Communicating Hydrocephalus in Adults: Prediction of Outcome after Ventricular Shunting Procedures

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 655-660 ◽  
Author(s):  
Edward C. Benzel ◽  
Allen L. Pelletier ◽  
Pamela G. Levy
Keyword(s):  
High Pressure ◽  
Communicating Hydrocephalus ◽  
Ventricular Enlargement ◽  
Prediction Of Outcome ◽  
Additional Information ◽  
Computed Tomographic ◽  
Preoperative Diagnostic ◽  
Clinical Triad ◽  
Shunting Procedure ◽  
Ventricular Shunting

Abstract A series of adult patients with idiopathic hydrocephalus in whom shunts were placed are presented. Preoperative diagnostic and prognostic criteria were evaluated. Findings on computed tomographic scans (significant ventricular enlargement, the absence of gyral atrophy, and the absence of sylvian fissure enlargement) and the clinical triad associated with hydrocephalus in adults (dementia, ataxia, and especially incontinence of urine) all contributed individually and in combination to the diagnosis of hydrocephalus that could be corrected by surgery. The use of radionucleotide cisternography did not add any additional information. Its use as a diagnostic or prognostic aid is, therefore, suspect. The use of high-pressure shunting systems for the initial shunting procedure is emphasized.

Postoperative Extradural Hematomas: Computed Tomographic Survey of 1105 Intracranial Operations

Neurosurgery ◽  
1986 ◽  
Vol 19 (4) ◽  
pp. 589-593 ◽  
Author(s):  
Akira Fukamachi ◽  
Hidehito Koizumi ◽  
Yoshishige Nagaseki ◽  
Hideaki Nukui
Keyword(s):  
Brain Tumor ◽  
Postoperative Period ◽  
Ventricular Dilatation ◽  
Systemic Hypertension ◽  
Intracerebral Hematoma ◽  
Causal Factors ◽  
Computed Tomographic ◽  
The Brain ◽  
Shunting Procedure ◽  
Ventricular Shunting

Abstract We reviewed the computed tomographic findings after 1055 intracranial operations to determine the incidence of postoperative extradural hematomas. There were 11 medium and 5 large hematomas after 1055 operations (1.0%). Ten of the 16 hematomas were operated upon (10/1055, 0.9%). Four of the 10 hematomas were seen after 278 brain tumor removals (1.4%), another four after 190 aneurysmal operations (2.1%), one after 14 intracerebral hematoma removals (7.1%), and the last one after 251 ventricular shunting or drainage procedures (0.4%). In 4 of the 10 operated hematomas, sites were regional, in five sites were adjacent, and in one the site was distant. All of the five adjacent hematomas extended downward from a lower rim of the operative locus. Causes were analyzed in the three types of the hematomas. In case of the regional hematomas, the causes were incomplete hemostasis of the dura mater or the bone in all four patients, nonperformance of central stay sutures in three, systemic hypertension in one, and hypofibrinogenemia in one. In the adjacent hematomas, we could find dural separation at an edge of craniotomy in all five patients, abrupt collapse of the brain in all, ventricular dilatation in two, and systemic hypertension during immediate postoperative period in two. In one distant hematoma, ventricular dilatation and ventricular shunting procedure were themselves thought to be the causal factors.

Surface Laser Plasma in Laser Treatment of Materials in High Pressure Gases

1991 ◽  
Vol 236 ◽  
Author(s):  
A. Smirnov ◽  
C. Dupuy ◽  
G. Flamant
Keyword(s):  
High Pressure ◽  
Laser Treatment ◽  
Laser Plasma ◽  
Holographic Interferometry ◽  
Aerosol Particles ◽  
Optical Breakdown ◽  
Plasma Generation ◽  
Additional Information ◽  
Surface Laser ◽  
Condensation Front

AbstractUsing holographic interferometry the surface laser plasma generation in high pressure gases has been investigated. Additional information about the generation of surface cover laser plasma, optical breakdown in the presence of aerosol particles and condensation front forming in high pressure gases is given.

Somatosensory and Auditory Brain Stem Conduction after Head Injury: A Comparison with Clinical Features in Prediction of Outcome

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 278-285 ◽  
Author(s):  
Kenneth Lindsay ◽  
Aydin Pasaoglu ◽  
David Hirst ◽  
Gwen Allardyce ◽  
Ian Kennedy ◽  
...  
Keyword(s):  
Head Injury ◽  
Brain Stem ◽  
Evoked Potential ◽  
Predictive Accuracy ◽  
Normal Subjects ◽  
Prediction Of Outcome ◽  
Prognostic Information ◽  
Additional Information ◽  
Auditory Brain Stem ◽  
The Difference

Abstract Evoked potential conduction times in brain stem auditory (BCT) and central somatosensory pathways (CCT) were recorded from 23 normal subjects and 101 patients with severe head injury. Abnormalities in the CCT and the BCT findings correlated with the clinical indices of brain damage (coma score, motor response, pupil response, and spontaneous and reflex eye movements) in the head-injured patients and each correlated with outcome at 6 months from the injury. The CCT in the “best” hemisphere produced the strongest correlation with outcome (P<0.001). The correlation of the CCT with outcome was stronger in the 47 patients examined 2 to 3 days after the injury (P<0.001) compared to the 34 patients examined within 24 hours after the injury (P<0.02). No such difference was noted for the BCT. Serial studies within the first 2 weeks of injury did not show a consistent pattern and repetition of the investigation over this period did not provide any additional information. We used an INDEP-SELECT discriminant analysis program to determine whether information from the evoked potential data could improve prediction of outcome based on clinical data alone. With the addition of the CCT, the predictive accuracy (expressed as the correct classification probability) increased only slightly from 77 to 80%, and the difference was not significant. We conclude that central somatosensory and auditory brain stem conduction times provide useful prognostic information in paralyzed or sedated patients, but when neurological examination is feasible the benefits of evoked potential analysis do not justify the effort involved in data collection.

Slit Ventricle Syndrome Presenting with Paroxysmal Hypersomnia in an Adult: Case Report

Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 594-595 ◽  
Author(s):  
Ender Korfali ◽  
Kaya Aksoy ◽  
Imran Safi
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Shunt Malfunction ◽  
Ventricular Catheter ◽  
Ventricular Enlargement ◽  
Adult Case ◽  
Slit Ventricle Syndrome ◽  
Computed Tomographic ◽  
Lateral Ventricles ◽  
Slit Ventricle

Abstract The slit ventricle syndrome (SVS), defined as intermittent shunt malfunction without substantial ventricular enlargement, is usually observed in shunted children with small, slitlike ventricles. This syndrome has been attributed to recurrent obstruction of the ventricular catheter, which then causes an increase of intracranial pressure. Only rarely has the SVS been reported in adults. We describe a 29-year-old woman whose shunt malfunction presented with longlasting paroxysmal hypersomnia and was diagnosed with computed tomographic evidence of small lateral ventricles. This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well. (Neurosurgery 22:594-595, 1988)

Cerebral Aqueduct CSF Stroke Volume Hydrodynamics in Chronic Communicating Hydrocephalus: Exploration of the Initial and Late Phases in an Animal Model

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Tito G M Vivas-Buitrago ◽  
Ignacio Jusue Torres ◽  
Gabriel D Pinilla-Monsalve ◽  
Armelle Lokossou ◽  
Jiadi Xu ◽  
...  
Keyword(s):  
Animal Model ◽  
Stroke Volume ◽  
Microstructural Analysis ◽  
Ventricular Volume ◽  
Diagnostic Tools ◽  
Communicating Hydrocephalus ◽  
Second Phase ◽  
Ventricular Enlargement ◽  
Time Points ◽  
Significant Difference

Abstract INTRODUCTION Early diagnosis of NPH during its initial stages is almost impossible, given the delayed onset of clinical symptoms, making the study and the understanding of the CSF dynamics very challenging in human subjects. In this study, we explore these dynamics in a novel animal model with induced chronic communicating hydrocephalus with the aim to better understand the pathophysiology of NPH to pursue earlier diagnostic tools that will ultimately translate into better treatment outcomes. METHODS Chronic communicating hydrocephalus was induced in 15 adult Sprague-Dawley rats using a technique developed by our group. Kaolin is injected into the subarachnoid space over the cerebral convexities. Additionally, 4 animals were used as controls and 3 as shams with saline injections. PCMRI was performed to calculate the aqueductal stroke volume (ASV) and T2-W images for ventricular size measurements on days 15, 60, 90, and 120 using a Bruker 11.7-TMR. Nonparametric tests were implemented to analyze the ASV and its correlation with the ventricular volumes after the hydrocephalus induction. RESULTS Kaolin-injected (KI) animals showed a significant ventricular enlargement at all time points. A significant difference in ASV was present between KI and controls at all times. There was a significant positive correlation between the ventricular volume expansion and the ASV between 15 and 60 d. CONCLUSION An initial active phase of rapid ventricular enlargement shows a strong correlation between the expansion of the ventricular volume and the increment in ASV during the first 60 d, followed by a second phase with a less ventricular enlargement and heterogeneous behavior in the ASV. Results may suggest an optimal window for CSF diversion treatment. This hypothesis will be explored in the following experiment by shunting groups of animals at all time points. Future studies will include an evaluation of the intracranial pressure and histological/microstructural analysis to better understand the ASV variations after 60 d.

Pseudopsychopathic Syndrome in Hydrocephalus: A Case Report and Review

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 661-663 ◽  
Author(s):  
Matthew Bowen ◽  
Arun Verma ◽  
Saeed Bajwa ◽  
Leslie Kusmirek
Keyword(s):  
Case Report ◽  
Head Injury ◽  
Low Pressure ◽  
Rehabilitation Program ◽  
Shunt Revision ◽  
Communicating Hydrocephalus ◽  
Computed Tomographic ◽  
Ventriculoperitoneal Shunting ◽  
Acute Rehabilitation

Abstract A 24-year-old man with a head injury developed a communicating hydrocephalus and underwent ventriculoperitoneal shunting. A revision was required, and the patient emerged from coma with severe behavior outbursts, which persisted for more than 1 year. Computed tomographic scans indicated a recurrence of low-pressure communicating hydrocephalus and a shunt revision was performed. The patient's severe behavior outbursts immediately decreased dramatically, The improvement continued long term and extended beyond the acute rehabilitation program.

The central canal of the filum terminale in communicating hydrocephalus

1980 ◽  
Vol 53 (4) ◽  
pp. 528-532 ◽  
Author(s):  
Vijayashekara S. Murthy ◽  
Dhirendra H. Deshpande
Keyword(s):  
Tuberculous Meningitis ◽  
Surgical Procedure ◽  
Central Canal ◽  
Communicating Hydrocephalus ◽  
Filum Terminale ◽  
Ventricular Enlargement ◽  
Content Type ◽  
Fine Print

✓ Lumbar thecoperitoneal shunting was carried out in patients with communicating hydrocephalus due to long-standing tuberculous meningitis. At the time of this surgical procedure, the filum terminale was excised to achieve filum terminostomy. The central canal of the excised filum terminale in seven hydrocephalic children and an equal number from control cases was studied histologically. These observations indicate that the central canal of the filum terminale dilates in communicating hydrocephalus, and the dilatation is proportionate to the lateral ventricular enlargement.

New lumboperitoneal shunt for communicating hydrocephalus

1976 ◽  
Vol 44 (2) ◽  
pp. 258-261 ◽  
Author(s):  
Harold J. Hoffman ◽  
E. Bruce Hendrick ◽  
Robin P. Humphreys
Keyword(s):  
Communicating Hydrocephalus ◽  
Content Type ◽  
T Tube ◽  
The Past ◽  
Lumboperitoneal Shunt ◽  
Tube Type ◽  
Shunting Procedure ◽  
Fine Print

✓ The authors describe a T-tube Silastic shunting device which has been used for lumboperitoneal shunting in 62 patients with communicating hydrocephalus during the past 3 years. In 38 patients it was inserted as a primary shunting procedure; 24 patients had the shunt inserted following problems secondary to arachnoiditis created by a polyethylene-type lumboperitoneal shunt. The shunt described here has not led to arachnoiditis when inserted as a primary shunting procedure. In 61% of patients no operative revisions of their shunt has been required to date, and 81% continue to do well on their T-tube type shunt.

Mayo Clinic Medical Neurosciences

2017 ◽  
Author(s):  
Eduardo E. Benarroch ◽  
Jeremy K. Cutsforth-Gregory ◽  
Kelly D. Flemming
Keyword(s):  
Nervous System ◽  
Current Knowledge ◽  
Gross Anatomy ◽  
Self Assessment ◽  
Tomographic Images ◽  
Additional Information ◽  
Computed Tomographic ◽  
Neurologic Disorders ◽  
Clinic Medical ◽  
Large Sections

This text is intended to serve as an effective foundation on which to build knowledge in the classroom and at the bedside. Chapters have been ordered to improve the integration of neurochemistry and neuropharmacology with our understanding of the nervous system and to facilitate student grasp of the large sections of knowledge. Major sections are devoted to gross anatomy. The format of each chapter consists of Objectives, Introduction, Overview, and text. Clinical problems have been integrated into the text for self assessment. Detailed additional information has been identified in each chapter for those with a desire to go beyond general knowledge. The need to present the vast array of current knowledge of the nervous system required diagrams of anatomy and histology, including magnetic resonance and computed tomographic images to correlate with basic anatomy. Many concepts are clarified further with figures and the abundant use of color throughout. Sections address the neurologic examination and common disorders for systems and levels, including immunologic and genetic neurologic disorders.

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