scholarly journals An analysis of factors determining the requirement of ventriculoperitoneal shunt surgery in the children suffering from posterior fossa tumour: a single centre retrospective review

2020 ◽  
Vol 7 (4) ◽  
pp. 1025
Author(s):  
Mrinal Bhuyan ◽  
Debadatta Saha ◽  
Basanta Kumar Baishya
Keyword(s):  
Clinical Outcome ◽  
Posterior Fossa ◽  
Ventriculoperitoneal Shunt ◽  
Tumour Size ◽  
External Ventricular Drain ◽  
Ventilatory Support ◽  
Tumour Resection ◽  
Anatomical Location ◽  
Consecutive Series ◽  
Posterior Fossa Tumour

Background: Hydrocephalus is a relatively common occurrence in a children suffering from the posterior fossa tumour (PFTm). However, there is a divided opinion regarding the ventriculoperitoneal shunt (VPS) surgery before the posterior fossa tumour resection in a child. For the better clinical outcome, we should be able to predict which patient will require VPS following the resection of PFTm. Purpose of our retrospective analysis is to analyse various factors that predicts the necessity of VPS following PFTm resection.Methods: A consecutive series of twenty-six patients who underwent PFTm resection without undergoing VPS preoperatively are analysed in our series.Results: In our series, we found that the younger age at presentation, incomplete tumour resection, longer period of artificial ventilatory support, insertion of external ventricular drain (EVD) and its duration during the postoperative period correlate the necessity of VPS following PFTm resection. However, the severity of hydrocephalus prior to tumor surgery, tumour size, anatomical location of the tumour, tumour dissemination, use of Dural grafts during closure and histopathological type do not predict the requirement of the VPS following PFTm.Conclusions: Patients who are younger at diagnosis should be treated with utmost importance. Gross total resection should be the goal. Factors which predict the likelihood of the EVD which parallels the likelihood of postresection hydrocephalus must be prevented for the better clinical outcome.

Mutism after Posterior Fossa Tumour Resection in Children: Incomplete Recovery on Long-Term Follow-Up

2003 ◽  
Vol 39 (4) ◽  
pp. 179-183 ◽  
Author(s):  
Paul Steinbok ◽  
D. Douglas Cochrane ◽  
Richard Perrin ◽  
Angela Price
Keyword(s):  
Posterior Fossa ◽  
Tumour Resection ◽  
Posterior Fossa Tumour ◽  
Long Term Follow Up

scholarly journals IMG-18. ASSESSMENT OF SUSPECTED DISEASE PROGRESSION USING MULTIPARAMETRIC 18F-CHOLINE PET/MRI IN CHILDHOOD AND TEENAGE-YOUNG ADULT GLIOMAS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii358-iii358
Author(s):  
Valentina Ferrazzoli ◽  
Ananth Shankar ◽  
Julia Cockle ◽  
Christine Tang ◽  
Ahmed Al-khayfawee ◽  
...  
Keyword(s):  
Disease Progression ◽  
Posterior Fossa ◽  
Cerebral Blood Volume ◽  
Posterior Fossa Tumour ◽  
Recurrent Tumour ◽  
Normal Appearing White Matter ◽  
Conventional Mri ◽  
Apparent Diffusion ◽  
Teenagers And Young Adults

Abstract OBJECTIVES Evaluation of post-treatment glioma burden remains a significant challenge in children, teenagers and young adults (TYA). The aim of this study was to evaluate the utility of ChoPET/MRI for evaluation of suspected disease progression in childhood and TYA gliomas. METHODS 27 patients (mean age 14 years, range 6–21 years) with suspected glioma disease progression were evaluated with ChoPET/MRI (n=59). Relative cerebral blood volume (rCBV), apparent diffusion coefficient (ADC) and maximum standardised uptake values (SUVmax) in enhancing (enh) and non-enhancing (ne) tumour and normal-appearing white matter (wm) were calculated (rCBVenh, rCBVne, rCBVwm, ADCenh, ADCne, ADCwm, SUVenh, SUVne, SUVwm). 2 blinded radiologists scored tumour probability (1 = unlikely; 5 = definitely). Sensitivity and specificity calculated with gold standard histopathology or clinical follow-up. RESULTS Accuracy for the detection of residual/recurrent tumour on conventional MRI was 96.3% (91.7% ≤14 years, 100% ≥15 years) and ChoPET was 73.1% (66.7% ≤14 years, 80.0% ≥15 years). Lack of agreement was observed in 9/27 patients, with ChoPET superior to MRI in 1 case of a posterior fossa tumour. Tumour component analysis demonstrated significantly higher SUVenh and SUVne than SUVwm (SUVenh: p<0.001; SUVne: p=0.004, equivalent to results were observed for ADV and rCBV (ADCenh, ADCne: p<0.001 vs ADCwm; rCBVenh, rCBVne: p<0.001 vs rCBVwm). CONCLUSIONS MRI is more sensitive than ChoPET in the evaluation of suspected disease progression in TYA gliomas. However, quanititative ChoPET is able to detect enhancing and non-enhancing tumour and may be helpful in evaluating posterior fossa disease where MRI is equivocal.

Audit of regional screening guidelines for vestibular schwannoma

1998 ◽  
Vol 112 (9) ◽  
pp. 860-864 ◽  
Author(s):  
P. J. D. Dawes ◽  
J.-P. Jeannon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Posterior Fossa ◽  
Vestibular Schwannoma ◽  
Acoustic Neuroma ◽  
Resonance Imaging ◽  
Posterior Fossa Tumour ◽  
Screening Guidelines ◽  
Magnetic Resonance Imaging Mri

AbstractAn audit of 334 patients who underwent magnetic resonance imaging (MRI) as investigation for a possible diagnosis of vestibular schwannoma was carried out to assess adherence to previously agreed screening guidelines. This represents one year's activity. A posterior fossa tumour was identified in 12 patients. Scan requests were judged to be inappropriate for 28 cases. The issues surrounding the screening for acoustic neuroma are discussed.

Transsylvian Insular Glioma Surgery: New Classification System, Clinical Outcome in a Consecutive Series of 79 Cases

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S167-S167
Author(s):  
David Pitskhelauri ◽  
Andrey Bykanov ◽  
Alexander Konovalov ◽  
Gleb Danilov ◽  
Svetlana Buklina ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Classification System ◽  
Consecutive Series ◽  
New Classification ◽  
Glioma Surgery

Characterization of Subarachnoid Hyperdensities After Thrombectomy for Acute Stroke Using Dual-Energy CT

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013198
Author(s):  
Arturo Renú ◽  
Carlos Laredo ◽  
Alejandro Rodríguez-Vázquez ◽  
Daniel Santana ◽  
Mariano Werner ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Mechanical Thrombectomy ◽  
Dual Energy ◽  
Common Finding ◽  
Dual Energy Ct ◽  
Consecutive Series ◽  
Contrast Extravasation ◽  
Logistic Regression Models ◽  
Increased Risk

Background and Objectives:The presence of post-interventional subarachnoid hyperdensities (SA-HD) is a relatively common finding after mechanical thrombectomy (MT). We aimed to assess the incidence, characteristics, clinical relevance and predictors of SA-HD after MT as categorized through the use of post-interventional Dual Energy-CT (DE-CT).Methods:A single-center consecutive series of acute stroke patients treated with MT were retrospectively reviewed. Post-treatment SA-HD were defined as incident extra-axial hyperdensities in a follow-up DE-CT performed within a median of 8 hours after MT. SA-HD were further classified according to their content (isolated contrast extravasation versus blood extravasation) and extension [diffuse (hyperdensities in more than one extraparenchymal compartments) versus non-diffuse]. Adjusted logistic regression models assessed the association of SA-HD with pretreatment and procedural variables and with bad clinical outcome (shift towards worse categories in the ordinal Rankin Scale at 90 days).Results:SA-HD were observed in 120 (28%) of the 424 included patients (isolated contrast extravasation n=22, blood extravasation n=98). In this group, SA-HD were diffuse in 72 (60%) patients (isolated contrast extravasation n=7, blood extravasation n=65) and non-diffuse in 48 (40%) patients (isolated contrast extravasation n=15, blood extravasation n=33). Diffuse SA-HD were significantly associated with worse clinical outcome in adjusted models (cOR=2.3, 95%CI=1.36-4.00, p=0.002), unlike the specific SA-HD content alone. In contrast with the absence of SA-HD, only the diffuse pattern with blood extravasation was significantly associated with worse clinical outcome (cOR=2.4, 95%CI=1.36-4.15, p=0.002). Diffuse SA-HD patterns were predicted by M2 occlusions, more thrombectomy passes and concurrent parenchymal hematomas.Discussion:In our cohort of patients imaged within a median of 8 hours after MT, post-interventional SA-HD showed a diffuse pattern in 17% of thrombectomies and were associated with more arduous procedures. Diffuse SA-HD but not local collections of blood or contrast extravasations were associated with an increased risk of poor outcome and death. These findings reinforce the need for improvement in reperfusion strategies.Classification of Evidence:This study provides Class II evidence that in individuals with proximal carotid artery territory occlusions treated with mechanical thrombectomy, diffuse post-interventional subarachnoid hyperdensities on imaging 8 hours post-procedure are associated with worse clinical outcomes at 90 days.

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