Lumbar Cisternography in Evaluation of Hydrocephalus in the Preterm Infant

PEDIATRICS ◽  
1983 ◽  
Vol 72 (5) ◽  
pp. 670-676
Author(s):  
Steven M. Donn ◽  
Dietrich W. Roloff ◽  
John W. Keyes
Keyword(s):  
Periventricular Leukomalacia ◽  
Csf Dynamics ◽  
Flow Paths ◽  
Posthemorrhagic Hydrocephalus ◽  
Complete Obstruction ◽  
Arnold Chiari Malformation ◽  
Indium 111 ◽  
Noncommunicating Hydrocephalus ◽  
Serial Images ◽  
Ventricular Filling

Radionuclide lumbar cisternography using indium 111-diethylenetriamine pentaacetic acid (111 In-DTPA) and a mobile γ-camera with a converging collimator was utilized as a bedside procedure to evaluate CSF dynamics and the patency of the cerebral ventricular system in 30 preterm infants with hydrocephalus. Serial images of the brain were obtained at 0, 1, 2, 6, 24, and 48 hours after instillation of the isotope in the lumbar subarachnoid space. Three distinct patterns were seen. Infants with posthemorrhagic hydrocephalus displayed prompt ventricular filling but markedly delayed emptying with minimal flow over the cerebral convexities. Infants with ventriculomegaly secondary to suspected brain atrophy or periventricular leukomalacia demonstrated a pattern of prompt ventricular filling, delayed emptying, but with flow present over the convexities. An infant with noncommunicating hydrocephalus secondary to an Arnold-Chiari malformation showed a pattern of complete obstruction with no ventricular filling. Radionuclide lumbar cisternography appears to be a safe, well-tolerated procedure which produces images of sufficient resolution to provide valuable information about CSF dynamics, delineating basal cisternae, ventricles, and subarachnoid flow paths.

scholarly journals Cumulative Damage: Cell Death in Posthemorrhagic Hydrocephalus of Prematurity

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1911
Author(s):  
Riley Sevensky ◽  
Jessie C. Newville ◽  
Ho Lam Tang ◽  
Shenandoah Robinson ◽  
Lauren L. Jantzie
Keyword(s):  
Cell Death ◽  
Relevant Literature ◽  
Cellular Structures ◽  
Ependymal Cells ◽  
Csf Dynamics ◽  
Posthemorrhagic Hydrocephalus ◽  
Downstream Signaling ◽  
Very Preterm ◽  
Severe Manifestation ◽  
Shed Light

Globally, approximately 11% of all infants are born preterm, prior to 37 weeks’ gestation. In these high-risk neonates, encephalopathy of prematurity (EoP) is a major cause of both morbidity and mortality, especially for neonates who are born very preterm (<32 weeks gestation). EoP encompasses numerous types of preterm birth-related brain abnormalities and injuries, and can culminate in a diverse array of neurodevelopmental impairments. Of note, posthemorrhagic hydrocephalus of prematurity (PHHP) can be conceptualized as a severe manifestation of EoP. PHHP impacts the immature neonatal brain at a crucial timepoint during neurodevelopment, and can result in permanent, detrimental consequences to not only cerebrospinal fluid (CSF) dynamics, but also to white and gray matter development. In this review, the relevant literature related to the diverse mechanisms of cell death in the setting of PHHP will be thoroughly discussed. Loss of the epithelial cells of the choroid plexus, ependymal cells and their motile cilia, and cellular structures within the glymphatic system are of particular interest. Greater insights into the injuries, initiating targets, and downstream signaling pathways involved in excess cell death shed light on promising areas for therapeutic intervention. This will bolster current efforts to prevent, mitigate, and reverse the consequential brain remodeling that occurs as a result of hydrocephalus and other components of EoP.

Changes in cerebrospinal fluid hydrodynamics following endoscopic third ventriculostomy for shunt-dependent noncommunicating hydrocephalus

2003 ◽  
Vol 98 (5) ◽  
pp. 1027-1031 ◽  
Author(s):  
Kenichi Nishiyama ◽  
Hiroshi Mori ◽  
Ryuichi Tanaka
Keyword(s):  
Cerebrospinal Fluid ◽  
Absorptive Capacity ◽  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Csf Dynamics ◽  
Shunt System ◽  
Independent State ◽  
Content Type ◽  
Noncommunicating Hydrocephalus ◽  
Fine Print

Object. The aim of this study was to analyze physiological changes in cerebrospinal fluid (CSF) dynamics following endoscopic third ventriculostomy (ETV) for shunt-dependent noncommunicating hydrocephalus. Methods. Clinical data obtained in 15 patients treated with ETV for shunt malfunction were analyzed. Magnetic resonance imaging studies demonstrated the obstruction of the ventricular system preoperatively. After ETV, the existing shunt system was removed and a continuous extraventricular drain, set at 30 cm H2O in height, was installed to measure daily amounts of CSF outflow. Cerebrospinal fluid dynamics after ETV were also evaluated using 111In-diethylenetriamine pentaacetic acid radioisotope cisternography in six of 15 patients within 1 month of the procedure. Three patients underwent cisternography at 6 months after ETV. Cisternograms were obtained at 1, 5, 24, and 48 hours after injection of the radioisotope. To study CSF absorptive capacity, ratios of radioisotope counts at 48 and 5 hours after injection were calculated (C48:C5). Seven of 15 patients had daily outflows of CSF of less than 20 ml; this volume decreased quickly within a few days. The other eight patients demonstrated an outflow of more than 150 ml of CSF for several days, three of whom had signs of transiently increased intracranial pressure. Their CSF outflow volume decreased gradually and symptoms improved within 1 week. Ratios of C48:C5 were within normal limits in five of six patients who had undergone cisternography 1 month after ETV. These ratios were decreased in all three patients who had undergone cisternography at 6 months after ETV compared with that measured at 1 month after the procedure. Conclusions. Our data suggest that CSF dynamics convert from a shunt-dependent state to a shunt-independent state within 1 week following ETV in patients with shunt-dependent noncommunicating hydrocephalus. Nonetheless, intraventricular pressure does not decrease quickly in certain cases. Cerebrospinal fluid absorptive capacity or CSF circulation through the subarachnoid space may show further improvement several months after ETV.

Theories of cerebrospinal fluid dynamics and hydrocephalus: historical trend

2013 ◽  
Vol 11 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Nigel Peter Symss ◽  
Shizuo Oi
Keyword(s):  
Obstructive Hydrocephalus ◽  
Stage Iv ◽  
Treatment Modalities ◽  
Historical Trends ◽  
Csf Dynamics ◽  
Major Pathway ◽  
Noncommunicating Hydrocephalus ◽  
Absorption Pathways ◽  
Selection Of

According to the CSF bulk flow theory, hydrocephalus is caused by an imbalance between CSF formation and absorption, or a block at various locations in the major CSF pathway. New theories, however, have been proposed in which minor CSF pathways may play a significant role in the development of congenital hydrocephalus. The authors review major contributions to the literature and analyze the evolution of theories of CSF dynamics in relation to hydrocephalus, dividing their development into 4 stages on the basis of historical trends. In Stage I (prior to 1950), 2 systems of classifying hydrocephalus were proposed, namely Dandy's classifications of communicating and noncommunicating hydrocephalus and Russell's nonobstructive and obstructive hydrocephalus. In Stage II (1950–1974), based on these theories of major CSF pathway dynamics, treatment focused on ventriculostomy as an alternative to reduction of CSF production by choroid plexus coagulation. In Stage III (1975–1999), some of the specific forms of hydrocephalus, especially in premature infants, were found to be unsuitable for ventriculostomy. In Stage IV (2000–2008), selection of treatment modalities evolved further, with a focus on analysis of the chronological changes in CSF dynamics and the differences in absorption pathways in the developing and mature brains. The authors focus on “minor pathway hydrocephalus” in the immature brain, differentiating it from the conventional classification of obstructive and nonobstructive “major pathway hydrocephalus.”

Malignant hyperthermia

1977 ◽  
Vol 46 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Jeffery L. Rush ◽  
Eldon L. Foltz
Keyword(s):  
Metabolic Acidosis ◽  
Malignant Hyperthermia ◽  
Chiari Malformation ◽  
Tissue Hypoxia ◽  
Content Type ◽  
Arnold Chiari Malformation ◽  
Noncommunicating Hydrocephalus ◽  
Unusual Problem ◽  
Fine Print

✓ The authors report the case of an infant with noncommunicating hydrocephalus, Arnold-Chiari malformation, and a lumbar myelomeningocele, in whom malignant hyperthermia occurred. The genetics and presumed etiology of this unusual problem are reviewed. The management is directed toward establishing effective cooling measures, reversing tissue hypoxia, and correcting respiratory and metabolic acidosis.

scholarly journals Motor development of children born prematurely with perinatal hypoxic-ischemic damages of the central nervous system

2019 ◽  
Vol 84 (3) ◽  
pp. 43-48
Author(s):  
O. Vareshniuk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cerebral Palsy ◽  
Periventricular Leukomalacia ◽  
Spastic Diplegia ◽  
Motor Disorders ◽  
Motor Functions ◽  
Posthemorrhagic Hydrocephalus ◽  
Severe Motor ◽  
The Central Nervous System

A comprehensive examination of 79 children of middle age (3,2±1,3) years old with perinatal hypoxic-ischemic damage to the central nervous system who were born prematurely was performed. The clinical features of impaired motor functions in premature infants who underwent perinatal hypoxic-ischemic brain damage complicated by intraventricular hemorrhages were studied. It was shown that cerebral palsy was diagnosed in 20,3 % of sick children, which was accompanied by severe motor disorders of levels IV–V according to the classification of motor functions GMFCS; 37,9 % have spastic diplegia with II–III level of motor disorders; 27,8 % have a hemiplegic form of cerebral palsy with motor disorders corresponding to level II of the GMFCS classification. Acquired posthemorrhagic hydrocephalus was diagnosed in 14,0 % of the examined children, while the vast majority of children who were operated on before 6 months of age did not have motor deficiency (level III according to the GMFCS classification); 1 child (9,1 %) was not operated on and had a V level of motor disorders according to GMFCS. It has been established that the most significant factors that form a severe motor prognosis are: gestational age of 27–30 weeks, peri-intraventricular hemorrhages of II–IV degrees, periventricular leukomalacia of III degree and signs of periventricular ischemia.

190 Doppler echocardiographic evaluation of left ventricular filling in patients with pacing-induced ischaemia

1999 ◽  
Vol 1 ◽  
pp. S35-S35
Author(s):  
S RTSKHILADZE ◽  
R NAPETVARIDZE ◽  
N EMUKHVARI ◽  
S PETRIASHVILI ◽  
I KHINTIBIDZE ◽  
...  
Keyword(s):  
Left Ventricular ◽  
Left Ventricular Filling ◽  
Echocardiographic Evaluation ◽  
Ventricular Filling

Migräne? Arnold-Chiari-Malformation? Oder doch einfach nur eine Migräne?

Praxis ◽  
2020 ◽  
Vol 109 (10) ◽  
pp. 806-811
Author(s):  
Kristian Jäckel ◽  
Beat Knechtle
Keyword(s):  
Chiari Malformation ◽  
Arnold Chiari Malformation

Zusammenfassung. Zusammenfassung: Bei einer jungen Frau mit langjährigen Kopfschmerzen im Sinne einer Migräne ergab eine neurologische Neubeurteilung inklusive neuer Befundung der vorhandenen MRI-Bilder des Schädels die Diagnose einer Chiari-Malformation vom Typ 1. Nach erfolgreicher Operation des Befundes gingen die Kopfschmerzen deutlich zurück. Da aber noch geringe Kopfschmerzen einer anderen Qualität bestehen blieben, ist davon auszugehen, dass eine Migräne sowie als Zufallsbefund die Malformation vorliegen.

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