scholarly journals Ultrasound-assisted neuroendoscopic lavage for intraventricular hemorrhage in a newborn: illustrative case

2021 ◽  
Vol 1 (23) ◽  
Author(s):  
Luca Sartori ◽  
Giulia Melinda Furlanis ◽  
Samuel Luciano Caliri ◽  
Elisa Garbin ◽  
Valentina Baro ◽  
...  
Keyword(s):  
Recent Literature ◽  
Illustrative Case ◽  
Neurodevelopmental Outcomes ◽  
Posthemorrhagic Hydrocephalus ◽  
Ultrasound Monitoring ◽  
Clot Removal ◽  
Inflammatory Damage ◽  
Reliable Procedure ◽  
Ultrasound Assisted ◽  
Therapeutic Alternatives

BACKGROUND The optimal treatment for posthemorrhagic hydrocephalus in newborns has not been established yet. Moreover, despite many valid therapeutic alternatives, unfavorable neurodevelopmental outcomes are frequent. According to recent literature, these discouraging results could be related to secondary inflammatory damage of the white matter due to the gradual dissolution of the intraventricular hematoma, which should be removed. OBSERVATIONS Neuroendoscopic lavage (NEL) has proven to be a safe and reliable procedure, able to adequately remove the intraventricular clots and the products of blood degradation. To increase surgical control of the entire ventricular system, the authors illustrated a case in which they associated real-time transfontanellar ultrasound monitoring with NEL. LESSONS Coupling these two techniques, the authors performed a rapid ventricular wash and obtained intraoperative confirmation of complete and accurate clot removal.

scholarly journals Germinal Matrix-Intraventricular Hemorrhage: A Tale of Preterm Infants

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Walufu Ivan Egesa ◽  
Simon Odoch ◽  
Richard Justin Odong ◽  
Gloria Nakalema ◽  
Daniel Asiimwe ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Preterm Neonates ◽  
Low Birth Weight Infants ◽  
Neurodevelopmental Outcomes ◽  
Germinal Matrix ◽  
Posthemorrhagic Hydrocephalus ◽  
Management Interventions ◽  
Incidence Risk

Germinal matrix-intraventricular hemorrhage (GM-IVH) is a common intracranial complication in preterm infants, especially those born before 32 weeks of gestation and very-low-birth-weight infants. Hemorrhage originates in the fragile capillary network of the subependymal germinal matrix of the developing brain and may disrupt the ependymal lining and progress into the lateral cerebral ventricle. GM-IVH is associated with increased mortality and abnormal neurodevelopmental outcomes such as posthemorrhagic hydrocephalus, cerebral palsy, epilepsy, severe cognitive impairment, and visual and hearing impairment. Most affected neonates are asymptomatic, and thus, diagnosis is usually made using real-time transfontanellar ultrasound. The present review provides a synopsis of the pathogenesis, grading, incidence, risk factors, and diagnosis of GM-IVH in preterm neonates. We explore brief literature related to outcomes, management interventions, and pharmacological and nonpharmacological prevention strategies for GM-IVH and posthemorrhagic hydrocephalus.

Ventricular reservoir versus ventriculosubgaleal shunt for posthemorrhagic hydrocephalus in preterm infants: infection risks and ventriculoperitoneal shunt rate

2014 ◽  
Vol 14 (5) ◽  
pp. 447-454 ◽  
Author(s):  
Joanna Y. Wang ◽  
Anubhav G. Amin ◽  
George I. Jallo ◽  
Edward S. Ahn
Keyword(s):  
Preterm Infants ◽  
Time Interval ◽  
Neurodevelopmental Outcomes ◽  
Shunt Insertion ◽  
Posthemorrhagic Hydrocephalus ◽  
Vp Shunt ◽  
Shunt Placement ◽  
Device Infection ◽  
Ventriculosubgaleal Shunt ◽  
Ventricular Reservoir

Object The most common neurosurgical condition observed in preterm infants is intraventricular hemorrhage (IVH), which often results in posthemorrhagic hydrocephalus (PHH). These conditions portend an unfavorable prognosis; therefore, the potential for poor neurodevelopmental outcomes necessitates a better understanding of the comparative effectiveness of 2 temporary devices commonly used before the permanent insertion of a ventriculoperitoneal (VP) shunt: the ventricular reservoir and the ventriculosubgaleal shunt (VSGS). Methods The authors analyzed retrospectively collected information for 90 patients with IVH and PHH who were treated with insertion of a ventricular reservoir (n = 44) or VSGS (n = 46) at their institution over a 14-year period. Results The mean gestational age and weight at device insertion were lower for VSGS patients (30.1 ± 1.9 weeks, 1.12 ± 0.31 kg) than for reservoir patients (31.8 ± 2.9 weeks, 1.33 ± 0.37 kg; p = 0.002 and p = 0.004, respectively). Ventricular reservoir insertion was predictive of more CSF taps prior to VP shunt placement compared with VSGS placement (10 ± 8.7 taps vs 1.6 ± 1.7 taps, p < 0.001). VSGS patients experienced a longer time interval prior to VP shunt placement than reservoir patients (80.8 ± 67.5 days vs 48.8 ± 26.4 days, p = 0.012), which corresponded to VSGS patients gaining more weight by the time of shunt placement than reservoir patients (3.31 ± 2.0 kg vs 2.42 ± 0.63 kg, p = 0.016). Reservoir patients demonstrated a trend toward more positive CSF cultures compared with VSGS patients (n = 9 [20.5%] vs n = 5 [10.9%], p = 0.21). There were no significant differences in the rates of overt device infection requiring removal (reservoir, 6.8%; VSGS, 6.5%), VP shunt insertion (reservoir, 77.3%; VSGS, 76.1%), or early VP shunt infection (reservoir, 11.4%; VSGS, 13.0%) between the 2 cohorts. Conclusions Although the rates of VP shunt requirement and device infection were similar between patients treated with the reservoir versus the VSGS, VSGS patients were significantly older and had achieved greater weights at the time of VP shunt insertion. The authors' results suggest that the VSGS requires less labor-intensive management by ventricular tapping; the VSGS patients also attained higher weights and more optimal surgical candidacy at the time of VP shunt insertion. The potential differences in long-term developmental and neurological outcomes between VSGS and reservoir placement warrant further study.

scholarly journals Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts

2012 ◽  
Vol 9 (3) ◽  
pp. 242-258 ◽  
Author(s):  
Shenandoah Robinson
Keyword(s):  
Preterm Infants ◽  
Current Knowledge ◽  
Perioperative Complications ◽  
Current Treatment ◽  
Neurosurgical Procedures ◽  
Perinatal Complications ◽  
Neurodevelopmental Outcomes ◽  
Posthemorrhagic Hydrocephalus ◽  
Multicenter Trials ◽  
Neonatal Icu

Object Preterm infants are at risk for perinatal complications, including germinal matrix–intraventricular hemorrhage (IVH) and subsequent posthemorrhagic hydrocephalus (PHH). This review summarizes the current understanding of the epidemiology, pathophysiology, management, and outcomes of IVH and PHH in preterm infants. Methods The MEDLINE database was systematically searched using terms related to IVH, PHH, and relevant neurosurgical procedures to identify publications in the English medical literature. To complement information from the systematic search, pertinent articles were selected from the references of articles identified in the initial search. Results This review summarizes the current knowledge regarding the epidemiology and pathophysiology of IVH and PHH, primarily using evidence-based studies. Advances in obstetrics and neonatology over the past few decades have contributed to a marked improvement in the survival of preterm infants, and neurological morbidity is also starting to decrease. The incidence of IVH is declining, and the incidence of PHH will likely follow. Currently, approximately 15% of preterm infants who suffer severe IVH will require permanent CSF diversion. The clinical presentation and surgical management of symptomatic PHH with temporary ventricular reservoirs (ventricular access devices) and ventriculosubgaleal shunts and permanent ventriculoperitoneal shunts are discussed. Preterm infants who develop PHH that requires surgical treatment remain at high risk for other related neurological problems, including cerebral palsy, epilepsy, and cognitive and behavioral delay. This review highlights numerous opportunities for further study to improve the care of these children. Conclusions A better grasp of the pathophysiology of IVH is beginning to impact the incidence of IVH and PHH. Neonatologists conduct rigorous Class I and II studies to advance the outcomes of preterm infants. The need for well-designed multicenter trials is essential because of the declining incidence of IVH and PHH, variations in referral patterns, and neonatal ICU and neurosurgical management. Well-designed multicenter trials will eventually produce evidence to enable neurosurgeons to provide their smallest, most vulnerable patients with the best practices to minimize perioperative complications and permanent shunt dependence, and most importantly, optimize long-term neurodevelopmental outcomes.

scholarly journals The Design Thinking Umbrella for Inclusive Growth in India? Discussion and Case Study

2020 ◽  
Vol 11 (2) ◽  
pp. 49
Author(s):  
Gavin Melles
Keyword(s):  
Design Thinking ◽  
Recent Literature ◽  
Innovation Process ◽  
Inclusive Development ◽  
Technical Innovation ◽  
Illustrative Case ◽  
Inclusive Growth ◽  
Complex Process

<p>India faces challenges in achieving sustainable inclusive growth. While business, finance, social and technical innovation and other reforms are necessary, stakeholder inclusion through participatory processes is essential for achieving inclusive development. Following decades of implementation globally, Human-centred Design (HCD) approaches are now being promoted in India as an answer to participatory and creative business, social and industry innovation, albeit less so as a tool for inclusive growth and innovation. However, there is a growing critique of HCD effectiveness, ambiguity about its role in the innovation process, and other questions. Enthusiasm in India for HCD and design thinking ignores this critique, and risks repeating history unless the benefits and limits of HCD for innovation generally and inclusive growth are understood. Following a review of the recent literature this paper identifies the role of HCD in an inclusive growth framework, highlights the real challenges, and presents an illustrative case of HCD application for slum redevelopment for discussion and development. This paper identifies design thinking as a vague umbrella term, highlights the need for an informed approach relative to inclusive growth, and suggests HCD is a potentially helpful adjunct to the complex process of inclusive growth.</p>

scholarly journals Neurodevelopmental outcomes of preterm infants: a recent literature review

2020 ◽  
Vol 9 (S1) ◽  
pp. S3-S8 ◽  
Author(s):  
Estefani Hee Chung ◽  
Jesse Chou ◽  
Kelly A. Brown
Keyword(s):  
Literature Review ◽  
Preterm Infants ◽  
Recent Literature ◽  
Neurodevelopmental Outcomes

scholarly journals Market shaping dynamics: interplay of actor engagement and institutional work

2020 ◽  
Vol 35 (9) ◽  
pp. 1425-1439
Author(s):  
Julia A. Fehrer ◽  
Jodie Conduit ◽  
Carolin Plewa ◽  
Loic Pengtao Li ◽  
Elina Jaakkola ◽  
...  
Keyword(s):  
Design Methodology ◽  
Recent Literature ◽  
Future Market ◽  
Illustrative Case ◽  
Institutional Work ◽  
Content Type ◽  
Resource Density ◽  
Illustrative Case Study ◽  
Market Shaping

Purpose Combining institutional work and actor engagement (AE) literature, this paper aims to elucidate how the collective action of market shaping occurs through the interplay between market shapers’ institutional work and engagement of other market actors. While markets are shaped by actors’ purposive actions and recent literature notes the need to also mobilize AE, the underlying process remains nebulous. Design/methodology/approach This paper is conceptual but supported by an illustrative case study: the Winding Tree. This blockchain-based, decentralized travel marketplace shapes a market by decoupling existing resource linkages, creating new ones and stabilizing others through a dynamic, iterative process between the market shaper’s institutional work and others’ AE. Findings The paper develops a dynamic, iterative framework of market shaping through increased resource density, revealing the interplay between seven types of market shapers’ institutional work distilled from the literature and changes in other market actors’ engagement dispositions, behaviors and the diffusion of AE through the market. Originality/value This research contributes to the emergent market shaping and market innovation literature by illustrating how the engagement of market actors is a fundamental means of market shaping. Specifically, it advances understanding of how market shapers’ institutional work leads to new resource linkages and higher resource density in emergent market systems through AE. The resultant framework offers an original, critical foundation for future market shaping research.

scholarly journals Neurodevelopmental outcome at 2 years after neuroendoscopic lavage in neonates with posthemorrhagic hydrocephalus

2020 ◽  
Vol 26 (5) ◽  
pp. 495-503
Author(s):  
Philine Behrens ◽  
Anna Tietze ◽  
Elisabeth Walch ◽  
Petra Bittigau ◽  
Christoph Bührer ◽  
...  
Keyword(s):  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Fibrinolytic Therapy ◽  
Neurodevelopmental Outcomes ◽  
Brain Volumes ◽  
Invasive Approach ◽  
Posthemorrhagic Hydrocephalus ◽  
Neurocognitive Development ◽  
Study Results ◽  
Volume Measurements

OBJECTIVEA standardized guideline for treatment of posthemorrhagic hydrocephalus in premature infants is still missing. Because an early ventriculoperitoneal shunt surgery is avoided due to low body weight and fragility of the patients, the neurosurgical treatment focuses on temporary solutions for CSF diversion as a minimally invasive approach. Neuroendoscopic lavage (NEL) was additionally introduced for early elimination of intraventricular blood components to reduce possible subsequent complications such as shunt dependency, infection, and multiloculated hydrocephalus. The authors report their first experience regarding neurodevelopmental outcome after NEL in this patient cohort.METHODSIn a single-center retrospective cohort study with 45 patients undergoing NEL, the authors measured neurocognitive development at 2 years with the Bayley Scales of Infant Development, 2nd Edition, Mental Developmental Index (BSID II MDI) and graded the ability to walk with the Gross Motor Function Classification System (GMFCS). They further recorded medication with antiepileptic drugs (AEDs) and quantified ventricular and brain volumes by using 3D MRI data sets.RESULTSForty-four patients were alive at 2 years of age. Eight of 27 patients (30%) assessed revealed a fairly normal neurocognitive development (BSID II MDI ≥ 70), 28 of 36 patients (78%) were able to walk independently or with minimal aid (GMFCS 0–2), and 73% did not require AED treatment. Based on MR volume measurements, greater brain volume was positively correlated with BSID II MDI (rs = 0.52, 95% CI 0.08–0.79) and negatively with GMFCS (rs = −0.69, 95% CI −0.85 to −0.42). Based on Bayesian logistic regression, AED treatment, the presence of comorbidities, and also cerebellar pathology could be identified as relevant risk factors for both neurodevelopmental outcomes, increasing the odds more than 2-fold—but with limited precision in estimation.CONCLUSIONSNeuromotor outcome assessment after NEL is comparable to previously published drainage, irrigation, and fibrinolytic therapy (DRIFT) study results. A majority of NEL-treated patients showed independent mobility. Further validation of outcome measurements is warranted in an extended setup, as intended by the prospective international multicenter registry for treatment of posthemorrhagic hydrocephalus (TROPHY).

Materials for Electron Beam Information Storage

1969 ◽  
Vol 27 ◽  
pp. 152-153 ◽  
Author(s):  
D. E. Speliotis
Keyword(s):  
Magnetic Field ◽  
Electron Beam ◽  
Recent Literature ◽  
Electron Beams ◽  
Information Storage ◽  
The Subject ◽  
The Magnetic Field

The interaction of electron beams with a large variety of materials for information storage has been the subject of numerous proposals and studies in the recent literature. The materials range from photographic to thermoplastic and magnetic, and the interactions with the electron beam for writing and reading the information utilize the energy, or the current, or even the magnetic field associated with the electron beam.

Optical characteristics of the hitachi HF-2000 cold field-emission TEM

1993 ◽  
Vol 51 ◽  
pp. 1076-1077
Author(s):  
L. F. Allard ◽  
E. Völkl ◽  
T. A. Nolan
Keyword(s):  
Field Emission ◽  
Recent Literature ◽  
Electron Gun ◽  
High Brightness ◽  
Condenser Lens ◽  
Illumination System ◽  
High Resolution Images ◽  
Imaging Mode ◽  
Better Than ◽  
Illuminating System

The illumination system of the cold field emission (CFE) Hitachi HF-2000 TEM operates with a single condenser lens in normal imaging mode, and with a second condenser lens excited to give the ultra-fine 1 nm probe for microanalysis. The electron gun provides a guaranteed high brightness of better than 7×l08 A/cm2/sr, more than twice the guaranteed brightness of Schottky emission guns. There have been several articles in the recent literature (e.g. refs.) which claim that the geometry of this illumination system yields a total current which is so low that when the beam is spread at low magnifications (say 10 kX), the operator must “keep his eyes glued to the binoculars” in order to see the image. It is also claimed that this illuminating system produces an isoplanatic patch (the area over which image character does not vary significantly) at high magnification which is so small that the instrument is ineffective for recording high resolution images.

Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochrane Library ◽  
Neurodevelopmental Outcomes ◽  
Frequency Following Response ◽  
Ovid Medline ◽  
Published Evidence ◽  
Mesh Terms ◽  
Potential Applicability ◽  
Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

Sign in / Sign up

Export Citation Format

Share Document