scholarly journals The treatment of patients with posthemorrhagic hydrocephalus

2021 ◽  
Vol 66 (5) ◽  
pp. 97-104
Author(s):  
N. K. Samochernykh ◽  
K. B. Abramov ◽  
M. S. Nikolaenko ◽  
L. V. Sakhno ◽  
K. A. Samochernykh ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Integrated Approach ◽  
Treatment Method ◽  
Biomechanical Properties ◽  
Pathological Process ◽  
Free Fluid ◽  
Posthemorrhagic Hydrocephalus ◽  
Occlusive Hydrocephalus ◽  
Inflammatory Changes ◽  
Inflammatory Syndrome

The article discusses the possible causes of polycystic posthemorrhagic ventriculomegaly in infants, as well as predictors of this pathological process. When choosing a treatment method the doctor shall take into account not only the etiology of the disease, but also age parameters, concomitant pathology. An important aspect in the approach to the treatment of polycystic posthemorrhagic multilevel hydrocephalus includes the determination of the biomechanical properties of the craniospinal system, especially the compliance of the brain and resorption of cerebrospinal fluid. Particular attention is paid to the timely correction of complications, including the analysis of inflammatory changes markers in the craniospinal system, which serve as predictors of the outcome of cerebrospinal fluid resorption. The authors also noted that the violation of the cerebrospinal fluid outflow from the cranial cavity in children may depend on a large number of «extracerebral» factors. They consider the stages of neurosurgical care to patients in this group on a clinical example. This example and literature data demonstrate that children with age develop changes not only in the craniospinal segment, which is responsible for the transformation of free fluid, but also in the extracranial cavities. Thus, we are able to recommend an integrated approach for the management of newborns with intracranial hemorrhage, complicated by posthemorrhagic hyporesorbent and occlusive hydrocephalus, with the justification of the optimal neurosurgical tactics for managing drainage-dependent patients, the course of the disease in which is accompanied by a multicomponent inflammatory syndrome.

scholarly journals Posthemorrhagic Hydrocephalus With Decompensation Of Cerebrospinal Fluid Dynamics In Newborns: New In Treatment Tactics

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Oleg V. Volkodav ◽  
Svetlana A. Zinchenko ◽  
William А. Khachatryan
Keyword(s):  
Fluid Dynamics ◽  
Cerebrospinal Fluid ◽  
Standard Treatment ◽  
Positive Outcome ◽  
Cerebrospinal Fluid Dynamics ◽  
Posthemorrhagic Hydrocephalus ◽  
Single Method ◽  
Hydrocephalus Treatment ◽  
Intracranial Circulation ◽  
Group 1

Background ― Posthemorrhagic hydrocephalus in newborns with occlusion of cerebrospinal fluid leads to decompensation of cerebrospinal fluid dynamics. There is no single method that meets all the criteria for the effectiveness and safety of treatment. The study goal was to investigate the use of coronary translambdoid subarachnoid ventriculostomy (CTSV) and ventricular subarachnoid stenting (VSS) in the treatment of neonatal hydrocephalus. Material and Methods ― The analysis of the posthemorrhagic hydrocephalus treatment in 327 newborns for the period of 2000-2018 in Crimea. Two groups have been identified. In the Group 1, 184 children underwent standard treatment according to the ‘LVV protocol’ with lumbar and ventricular punctures with 20-22G needles, while with progression of hydrocephalus, with ventriculosubgaleal drainage and ventriculoperitoneal shunt. In 143 children with occlusion and ventricular block, the treatment complex included CTSV – RF Patent No. 2715535, and ventricular drainage by the ventricular subarachnoid stenting (VSS) – RF Patent No. 2721455. Results ― An increase in the treatment radicality under CTSV is achieved through the use of the cerebral needles of a larger diameter (14G) and puncture access zones, elimination of occlusion, while under VSS, restoration of intracranial circulation and absorption of cerebrospinal fluid is ensured by prolonged sanitation with a saline solution of cerebrospinal fluid spaces. A positive outcome with compensation for hydrocephalus was achieved in 75.4% of cases versus 28.2% under the conventional protocol (p<0.001). In other cases, the imbalance of production and absorption of cerebrospinal fluid remained, which required the integration of the VSS with the peritoneal segment of the shunt, without further replacement and reinstallation of the system. Conclusion ― Our results allow us to consider the effectiveness of CTSV and VSS inclusion in the contemporary algorithm for the treatment of decompensated posthemorrhagic hydrocephalus in newborns.

scholarly journals Transmural Colonic Infarction after Routine Colonoscopy in a Young Patient without Risk Factors

2016 ◽  
Vol 10 (2) ◽  
pp. 479-488 ◽  
Author(s):  
Maurizio Zizzo ◽  
Carolina Castro Ruiz ◽  
Lara Ugoletti ◽  
Alessandro Giunta ◽  
Stefano Bonacini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conservative Therapy ◽  
Pathological Process ◽  
Screening Colonoscopy ◽  
Clinical State ◽  
Free Fluid ◽  
Transmural Infarction ◽  
Screening And Surveillance ◽  
Specific Mortality ◽  
Tomography Scan

Colonoscopy is one of the most widely used procedures in medical practice for the diagnosis and treatment of many benign and malignant diseases of the colorectal tract. Colonscopy has become the reference procedure for screening and surveillance of colorectal cancer. The overall rate of adverse events is estimated to be about 2.8 per 1,000 procedures, while complications requiring hospitalization are about 1.9 per 1,000 colonoscopies. Mortality from all causes and colonoscopy-specific mortality are estimated to be 0.07 and 0.007%, respectively. An exceptional fearsome postcolonoscopy complication is colon ischemia (CI); only few cases have been reported worldwide. We present the case of a 43-year-old woman who presented to the emergency department complaining of abdominal pain; fever and rectal bleeding appeared 12 h after a voluntary ‘screening’ colonoscopy. She had no risk factors for CI. Her laboratory tests showed alterations in inflammatory markers and a computed tomography scan showed a circumferential thickening in the left colon and free fluid in the abdomen. After 12 h of observation and conservative therapy, the clinical state of the patient worsened with the rising of signs of peritonitis. Laparoscopy showed that colon infarction extended from the distal third of the transverse colon to the proximal rectum. Laparotomy, resection of the pathological colon and terminal colostomy were performed. The specimen examined confirmed an extended ischemic colitis and transmural infarction on the antimesocolic side, in the absence of a vasculitis. The patient underwent recanalization after 8 months. CI after colonoscopy is a rare and alarming complication that must be known and taken into account in the differential diagnosis of symptomatic cases after colonoscopy, particularly in patients with known risk factors. The diagnosis is mainly based on clinical data, imaging and especially endoscopy. Treatment is almost always conservative but, in some cases in which the pathological process appears irreversible, surgery becomes mandatory.

scholarly journals Cerebrospinal fluid ceftazidime kinetics in patients with external ventriculostomies.

1996 ◽  
Vol 40 (3) ◽  
pp. 763-766 ◽  
Author(s):  
R Nau ◽  
H W Prange ◽  
M Kinzig ◽  
A Frank ◽  
A Dressel ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
High Performance ◽  
Elimination Half ◽  
Daily Dose ◽  
Order Of Magnitude ◽  
The Central Nervous System ◽  
Occlusive Hydrocephalus ◽  
A Minor

Ceftazidime has proven to be effective for the treatment of bacterial meningitis caused by multiresistant gram-negative bacteria. Since nosocomial central nervous system infections are often accompanied by only a minor dysfunction of the blood-cerebrospinal fluid (CSF) barrier, patients with noninflammatory occlusive hydrocephalus who had undergone external ventriculostomy were studied (n = 8). Serum and CSF were drawn repeatedly after the administration of the first dose of ceftazidime (3 g over 30 min intravenously), and concentrations were determined by high-performance liquid chromatography by using UV detection. The concentrations of ceftazidime in CSF were maximal at 1 to 13 h (median, 5.5 h) after the end of the infusion and ranged from 0.73 to 2.80 mg/liter (median, 1.56 mg/liter). The elimination half-lives were 3.13 to 18.1 h (median, 10.7 h) in CSF compared with 2.02 to 5.24 h (median, 3.74 h) in serum. The ratios of the areas under the concentration-time curves in CSF and serum (AUCCSF/AUCS) ranged from 0.027 to 0.123 (median, 0.054). After the administration of a single dose of 3 g, the maximum concentrations of ceftazidime in CSF were approximately four times higher than those after the administration of 2-g intravenous doses of cefotaxime (median, 0.44 mg/liter) and ceftriaxone (median, 0.43 mg/liter) (R. Nau, H. W. Prange, P. Muth, G. Mahr, S. Menck, H. Kolenda, and F. Sörgel, Antimicrob. Agents Chemother. 37:1518-1524, 1993). The median AUCCSF/AUCS ratio of ceftazidime was slightly below that of cefotaxime (0.12), but it was 1 order of magnitude above the median AUCCSF/AUCS of ceftriaxone (0.007) (Nau et al., Antimicrob. Agents Chemother. 37:1518-1524, 1993). The concentrations of ceftazidime observed in CSF were above the MICs for most Pseudomonas aeruginosa strains. However, they are probably not high enough to be rapidly bactericidal. For this reason, the daily dose should be increased to 12 g in cases of P. aeruginosa infections of the central nervous system when the blood-CSF barrier is minimally impaired.

scholarly journals 4D physiologically adaptable cardiac patch: A 4-month in vivo study for the treatment of myocardial infarction

2020 ◽  
Vol 6 (26) ◽  
pp. eabb5067 ◽  
Author(s):  
Haitao Cui ◽  
Chengyu Liu ◽  
Timothy Esworthy ◽  
Yimin Huang ◽  
Zu-xi Yu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Treatment Method ◽  
Biomechanical Properties ◽  
Vascular Supply ◽  
Cardiac Tissues ◽  
Cell Engraftment ◽  
Organ Regeneration ◽  
Cardiac Patch

There has been considerable progress in engineering cardiac scaffolds for the treatment of myocardial infarction (MI). However, it is still challenging to replicate the structural specificity and variability of cardiac tissues using traditional bioengineering approaches. In this study, a four-dimensional (4D) cardiac patch with physiological adaptability has been printed by beam-scanning stereolithography. By combining a unique 4D self-morphing capacity with expandable microstructure, the specific design has been shown to improve both the biomechanical properties of the patches themselves and the dynamic integration of the patch with the beating heart. Our results demonstrate improved vascularization and cardiomyocyte maturation in vitro under physiologically relevant mechanical stimulation, as well as increased cell engraftment and vascular supply in a murine chronic MI model. This work not only potentially provides an effective treatment method for MI but also contributes a cutting-edge methodology to enhance the structural design of complex tissues for organ regeneration.

Differential Diagnosis of Rapid Progressive Dementia

2010 ◽  
Vol 5 (2) ◽  
pp. 21 ◽  
Author(s):  
Uta Heinemann ◽  
Joanna Gawinecka ◽  
Christian Schmidt ◽  
Inga Zerr ◽  
◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Lumbar Puncture ◽  
Early Onset ◽  
Senile Dementia ◽  
Diagnostic Process ◽  
Progressive Dementia ◽  
Early Onset Dementia ◽  
Detailed Evaluation ◽  
Inflammatory Changes

There is a broad range of diseases underlying dementia, of which Alzheimer’s disease is the most frequent in senile and pre-senile dementia. While senile dementia is predominantly caused by neurodegenerative or vascular disorders, in early-onset dementia other conditions are more relevant. Autoimmune, metabolic and genetic reasons should be evaluated, as well as toxic causes. A list of mutations associated with dementia is provided in this article. A higher proportion of potentially reversible conditions in pre-senile dementia highlights the value of detailed evaluation. Lumbar puncture is important in the diagnostic process to detect inflammatory changes, but dementia markers such as Aβ1–42 are also helpful in differential diagnosis. The value of cerebrospinal fluid markers for differential diagnosis is discussed in this article.

scholarly journals Relationship of Human Immunodeficiency Virus Viral Load in Cerebrospinal Fluid and Plasma in Patients Co-infected With Cryptococcal Meningitis

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Christina C. Chang ◽  
Richard Kangethe ◽  
Saleha Omarjee ◽  
Keshni Hiramen ◽  
Bernadett Gosnell ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cerebrospinal Fluid ◽  
Cryptococcal Meningitis ◽  
Cd4 T Cell ◽  
Hiv Rna ◽  
Cell Percentage ◽  
Immunodeficiency Virus ◽  
A Prospective Study ◽  
Relationship Of ◽  
Inflammatory Syndrome

Abstract We measured human immunodeficiency virus (HIV) ribonucleic acid (RNA) in paired cerebrospinal fluid (CSF) and plasma samples in a prospective study of 91 HIV-infected, antiretroviral therapy-naive patients with cryptococcal meningitis. Cerebrospinal fluid HIV RNA was lower than in plasma (median 4.7 vs 5.2 log10 copies/mL, P &lt; .0001) and positively correlated with plasma HIV RNA, peripheral CD4+ T-cell percentage, and CSF CXCL10. Plasma/CSF ratio of HIV RNA ranged widely from 0.2 to 265.5 with a median of 2.6. Cerebrospinal fluid quantitative cryptococcal culture positively correlated with CSF CCL2 and CCL3. CSF-plasma viral discordance was not associated with cryptococcal-associated immune reconstitution inflammatory syndrome.

scholarly journals Modern aspects of diagnosis and treatment of chronic pancreatitis in children: experience of the center Center for the treatment of developmental anomalies and diseases of the hepatopancreatobiliary system in children

2022 ◽  
pp. 28-34
Author(s):  
B. O. Kulevich ◽  
A. Yu. Razumovsky ◽  
V. V. Kholostova ◽  
Z. B. Mitupov ◽  
A. I. Khavkin ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Manifestations ◽  
Treatment Method ◽  
Pathological Process ◽  
Diagnosis And Treatment ◽  
Developmental Anomalies ◽  
Enzyme Replacement ◽  
Effective Interventions ◽  
Endocrine Insufficiency ◽  
Long Time

Chronic pancreatitis is one of the most pressing problems of pediatric gastroenterology and surgery of hepatopancreatobiliary organs. Diagnosis and treatment of this category of patients requires a comprehensive examination using modern highly sensitive research methods and the collegial participation of a surgeon, gastroenterologist and endocrinologist. Due to the fact that the algorithm for managing these patients is not regulated, patients often receive enzyme replacement therapy for a long time, with indications for surgical treatment. In addition, the non-specificity of complaints and clinical manifestations of chronic pancreatitis, the asymptomatic course and the initial detection of exo- and endocrine insufficiency lead to a later choice of the optimal treatment method and increase the risk of complications. The key to effective care for children with chronic pancreatitis is the staging and continuity in research and treatment. At the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Filatov Hospital, highly effective interventions are carried out for chronic pancreatitis in children, the purpose of which is to ensure an adequate outflow of pancreatic juice using longitudinal pancreaticojejunostomy, which, in addition to draining the pancreas, allows to achieve clinical remission and stop the progression pathological process, including diabetes mellitus. The article reflects the experience of diagnosis and treatment of chronic pancreatitis in children.

scholarly journals Staphylococcal Meningitis as a Complication of Purulent Epiduritis

2020 ◽  
Vol 25 (3) ◽  
pp. 34-39
Author(s):  
N. V. Skripchenko ◽  
K. V. Markova ◽  
A. V. Astapova ◽  
E. Yu. Skripchenko ◽  
N. V. Marchenko
Keyword(s):  
Search Algorithm ◽  
Spinal Injury ◽  
Integrated Approach ◽  
Surgical Interventions ◽  
Reactive Protein ◽  
Purulent Meningitis ◽  
Appropriate Therapy ◽  
Examination Methods ◽  
Meningitis In Children ◽  
Inflammatory Changes

Purulent meningitis in children can be both primary and secondary. The latter are the result of various surgical interventions, ENT pathology, immunosuppressive therapy, as well as craniocerebral and spinal trauma, which justifies the need for an integrated approach to differential diagnosis to select the appropriate therapy tactics. The article presents a clinical observation of a child in whom purulent meningitis developed on the background of epiduritis, which was the result of a spinal injury. The diagnostic search algorithm is described. The authors concluded that if the patient has laboratory confirmed purulent meningitis and adequate therapy with clinical improvement in the patient’s condition, but persistent febrile fever, an increase in inflammatory changes in the blood amid a decrease in the level of acute phase inflammation proteins (C-reactive protein) and negative procalcitonin the test requires a search for a local inflammatory focus using additional examination methods, such as MRI or CT, as well as consultations with a neurosurgeon That allows you to specify the diagnosis and to determine the conduct of tactics, thus providing a favorable outcome.

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