Orthostatic hypotension from a cerebellar gangliocytoma (Lhermitte-Duclos disease)

1986 ◽  
Vol 65 (2) ◽  
pp. 245-248 ◽  
Author(s):  
Marie-Magdeleine Ruchoux ◽  
Francoise Gray ◽  
Romain Gherardi ◽  
Annette Schaeffer ◽  
Jean Comoy ◽  
...  
Keyword(s):  
Orthostatic Hypotension ◽  
Baroreceptor Reflex ◽  
Cerebellar Hemisphere ◽  
Complete Disappearance ◽  
Vertebral Angiography ◽  
Content Type ◽  
Ventriculoperitoneal Shunting ◽  
Reflex Arc ◽  
Left Cerebellar Hemisphere ◽  
Fine Print

✓ A 49-year-old woman presented with orthostatic hypotension. Vertebral angiography and ventriculography revealed a tumor of the left cerebellar hemisphere. Ventriculoperitoneal shunting was followed by complete disappearance of the orthostatic hypotension. The tumor was subsequently removed and microscopic study showed Lhermitte-Duclos disease. Orthostatic hypotension has been rarely reported in association with tumors of the posterior fossa except for those tumors destroying the medullary centers and interrupting the baroreceptor reflex arc. This case is of interest because the tumor was restricted to the cerebellum. The authors have found no previous case in which orthostatic hypotension was a presenting symptom of Lhermitte-Duclos disease.

Development of cerebellar malignant astrocytoma at site of a medulloblastoma treated 11 years earlier

1978 ◽  
Vol 49 (3) ◽  
pp. 445-449 ◽  
Author(s):  
Enrique Klériga ◽  
Joanna Hollenberg Sher ◽  
Sanath-Kumar Nallainathan ◽  
Sherman C. Stein ◽  
Michael Sacher
Keyword(s):  
Cerebellar Hemisphere ◽  
Malignant Astrocytoma ◽  
Content Type ◽  
Left Cerebellar Hemisphere ◽  
Desmoplastic Medulloblastoma ◽  
Second Tumor ◽  
Fine Print

✓ A child treated for a desmoplastic medulloblastoma of the left cerebellar hemisphere at the age of 10 months developed a malignant astrocytoma in the same site 11 years later. Theories of origin of the second tumor, particularly in relation to concepts of the genesis of medulloblastoma in general, are discussed.

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.

Intestinal volvulus secondary to a ventriculoperitoneal shunt

1971 ◽  
Vol 35 (1) ◽  
pp. 95-96 ◽  
Author(s):  
Thomas H. Sakoda ◽  
John A. Maxwell ◽  
Charles E. Brackett
Keyword(s):  
Intestinal Obstruction ◽  
Ventriculoperitoneal Shunt ◽  
Unusual Complication ◽  
Content Type ◽  
Intestinal Volvulus ◽  
Silastic Catheter ◽  
Ventriculoperitoneal Shunting ◽  
Catheter Implantation ◽  
Fine Print

✓ Volvulus with intestinal obstruction is an unusual complication of ventriculoperitoneal shunting. It was the most serious of the few complications experienced in 56 cases of intraperitoneal Silastic catheter implantation and probably represented reaction to the peritoneal incision rather than reaction of the tissue to Silastic.

Dural arteriovenous shunts at the craniocervical junction

1998 ◽  
Vol 89 (5) ◽  
pp. 755-761 ◽  
Author(s):  
Hiroyuki Kinouchi ◽  
Kazuo Mizoi ◽  
Akira Takahashi ◽  
Yoshihide Nagamine ◽  
Keiji Koshu ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Craniocervical Junction ◽  
Vertebral Angiography ◽  
Content Type ◽  
Arteriovenous Shunts ◽  
Dural Arteriovenous Shunts ◽  
Intradural Space ◽  
Tomography Scanning ◽  
Fine Print

Object. A retrospective analysis was conducted of 10 patients (three women and seven men) who were treated for spinal dural arteriovenous shunts (AVSs) located at the craniocervical junction. This analysis was performed to evaluate the characteristics of this unusual location in contrast with those of the more common thoracic and lumbar AVSs. Methods. Seven patients presented with subarachnoid hemorrhage (SAH) and one with slowly progressive quadriparesis and dyspnea due to myelopathy. The other two cases were detected incidentally and included a transverse—sigmoid dural AVS and a cerebellar arteriovenous malformation. Angiographic studies revealed that the spinal dural AVSs at the C-1 and/or C-2 levels were fed by the dural branches of the radicular arteries that coursed from the vertebral artery and drained into the medullary veins. Venous drainage was caudally directed in the patient with myelopathy. In contrast, the shunt flow drained mainly into the intracranial venous system in patients with SAH. Furthermore, in four of these patients a varix was found on the draining vein. In all patients, the draining vein was interrupted surgically at the point at which this vessel entered the intradural space, using intraoperative digital subtraction angiography to monitor flow. The postoperative course was uneventful in all patients and no recurrence was confirmed on follow-up angiographic studies obtained in seven patients at 6 months after discharge. Conclusions. If computerized tomography scanning shows SAH predominantly in the posterior fossa and no abnormalities are found on intracranial four-vessel angiographic study, proximal vertebral angiography should be performed to detect dural AVS at the craniocervical junction. The results of surgical intervention for this disease are quite satisfactory.

Experimental cerebral vasospasm

1975 ◽  
Vol 42 (4) ◽  
pp. 420-428 ◽  
Author(s):  
Hajime Nagai ◽  
Satoshi Noda ◽  
Hideo Mabe
Keyword(s):  
Vertebral Artery ◽  
Cerebral Vasospasm ◽  
Blocking Agent ◽  
Vasoactive Drugs ◽  
Vertebral Angiography ◽  
Content Type ◽  
Adrenergic Blocking ◽  
Fine Print

✓ The authors report the effects of vasoactive drugs and sympathectomy on experimental spasm using vertebral angiography. Papaverine and isoxsuprine injections into the vertebral artery released both early and late spasm. The antiserotonin agent, methysergide, and the alpha adrenergic blocking agent, phentolamine, released early but not late spasm. In sympathectomized dogs, early spasm was milder than in untreated dogs; however, late spasm was the same as in untreated dogs. The authors discuss an etiological difference between early and late spasm.

Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus

1979 ◽  
Vol 50 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Thomas R. Keucher ◽  
John Mealey
Keyword(s):  
Late Complications ◽  
Long Term Results ◽  
Infection Rates ◽  
Infantile Hydrocephalus ◽  
Content Type ◽  
Vp Shunt ◽  
Ventriculoperitoneal Shunting ◽  
Fine Print

✓ This series of 228 patients with infantile non-neoplastic hydrocephalus who received either a ventriculoatrial (VA) or a ventriculoperitoneal (VP) shunt before 2 years of age was followed for an average of 7 years, and the results with the two types of shunt were compared. Mortality and infection rates were similar for both groups of patients, but children with VP shunts required significantly fewer revisions and had a much greater likelihood of not having any revisions during the follow-up period. Late complications occurred more frequently with VA shunts and were more serious. It is concluded that VP shunts offer significant advantages over VA systems in this population.

The prognosis in subarachnoid hemorrhage of unknown etiology

1984 ◽  
Vol 61 (6) ◽  
pp. 1029-1031 ◽  
Author(s):  
Vagn Eskesen ◽  
Ebbe B. Sørensen ◽  
Jarl Rosenørn ◽  
Kaare Schmidt
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mortality Rate ◽  
Functional Capacity ◽  
Unknown Etiology ◽  
Vertebral Angiography ◽  
Content Type ◽  
Moderate Reduction ◽  
Bilateral Carotid ◽  
Fine Print

✓ The mortality rate, risk of rebleeding, relevant subjective and objective symptoms, and daily functional capacity after a verified subarachnoid hemorrhage (SAH) of unknown etiology were evaluated in 44 patients treated during a 5-year period (1978 to 1983). A vascular basis for the SAH had been excluded by bilateral carotid and vertebral angiography and computerized tomography. The patients were interviewed at a follow-up examination from 3 to 64 months (median 36 months) after the bleed. The results revealed a 5% mortality rate and a 7% risk of rebleeding. Persisting headache and fatigue were found in 40% of patients, 29% had mild demential symptoms, and 5% had persisting and severe objective neurological symptoms. None had developed epilepsy. A normal daily functional capacity was enjoyed by 84%, while 14% had a moderate reduction in these functions, but were independent of help from other persons. One patient (2%) was not fully assessed.

Focal motor seizures with secondary generalization arising in the cerebellum

2002 ◽  
Vol 97 (1) ◽  
pp. 190-196 ◽  
Author(s):  
Ali H. Mesiwala ◽  
John D. Kuratani ◽  
Anthony M. Avellino ◽  
Theodore S. Roberts ◽  
Marcio A. Sotero ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Cerebellar Hemisphere ◽  
Dysplastic Lesion ◽  
Content Type ◽  
Depth Electrodes ◽  
Left Cerebellar Hemisphere ◽  
Eeg Recordings ◽  
Cerebellar Mass ◽  
Secondary Generalization

✓ The issue of whether seizures can arise in the cerebellum remains controversial. The authors present the first known case of focal subcortical epilepsy with secondary generalization thought to arise from a dysplastic lesion within the cerebellum. A newborn infant presented with daily episodes of left eye blinking, stereotyped extremity movements, postural arching, and intermittent altered consciousness lasting less than 1 minute. These episodes began on his 1st day of life and progressively increased in frequency to more than 100 events per day. Antiepileptic medications had no effect, and interictal and ictal scalp electroencephalography (EEG) recordings demonstrated bilateral electrical abnormalities. Magnetic resonance imaging revealed a mass in the left cerebellar hemisphere, and ictal and interictal single-photon emission computerized tomography revealed a focal perfusion abnormality in the region of the cerebellar mass. The patient subsequently underwent intraoperative EEG monitoring with cortical scalp electrodes and cerebellar depth electrodes. Intraoperative EEG recordings revealed focal seizure discharges that arose in the region of the cerebellar mass and influenced electrographic activity in both cerebral hemispheres. Resection of this mass and the left cerebellar hemisphere led to complete resolution of the patient's seizures and normalization of the scalp EEG readings. Neuropathological findings in this mass were consistent with ganglioglioma. A review of the literature on the cerebellar origins of epilepsy is included.

Audible cerebrospinal fluid flow through a ventriculoperitoneal shunt

1987 ◽  
Vol 67 (3) ◽  
pp. 460-462 ◽  
Author(s):  
Joe I. Ordia ◽  
Ronald W. Mortara ◽  
Edward L. Spatz
Keyword(s):  
Cerebrospinal Fluid ◽  
Fluid Flow ◽  
Ventriculoperitoneal Shunt ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Ventriculoperitoneal Shunting ◽  
Flow Through ◽  
Fine Print

✓ An audible, noisy cerebrospinal fluid flow is an uncommon sequela of ventriculoperitoneal shunting. Two cases presenting this phenomenon are described.

Case of penetrating brain injury caused by a ventriculoperitoneal shunting procedure

2021 ◽  
Vol 14 (4) ◽  
pp. e241392
Author(s):  
Yuzaburo Shimizu ◽  
Mario Suzuki ◽  
Osamu Akiyama ◽  
Akihide Kondo
Keyword(s):  
Brain Injury ◽  
Rare Complication ◽  
Occipital Lobe ◽  
Cerebellar Hemisphere ◽  
Penetrating Brain Injury ◽  
Ventriculoperitoneal Shunting ◽  
Straight Line ◽  
Tumour Biopsy ◽  
Left Cerebellar Hemisphere ◽  
Ventricular Puncture

Brain injury with ventricle puncture is a well-known complication of ventriculoperitoneal (VP) shunting. However, parenchymal injuries caused by a shunt tunneller are rare. Herein, we present a case of penetrating brain injury caused by a shunt tunneller during VP shunting. An 83-year-old woman with brainstem glioma underwent VP shunting to control hydrocephalus due to tumour growth. She underwent brainstem tumour biopsy with a lateral suboccipital approach. After the shunting, CT showed a linear haematoma in the left occipital lobe far from the site of the ventricular puncture. MRI revealed a small contusion in the left cerebellar hemisphere, disconnection of the left tentorial membrane and linear haematoma on a straight line. These facts suggested that the shunt tunneller had penetrated the skull through the craniotomy of the posterior fossa. This is a rare complication of VP shunting, with limited cases reported in the literature.

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