Acoustic neuroma in a child treated with the aid of preoperative arterial embolization

1984 ◽  
Vol 61 (2) ◽  
pp. 396-398 ◽  
Author(s):  
Robin G. Rushworth ◽  
William A. Sorby ◽  
Sarah F. Smith
Keyword(s):  
Intracranial Pressure ◽  
Acoustic Neuroma ◽  
Arterial Embolization ◽  
Raised Intracranial Pressure ◽  
Tumor Excision ◽  
Content Type ◽  
Acoustic Neuromas ◽  
Ventriculoperitoneal Shunting ◽  
Acoustic Neuroma Surgery ◽  
Fine Print

✓ A child is described who presented with a large right vascular acoustic neuroma causing raised intracranial pressure and brain-stem compression. Ventriculoperitoneal shunting and arterial embolization were performed prior to total tumor excision. Acoustic neuromas are a rarity in childhood, and preoperative arterial embolization has infrequently been described as an adjunct to acoustic neuroma surgery.

Pneumocephalus following ventriculoperitoneal shunt

1975 ◽  
Vol 43 (5) ◽  
pp. 631-633 ◽  
Author(s):  
Lawrence H. Pitts ◽  
Charles B. Wilson ◽  
Herbert H. Dedo ◽  
Robert Weyand
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Ventriculoperitoneal Shunt ◽  
Cerebrospinal Fluid Leakage ◽  
Congenital Defects ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Tegmen Tympani ◽  
Temporal Bones ◽  
Fine Print

✓ The authors describe a case of massive pneumocephalus following ventriculoperitoneal shunting for hydrocephalus. After multiple diagnostic and surgical procedures, congenital defects in the tegmen tympani of both temporal bones were identified as the sources for entry of air. A functioning shunt intermittently established negative intracranial pressure and allowed ingress of air through these abnormalities; when the shunt was occluded, air did not enter the skull, and there was no cerebrospinal fluid leakage. Repair of these middle ear defects prevented further recurrence of pneumocephalus.

Self-assessed quality of life after acoustic neuroma surgery

2003 ◽  
Vol 99 (5) ◽  
pp. 818-823 ◽  
Author(s):  
Simone A. Betchen ◽  
Jane Walsh ◽  
Kalmon D. Post
Keyword(s):  
Quality Of Life ◽  
Acoustic Neuroma ◽  
Hearing Level ◽  
Content Type ◽  
Sf 36 ◽  
Acoustic Neuroma Surgery ◽  
Persistent Headache ◽  
Facial Function ◽  
Fine Print

Object. The aim of this study was to determine if factors such as postoperative hearing, facial function, headaches, or other factors have an impact on self-assessed quality of life (QOL) after acoustic neuroma surgery. Methods. The SF-36 and seven additional questions on the impact of surgery on the QOL were sent to 135 consecutive patients who had undergone acoustic neuroma surgery. The Spearman rho correlations were calculated for each of the eight categories of the SF-36 (general health, physical functioning, physical role limitations, emotional role limitations, mental health, energy/vitality, pain, social functioning). The results were correlated with patients' sex, age, persistent headache, years since surgery, postoperative hearing level, and facial function. The response rate was 74.8%. The transformed scores of the eight categories of the SF-36 were lower than age-matched healthy controls in approximately half of the categories. The strongest trend toward lower scores with statistical significance in two categories was persistent headaches. Some categories demonstrated trends toward lower scores with females or age older than 55 years. Postoperative hearing and facial functioning, and time since surgery showed no statistically significant impact on QOL measured by the SF-36. Responses to the additional questions indicate that hearing, facial function, and headache influenced people's feelings about surgery and had an impact on their return to work. Conclusions. The QOL scores are not consistently lower than population normative values compared with different normative studies. The strongest correlation was between the presence of persistent headache and QOL. Other correlations were not consistent in all categories, and few were statistically significant. These trends in some categories do not explain the difference seen between patients after acoustic neuroma surgery in this study and normal populations in other studies.

Oligodendroglioma and cerebral cavernous angioma

1985 ◽  
Vol 62 (1) ◽  
pp. 145-147 ◽  
Author(s):  
Chee Pin Chee ◽  
Robin Johnston ◽  
David Doyle ◽  
Peter Macpherson
Keyword(s):  
Intracranial Pressure ◽  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Vascular Malformation ◽  
Signs And Symptoms ◽  
Cavernous Angioma ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Vascular Component ◽  
Fine Print

✓ The authors report a case of frontal lobe oligodendroglioma associated with a cavernous angioma. The patient presented with signs and symptoms of raised intracranial pressure. Computerized tomography with contrast enhancement failed to detect the vascular component. The clinical and pathological significance of the presence of this vascular malformation in an oligodendroglioma is discussed.

Vasoactive treatment for hearing preservation in acoustic neuroma surgery

2001 ◽  
Vol 95 (5) ◽  
pp. 771-777 ◽  
Author(s):  
Christian Strauss ◽  
Barbara Bischoff ◽  
Mandana Neu ◽  
Michael Berg ◽  
Rudolf Fahlbusch ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Acoustic Neuroma ◽  
Auditory Evoked Potentials ◽  
Consecutive Series ◽  
Hearing Level ◽  
Pathophysiological Mechanism ◽  
Content Type ◽  
Acoustic Neuromas ◽  
Vasoactive Medication ◽  
Fine Print

Object. Delayed hearing loss following surgery for acoustic neuroma indicates anatomical and functional preservation of the cochlear nerve and implies that a pathophysiological mechanism is initiated during surgery and continues thereafter. Intraoperative brainstem auditory evoked potentials (BAEPs) typically demonstrate gradual reversible loss of components in these patients. Methods. Based on this BAEP pattern, a consecutive series of 41 patients with unilateral acoustic neuromas was recruited into a prospective randomized study to investigate hearing outcomes following the natural postoperative course and recuperation after vasoactive medication. Both groups were comparable in patient age, tumor size, and preoperative hearing level. Twenty patients did not receive postoperative medical treatment. In 70% of these patients anacusis was documented and in 30% hearing was preserved. Twenty-one patients were treated with hydroxyethyl starch and nimodipine for an average of 9 days. In 66.6% of these patients hearing was preserved and in 33.3% anacusis occurred. Conclusions. These results are statistically significant (p < 0.05, χ2 = 5.51) and provide evidence that these surgically treated patients suffer from a disturbed microcirculation that causes delayed hearing loss following removal of acoustic neuromas.

Thoracic disc herniation associated with papilledema

1984 ◽  
Vol 61 (6) ◽  
pp. 1132-1134 ◽  
Author(s):  
Shalom D. Michowiz ◽  
Harry Z. Rappaport ◽  
Itzchak Shaked ◽  
Allon Yellin ◽  
Abraham Sahar
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Intervertebral Disc ◽  
Spastic Paraparesis ◽  
Raised Intracranial Pressure ◽  
Thoracic Disc Herniation ◽  
Spinal Cord Lesions ◽  
Content Type ◽  
Thoracic Disc ◽  
Fine Print

✓ The occurrence of papilledema in a patient with progressive spastic paraparesis due to herniation of the T11–12 intervertebral disc is reported. The papilledema resolved following discectomy. The association and possible pathogenetic mechanisms between spinal cord lesions and signs of raised intracranial pressure are reviewed.

Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus

1971 ◽  
Vol 35 (3) ◽  
pp. 309-313 ◽  
Author(s):  
S. N. Bhagwati
Keyword(s):  
Intracranial Pressure ◽  
Tuberculous Meningitis ◽  
Raised Intracranial Pressure ◽  
Ventriculoatrial Shunt ◽  
Active Stage ◽  
Content Type ◽  
Fine Print

✓ Raised intracranial tension affects the course of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a ventriculoatrial shunt significantly alters the course of the disease. The results in seven cases have been detailed and discussed. The levels of consciousness improved, hemiplegia and aphasia practically cleared up, and vision returned even in children who were blind for 4 to 6 weeks. Operation could be performed even in an active stage of the disease without much fear of miliary dissemination.

Facial nerve injury in acoustic neuroma (vestibular schwannoma) surgery: etiology and prevention

1997 ◽  
Vol 87 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Prakash Sampath ◽  
Michael J. Holliday ◽  
Henry Brem ◽  
John K. Niparko ◽  
Donlin M. Long
Keyword(s):  
Facial Nerve ◽  
Nerve Injury ◽  
Acoustic Neuroma ◽  
Facial Nerve Palsy ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Content Type ◽  
Facial Nerve Injury ◽  
Acoustic Neuroma Surgery ◽  
Fine Print

✓ Facial nerve injury associated with acoustic neuroma surgery has declined in incidence but remains a clinical concern. A retrospective analysis of 611 patients surgically treated for acoustic neuroma between 1973 and 1994 was undertaken to understand patterns of facial nerve injury more clearly and to identify factors that influence facial nerve outcome. Anatomical preservation of the facial nerve was achieved in 596 patients (97.5%). In the immediate postoperative period, 62.1% of patients displayed normal or near-normal facial nerve function (House—Brackmann Grade 1 or 2). This number rose to 85.3% of patients at 6 months after surgery and by 1 year, 89.7% of patients who had undergone acoustic neuroma surgery demonstrated normal or near-normal facial nerve function. The surgical approach appeared to have no effect on the incidence of facial nerve injury. Poor facial nerve outcome (House—Brackmann Grade 5 or 6) was seen in 1.58% of patients treated via the suboccipital approach and in 2.6% of patients treated via the translabyrinthine approach. When facial nerve outcome was examined with respect to tumor size, there clearly was an increased incidence of facial nerve palsy seen in the immediate postoperative period in cases of larger tumors: 60.8% of patients with tumors smaller than 2.5 cm had normal facial nerve function, whereas only 37.5% of patients with tumors larger than 4 cm had normal function. This difference was less pronounced, however, 6 months after surgery, when 92.1% of patients with tumors smaller than 2.5 cm had normal or near normal facial function, versus 75% of patients with tumors larger than 4 cm. The etiology of facial nerve injury is discussed with emphasis on the pathophysiology of facial nerve palsy. In addition, on the basis of the authors' experience with these complex tumors, techniques of preventing facial nerve injury are discussed.

Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor

2002 ◽  
Vol 97 (2) ◽  
pp. 337-340 ◽  
Author(s):  
Takuzou Moriyama ◽  
Takanori Fukushima ◽  
Katsuyuki Asaoka ◽  
Pierre-Hugues Roche ◽  
David M. Barrs ◽  
...  
Keyword(s):  
Acoustic Neuroma ◽  
Hearing Preservation ◽  
Cochlear Nerve ◽  
Significant Prognostic Factor ◽  
Speech Discrimination ◽  
Middle Fossa ◽  
Content Type ◽  
Middle Fossa Approach ◽  
Acoustic Neuromas ◽  
Fine Print

Object. To evaluate the possible prognostic factors for hearing preservation, the authors retrospectively reviewed the results of 30 consecutive acoustic neuroma operations in which hearing preservation was attempted, in a total series of 63 acoustic neuromas. Methods. Intracanalicular tumors or those that extended less than 3 mm outside the porus acusticus (10 cases) were resected via the middle fossa approach. The retrosigmoid approach was used for tumors exceeding the limits for the middle fossa approach (20 cases). Overall, hearing was preserved (pure tone average ≤ 50 dB and speech discrimination score ≥ 50%) in 21 patients (70%). There were 11 patients with severe adhesion between the cochlear nerve and tumor capsule, and 19 without. Hearing was preserved postoperatively in only two (18.2%) of 11 patients with severe adhesion, whereas all 19 without severe adhesion had hearing preservation. Conclusions. The presence or absence of severe adhesion in the interface between the cochlear nerve and the tumor might be the most significant prognostic factor for hearing preservation postsurgery.

Use of long-term intracranial pressure measurement to assess hydrocephalic patients prior to shunt surgery

1975 ◽  
Vol 42 (3) ◽  
pp. 258-273 ◽  
Author(s):  
Lindsay Symon ◽  
Nicholas W. C. Dorsch
Keyword(s):  
Intracranial Pressure ◽  
Pressure Measurement ◽  
Pressure Profile ◽  
Shunt Surgery ◽  
Raised Intracranial Pressure ◽  
Epidural Pressure ◽  
Content Type ◽  
Pressure Recording ◽  
Fine Print

✓ The authors present their experience with long-term epidural pressure recording in hydrocephalic patients. The technique identifies those with episodically raised intracranial pressure. The effect of shunts on the pressure profile in these patients is described.

Considerations in early surgery on good-risk patients with ruptured intracranial aneurysms

1982 ◽  
Vol 56 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Herman Hugenholtz ◽  
Robert G. Elgie
Keyword(s):  
Intracranial Pressure ◽  
Retrospective Analysis ◽  
Intracranial Aneurysms ◽  
Early Operation ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Risk Patients ◽  
Ruptured Intracranial Aneurysms ◽  
Good Risk ◽  
Fine Print

✓ A retrospective analysis of 100 consecutive patients with proven ruptured intracranial aneurysms, classified as Botterell Grades I to III on admission, was carried out to evaluate the efficacy of early operation. Surgical and management mortality/morbidity rates were lower for cases in which a single hemorrhage was operated on within 48 hours than when surgery was delayed for 7 days or more. Surgical and management mortality/morbidity rates were worse in good-risk patients treated surgically between the 3rd and 7th days following a hemorrhage, reflecting the increased incidence of postoperative vasospasm and raised intracranial pressure encountered at surgery during this interval.

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