) ◽  
pp. 1-6 ◽  
Author(s):  
George I. Jallo ◽  
Diana Freed ◽  
Michelle Zareck ◽  
Fred Epstein ◽  
Karl F. Kothbauer
Keyword(s):  
Mr Imaging ◽  
Chart Review ◽  
Clinical Presentation ◽  
Retrospective Chart Review ◽  
Acute Onset ◽  
Total Removal ◽  
Cavernous Malformations ◽  
Characteristic Imaging ◽  
Preoperative Magnetic Resonance ◽  
Microsurgical Resection

Object Intramedullary cavernous malformations (CMs) account for approximately 5% of all intraspinal lesions. The purpose of this study was to define the spectrum of presentation for spinal intramedullary CMs and the results of microsurgery for these benign but clinically progressive lesions. Methods Retrospective chart review was performed in 26 patients with histologically diagnosed CMs. All patients had undergone preoperative magnetic resonance (MR) imaging studies. All patients were treated with a laminectomy and microsurgical resection of the malformation. Conclusions The MR imaging findings are diagnostic for intramedullary CMs; these lesions abut a pial surface and have a characteristic imaging pattern. Spinal intramedullary CMs present with either an acute onset of neurological compromise or a slowly progressive neurological decline. Acute neurological decline occurs secondary to hemorrhage inside the spinal cord. Chronic progressive myelopathy occurs due to microhemorrhages and resulting gliotic reaction to blood products. Surgery and total removal of the lesion tends to halt progression of symptoms.

scholarly journals Endoscopic fenestration of intraventricular cerebrospinal fluid cysts: the contralateral approach

2016 ◽  
Vol 124 (4) ◽  
pp. 1047-1052 ◽  
Author(s):  
Michael Hugelshofer ◽  
Nicolas Olmo Koechlin ◽  
Hani J. Marcus ◽  
Ralf A. Kockro ◽  
Robert Reisch
Keyword(s):  
Obstructive Hydrocephalus ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Third Ventriculostomy ◽  
Image Guided ◽  
Contralateral Approach ◽  
Eloquent Cortex ◽  
Definition Of ◽  
Endoscopic Fenestration ◽  
Cyst Fenestration

OBJECT The endoscopic fenestration of intraventricular CSF cysts has evolved into a well-accepted treatment modality. However, definition of the optimal trajectory for endoscopic fenestration may be difficult. Distorted ventricular anatomy and poor visibility within the cyst due to its contents can make endoscopic fenestration challenging if approached from the ipsilateral side. In addition, transcortical approaches can theoretically cause injury to eloquent cortex, particularly in patients with dominant-sided lesions. The aim of this study was to examine the value of the contralateral transcortical transventricular approach in patients with dominant-sided ventricular cysts. METHODS During a 5-year period between 2007 and 2011, 31 patients with intraventricular CSF cysts underwent surgery by the senior author (R.R.). Fourteen of these patients had cysts located on the dominant side. An image-guided endoscopic cyst fenestration via the contralateral transcortical transventricular approach was performed in 11 patients. A retrospective chart review was performed in all these patients to extract data on clinical presentation, operative technique, and surgical outcome. RESULTS The most common presenting symptom was headache, followed by memory deficits and cognitive deterioration. In all cases CSF cysts were space occupying, with associated obstructive hydrocephalus in 8 patients. Image-guided endoscopic fenestration was successfully performed in all cases, with septum pellucidotomy necessary in 6 cases, and endoscopic third ventriculostomy in 1 case for additional aqueductal occlusion. Postoperative clinical outcome was excellent, with no associated permanent neurological or neuropsychological morbidity. No recurrent cysts were observed over a mean follow-up period of 2 years and 3 months. CONCLUSIONS The contralateral approach to ventricular cysts can achieve excellent surgical outcomes while minimizing approach-related trauma to the dominant hemisphere. Careful case selection is essential to ensure that the contralateral endoscopic trajectory is the best possible exposure for sufficient cyst fenestration and restoration of CSF circulation.

Thirty-day mortality following interventional line or drain placement among hospitalized cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18222-e18222
Author(s):  
Kerry L. Kilbridge ◽  
Brett Glotzbecker ◽  
Sherri Oliver Stuver ◽  
Cecilia H. Rosenbaum ◽  
Susan Kiernan O'Horo ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Solid Tumor ◽  
Hospital Readmission ◽  
Chart Review ◽  
Medical Oncology ◽  
Retrospective Chart Review ◽  
Office Visit ◽  
Phone Call ◽  
Tumor Patients ◽  
Drain Placement

e18222 Background: Percutaneous lines and drains provide a less invasive alternative to operative procedures for patients with cancer. We categorized outcomes for placements among solid tumor patients hospitalized on the medical oncology services of a tertiary care academic center. Methods: Consecutive cases (n=71, Mar-Sept 2016) were identified by electronic medical record orders for non-vascular lines and drains placed in solid tumor patients hospitalized on medical oncology services and confirmed by retrospective chart review. Percutaneous nephrostomy tubes, pleurx catheters (abdominal and thoracic), gastrojejunostomy/gastric tubes, biliary drains, and wound/abscess drains were included. Retrospective chart review was used to categorize 30-day outcomes including those deemed related or possibly related to the placement that resulted in a phone call, office visit, ED evaluation, or hospital readmission. Results: Mean age at placement was 62 years and 53% of patients were female. All patients had metastatic tumor. The majority of patients had an Eastern Cooperative Oncology Group Performance Status of 3-4 (63.4%). Patients with gastrointestinal, gynecological and genitourinary malignancies required more procedures than all other tumor types combined. The 30-day mortality rate following line and drain placement was 32.4%. Of these deaths, 43.5% occurred prior to discharge and 30.4% occurred within two weeks. 40.8% of patients required ED evaluation or hospital readmission and 29.6% of patients required an office visit or phone call within 30 days. Conclusions: Although percutaneous interventions are generally safe and minimally invasive, there is a high 30-day mortality rate associated with line and drain placement among hospitalized patients with advanced cancer. Among patients who expired, over forty percent of deaths occurred during the index hospitalization, suggesting placements are occurring at the end of life, may potentially reflect overuse and may represent a missed opportunity to address goals of care. [Table: see text]

Clinical Analysis of 60 Patients with Hepatocellular Cancer Treated in Korean Medicine Hospital; A Retrospective Chart Review

2020 ◽  
Vol 41 (3) ◽  
pp. 447-456
Author(s):  
Mi-jung Yoon ◽  
Na-kyung Cho ◽  
Hong-sic Choi ◽  
Seung-mo Kim ◽  
Sang-chan Kim ◽  
...  
Keyword(s):  
Chart Review ◽  
Hepatocellular Cancer ◽  
Retrospective Chart Review ◽  
Clinical Analysis ◽  
Korean Medicine

Physical Medicine Rehabilitation Consults and 30 Day Readmissions: A Retrospective Chart Review

2014 ◽  
Vol 95 (10) ◽  
pp. e93-e94
Author(s):  
Aziza Azadali Kamani ◽  
Earl L. Smith ◽  
Jeffrey Fine ◽  
Lawrence M. Reich
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Physical Medicine

scholarly journals Can an amino acid mixture alleviate gastrointestinal symptoms in neuroendocrine tumor patients?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aman Chauhan ◽  
Satya Das ◽  
Rachel Miller ◽  
Laura Luque ◽  
Samuel N. Cheuvront ◽  
...  
Keyword(s):  
Amino Acid ◽  
Neuroendocrine Tumor ◽  
Gastrointestinal Symptoms ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Acid Mixture ◽  
Tumor Patients ◽  
Short Gut Syndrome ◽  
Oral Rehydration ◽  
The Mean

Abstract Background Neuroendocrine tumors, although relatively rare in incidence, are now the second most prevalent gastrointestinal neoplasm owing to indolent disease biology. A small but significant sub-group of neuroendocrine tumor patients suffer from diarrhea. This is usually secondary to carcinoid syndrome but can also be a result of short gut syndrome, bile acid excess or iatrogenic etiologies. Recently, an amino acid based oral rehydration solution (enterade® Advanced Oncology Formula) was found to have anti-diarrheal properties in preclinical models. Methods A retrospective chart review of all NET patients treated with enterade® AO was performed after IRB approval. Results Ninety-eight NET patients who had received enterade® AO at our clinic from May 2017 through June 2019 were included. Patients (N = 49 of 98) with follow up data on bowel movements (BMs) were included for final analysis. Eighty-four percent of patients (41/49) had fewer BMs after taking enterade® AO and 66% (27/41) reported more than 50% reduction in BM frequency. The mean number of daily BMs was 6.6 (range, 3–20) at baseline before initiation of therapy, while the mean number of BMs at 1 week time point post enterade® AO was 2.9 (range, 0–11). Conclusions Our retrospective observations are encouraging and support prospective validation with appropriate controls in NET patients. This is first published report of the potential anti-diarrheal activity of enterade® AO in NET patients.

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