scholarly journals Ventriculitis: a severe complication of central nervous system infections

2021 ◽  
Author(s):  
David Luque-Paz ◽  
Matthieu Revest ◽  
François Eugène ◽  
Sarrah Boukthir ◽  
Loren Dejoies ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Behavior Disorder ◽  
Severe Complication ◽  
Limited Attention ◽  
Neurosurgical Procedures ◽  
Imaging Features ◽  
Neurological Sequelae ◽  
Single Centre Study ◽  
One Year ◽  
Gait Disturbances

Abstract Background Ventriculitis, a dreaded complication of brain abscess, meningitis, and various neurosurgical procedures, has attracted limited attention in the medical literature. Methods Retrospective single-centre study. We screened medical files of all patients who had a brain imaging report including the word “ventriculitis” during years 2005-2019. Only patients with clinical, microbiological and imaging features of ventriculitis were included. Data were collected through a standardized questionnaire. Results Ninety-eight patients fulfilled inclusion criteria: 42 women and 56 men, median age 60 years [interquartile range 48-68]. Primary mechanism for ventriculitis was classified as follows: brain abscess (n=29, 29.6%), meningitis (n=27, 27.6%), intraventricular catheter-related (n=17, 17.3%), post-neurosurgery (n=13, 13.3%), and hematogenous (n=12, 12.2%). Main neuroimaging features were intraventricular pus (n=81, 82.7%), ependymal enhancement (n=70, 71.4%) and intraventricular loculations (n=15, 15.3%). Main pathogens were streptococci (n=44, 44.9%), Gram-negative bacilli (n=27, 27.6%), and staphylococci (n=15, 15.3%). In-hospital and one-year mortality rates were, respectively, 30.6% (n=30), and 38.8% (n=38). Neurological sequelae were reported in 34/55 (61.8%) survivors, including cognitive impairment (n=11), gait disturbances (n=9), paresis (n=7), behavior disorder (n=6), epilepsy (n=5). On multivariate analysis, age > 65 years, Glasgow Coma Scale score < 13 at initial presentation, status epilepticus, hydrocephalus and positive cerebrospinal fluid culture were associated with one-year mortality. We built a scoring system to stratify patients with ventriculitis into low-risk (12.5%), intermediate-risk (36.5%), and high-risk (71.4%) of death. Conclusion Ventriculitis is a severe complication of brain abscess, meningitis, or neurosurgery, with in-hospital mortality rate of 30%, and neurological sequelae in 60% of survivors.

Intracranial meningioma in a patient with osteogenesis imperfecta

Open Medicine ◽  
2008 ◽  
Vol 3 (4) ◽  
pp. 517-520
Author(s):  
Parmenion Tsitsopoulos ◽  
Ioannis Anagnostopoulos ◽  
Vasileios Tsitouras ◽  
Ioannis Venizelos ◽  
Philippos Tsitsopoulos
Keyword(s):  
Osteogenesis Imperfecta ◽  
Muscle Power ◽  
Brain Mri ◽  
Intracranial Meningioma ◽  
Type I ◽  
Mri Scans ◽  
Heritable Disorder ◽  
History Of ◽  
One Year ◽  
Gait Disturbances

AbstractOsteogenesis imperfecta (OI) is a heritable disorder characterized mainly by connective tissue manifestations. In dinstinct cases, several neurological features have also been described. A 46-year-old male with a known family history of OI type I presented with progressive gait disturbances and diminished muscle strength. Brain MRI scans revealed an infiltrative intracranial mass occupying both frontoparietal lobes. The patient underwent surgical intervention. The histological diagnosis was an atypical (Grade II) meningioma. The bony parts demonstrated a mixture of osseous defects due to OI and infiltration by the tumor. At one-year follow up the patient′s muscle power partially returned while repeat MRI scans were negative for tumor recurrence.

Abstract 19622: Trans-apical Off-pump Mitral Valve Repair With Neochords Implantation: One Year Clinical and Echocardiographic Follow-up

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Andrea Colli ◽  
Laura Besola ◽  
Lorenzo Bagozzi ◽  
Erica Manzan ◽  
Eleonora Bizzotto ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Type A ◽  
Mitral Valve Regurgitation ◽  
Disease Type ◽  
Reverse Remodeling ◽  
Off Pump ◽  
Single Centre Study ◽  
Type C ◽  
One Year

Introduction: TOP-MINI is a new micro invasive surgical procedure to treat degenerative mitral valve regurgitation due to flail/prolapse. Hypothesis: This prospective single centre study sought to assess the safety and effectiveness of the TOP-MINI procedure up to one year follow-up. Methods: Clinical and Echocardiographic outcomes were evaluated at 1, 3, 6 months and 1 year follow-up for all patients underwent TOP-MINI procedure from November 2013 to March 2015. Procedural success was defined as residual MR≤2+ at any time. Results: Sixty-one patients were treated during study period. One year survival was 96.7±2.3%. Freedom from MR>2+ is shown in figure 1 Panel A, Freedom from MR>2+ according to valve anatomy (Type A isolated P2 disease, Type B posterior multisegment disease, Type C anterior or bileaflet and/or calcified disease) is shown in Figure 1 Panel B. Freedom from MR>2+ according to STS risk profile is shown in Figure 2. The trend of Echocardiographic parameters is shown in Figure 3. Conclusions: TOP-MINI is a safe and effective procedure at 1 year FU. Residual MR is influenced by valve anatomy showing good results in Type A and B patients. Future techniques refinements are needed in order to improve outcomes of Type C patients. The lack of annuloplasty procedure does not influence negatively left ventricle reverse remodeling.

A Case of Incidentally Detected Bladder Lipoma and a Review of the Literature

2021 ◽  
Vol 17 ◽  
Author(s):  
Emre Emekli ◽  
Elif Gündoğdu
Keyword(s):  
Histopathological Examination ◽  
Adrenal Adenoma ◽  
Bladder Wall ◽  
Benign Tumors ◽  
Imaging Features ◽  
Multiplanar Reconstructions ◽  
Clinical Presentations ◽  
Pelvic Lipomatosis ◽  
One Year

Background: Lipomas are benign fatty tumors made of fat tissue. Bladder lipomas are extremely rare. For this reason, it is necessary to be aware of the imaging features when incidentally detected in imaging. Case Report: In the abdominal computed tomography (CT) performed as part of the follow-up examination of a 43-year-old patient, who had undergone surgery for adrenal adenoma five years earlier, a 14x9x8 mm smoothly marginated, ovoid-shaped, hypodense mass lesion with a homogeneous internal structure was detected in the anterior bladder wall. The pre-contrast density of the lesion was measured as -105 HU. The magnetic resonance imaging performed one year after the CT examination revealed a 14x9x8 intramural mass in the bladder wall, showing protrusion toward the lumen. The group was observed to be markedly hypointense on fat-suppressed T1 and T2-weighted images and considered consistent with a bladder lipoma. Discussion: Bladder lipomas are benign lesions that can vary in clinical presentations but usually cause hematuria. The differential diagnosis of bladder lipomas includes other mesenchymal rare benign tumors that can arise from the urinary bladder submucosal layer, including leiomyoma, hemangioma, plasmacytoma, fibroma, and neurofibroma, in imaging bladder lipomas present as homogeneous lesions containing macroscopic fat. Only the liposarcoma and pelvic lipomatosis could also show similar features. The less differentiated liposarcomas tend to present more heterogeneous enhancement, irregular-shaped margins, and infiltrative behavior. Also, appropriate multiplanar reconstructions may allow the radiologist to determine it is an extravesical pelvic lipomatosis. Conclusion: Using CT and MRI, these lesions rich in adipose tissue can be distinguished from other lesions, and their diagnosis can be made to a great extent. However, a histopathological examination is required for a definitive diagnosis.

scholarly journals A Combined Approach to Treatment of the Dissecting Middle Cerebral Artery Fusiform Aneurysm

2009 ◽  
Vol 15 (3) ◽  
pp. 349-354 ◽  
Author(s):  
T. Hrbáč ◽  
P. Drábek ◽  
P. Klement ◽  
V. Procházka
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Fusiform Aneurysm ◽  
Neurological Sequelae ◽  
Parent Artery Occlusion ◽  
Aneurysm Embolization ◽  
Mca Aneurysm ◽  
One Year

A fusiform aneurysm in the terminal M1 middle cerebral artery (MCA) segment was treated by a construction of a high-flow arterial extracranial-intracranial (EC-IC) bypass. Due to severe bypass vasospasms, local vasodilating agents together with percutaneous angioplasty and stent implantation were applied, but failed due to subsequent bypass occlusion. To remedy this complication a new bypass was created from a segment of the saphenous vein, followed by MCA aneurysm embolization and parent artery occlusion. One year after the surgery, the venous bypass remains patent and the aneurysm occluded, with the patient fully active, without any neurological sequelae.

P110 External ventricular drain-related infections: a single centre study

2019 ◽  
Vol 90 (3) ◽  
pp. e51.1-e51
Author(s):  
JC Duddy ◽  
MGJ O’Sullivan ◽  
C Lim ◽  
GF Kaar
Keyword(s):  
Average Length ◽  
External Ventricular Drain ◽  
Sampling Rate ◽  
University Hospital ◽  
Sampling Protocol ◽  
Retrospective Audit ◽  
Single Centre Study ◽  
Hospital Stays ◽  
One Year

ObjectivesTo quantify the External Ventricular Drain-related infection (ERI) rate in a one year period at Cork University Hospital, and to identify any risk factors for infection.DesignA retrospective audit of all External Ventricular Drains (EVDs) inserted in a one year period.SubjectsAll patients who had an EVD inserted between February 2017 and February 2018.MethodsPatients were identified from operating theatre logbooks. All relevant data was obtained from a retrospective review of medical and operative records. ERI was defined as evidence of positive CSF culture.Results41 EVDs were inserted in a total of 30 patients during the study period. The average age was 52.9 years. 46.6% of patients were female. The average length of EVD insertion was 8.85 days. The most common reason for EVD insertion was subarachnoid haemorrhage (31.7%) followed by supratentorial tumour (24.4%). 78% of EVDs were antibiotic-impregnated. Average EVD sampling rate was 0.7. ERI rate was 1/41 (2.4%). The infection occurred in a patient who had an EVD inserted for haemorrhage secondary to an AVM which had remained in situ for 13 days. The patient subsequently developed problems with repeated shunt infections resulting in a nine-month hospital stay.ConclusionsThe ERI rate in our patient cohort was 2.4%. We recommend using a strict EVD sampling protocol to minimise manipulation of EVDs and where possible to limit the length of time an EVD remains in situ. EVD-related infections can result in lengthy hospital stays and increased healthcare costs.

scholarly journals Idiopathic Acute Exudative Polymorphous Vitelliform Maculopathy: Insight into Imaging Features and Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Sónia Torres-Costa ◽  
Susana Penas ◽  
Ângela Carneiro ◽  
Renato Santos-Silva ◽  
Rodolfo Moura ◽  
...  
Keyword(s):  
Complete Resolution ◽  
Indocyanine Green Angiography ◽  
Fundus Autofluorescence ◽  
Correct Diagnosis ◽  
Posterior Pole ◽  
Imaging Features ◽  
Corrected Visual Acuity ◽  
Blurry Vision ◽  
One Year ◽  
Insight Into

The authors describe imagiological findings in idiopathic exudative polymorphous vitelliform maculopathy. A 41-year-old woman complained of bilateral blurry vision. Best-corrected visual acuity was 20/20 bilaterally. Bilateral small serous neurosensory detachments in the fovea were seen at fundoscopy and confirmed by spectral-domain optical coherence tomography. Fluorescein angiography was unremarkable. Indocyanine green angiography presented discrete hyperfluorescent spots on the posterior pole. Later, more bleb-like lesions with a vitelliform appearance and hyperautofluorescent on blue fundus autofluorescence were detected. One year later, a complete resolution of the fluid was observed. To conclude, multimodal evaluation of patients with idiopathic exudative polymorphous vitelliform maculopathy is essential for the correct diagnosis of this disease.

scholarly journals Origin of craniopharyngiomas: implications for growth pattern, clinical characteristics, and outcomes of tumor recurrence

2016 ◽  
Vol 125 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Yun Bao ◽  
Jun Pan ◽  
Song-tao Qi ◽  
Yun-tao Lu ◽  
Jun-xiang Peng
Keyword(s):  
Growth Pattern ◽  
Functional Outcomes ◽  
Growth Patterns ◽  
High Rate ◽  
Pituitary Function ◽  
Delayed Puberty ◽  
Neurosurgical Procedures ◽  
Type I ◽  
Imaging Features ◽  
Recurrent Tumors

OBJECT Craniopharyngiomas are associated with a high rate of recurrence. The surgical management of recurrent lesions has been among the most challenging neurosurgical procedures because of the craniopharyngioma's complex topographical relationship with surrounding structures. The aim of this study was to define the determinative role of the site of origin on the growth pattern and clinical features of recurrent craniopharyngiomas. METHODS The authors performed a retrospective analysis of 52 patients who had undergone uniform treatment by a single surgeon. For each patient, data concerning symptoms and signs, imaging features, hypothalamic-pituitary function, and recurrence-free survival rate were collected. RESULTS For children, delayed puberty was more frequent in the group with Type I (infradiaphragmatic) craniopharyngioma than in the group with Type TS (tuberoinfundibular and suprasellar extraventricular) lesions (p < 0.05). For adults, blindness was more frequent in the Type I group than in the Type TS group (p < 0.05). Nausea or vomiting, delayed puberty, and growth retardation were more frequent in children than in adults (p < 0.05). Overall clinical outcome was good in 48.07% of the patients and poor in 51.92%. Patients with Type TS recurrent tumors had significantly worse functional outcomes and hypothalamic function than patients with the Type I recurrent tumors but better pituitary function especially in children. CONCLUSIONS The origin of recurrent craniopharyngiomas significantly affected the symptoms, signs, functional outcomes, and hypothalamic-pituitary functions of patients undergoing repeated surgery. Differences in tumor growth patterns and site of origin should be considered when one is comparing outcomes and survival across treatment paradigms in patients with recurrent craniopharyngiomas.

scholarly journals Seasonal Pattern of Epileptic Seizures: A Single-Center Experience

2020 ◽  
pp. 1-4 ◽  
Author(s):  
Ioanna Alexandratou ◽  
A. Verentzioti ◽  
A. Siatouni ◽  
A. Alexoudi ◽  
D. Gkougka ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Linear Models ◽  
Seasonal Pattern ◽  
Demographic Data ◽  
Seasonal Fluctuation ◽  
Epileptic Seizures ◽  
Weather Conditions ◽  
Tertiary Hospital ◽  
Limited Attention ◽  
One Year

Purpose: To evaluate the seasonal fluctuation of epileptic seizures during one year. Methods: This was a single centre retrospective observational study. Demographic data, number and type of epileptic seizures were collected and analyzed using a dataset from the outpatient epilepsy clinic of a tertiary hospital, during one year. The statistical tools included descriptive statistics, contingency tables, Chi-square of goodness-of-fit tests, and general linear models. Results: In total, 143 consecutive patients were included in the study. Among the patients, 72 were women and 71 men. In total, 1,351 epileptic seizures were recorded during one year. A significantly higher rate of epileptic seizures during spring and summer was revealed. An association between the type of epileptic seizure and the month of the year was recorded. Specifically, focal seizures with impairment of awareness fluctuate throughout the year, with a sudden peak during June. Significance: Epidemiologic data regarding epilepsy seasonality have so far received only limited attention. In our study, a seasonal pattern was recorded on the occurrence of epileptic seizures. Further research combining different weather conditions and environments is needed to fully characterize the seasonality of epilepsy.

scholarly journals Effect of selective dorsal rhizotomy for treatment of spasticity related to cerebral palsy - report on one-year postoperative results in the Polish population

2020 ◽  
Vol 29 (58) ◽  
pp. 19-26
Author(s):  
Leszek Sagan ◽  
◽  
Jarosław Ogłodziński ◽  
Łukasz Madany ◽  
Monika Jarosz ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Metabolic Diseases ◽  
Neurosurgical Procedures ◽  
Polish Population ◽  
Selective Dorsal Rhizotomy ◽  
Gross Motor ◽  
Motor Functioning ◽  
Dorsal Rhizotomy ◽  
Significant Difference ◽  
One Year

Aim: Selective dorsal rhizotomy (SDR) is a form of surgical treatment that reduces tone in lower extremities by selective sectioning of lumbosacral dorsal roots fibers. However, the method occasionally still arouses some controversies. Since it was introduced in Poland, relatively recently, the discussion on its efficacy is even more vivid. To address this issue we present the analysis of patients treated with SDR in our institution. Material and methods: Out of 96 operated patients 76 were eligible for the study and 30 of them showed up for one-year follow up and were finally analyzed. Modified Ashworth Scale (MAS) was used to measure spasticity and the Gross Motor Function Measure (GMFM) to asses gross motor functioning of the patients. Results: For spasticity of different muscles measured by MAS there were significant differences between pre-treatment and post- -treatment (p < 0.05, after Holm-Bonferroni correction; effect size 1.26 < d> 2.32). Furthermore, for gross motor functioning measured by GMFM, there was significant difference between both time points treatment (d = 0.68). Conclusions: To our knowledge this is the first report on results of SDR for cerebral palsy treatment in Polish population. The treatment significantly diminished spasticity and improved gross motor functioning on the long term basis. This should provide reassurance to parents considering the procedure and influence the discussion on including SDR in the group of neurosurgical procedures founded by health system authorities in Polandneurodegenerative and metabolic diseases are suspected, genetic testing is performed. Despite the progress that has been made in treating some ataxia disorders in recent years, with few exceptions, for most of patients the therapy of choice is symptomatic and supportive treatment.

P104 One year failure rates for de novo ventriculo-peritonealshunts in under 3- month-old children

2019 ◽  
Vol 90 (3) ◽  
pp. e50.1-e50
Author(s):  
E Bentley ◽  
R Ved ◽  
A Amato-Watkins ◽  
J Lang ◽  
G Zilani ◽  
...  
Keyword(s):  
Infection Rate ◽  
De Novo ◽  
Descriptive Statistics ◽  
Infection Rates ◽  
Older Children ◽  
Single Centre ◽  
Single Centre Study ◽  
One Year ◽  
Shunt Survival ◽  
Shunt Infections

ObjectivesHistorically VPS failure and infection rates are higher for neonates than for older children. We compared our one year VPS failure and infection rates in under 3-month-olds with those of older children.DesignA retrospective, single centre study comparing 1 year survival and infection rates of VPS in under 3-month-olds verses older children.Subjects58 children under 3 months of age underwent VPS insertion between January 2007 and December 2016.MethodsData was collected by three independent reviewers from electronic files and case notes. Data was analysed using descriptive statistics and one year shunt survival curves were produced.ResultsFor children under 3 months there was a 29.3% one-year shunt failure rate, of which 2 were shunt infections (3.4%). In patients greater than 3 months, the shunt malfunction rate was 23.4% and the infection rate was 4.3%. There were no shunt-related mortalities in either group.ConclusionsChildren under 3-months-old undergoing VPS insertion should not automatically expect an increased 1 year failure or infection rate compared with older children. Reasons for this may be increased sub-specialisation, improved neonatal care and use of antibiotic impregnated catheters.

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