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Sample records for coincident hydrocephalus treated

  1. Hearing Loss in Patients with Shunt-Treated Hydrocephalus

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    Panova Margarita V.

    2015-12-01

    Full Text Available Hearing loss is a common manifestation of the long-term complications in patients with shunt treated hydrocephalus along with motor development disturbance, cognitive and visual impairment, epilepsy and endocrine disorders.

  2. Hearing Loss in Patients with Shunt-Treated Hydrocephalus.

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    Panova, Margarita V; Geneva, Ina E; Madjarova, Kalina I; Bosheva, Miroslava N

    2015-01-01

    Hearing loss is a common manifestation of the long-term complications in patients with shunt treated hydrocephalus along with motor development disturbance, cognitive and visual impairment, epilepsy and endocrine disorders. The aim of the present study was to investigate the alterations of hearing in patients with shunt treated hydrocephalus of non-tumor etiology and at least one year after implantation of ventriculo-peritoneal shunt, as well as their impact on the quality of life of patients. The study included 70 patients (age range 1.25 years - 21.25 years) with shunted non-tumor hydrocephalus and at least one year after placement of the shunt system. Hearing alterations were proved by measuring the brainstem auditory evoked potentials (BAEP) for children up to 5 years of age and children with mental retardation; audiograms was used for children older than 5 years with normal neuro-psychological development (NPD). Of the 70 studied patients 17 (24%) had hearing loss (10 bilateral and 7-unilateral) and all of them had sensorineural hearing loss, which is associated with low weight at birth, posthemorrhagic hydrocephalus and brainstem symptoms at the time of diagnosis of hydrocephalus. Hearing pathology was found more often in shunt-treated patients with NPD retardation, poor functional status and low quality of life. Children with shunt-treated hydrocephalus have hearing loss of sensorineural type. Children with brain stem symptomatology at diagnosing hydrocephalus and children with post-hemorrhagic hydrocephalus show higher risk of hearing loss. Children with shunted hydrocephalus and hearing loss show lower NPD, lower quality of life and lower functional status.

  3. Hydrocephalus

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    Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain. Normally, this fluid cushions your ... though, it puts harmful pressure on your brain. Hydrocephalus can be congenital, or present at birth. Causes ...

  4. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

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    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  5. Radiation doses to children with shunt-treated hydrocephalus

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    Holmedal, Lise J. [Helse Fonna, Department of Radiology, Stord Hospital, Stord (Norway); Friberg, Eva G.; Boerretzen, Ingelin; Olerud, Hilde [The Norwegian Radiation Protection Authority, Oesteraas (Norway); Laegreid, Liv [Haukeland University Hospital, Department of Paediatrics, Bergen (Norway); Rosendahl, Karen [University of Bergen, Department of Surgical Sciences, Radiology Section, Bergen (Norway); Great Ormond Street Hospital for Children, Department of Diagnostic Radiology, London (United Kingdom)

    2007-12-15

    Children with shunt-treated hydrocephalus are still followed routinely with frequent head CT scans. To estimate the effective dose, brain and lens doses from these examinations during childhood, and to assess dose variation per examination. All children born between 1983 and 1995 and treated for hydrocephalus between 1983 and 2002 were included. We retrospectively registered the number of examinations and the applied scan parameters. The effective dose was calculated using mean conversion factors from the CT dose index measured free in air, while doses to the lens and brain were estimated using tabulated CT dose index values measured in a head phantom. A total of 687 CT examinations were performed in 67 children. The mean effective dose, lens dose and brain dose to children over 6 months of age were 1.2 mSv, 52 mGy and 33 mGy, respectively, and the corresponding doses to younger children were 3.2 mSv, 60 mGy and 48 mGy. The effective dose per CT examination varied by a factor of 64. None of the children was exposed to doses known to cause deterministic effects. However, since the threshold for radiation-induced damage is not known with certainty, alternative modalities such as US and MRI should be used whenever possible. (orig.)

  6. The Relationship of Intelligence and Cerebral Mantle in Treated Infantile Hydrocephalus (IQ Potential in Hydrocephalic Children)

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    Young, Harold F.; And Others

    1973-01-01

    Analyzed were 147 patients (between 3 and 20 years) with hydrocephalus (an accumulation of fluid in the brain) who had been treated by valve regulated ventriculovenous shunt to determine the relationship between early surgical intervention and later IQ. (DB)

  7. Relationship between ventricular size, white matter injury, and neurocognition in children with stable, treated hydrocephalus.

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    Kulkarni, Abhaya V; Donnelly, Ruth; Mabbott, Donald J; Widjaja, Elysa

    2015-09-01

    Larger-than-normal ventricles can persist in children following hydrocephalus treatment, even if they are asymptomatic and clinically well. This study aims to answer the following question: do large ventricles result in brain injuries that are detectable on diffusion tensor imaging (DTI) and/or in measurable neurocognitive deficits in children with stable, treated hydrocephalus that are not seen in children with small ventricles? For this prospective study, we recruited 23 children (age range 8-18 years) with hydrocephalus due to aqueductal stenosis or tectal glioma who were asymptomatic following hydrocephalus treatment that had been performed at least 2 years earlier. All patients underwent detailed DTI and a full battery of neuropsychological tests. Correlation analysis was performed to assess the relationship between DTI parameters, neurocognitive tests, and ventricular size. The false-discovery rate method was used to adjust for multiple comparisons. The median age of these 23 children at the time of assessment was 15.0 years (interquartile range [IQR] 12.1-17.6 years), and the median age at the first hydrocephalus treatment was 5.8 years (IQR 2.2 months-12.8 years). At the time of assessment, 17 children had undergone endoscopic third ventriculostomy and 6 children had received a shunt. After adjusting for multiple comparisons, there were no significant correlations between any neurocognitive test and ventricular volume, any DTI parameter and ventricular volume, or any DTI parameter and neurocognitive test. Our data do not show an association between large ventricular size and additional white matter injury or worse neurocognitive deficits in asymptomatic children with stable, treated hydrocephalus caused by a discrete blockage of the cerebral aqueduct. Further investigations using larger patient samples are needed to validate these results.

  8. 3D mapping of cerebrospinal fluid local volume changes in patients with hydrocephalus treated by surgery: preliminary study

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    Hodel, Jerome [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Hopital Roger Salengro, Service de Neuroradiologie, Lille (France); Besson, Pierre; Pruvo, Jean-Pierre; Leclerc, Xavier [Hopital Roger Salengro, Department of Neuroradiology, Lille (France); Rahmouni, Alain; Grandjacques, Benedicte; Luciani, Alain [Hopital Henri Mondor, Department of Radiology, Creteil (France); Petit, Eric; Lebret, Alain [Signals Images and Intelligent Systems Laboratory, Creteil (France); Outteryck, Olivier [Hopital Roger Salengro, Department of Neurology, Lille (France); Benadjaoud, Mohamed Amine [Radiation Epidemiology Team, CESP, Centre for Research in Epidemiology and Population Health U1018, Villejuif (France); Maraval, Anne [Hopital Henri Mondor, Department of Neuroradiology, Creteil (France); Decq, Philippe [Hopital Henri Mondor, Department of Neurosurgery, Creteil (France)

    2014-01-15

    To develop automated deformation modelling for the assessment of cerebrospinal fluid (CSF) local volume changes in patients with hydrocephalus treated by surgery. Ventricular and subarachnoid CSF volume changes were mapped by calculating the Jacobian determinant of the deformation fields obtained after non-linear registration of pre- and postoperative images. A total of 31 consecutive patients, 15 with communicating hydrocephalus (CH) and 16 with non-communicating hydrocephalus (NCH), were investigated before and after surgery using a 3D SPACE (sampling perfection with application optimised contrast using different flip-angle evolution) sequence. Two readers assessed CSF volume changes using 3D colour-encoded maps. The Evans index and postoperative volume changes of the lateral ventricles and sylvian fissures were quantified and statistically compared. Before surgery, sylvian fissure and brain ventricle volume differed significantly between CH and NCH (P = 0.001 and P = 0.025, respectively). After surgery, 3D colour-encoded maps allowed for the visual recognition of the CSF volume changes in all patients. The amounts of ventricle volume loss of CH and NCH patients were not significantly different (P = 0.30), whereas readjustment of the sylvian fissure volume was conflicting in CH and NCH patients (P < 0.001). The Evans index correlated with ventricle volume in NCH patients. 3D mapping of CSF volume changes is feasible providing a quantitative follow-up of patients with hydrocephalus. (orig.)

  9. Reversible Foix-Chavany-Marie Syndrome in a patient treated for hydrocephalus.

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    Kaloostian, P; Chen, H; Harrington, H

    2012-10-01

    The authors report the first known case of Foix-Chavany-Marie Syndrome in a patient with hydrocephalus that reversed with ventriculoperitoneal shunting. A 34-year-old x-ray technician with a history of pilocytic astrocytoma resection and radiotherapy and ventriculoperitoneal shunt placement as a child presented with altered mental status and nausea. She was found to have acute hydrocephalus. Post-operatively she did well and was discharged home. The next day she became acutely altered with anarthria, difficulty speaking, and stiff facial muscles. After multiple revisions, she slowly recovered to her pre-op baseline over the course of next 2 months. This is the first known case of acute hydrocephalus causing Foix-Chavany-Marie Syndrome. Additionally, we show that this unique syndrome is slowly reversible after treatment of hydrocephalus.

  10. Endoscopic considerations treating hydrocephalus caused by basal ganglia and large thalamic tumors

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    Jonathan Roth

    2015-01-01

    Conclusions: Endoscopic surgery may potentially play a significant role in the initial management of patients with large basal ganglia and large thalamic tumors causing obstructive hydrocephalus. Technical nuances and individualized goals are crucial for optimal outcomes.

  11. Reversible Foix–Chavany–Marie Syndrome in a patient treated for hydrocephalus

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    Kaloostian, P; H. Chen; Harrington, H

    2012-01-01

    The authors report the first known case of Foix-Chavany-Marie Syndrome in a patient with hydrocephalus that reversed with ventriculoperitoneal shunting. A 34-year-old x-ray technician with a history of pilocytic astrocytoma resection and radiotherapy and ventriculoperitoneal shunt placement as a child presented with altered mental status and nausea. She was found to have acute hydrocephalus. Post-operatively she did well and was discharged home. The next day she became acutely altered with an...

  12. Clinical observation on treating traumatic hydrocephalus in TCM medicine%中医药治疗外伤性脑积水1例

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    潘贵春; 刘灿; 魏海燕; 王振华; 于智谋; 任长安

    2014-01-01

    There are two types of traumatic hydrocephalus:acute and chronic type. The pathogenesis of traumatic hydrocephalus is related to CSF circulatory disorder. A patient with traumatic hydrocephalus was treated in TCM medicine, which was introduced as followed.%外伤性脑积水分为急性和慢性两种,其发病机制普遍认为与脑脊液循环障碍有关。本文介绍了中医药干预1例外伤性脑积水患者,报道如下。

  13. Noncommunicating Hydrocephalus.

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    Maller, Vijetha V; Gray, Richard Ian

    2016-04-01

    Noncommunicating hydrocephalus is often referred to as obstructive hydrocephalus and is by definition an intraventricular obstruction of cerebrospinal fluid flow. Patient symptoms depend on the rapidity of onset. Acute obstructive hydrocephalus causes sudden rise in the intracranial pressure, which may lead to death, whereas in chronic hydrocephalus there may not be any symptoms. Computed tomography and magnetic resonance imaging play important roles in the diagnosis and management of hydrocephalus. Advances in magnetic resonance imaging such as the 3D sequences and phase-contrast imaging have revolutionized the preoperative and postoperative assessment of noncommunicating hydrocephalus. We would be discussing the various causes of noncommunicating hydrocephalus and their imaging.

  14. Normal pressure hydrocephalus

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    Hydrocephalus - occult; Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating; Dementia - hydrocephalus; NPH ... Ferri FF. Normal pressure hydrocephalus. In: Ferri FF, ed. ... Elsevier; 2016:chap 648. Rosenberg GA. Brain edema and disorders ...

  15. Hydrocephalus Defined

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    ... in the ventricles and can not complete its circulation, usually due to a blockage. The excess fluid ... Our Shining Star So Grateful Living with Hydrocephalus Fetal MRI Advancements Normal Pressure Hydrocephalus Communication and Development ...

  16. A retrospective outcomes review of patients with idiopathic normal pressure hydrocephalus treated with a low flow valve system

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    Phillip G. St. Louis, MD, FACS

    2015-03-01

    Full Text Available Accepted treatment of patients with Idiopathic Normal Pressure Hydrocephalus (INPH dictates the placement of a Ventriculoperitoneal (VP shunt. Selection of a valve regulated system for implantation is usually determined by the treating surgeon. Data regarding the efficacy of a Low Flow Valve (LFV are sparse. The use of this type of system may be of benefit in patients with INPH. Data from fourteen patients in the Florida Hospital NPH Program Registry with placement of a Low Flow Valve were retrospectively examined. All patients completed baselines studies to quantify gait disturbance, cognitive dysfunction, and ventriculomegaly (Evan's Ratio. Studies were repeated post three day external lumbar drain, as well as 6, 12, and 24 months post shunt placement. Significant improvement was noted in gait (Berg Balance Score at six months and one year post shunt placement. Patients improved from a "medium" fall risk to a "low" fall risk. Significant improvement in NAB was noted at 2 years of follow up, improving from "mildly impaired" to "average". Evan's ratio was stable throughout the study. There were no instances of over drainage or shunt infection. One shunt obstruction which necessitated surgical intervention was observed. Objective improvement in BERG and NAB appears to provide conclusive evidence of efficacy in this small group of patients with INPH treated with placement of an LFV and followed for two years. The absence of over-drainage as a related complication in this small group is encouraging.

  17. Normal Pressure Hydrocephalus (NPH)

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    ... your local chapter Join our online community Normal Pressure Hydrocephalus (NPH) Normal pressure hydrocephalus is a brain ... About Symptoms Diagnosis Causes & risks Treatments About Normal Pressure Hydrocephalus Normal pressure hydrocephalus occurs when excess cerebrospinal ...

  18. Congenital Hydrocephalus.

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    Estey, Chelsie M

    2016-03-01

    There are several types of hydrocephalus, which are characterized based on the location of the cerebrospinal fluid (CSF) accumulation. Physical features of animals with congenital hydrocephalus may include a dome-shaped skull, persistent fontanelle, and bilateral ventrolateral strabismus. Medical therapy involves decreasing the production of CSF. The most common surgical treatment is placement of a ventriculoperitoneal shunt. Postoperative complications may include infection, blockage, drainage abnormalities, and mechanical failure.

  19. Hydrocephalus and Shunts

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    SBA National Resource Center: 800-621-3141 Hydrocephalus and Shunts Approximately 80% of people with SB have Hydrocephalus Hydrocephalus means there is a build-up of cerebrospinal also called CSF, around ...

  20. Cervicomedullary neurocysticercosis causing obstructive hydrocephalus.

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    Wang, Doris D; Huang, Michael C

    2015-09-01

    We present a 45-year-old man with tussive headache and blurred vision found to have obstructive hydrocephalus from a neurocysticercal cyst at the cervicomedullary junction who underwent surgical removal of the cyst. We performed a suboccipital craniectomy to remove the cervicomedullary cyst en bloc. Cyst removal successfully treated the patient's headaches without necessitating permanent cerebrospinal fluid diversion. Neurocysticercosis is the most common parasite infection of the central nervous system causing seizures and, less commonly, hydrocephalus. Intraventricular cysts or arachnoiditis usually cause hydrocephalus in neurocysticercosis but craniocervical junction cysts causing obstructive hydrocephalus are rare. Neurocysticercosis at the craniocervical junction may cause Chiari-like symptoms. In the absence of arachnoiditis and leptomeningeal enhancement, surgical removal of the intact cyst can lead to favorable outcomes.

  1. Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training.

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    Piquer, José; Qureshi, Mubashir Mahmood; Young, Paul H; Dempsey, Robert J

    2015-06-01

    OBJECT A shortage of neurosurgeons and a lack of knowledge of neuroendoscopic management of hydrocephalus limits modern care in sub-Saharan Africa. Hence, a mobile teaching project for endoscopic third ventriculostomy (ETV) procedures and a subsequent program to develop neurosurgery as a permanent specialty in Kenya and Zanzibar were created and sponsored by the Neurosurgery Education and Development (NED) Foundation and the Foundation for International Education in Neurological Surgery. The objective of this work was to evaluate the results of surgical training and medical care in both projects from 2006 to 2013. METHODS Two portable neuroendoscopy systems were purchased and a total of 38 ETV workshops were organized in 21 hospitals in 7 different countries. Additionally, 49 medical expeditions were dispatched to the Coast General Hospital in Mombasa, Kenya, and to the Mnazi Moja Hospital in Zanzibar. RESULTS From the first project, a total of 376 infants with hydrocephalus received surgery. Six-month follow-up was achieved in 22%. In those who received follow-up, ETV efficacy was 51%. The best success rates were achieved with patients 1 year of age or older with aqueductal stenosis (73%). The main causes of hydrocephalus were infection (56%) and spina bifida (23%). The mobile education program interacted with 72 local surgeons and 122 nurses who were trained in ETV procedures. The second project involved 49 volunteer neurosurgeons who performed a total of 360 nonhydrocephalus neurosurgical operations since 2009. Furthermore, an agreement with the local government was signed to create the Mnazi Mmoja NED Institute in Zanzibar. CONCLUSIONS Mobile endoscopic treatment of hydrocephalus in East Africa results in reasonable success rates and has also led to major developments in medicine, particularly in the development of neurosurgery specialty care sites.

  2. [Congenital hydrocephalus].

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    Malagón-Valdez, J

    2006-04-10

    Congenital hydrocephalus or ventriculomegaly is a disorder that now can be diagnosed in uterus with ultrasonography, this gives the chance of being able to give a treatment the earliest as possible. The clinical manifestations are reviewed, the diagnosis, the frequent treatment and causes of congenital hydrocephalus, being the first agenesis of the Sylvius' aqueduct, followed by Arnold-Chiari's malformations with mielomeningocele. In most of the cases the peritoneal-ventricle shunt is the best surgery treatment and now, the treatment with ventriculostomy of third ventricle by endoscopy has fewer complications apparently and in several cases it is the definitive treatment. The evolution of the diagnosis with the support of specific therapies is effective and the early treatment is good, of course taking into account the etiology.

  3. Normal pressure hydrocephalus after gamma knife radiosurgery for vestibular schwannoma

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    Mohammed T

    2010-01-01

    Full Text Available Vestibular schwannomas are not uncommon, and gamma knife radiosurgery is one of the treatment options for symptomatic tumors. Hydrocephalus is a complication of gamma knife treatment of vestibular schwannoma, though the mechanism of the development of hydrocephalus remains controversial. We present an unusual case of normal pressure hydrocephalus (NPH after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of the hydrocephalus. This is probably the first case of NPH post radiosurgery with normal cerebrospinal fluid protein. Communicating hydrocephalus should be treated with placement of shunt while non-communicating hydrocephalus can be treated with third ventriculostomy. Frequent monitoring and early intervention post radiosurgery is highly recommended to prevent irreversible cerebral damage.

  4. Hydrocephalus in children.

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    Kahle, Kristopher T; Kulkarni, Abhaya V; Limbrick, David D; Warf, Benjamin C

    2016-02-20

    Hydrocephalus is a common disorder of cerebral spinal fluid (CSF) physiology resulting in abnormal expansion of the cerebral ventricles. Infants commonly present with progressive macrocephaly whereas children older than 2 years generally present with signs and symptoms of intracranial hypertension. The classic understanding of hydrocephalus as the result of obstruction to bulk flow of CSF is evolving to models that incorporate dysfunctional cerebral pulsations, brain compliance, and newly characterised water-transport mechanisms. Hydrocephalus has many causes. Congenital hydrocephalus, most commonly involving aqueduct stenosis, has been linked to genes that regulate brain growth and development. Hydrocephalus can also be acquired, mostly from pathological processes that affect ventricular outflow, subarachnoid space function, or cerebral venous compliance. Treatment options include shunt and endoscopic approaches, which should be individualised to the child. The long-term outcome for children that have received treatment for hydrocephalus varies. Advances in brain imaging, technology, and understanding of the pathophysiology should ultimately lead to improved treatment of the disorder.

  5. At what age is hydrocephalus detected, and what is the role of head circumference measurements?

    NARCIS (Netherlands)

    Breuning-Broers, J.M.; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2014-01-01

    To investigate at what age hydrocephalus is detected and to assess the role of head circumference measurements in detecting hydrocephalus, we performed a retrospective chart review in children with hydrocephalus treated in a tertiary paediatric hospital in the Netherlands. The study group contained

  6. At what age is hydrocephalus detected, and what is the role of head circumference measurements?

    NARCIS (Netherlands)

    Breuning-Broers, J.M.; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2014-01-01

    To investigate at what age hydrocephalus is detected and to assess the role of head circumference measurements in detecting hydrocephalus, we performed a retrospective chart review in children with hydrocephalus treated in a tertiary paediatric hospital in the Netherlands. The study group contained

  7. Compensated or progressive hydrocephalus?

    NARCIS (Netherlands)

    Leliefeld, P.H.

    2012-01-01

    OBJECTIVE: Raised intracranial pressure (ICP) that is associated with hydrocephalus may lead to alterations in cerebral hemodynamics and ischemic changes in the brain. In infants with hydrocephalus, defining the right moment for surgical intervention based on clinical signs alone, can sometimes be a

  8. Gevolgen van hydrocephalus

    NARCIS (Netherlands)

    Tromp, Cornelis Nicolaas

    1984-01-01

    Hydrocephalus is een aandoening van het centrale zenuwstelsel die de clinicus vrij lang voor grote problemen ten aanzien van de behandeling heeft qesteld. Door de toepassing van de ventriculo-atriale shunttechniek zijn de behandelingsmogelijkheden van hydrocephalus sterk verbeterd. Deze studie probe

  9. Gevolgen van hydrocephalus

    NARCIS (Netherlands)

    Tromp, Cornelis Nicolaas

    1984-01-01

    Hydrocephalus is een aandoening van het centrale zenuwstelsel die de clinicus vrij lang voor grote problemen ten aanzien van de behandeling heeft qesteld. Door de toepassing van de ventriculo-atriale shunttechniek zijn de behandelingsmogelijkheden van hydrocephalus sterk verbeterd. Deze studie

  10. Imaging of Communicating Hydrocephalus.

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    Agarwal, Amit; Bathla, Girish; Kanekar, Sangam

    2016-04-01

    Hydrocephalus basically means an increase in the volume of cerebrospinal fluid (CSF) and the ventricles. As simple as it may sound, the definition and classification of hydrocephalus have been a matter of debate over many decades. Many international neurosurgical and radiological workgroups have tried to develop a consensus and over the last 5-10 years have been able to put forth a more well-defined and standardized approach. Though, the debate and controversy surrounding this topic is expected to continue, we have tried to review the most recent and consensually accepted definition and classification. Although conventionally classified as either "obstructive and nonobstructive" or "communicating and noncommunicating," none of the classification schemes were without confusion and errors. A more precise nomenclature is to divide hydrocephalus as either "communicating": with or without obstruction of CSF absorption, or as "noncommunicating": with definite obstruction to CSF absorption. We discuss communicating hydrocephalus in the current article, and the subsequent article deals with noncommunicating hydrocephalus.

  11. Biomarkers in chronic adult hydrocephalus

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    Kitchen Neil D

    2006-10-01

    Full Text Available Abstract Awareness of the importance of chronic adult hydrocephalus has been raised again with the recent emergence of epidemiological studies. It is estimated that between 5 and 10% of patients suffering from dementia might, in fact, have chronic hydrocephalus. Although, surgical diversion of the cerebrospinal fluid (CSF represents the only known procedure able to treat the symptoms of this condition, the selection of surgical patients has always been problematic. In the last 40 years, we have become wiser in using appropriate diagnostic tests for the selection of these patients; however, the area of biological markers has so far been overlooked in this condition, in contrast to that for other neurodegenerative disorders and dementias. Biomarkers are biological substances that may be used to indicate either the onset or the presence, and the progression of a clinical condition, being closely linked to its pathophysiology. In such a setting they might assist in the more appropriate selection of patients for shunt surgery. In this article, we have reviewed research carried out in the last 25 years regarding the identification of serum and CSF biomarkers for chronic hydrocephalus, discussed the potential for each one, and finally discussed the limitations for use, as well as future directions and possibilities in this field. It is concluded that tumour-necrosis factor, tau protein, lactate, sulfatide and neurofilament triple protein are the most promising CSF markers for chronic hydrocephalus. At present however, none of these meet the criteria required to justify a change clinical practice. In the future, collaborative multi-centre projects will be needed to obtain more substantial data that overcome the problems that arise from small individual and uncoordinated studies.

  12. Hydrocephalus (For Parents)

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    ... swollen veins that are easily seen with the naked eye downward cast of the eyes (called "sunsetting") ... of the signs and symptoms of hydrocephalus should see a doctor right away. The doctor will do ...

  13. Idiopathic Normal Pressure Hydrocephalus

    OpenAIRE

    2016-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords “normal pressure hydrocephalus,” “diagnosis,” “shunt treatment,” “biomarkers,” ...

  14. Hydrocephalus in children.

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    Rekate, Harold L; Blitz, Ari M

    2016-01-01

    Imaging of hydrocephalus in utero, in infants and children is critically dependent on an understanding of the pathophysiology and treatment options for this condition in this age spectrum. For this reason, this chapter deals not only with the imaging modalities used to study hydrocephalus and how they are applied but also reviews key aspects of the pathophysiology and treatment of hydrocephalus in children. Imaging techniques to establish the diagnosis of chronic hydrocephalus fall into two categories: (1) tracer-type techniques that require an injection and observation of the transit of an injected substance through the ventricular system or subarachnoid space and (2) cross-sectional imaging, which allows for direct visualization of a point of obstruction within the ventricular system or subarachnoid space. For cross-sectional imaging, both magnetic resonance imaging (MRI) and computed tomography can be used, but MRI is usually preferred. Nomenclature has obscured the description of imaging findings in hydrocephalus. We suggest that most hydrocephalus is obstructive and propose to designate ventriculomegaly, the condition in which the ventricles are large on imaging, but there is no true obstruction to the outflow of cerebrospinal fluid.

  15. Using external lumbar CSF drainage to treat communicating external hydrocephalus in adult patients after acute traumatic or non-traumatic brain injury.

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    Manet, Romain; Payen, Jean-François; Guerin, Romain; Martinez, Orianne; Hautefeuille, Serge; Francony, Gilles; Gergelé, Laurent

    2017-08-08

    Despite various treatments to control intracranial pressure (ICP) after brain injury, patients may present a late onset of high ICP or a poor response to medications. External lumbar drainage (ELD) can be considered a therapeutic option if high ICP is due to communicating external hydrocephalus. We aimed at describing the efficacy and safety of ELD used in a cohort of traumatic or non-traumatic brain-injured patients. In this multicentre retrospective analysis, patients had a delayed onset of high ICP after the initial injury and/or a poor response to ICP treatments. ELD was considered in the presence of radiological signs of communicating external hydrocephalus. Changes in ICP values and side effects following the ELD procedure were reported. Thirty-three patients with a median age of 51 years (25-75th percentile: 34-61 years) were admitted after traumatic (n = 22) or non-traumatic (n = 11) brain injuries. Their initial Glasgow Coma Scale score was 8 (4-11). Eight patients underwent external ventricular drainage prior to ELD. Median time to ELD insertion was 5 days (4-8) after brain insult. In all patients, ELD was dramatically effective in lowering ICP: 25 mmHg (20-31) before versus 7 mmHg (3-10) after (p < 0.001). None of the patients showed adverse effects such as pupil changes or intracranial bleeding after the procedure. One patient developed an ELD-related infection. These findings indicate that ELD may be considered potentially effective in controlling ICP, remaining safe if a firm diagnosis of communicating external hydrocephalus has been made.

  16. Ventriculoperitoneal shunt for intracranial hypertension in cryptococcal meningitis without hydrocephalus.

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    Petrou, Panayota; Moscovici, Samuel; Leker, Ronen R; Itshayek, Eyal; Gomori, John M; Cohen, José E

    2012-08-01

    The use of a ventriculoperitoneal (VP) shunt to treat uncontrollable intracranial hypertension in patients with cryptococcal meningitis without hydrocephalus is somewhat unusual and still largely unreported. However, uncontrollable intracranial hypertension without hydrocephalus in these patients is a potentially life-threatening condition. Early diagnosis and shunt placement are essential to improve survival and neurological function. We report uncontrollable intracranial hypertension without hydrocephalus in a 23-year-old woman, which was successfully managed by VP shunt placement. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  18. Idiopathic Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Basant R. Nassar BS

    2016-04-01

    Full Text Available Idiopathic normal pressure hydrocephalus (iNPH is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords “normal pressure hydrocephalus,” “diagnosis,” “shunt treatment,” “biomarkers,” “gait disturbances,” “cognitive function,” “neuropsychology,” “imaging,” and “pathogenesis,” articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

  19. Idiopathic Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Basant R. Nassar BS

    2016-04-01

    Full Text Available Idiopathic normal pressure hydrocephalus (iNPH is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords “normal pressure hydrocephalus,” “diagnosis,” “shunt treatment,” “biomarkers,” “gait disturbances,” “cognitive function,” “neuropsychology,” “imaging,” and “pathogenesis,” articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

  20. Two Hundred Thirty-Six Children With Developmental Hydrocephalus: Causes and Clinical Consequences.

    Science.gov (United States)

    Tully, Hannah M; Ishak, Gisele E; Rue, Tessa C; Dempsey, Jennifer C; Browd, Samuel R; Millen, Kathleen J; Doherty, Dan; Dobyns, William B

    2016-03-01

    Few systematic assessments of developmental forms of hydrocephalus exist. We reviewed magnetic resonance images (MRIs) and clinical records of patients with infancy-onset hydrocephalus. Among 411 infants, 236 had hydrocephalus with no recognizable extrinsic cause. These children were assigned to 1 of 5 subtypes and compared on the basis of clinical characteristics and developmental and surgical outcomes. At an average age of 5.3 years, 72% of children were walking independently and 87% could eat by mouth; in addition, 18% had epilepsy. Distinct patterns of associated malformations and syndromes were observed within each subtype. On average, children with aqueductal obstruction, cysts, and encephaloceles had worse clinical outcomes than those with other forms of developmental hydrocephalus. Overall, 53% of surgically treated patients experienced at least 1 shunt failure, but hydrocephalus associated with posterior fossa crowding required fewer shunt revisions. We conclude that each subtype of developmental hydrocephalus is associated with distinct clinical characteristics, syndromology, and outcomes, suggesting differences in underlying mechanisms.

  1. MR elastography of hydrocephalus

    Science.gov (United States)

    Pattison, Adam J.; Lollis, S. Scott; Perrinez, Phillip R.; Weaver, John B.; Paulsen, Keith D.

    2009-02-01

    Hydrocephalus occurs due to a blockage in the transmission of cerebrospinal fluid (CSF) in either the ventricles or subarachnoid space. Characteristics of this condition include increased intracranial pressure, which can result in neurologic deterioration [1]. Magnetic resonance elastography (MRE) is an imaging technique that estimates the mechanical properties of tissue in vivo. While some investigations of brain tissue have been performed using MRE [2,3,4,5], the effects due to changes in interstitial pressure and fluid content on the mechanical properties of the brain remain unknown. The purpose of this work is to assess the potential of MRE to differentiate between the reconstructed properties of normal and hydrocephalic brains. MRE data was acquired in 18 female feline subjects, 12 of which received kaolin injections resulting in an acute form of hydrocephalus. In each animal, four MRE scans were performed during the process including one pre-injection and three post-injection scans. The elastic parameters were obtained using a subzone-based reconstruction algorithm that solves Navier's equations for linearly elastic materials [6]. The remaining cats were used as controls, injected with saline instead of kaolin. To determine the state of hydrocephalus, ventricular volume was estimated from segmenting anatomical images. The mean ventricular volume of hydrocephalic cats significantly increased (P ~ 0.5) for the control cats. Also, there was an observable increase in the recorded elastic shear modulus of brain tissue in the normal and hydrocephalic acquisitions. Results suggest that MRE is able to detect changes in the mechanical properties of brain tissue resulting from kaolin-induced hydrocephalus, indicating the need for further study.

  2. Stereotactic CO2 laser therapy for hydrocephalus

    Science.gov (United States)

    Kozodoy-Pins, Rebecca L.; Harrington, James A.; Zazanis, George A.; Nosko, Michael G.; Lehman, Richard M.

    1994-05-01

    A new fiber-optic delivery system for CO2 radiation has been used to successfully treat non-communicating hydrocephalus. This system consists of a hollow sapphire waveguide employed in the lumen of a stereotactically-guided neuroendoscope. CO2 gas flows through the bore of the hollow waveguide, creating a path for the laser beam through the cerebrospinal fluid (CSF). This delivery system has the advantages of both visualization and guided CO2 laser radiation without the same 4.3 mm diameter scope. Several patients with hydrocephalus were treated with this new system. The laser was used to create a passage in the floor of the ventricle to allow the flow of CSF from the ventricles to the sub-arachnoid space. Initial postoperative results demonstrated a relief of the clinical symptoms. Long-term results will indicate if this type of therapy will be superior to the use of implanted silicone shunts. Since CO2 laser radiation at 10.6 micrometers is strongly absorbed by the water in tissue and CSF, damage to tissue surrounding the lesion with each laser pulse is limited. The accuracy and safety of this technique may prove it to be an advantageous therapy for obstructive hydrocephalus.

  3. Changes of White Matter Diffusion Anisotropy in Response to a 6-Week iPad Application-Based Occupational Therapy Intervention in Children with Surgically Treated Hydrocephalus: A Pilot Study.

    Science.gov (United States)

    Yuan, Weihong; Harpster, Karen; Jones, Blaise V; Shimony, Joshua S; McKinstry, Robert C; Weckherlin, Nicole; Powell, Stephanie S; Barnard, Holly; Engsberg, Jack; Kadis, Darren S; Dodd, Jonathan; Altaye, Mekibib; Limbrick, David D; Holland, Scott K; Simpson, Sarah M; Bidwell, Sarah; Mangano, Francesco T

    2016-10-01

    Objective Our aims were (1) to test whether diffusion tensor imaging (DTI) could detect underlying white matter (WM) changes after a 6-week iPad application-based occupational therapy (OT) intervention in children with surgically treated hydrocephalus (HCP); and (2) to explore the association between WM changes and performance outcomes. Methods Five children (age range: 6.05-9.10 years) with surgically treated HCP completed an intensive iPad-based OT intervention targeting common domains of long-term deficits in children with HCP. The intervention included 6 weekly sessions in an OT clinic supplementing home-based program (1 hour/day, 4 days/week). DTI and neuropsychological assessments were performed before and after the intervention. Observation After the therapy, significant increases in fractional anisotropy (FA) and/or decreases in radial diffusivity were found in extensive WM areas. All participants demonstrated an increased perceptual reasoning index (PRI, Wechsler Abbreviated Scale of Intelligence: 2nd edition, PRI gains = 14.20 ± 7.56, p = 0.014). A significant positive correlation was found between PRI increase and the increase of FA in the right posterior limb of the internal capsule and the right external capsule (both p < 0.05). Conclusion This study provides initial evidence of DTI's sensitivity to detect subtle WM changes associated with performance improvements in response to a 6-week OT intervention in children with HCP.

  4. Prenatal hydrocephalus: outcome and prognosis.

    Science.gov (United States)

    Renier, D; Sainte-Rose, C; Pierre-Kahn, A; Hirsch, J F

    1988-08-01

    The clinical records of 108 infants presenting with hydrocephalus at birth and operated on from 1971 to 1981 were reviewed in order to evaluate the functional results. Premature newborns and spina bifida patients were excluded. Communicated hydrocephalus (39 cases) and aqueductal stenosis (32 cases, excluding 6 X-linked hydrocephalus and 4 toxoplasmoses) were the two main types of hydrocephalus in this series. Eighty-four percent of the infants were operated on before the age of 3 months. The mean follow-up time was 7 years (range 1 to 14 years). The survival rate, calculated by the life table method, was 62% at 10 years. The functional results were evaluated according to intellectual performance, academic level, and psychological status. Of the 75 surviving children, 28% have an I.Q. over 80 and 50% an I.Q. under 60. The mean I.Q. is 54 (range 0 to 130). Of the 52 children who have now reached school age, only 29% have reached a normal academic level. The psychological status is normal or borderline in 46% of the patients. The importance of head enlargement at birth, ventricular size, and the age at the time of surgery are not related to late functional results. The results were best when there were no associated malformations, no shunt infection, when hydrocephalus was due to aqueductal stenosis (excluding X-linked hydrocephalus and toxoplasmosis), or when the first developmental quotient measured at 6 months was over 80.

  5. The influence of decompressive craniectomy on the development of hydrocephalus: a review

    Directory of Open Access Journals (Sweden)

    Jun Ding

    2014-09-01

    Full Text Available Decompressive craniectomy (DC is widely used to treat intracranial hypertension following traumatic brain injury (TBI or cerebral vascular disease. Many studies have discussed complications of this procedure, and hydrocephalus is a common complication of DC. To further evaluate the relationship between DC and hydrocephalus, a review of the literature was performed. Numerous complications may arise after DC, including contusion or hematoma expansion, epilepsy, herniation of the cortex through a bone defect, CSF leakage through the scalp incision, infection, subdural effusion, hydrocephalus and “syndrome of the trephined”. Several hydrocephalus predictors were identified; these included DC, distance from the midline, hygroma, age, injury severity, subarachnoid or intraventricular hemorrhage, delayed time to craniotomy, repeated operation, and duraplasity. However, results differed among studies. The impact of DC on hydrocephalus remains controversial.

  6. Treatment of refractory low-pressure hydrocephalus with an active pumping negative-pressure shunt system.

    Science.gov (United States)

    Kalani, M Yashar S; Turner, Jay D; Nakaji, Peter

    2013-03-01

    Low-pressure hydrocephalus is a rare type of hydrocephalus characterized by negative intracranial pressure (ICP) and ventriculomegaly. Given the shortcomings of available methods to treat refractory low-pressure hydrocephalus, we set out to develop a new system for evacuation of cerebrospinal fluid (CSF) from the ventricular system where existing shunt systems do not produce the necessary gradient for CSF drainage. We retrospectively reviewed the charts of two patients with the diagnosis of negative-pressure hydrocephalus refractory to traditional treatments. We combined a traditional low-pressure, non-siphoning valve with a pumping chamber placed distal to the valve to create a system that could be actively pumped to remove excess CSF. Treatment of negative-pressure hydrocephalus requires the establishment of a lower ventricular drainage pressure than the drainage pressure in the subarachnoid space. In refractory cases, we propose the use of this active negative-pressure pumping system.

  7. Brucella meningoencephalitis with hydrocephalus masquerading as tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Vishwanath Sathyanarayanan; Bekur Ragini; Abdul Razak; M Mukhya prana Prabhu

    2010-01-01

    Neurobrucellosis is a rare form of localized brucellosis usually with no systemic manifestations. We report a rare case of brucellosis presenting as meningoencephalitis associated with hydrocephalus. This patient had a lymphocytic predominantCSF and was initially treated with empirical anti tubercular therapy and steroids.A week later, when hisCSF culture grew Brucella species, the treatment was changed to a combination of streptomycin, doxycycline and rifampicin and the patient improved with this therapy. This case illustrates the need to consider neurobrucellosis as a close differential diagnosis of neurotuberculosis in endemic areas when the patient presents with meningo encephalitis with lymphocyticCSF.

  8. The efficacy of early lamina terminalis fenestration in treating acute hydrocephalus after aneurismal subarachnoid hemorrhage%早期终板造瘘治疗动脉瘤性蛛网膜下腔出血后急性脑积水的疗效

    Institute of Scientific and Technical Information of China (English)

    彭四维; 漆松涛; 冯文峰; 刘忆; 张国忠; 王刚; 李明洲

    2015-01-01

    Objective To explore the efficacy of early lamina terminalis fenestration in the treatment of acute hydrocephalus after aneurismal subarachnoid hemorrhage.Methods Ninety-eight patients of acute hydrocephalus after aneurismal subarachnoid hemorrhage who were treated by clipping were retrospectively analyzed.These cases were divided into two groups,including aneurysm clipping group alone (42 cases) and clipping with lamina terminalis fenestration group(56 cases).The improving rate of acute hydrocephalus and the incidence rate of shunt-dependent hydrocephalus after surgical treatment were compared between two groups.Results All surgical clipping procedures were performed within 72 hours after aneurysm rupture.Ultimately,46 cases of acute hydrocephalus patients acquired improvement and 27 cases developed to chronic hydrocephalus after surgical treatment among 98 patients.Fourteen cases of acute hydrocephalus patients in aneurysm clipping group were improved (the improvement rate was 33.3%) and 14 cases developed into shunt-dependent hydrocephalus (the incidence rate was 33.3%).Thirty-two cases of acute hydrocephalus patients in lamina terminalis fenestration after aneurysm clipping group were improved (the improvement rate was 57.1%) and 13 cases developed into chronic hydrocephalus (the incidence rate was 23.2%).The acute hydrocephalus improvement rate and shunt-dependent hydrocephalus incidence rate in posterior circulation aneurysm group were statistically difference between aneurysm clipping group and lamina terminalis fenestration after aneurysm clipping group (P < 0.05),but not in anterior circulation aneurysm group (P > 0.05).Conclusions The efficacy of early lamina terminalis fenestration in the treatment of acute hydrocephalus after aneurismal subarachnoid hemorrhage was effective in posteriorcirculation aneurysm clipping.%目的 探究早期终板造瘘治疗动脉瘤性蛛网膜下腔出血(aSAH)后急性脑积水的疗效.方法

  9. Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normal pressure hydrocephalus

    DEFF Research Database (Denmark)

    Ziebell, Morten; Wetterslev, Jørn; Tisell, Magnus

    2013-01-01

    Since 1965 many ventriculo-peritoneal shunt systems have been inserted worldwide to treat hydrocephalus. The most frequent indication in adults is normal pressure hydrocephalus (NPH), a condition that can be difficult to diagnose precisely. Surgical intervention with flow-regulated and differential...

  10. The Observation of the Effect of Skull Defect With Hydrocephalus Treating by Cranioplasty and Ventriculo-Peritoneal Shunt at the Early Stage or the Same Stage%早期同期颅骨修补及脑室分流对颅骨缺损并脑积水的治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    李海洲

    2015-01-01

    Objective To explore the curative effect of skul defect with hydrocephalus treating by cranioplasty and ventriculo-peritoneal shunt at the early stage or the same stage. Methods 88 cases of skul defect with hydrocephalus were randomly divided into control group and treatment group. Each group had 44 cases. The control group were treated with cranioplasty,while the treatment group were treated with early cranioplasty and ventriculo peritoneal shunt therapy. Compared the treatment effect between two groups. Results The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05). Conclusion The treatment of early stage cranioplasty and ventriculo peritoneal shunt to skul defect with hydrocephalus has obvious therapeutic effect.%目的:观察早期同期颅骨修补及脑室分流对颅骨缺损并脑积水的治疗效果。方法选取88例颅骨缺损并脑积水患者,随机分为对照组和治疗组各44例。对照组分流后行颅骨修补治疗,治疗组采用早期同期颅骨修补及脑室分流治疗,对比两组治疗效果。结果治疗组总有效率高于对照组(P<0.05)。结论早期同期颅骨修补及脑室分流对颅骨缺损并脑积水治疗效果较好。

  11. Hydrocephalus Onset after Microsurgical or Endovascular Treatment for Acute Subarachnoid Hemorrhage. Retrospective Italian Multicenter Study

    Science.gov (United States)

    Gangemi, Michelangelo; Cavallo, Luigi Maria; Di Somma, Alberto; Mazzucco, Grazia Marina; Bono, Paolo Sebastiano; Ghetti, Giovanni; Zambon, Giampaolo

    2014-01-01

    Background Chronic shunt-dependent hydrocephalus is a complication of aneurysmal subarachnoid hemorrhage (aSAH). Its incidence and risk factors have been described while the hydrocephalus onset in terms of days after treatment (microsurgical or endovascular) has not been yet analyzed. Materials and Methods 45 patients, treated for aSAH in 4 Italian Neurosurgical Departments, were retrospectively analyzed. It was calculated the time that elapses between treatment and hydrocephalus onset in 36 patients. Results Of the 45 shunted patients, 15 (33.3%) were included in the microsurgical group (group A) and 30 (66.6%) were in the endovascular one (group B). There was no difference of the hydrocephalus onset between the two groups (24,1 days, group A vs. 27,7 days, group B). The presence of intracerebral hematoma (ICH) caused a delay in the hydrocephalus onset after endovascular treatment in terms of 11,5 days compared to microsurgical group as well the absence of vasospasm determined a delay of 13,7 days (not statistically significant). Conclusion No difference in terms of hydrocephalus onset after microsurgical or endovascular treatment has been demonstrated. Only the presence of ICH or the absence of vasospasm can cause a slight delay in the time of hydrocephalus onset in the endovascular series (not statistically significant). Long-term follow-up studies involving higher numbers of subjects are needed to better demonstrate this issue. PMID:24809036

  12. GDC血管内栓塞治疗动脉瘤性蛛网膜下腔出血后慢性脑积水的影响机制与预后研究%Pathogenesis and prognosis of chronic hydrocephalus following aneurismal subarachnoid hemorrhage treated by endovascular embolization with Guglielmi detachable coils

    Institute of Scientific and Technical Information of China (English)

    王立江; 段传志; 何旭英; 文军; 汪求精; 李西锋; 柳晓秋; 王建奇

    2010-01-01

    Objective To explore the risk factors and the prognosis of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage (SAH) treated by endovaseular embolization with Guglielmi detachable coils (GDCs). Methods Endovascular embolization with GDCs were performed in 132 patients with aneurysmal subarachnoid hemorrhage that satisfied our research standard. After endovascular embolization, ventricular drainage was conventionally performed in patients who occurred intraventricular hemorrhage combined with obstruction in the ventricular system, while cerebrospinal fluid permutation was performed in other patients. Chronic hydrocephalus was evaluated by CT 1 month after SAH. Ventricle-peritoneal shunt was carried out for patients with severe chronic hydrocephalus while only clinical observation was needed for patients with mild chronic hydrocephalus. Clinical follow-up evaluation was carried out 6 months after SAIl according to the modified Rankin scale score. The risk factors related to chronic hydrocephalus were noted through the statistical analysis of the patients' data and the relation between the appearing of chronic hydrocephalus and clinical prognosis of SAH was analyzed. Results The overall incidence rate of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage was 12.12% and age, Fisher grade and Hunt-Hess grade had important value in the prognosis of chronic hydrocephalus. Clinical prognosis of SAH was not significantly related to chronic hydrocephalus following SAH (P >0.05). Conclusion Chronic hydrocephalus following aneurysmal subarachnoid hemorrhage is not only resulted from one single risk factor and good clinical prognosis can be achieved by promptly performing ventricle-peritoneal shunt in patients with severe chronic hydrocephalus.%目的 探讨GDC血管内栓塞治疗动脉瘤性蛛网膜下腔出血后慢性脑积水发生的易患因素和临床预后.方法 纳入研究标准的132例动脉瘤性蛛网膜下腔出血患者均

  13. MANAGEMENT OF HYDROCEPHALUS IN POSTERIOR CRANIAL FOSSA TUMORS

    Directory of Open Access Journals (Sweden)

    S. M. Abdollahzadeh-Hosseini

    2006-06-01

    Full Text Available Treatment of hydrocephalus in posterior fossa tumors in children is still a matter of controversy and different centers have their own routines. In this regard, hospital records of all children with posterior fossa tumors treated in our center during the interval of 1985-1995 were reviewed. Patients’ demographic and diagnostic data were analyzed and the frequencies of shunting procedures were determined. Fisher exact test was employed to compare the frequency of postoperative complications in different groups. A total of 108 patients with age ranging from 3 months to 18 years and a male to female ratio of 1.5 comprised the study population. Ninety-nine cases had hydrocephalus at the time of diagnosis and 81 patients underwent preoperative shunting. Of the remaining 18 patients, 13 underwent external ventricular drainage at tumor operation session plus preoperative corticosteroid therapy. The rest of the patients got no primary treatment for hydrocephalus. Three of these 5 patients had postoperative shunting after tumor removal, but the other 2 remained shunt free. The rate of postoperative complications including cerebrospinal fluid leakage and septic meningitis were significantly lower in patients with preoperative shunting. The results of this study are in favor of those that approve the effect of preoperative shunting in decreasing postoperative complications. This is well established when the tumor size is big or when the diagnosis of posterior fossa tumor is made in later stages or when hydrocephalus is severe. It could be concluded that preoperative shunting can decrease the rate of postoperative complications.

  14. Pediatric hydrocephalus outcomes: a review

    Directory of Open Access Journals (Sweden)

    Vinchon Matthieu

    2012-08-01

    Full Text Available Abstract The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy, clinical outcome (neurological, sensory, cognitive sequels, epilepsy, schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review

  15. Meta analysis of endoscopic third ventriculostomy and ventriculo-peritoneal shunt for treating non-communicating hydrocephalus%第三脑室底造瘘术和脑室-腹腔分流术治疗非交通性脑积水的Meta分析

    Institute of Scientific and Technical Information of China (English)

    刘欣; 王茂德

    2012-01-01

    目的 通过Meta分析对神经内镜下第三脑室底造瘘术(ETV)和脑室-腹腔(V-P)分流术治疗非交通性脑积水的疗效进行综合分析.方法 通过计算机检索PubMed、EMBASE、Ovid、ScienceDirec、SpringerLink、中国知网数据库、万方、维普及中国生物医学文献数据库,查出2000-2010年发表的有关ETV和V-P分流术治疗非交通性脑积水的相关文献,选择RevMan5.0软件以固定效应模型进行Meta分析.结果 纳入9项临床对照研究.Meta分析结果显示:与V-P分流术相比,ETV术后症状缓解率、颅内血肿形成率差异无统计学意义(P >0.01),而ETV术后并发症发生率及复发率均明显低于V-P分流术(P<0.01).结论 ETV和V-P分流术疗效相当.但ETV术后并发症发生率和复发率较低.%Objective To systematically evaluate the efficacy of endoscopic third ventriculostomy (ETV) and ventriculo-peritonea (V-P) shunt for treating non-communicating hydrocephalus via Meta analysis. Methods The literatures about the comparative studies of ETV and V-P shunt for treating non-communicating hydrocephalus were collected from Pubmed, EMBASE, Ovid, ScienceDirect, Springerlink, CNKI, Wanfang databases, Weipu databases, CBMdisc databases and manual retrieval from 2000 to 2010. RevMan5.0 software was used for data analysis. Results Nine literatures were selected finally. The comprehensive results of Meta analysis showed as follows: there was no statistical significance in the difference of symptom relief rate and intracranial hematoma rate between V-P shunt and ETV (P>0.01). While the difference in the complication rates and recurrence rate between V-P shunt and ETV reached statistical significance (P<0.01). Conclusions ETV and V-P shunt have therapeutic equivalence for obstructive hydrocephalus, whereas ETV can result in lower incidence of postoperative complication and recurrence rate of hydrocephalus.

  16. Congenital hydrocephalus in clinical practice : A genetic diagnostic approach

    NARCIS (Netherlands)

    Verhagen, J. M. A.; Schrander-Stumpel, C. T. R. M.; Krapels, P. C.; de Die-Smulders, C. E. M.; van Lint, F. H. M.; Willekes, C.; Weber, J. W.; Gavilanes, A. W. D.; Macville, M. V. E.; Stegmann, A. P. A.; Engelen, J. J. M.; Bakker, J.; Vos, Y. J.; Frints, S. G. M.

    2011-01-01

    Congenital hydrocephalus is a common and often disabling disorder. The etiology is very heterogeneous. Little is known about the genetic causes of congenital hydrocephalus. A retrospective survey was performed including patients with primary congenital hydrocephalus referred to the Department of

  17. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus

    DEFF Research Database (Denmark)

    Andreasen, Trine Hjorslev; Holst, Anders Vedel; Lilja, Alexander

    2016-01-01

    BACKGROUND: Implant infection and obstruction are major complications for ventriculoperitoneal shunts in patients with post-haemorrhagic hydrocephalus. In an effort to (1) reduce the incidence of these complications, (2) reduce the rate of shunt failure and (3) shorten the duration of neurosurgical...... hospitalisation, we have implemented valveless ventriculoperitoneal shunts at our department for adult patients with post-haemorrhagic hydrocephalus and haemorrhagic cerebrospinal fluid at the time of shunt insertion. METHODS: All adult patients (>18 years old) treated for post-haemorrhagic hydrocephalus.......3 %, p = 0.02), but a higher rate of overdrainage (10.3 % vs 2.6 %, p = 0.04). CONCLUSION: The use of a valveless shunting for patients with post-haemorrhagic hydrocephalus results in shorter duration of neurosurgical hospitalisation and lower rate of shunt infection, although these advantages should...

  18. A wireless monitoring system for Hydrocephalus shunts.

    Science.gov (United States)

    Narayanaswamy, A; Nourani, M; Tamil, L; Bianco, S

    2015-08-01

    Patients with Hydrocephalus are usually treated by diverting the excess Cerebrospinal Fluid (CSF) to other parts of the body using shunts. More than 40 percentage of shunts implanted fail within the first two years. Obstruction in the shunts is one of the major causes of failure (45 percent) and the detection of obstruction reduces the complexity of the revision surgery. This paper describes a proposed wireless monitoring system for clog detection and flow measurement in shunts. A prototype was built using multiple pressure sensors along the shunt catheters for sensing the location of clog and flow rate. Regular monitoring of flow rates can be used to adjust the valve in the shunt to prevent over drainage or under drainage of CSF. The accuracy of the flow measurement is more than 90 percent.

  19. Benign communicating hydrocephalus in children

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, B.; Holland, I.

    1981-03-01

    A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have mengalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.

  20. CAUSING OBSTRICTIVE HYDROCEPHALUS

    African Journals Online (AJOL)

    tions regarding their treatment difhcult and as- signment of prognostic .... gical intervention and the appropriate technology ... (To the nursing staff for taking care of the patient. We are also ... treat- ment. New York, Raven Press 1994; 2 : 219-.

  1. Social media networking in pediatric hydrocephalus: a point-prevalence analysis of utilization.

    Science.gov (United States)

    Elkarim, Ghassan Awad; Alotaibi, Naif M; Samuel, Nardin; Wang, Shelly; Ibrahim, George M; Fallah, Aria; Weil, Alexander G; Kulkarni, Abhaya V

    2017-08-01

    OBJECTIVE A recent survey has shown that caregivers of children with shunt-treated hydrocephalus frequently use social media networks for support and information gathering. The objective of this study is to describe and assess social media utilization among users interested in hydrocephalus. METHODS Publicly accessible accounts and videos dedicated to the topic of hydrocephalus were comprehensively searched across 3 social media platforms (Facebook, Twitter, and YouTube) throughout March 2016. Summary statistics were calculated on standard metrics of social media popularity. A categorization framework to describe the purpose of pages, groups, accounts, channels, and videos was developed following the screening of 100 titles. Categorized data were analyzed using nonparametric tests for statistical significance. RESULTS The authors' search identified 30 Facebook pages, 213 Facebook groups, 17 Twitter accounts, and 253 YouTube videos. These platforms were run by patients, caregivers, nonprofit foundations, and patient support groups. Most accounts were from the United States (n = 196), followed by the United Kingdom (n = 31), Canada (n = 17), India (n = 15), and Germany (n = 12). The earliest accounts were created in 2007, and a peak of 65 new accounts were created in 2011. The total number of users in Facebook pages exceeded those in Facebook groups (p media use in the topic of hydrocephalus. Users interested in hydrocephalus seek privacy for support communications and are attracted to treatment procedure and surgical products videos. These findings provide insight into potential avenues of hydrocephalus outreach, support, or advocacy in social media.

  2. Coincidence Auger spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Penent, F. [LCPMR, Universite Pierre et Marie Curie, 75231 Paris 5 (France) and DIAM, Universite Pierre et Marie Curie, 75252 Paris 5 (France)]. E-mail: penent@ccr.jussieu.fr; Lablanquie, P. [LURE, Universite Paris Sud, 91898 Orsay (France); Hall, R.I. [DIAM, Universite Pierre et Marie Curie, 75252 Paris 5 (France); Palaudoux, J. [LCPMR, Universite Pierre et Marie Curie, 75231 Paris 5 (France); Ito, K. [Photon Factory, IMSS, KEK, Tsukuba 305-0801 (Japan); Hikosaka, Y. [Photon Factory, IMSS, KEK, Tsukuba 305-0801 (Japan); IMS, Okazaki 444-8585 (Japan); Aoto, T. [Photon Factory, IMSS, KEK, Tsukuba 305-0801 (Japan); Eland, J.H.D. [Physical and Theoretical Chemistry Laboratory, South Parks Road, Oxford OX1 3DW (United Kingdom)

    2005-06-15

    Auger electron spectroscopy (AES) and photoelectron spectroscopy (PES) are (with X-ray emission spectroscopy, XES) powerful analytical tools for material science and gas phase studies. However, the interpretation of Auger spectra can be very difficult due to the number and complexity of the involved processes. A deeper analysis, that allows a better understanding of relaxation processes following inner shell ionization, is possible with coincidence Auger spectroscopy. This method gives a new insight into electron correlation and allows disentangling of complex Auger electron spectra. In this paper, we present some examples related to gas phase coincidence Auger electron spectroscopy using synchrotron radiation. The detection in coincidence of an Auger electron with a threshold photoelectron presents two main advantages which are good energy resolution and high coincidence count rates. This technique has also provided new results on double Auger decay processes. A further qualitative breakthrough has been made with the development of a new experimental set-up based on a magnetic bottle time-of-flight electron spectrometer. This opens up the field of multi-electron coincidence spectroscopy and allows a most detailed analysis with characterization of all possible decay pathways following inner shell ionization.

  3. Minimally invasive ventriculo-atrial shunt for hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    李江山; 江勇豪; 程成; 张世凯

    2005-01-01

    Objective: To study the therapeutic effect of mini-traumatic ventriculo-atrial shunt on hydrocephalus. Methods: Seventeen patients were treated with right internal jugular venepuncture intubation to finish minimally invasive ventriculo-atrial shunt for hydrocephalus. The patients were evaluated by CT/MRI. The catheters were deployed at the proper position in the right atrium under X-ray fluoroscopy.Results: The hydrocephalus in all the 17 patients eliminated with this surgical procedure with a 100% success rate technically. The operational duration ranged from 0.75 to 1.5 h (average: 1 h). Mistaken puncture into the internal carotid artery as a complication occurred on 1 case.Conclusions: The mini-traumatic ventriculo-atrial shunt, as a novel minimal invasion technique, has the advantages of small trauma, no influence on local blood circulation, short time and simplicity at operation, rapid healing, and good short-term effect. Moreover, it is suitable for those patients with organic dysfunction.

  4. Postmeningitic hydrocephalus; Discussion of CT findings and prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Sumio; Sakamoto, Keizo; Kobayashi, Norio (Kobe Children' s Hospital (Japan))

    1993-04-01

    We have treated 23 patients with postmeningitic hydrocephalus during the past 20 years; 13 males and 10 females, ranging in age from 1 day to 6 years (mean 300 days). The outcome was good in 6 patients, fair in 5, moderately good in 5 and poor in 7. Ventricular size on CT scan was analyzed pre- and postoperatively by Evans' Index. Postmenigitic hydrocephalus was classified into 3 types; S-S type (slow onset-slow response), R-R type (rapid onset-rapid response), and N-R type (no response). In the S-S type, it took several months for the ventricle to increase and decrease in size, while in the R-R type, it took a few weeks. Patients with the S-S type had almost normal mental status and in those with the R-R type, mental status was mildly deteriorated. In the N-R type patients, ventricular size did not decrease after V-P shunt. These findings suggest that the choice of therapeutic options for patients with postmeningitic hydrocephalus should be based on the chronological changes after onset. In S-S type patients, correct diagnosis and optimal treatment are important for obtaining a good outcome. (author).

  5. Coincidence studies with antiprotons

    Energy Technology Data Exchange (ETDEWEB)

    McGovern, M; Walters, H R J [Department of Applied Mathematics and Theoretical Physics, Queen' s University, Belfast BT7 1NN (United Kingdom); Assafrao, D; Mohallem, J R [Laboratorio de Atomos e Moleculas Especiais, Departamento de Fisica, ICEx, Universidade Federal de Minas Gerais, P.O Box 702, 30123-970 Belo Horizonte, MG (Brazil); Whelan, Colm T, E-mail: mmcgovern06@qub.ac.u [Department of Physics, Old Dominion University, Norfolk, VA 23529-0116 (United States)

    2010-02-01

    We present a short overview of a new method for calculating fully differential cross sections that is able to describe any aspect of coincidence measurements involving heavy projectiles. The method is based upon impact parameter close coupling with pseudostates. Examples from antiproton impact ionization are shown.

  6. Cerebrospinal fluid hypersecretion in pediatric hydrocephalus.

    Science.gov (United States)

    Karimy, Jason K; Duran, Daniel; Hu, Jamie K; Gavankar, Charuta; Gaillard, Jonathan R; Bayri, Yasar; Rice, Hunter; DiLuna, Michael L; Gerzanich, Volodymyr; Marc Simard, J; Kahle, Kristopher T

    2016-11-01

    Hydrocephalus, despite its heterogeneous causes, is ultimately a disease of disordered CSF homeostasis that results in pathological expansion of the cerebral ventricles. Our current understanding of the pathophysiology of hydrocephalus is inadequate but evolving. Over this past century, the majority of hydrocephalus cases has been explained by functional or anatomical obstructions to bulk CSF flow. More recently, hydrodynamic models of hydrocephalus have emphasized the role of abnormal intracranial pulsations in disease pathogenesis. Here, the authors review the molecular mechanisms of CSF secretion by the choroid plexus epithelium, the most efficient and actively secreting epithelium in the human body, and provide experimental and clinical evidence for the role of increased CSF production in hydrocephalus. Although the choroid plexus epithelium might have only an indirect influence on the pathogenesis of many types of pediatric hydrocephalus, the ability to modify CSF secretion with drugs newer than acetazolamide or furosemide would be an invaluable component of future therapies to alleviate permanent shunt dependence. Investigation into the human genetics of developmental hydrocephalus and choroid plexus hyperplasia, and the molecular physiology of the ion channels and transporters responsible for CSF secretion, might yield novel targets that could be exploited for pharmacotherapeutic intervention.

  7. Control volume based hydrocephalus research

    Science.gov (United States)

    Cohen, Benjamin; Voorhees, Abram; Wei, Timothy

    2008-11-01

    Hydrocephalus is a disease involving excess amounts of cerebral spinal fluid (CSF) in the brain. Recent research has shown correlations to pulsatility of blood flow through the brain. However, the problem to date has presented as too complex for much more than statistical analysis and understanding. This talk will highlight progress on developing a fundamental control volume approach to studying hydrocephalus. The specific goals are to select physiologically control volume(s), develop conservation equations along with the experimental capabilities to accurately quantify terms in those equations. To this end, an in vitro phantom is used as a simplified model of the human brain. The phantom's design consists of a rigid container filled with a compressible gel. The gel has a hollow spherical cavity representing a ventricle and a cylindrical passage representing the aquaducts. A computer controlled piston pump supplies pulsatile volume fluctuations into and out of the flow phantom. MRI is used to measure fluid velocity, and volume change as functions of time. Independent pressure measurements and flow rate measurements are used to calibrate the MRI data. These data are used as a framework for future work with live patients.

  8. Periventricular hyperintensity in children with hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Akbari, S.H.A.; Ragan, Dustin K. [St. Louis Children' s Hospital, Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Limbrick, David D. [St. Louis Children' s Hospital, Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); McKinstry, Robert C.; Shimony, Joshua S. [St. Louis Children' s Hospital, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Altaye, Mekibib [Cincinnati Children' s Hospital, Division of Biostatistics and Epidemiology, Cincinnati, OH (United States); Yuan, Weihong; Holland, Scott K. [Cincinnati Children' s Hospital, Department of Pediatric Radiology, Cincinnati, OH (United States); Mangano, Francesco T. [Cincinnati Children' s Hospital, Department of Pediatric Neurological Surgery, Cincinnati, OH (United States)

    2015-08-15

    Magnetic resonance images of children with hydrocephalus often include a rim of hyperintensity in the periventricular white matter (halo). The purpose of this study was to decide between the hypothesis that the halo is caused by cerebrospinal fluid (CSF) flow during the cardiac cycle, and the alternate hypothesis that the halo is caused by anatomical changes (stretching and compression of white matter). Participants were selected from a multicenter imaging study of pediatric hydrocephalus. We compared 19 children with hydrocephalus to a group of 52 controls. We quantified ventricle enlargement using the frontal-occipital horn ratio. We conducted qualitative and quantitative analysis of diffusion tensor imaging in the corpus callosum and posterior limb of the internal capsule. Parameters included the fractional anisotropy (FA), mean diffusivity, axial diffusivity and radial diffusivity. The halo was seen in 16 of the 19 children with hydrocephalus but not in the controls. The corpus callosum of the hydrocephalus group demonstrated FA values that were significantly decreased from those in the control group (P = 4 . 10{sup -6}), and highly significant increases were seen in the mean diffusivity and radial diffusivity in the hydrocephalus group. In the posterior limb of the internal capsule the FA values of the hydrocephalus group were higher than those for the control group (P = 0.002), and higher values in the hydrocephalus group were also noted in the axial diffusivity. We noted correlations between the diffusion parameters and the frontal-occipital horn ratio. Our results strongly support the hypothesis that the halo finding in hydrocephalus is caused by structural changes rather than pulsatile CSF flow. (orig.)

  9. Outcome analysis of shunt surgery in hydrocephalus

    Directory of Open Access Journals (Sweden)

    Ahmed Ashraf

    2009-01-01

    Full Text Available Aim: To study the clinical outcome of shunt surgeries in children suffering from hydrocephalus. Methods: A prospective study of 50 children with hydrocephalus who underwent a ventriculo-peritoneal shunt insertion over a period of two years. These patients were then followed up for shunt related complications, shunt revisions and outcome. Results : Twenty six of the 50 patients (52% suffered from complications. The most common complications were shunt blockage (n=7 and shunt infection (n=6. These complications necessitated repeated shunt revisions. Conclusions: Infective complications of hydrocephalus are more likely to leave behind an adverse neurological outcome in the form of delayed milestones and mental retardation.

  10. Endoscopic third ventriculostomy in obstructed hydrocephalus

    Directory of Open Access Journals (Sweden)

    Singh D

    2003-01-01

    Full Text Available Forty-three ETV were performed in 46 patients of obstructive hydrocephalus. Study was divided into two groups. Group 1 was with 29 children of less than two years age. Group 2 had seventeen patients of more than 2 years, adolescent and adults. Group 1 had 70% clinical and 63% radiological improvement whereas Group 2 showed 100% clinical and 73% radiological improvement. ETV failed in relieving the symptoms of hydrocephalus in eight patients. They were eventually benefited with VP Shunt. There was one postoperative death, which was not related to the procedure. ETV is an important alternative to VP Shunt in relieving hydrocephalus due to obstruction in CSF pathway.

  11. Subdural Effusions with Hydrocephalus after Severe Head Injury: Successful Treatment with Ventriculoperitoneal Shunt Placement: Report of 3 Adult Cases

    Directory of Open Access Journals (Sweden)

    N. Tzerakis

    2010-01-01

    Full Text Available Background. Subdural collections of cerebrospinal fluid (CSF with associated hydrocephalus have been described by several different and sometimes inaccurate terms. It has been proposed that a subdural effusion with hydrocephalus (SDEH can be treated effectively with a ventriculoperitoneal shunt (V-P shunt. In this study, we present our experience treating patients with SDEH without directly treating the subdural collection. Methods. We treated three patients with subdural effusions and hydrocephalus as a result of a head injury. All the patients were treated with a V-P shunt despite the fact that there was an extra-axial CSF collection with midline shift. Results. In all of the patients, the subdural effusions subsided and the ventricular dilatation improved in the postoperative period. The final clinical outcome remains difficult to predict and depends not only on the successful CSF diversion but also on the primary and secondary brain insult. Conclusion. Subdural effusions with hydrocephalus can be safely and effectively treated with V-P shunting, without directly treating the subdural effusion which subsides along with the treatment of hydrocephalus. However, it is extremely important to make an accurate diagnosis of an SDEH and differentiate this condition from other subdural collections which require different management.

  12. Hydrocephalus in Children with Spina Bifida

    Directory of Open Access Journals (Sweden)

    Sanjay sadhu, H.L.Goswamy, S.K.Gupta, Inder Singh, Nasib C. digra, Ravinder Gupta

    2003-01-01

    Full Text Available A prospective study consisting of 50 infants having spina bifida and cranium bifidum and relationshipof hydrocephalus was carried out. The male preponderance was obvious (1.7:1 with majority ofinfants being less than 3 months. The presenting complaint in almost all the children was swellingon back or head. Lumbar spine was affected most commonly with 36% children having lesion atthis site followed by lumbosacral (20% and occiptal (16%. Neuromuscular deficit was present in32% cases. Clinical evidence of hydrocephalus was seen in 22% children. X-ray si~ull was suggestiveof hydrocephalus in 22% cases. Ultrasound examination of skull confirmed the diagnosis in 52%cases. Hydrocephalus had no specific relationship with site of lesion. It was more commonlyassociated with neurological deficit. Sonographic examination is relatively cheaper and invaluableinvestigation. and should be done routinely in patients with spina bifida.

  13. Biodriven microsystem for treatment of hydrocephalus

    Science.gov (United States)

    Joswig, Jurgen; Oswald, Jens; Seifert, Steffen

    1995-09-01

    A microvalve system made of silicon for use in hydrocephalus therapy is presented, which will provide an excellent intracranial pressure stabilization. Design and processing are described. Testing results (in vitro) are presented.

  14. CSF Obstruction and Malabsorption in Congenital Hydrocephalus

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-11-01

    Full Text Available The relative contribution of CSF malabsorption and obstruction in three different etiological groups of neonatal high-pressure hydrocephalus (HC was assessed in a study at University of Bonn, Germany, and University of Groningen, The Netherlands.

  15. A hydroelastic model of hydrocephalus

    Science.gov (United States)

    Smillie, Alan; Sobey, Ian; Molnar, Zoltan

    2005-09-01

    We combine elements of poroelasticity and of fluid mechanics to construct a mathematical model of the human brain and ventricular system. The model is used to study hydrocephalus, a pathological condition in which the normal flow of the cerebrospinal fluid is disturbed, causing the brain to become deformed. Our model extends recent work in this area by including flow through the aqueduct, by incorporating boundary conditions that we believe accurately represent the anatomy of the brain and by including time dependence. This enables us to construct a quantitative model of the onset, development and treatment of this condition. We formulate and solve the governing equations and boundary conditions for this model and give results that are relevant to clinical observations.

  16. A Rare Hydrocephalus Complication: Cortical Blindness.

    Science.gov (United States)

    Ünal, Emre; Göçmen, Rahşan; Işıkay, Ayşe İlksen; Tekşam, Özlem

    2015-01-01

    Cortical blindness related to bilateral occipital lobe infarction is an extremely rare complication of hydrocephalus. Compression of the posterior cerebral artery, secondary to tentorial herniation, is the cause of occipital infarction. Particularly in children and mentally ill patients, cortical blindness may be missed. Therefore, early diagnosis and treatment of hydrocephalus is important. We present herein a child of ventricular shunt malfunction complicated by cortical blindness.

  17. Hydrocephalus

    Science.gov (United States)

    ... setting sun" Reflexes may be normal Repeated head circumference measurements over time may show that the head ... cry No pulse (heartbeat) Seizures Severe headache Stiff neck Vomiting You should also call your provider if: ...

  18. Hydrocephalus

    Science.gov (United States)

    ... children and adults: Have signs and symptoms included headache? In older children and adults: Have signs and symptoms included urinary ... may include: Fever Irritability Drowsiness Nausea or ... particularly children, may need additional treatment, depending on the severity ...

  19. Hydrocephalus

    Science.gov (United States)

    ... and 3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain). The balance between production and absorption of CSF is critically ...

  20. VEGF: a potential target for hydrocephalus.

    Science.gov (United States)

    Shim, Joon W; Sandlund, Johanna; Madsen, Joseph R

    2014-12-01

    Growth factors are primarily responsible for the genesis, differentiation and proliferation of cells and maintenance of tissues. Given the central role of growth factors in signaling between cells in health and in disease, it is understandable that disruption of growth factor-mediated molecular signaling can cause diverse phenotypic consequences including cancer and neurological conditions. This review will focus on the specific questions of enlarged cerebral ventricles and hydrocephalus. It is also well known that angiogenic factors, such as vascular endothelial growth factor (VEGF), affect tissue permeability through activation of receptors and adhesion molecules; hence, recent studies showing elevations of this factor in pediatric hydrocephalus led to the demonstration that VEGF can induce ventriculomegaly and altered ependyma when infused in animals. In this review, we discuss recent findings implicating the involvement of biochemical and biophysical factors that can induce a VEGF-mimicking effect in communicating hydrocephalus and pay particular attention to the role of the VEGF system as a potential pharmacological target in the treatment of some cases of hydrocephalus. The source of VEGF secretion in the cerebral ventricles, in periventricular regions and during pathologic events including hydrocephalus following hypoxia and hemorrhage is sought. The review is concluded with a summary of potential non-surgical treatments in preclinical studies suggesting several molecular targets including VEGF for hydrocephalus and related neurological disorders.

  1. Surgical management of hydrocephalus secondary to intraventricular hemorrhage in the preterm infant.

    Science.gov (United States)

    Christian, Eisha A; Melamed, Edward F; Peck, Edwin; Krieger, Mark D; McComb, J Gordon

    2016-03-01

    OBJECT Posthemorrhagic hydrocephalus (PHH) in the preterm infant remains a major neurological complication of prematurity. The authors first described insertion of a specially designed low-profile subcutaneous ventricular catheter reservoir for temporary management of hydrocephalus in 1983. This report presents the follow-up experience with the surgical management of PHH in this population and describes outcomes both in infants who were stable for permanent shunt insertion and those initially temporized with a ventricular reservoir (VR) prior to permanent ventriculoperitoneal (VP)/ventriculoatrial (VA) shunt placement. METHODS A retrospective review was undertaken of the medical records of all premature infants surgically treated for posthemorrhagic hydrocephalus (PHH) between 1997 and 2012 at Children's Hospital Los Angeles. RESULTS Over 14 years, 91 preterm infants with PHH were identified. Fifty neonates received temporizing measures via a VR that was serially tapped for varying time periods. For the remaining 41 premature infants, VP/VA shunt placement was the first procedure. Patients with a temporizing measure as their initial procedure had undergone CSF diversion significantly earlier in life than those who had permanent shunting as the initial procedure (29 vs 56 days after birth, p hydrocephalus and shunt infection did not statistically differ between the 2 groups. CONCLUSIONS Patients with initial VR insertion as a temporizing measure received a CSF diversion procedure significantly earlier than those who received a permanent shunt as their initial procedure. Otherwise, the outcomes with regard to shunt revisions, loculated hydrocephalus, and shunt infection were not different for the 2 groups.

  2. Infantile hydrocephalus: a review of epidemiology, classification and causes.

    Science.gov (United States)

    Tully, Hannah M; Dobyns, William B

    2014-08-01

    Hydrocephalus is a common but complex condition caused by physical or functional obstruction of CSF flow that leads to progressive ventricular dilatation. Though hydrocephalus was recently estimated to affect 1.1 in 1000 infants, there have been few systematic assessments of the causes of hydrocephalus in this age group, which makes it a challenging condition to approach as a scientist or as a clinician. Here, we review contemporary literature on the epidemiology, classification and pathogenesis of infantile hydrocephalus. We describe the major environmental and genetic causes of hydrocephalus, with the goal of providing a framework to assess infants with hydrocephalus and guide future research.

  3. Psychotic symptoms in normal pressure hydrocephalus.

    Science.gov (United States)

    Chatziioannidis, S; Charatsidou, I; Nikolaidis, N; Garyfallos, G; Giouzepas, I

    2013-01-01

    Normal Pressure Hydrocephalus due to idiopathic aqueductal stenosis is a chronic abnormal accumulation of cerebrospinal fluid in the cerebral ventricles caused by an obstruction in the Sylvian aqueduct. This leads to a dilatation of the ventricular system and to subsequent damage of the adjacent parenchyma. Although NPH typically presents with the progressive 'triad' of cognitive impairment, gait disturbance and urinary incontinence, it has been described that it rarely manifests in the form of predominant psychotic symptoms. It has been suggested that thought and perceptual disorders could develop secondary to the damage caused by NPH. Although precise anatomical correlates have not yet been established, certain cerebral regions -primarily the frontal cortex, mesencephalic and diencephalic structures of the brain- have been implicated in the pathogenesis of hydrocephalic psychosis. Because frontal lobe lesions are traditionally known to facilitate one's inability to integrate and correct perceptual distortions in the face of contradictory evidence, frontal lobe dysfunction may be integral in delineating the etiology of delusions in NPH. We present the case of a 30-year-old female, admitted involuntarily to our acute psychiatric department because she exhibited aggressive behavior while being in an agitated state with delusions of persecution. Her neurological examination disclosed subtle bradykinesia. Neuropsychological batteries and intelligence testing revealed mild cognitive impairment and a CT scan showed considerable dilatation of the ventricular system due to idiopathic aqueductal stenosis. While a conservative approach was chosen for the treatment of NPH, our patient was initiated on 2nd generation antipsychotics showing marked improvement of her psychiatric symptomatology. The atypical presentation of hydrocephalus in the aforementioned case underlines the necessity to thoroughly investigate the possible presence of an underlying organic factor in those

  4. [Cerebrospinal fluid shunts for hydrocephalus and related disorders].

    Science.gov (United States)

    Ito, Masaki; Houkin, Kiyohiro; Saito, Hisayasu; Shimbo, Daisuke; Motegi, Hiroaki; Kawabori, Masahito; Miyamoto, Michiyuki; Yamauchi, Tomohiro

    2012-10-01

    Cerebrospinal fluid (CSF) shunts are commonly employed to treat patients with hydrocephalus. A large number of papers have been published focusing on complications and failures of CSF shunts. However, there appears to be a paucity of knowledge comprehensively covering both common complications and rare ones. In this systematic review, we surveyed articles about surgical complications of CSF shunts as comprehensively as possible. Quantitative analysis was performed to determine the frequency of well-known complications, mortality and revision rates of CSF shunts. Furthermore, rare complications of CSF shunts have also been reviewed.

  5. Treatment of hydrocephalus with high-pressure valve ventriculoperitoneal shunt in a dog.

    Science.gov (United States)

    Kim, Jong Min; Park, Jinuk; Kim, Ji-Hye; Han, Tae Sung; Chang, Dongwoo; Na, Ki-Jeong; Choi, Seok Hwa; Kim, Gonhyung

    2010-08-01

    A 5-month-old male Maltese with right-sided circling, deafness, and blindness was presented. A diagnosis of communicating hydrocephalus was made. A ventriculoperitoneal shunt was implanted and the cerebrospinal fluid was drained by using an adjustable valve type (Medtronic Strata). The valve was set at 2.5 (135-155 mmH2O). This was done to prevent the possibility of an overdrainage-induced collapse of the brain parenchyma, which can occur rarely when canine hydrocephalus is treated by using a low-pressure valve. Computed tomography performed 6 weeks and 1 year after surgery revealed the ventricles had decreased in size. Thus, a high-pressure valve used during the treatment of hydrocephalus was able to maintain normal intracranial pressure.

  6. Expanding the phenotypic spectrum of Lenz-Majewski syndrome: facial palsy, cleft palate and hydrocephalus.

    Science.gov (United States)

    Wattanasirichaigoon, Duangrurdee; Visudtibhan, Anannit; Jaovisidha, Suphaneewan; Laothamatas, Jiraporn; Chunharas, Amornsri

    2004-07-01

    We report a sporadic case of Lenz-Majewski syndrome (LMS) with newly recognized manifestations including facial palsy, cleft palate and hydrocephalus developing later in infancy. The clinical course of the patient and neuroimaging studies are described. Increased intracranial pressure was recognized and treated early with the aim of preventing neurological morbidity.

  7. Normal-pressure hydrocephalus: current understanding of diagnostic tests and shunting

    Energy Technology Data Exchange (ETDEWEB)

    Black, P.M.

    1982-02-01

    Normal-pressure hydrocephalus is no longer difficult to diagnose or treat-cranial computed tomographic scanning has made the diagnosis of ventricular enlargement straightforward, and shunt placement often helps the patient whose condition can be traced to a specific cause. Predicting accurately whether a patient will benefit from a shunt, however, is still problematic.

  8. Case study of relevant pressures for an implanted hydrocephalus valve in everyday life.

    Science.gov (United States)

    Elixmann, Inga Margrit; Goffin, Christine; Krueger, Rolf; Meier, Ullrich; Lemcke, Johannes; Kiefer, Michael; Antes, Sebastian; Leonhardt, Steffen

    2012-01-01

    Hydrocephalus patients with increased intracranial pressure are generally treated by draining cerebrospinal fluid (CSF) into the abdomen through an implanted shunt with a passive differential pressure valve. To perfectly adapt the valve's opening pressure to the patient's need, more information on the acutal pressure across the valve in everyday life actions like walking, eating, sleeping etc. is necessary.

  9. A contemporary definition and classification of hydrocephalus.

    Science.gov (United States)

    Rekate, Harold L

    2009-03-01

    This review focuses on the problems related to defining hydrocephalus and on the development of a consensus on the classification of this common problem. Such a consensus is needed so that diverse research efforts and plans of treatment can be understood in the same context. The literature was searched to determine the definition of hydrocephalus and to identify previously proposed classification schemes. The historic perspective, purpose, and result of these classifications are reviewed and analyzed. The concept of the hydrodynamics of cerebrospinal fluid (CSF) as a hydraulic circuit is presented to serve as a template for a contemporary classification scheme. Finally, a definition and classification that include all clinical causes and forms of hydrocephalus are suggested. The currently accepted classification of hydrocephalus into "communicating" and "noncommunicating" varieties is almost 90 years old and has not been modified despite major advances in neuroimaging, neurosciences, and treatment outcomes. Despite a thorough search of the literature using computerized search engines and bibliographies from review articles and book chapters, I identified only 6 previous attempts to define and classify different forms of hydrocephalus. This review proposes the following definition for hydrocephalus: hydrocephalus is an active distension of the ventricular system of the brain related to inadequate passage of CSF from its point of production within the ventricular system to its point of absorption into the systemic circulation. Based on this definition (potential points of flow restriction) and on the view of the CSF system as a hydraulic circuit, a classification system is proposed. The acceptance of this proposed definition and classification schema would allow clinicians and basic scientists to communicate effectively, to share information and results, and to develop testable hypotheses.

  10. Childhood hydrocephalus – is radiological morphology associated with etiology

    DEFF Research Database (Denmark)

    Foss-Skiftesvik, Jon; Andresen, Morten; Juhler, Marianne

    2013-01-01

    Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus.......Clinicians use a non-standardized, intuitive approach when correlating radiological morphology and etiology of hydrocephalus....

  11. Genetics Home Reference: megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome

    Science.gov (United States)

    ... Home Health Conditions MPPH syndrome megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome Enable Javascript to view the expand/collapse ... Open All Close All Description Megalencephaly- polymicrogyria -polydactyly-hydrocephalus (MPPH) syndrome is a rare disorder that primarily ...

  12. 脑室镜下手术治疗早产儿重度梗阻性脑积水%Effect of endoscopic third ventriculostomy in treating severe obstructive hydrocephalus in premature infant

    Institute of Scientific and Technical Information of China (English)

    陈红武; 薛乔; 彭玉平

    2013-01-01

    Objective To discuss the treatment and the clinical effect of endoscopic third ventriculostomy on severe obstructive hydrocephalus in premature infant.Methods Eleven patients were operated,ultrasound,CT and MRI showed severe obstructive hydrocephalus and cerebral spinal fluid absorption was normal.The technique was that endoscope was inserted through the foramen of Monro into the third ventricle,then perforating the floor of the third ventriculostomy.Comparison before and after surgery of ventricular system ultrasonic measurement about the change of lateral ventricle and the MRI and CT imaging changes were performed.The complications,operation effect and security were observed.The bailey baby scale and Peabody movement function scale was used to assess the patient's neurologic system status.Results The follow-up time was 6 months and 6 years after operation,an excellent operative result was got in 9 cases.The ventricular width of 1 patient was mild ventriculomegaly,but stayed stabilily.No change of ventricular width was found in 1 case.Additional shunt were needed in 1 case.No severe complications were found.The left and right lateral ventricle measured by ultrasonic before operation were (9.60 ± 3.52) mm and (8.63 ± 3.10) mm before operation,and (5.50 ± 2.20) mm and (4.90 ± 2.70) mm after operation.The 11 cases of lateral ventricle side edema were disappeared,the follow-up time in 9 cases were more than 12 months,obstructive hydrocephalus clinical symptoms were relieved.Conclusions Ventricular mirror operation significantly improve severe hydrocephalic short and longterm poor prognosis,it is a safe,effective and less complications of minimally invasive surgery.%目的 探讨脑室镜下三脑室造瘘术治疗早产儿重度梗阻性脑积水的疗效和安全性.方法 对CT、MRI或颅脑B超证实为重度梗阻性脑积水的11例早产儿,采用经侧脑室、室间孔、三脑室置入神经内镜,于三脑室底与脚间池造一瘘孔.比较手术前

  13. Hydrocephalus caused by unilateral foramen of Monro obstruction: A review on terminology

    Directory of Open Access Journals (Sweden)

    Flavio Nigri

    2016-01-01

    Conclusion: In unilateral FM obstruction hydrocephalus, an in-depth review on terminology application is critical to avoid mistakes that may compromise comparisons among different series. This terminology review suggests that Type B hydrocephalus, i.e., the hydrocephalus confined to just one lateral ventricle with no other sites of cerebrospinal fluid circulation blockage, are best described by the terms unilateral hydrocephalus (UH and monoventricular hydrocephalus, the first being by far the most popular. Type A hydrocephalus is best represented in the literature by the terms uniloculated hydrocephalus and loculated ventricle; Type C hydrocephalus by the terms isolated lateral ventricle and isolated UH; and Type D hydrocephalus by the term asymmetric hydrocephalus.

  14. Effects of Melatonin on the Cerebellum of Infant Rat Following Kaolin-Induced Hydrocephalus: a Histochemical and Immunohistochemical Study.

    Science.gov (United States)

    Uyanıkgil, Yiğit; Turgut, Mehmet; Baka, Meral

    2017-02-01

    Hydrocephalus is a developmental disorder causing abnormally collected cerebrospinal fluid within the cerebral ventricles. It leads to bigger skulls and many dysfunctions related to the nervous system. Here, we addressed whether exogenous melatonin administration could reverse the clinical features of kaolin-induced hydrocephalus in infantile rats. A controlled double-blinded study was conducted in 2-week-old 45 Wistar albino rats, which were divided into three groups: Group A, the control group, received intracisternal sham injection with solely the needle insertion; group B, the hydrocephalus group, was treated with isotonic NaCl after kaolin injection; and group C, the hydrocephalus + melatonin group, was given i.p. exogenous melatonin at a dose of 0.5 mg/100 g body weight after kaolin injection. Histological and immunohistochemical analyses were performed after the induction of hydrocephalus and melatonin administration. Glial fibrillary acidic protein was stained by immunohistochemical method. TUNEL method was used to define and quantitate apoptosis in the cerebellar tissues. Statistical analysis was performed by nonparametric Kruskal-Wallis H test, and once significance was determined among means, post hoc pairwise comparisons were carried out using Mann-Whitney U test. We found that melatonin administration significantly ameliorated ratio of substantia grisea area/substantia alba area in the cerebellum of infantile rats. Histologically, there was a significant reduction in the number of cerebellar apoptotic cells after the hydrocephalus induced by kaolin (P kaolin-induced hydrocephalus. Nevertheless, further studies are needed to suggest melatonin as a candidate protective drug in children with hydrocephalus.

  15. Endoscopic third ventriculostomy for post-inflammatory hydrocephalus in pediatric patients: is it worth a try?

    Science.gov (United States)

    Raouf, Alaa; Zidan, Ihab; Mohamed, Eshra

    2015-01-01

    Hydrocephalus is a very common disease in developing countries. Congenital aqueductal obstruction and post-inflammatory hydrocephalus come on the top of the list of causes of hydrocephalus. Till the recent introduction of cranial endoscopy and despite their frequent complications, shunts were considered as the mainstream treatment for this disease. Endoscopic third ventriculostomy (ETV), especially for obstructive hydrocephalus, introduced a new era of treatment that is free of lifetime shunt dependency. This study was done to assess the efficacy of ETV for treating post-inflammatory hydrocephalus in a unique group of patients thus preventing—if possible—the lifetime shunt dependency and suffering. ETV was tried as a first-line therapy in 35 children (23 males and 12 females) with hydrocephalus proved to be secondary to intracranial infection. Mean age was 9.2 months (4-15). Twenty-four patients (68.6%) were below the age of 6 months while 11 patients (31.4%) were above 6 months. Twenty-five patients (71.4%) had a head circumference of 3 cm and 10 patients (28.6%) had a 5 cm or more increase in the head circumference above the 95th percentile. All the patients included were followed postoperatively with regular clinical, computerized tomography (CT), and magnetic resonance imaging (MRI) examinations as well as cerebrospinal fluid (CSF) analysis and culture. The overall success of ETV was 55.9% (19/34). Nine (81.9%) out of the 11 patients that were endoscopically documented to have aqueductal obstruction showed improvement. While out of the 23 patients with patent aqueduct, only 10 patients (43.4%) had improved. Procedure-related complications were not encountered. CSF leakage from the surgical wound occurred in three patients and mild CSF infection occurred in one patient. ETV is a simple, safe, and effective method in treating not only obstructive hydrocephalus due to non-inflammatory etiology, but also post-inflammatory hydrocephalus especially when the

  16. Congenital hydrocephalus in clinical practice : A genetic diagnostic approach

    NARCIS (Netherlands)

    Verhagen, J. M. A.; Schrander-Stumpel, C. T. R. M.; Krapels, P. C.; de Die-Smulders, C. E. M.; van Lint, F. H. M.; Willekes, C.; Weber, J. W.; Gavilanes, A. W. D.; Macville, M. V. E.; Stegmann, A. P. A.; Engelen, J. J. M.; Bakker, J.; Vos, Y. J.; Frints, S. G. M.

    2011-01-01

    Congenital hydrocephalus is a common and often disabling disorder. The etiology is very heterogeneous. Little is known about the genetic causes of congenital hydrocephalus. A retrospective survey was performed including patients with primary congenital hydrocephalus referred to the Department of Cli

  17. Cerebral hemodynamics and functional prognosis in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Hirai, Osamu; Nishikawa, Michio; Watanabe, Shu; Yamakawa, Hiroyasu; Kinoshita, Yoshimasa; Uno, Akira; Handa, Hajime (Hamamatsu Rosai Hospital, Shizuoka (Japan))

    1989-11-01

    The functional outcome of cerebral hemodynamics in the chronic stage of juvenile hydrocephalus was determined using single photon emission computed tomography (SPECT). Five patients including three with aqueductal stenosis, one with post-meningitic hydrocephalus, and one case with hydrocephalus having developed after repair of a huge occipital encephalocele. Early images of cerebral blood flow (CBF) were obtained 25 minutes after intravenous injection of 123-I-iodoamphetamine (IMP), and late images were scanned 3 hours later. Cerebral blood volume (CBV) was also measured using {sup 99m}Tc in three patients. Twenty cases with adult communicating hydrocephalus were also investigated from the point of view of shunt effectiveness. Although there was no remarkable change in the cerebrovascular bed in the juvenile cases, CBF of the remnant brain parenchyma was good irrespective of the degree of ventricular dilatation. There was a periventricular-related IMP uptake in each case; however, it somehow matched the ventricular span. Functional outcome one to 23 years after the initial shunt operation was good in every case, despite multiple shunt revisions. Redistribution on late images had no bearing on clinical states. In adult cases, 8 patients with effective shunting demonstrated a relatively localized periventricular low perfusion, with preoperative increased cerebrospinal fluid (CSF) pressure. On the contrary, 12 patients with no improvement with or without ventricular-reduced IMP uptake, despite low CSF pressure. The present study indicates that periventricular hemodynamics may play an important role in cerebral function compromised by hydrocephalus. (J.P.N.).

  18. Familial idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Huovinen, Joel; Kastinen, Sami; Komulainen, Simo; Oinas, Minna; Avellan, Cecilia; Frantzen, Janek; Rinne, Jaakko; Ronkainen, Antti; Kauppinen, Mikko; Lönnrot, Kimmo; Perola, Markus; Pyykkö, Okko T; Koivisto, Anne M; Remes, Anne M; Soininen, Hilkka; Hiltunen, Mikko; Helisalmi, Seppo; Kurki, Mitja; Jääskeläinen, Juha E; Leinonen, Ville

    2016-09-15

    Idiopathic normal pressure hydrocephalus (iNPH) is a late-onset surgically alleviated, progressive disease. We characterize a potential familial subgroup of iNPH in a nation-wide Finnish cohort of 375 shunt-operated iNPH-patients. The patients were questionnaired and phone-interviewed, whether they have relatives with either diagnosed iNPH or disease-related symptomatology. Then pedigrees of all families with more than one iNPH-case were drawn. Eighteen patients (4.8%) from 12 separate pedigrees had at least one shunt-operated relative whereas 42 patients (11%) had relatives with two or more triad symptoms. According to multivariate logistic regression analysis, familial iNPH-patients had up to 3-fold risk of clinical dementia compared to sporadic iNPH patients. This risk was independent from diagnosed Alzheimer's disease and APOE ε4 genotype. This study describes a familial entity of iNPH offering a novel approach to discover the potential genetic characteristics of iNPH. Discovered pedigrees offer an intriguing opportunity to conduct longitudinal studies targeting potential preclinical signs of iNPH. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Comparative study of lumboperitoneal shunt versus ventriculoperitoneal shunt in post meningitis communicating hydrocephalus in children

    Directory of Open Access Journals (Sweden)

    Amit Singh

    2013-01-01

    Full Text Available Background: Managing post meningitis hydrocephalus in children is a herculean task for the treating pediatric surgeon or neurosurgeon because of the morbidity associated with the disease per se and the complications of shunt surgery. By this study, the effectiveness of lumboperitoneal (LP shunt and ventriculoperitoneal (VP shunt in cases of post meningitis communicating hydrocephalus was assessed in children. Materials and Methods: This was a retrospective analysis of the records of children admitted in our institute between December 2005 and March 2008. Only children with post meningitis communicating hydrocephalus who underwent either LP or VP with a minimum follow-up period of 36 months were included in the study. Children with non-communicating hydrocephalus or hydrocephalus due to another etiology were excluded. Investigations were included plain brain computed tomography scan, air encephalography and X-ray skull. Medium pressure Chabbra shunt with slit valves was used in all cases of VP and LP shunt. A comparative analysis of the outcome was carried out between the two groups. Results: There were 66 males and 24 females (M: F 2.7:1. The average age at presentation was 40.3 months. LP shunt was performed in 37 while VP shunt in 53 cases Complication rate in the LP and VP shunt was 15% and 29% respectively with non-obstructed complications higher in VP group when compared to LP group. Obstructed complication rate was similar in both groups. Conclusion: Due to less morbidity and ease of placement, LP shunt can be an alternative to VP shunt in cases of communicating hydrocephalus in children, which has more non-obstructed complication rates as compared to LP shunt.

  20. Simulation of hydrocephalus condition in infant head

    Science.gov (United States)

    Wijayanti, Erna; Arif, Idam

    2014-03-01

    Hydrocephalus is a condition of an excessive of cerebrospinal fluid in brain. In this paper, we try to simulate the behavior of hydrocephalus conditions in infant head by using a hydro-elastic model which is combined with orthotropic elastic skull and with the addition of suture that divide the skull into two lobes. The model then gives predictions for the case of stenosis aqueduct by varying the cerebral aqueduct diameter, time constant and brain elastic modulus. The hydrocephalus condition which is shown by the significant value of ventricle displacement, as the result shows, is occurred when the aqueduct is as resistant as brain parenchyma for the flow of cerebrospinal fluid. The decrement of brain elastic modulus causes brain parenchyma displacement value approach ventricle displacement value. The smaller of time constant value causes the smaller value of ventricle displacement.

  1. Hydrocephalus and its treatment according to Rhazes.

    Science.gov (United States)

    Aciduman, Ahmet; Belen, Deniz

    2009-03-01

    The renowned medieval Persian physician Rhazes was an early proponent of experimental medicine. Rhazes made fundamental and enduring contributions to medicine and to other scientific fields. He wrote over 200 scientific books, more than half of which concerned medicine. He was well versed in Persian, Greek, and Indian medical knowledge, and made numerous contributions to the medical field through his own observations and discoveries. He was also a pioneer in the field of neurosurgery and, as he was predominantly a pediatrician, he dealt with the subject of hydrocephalus. A large part of his medical tome, al-Hawi, deals with head-related disorders including the hydrocephalus. Although he did not introduce novel concepts of hydrocephalus and its management, by combining the different approaches of experienced scholars he endeavored to improve treatment and knowledge of this problematic disease.

  2. Obstructive hydrocephalus due to CNS toxocariasis.

    Science.gov (United States)

    Choi, Jae-Hwan; Cho, Jae-Wook; Lee, Jae-Hyeok; Lee, Sang Weon; Kim, Hak-Jin; Choi, Kwang-Dong

    2013-06-15

    A 46-year-old man developed intermittent headache, diplopia, and visual obscuration for two months. Funduscopic examination showed optic disk swelling in both eyes. Brain MRI exhibited hydrocephalus and leptomeningeal enhancement at the prepontine cistern, left cerebellopontine angle cistern and bilateral cerebral hemisphere, and hemosiderin deposition along the cerebellar folia. CSF analysis revealed an elevated opening pressure with xanthochromic appearance and small amount of red blood cells. Antibody titer against Toxocariasis using ELISA was elevated both in blood and CSF. Obstructive hydrocephalus and hemosiderin deposition in this case may result from the active inflammatory process due to CNS toxocariasis within the subarachnoid space.

  3. SYNDROME OF HYDROCEPHALUS IN YOUNG AND MIDDLE-AGED ADULTS. REVIEW OF THE LITERATURE AND ILLUSTRATIVE CASES

    Directory of Open Access Journals (Sweden)

    Kalevski Svetoslav

    2015-03-01

    Full Text Available Introduction: A multitude of underlying reasons result in hydrocephalus (HC, and its classification remains controversial. The current study looks at patients with the Syndrome of Hydrocephalus in Young and Middle-Aged adults (SHYMA through a case series. Patients and methods: We report 35 patients with HC referred to St. Anna Multiprofile Hospital during the period 2008–2012. Inclusion criteria were decompensated congenital hydrocephalus, (DCH, acquired hydrocephalus (AHC, or idiopathic hydrocephalus (IHC in the age range of 16–55 years, treated with a ventriculo-peritoneal shunt (VPS — 17 patients were treated with Strata Adjustable Delta Valve (“Strata” group and 18 patients had Medtronic Orbis Sigma valves inserted (“Orbis Sigma” group. Results: Eight patients (22.86% had DCH, 14 (40% had AHC, and 13 (37.14% had IHC. Regardless the underlying cause for HC, all the patients had similar symptoms, mainly related to gait in 26 (74.3%, cognition in 30 (85.7%, bladder control in 20 (57.14% and chronic headaches in 24 patients (68.57%. Symptomatic improvement was achieved in 34 of the shunted 35 patients (97.14%, but the postoperative complications rate was found to be significantly lower in the “Strata” group. Conclusion: The clinical presentation of hydrocephalus in the age 16–55 years has common features presenting with syndrome of hydrocephalus in young and middle-aged adults as separate clinical entity. VPS is a feasible treatment option in SHYMA. Due to the excessive, long standing ventriculomegaly, thus sensitive compliance of brain parenchyma and high tendency to develop subdural hematomas, adjustable VPS are advisable option.

  4. Normal pressure hydrocephalus presenting as delusional disorder

    Directory of Open Access Journals (Sweden)

    Shruti Srivastava

    2015-01-01

    Full Text Available Normal pressure hydrocephalus (NPH is caused by aqueductal stenosis resulting in syndrome of gait disturbance, cognitive impairment, and urinary incontinence. Late onset psychosis should be evaluated thoroughly to rule out any organic cause. We present the case of a female patient presenting with delusions, gait disturbances, urinary incontinence in her 50s.

  5. Normal pressure hydrocephalus presenting as delusional disorder.

    Science.gov (United States)

    Srivastava, Shruti; Bhatia, Manjeet Singh; Gautam, Priyanka

    2015-01-01

    Normal pressure hydrocephalus (NPH) is caused by aqueductal stenosis resulting in syndrome of gait disturbance, cognitive impairment, and urinary incontinence. Late onset psychosis should be evaluated thoroughly to rule out any organic cause. We present the case of a female patient presenting with delusions, gait disturbances, urinary incontinence in her 50s.

  6. Neuropathology and Structural Changes in Hydrocephalus

    Science.gov (United States)

    Del Bigio, Marc R.

    2010-01-01

    In the context of spina bifida, hydrocephalus is usually caused by crowding of the posterior fossa with obstruction to cerebrospinal fluid flow from the forth ventricle, and less often by malformation of the cerebral aqueduct. Enlargement of the cerebral ventricles causes gradual destruction of periventricular white matter axons. Motor, sensory,…

  7. Edaravone reduces astrogliosis and apoptosis in young rats with kaolin-induced hydrocephalus.

    Science.gov (United States)

    Garcia, Camila Araújo Bernardino; Catalão, Carlos Henrique Rocha; Machado, Hélio Rubens; Júnior, Ivair Matias; Romeiro, Thais Helena; Peixoto-Santos, José Eduardo; Santos, Marcelo Volpon; da Silva Lopes, Luiza

    2017-03-01

    We investigated the possible neuroprotective effects of the free radical scavenger edaravone in experimental hydrocephalus. Seven-day-old Wistar rats were divided into three groups: control group (C), untreated hydrocephalic (H), and hydrocephalic treated with edaravone (EH). The H and EH groups were subjected to hydrocephalus induction by 20% kaolin intracisternal injection. The edaravone (20 mg/kg) was administered daily for 14 days from the induction of hydrocephalus. All animals were daily weighed and submitted to behavioral test and assessment by magnetic resonance imaging. After 14 days, the animals were sacrificed and the brain was removed for histological, immunohistochemical, and biochemical studies. The gain weight was similar between groups from the ninth post-induction day. The open field test performance of EH group was better (p  0.01), germinal matrix (p > 0.05), and cerebral cortex (p > 0.05), as compared to H group. We have demonstrated that administration of edaravone for 14 consecutive days after induction of hydrocephalus reduced astrocyte activity and that it has some beneficial effects over apoptotic cell death.

  8. Minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal shunt

    Institute of Scientific and Technical Information of China (English)

    Lu JIA; Guo-ping LI; Zhong-xin ZHAO; Chao YOU; Jia-gang LIU; Si-qing HUANG; Min HE; Pei-gang JI; Jie DUAN; Yi-jun ZENG

    2011-01-01

    Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared),25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP)shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.

  9. Minimally Invasive Treatment of Biventricular Hydrocephalus Caused by a Giant Basilar Apex Aneurysm via a Staged Combination of Endoscopy and Endovascular Embolization: A Case Report.

    Science.gov (United States)

    Setty, Pradeep; Volkov, Andrey; Richards, Boyd; Barrett, Ryan

    2015-01-01

    Biventricular hydrocephalus caused by a Giant Basilar Apex Aneurysm (GBAA) is a rare finding that presents unique and challenging treatment decisions. We report a case of GBAA causing a life-threatening biventricular hydrocephalus in which both the aneurysm and hydrocephalus were given definitive treatment through a staged, minimally invasive approach. An obtunded 82-year-old male was found to have biventricular hydrocephalus caused by an unruptured GBAA obstructing the foramina of Monro. The patient was treated via staged, minimally invasive technique that first involved endoscopic fenestration of the septum pellucidum to create communication between the lateral ventricles. A programmable ventriculo-peritoneal shunt was then placed with a high-pressure setting. The patient was then loaded with dual anti-platelet therapy prior to undergoing endovascular coiling of the GBAA with adjacent stenting of the Posterior Cerebral Artery. He remained on dual anti-platelet therapy and the shunt setting was lowered at the bedside to treat the hydrocephalus. At 6-month follow up, the patient had returned to his cognitive baseline, speaking fluently and appropriately. Biventricular hydrocephalus caused by a GBAA can successfully be treated in a minimally invasive fashion utilizing a combination of endoscopy and endovascular therapy, even when a stent-assisted coiling is needed.

  10. Deferoxamine attenuates acute hydrocephalus after traumatic brain injury in rats.

    Science.gov (United States)

    Zhao, Jinbing; Chen, Zhi; Xi, Guohua; Keep, Richard F; Hua, Ya

    2014-10-01

    Acute post-traumatic ventricular dilation and hydrocephalus are relatively frequent consequences of traumatic brain injury (TBI). Several recent studies have indicated that high iron levels in brain may relate to hydrocephalus development after intracranial hemorrhage. However, the role of iron in the development of post-traumatic hydrocephalus is still unclear. This study was to determine whether or not iron has a role in hydrocephalus development after TBI. TBI was induced by lateral fluid-percussion in male Sprague-Dawley rats. Some rats had intraventricular injection of iron. Acute hydrocephalus was measured by magnetic resonance T2-weighted imaging and brain hemorrhage was determined by T2* gradient-echo sequence imaging and brain hemoglobin levels. The effect of deferoxamine on TBI-induced hydrocephalus was examined. TBI resulted in acute hydrocephalus at 24 h (lateral ventricle volume: 24.1 ± 3.0 vs. 9.9 ± 0.2 mm(3) in sham group). Intraventricular injection of iron also caused hydrocephalus (25.7 ± 3.4 vs. 9.0 ± 0.6 mm(3) in saline group). Deferoxamine treatment attenuated TBI-induced hydrocephalus and heme oxygenase-1 upregulation. In conclusion, iron may contribute to acute hydrocephalus after TBI.

  11. Familial aggregation of congenital hydrocephalus in a nationwide cohort

    DEFF Research Database (Denmark)

    Munch, Tina Nørgaard; Rostgaard, Klaus; Rasmussen, Marie-Louise Hee

    2012-01-01

    The objective of the study was to investigate familial aggregation of primary congenital hydrocephalus in an unselected, nationwide population. Based on the Danish Central Person Register, we identified all children born in Denmark between 1978 and 2008 and their family members (up to third......-degree relatives). Information on primary congenital hydrocephalus was obtained from the National Patient Discharge Register. Using binomial log-linear regression, we estimated recurrence risk ratios of congenital hydrocephalus. An alternative log-linear regression model was applied to quantify the genetic effect...... and the maternal effect. Of 1 928 683 live-born children, 2194 had a diagnosis of idiopathic congenital hydrocephalus (1.1/1000). Of those, 75 (3.4%) had at least one other family member with primary congenital hydrocephalus. Significantly increased recurrence risk ratios of primary congenital hydrocephalus were...

  12. Congenital hydrocephalus in an Egyptian baby with trisomy 18: a case report

    Directory of Open Access Journals (Sweden)

    Metwalley Kotb A

    2009-11-01

    Full Text Available Abstract Introduction Trisomy 18 is the second most common autosomal trisomy after Down syndrome (trisomy 21. A variety of anomalies of the central nervous system are observed in cases of trisomy 18. The association between trisomy 18 and congenital hydrocephalus is very rare. Case presentation A 4-month-old male Egyptian baby boy was referred to Assiut University hospital for evaluation of his large-sized head. The initial clinical examination revealed facial dysmorphism including a prominent wide forehead, wide anterior fontanel, bushy eyebrows, synophrosis, small palpebral fissures, ocular hypertelorism, high arched palate, depressed nasal bridge, low-set ears, micrognathia, bilateral clenched hands with over lapping fingers, rocker-bottom feet and penile hypospadius. A computed tomography scan of the patient's head showed a dilatation of all the ventricular systems of the brain that suggested hydrocephalus. A chromosome analysis of his peripheral blood confirmed a trisomy of chromosome 18 (47, XX+18. The hydrocephalus was treated with a ventriculoperitoneal shunt because of the abnormal increase in his head circumference. He was discharged home on nasogastric feeds at the age of 5 months. Despite the advice of the medical team, his parents did not bring him for further follow up. He died at the age of 7 months due to a sudden cardiorespiratory arrest at home. Conclusion Microcephaly is not mandatory for the diagnosis of trisomy 18 syndrome because some cases of trisomy 18 can be associated with other anomalies of the central nervous system, including hydrocephalus. There is no proven explanation for this association, and the management of hydrocephalus in such a situation is not different from the usual course of management.

  13. Osteopenia, abnormal dentition, hydrops fetalis and communicating hydrocephalus.

    Science.gov (United States)

    MacDermot, K D; Buckley, B; Van Someren, V

    1995-10-01

    We describe a single male infant who developed severe hydrops fetalis between 19 and 28 weeks of gestation. After delivery at 32 weeks he was treated by hemofiltration, prolonged ventilation and intravenous feeding. He had hypertelorism, orbital hypoplasia without proptosis, brachydactyly, frontal and temporal bossing of the skull, central hypotonia, communicating hydrocephalus, and severe delay in psychomotor development. Signs of connective tissue disorder included: osteopenia, pathological fracture, yellow/grey discolored teeth, blue sclerae and easy bruising. Laboratory investigations failed to reveal the cause of fetal hydrops or collagen abnormality. His mother and one sib had learning difficulties. Although some of these findings may be due to perinatal factors, the connective tissue abnormalities suggest a genetic syndrome in the heterogeneous group of osteogenesis imperfecta. This case either represents the more severe end of the spectrum of Type IV osteogenesis imperfecta or the mild end of the spectrum of Cole-Carpenter syndrome.

  14. Neurosonography of hydrocephalus in infants. [Comparison with CT studies

    Energy Technology Data Exchange (ETDEWEB)

    Shackelford, G.D.

    1986-10-01

    Transfontanel cranial ultrasonography reliably delineates ventricular size and anatomy in small infants. In these children, it is an excellent primary imaging technique for evaluation of the many clinical problems related to ventricular dilatation. Sonography can be useful for: detecting ventriculomegaly, differentiating nonobstructive ventricular dilatation from obstructive enlargement (hydrocephalus), determining the cause of hydrocephalus; aiding in the temporary management of patients with hydrocephalus; and aiding in the management of patients with permanent ventricular shunts.

  15. Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation

    DEFF Research Database (Denmark)

    Birkeland, Peter; Lauritsen, Jens; Poulsen, Frantz Rom

    2015-01-01

    OBJECT: In this paper the authors investigate whether shunt-treated patients with normal-pressure hydrocephalus receiving aspirin therapy are at increased risk of developing subdural hematoma (SDH). METHODS: Records from 80 consecutive patients who had undergone implantation of a cerebrospinal...... fluid shunt for the treatment of normal-pressure hydrocephalus were retrospectively reviewed. RESULTS: Eleven cases of symptomatic SDH occurred, all among patients receiving aspirin or clopidogrel. The 5-year survival estimate was 0.3 (p ...% CI 3.1-53). CONCLUSIONS: Patients on an aspirin therapy regimen have a markedly increased risk of SDH after a shunt has been implanted for the treatment of normal-pressure hydrocephalus. Users of clopidogrel may have an even greater risk....

  16. Prevalence of hydrocephalus in 157 patients with vestibular schwannoma

    Energy Technology Data Exchange (ETDEWEB)

    Rogg, Jeffrey M.; Ahn, S.H.; Tung, G.A. [Rhode Island Hospital, Department of Diagnostic Imaging, Providence, Rhode Island (United States); Reinert, S.E. [Rhode Island Hospital, Lifespan Medical Computing, Providence, Rhode Island (United States); Noren, G. [Rhode Island Hospital, Department of Neurosurgery, Providence, Rhode Island (United States)

    2005-05-01

    The purpose of this study was to determine the prevalence of hydrocephalus in patients with vestibular schwannoma. A second objective was to investigate possible etiologies for hydrocephalus in this population by attempting to correlate the incidence and severity of hydrocephalus with tumor volume and extent of fourth ventricular compression. The MRI examinations of 157 adult patients with vestibular schwannoma were retrospectively reviewed. Tumor size was quantified, and the presence of accompanying hydrocephalus was assessed, categorized as communicating type or non-communicating type and then rated as mild, moderate or severe (grades 1-3). Next, the degree of fourth ventricular distortion caused by tumor mass effect was evaluated and categorized as mild, moderate or severe (grades 1-3). Spearman's rank correlation coefficient was used to test the relationships between tumor volume and (1) the extent of fourth ventricular effacement and (2) severity of hydrocephalus. Hydrocephalus was present in 28/157 (18%) cases and was categorized as mild in 11/28 (39%), moderate in 15/28 (54%) and severe in 2/28 (7%). Communicating-type hydrocephalus was present in 17/28 (61%) and non-communicating type in 11/28 (39%). There was a positive correlation between the grade of non-communicating hydrocephalus and tumor volume (r=0.38; P<0.001) and between the severity of fourth ventricular compression and extent of hydrocephalus in this group(r=0.43; P<0.001). (orig.)

  17. Coincidence classes in nonorientable manifolds

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available We study Nielsen coincidence theory for maps between manifolds of same dimension regardless of orientation. We use the definition of semi-index of a class, review the definition of defective classes, and study the occurrence of defective root classes. We prove a semi-index product formula for lifting maps and give conditions for the defective coincidence classes to be the only essential classes.

  18. Ventriculoperitoneal shunt in cryptococcal meningitis with hydrocephalus.

    Science.gov (United States)

    Tang, L M

    1990-05-01

    Fourteen patients with cryptococcal meningitis were reviewed. All patients had a ventriculoperitoneal shunt for hydrocephalus. Early recognitions and prompt relief of hydrocephalus were useful for eight patients who showed rapid deterioration of consciousness or signs of cerebral herniation. There was no surgical response in four patients who had had weeks of confusion or mental change. It seems, therefore, that the duration of disturbance of consciousness or change of mentality before shunting is critical in determination of the outcome of the treatment. Ventricular shunting was effective in relieving papilledema in five patients. However, the surgery did not prevent the development of papilledema to optic atrophy and subsequent blindness in two patients. Hence, in addition to hydrocephalus with increased intracranial pressure, conditions such as direct invasion of the optic pathways by Cryptococcus neoformans or optochiasmatic arachnoiditis may be responsible for the visual failure. Ventricular shunting was also helpful in restoring paraparesis in one patient. Of the cerebrospinal fluid determinations, low protein concentration was a favorable indicator for surgery. Of the seven patients who received the surgical procedure before the start of antifungal therapy, four showed a significant improvement despite active infection of the central nervous system. None of the seven patients deteriorated because of the surgical operation. Thus, active stage of cryptococcal meningitis does not contraindicate the necessity of shunting, and premedication with antifungal drugs is unnecessary. Also, no shunt-related morbidity and mortality was seen in this study.

  19. Endoscopic third ventriculostomy for treatment of adult hydrocephalus: long-term follow-up of 163 patients.

    Science.gov (United States)

    Isaacs, Albert M; Bezchlibnyk, Yarema B; Yong, Heather; Koshy, Dilip; Urbaneja, Geberth; Hader, Walter J; Hamilton, Mark G

    2016-09-01

    OBJECTIVE The efficacy of endoscopic third ventriculostomy (ETV) for the treatment of pediatric hydrocephalus has been extensively reported in the literature. However, ETV-related long-term outcome data are lacking for the adult hydrocephalus population. The objective of the present study was to assess the role of ETV as a primary or secondary treatment for hydrocephalus in adults. METHODS The authors performed a retrospective chart review of all adult patients (age ≥ 18 years) with symptomatic hydrocephalus treated with ETV in Calgary, Canada, over a span of 20 years (1994-2014). Patients were dichotomized into a primary or secondary ETV cohort based on whether ETV was the initial treatment modality for the hydrocephalus or if other CSF diversion procedures had been previously attempted respectively. Primary outcomes were subjective patient-reported clinical improvement within 12 weeks of surgery and the need for any CSF diversion procedures after the initial ETV during the span of the study. Categorical and actuarial data analysis was done to compare the outcomes of the primary versus secondary ETV cohorts. RESULTS A total of 163 adult patients with symptomatic hydrocephalus treated with ETV were identified and followed over an average of 98.6 months (range 0.1-230.4 months). All patients presented with signs of intracranial hypertension or other neurological symptoms. The primary ETV group consisted of 112 patients, and the secondary ETV consisted of 51 patients who presented with failed ventriculoperitoneal (VP) shunts. After the initial ETV procedure, clinical improvement was reported more frequently by patients in the primary cohort (87%) relative to those in the secondary ETV cohort (65%, p = 0.001). Additionally, patients in the primary ETV group required fewer reoperations (p hydrocephalus. The overall ETV success rate when it was the primary treatment modality for adult hydrocephalus was approximately 87%, and 99% of patients experience symptomatic

  20. Intraventricular infusion of hyperosmolar dextran induces hydrocephalus: a novel animal model of hydrocephalus

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    Krishnamurthy Satish

    2009-12-01

    Full Text Available Abstract Background Popular circulation theory of hydrocephalus assumes that the brain is impermeable to cerebrospinal fluid (CSF, and is therefore incapable of absorbing the CSF accumulating within the ventricles. However, the brain parenchyma is permeable to water due to the presence of specific ion channels as well as aquaporin channels. Thus, the movement of water into and out of the ventricles may be determined by the osmotic load of the CSF. If osmotic load determines the aqueous content of CSF in this manner, it is reasonable to hypothesize that hydrocephalus may be precipitated by pathologies and/or insults that produce sustained elevations of osmotic content within the ventricles. Methods We investigated this hypothesis by manipulating the osmotic content of CSF and assaying the development of hydrocephalus in the rat brain. This was achieved by continuously infusing artificial CSF (negative control; group I, fibroblast growth factor (FGF2 solution (positive control; group II and hyperosmotic dextran solutions (10 KD and 40 KD as experimental solutions: groups III and IV for 12 days at 0.5 μL/h. The osmolality of the fluid infused was 307, 664, 337 and 328 mOsm/L in Groups I, II, III and IV, respectively. Magnetic resonance imaging (MRI was used to evaluate the ventricular volumes. Analysis of variance (ANOVA with pairwise group comparisons was done to assess the differences in ventricular volumes among the four groups. Results Group I had no hydrocephalus. Group II, group III and group IV animals exhibited significant enlargement of the ventricles (hydrocephalus compared to group I. There was no statistically significant difference in the size of the ventricles between groups II, III and IV. None of the animals with hydrocephalus had obstruction of the aqueduct or other parts of CSF pathways on MRI. Conclusion Infusing hyperosmolar solutions of dextran, or FGF into the ventricles chronically, resulted in ventricular enlargement. These

  1. Evaluation of functional outcomes in congenital hydrocephalus

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    N K Venkataramana

    2011-01-01

    Full Text Available Aim: The long term outcomes of congenital hydrocephalus are still not clearly known despite it being a common clinical condition. Several clinical, radiological factors were correlated to predict the functional outcomes. This study aimed to correlate the clinical, radiological parameters with the regional functional outcomes of the brain. Materials and Methods: Children with congenital hydrocephalus were divided into Group A with hydrocephalus alone and Group B hydrocephalus with spina bifida. Ventriculoperitoneal shunt surgery was performed by the same surgeon. CT scans and neuropsychological assessments were performed before and serially after the shunt. The clinical and the radiological findings were correlated with the developmental levels during the follow-up. Results: There were 25 children in Group A and 15 children in Group B; 72% in Group A and 93% in Group B were less than 6 months of age at the time of treatment. Forty percent in Group A and 92% in Group B had the signs of hydrocephalus at admission. Cerebrospinal fluid (CSF diversion results in the reduction in ventricular dilatation and corresponding increase in the cortical mantle thickness. The ventricular size and the cortical mantle thickness were measured serially and correlated with the development in the neuropsychological function. In this study, 80% in Group B reached near normal development in comparison to 33% in Group A. We have noticed a significant correlation in the increase in the regional cortical mantle thickness with corresponding improvement in the functional development. This clearly ratifies the improvement in the frontal and parietal areas having their distinctive effect on the functional development of the child. Conclusion: Early CSF diversion and timely intervention seems to benefit functional recovery. It is interesting to note that reconstitution of cortical mantle in different areas of the brain showing corresponding improvement in their respective areas

  2. Phenotypic characteristics of hydrocephalus in stillborn Friesian foals.

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    Sipma, K D; Cornillie, P; Saulez, M N; Stout, T A E; Voorhout, G; Back, W

    2013-11-01

    Hydrocephalus is uncommon in horses. However, in recent years, it has become clear that the prevalence of hydrocephalus is greater in Friesian horses than in other breeds probably due to their limited gene pool. Before identification of candidate genes that predispose to the development of hydrocephalus in Friesian horses can be pursued, an in-depth, phenotypic, pathological description of the condition in Friesians would be of great benefit. Our study aimed to characterize the morphology of hydrocephalus in Friesian horses, to support further investigation of the genetic background of this condition. Four stillborn Friesian foals with hydrocephalus were examined macroscopically and microscopically and compared with 2 normal stillborn Friesian foals without hydrocephalus. In all clinical cases, tetraventricular and venous dilatations were observed, together with malformation of the petrosal bone and, as a result, narrowing of the jugular foramen. These observations suggest a communicative hydrocephalus with a diminished absorption of cerebrospinal fluid into the systemic circulation at the venous sinuses due to a distorted, nonfunctional jugular foramen. This type of hydrocephalus is also recognized in humans and dogs and has been linked genetically to chondrodysplasia; this has already been recognized in dwarfism, which is another monogenetic defect in Friesian horses.

  3. Hydrocephalus in adults with community-acquired bacterial meningitis

    NARCIS (Netherlands)

    E. Soemirien Kasanmoentalib; M.C. Brouwer; A. van der Ende; D. van de Beek

    2010-01-01

    Objective: To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. Methods: Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. Results: Hydrocephalus was diagnosed in 26 of 577 epi

  4. Late onset hydrocephalus in children with tuberculous meningitis

    Science.gov (United States)

    Sharma, Disha; Shah, Ira; Patel, Sharad

    2016-01-01

    Hydrocephalus is a known complication of tuberculous meningitis (TBM). It is almost always present in patients who have had the disease for four to six weeks. However, hydrocephalus can also develop later in the disease course as seen in our 3 patients. All 3 patients had multi-drug resistant (MDR) tuberculosis (TB) and developed hydrocephalus after variable time after starting second line anti-tuberculous therapy (ATT). A 7 years old girl had hydrocephalus at onset of TBM and was shunted but the hydrocephalus increased in size after 6 months of being on second line ATT in spite of a patent ventricular peritoneal (VP) shunt. Hydrocephalus responded to oral acetazolamide. Other 2 patients, a 2 years old girl and 3½ years old boy developed hydrocephalus after being on treatment for 14 months. Both required insertion of VP shunt. Thus, in patients with MDR-TB, hydrocephalus may develop as late onset phenomenon and a neurological examination would be essential in each visit to the hospital.

  5. Meaning Construction and Integration in Children with Hydrocephalus

    Science.gov (United States)

    Barnes, Marcia A.; Faulkner, Heather; Wilkinson, Margaret; Dennis, Maureen

    2004-01-01

    Text comprehension processes were investigated in children with hydrocephalus, a neurodevelopmental disorder associated with good word decoding, but deficient reading comprehension. In Experiment 1, hydrocephalus and control groups were similar in processes related to activating word meanings and using context to enhance meaning. The hydrocephalus…

  6. Lateral intraventricular epidermoid in a child with hydrocephalus

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    B Aher Rajendra

    2012-01-01

    Full Text Available Lateral intraventricular tumors are uncommon. They grow linearly rather than exponentially and hence are slow-growing lesions without causing mass effects and hydrocephalus. We report a rare case of large bulky right intraventricular epidermoid tumor in a child. This tumor was associated with mass effect on the surrounding structures and hydrocephalus.

  7. Treatment of acute hydrocephalus and cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    D. Hasan (Djo)

    1990-01-01

    textabstractOnly recently has acute hydrocephalus after subarachnoid hemorrhage been recognized as a clinical important problem. The mortality rate in patients with acute hydrocephalus after subarachnoid hemorrhage is higher than in those without, which is mainly caused by cerebral ischemia. An expl

  8. Treatment of acute hydrocephalus and cerebral ischemia after subarachnoid hemorrhage

    NARCIS (Netherlands)

    D. Hasan (Djo)

    1990-01-01

    textabstractOnly recently has acute hydrocephalus after subarachnoid hemorrhage been recognized as a clinical important problem. The mortality rate in patients with acute hydrocephalus after subarachnoid hemorrhage is higher than in those without, which is mainly caused by cerebral ischemia. An

  9. Revisiting hydrocephalus as a model to study brain resilience.

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    Matheus Fernandes De Oliveira

    2012-01-01

    Full Text Available Hydrocephalus is an entity which embraces a variety of diseases whose final result is the enlarged size of cerebral ventricular system, partially or completely. The physiopathology of hydrocephalus lies in the dynamics of circulation of cerebrospinal fluid (CSF. The consequent CSF stasis in hydrocephalus interferes with cerebral and ventricular system development. Children and adults who sustain congenital or acquired brain injury typically experience a diffuse insult that impacts many areas of the brain. Development and recovery after such injuries reflects both restoration and reorganization of cognitive functions. Classic examples were already reported in literature. This suggests the presence of biological mechanisms associated with resilient adaptation of brain networks. We will settle a link between the notable modifications to neurophysiology secondary to hydrocephalus and the ability of neuronal tissue to reassume and reorganize its functions.Key words: hydrocephalus; resilience; brain; neural networks; plasticity.

  10. Video Histories, Memories, and Coincidences

    DEFF Research Database (Denmark)

    Kacunko, Slavko

    2012-01-01

    Looping images allows us to notice things that we have never noticed before. Looping a small but exquisite selection of the video tapes of Marcel Odenbach, Dieter Kiessling and Matthias Neuenhofer may allow the discovering of Histories, Coincidences, and Infinitesimal Aesthetics inscribed...... into the Video medium as its unsurpassed topicality....

  11. Extensive spinal epidural abscess complicated with hydrocephalus

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    Balan Corneliu

    2015-12-01

    Full Text Available Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage.

  12. Cerebrospinal fluid biomarkers of infantile congenital hydrocephalus

    Science.gov (United States)

    Limbrick, David D.; Baksh, Brandon; Morgan, Clinton D.; Habiyaremye, Gakwaya; McAllister, James P.; Inder, Terrie E.; Mercer, Deanna; Holtzman, David M.; Strahle, Jennifer; Wallendorf, Michael J.; Morales, Diego M.

    2017-01-01

    Introduction Hydrocephalus is a complex neurological disorder with a pervasive impact on the central nervous system. Previous work has demonstrated derangements in the biochemical profile of cerebrospinal fluid (CSF) in hydrocephalus, particularly in infants and children, in whom neurodevelopment is progressing in parallel with concomitant neurological injury. The objective of this study was to examine the CSF of children with congenital hydrocephalus (CHC) to gain insight into the pathophysiology of hydrocephalus and identify candidate biomarkers of CHC with potential diagnostic and therapeutic value. Methods CSF levels of amyloid precursor protein (APP) and derivative isoforms (sAPPα, sAPPβ, Aβ42), tau, phosphorylated tau (pTau), L1CAM, NCAM-1, aquaporin 4 (AQP4), and total protein (TP) were measured by ELISA in 20 children with CHC. Two comparative groups were included: age-matched controls and children with other neurological diseases. Demographic parameters, ventricular frontal-occipital horn ratio, associated brain malformations, genetic alterations, and surgical treatments were recorded. Logistic regression analysis and receiver operating characteristic curves were used to examine the association of each CSF protein with CHC. Results CSF levels of APP, sAPPα, sAPPβ, Aβ42, tau, pTau, L1CAM, and NCAM-1 but not AQP4 or TP were increased in untreated CHC. CSF TP and normalized L1CAM levels were associated with FOR in CHC subjects, while normalized CSF tau levels were associated with FOR in control subjects. Predictive ability for CHC was strongest for sAPPα, especially in subjects ≤12 months of age (p<0.0001 and AUC = 0.99), followed by normalized sAPPβ (p = 0.0001, AUC = 0.95), tau, APP, and L1CAM. Among subjects ≤12 months, a normalized CSF sAPPα cut-point of 0.41 provided the best prediction of CHC (odds ratio = 528, sensitivity = 0.94, specificity = 0.97); these infants were 32 times more likely to have CHC. Conclusions CSF proteins such as s

  13. Normal pressure hydrocephalus: did publications alter management?

    Science.gov (United States)

    Vanneste, J; van Acker, R

    1990-07-01

    Forty six Dutch neurologists and neurosurgeons were interviewed to evaluate the clinical value of research articles on normal pressure hydrocephalus (NPH). From this survey it appears that most clinicians still limit investigations to psychometry, CSF-tap test(s), and cisternography. The main reasons for not using other techniques were: their invasiveness, technical complexity, poor availability, lack of time and doubt on their additional predictive value. There is an obvious discrepancy between the quantity of publications on NPH and their impact and their ability to assist clinicians in selecting potential NPH patients for a shunt.

  14. Minocycline inhibits glial proliferation in the H-Tx rat model of congenital hydrocephalus

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    Miller Janet M

    2010-05-01

    Full Text Available Abstract Background Reactive astrocytosis and microgliosis are important features of the pathophysiology of hydrocephalus, and persistent glial "scars" that form could exacerbate neuroinflammation, impair cerebral perfusion, impede neuronal regeneration, and alter biomechanical properties. The purpose of this study was to determine the efficacy of minocycline, an antibiotic known for its anti-inflammatory properties, to reduce gliosis in the H-Tx rat model of congenital hydrocephalus. Methods Minocycline (45 mg/kg/day i.p. in 5% sucrose at a concentration of 5-10 mg/ml was administered to hydrocephalic H-Tx rats from postnatal day 15 to day 21, when ventriculomegaly had reached moderate to severe stages. Treated animals were compared to age-matched non-hydrocephalic and untreated hydrocephalic littermates. The cerebral cortex (both gray matter laminae and white matter was processed for immunohistochemistry (glial fibrillary acidic protein, GFAP, for astrocytes and ionized calcium binding adaptor molecule, Iba-1, for microglia and analyzed by qualitative and quantitative light microscopy. Results The mean number of GFAP-immunoreactive astrocytes was significantly higher in untreated hydrocephalic animals compared to both types of controls (p p p Conclusions Overall, these data suggest that minocycline treatment is effective in reducing the gliosis that accompanies hydrocephalus, and thus may provide an added benefit when used as a supplement to ventricular shunting.

  15. Obstructive hydrocephalus, fifth nerve and hypothalamus involvement: acute presentation of a giant prolactinoma.

    Science.gov (United States)

    Alkatari, Shadin; Aljohani, Naji

    2012-01-01

    Pituitary tumors from lactotrope cells account for about 40% of all functioning pituitary cancers. Men tend to present with a larger, more invasive and rapid growth prolactinomas than women, possibly because hypogonadism features are less evident. A 27-year-old, previously asymptomatic Saudi man presented with a 3-day history of emesis with severe left-sided frontal headache, left face and right upper limb numbness, with signs of obstructive hydrocephalus. Brain Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a giant pituitary mass occupying several regions (sellar, infra-sellar, and supra-sellar) measuring 6.5 × 5.7 × 5.9 cm, and invading the sphenoid sinus as well as the cavernous sinuses bilaterally, with intra-pituitary hemorrhage compressing the third ventricle causing obstructive hydrocephalus. Prolactin levels were >200,000 mIU/L, consistent with invasive giant prolactinoma (IGP). He was treated with Cabergoline which eventually normalized the prolactin level and significantly reduced the size of IGP. This is a rare case of obstructive hydrocephalus with super-imposed intra-pituitary hemorrhage secondary to IGP, highlighting the importance of a full hormonal assessment for proper diagnosis and management.

  16. Pathophysiology of shunt dysfunction in shunt treated hydrocephalus

    DEFF Research Database (Denmark)

    Blegvad, C.; Skjolding, A D; Broholm, H

    2013-01-01

    We hypothesized that shunt dysfunction in the ventricular catheter and the shunt valve is caused by different cellular responses. We also hypothesized that the cellular responses depend on different pathophysiological mechanisms....

  17. Clinical benefits of diffusion tensor imaging in hydrocephalus.

    Science.gov (United States)

    Ben-Sira, Liat; Goder, Noam; Bassan, Haim; Lifshits, Shlomi; Assaf, Yaniv; Constantini, Shlomi

    2015-08-01

    OBJECT The object of this study was to use diffusion tensor imaging (DTI) to evaluate and characterize white matter changes in hydrocephalus. METHODS The authors performed a retrospective analysis of DTI in a cohort of patients with hydrocephalus (n = 35), 19 of whom had both pre- and postsurgical imaging studies. These patient's DTI values were compared with values extracted from age-dependent trend lines computed from a healthy subject group (n = 70, age span 14 months-14 years). Several DTI parameters in different regions of interest (ROIs) were evaluated to find the most sensitive parameters for clinical decision making in hydrocephalus. RESULTS Compared with healthy controls, patients with active hydrocephalus had a statistically significant change in all DTI parameters. The most sensitive and specific DTI parameter for predicting hydrocephalus was axial diffusivity (λ1) measured at the level of the corona radiata. Diffusion tensor imaging parameters correlated with several conventional radiological parameters in the assessment of hydrocephalus but were not superior to them. There was no convincing correlation between clinical disease severity and DTI parameters. When examining the pre- and postsurgical effect, it was found that DTI may be a sensitive tool for estimating tissue improvement. CONCLUSIONS This large-cohort study with a multidisciplinary approach combining clinical, neurological, radiological, and multiple DTI parameters revealed the most sensitive DTI parameters for identifying hydrocephalus and suggested that they may serve as an important tool for the disorder's quantitative radiological assessment.

  18. Hearing loss in hydrocephalus: a review, with focus on mechanisms.

    Science.gov (United States)

    Satzer, David; Guillaume, Daniel J

    2016-01-01

    While neither hydrocephalus nor cerebrospinal fluid (CSF) shunt placement is traditionally considered in the differential diagnosis of hearing loss, there is substantial evidence that CSF circulation and pressure abnormalities can produce auditory dysfunction. Several indirect mechanisms may explain association between hydrocephalus and hearing loss, including mass effect, compromise of the auditory pathway, complications of prematurity, and genetically mediated hydrocephalus and hearing loss. Nevertheless, researchers have proposed a direct mechanism, which we term the hydrodynamic theory. In this hypothesis, the intimate relationship between CSF and inner ear fluids permits relative endolymphatic or perilymphatic hydrops in the setting of CSF pressure disturbances. CSF is continuous with perilymph, and CSF pressure changes are known to produce parallel perilymphatic pressure changes. In support of the hydrodynamic theory, some studies have found an independent association between hydrocephalus and hearing loss. Moreover, surgical shunting of CSF has been linked to both resolution and development of auditory dysfunction. The disease burden of hydrocephalus-associated hearing loss may be large, and because hydrocephalus and over-shunting are reversible, this relationship merits broader recognition. Hydrocephalic patients should be monitored for hearing loss, and hearing loss in a patient with shunted hydrocephalus should prompt further evaluation and possibly adjustment of shunt settings.

  19. 动脉瘤性蛛网膜下腔出血患者行腰大池置管引流治疗发生分流依赖性脑积水的相关因素研究%Study on relevant factors of shunt-dependent hydrocephalus when occurred in aSAH patients given lumbar catheter drainage treat-ment

    Institute of Scientific and Technical Information of China (English)

    侯双兴; 夏峰

    2014-01-01

    Objective To study relevant factors of aneurysmal subarachnoid hemorrhage( aSAH)patients given lumbar catheter drainage treatment when occurring shunt-dependent hydrocephalus. Methods Retrospective analysis May 2010 to August 2013 for treatment of aSAH clinical data of 42 cases. All patients Hunt-Hess grade classification grade Ⅰ ~ Ⅲ,underwent surgery;surgery during or after surgery,1~3 d for all patients with lumbar catheter drainage treatment. According to shunt-dependent hydrocephalus to analysis Hunt-Hess grade,the aver-age number of days of catheterization,acute ventricular dilatation,aneurysm location and surgical approach were observed. Results Seven cases (16. 7%)occurred shunt dependency hydrocephalus in 42 patients. ①which admission Hunt-Hess grade 1 to gradeⅠcases,Ⅱgrade 2 cases,Ⅲ grade 4 patients,Hunt-Hess more likely in patients with high shunt-dependent hydrocephalus. ②occurrence of cerebral shunt-dependent hydrocephalus patients with lumbar puncture tube was significantly longer than the average number of days hydrocephalus patients(14. 7 ± 1. 9 d ratio of 8. 9 ± 1. 8 d)did not occur. ③proportion of patients with acute ventricular dilatation occurs hydrocephalus does not appear significantly higher in patients with acute ventricular dilatation(44. 4% compared with 9. 1%). Communicating artery aneurysm and posterior circulation aneu-rysms after. ④shunt-dependent hydrocephalus highest incidence was 33. 3% in posterior circulation aneurysm;followed by 25. 0% in the poste-rior communicating artery aneurysm. ⑤line treatment of patients with surgical clipping of the emergence of shunt-dependent hydrocephalus ratio endovascular embolization patients(14. 8% compared to 20. 0%)below the line,but the difference was not statistically significant. Conclusion Occurs when treatment aneurysmal subarachnoid hemorrhage patients underwent drainage shunt -dependent hydrocephalus and Hunt -Hess grade level,the position of the aneurysm

  20. RELATIVE FREQUENCY OF HYDROCEPHALUS IN RASHT PEDIATRIC PATIENTS

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    Elham BIDABADI

    2011-02-01

    Full Text Available ObjectiveThere are few studies evaluating the relative frequency of different etiologies of hydrocephalus in pediatric population, in Iran; therefore, this topic was considered in the present study.Material & MethodsIn a prospective study, the study group consisted of all children fulfilling the imaging criteria for having hydrocephalus, aged below 12 years, admitted at Rasht 17th Shahrivar and Poursina Hospitals, between March 2006 andSeptember 2008. Demographic data and information on the etiology and type of hydrocephalus, and surgical and pathological diagnosis were recorded for all cases. All data were analyzed with SPSS version 13 software.ResultsThere were a total of 67 patients, with a mean age of 33.25 ± 43.40 months. Hydrocephalus was seen most frequently in the first 2 years of life. Thirty three patients (49.3% were female and 34 (50.7% were male. Mean age of the girls and boys was 30.78 ± 46.46 and 35.64 ± 40.77 months, respectively (p=0.650. Communicating and obstructive hydrocephalus was seen in 30(44.8% and 37 cases (55.2%, respectively. There was no statistically significant difference in the types of  ydrocephalus between the two sex groups. Mean age in obstructive and communicating groups was 3.76 ± 46.17 and 35.09 ± 40.42months, respectively (p=0.0006. The most common causes of hydrocephalus were myelomeningocele for obstructive (19.4% of total cases, and TORCH and meningitis for communicating (8.9% of total cases for each.ConclusionIn our study, there was a mild preponderance for male sex and obstructivetype. Mean age of the patients with obstructive hydrocephalus was significantlylower than those with communicating type. Overall, the most common causeof hydrocephalus was myelomeningocele.Keywords: Child, Hydrocephalus, Etiology.

  1. Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Liu, Ann; Sankey, Eric W; Jusué-Torres, Ignacio; Patel, Mira A; Elder, Benjamin D; Goodwin, C Rory; Hoffberger, Jamie; Lu, Jennifer; Rigamonti, Daniele

    2016-04-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that classically presents with a triad of progressive gait impairment, urinary incontinence, and cognitive deterioration. Treatment predominantly involves ventriculoperitoneal (VP) shunting, but one alternative is ventriculoatrial (VA) shunting. This study sought to describe and evaluate the clinical outcomes of patients with iNPH primarily treated with VA shunting. A retrospective review of patients with iNPH who were treated with VA shunting at a single institution, from 2003 to 2013, was performed. 58 patients with iNPH underwent primary VA shunting at a median age of 74 (IQR: 70-80) years. The most common comorbidities included hypertension (n=39, 67%) and diabetes mellitus (n=11, 19%). Median duration of symptoms prior to VA shunting was 24 (IQR: 12-36) months. All patients had gait impairment, 52 (90%) had cognitive decline, and 43 (74%) had urinary incontinence. Forty-three (74%) patients had all three symptoms. At a median last follow-up of 16 (IQR: 7-26) months, median iNPH score improved from 6 to 3 (pTinetti score improved from 19 to 25 (pscore, TUG, and Tinetti score, while improvement in MMSE trended toward significance. Patients also had improvement of clinical symptoms related to gait, urinary function and cognition. These results suggest that VA shunting can be an effective primary treatment alternative to VP shunting for iNPH. Published by Elsevier B.V.

  2. Vertebrobasilar Dolichoectasia Induced Hydrocephalus: the Water-Hammer Effect.

    Science.gov (United States)

    Zisimopoulou, Vaso; Ntouniadaki, Aikaterini; Aggelidakis, Panagiotis; Siatouni, Anna; Gatzonis, Stylianos; Tavernarakis, Antonios

    2015-04-24

    Vertebrobasilar dolichoectasia is a clinical entity associated rarely with obstructive hydrocephalus. We present a 48-year old male with a profound dilatation of the ventricular system due to a dolichoectatic basilar artery, as appeared in imaging studies. The patient suffered from longstanding hydrocephalus and presenile dementia. The underlying mechanism for obstructive hydrocephalus due to vertebrobasilar dolichoectasia is considered to be both a water-hammer effect and a direct compression of adjacent structures. We suggest prompt surgical intervention upon diagnosis as a first choice treatment in order to avoid further complications.

  3. Vertebrobasilar dolichoectasia induced hydrocephalus: the water-hammer effect

    Directory of Open Access Journals (Sweden)

    Vaso Zisimopoulou

    2015-05-01

    Full Text Available Vertebrobasilar dolichoectasia is a clinical entity associated rarely with obstructive hydrocephalus. We present a 48-year old male with a profound dilatation of the ventricular system due to a dolichoectatic basilar artery, as appeared in imaging studies. The patient suffered from longstanding hydrocephalus and presenile dementia. The underlying mechanism for obstructive hydrocephalus due to vertebrobasilar dolichoectasia is considered to be both a water-hammer effect and a direct compression of adjacent structures. We suggest prompt surgical intervention upon diagnosis as a first choice treatment in order to avoid further complications.

  4. The role of endoscopic third ventriculostomy in the treatment of triventricular hydrocephalus seen in children with achondroplasia.

    Science.gov (United States)

    Etus, Volkan; Ceylan, Savas

    2005-09-01

    The authors of this paper describe two patients with achondroplasia in whom triventricular hydrocephalus has been successfully treated using endoscopic third ventriculostomy (ETV). The authors performed ETVs in two children with achondroplasia involving a moderate macrocranium and enlarged lateral and third ventricles with intermittent clinical evidence of increased intracranial pressure. The endoscopic procedure revealed a significant deformation of the floor of the third ventricle in both patients caused by longstanding hydrocephalus. Because of the anatomical variations such as empty sella and the persistence of the infundibular recess, the ETV procedure became technically demanding. The standard ventriculostomy on the tuber cinereum was not possible. Ventriculostomies were performed on the part of the third ventricular floor that was hanging ventral to the pons. Both patients became symptom free postoperatively, and phase-contrast cine magnetic resonance (MR) imaging studies confirmed the patency and effectivity of the ventriculostomy sites. The authors suggest that ETVs may constitute an alternative for ventriculoperitoneal shunt therapy as the treatment of choice for patients with achondroplasia who have triventricular hydrocephalus and clinical symptoms. Attention should be paid to the shape of the floor of the third ventricle, however, especially in cases of longstanding hydrocephalus. An association of the empty sella or the persistence of the infundibular recess must be carefully evaluated using MR imaging studies before attempting ETVs in such patients.

  5. Contemporary occurrence of hydrocephalus and Chiari I malformation in sagittal craniosynostosis. Case report and review of the literature.

    Science.gov (United States)

    Sgulò, Francesco Giovanni; Spennato, Pietro; Aliberti, Ferdinando; Di Martino, Giuliana; Cascone, Daniele; Cinalli, Giuseppe

    2017-01-01

    Chiari malformation type I (CM-I) and hydrocephalus are often associated with complex craniosynostosis. On the contrary, their simultaneous occurrence in monosutural synostosis is extremely rare. The pathophysiological hypothesis is that they may alter posterior fossa growth and lead to cerebellar tonsil herniation also without skull base primary involvement. Hydrocephalus is multifactorial and may be secondary to fourth ventricle outlet obstruction. The management of these cases is quite complex and not well defined. Cranial vault remodeling should be the only treatment when CM-I is asymptomatic and not related to syringomyelia. Suboccipital decompression should be reserved only in complicated CM-I, usually as a second surgical step following the correction of the supratentorial deformity. In our opinion, the associated hydrocephalus should be treated first in order to normalize intracranial hypertension before opening the cranial sutures. We report the case of a 26-month-old child that presented with sagittal craniosynostosis, hydrocephalus, and CM-I. He was managed by performing endoscopic third ventriculostomy (ETV) first and cranial vault remodeling thereafter. Clinico-radiological outcome was very satisfying. Concerning literature is reviewed; physiopathology and surgical management are discussed.

  6. Subdural fluid collection and hydrocephalus following cervical schwannoma resection: hydrocephalus resolution after spinal pseudomeningocele repair: case report.

    Science.gov (United States)

    Benedetto, Nicola; Cagnazzo, Federico; Gambacciani, Carlo; Perrini, Paolo

    2016-12-01

    The authors report the case of a 31-year-old man who developed neck pain and headache 2 months after the uncomplicated resection of a cervical schwannoma. MR imaging revealed infratentorial subdural fluid collections and obstructive hydrocephalus associated with cervical pseudomeningocele. The clinical symptoms, subdural fluid collections, and ventricular dilation resolved after surgical correction of the pseudomeningocele. This report emphasizes that hydrocephalus may be related to disorders of cerebrospinal fluid flow dynamics induced by cervical pseudomeningocele. In these rare cases, both the hydrocephalus and the symptoms are resolved by the simple correction of the pseudomeningocele.

  7. Chronic hydrocephalus after experimental subarachnoid hemorrhage.

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    Peter Lackner

    Full Text Available Chronic communicating hydrocephalus is a significant health problem affecting up to 20% of survivors of spontaneous subarachnoid hemorrhage (SAH. The development of new treatment strategies is hampered by the lack of well characterized disease models. This study investigated the incidence of chronic hydrocephalus by evaluating the temporal profile of intracranial pressure (ICP elevation after SAH, induced by endovascular perforation in rats. Twenty-five adult male Sprague-Dawley rats (260-320 g were subjected to either endovascular perforation or sham surgery. Five animals died after SAH induction. At 7, 14 and 21 days after surgery ICP was measured by stereotaxic puncture of the cisterna magna in SAH (n=10 and SHAM (n=10 animals. On day 21 T-maze test was performed and the number of alterations and latency to decision was recorded. On day 23, samples were processed for histological analyses. The relative ventricle area was evaluated in coronal Nissl stained sections. On day 7 after surgery all animals showed normal ICP. The absolute ICP values were significantly higher in SAH compared to SHAM animals on day 21 (8.26±4.53 mmHg versus 4.38±0.95 mmHg but not on day 14. Observing an ICP of 10 mmHg as cut-off, 3 animals showed elevated ICP on day 14 and another animal on day 21. The overall incidence of ICP elevation was 40% in SAH animals. On day 21, results of T-maze testing were significantly correlated with ICP values, i.e. animals with elevated ICP showed a lower number of alterations and a delayed decision. Histology yielded a significantly higher (3.59 fold increased relative ventricle area in SAH animals with ICP elevation compared to SAH animals without ICP elevation. In conclusion, the current study shows that experimental SAH leads to chronic hydrocephalus, which is associated with ICP elevation, behavioral alterations and ventricular dilation in about 40% of SAH animals.

  8. Acute obstructive hydrocephalus complicating decompression surgery of the craniovertebral junction

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    Ohya, Junichi; Chikuda, Hirotaka; Nakatomi, Hirofumi; Sakamoto, Ryuji; Saito, Nobuhito; Tanaka, Sakae

    2016-01-01

    Obstructive hydrocephalus has been described as a rare complication following foramen magnum decompression for Chiari malformation. However, there are few reports of obstructive hydrocephalus after spinal surgery for other pathologies of the craniovertebral junction (CVJ). The authors herein report a 52-year-old female with achondroplasia presenting with an 8-month history of myelopathy due to spinal cord compression at CVJ. She underwent resection of the C1 posterior arch and part of the edge of the occipital bone. A computed tomography (CT) scan obtained 1-week after the surgery revealed bilateral infratentorial fluid collection. The patient was first managed conservatively; however, on the 17th day, her consciousness level showed sudden deterioration. Emergency CT demonstrated marked hydrocephalus due to obstruction of the cerebral aqueduct. Acute obstructive hydrocephalus can occur late after decompression surgery at the CVJ, and thus should be included in the differential diagnosis of a deteriorating mental status. PMID:27366268

  9. Low-Field Magnetic Resonance Imaging of Canine Hydrocephalus

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    Z. Adamiak* and M. Jaskólska and A. Pomianowski1

    2012-01-01

    Full Text Available The aim of presented study was to evaluate selected surface spine coil, and low-field magnetic resonance (MR selected sequences in diagnosing hydrocephalus in dogs. This paper discusses 19 dogs (14 canine patients with hydrocephalus and 5 healthy dogs, of five breeds, subjected to low-field magnetic resonance imaging (MRI of hydrocephalus. Area of the lateral ventricles and brain were examined in dogs with hydrocephalus using low-field MRI (at 0.25 Tesla. The MRI of FSE REL, SE, FLAIR, STIR, 3D HYCE, T3DT1, GE STIR 3D and 3D SHARC sequences with an indication of the most effective sequences are described. Additionally, coils for MR were compared, and models for infusion anesthesia were described. As a result of performed study all estimated sequences were diagnostically useful. However, spinal coil No. 2 (ESAOTE was the most optimal for examining and positioning the cranium.

  10. RELATIVE FREQUENCY OF HYDROCEPHALUS IN RASHT PEDIATRIC PATIENTS

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    Elham Bidabadi

    2010-12-01

    Full Text Available AbstractObjectiveThere are few studies evaluating the relative frequency of different etiologies of hydrocephalus in pediatric population, in Iran; therefore, this topic was considered in the present study.Material & MethodsIn a prospective study, the study group consisted of all children fulfilling the imaging criteria for having hydrocephalus, aged below 12 years, admitted at Rasht 17th Shahrivar and Poursina Hospitals, between March 2006 andSeptember 2008. Demographic data and information on the etiology and type of hydrocephalus, and surgical and pathological diagnosis were recorded for all cases. All data were analyzed with SPSS version 13 software.ResultsThere were a total of 67 patients, with a mean age of 33.25 ± 43.40 months. Hydrocephalus was seen most frequently in the first 2 years of life. Thirty three patients (49.3% were female and 34 (50.7% were male. Mean age of the girls and boys was 30.78 ± 46.46 and 35.64 ± 40.77 months, respectively (p=0.650. Communicating and obstructive hydrocephalus was seen in 30(44.8% and 37 cases (55.2%, respectively. There was no statistically significant difference in the types of ydrocephalus between the two sex groups. Mean age in obstructive and communicating groups was 3.76 ± 46.17 and 35.09 ± 40.42months, respectively (p=0.0006. The most common causes of hydrocephalus were myelomeningocele for obstructive (19.4% of total cases, and TORCH and meningitis for communicating (8.9% of total cases for each.ConclusionIn our study, there was a mild preponderance for male sex and obstructivetype. Mean age of the patients with obstructive hydrocephalus was significantlylower than those with communicating type. Overall, the most common causeof hydrocephalus was myelomeningocele.

  11. In vitro flow measurements in ion sputtered hydrocephalus shunts

    Science.gov (United States)

    Cho, Y. I.; Back, L. H.

    1989-01-01

    This paper describes an experimental procedure for accurate measurements of the pressure-drop/flow rate relationship in hydrocephalus shunts. Using a fish-hook arrangement, small flow rates in a perforated ion-sputtered Teflon microtubule were measured in vitro in a pressured system and were correlated with pressure in the system. Results indicate that appropriate drainage rates could be obtained in the physiological range for hydrocephalus shunts.

  12. Cerebrospinal Fluid Dynamics and the Pathophysiology of Hydrocephalus: New Concepts.

    Science.gov (United States)

    Yamada, Shinya; Kelly, Erin

    2016-04-01

    Many controversies remain regarding basic cerebrospinal fluid (CSF) physiology and the mechanism behind the development of hydrocephalus. Recent information obtained from CSF time spatial spin labeling inversion pulse method discovers different aspect of CSF dynamics. In this article, we would discuss how recent CSF imaging advances are leading to new concepts of CSF flow dynamics and the pathophysiology of hydrocephalus, with an emphasis on time spatial spin labeling inversion pulse imaging of CSF dynamics.

  13. Digital coincidence counting - initial results

    Science.gov (United States)

    Butcher, K. S. A.; Watt, G. C.; Alexiev, D.; van der Gaast, H.; Davies, J.; Mo, Li; Wyllie, H. A.; Keightley, J. D.; Smith, D.; Woods, M. J.

    2000-08-01

    Digital Coincidence Counting (DCC) is a new technique in radiation metrology, based on the older method of analogue coincidence counting. It has been developed by the Australian Nuclear Science and Technology Organisation (ANSTO), in collaboration with the National Physical Laboratory (NPL) of the United Kingdom, as a faster more reliable means of determining the activity of ionising radiation samples. The technique employs a dual channel analogue-to-digital converter acquisition system for collecting pulse information from a 4π beta detector and an NaI(Tl) gamma detector. The digitised pulse information is stored on a high-speed hard disk and timing information for both channels is also stored. The data may subsequently be recalled and analysed using software-based algorithms. In this letter we describe some recent results obtained with the new acquistion hardware being tested at ANSTO. The system is fully operational and is now in routine use. Results for 60Co and 22Na radiation activity calibrations are presented, initial results with 153Sm are also briefly mentioned.

  14. Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

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    Watt Sara

    2012-09-01

    Full Text Available Abstract Background A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS, the “virtual off” setting and compatibility with magnetic resonance imaging (MRI. Findings Forty-two patients with hydrocephalus from different etiologies were treated with the CertasTM adjustable shunt system. Data regarding implantation procedures, the use of the TMS system, x-ray imaging, and MRI procedures were recorded prospectively. All patients had clinical follow-up at four weeks after implantation and every three months until a stable clinical condition was obtained. The mean time for follow-up was 8.6 months (1–16.6. Seventy-one adjustments were performed with the TMS, 12 were problematic. Twenty-nine MRI procedures were performed and did not cause accidental resetting. Five patients were treated with the "virtual off" function for a period. Conclusions We found the CertasTM valve valuable in the treatment of hydrocephalus, usability of the TMS was high because it is small and portable, but in some cases we experienced adjustment problems with the first procedures performed by a surgeon, indicating that there is a learning curve. The "virtual off" function provided a possibility of treating over-drainage without the need for shunt ligation or other invasive procedures.

  15. Endoscopic third ventriculostomy in hydrocephalus associated with achondroplasia.

    Science.gov (United States)

    Swift, Dale; Nagy, Laszlo; Robertson, Brian

    2012-01-01

    Hydrocephalus in patients with achondroplasia is thought to be due to increased dural sinus venous pressure resulting from narrowing of the jugular foramen. In this setting, where hydrocephalus is presumed to be "vascular" in origin and therefore communicating, endoscopic third ventriculostomy (ETV) would seem contraindicated. The authors describe 3 patients in whom ETV was successfully performed, resulting in MR imaging-documented decreases in ventricle size. The patients were 11 months, 33 months, and 13 years at the time of surgery. All patients had serial preoperative MR images demonstrating progressive hydrocephalus in a "triventricular" pattern with a small fourth ventricle but an open aqueduct. All patients had undergone suboccipital decompression for foramen magnum stenosis prior to the treatment of hydrocephalus. Preoperative retrograde venography revealed variable pressure gradients across the jugular foramen. It is postulated that the increase in intracranial venous pressure resulting from jugular foramen stenosis may lead to disproportionate venous engorgement of the cerebellum and some degree of obstructive hydrocephalus amenable to ETV. The authors discuss the role of suboccipital decompression in the progression of hydrocephalus in patients with achondroplasia.

  16. Management of hydrocephalus in patients with tuberculous meningitis

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    Rajshekhar Vedantam

    2009-01-01

    Full Text Available Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM occurring in up to 85% of children with the disease. It is more severe in children than in adults. It could be either of the communicating type or the obstructive type with the former being more frequently seen. The Vellore grading system for clinical grading of patients with TBM and hydrocephalus with grade I being the best grade and grade IV being the worst grade has been validated by several authors. The management of hydrocephalus can include medical therapy with dehydrating agents and steroids for patients in good grades and those with communicating hydrocephalus. However, surgery is required for patients with obstructive hydrocephalus and those in poor grades. Surgery can involve either a ventriculo-peritoneal shunt or endoscopic third ventriculostomy (ETV. Complications of shunt surgery in patients with TBM and hydrocephalus are high with frequent shunt obstructions and shunt infections requiring repeated revisions. ETV has variable success in these patients and is generally not advisable in patients in the acute stages of the disease. Mortality on long-term follow up has been reported to vary from 10.5% to 57.1% in those with altered sensorium prior to surgery and 0 to 12.5% in patients with normal sensorium. Surgery for patients in Vellore grade IV is usually associated with a poor outcome and high mortality and therefore, its utility in these patients is debatable

  17. [Sepsis caused by Chryseobacterium indologenes in a patient with hydrocephalus].

    Science.gov (United States)

    Ceylan, Abdullah; Güdücüoğlu, Hüseyin; Akbayram, Sinan; Bektaş, Abdullah; Berktaş, Mustafa

    2011-10-01

    Chryseobacterium (formerly Flavobacterium) indologenes, is a non-fermentative gram-negative bacillus which is widely found in the nature, primarily soil and water. Since it can survive in chlorine-treated municipal water supplies, and can colonize the sink basins and tap waters of the hospitals, this bacterium may be a potential infectious agent. Contamination of the medical devices containing water (respirators, intubation tubes, humidifiers, incubators for newborns, etc.) in hospital settings may lead to serious infections especially in patients with predisposing diseases, newborns and immunocompromized patients. In this report, a case of fatal C.indologenes septicemia developed in a newborn with hydrocephalus has been presented. A two-months old male infant was admitted to our hospital with the complaints of failure to suck and lethargy for five days and head enlargement. He was diagnosed as meningitis based on the clinical and laboratory findings of cerebrospinal fluid (CSF) (protein: 572 mg/dl, glucose 9.5 mg/dl, chlorine: 111 mg/dl, and presence of abundant polymorphonuclear leukocytes), and empirical antibiotic treatment (ampicillin/sulbactam and cefotaxime) had been started. Since the computerized tomography of the brain pointed out hydrocephalus, an external shunt was placed for CSF drainage on the second day of hospitalization. A total of five CSF and two blood cultures collected during the hospitalization period were inoculated into pediatric aerobic CSF and blood culture bottles (BacT/ALERT, BioMerieux, France) and incubated for 24-48 hours. The isolated bacteria from all of the cultures were identified as C.indologenes by conventional methods and BD Phoenix (Becton Dickinson, USA) system. Antibiotic susceptibility tests were performed with microdilution method according to CLSI guidelines. The isolate was found susceptible to ciprofloxacin, levofloxacin and trimethoprim/sulfamethoxazole, while it was resistant to amikacin, gentamicin, tobramycin

  18. Revisiting secondary normal pressure hydrocephalus: does it exist? A review.

    Science.gov (United States)

    Daou, Badih; Klinge, Petra; Tjoumakaris, Stavropoula; Rosenwasser, Robert H; Jabbour, Pascal

    2016-09-01

    OBJECTIVE There are several etiologies that can lead to the development of secondary normal pressure hydrocephalus (sNPH). The aim of this study was to evaluate the etiology, diagnosis, treatment, and outcome in patients with sNPH and to highlight important differences between the separate etiologies. METHODS A comprehensive review of the literature was performed to identify studies conducted between 1965 and 2015 that included data regarding the etiology, treatment, diagnosis, and outcome in patients with sNPH. Sixty-four studies with a total of 1309 patients were included. The inclusion criteria of this study were articles that were written in English, included more than 2 patients with the diagnosis of sNPH, and contained data regarding the etiology, diagnosis, treatment, or outcome of NPH. The most common assessment of clinical improvement was based on the Stein and Langfitt grading scale or equivalent improvement on other alternative ordinal grading scales. RESULTS The main etiologies of sNPH were subarachnoid hemorrhage (SAH) in 46.5%, head trauma in 29%, intracranial malignancies in 6.2%, meningoencephalitis in 5%, and cerebrovascular disease in 4.5% of patients. In 71.9% of patients the sNPH was treated with ventriculoperitoneal shunt placement, and 24.4% had placement of a ventriculoatrial shunt. Clinical improvement after shunt placement was reported in 74.4% and excellent clinical improvement in 58% of patients with sNPH. The mean follow-up period after shunt placement was 13 months. Improvement was seen in 84.2% of patients with SAH, 83% of patients with head trauma, 86.4% of patients with brain tumors, 75% of patients with meningoencephalitis, and 64.7% of patients with NPH secondary to stroke. CONCLUSIONS Secondary NPH encompasses a diverse group of clinical manifestations associated with a subset of patients with acquired hydrocephalus. The most common etiologies of sNPH include SAH and traumatic brain injury. Secondary NPH does indeed exist, and

  19. Lack of shunt response in suspected idiopathic normal pressure hydrocephalus with Alzheimer disease pathology.

    Science.gov (United States)

    Hamilton, Roy; Patel, Sunil; Lee, Edward B; Jackson, Eric M; Lopinto, Joanna; Arnold, Steven E; Clark, Christopher M; Basil, Anuj; Shaw, Leslie M; Xie, Sharon X; Grady, M Sean; Trojanowski, John Q

    2010-10-01

    To determine the impact of cortical Alzheimer disease pathology on shunt responsiveness in individuals treated for idiopathic normal pressure hydrocephalus (iNPH), 37 patients clinically diagnosed with iNPH participated in a prospective study in which performance on neurologic, psychometric, and gait measures before and 4 months after shunting was correlated with amyloid β plaques, neuritic plaques, and neurofibrillary tangles observed in cortical biopsies obtained during shunt insertion. No complications resulted from biopsy acquisition. Moderate to severe pathology was associated with worse baseline cognitive performance and diminished postoperative improvement on NPH symptom severity scales, gait measures, and cognitive instruments compared to patients lacking pathology.

  20. An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium "Opportunities for Hydrocephalus Research: Pathways to Better Outcomes".

    Science.gov (United States)

    McAllister, James P; Williams, Michael A; Walker, Marion L; Kestle, John R W; Relkin, Norman R; Anderson, Amy M; Gross, Paul H; Browd, Samuel R

    2015-12-01

    Building on previous National Institutes of Health-sponsored symposia on hydrocephalus research, "Opportunities for Hydrocephalus Research: Pathways to Better Outcomes" was held in Seattle, Washington, July 9-11, 2012. Plenary sessions were organized into four major themes, each with two subtopics: Causes of Hydrocephalus (Genetics and Pathophysiological Modifications); Diagnosis of Hydrocephalus (Biomarkers and Neuroimaging); Treatment of Hydrocephalus (Bioengineering Advances and Surgical Treatments); and Outcome in Hydrocephalus (Neuropsychological and Neurological). International experts gave plenary talks, and extensive group discussions were held for each of the major themes. The conference emphasized patient-centered care and translational research, with the main objective to arrive at a consensus on priorities in hydrocephalus that have the potential to impact patient care in the next 5 years. The current state of hydrocephalus research and treatment was presented, and the following priorities for research were recommended for each theme. 1) Causes of Hydrocephalus-CSF absorption, production, and related drug therapies; pathogenesis of human hydrocephalus; improved animal and in vitro models of hydrocephalus; developmental and macromolecular transport mechanisms; biomechanical changes in hydrocephalus; and age-dependent mechanisms in the development of hydrocephalus. 2) Diagnosis of Hydrocephalus-implementation of a standardized set of protocols and a shared repository of technical information; prospective studies of multimodal techniques including MRI and CSF biomarkers to test potential pharmacological treatments; and quantitative and cost-effective CSF assessment techniques. 3) Treatment of Hydrocephalus-improved bioengineering efforts to reduce proximal catheter and overall shunt failure; external or implantable diagnostics and support for the biological infrastructure research that informs these efforts; and evidence-based surgical standardization with

  1. Left hemisphere structural connectivity abnormality in pediatric hydrocephalus patients following surgery.

    Science.gov (United States)

    Yuan, Weihong; Meller, Artur; Shimony, Joshua S; Nash, Tiffany; Jones, Blaise V; Holland, Scott K; Altaye, Mekibib; Barnard, Holly; Phillips, Jannel; Powell, Stephanie; McKinstry, Robert C; Limbrick, David D; Rajagopal, Akila; Mangano, Francesco T

    2016-01-01

    Neuroimaging research in surgically treated pediatric hydrocephalus patients remains challenging due to the artifact caused by programmable shunt. Our previous study has demonstrated significant alterations in the whole brain white matter structural connectivity based on diffusion tensor imaging (DTI) and graph theoretical analysis in children with hydrocephalus prior to surgery or in surgically treated children without programmable shunts. This study seeks to investigate the impact of brain injury on the topological features in the left hemisphere, contratelateral to the shunt placement, which will avoid the influence of shunt artifacts and makes further group comparisons feasible for children with programmable shunt valves. Three groups of children (34 in the control group, 12 in the 3-month post-surgery group, and 24 in the 12-month post-surgery group, age between 1 and 18 years) were included in the study. The structural connectivity data processing and analysis were performed based on DTI and graph theoretical analysis. Specific procedures were revised to include only left brain imaging data in normalization, parcellation, and fiber counting from DTI tractography. Our results showed that, when compared to controls, children with hydrocephalus in both the 3-month and 12-month post-surgery groups had significantly lower normalized clustering coefficient, lower small-worldness, and higher global efficiency (all p regional connectivity measures in a series of brain regions in the left hemisphere (8 and 10 regions in the 3-month post-surgery and the 12-month post-surgery group, respectively, all p < 0.05, corrected). No significant correlation was found between any of the global or regional measures and the contemporaneous neuropsychological outcomes [the General Adaptive Composite (GAC) from the Adaptive Behavior Assessment System, Second Edition (ABAS-II)]. However, one global network measure (global efficiency) and two regional network measures in the insula

  2. Left hemisphere structural connectivity abnormality in pediatric hydrocephalus patients following surgery

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    Weihong Yuan

    2016-01-01

    Full Text Available Neuroimaging research in surgically treated pediatric hydrocephalus patients remains challenging due to the artifact caused by programmable shunt. Our previous study has demonstrated significant alterations in the whole brain white matter structural connectivity based on diffusion tensor imaging (DTI and graph theoretical analysis in children with hydrocephalus prior to surgery or in surgically treated children without programmable shunts. This study seeks to investigate the impact of brain injury on the topological features in the left hemisphere, contratelateral to the shunt placement, which will avoid the influence of shunt artifacts and makes further group comparisons feasible for children with programmable shunt valves. Three groups of children (34 in the control group, 12 in the 3-month post-surgery group, and 24 in the 12-month post-surgery group, age between 1 and 18 years were included in the study. The structural connectivity data processing and analysis were performed based on DTI and graph theoretical analysis. Specific procedures were revised to include only left brain imaging data in normalization, parcellation, and fiber counting from DTI tractography. Our results showed that, when compared to controls, children with hydrocephalus in both the 3-month and 12-month post-surgery groups had significantly lower normalized clustering coefficient, lower small-worldness, and higher global efficiency (all p < 0.05, corrected. At a regional level, both patient groups showed significant alteration in one or more regional connectivity measures in a series of brain regions in the left hemisphere (8 and 10 regions in the 3-month post-surgery and the 12-month post-surgery group, respectively, all p < 0.05, corrected. No significant correlation was found between any of the global or regional measures and the contemporaneous neuropsychological outcomes [the General Adaptive Composite (GAC from the Adaptive Behavior Assessment System, Second

  3. Endoscopic third ventriculostomy in tubercular meningitis with hydrocephalus

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    Yad Ram Yadav

    2011-01-01

    Full Text Available Background: Endoscopic third ventriculostomy (ETV is increasingly being used as an alternative treatment in tubercular meningitis (TBM hydrocephalus. This study is aimed to evaluate the role of ETV in TBM hydrocephalus. Materials and Methods: This is a prospective study of 59 patients with TBM and obstructive hydrocephalus. The diagnosis was confirmed by a computed tomography scan and/or magnetic resonance imaging scan preoperatively. The procedure was performed using the standard technique or water jet dissection. Results: Three (5.1% patients had blocked stoma, 31 (53% had associated malnutrition, and 13 (22% had complex hydrocephalus. Clinical improvement was seen in 34 (58% after ETV and in 47 (80% patients after ETV with lumber peritoneal shunt. Thirteen patients with patent stoma and complex hydrocephalus did not improve after ETV alone; an additional lumber peritoneal shunt was required. Clinical outcome was significantly better in good grade. Early recovery was observed in 81%. Results of ETV were better in patients without cisternal exudates, good nutritional status, thin and identifiable floor of third ventricle compared to cases with cisternal exudates, malnourished, thick and unidentifiable floor respectively, although the difference was statistically insignificant. There was no operative death. Three patients with normal ICP did not show any improvement. The radiological recovery after 3 weeks of surgery was 52%; follow-up ranged between 7 and 54 months. Six patients developed CSF leak. Conclusion: Endoscopic third ventriculostomy was safe and effective in TBM hydrocephalus. Complex hydrocephalus and associated cerebral infarcts were the major causes of failure to improve. Good results were observed in better grades.

  4. Hydrocephalus and vasculitis delay therapeutic responses in tuberculous meninigitis: Results of Haydarpasa-III study

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    Yasemin Cag

    2016-01-01

    Conclusions: In the absence of hydrocephalus or vasculitis, one week of anti-tuberculosis treatment seems to be adequate for the resolution of TBM symptoms. Hydrocephalus and vasculitis delay the resolution of TBM symptoms in response to antimycobacterial treatment.

  5. Surgical treatment of hydrocephalus and spinal dysraphism

    Institute of Scientific and Technical Information of China (English)

    Besnik Elshani; Basri Lenjani

    2014-01-01

    Objective:To identify during intrauterine congenital malformations;Surgery to dysraphism and hydrocephalus neurological benefit, the ability to live independently;Forecast possibility of lowering birth rates with congenital malformations.Methods:Epidemiological and congenital malformations of the spinal dysraphism were included in this prospective clinical study-research.Its forms were manifested by the appearance of hydrocephalus inNeurosurgicalClinic inPristina for the period2010-2012.All cases of spinal dysraphism operated in theNeurosurgery Clinic inPrishtina for the period2010-2012 were analyzed.Results:In theNeurosurgeryClinic atUCC since2010 to2012 are operated total55 cases of spinal dysraphism;The largest number of operations were recorded in2011 with20 operated cases or36.36%, while smaller in2010 with17 operated cases or30.91%,Number of patients varies by year, with some variations of the graph, where at the beginning of the graph have gradually increased over the years, following the continuous growing and finally landing back with graph;By sex and years, the largest number of cases in male gender with spinal dysraphism were registered in2012 with14 cases or37.8%, while the smallest number in2010 with11 cases or29.7%,Whereas the female gender, number of large backlog of cases was registered in2011 with8 cases or44.4%, while the smallest number in 2012 with4 cases or22.2%.Divided by types of spinal dysraphism total were identified:13 with spinal dysraphism meningocele or23.6% and42 spinal dysraphism myelomeningocele or76.4% of which were male dominance in relation to female sex ratio(M:F =40:15 occasions), by gender and spinal dysraphism species, the males are identified with many cases, the spinal dysraphism meningocele8 or20% and32 with spinal dysraphism myelomeningocele or80%,Eksterioizm Shanti where the body rejects foreign body system as the one we had at1 patient.Conclusions:Shant meningitis due to infection or eventual reduction in immune

  6. New concept of the pathogenesis and therapeutic orientation of acquired communicating hydrocephalus.

    Science.gov (United States)

    Xu, Hao

    2016-09-01

    Hydrocephalus is a common medical condition characterized by abnormalities in the secretion, circulation and absorption of cerebrospinal fluid (CSF), resulting in ventricle dilatation. For the communicating hydrocephalus, without etiological treatment, its pathogenesis has been considered as a research emphasis. Many factors can damage the CSF system and trigger communicating hydrocephalus, including tumor surgery and hydrocephalus neurological diseases, such as brain trauma, infection, ICH and SAH. But according to our clinical experience, a big proportion of patients do not develop hydrocephalus. That is because the absorbing ability of CSF can compensate within a certain range. If the damage exceeds that range, hydrocephalus will occur. Once it occurs, it is not likely to be reversed, so a shunt surgery is always needed. Therefore, we believe that our orientation could transform the treatment of patient who has already showed hydrocephalus symptoms to the prevention of the occurrence in the patient with high risk of hydrocephalus. Based on the hypothesis above, we first divide the process of hydrocephalus into three stages and we believe that hydrocephalus are possible be reversed or halted in stage 1 and 2. The new concept of the pathogenesis in hydrocephalus will enrich our understanding and provide new insights to the therapeutic orientation. In conclusion, the future research direction should be the prevention of hydrocephalus, which should take a long period from the immediate occurrence of brain injury to several months or even years after the injury.

  7. X-linked hydrocephalus : Another two families with an L1 mutation

    NARCIS (Netherlands)

    Criado, GR; Aytes, AP; Martinez, F; Vos, YJ; Verlind, E; Lopez, AGM; Sanchez, IGD; Schrander-Stumpel, C

    2003-01-01

    X-linked hydrocephalus: another two families with an Ll mutation: X-linked hydrocephalus is a variable condition caused by mutations in the gene encoding for LICAM. This gene is located at Xq28. Clinically the spectrum ranges from males with lethal congenital hydrocephalus to mild/moderate mental

  8. [Normal pressure hydrocephalus: A review and practical aspects].

    Science.gov (United States)

    Mongin, M; Hommet, C; Mondon, K

    2015-12-01

    Idiopathic normal pressure hydrocephalus is a chronic disorder affecting the elderly. It is defined by Adams and Hakim's triad in addition to ventricular dilation visible by brain imaging and normal cerebrospinal fluid pressure during lumbar puncture. The objective of this review was to propose a standard of care for idiopathic normal pressure hydrocephalus based on an extensive literature review conducted on 459 articles published over the last 10 years. Those articles were obtained by searching for the keywords "normal pressure hydrocephalus" in the PubMed database and selecting all the articles published in English or in French. The diagnosis of idiopathic normal pressure hydrocephalus is difficult because of commonly associated diseases, such as Alzheimer's disease and microangiopathy. Brain MRI is one of the key procedures to assist in the diagnosis of idiopathic normal pressure hydrocephalus. Indeed, the presence of certain MRI features is highly predictive of a positive tap test and shunt responsiveness. Nevertheless, tap test remains the standard of care for diagnosis. Continuous cerebrospinal fluid drainage test is an alternative because it improves the sensitivity of diagnosis (but is a more complicated test to perform). Alzheimer's biomarkers dosing in the cerebrospinal fluid seems interesting when diagnosis remains uncertain: the presence of Alzheimer's profile of the biological markers is predictive of a lower response to the tap test.

  9. Pulsatile flow in ventricular catheters for hydrocephalus

    Science.gov (United States)

    Giménez, Á.; Galarza, M.; Thomale, U.; Schuhmann, M. U.; Valero, J.; Amigó, J. M.

    2017-05-01

    The obstruction of ventricular catheters (VCs) is a major problem in the standard treatment of hydrocephalus, the flow pattern of the cerebrospinal fluid (CSF) being one important factor thereof. As a first approach to this problem, some of the authors studied previously the CSF flow through VCs under time-independent boundary conditions by means of computational fluid dynamics in three-dimensional models. This allowed us to derive a few basic principles which led to designs with improved flow patterns regarding the obstruction problem. However, the flow of the CSF has actually a pulsatile nature because of the heart beating and blood flow. To address this fact, here we extend our previous computational study to models with oscillatory boundary conditions. The new results will be compared with the results for constant flows and discussed. It turns out that the corrections due to the pulsatility of the CSF are quantitatively small, which reinforces our previous findings and conclusions. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

  10. Giant Trigeminal Schwannoma Presenting with Obstructive Hydrocephalus

    Science.gov (United States)

    Martinez-Gutierrez, Juan Carlos; Elder, Benjamin D; Olivi, Alessandro

    2015-01-01

    Trigeminal schwannomas represent between 0.07% and 0.36% of all intracranial tumors and 0.8% to 8% of intracranial schwannomas. Selection of the appropriate management strategy requires an understanding of the tumor’s natural history and treatment outcomes. This report describes the case of a 36-year-old male who presented with a three-month history of progressive headaches, dizziness, loss of balance, decreased sleep, and cognitive decline. Magnetic resonance imaging revealed a large enhancing lesion centered around the left Meckel’s cave and extending into both the middle and the posterior fossa with obstructive hydrocephalus secondary to compression of the fourth ventricle. Resection of the posterior fossa component of the tumor was performed in order to relieve the mass effect upon the brainstem without attempting a radical removal of the middle fossa component and a potential risk of further cognitive impairment. The pathological exam confirmed the diagnosis of a trigeminal schwannoma. The residual tumor showed progressive spontaneous volumetric shrinkage after a subtotal surgical resection. This case shows the value of a planned conservative surgery in complex schwannomas and highlights the challenges in interpreting the treatment responses in these benign tumors, whether approached surgically or with stereotactic radiation techniques. PMID:26719829

  11. [A case of chronic enteroviral meningitis and hydrocephalus associated with Bruton type agammaglobulinemia].

    Science.gov (United States)

    Ozawa, T; Onodera, O; Iizuka, O; Tanno, Y; Eguchi, I; Soma, Y; Tsuji, S

    1998-02-01

    We report a 10-year-old boy with chronic enteroviral meningitis associated with agammaglobulinemia (CEMA) and hydrocephalus. He was treated with a low-dose intravenous administration (100 mg/kg/4 weeks) of gammaglobulin (gamma-gl) since he was diagnosed as having Bruton type agammaglobulinemia at 1 year of age. At this admission, neurological examination revealed meningeal signs, Babinski sign, frontal signs, urinary incontinence, and mental retardation (IQ = 48) which was considered to be a sequela of the enteroviral encephalitis which had occurred in his first year of life. T 1-weighted MR imaging of the brain following gadolinium administration revealed a marked dilatation of the lateral ventricles and dense enhancement of the meninges. Enterovirus was detected in the cerebrospinal fluid (CSF) using tissue culture. Histological examination of a biopsied leptomeningeal specimen revealed inflammatory thickening, which was a likely cause of the obstruction to the flow of CSF. The hydrocephalus in this patient was treated with external drainage of CSF from the lateral ventricle. The CEMA was brought into remission by means of the intraventricular administration of gamma-gl, at a dose of 125-250 mg/week (total dose: 1.5 g/8 weeks), in addition to the high dose intravenous administration (400 mg/kg/4 weeks) of gamma-gl. Because of the poor prognosis of patients with CEMA, the intraventricular administration of gamma-gl should be initiated immediately following a diagnosis of enteroviral meningitis.

  12. Persistent hydrocephalus due to postural activation of a ventricular shunt anti-gravity device.

    Science.gov (United States)

    Craven, Claudia L; Toma, Ahmed K; Watkins, Laurence D

    2017-03-01

    The ever present need to balance over drainage with under drainage in hydrocephalus has required innovations including adjustable valves with antigravity devices. These are activated in the vertical position to prevent siphoning. We describe a group of bedridden patients who presented with unexplained under drainage caused by activation of antigravity shunt components produced by peculiar head/body position. Retrospective single centre case series of hydrocephalus patients, treated with ventriculo-peritoneal (VP) shunt insertion between April 2014 - February 2016. These patients presented with clinical and radiological under drainage syndrome. Medical notes were reviewed for clinical picture and outcome. Radiological studies were reviewed assessing shunt placement and ventricular size. Seven patients presented with clinical and radiological under drainage syndrome. A consistent posturing of long term hyper-flexion of the neck whilst lying supine was observed. All patients had similar shunt construct (adjustable Miethke ProGAV valve and shunt assistant anti-gravity component). In each of those patients a hypothesis was formulated that neck flexion was activating the shunt assistance anti-gravity component in supine position. Five patients underwent shunt revision surgery removing the shunt assistant device from the cranium and adding an anti-gravity component to the shunt system at the chest. One had the shunt assistant completely removed and one patient was managed conservatively with mobilisation. All patients had clinical and radiological improvement. Antigravity shunt components implanted cranially in bedridden hydrocephalus patients will produce underdrainage due to head flexion induced anti-gravity device activation. In these patients, anti-gravity devices should be placed at the chest. Alternatively, special nursing attention should be paid to head-trunk angle.

  13. Primary Intraventricular Brain Abscess Resulting in Isolated Dilation of the Inferior Horn and Unilateral Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Joji Inamasu

    2015-07-01

    Full Text Available Primary intraventricular brain abscesses are rare, and there are no established treatment guidelines for this condition. We report a case in which isolated ventricular dilatation and unilateral hydrocephalus developed after seemingly successful conservative management and which required surgical diversion of the cerebrospinal fluid. A 59-year-old woman presented to our emergency department with high-grade fever and headache. Brain magnetic resonance imaging (MRI revealed abscesses in the bilateral posterior horn. Although surgical evacuation of the abscesses was considered, conservative management with antibiotics was selected because of the paucity of severe neurological deficits and the concern that an attempt to evacuate the intraventricular abscess might lead to inadvertent rupture of the abscess capsule and acute ventriculitis. Despite reduction in the abscess volume, the patient developed an altered mental status 4 weeks after admission. Follow-up MRI revealed isolated dilation of the left inferior horn, compressing the brainstem. Emergency fenestration of the dilated inferior horn was performed, and endoscopic observation revealed an encapsulated abscess with adhesion to the ventricular wall which was thought responsible for the ventricular dilation and unilateral hydrocephalus. Two weeks after the initial surgery, the unilateral hydrocephalus was treated by placement of a ventriculoperitoneal shunt. Eradication of the intraventricular brain abscesses without surgical evacuation may justify the conservative management of this patient. However, the possibility that earlier surgical evacuation might have prevented development of the isolated ventricular dilation cannot be denied. Additional clinical experience is required to determine which treatment (surgical vs. conservative is more appropriate in patients with primary intraventricular brain abscesses.

  14. Hydrocephalus in an elderly man with systemic lupus erythematosus.

    Science.gov (United States)

    Chen, Wei-Sheng; Wu, Tsai-Hung; Chou, Chung-Tei; Tsai, Chang-Youh

    2009-06-01

    A 71-year-old man presented with quadriplegia, seizures, dysarthria, motor aphasia and urinary incontinence lasting for several years. The development of proteinuria and increased susceptibility to infections brought the physician's attention to possible underlying autoimmune diseases. Laboratory investigations revealed evidence for systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Imaging studies showed obstructive hydrocephalus. Several courses of methylprednisolone therapies followed by maintenance therapy with low-dose steroid, ventriculoperitoneal shunt, and antihypertensives improved the proteinuria and dysarthria but not the urinary incontinence or dementia. A thromboembolic event in the central nervous system secondary to phospholipid antibodies or lupus activity may represent a pathogenetic basis for hydrocephalus. When encountering a patient with hydrocephalus but without apparent predisposing factors, it is always important to include SLE as a differential diagnosis.

  15. A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial

    NARCIS (Netherlands)

    Delwel, E.J.; Jong, Danielle de; Dammers, R.; Kurt, E.; Brink, W. van den; Dirven, C.M.

    2013-01-01

    BACKGROUND: In treating idiopathic normal pressure hydrocephalus (INPH) with a shunt there is always a risk of underdrainage or overdrainage. The hypothesis is tested whether patients treated using an adjustable valve preset at the highest opening pressure leads to comparable good clinical results w

  16. Decorin prevents the development of juvenile communicating hydrocephalus.

    Science.gov (United States)

    Botfield, Hannah; Gonzalez, Ana Maria; Abdullah, Osama; Skjolding, Anders Dæhli; Berry, Martin; McAllister, James Pat; Logan, Ann

    2013-09-01

    In post-haemorrhagic and other forms of communicating hydrocephalus, cerebrospinal fluid flow and drainage is obstructed by subarachnoid fibrosis in which the potent fibrogenic cytokine transforming growth factor-β has been aetiologically implicated. Here, the hypothesis that the transforming growth factor-β antagonist decorin has therapeutic potential for reducing fibrosis and ventriculomegaly was tested using a rat model of juvenile communicating hydrocephalus. Hydrocephalus was induced by a single basal cistern injection of kaolin in 3-week-old rats, immediately followed by 3 or 14 days of continuous intraventricular infusion of either human recombinant decorin or phosphate-buffered saline (vehicle). Ventricular expansion was measured by magnetic resonance imaging at Day 14. Fibrosis, transforming growth factor-β/Smad2/3 activation and hydrocephalic brain pathology were evaluated at Day 14 and the inflammatory response at Days 3 and 14 by immunohistochemistry and basic histology. Analysis of ventricular size demonstrated the development of hydrocephalus in kaolin-injected rats but also revealed that continuous decorin infusion prevented ventricular enlargement, such that ventricle size remained similar to that in intact control rats. Decorin prevented the increase in transforming growth factor-β1 and phosphorylated Smad2/3 levels throughout the ventricular system after kaolin injection and also inhibited the deposition of the extracellular matrix molecules, laminin and fibronectin in the subarachnoid space. In addition, decorin protected against hydrocephalic brain damage inferred from attenuation of glial and inflammatory reactions. Thus, we conclude that decorin prevented the development of hydrocephalus in juvenile rats by blocking transforming growth factor-β-induced subarachnoid fibrosis and protected against hydrocephalic brain damage. The results suggest that decorin is a potential clinical therapeutic for the treatment of juvenile post

  17. Role of endoscopic third ventriculostomy in tuberculous meningitis with hydrocephalus

    Science.gov (United States)

    Yadav, Yad R.; Parihar, Vijay S.; Todorov, Mina; Kher, Yatin; Chaurasia, Ishwar D.; Pande, Sonjjay; Namdev, Hemant

    2016-01-01

    Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor. Water jet dissection can be helpful in thick and opaque ventricular floor patients, while simple blunt perforation is possible in thin and transparent floor. Lumbar peritoneal shunt is a better option for communicating hydrocephalus as compared to VP shunt or ETV. Intraoperative Doppler or neuronavigation can help in proper planning of the perforation to prevent neurovascular complications. Choroid plexus coagulation with ETV can improve success rate in infants. Results of ETV are better in good grade patients. Poor results are observed in cisternal exudates, thick and opaque third ventricle floor, acute phase, malnourished patients as compared to patients without cisternal exudates, thin and transparent third ventricle floor, chronic phase, well-nourished patients. Some of the patients, especially in poor grade, can show delayed recovery. Failure to improve after ETV can be due to blocked stoma, complex hydrocephalus, or vascular compromise. Repeated lumbar puncture can help faster normalization of the raised intracranial pressure after ETV in patients with temporary defect in CSF absorption, whereas lumbar peritoneal shunt is required in permanent defect. Repeat ETV is recommended if the stoma is blocked. ETV should be considered as treatment of choice in chronic phase of the disease in obstructive hydrocephalus. PMID:27695532

  18. Parylene MEMS patency sensor for assessment of hydrocephalus shunt obstruction.

    Science.gov (United States)

    Kim, Brian J; Jin, Willa; Baldwin, Alexander; Yu, Lawrence; Christian, Eisha; Krieger, Mark D; McComb, J Gordon; Meng, Ellis

    2016-10-01

    Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment. The sensor was fabricated on a flexible polymer substrate to eventually allow integration into a shunt. In this study, the sensor was packaged for use with external ventricular drainage systems for clinical validation. Insights into the transduction mechanism of the sensor were obtained. The impact of electrode size, clinically relevant temperatures and flows, and hydrogen peroxide (H2O2) plasma sterilization on sensor function were evaluated. Sensor performance in the presence of static and dynamic obstruction was demonstrated using 3 different models of obstruction. Electrode size was found to have a minimal effect on sensor performance and increased temperature and flow resulted in a slight decrease in the baseline impedance due to an increase in ionic mobility. However, sensor response did not vary within clinically relevant temperature and flow ranges. H2O2 plasma sterilization also had no effect on sensor performance. This low power and simple format sensor was developed with the intention of future integration into shunts for wireless monitoring of shunt state and more importantly, a more accurate and timely diagnosis of shunt failure.

  19. A unifying hypothesis for hydrocephalus and the Chiari malformations part two: The hydrocephalus filling mechanism.

    Science.gov (United States)

    Williams, Helen

    2016-09-01

    It is proposed that negative central nervous system (CNS) pressure is one of the filling mechanisms of the fluid spaces of the CNS. Negative CNS pressure is caused by the combination of gravitational force and body movement. The venous system imposes pressure fluctuations on the CNS due to changes in posture and body cavity pressure. It is proposed here that filling of veins, arteries and cerebrospinal (CSF) spaces are all assisted by negative CNS pressure. Hyperemia in the CNS in response to pressure changes with movement was described in the first part of this hypothesis. By this means parenchyma water levels may increase (Williams, 2008). In the developmental forms of hydrocephalus expansion of CSF spaces is a more prominent feature than parenchyma water changes. This feature is explained by this second part of the hypothesis where the negative pulsatility of pressure that can accompany positive pressure pulsatility, which occurs with body movement, is described as the pathological force that leads to cavity filling. When CNS compliance is lost there is overrepresentation of low and well as high pressure pulsations in response to body movements. Pressure that leads to the development of hydrocephalus can be described as being abnormally labile. Negative CNS pressure causes cavity filling in an analogous way to pleural cavity filling, with water passing from parenchyma tissue. Positive pressure within the pressure profile may cause expansion of regions of the CNS skeletal system that are able to grow such as the cranial vault so that large head size is a frequent accompaniment to hydrocephalus that is caused by this mechanism. Hydrocephalic disorders that are characterised by negative pressure filling mechanism often have a skeletal anatomical abnormality that causes reduced CNS compliance and adversely affect neural development. This is often in the form of obstruction to CSF flow around the base of the brain that then leads to vault expansion by means of high

  20. Magnesium sulfate treatment for juvenile ferrets following induction of hydrocephalus with kaolin.

    Science.gov (United States)

    Di Curzio, Domenico L; Turner-Brannen, Emily; Mao, Xiaoyan; Del Bigio, Marc R

    2016-04-27

    Previous work with 3-week hydrocephalic rats showed that white matter damage could be reduced by the calcium channel antagonist magnesium sulfate (MgSO4). We hypothesized that MgSO4 therapy would improve outcomes in ferrets with hydrocephalus induced with kaolin at 15 days. MRI was performed at 29 days to assess ventricle size and stratify ferrets to treatment conditions. Beginning at 31 days age, they were treated daily for 14 days with MgSO4 (9 mM/kg/day) or sham saline therapy, and then imaged again before sacrifice. Behavior was examined thrice weekly. Histological and biochemical ELISA and myelin enzyme activity assays were performed at 46 days age. Hydrocephalic ferrets exhibited some differences in weight and behavior between treatment groups. Those receiving MgSO4 weighed less, were more lethargic, and displayed reduced activity compared to those receiving saline injections. Hydrocephalic ferrets developed ventriculomegaly, which was not modified by MgSO4 treatment. Histological examination showed destruction of periventricular white matter. Glial fibrillary acidic protein content, myelin basic protein content, and myelin enzyme activity did not differ significantly between treatment groups. The hydrocephalus-associated disturbances in juvenile ferret brains are not ameliorated by MgSO4 treatment, and lethargy is a significant side effect.

  1. Hydrocephalus associated with subarachnoid hemorrhage: clinical study by computed tomography, radioisotope cisternography and constant infusion test.

    Directory of Open Access Journals (Sweden)

    Nosaka,Yoshiki

    1981-02-01

    Full Text Available Thirteen patients exhibited a communicating hydrocephalus following subarachnoid hemorrhage secondary to ruptured intracranial aneurysms and were treated with shunt procedures. The interval between subarachnoid hemorrhage and surgery averaged 9 weeks. Seven of the patients showed improvement. The prognostic value for surgical management was evaluated on the basis of three different diagnostic examinations (computed tomography(CT, cisternography and constant infusion test. A correct diagnosis was obtained in 78 per cent in cisternography, and 63 per cent in infusion test and CT. All patients responding to surgery showed a typical pattern in cisternography, consisting of ventricular retention of radiopharmaceutical tracer for 48 h or longer in association with no radioactivity over the cerebral hemispheres. The constant infusion test correlated well with typical cisternographic patterns. CT is useful in demonstrating pathophysiological changes in hydrocephalus. Periventricular hypodensity was visible in patients with normal or slightly elevated intracranial pressure, accompanied by fairly rapid deterioration. All of them responded well to shunting. In most cases which benefited from the shunt, the postoperative CT showed not only normal-sized ventricles but also marked regression of the hypodensity over a short period.

  2. Hydrocephalus associated with subarachnoid hemorrhage. Clinical study by computed tomography, radioisotope cisternography and constant infusion test

    Energy Technology Data Exchange (ETDEWEB)

    Nosaka, Y. (Okayama Univ. (Japan). School of Medicine)

    1981-02-01

    Thirteen patients exhibited a communicating hydrocephalus following subarachnoid hemorrhage secondary to ruptured intracranial aneurysms and were treated with shunt procedures. The interval between subarachnoid hemorrhage and surgery averaged 9 weeks. Seven of the patients showed improvement. The prognostic value for surgical management was evaluated on the basis of three different diagnostic examinations (computed tomography (CT), cisternography and constant infusion test). A correct diagnosis was obtained in 78 per cent in cisternography, and 63 per cent in infusion test and CT. All patients responding to surgery showed a typical pattern in cisternography, consisting of ventricular retention of radiopharmaceutical tracer for 48 h or longer in association with no radioactivity over the cerebral hemispheres. The constant infusion test correlated well with typical cisternographic patterns. CT is useful in demonstrating pathophysiological changes in hydrocephalus. Periventricular hypodensity was visible in patients with normal or slightly elevated intracranial pressure, accompanied by fairly rapid deterioration. All of them responded well to shunting. In most cases which benefited from the shunt, the postoperative CT showed not only normal-sized ventricles but also marked regression of the hypodensity over a short period.

  3. Visual disturbance following shunt malfunction in a patient with congenital hydrocephalus.

    Science.gov (United States)

    Oyama, Hirofumi; Hattori, Kenichi; Kito, Akira; Maki, Hideki; Noda, Tomoyuki; Wada, Kentaro

    2012-01-01

    A 25-year-old woman presented with complaints of nausea and headache. She had been treated with a ventriculoperitoneal shunt for hydrocephalus when she was 7 months old. Her bilateral optic discs showed moderate atrophy. Right visual acuity allowed only perception of hand movement and left visual acuity was 0.02 (1.2). Computed tomography (CT) showed mild ventricular dilation but no periventricular lucency. Intracranial pressure (ICP) was not high when the shunt valve was punctured. Her visual acuity deteriorated 5 days after the consultation. She was referred again 8 days after the first consultation. The bilateral optic discs were completely pale. Both pupils were dilated on admission, and the bilateral direct light reflexes were absent. The patient could slightly detect only green light stimulus. CT showed moderate enlargement of the ventricle. ICP was 47 cmH(2)O when the shunt valve was punctured. Shuntgraphy showed obstruction of the shunt at the distal end of peritoneal catheter. Emergent total shunt revision was performed. She could detect dark stimulus and the still-dilated left pupil had recovered direct light reflex on the next day. The visual acuity was 0.01 (0.7) on the left 6 months after the operation, although she was blind in the right eye and the bilateral optic discs were completely pale. Visual loss associated with shunt failure remains a major morbidity in shunted congenital hydrocephalus. Early diagnosis and shunt revision may allow visual recovery.

  4. K-causality coincides with stable causality

    OpenAIRE

    Minguzzi, E

    2008-01-01

    It is proven that K-causality coincides with stable causality, and that in a K-causal spacetime the relation K^+ coincides with the Seifert's relation. As a consequence the causal relation "the spacetime is strongly causal and the closure of the causal relation is transitive" stays between stable causality and causal continuity.

  5. From Mere Coincidences to Meaningful Discoveries

    Science.gov (United States)

    Griffiths, Thomas L.; Tenenbaum, Joshua B.

    2007-01-01

    People's reactions to coincidences are often cited as an illustration of the irrationality of human reasoning about chance. We argue that coincidences may be better understood in terms of rational statistical inference, based on their functional role in processes of causal discovery and theory revision. We present a formal definition of…

  6. Sensitivity to coincidences and paranormal belief.

    Science.gov (United States)

    Hadlaczky, Gergö; Westerlund, Joakim

    2011-12-01

    Often it is difficult to find a natural explanation as to why a surprising coincidence occurs. In attempting to find one, people may be inclined to accept paranormal explanations. The objective of this study was to investigate whether people with a lower threshold for being surprised by coincidences have a greater propensity to become believers compared to those with a higher threshold. Participants were exposed to artificial coincidences, which were formally defined as less or more probable, and were asked to provide remarkability ratings. Paranormal belief was measured by the Australian Sheep-Goat Scale. An analysis of the remarkability ratings revealed a significant interaction effect between Sheep-Goat score and type of coincidence, suggesting that people with lower thresholds of surprise, when experiencing coincidences, harbor higher paranormal belief than those with a higher threshold. The theoretical aspects of these findings were discussed.

  7. Hydrocephalus induced via intraventricular kaolin injection in adult rats.

    Science.gov (United States)

    Shaolin, Z; Zhanxiang, W; Hao, X; Feifei, Z; Caiquan, H; Donghan, C; Jianfeng, B; Feng, L; Shanghang, S

    2015-01-01

    Hydrocephalus is a common neurological disease in humans, but a uniform and particularly effective hydrocephalic animal model amenable to proper appraisal and deep study has not yet been established. In this study, we attempted to construct a high-efficiency model of hydrocephalus via intraventricular kaolin injection. Adult male Sprague-Dawley rats were randomly divided into 2 groups: the control group (n = 15) and the experimental group (n = 30). Kaolin was injected into the lateral ventricle of experimental animals. Control rats underwent the same procedure but received sterile saline injection instead of kaolin. All animals with kaolin injection into the lateral ventricle developed hydrocephalus according to magnetic resonance imaging (MRI) results (success rate up to 100%). Also, the Morris water maze (MWM) test demonstrated disturbed spatial learning and memory. Furthermore, there were significant differences between groups with respect to the histological changes in the periventricular tissue. Our results indicate that experimental hydrocephalus induced by lateral ventricle injection of kaolin in adult rats is feasible and may be widely used.

  8. ["Water Hammer effect": a rare mechanism of hydrocephalus].

    Science.gov (United States)

    Hage, P; El Helou, A

    2012-10-01

    We are reporting a case of functional hydrocephalus in a 66-year-old male patient presenting for gait disturbance. The etiology of the disease is a cerebrospinal fluid flow disturbance due to an ectatic basilar artery at the level of Monro foramen. Different pathophysiological mechanisms are discussed below.

  9. Nonverbal Learning Disability Explained: The Link to Shunted Hydrocephalus

    Science.gov (United States)

    Rissman, Barbara

    2011-01-01

    A nonverbal learning disability is believed to be caused by damage, disorder or destruction of neuronal white matter in the brain's right hemisphere and may be seen in persons experiencing a wide range of neurological diseases such as hydrocephalus and other types of brain injury (Harnadek & Rourke 1994). This article probes the relationship…

  10. Complication during Postacute Rehabilitation: Patients with Posttraumatic Hydrocephalus

    Science.gov (United States)

    Denes, Zoltan; Barsi, Peter; Szel, Istvan; Boros, Erzsebet; Fazekas, Gabor

    2011-01-01

    The objective of this study was to determine the incidence of posttraumatic hydrocephalus (PTH) among patients in our rehabilitation unit for traumatic brain injury. Furthermore, we aimed to assess the effect of shunt implantation and to identify the postoperative complication rate. This is a retrospective cohort study, in which between 2000 and…

  11. Decreased relative brain tissue levels of inositol in fetal hydrocephalus.

    NARCIS (Netherlands)

    Kok, R.D.; Steegers-Theunissen, R.P.M.; Eskes, T.K.A.B.; Heerschap, A.; Berg, P.P. van den

    2003-01-01

    OBJECTIVE: Inositol seems to play a role in the development of the central nervous system. In this study, the brain tissue level of inositol in fetal hydrocephalus was compared with that of healthy control subjects. STUDY DESIGN: Proton magnetic resonance spectroscopy was used to examine the inosito

  12. External hydrocephalus in primary hypomagnesaemia: a new finding.

    Science.gov (United States)

    Bhasker, B; Raghupathy, P; Nair, T M; Ahmed, S R; deSilva, V; Bhuyan, B C; Al Khusaiby, S M

    1999-12-01

    This paper reports a new finding in two siblings with primary hypomagnesaemia as a result of renal magnesium wasting, namely, rapidly increasing head size. External hydrocephalus and brain shrinkage in primary hypomagnesaemia seen on computed tomography of the brain with reversibility after magnesium treatment has not been reported previously.

  13. Acute infarction of corpus callosum due to transient obstructive hydrocephalus.

    Science.gov (United States)

    Kaymakamzade, Bahar; Eker, Amber

    2016-01-01

    Acute ischemia of the corpus callosum (CC) is not a well-known feature in patients with acute hydrocephalus. Herein, we describe a case with acute CC infarction due to another rare entity; transient obstructive hydrocephalus. A 66-year-old male was admitted with sudden onset right-sided hemiparesia. CT demonstrated a hematoma on the left basal ganglia with extension to all ventricles. The following day, the patient's neurological status progressed to coma and developed bilateral pyramidal signs. MRI demonstrated obstructive hydrocephalus and acute diffuse infarction accompanied by elevation of the CC. On the same day there was improvement in his neurological status with significant decrease in ventricular size and complete resolution of the clot in the third ventricle. The mechanism of signal abnormalities is probably related with the neural compression of the CC against the falx. Presumably, the clot causing obstruction in the third ventricle dissolved or decayed by the help of fibrinolytic activity of CSF, which was raised after IVH and caused spontaneous improvement of hydrocephalus. Bilateral neurological symptoms suggest diffuse axonal damage and normalization of the intracranial pressure should be performed on the early onset of clinical detorioration in order to prevent axonal injury.

  14. Can infusion tests be recommended for patients with giant hydrocephalus?

    Directory of Open Access Journals (Sweden)

    Cieslicki Krzysztof

    2010-01-01

    Full Text Available Background : The problem of adequate diagnosis of hydrocephalus followed by administration of an effective treatment has not yet been properly solved. Specifically, this pertains to the decision about the surgical insertion of a flow diverting device. Aims : A lumbar infusion test was used to examine the compensatory parameters of intracranial space in giant hydrocephalus. The early and late results of shunt implantation were analyzed together with complications after surgery. Settings and Design : In-house software was used offline to adjust the dynamic intracranial pressure (ICP response to infusion. Materials and Methods : Nine patients with giant hydrocephalus were the subjects for the study. We analyzed recordings of the response in ICP to the 2 ml/min infusion of saline. We performed computerized identification of outflow resistance and intracranial compliance based on the truncated (30- 100% ICP response and assessed the stability of estimates over time. Eight out of nine patients were shunted. Monitoring of patients was followed for a period of up to 9 months. Results : Five out of eight shunted patients improved within a few days of surgery. During follow-up five patients developed various complications. A definite improvement was noted in four patients. The improvement rate did not correlate with any of the compensatory parameters. Most of the patients studied exhibited a lack of intracranial space reserve, a significantly reduced rate of CSF secretion, and a slightly elevated value of outflow resistance. Conclusions : The infusion test showed itself to be more useful as a way of revealing the compensatory parameters of the intracranial space than as a prognostic tool. The outcome of shunted patients with giant hydrocephalus was uncertain, owing to the relatively high rate of complications. We may therefore suggest that the diagnosis of giant hydrocephalus is a relative contraindication to implantation, as well as to the performance of

  15. Knot polynomial identities and quantum group coincidences

    CERN Document Server

    Morrison, Scott; Snyder, Noah

    2010-01-01

    We construct link invariants using the D_2n subfactor planar algebras, and use these to prove new identities relating certain specializations of colored Jones polynomials to specializations of other quantum knot polynomials. These identities can also be explained by coincidences between small modular categories involving the even parts of the D_2n planar algebras. We discuss the origins of these coincidences, explaining the role of SO level-rank duality, Kirby-Melvin symmetry, and properties of small Dynkin diagrams. One of these coincidences involves G_2 and does not appear to be related to level-rank duality.

  16. Frequency and long-term follow-up of trapped fourth ventricle following neonatal posthemorrhagic hydrocephalus.

    Science.gov (United States)

    Pomeraniec, I Jonathan; Ksendzovsky, Alexander; Ellis, Scott; Roberts, Sarah E; Jane, John A

    2016-05-01

    OBJECTIVE Intraventricular hemorrhage (IVH) is a common complication of premature neonates with small birth weight, which often leads to hydrocephalus and treatment with ventriculoperitoneal (VP) shunting procedures. Trapped fourth ventricle (TFV) can be a devastating consequence of the subsequent occlusion of the cerebral aqueduct and foramina of Luschka and Magendie. METHODS The authors retrospectively reviewed 8 consecutive cases involving pediatric patients with TFV following VP shunting for IVH due to prematurity between 2003 and 2012. The patients ranged in gestational age from 23.0 to 32.0 weeks, with an average age at first shunting procedure of 6.1 weeks (range 3.1-12.7 weeks). Three patients were managed with surgery. Patients received long-term radiographic (mean 7.1 years; range 3.4-12.2 years) and clinical (mean 7.8 years; range 4.6-12.2 years) follow-up. RESULTS The frequency of TFV following VP shunting for neonatal posthemorrhagic hydrocephalus was found to be 15.4%. Three (37.5%) patients presented with symptoms of posterior fossa compression and were treated surgically. All of these patients showed signs of radiographic improvement with stable or improved clinical examinations during postoperative follow-up. Of the 5 patients treated conservatively, 80% experienced stable ventricular size and 1 patient experienced a slight increase (3 mm) on imaging. All of the nonsurgical patients showed stable to improved clinical examinations over the follow-up period. CONCLUSIONS The frequency of TFV among premature IVH patients is relatively high. Most patients with TFV are asymptomatic at presentation and can be managed without surgery. Symptomatic patients may be treated surgically for decompression of the fourth ventricle.

  17. Obstruction Theory and Coincidences in Positive Codimension

    Institute of Scientific and Technical Information of China (English)

    Daciberg GON(C)ALVES; Jerzy JEZIERSKI; Peter WONG

    2006-01-01

    Let f, g: X → Y be two maps between closed manifolds with dim X ≥ dim Y = n ≥ 3.We study the primary obstruction on(f,g) to deforming f and g to be coincidence free on the n-th skeleton of X. We give examples for which obstructions to deforming f and g to be coincidence free are detected by on (f, g).

  18. Determining activities of radionuclides from coincidence signatures

    Science.gov (United States)

    Warren, Glen A.; Smith, L. Eric; Aalseth, Craig E.; Ellis, Edward; Hossbach, Todd W.; Valsan, Andrei B.

    2006-05-01

    The spectral analysis of simultaneously observed photons in separate detectors may provide an invaluable tool for radioisotope identification applications. A general recursive method to determine the activity of an isotope from the observed coincidence signature rate is discussed. The method coherently accounts for effects of true coincidence summing within a single detector and detection efficiencies. A verification of the approach with computer simulations is also discussed.

  19. 颅脑损伤后脑积水治疗研究%Study on the Treatment of Hydrocephalus after Craniocerebral Injury

    Institute of Scientific and Technical Information of China (English)

    谢志强; 关健雄

    2014-01-01

    Objective:To study the effects of operation and conservative treatment on hydrocephalus after craniocerebral injury. Methods:40 cases of patients with hydrocephalus after craniocerebral injury were treated with shunt operation, 6 patients with conservative treatment of oxygen inhala-tion, dewatering and so on, to observe the effects. Results: 23 cases were cured, 16 cases effective, 7 cases ineffective, the total efficiency was 84.78%. Conclusion:Operation is not suitable for hydrocephalus after craniocerebral injury in acute period, selecting corresponding shunt operation according to the condition and hydrocephalus type for hydrocephalus in remission or chronic period can effectively reduce the mortality and disabili-ty rate and improve the cure rate.%目的:研究手术及保守治疗颅脑损伤后脑积水的效果。方法:40例颅脑损伤后脑积水患者予分流手术治疗,6例患者予吸氧、脱水等保守治疗,观察效果。结果:治愈23例,有效16例,无效7例,总有效率84.78%。结论:急性期颅脑损伤后脑积水不宜手术治疗,缓解期或慢性脑积水患者根据病情和脑积水类型选择相应的分流手术,可有效降低死亡率、致残率,提高治愈率。

  20. 老年脑积水的手术治疗分析%Analysis of operation on senile patients with hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    万晓强; 郑念东; 卫正洪; 雷波; 张道宝

    2015-01-01

    目的:探讨老年脑积水患者行手术治疗的临床效果。方法回顾分析我院68例老年脑积水患者,观察手术治疗的临床效果。结果急性脑积水患者总有效率为93.33%,慢性脑积水患者手术治疗的总有效率为89.47%,术后并发症发生率为16.18%。结论手术治疗老年脑积水是临床较为常见的方法,能够有效提高治愈率,值得推广。%Objective To investigate the clinical effect of elderly hydrocephalus treated by operation. Methods A retro‐spective analysis of 68 patients with hydrocephalus in our hospital from 2008 to 2014 was taken ,and the clinical effect of opera‐tion treatment was observed.Results The total effective rate was 93.33% in patients with acute hydrocephalus ,which was 89.47% in patients with chronic hydrocephalus ;the complication rate was 16.18% after the operation.Conclusion Operation for patients with hydrocephalus is a common method in clinic ,and can effectively improve the cure rate ,which is worthy of promotion.

  1. Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Noriko Kato

    2011-01-01

    Full Text Available A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD and hemodialysis (HD. Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

  2. Comparison of CSF Distribution between Idiopathic Normal Pressure Hydrocephalus and Alzheimer Disease.

    Science.gov (United States)

    Yamada, S; Ishikawa, M; Yamamoto, K

    2016-07-01

    CSF volumes in the basal cistern and Sylvian fissure are increased in both idiopathic normal pressure hydrocephalus and Alzheimer disease, though the differences in these volumes in idiopathic normal pressure hydrocephalus and Alzheimer disease have not been well-described. Using CSF segmentation and volume quantification, we compared the distribution of CSF in idiopathic normal pressure hydrocephalus and Alzheimer disease. CSF volumes were extracted from T2-weighted 3D spin-echo sequences on 3T MR imaging and quantified semi-automatically. We compared the volumes and ratios of the ventricles and subarachnoid spaces after classification in 30 patients diagnosed with idiopathic normal pressure hydrocephalus, 10 with concurrent idiopathic normal pressure hydrocephalus and Alzheimer disease, 18 with Alzheimer disease, and 26 control subjects 60 years of age or older. Brain to ventricle ratios at the anterior and posterior commissure levels and 3D volumetric convexity cistern to ventricle ratios were useful indices for the differential diagnosis of idiopathic normal pressure hydrocephalus or idiopathic normal pressure hydrocephalus with Alzheimer disease from Alzheimer disease, similar to the z-Evans index and callosal angle. The most distinctive characteristics of the CSF distribution in idiopathic normal pressure hydrocephalus were small convexity subarachnoid spaces and the large volume of the basal cistern and Sylvian fissure. The distribution of the subarachnoid spaces in the idiopathic normal pressure hydrocephalus with Alzheimer disease group was the most deformed among these 3 groups, though the mean ventricular volume of the idiopathic normal pressure hydrocephalus with Alzheimer disease group was intermediate between that of the idiopathic normal pressure hydrocephalus and Alzheimer disease groups. The z-axial expansion of the lateral ventricle and compression of the brain just above the ventricle were the common findings in the parameters for differentiating

  3. Simulation of triple coincidences in PET.

    Science.gov (United States)

    Cal-González, J; Lage, E; Herranz, E; Vicente, E; Udias, J M; Moore, S C; Park, M-A; Dave, S R; Parot, V; Herraiz, J L

    2015-01-07

    Although current PET scanners are designed and optimized to detect double coincidence events, there is a significant amount of triple coincidences in any PET acquisition. Triple coincidences may arise from causes such as: inter-detector scatter (IDS), random triple interactions (RT), or the detection of prompt gamma rays in coincidence with annihilation photons when non-pure positron-emitting radionuclides are used (β(+)γ events). Depending on the data acquisition settings of the PET scanner, these triple events are discarded or processed as a set of double coincidences if the energy of the three detected events is within the scanner's energy window. This latter option introduces noise in the data, as at most, only one of the possible lines-of-response defined by triple interactions corresponds to the line along which the decay occurred. Several novel works have pointed out the possibility of using triple events to increase the sensitivity of PET scanners or to expand PET imaging capabilities by allowing differentiation between radiotracers labeled with non-pure and pure positron-emitting radionuclides. In this work, we extended the Monte Carlo simulator PeneloPET to assess the proportion of triple coincidences in PET acquisitions and to evaluate their possible applications. We validated the results of the simulator against experimental data acquired with a modified version of a commercial preclinical PET/CT scanner, which was enabled to acquire and process triple-coincidence events. We used as figures of merit the energy spectra for double and triple coincidences and the triples-to-doubles ratio for different energy windows and radionuclides. After validation, the simulator was used to predict the relative quantity of triple-coincidence events in two clinical scanners assuming different acquisition settings. Good agreement between simulations and preclinical experiments was found, with differences below 10% for most of the observables considered. For clinical

  4. Analysis of the treatment of Hydrocephalus byneuroendoscope%经神经内窥镜治疗脑积水分析

    Institute of Scientific and Technical Information of China (English)

    冯文; 高晋健; 吴建兵; 杜春富; 赵鹤翔

    2012-01-01

    Objective To evaluation the effect of the treatment of hydrocephalus by neuroendoscope. Methods Retrospective analysis of 50 cases of different types of hydrocephalus patients treatment by neuroendoscope from May 2005 ~2010 December. 10 patients with obstructive hydrocephalus were treated with endoscopic third ventriculostomy(ETV), Septum pellueidum ventriculostomy + endoscope-assisted ventricular-peritoneal( V-P) shunts in 18; 22 cases of communicating hydrocephalus were treated by neuroendoscopic choroid plexus coagulation + endoscope-assisted ventricular-peritoneal( V-P) shunls. Results All eases were follow-up 3 ~ 50 months. Patients'symptoms were improved, no fatalities. Ephemeral fever in 4. 2 cases of Hydrocephalus in no improvement after endoscopic third ventriculostomy, treated by V-P shunts, diversion pipe plug line divider to adjust in 4. Conclusion The treatment of hydrocephalus by neuroendoscope is effective.%目的 评价神经内窥镜对脑积水的治疗作用.方法 回顾性分析2005年5月~2010年12月神经内窥镜下行不同治疗方式的50例不同类型脑积水患者的临床资料.10例梗阻性脑积水患者行第三脑室底造瘘术(endoscopic third ventriculostomy,ETV),18例行透明隔造瘘术加内窥镜下引导脑室-腹腔分流术(ventricular-peritoneal shunts,V-P);22例交通性脑积水患者采用脉络丛绒毛凝固术及内窥镜下引导脑室-腹腔分流术.结果 随访3 ~50个月,患者脑积水症状均有所改善.全部患者无死亡.4例出现短暂高热,经对症处理后症状缓解,2例行三脑室底造瘘术后脑积水无改善,改行V-P分流术.4例分流管堵塞行分流管调整术.结论 经神经内窥镜治疗脑积水可获得满意疗效.

  5. HYDROCEPHALUS IN THREE JUVENILE NORTH AMERICAN BLACK BEARS (URSUS AMERICANUS).

    Science.gov (United States)

    Ferguson, Sylvia H; Novak, Janelle; Hecht, Silke; Craig, Linden E

    2016-06-01

    Hydrocephalus has been reported in a variety of species, including the North American black bear ( Ursus americanus ). This report describes three cases of hydrocephalus in this species from wild bears aged 3-4 mo considered retrospectively from necropsy records of one institution. Clinical signs included cortical blindness and ataxia. Primary gross findings were doming of the skull, gyri compression and flattening, and lateral ventricle dilation. Two cases had severe bilateral ventricular dilation with loss of the septum pellucidum; atrophy of the surrounding corpus callosum; and bilateral periventricular tears involving the caudate nuclei, internal capsule, and adjacent cerebrum. Histologically, the cases with periventricular tearing had severe axonal loss and degeneration, malacia, hemorrhage, and variable periventricular astrocytosis. All cases were likely congenital, given the bears' age and lack of an apparent acquired obstruction.

  6. Idiopathic Normal Pressure Hydrocephalus: A Review for General Practitioners.

    Science.gov (United States)

    Nassar, Basant R; Lippa, Carol F

    2016-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords "normal pressure hydrocephalus," "diagnosis," "shunt treatment," "biomarkers," "gait disturbances," "cognitive function," "neuropsychology," "imaging," and "pathogenesis," articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

  7. Intramedullary spinal cord primitive neuroectodermal tumor presenting with hydrocephalus.

    Science.gov (United States)

    Alexiou, George A; Siozos, George; Stefanaki, Kalliopi; Moschovi, Maria; Prodromou, Neofytos

    2013-02-01

    Spinal primitive neuroectodermal tumors are exceedingly rare. Herewith, we present the first case of an intramedullary spinal cord tumor associated with hydrocephalus in a 2-month-old boy that presented with left hemiparesis. The patient had been diagnosed on prenatal ultrasound with enlarged ventricular system. At his current admission, a brain magnetic resonance imaging (MRI) revealed hydrocephalus and an intramedullary lesion extending from the second cervical to the first thoracic vertebrae. Dissemination of the tumor was revealed intracranially and in the spinal canal. After a ventriculoperitoneal shunt placement a radical resection of the tumor was performed, however some small tumor remnants could not be safely removed. Postoperative there was no neurologic deterioration. The tumor was diagnosed as a central nervous system primitive neuroectodermal tumor (World Health Organization grade IV). Spinal intramedullary primitive neuroectodermal tumors are extremely rare. In such rare tumors, multiinstitutional studies are needed for treatment guidelines to be established.

  8. Diagnosis and prognosis in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Ghosh, Sayantani; Lippa, Carol

    2014-11-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a communicating hydrocephalus, of unknown pathophysiology, characterized by the classical triad of dementia, urinary incontinence, and ataxia. The most popular treatment option is shunt surgery, although it is not a cure. The diagnosis of the disorder is challenging as it may mimic a lot of other neurological conditions and has no distinct biomarker. It becomes even more challenging as majority of the cases are diagnosed by invasive cerebrospinal fluid (CSF) removal tests. However, a careful history taking, a keen and detailed physical examination, and pertinent imaging studies can lead to an early diagnosis. The gait symptoms respond the most to surgery. The predictors deciding the postsurgical prognosis has been discussed. Improved shunting modalities and novel shunt materials with valve adjustments have improved the precision of the shunting procedures. Still we have lot more to achieve in terms of early diagnosis and definitive management of iNPH.

  9. Neuronal ceroid-lipofuscinosis and hydrocephalus in a chihuahua.

    Science.gov (United States)

    Kuwamura, M; Hattori, R; Yamate, J; Kotani, T; Sasai, K

    2003-05-01

    A two-year-old, female chihuahua presented with a six-month history of visual dysfunction. Computed tomography revealed dilation of the lateral ventricles in the central nervous system (CNS). The dog was tentatively diagnosed as having hydrocephalus and a month later was euthanased at the owner's request. The skull was expanded and dome-like in shape and an open fontanelle was observed on postmortem examination. Histologically, swollen neurons possessing yellowish pigment granules in the cytoplasm were observed throughout the CNS. These storage materials stained positively with periodic acid Schiff, Schmorl method for lipofuscin and oil red O for lipid, and showed autofluorescence under fluorescence microscopy. Ultrastructurally, the storage materials consisted of dense lamellar structures. This case was unique in having ceroid-lipofuscinosis in association with hydrocephalus.

  10. CSF concentration gradients of monoamine metabolites in patients with hydrocephalus.

    Science.gov (United States)

    Malm, J; Kristensen, B; Ekstedt, J; Wester, P

    1994-09-01

    Concentration gradients of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG), were assessed in 762 successive CSF fractions (2 ml lumbar CSF) from 15 patients with the adult hydrocephalus syndrome (AHS) and 11 patients with hydrocephalus of other causes (mixed group). A mean volume of 49.6 (SD 11.8) ml CSF was removed in the AHS group and 56.4 (10.2) ml in the mixed group. The CSF was collected with a specially designed carousel fraction collector and the corresponding CSF dynamics were continuously registered by a constant pressure CSF infusion method. Pronounced gradients in CSF HVA and CSF 5-HIAA were seen in both patient groups in the first 25 ml of CSF removed. The concentration curves levelled off, despite the removal of larger amounts of CSF and stabilised at about twice the initial concentrations. This phenomenon has not been described before. Concentrations of HVA and 5-HIAA in the first CSF fraction correlated strongly with concentrations in fractions up to about 40 ml. A positive correlation between the first fraction of CSF HVA and CSF 5-HIAA concentrations and CSF outflow conductance was found in the AHS group. There was no gradient in MHPG. It is suggested that the rostrocaudal gradients in CSF HVA and 5-HIAA may be explained by a downward flow of CSF along the spinal cord with absorption of metabolites occurring during passage. Mixing of CSF from different CSF compartments, extraventricular production sites of CSF, clearance of metabolites to venous blood or extracellular fluid, and CSF outflow conductance are probably important determinants of the plateau phase in patients with hydrocephalus. It is concluded that lumbar CSF does not exclusively reflect the concentrations of HVA, 5-HIAA, or MHPG in the ventricles. It should be noted that these results obtained in patients with hydrocephalus may not be applicable to other groups of patients or normal subjects.

  11. Sustained Attention in Children With Two Etiologies of Early Hydrocephalus

    OpenAIRE

    Swartwout, Maegan D.; Cirino, Paul T.; Hampson, Amy W.; Fletcher, Jack M.; Brandt, Michael E.; Dennis, Maureen

    2008-01-01

    Several studies have shown that children with spina bifida meningomyelocele (SBM) and hydrocephalus have attention problems on parent ratings and difficulties in stimulus orienting associated with a posterior brain attention system. Less is known about response control and inhibition associated with an anterior brain attention system. Using the Gordon Vigilance Task (Gordon, 1983), we studied error rate, reaction time, and performance over time for sustained attention, a key anterior attentio...

  12. Neurobehavioral Deficits in Progressive Experimental Hydrocephalus in Neonatal Rats.

    Science.gov (United States)

    Olopade, F E; Shokunbi, M T

    2017-03-06

    Hydrocephalus is usually associated with functional deficits which can be assessed by neurobehavioral tests. This study characterizes the neurobehavioral deficits occurring with increasing duration and severity of ventriculomegaly in an experimental neonatal hydrocephalic rat model. Hydrocephalus was induced in three weeks old albino rats by intracisternal injection of kaolin while controls received sterile water injection. They were sacrificed in batches at one, four and eight weeks post-injection after neurobehavioral tests (forelimb grip strength, open field and Morris water maze tests) were performed. The hydrocephalic rats were also categorized into mild, moderate and severe hydrocephalus based on ventricular size. The indices of muscular strength and vertical movements in severely hydrocephalic rats were 28.05 ± 5.19 seconds and 7.29 ± 2.71 rearings respectively, compared to controls (75.68 ± 8.58 seconds and 17.09 ± 1.25 rearings respectively). At eight weeks, vertical movements were significantly reduced in hydrocephalic rats compared to controls (3.14 ± 1.3 vs 13 ± 4.11 rearings). At one week, indices of learning and memory were significantly reduced in hydrocephalic rats, compared to controls (0.89±0.31 vs 3.88±1.01 crossings), but at 8 weeks, the indices were similar (2.56 ± 0.41 vs 3.33 ± 0.71 crossings). Untreated hydrocephalus is accompanied by decline in motor functions which increase with duration and severity of ventriculomegaly. However, cognitive deficits appear to partially recover.

  13. An unusual cause of hydrocephalus: aqueductal developmental venous anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Yagmurlu, Banu; Fitoz, Suat; Atasoy, Cetin; Erden, ilhan [Ankara University School of Medicine, Department of Radiology, Ankara (Turkey); Deda, Gulhis; Unal, Ozlem [Ankara University School of Medicine, Division of Pediatric Neurology, Ankara (Turkey)

    2005-06-01

    Vascular malformations are infrequent causes of aqueductal stenoses, developmental venous anomaly (DVA) being the rarest among them. DVAs, also known as venous angiomas, are congenital in origin and characterized by dilatation of vessels in the superficial and deep venous system. Although they are usually clinically silent, they can be complicated by hemorrhage, seizures and neurologic deficits. Herein, we report MR imaging findings of a 7-year-old girl whose hydrocephalus was due to an abnormal vein coursing through the aqueduct. (orig.)

  14. Periventricular lucency on computed tomography in experimental canine hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Murata, T.; Mori, K.; Handa, H.; Nakano, Y. (Kyoto Univ. (Japan). Faculty of Medicine)

    1980-08-01

    We investigated chronological CT scans and epidural pressure monitorings in experimental canine hydrocephalus (Kaolin-induced hydrocephalus). We also investigated Metrizamide ventriculography, contrast enhancement study, and the observations before and after the ventriculo-peritoneal shunting operation. Here, we discuss the pathogenesis of periventricular lucency (PVL) in hydrocephalus. An EMI head scanner model 1010 was used throughout the examinations. We investigated the ventricular size by ''volume index of ventricles'', which was calculated from the printout CT numbers. The epidural pressure was monitored by means of a Ladd intracranial pressure monitoring apparatus. In Metrizamide ventriculography, we discussed the pathogenesis of PVL in the acute stage of hydrocephalus. According to the study of the printout CT number, the activity of transependymal CSF egress in PVL was regarded as more marked than that in the other periventricular white matter. In contrast enhancement study, in both the acute and chronic stages, PVL were only slightly enhanced in spite of the marked enhancement in the other perventricular areas. In observations before and after ventriculo-peritoneal shunting operation in both the acute and chronic stages, PVL immediately disappeared after the operation, while the epidual pressure (EDP) decreased with a reduction in the ventricular size. There was a tendency for the degree of PVL reduction to be correlated with the rate of ventricular contraction. Thereafter, all dogs became hydrocephaltic again because of shunt malfunctions, with EDP increasing and PVL reappearing. These sudden and reversible changes on CT scans were impossible to explain in terms of the loss and restoration of lipids and proteins, but were considered to be a result of a change in water content.

  15. The hydrokinetic parameters of shunts for hydrocephalus might be inadequate.

    Science.gov (United States)

    Sotelo, Julio

    2012-01-01

    Long-term treatment of hydrocephalus continues to be dismal. Shunting is the neurosurgical procedure more frequently associated with complications, which are mostly related with dysfunctions of the shunting device, rather than to mishaps of the rather simple surgical procedure. Overdrainage and underdrainage are the most common dysfunctions; of them, overdrainage is a conspicuous companion of most devices. Even when literally hundreds of different models have been proposed, developed, and tested, overdrainage has plagued all shunts for the last 60 years. Several investigations have demonstrated that changes in the posture of the subject induce unavoidable and drastic differences of intraventricular hydrokinetic pressure and cerebrospinal fluid (CSF) drainage through the shunt. Of all the parameters that participate in the pathophysiology of hydrocephalus, the only invariable one is cerebrospinal fluid production at a constant rate of approximately 0.35 ml/min. However, this feature has not been considered in the design of currently available shunts. Our experimental and clinical studies have shown that a simple shunt, whose drainage capacity complies with this unique parameter, would prevent most complications of shunting for hydrocephalus.

  16. Lumbar cisternography in evaluation of hydrocephalus in the preterm infant

    Energy Technology Data Exchange (ETDEWEB)

    Donn, S.M.; Roloff, D.W.; Keyes, J.W. Jr.

    1983-10-01

    Radionuclide lumbar cisternography using indium 111-diethylenetriamine pentaacetic acid (111In-DTPA) and a mobile gamma-camera with a converging collimator was utilized as a bedside procedure to evaluate CSF dynamics and the patency of the cerebral ventricular system in 30 preterm infants with hydrocephalus. Serial images of the brain were obtained at 0, 1, 2, 6, 24, and 48 hours after instillation of the isotope in the lumbar subarachnoid space. Three distinct patterns were seen. Infants with posthemorrhagic hydrocephalus displayed prompt ventricular filling but markedly delayed emptying with minimal flow over the cerebral convexities. Infants with ventriculomegaly secondary to suspected brain atrophy or periventricular leukomalacia demonstrated a pattern of prompt ventricular filling, delayed emptying, but with flow present over the convexities. An infant with noncommunicating hydrocephalus secondary to an Arnold-Chiari malformation showed a pattern of complete obstruction with no ventricular filling. Radionuclide lumbar cisternography appears to be a safe, well-tolerated procedure which produces images of sufficient resolution to provide valuable information about CSF dynamics, delineating basal cisternae, ventricles, and subarachnoid flow paths.

  17. Ventriculoperitoneal shunt for hydrocephalus caused by central nervous system metastasis.

    Science.gov (United States)

    Lee, Seung Hoon; Kong, Doo Sik; Seol, Ho Joon; Nam, Do-Hyun; Lee, Jung-Il

    2011-09-01

    The development of better diagnostic tools and therapeutic modalities has increased the incidence of central nervous system (CNS) metastasis in malignant tumor patients. Hydrocephalus can result from CNS metastasis and frustrate cancer treatment. The authors sought to investigate the outcomes and the roles of ventriculoperitoneal shunts (VPS) in patients with CNS metastasis. The medical records of 50 consecutive patients who underwent VPS for hydrocephalus related to CNS metastasis were analyzed retrospectively. Data included features of primary malignancies, CNS involvement, clinical course and surgical outcome. Median patient age was 55.0 years (range 25-77), and 30 female and 20 male patients were included in the study. At the time of VPS, 10 patients had parenchymal metastases only and 40 patients had leptomeningeal seeding (LMS). Symptom improvement was observed postoperatively in 40 patients (80%), mean Karnofsky performance status (KPS) scale change was from 37.8 to 46.0, and median survival from VPS was 3.0 months (2 days to 54 months). A ventricular opening pressure of >30 cmH(2)O (HR 6.44, 95% CI 1.26-32.9, P = 0.02) and further cancer treatment after VPS (HR 0.17, 95% CI 0.07-0.42, P Hydrocephalus in CNS metastasis requiring VPS is commonly associated with LMS. VPS is an effective palliative measure and an adequate cancer treatment after VPS may provide the best means of improving survival.

  18. Setting confidence intervals in coincidence search analysis

    CERN Document Server

    Baggio, L; Baggio, Lucio; Prodi, Giovanni A.

    2003-01-01

    The main technique that has been used to estimate the rate of gravitational wave (gw) bursts is to search for coincidence among times of arrival of candidate events in different detectors. Coincidences are modeled as a (possibly non-stationary) random time series background with gw events embedded in it, at random times but constant average rate. It is critical to test whether the statistics of the coincidence counts is Poisson, because the counts in a single detector often are not. At some point a number of parameters are tuned to increase the chance of detection by reducing the expected background: source direction, epoch vetoes based on sensitivity, goodness-of-fit thresholds, etc. Therefore, the significance of the confidence intervals itself has to be renormalized. This review is an insight of the state-of-the-art methods employed in the recent search performed by the International Gravitational Event Collaboration for the worldwide network of resonant bar detectors.

  19. Chiari-related hydrocephalus: assessment of clinical risk factors in a cohort of 297 consecutive patients.

    Science.gov (United States)

    Guan, Jian; Riva-Cambrin, Jay; Brockmeyer, Douglas L

    2016-11-01

    OBJECTIVE Patients treated for Chiari I malformation (CM-I) with posterior fossa decompression (PFD) may occasionally and unpredictably develop postoperative hydrocephalus. The clinical risk factors predictive of this type of Chiari-related hydrocephalus (CRH) are unknown. The authors' objective was to evaluate their experience to identify risk factors that may predict which of these patients undergoing PFD will develop CRH after surgery. METHODS The authors performed a retrospective clinical chart review of all patients who underwent PFD surgery and duraplasty for CM-I at the Primary Children's Hospital in Utah from June 1, 2005, through May 31, 2015. Patients were dichotomized based on the need for long-term CSF diversion after PFD. Analysis included both univariate and multivariable logistic regression analyses. RESULTS The authors identified 297 decompressive surgeries over the period of the study, 22 of which required long-term postoperative CSF diversion. On multivariable analysis, age < 6 years old (OR 3.342, 95% CI 1.282-8.713), higher intraoperative blood loss (OR 1.003, 95% CI 1.001-1.006), and the presence of a fourth ventricular web (OR 3.752, 95% CI 1.306-10.783) were significantly associated with the need for long-term CSF diversion after decompressive surgery. CONCLUSIONS Younger patients, those with extensive intraoperative blood loss, and those found during surgery to have a fourth ventricular web were at higher risk for the development of CRH. Clinicians should be alert to evidence of CRH in this patient population after PFD surgery.

  20. A Precise Analytic Delayed Coincidence Efficiency and Accidental Coincidence Rate Calculation

    CERN Document Server

    Yu, Jingyi; Chen, Shaomin

    2013-01-01

    In a delayed coincidence experiment, for example, the recent reactor neutrino oscillation experiments, a precise analytic determination of the delayed coincidence signal efficiency and the accidental coincidence background rate is important for the high accuracy measurement of the oscillation parameters and to understand systematic uncertainties associated with fluctuations in muon rate and random background rate. In this work, a data model is proposed to describe the full time sequence of all possible events on the live time axis. The acceptance of delayed coincidence signals, the rate of accidental backgrounds and other coincidence possibilities are calculated by assuming that all of the `net muons' are uniformly distributed on the live time axis. The intrinsic relative uncertainties in the event rates are at the $10^{-5}$ level for all combinations. The model and predictions are verified with a high statistics Monte Carlo study with a set of realistic parameters.

  1. Community Knowledge, Beliefs, Attitudes, and Practices towards Children with Spina Bifida and Hydrocephalus in Uganda

    Science.gov (United States)

    Bannink, Femke; Stroeken, Koenraad; Idro, Richard; van Hove, Geert

    2015-01-01

    This article describes the findings of a qualitative study on knowledge, beliefs, attitudes, and practices towards children with spina bifida and hydrocephalus in four regions of Uganda. Focus group discussions and semi-structured interviews were held with parents of children with spina bifida and hydrocephalus, policy-makers, and service…

  2. Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

    NARCIS (Netherlands)

    HOLTZER, G.J.; de LANGE, S.A.; ORBAAN, I.J.C.; GELSEMA, R.

    1971-01-01

    textabstractMeasurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the ventri

  3. Community Knowledge, Beliefs, Attitudes, and Practices towards Children with Spina Bifida and Hydrocephalus in Uganda

    Science.gov (United States)

    Bannink, Femke; Stroeken, Koenraad; Idro, Richard; van Hove, Geert

    2015-01-01

    This article describes the findings of a qualitative study on knowledge, beliefs, attitudes, and practices towards children with spina bifida and hydrocephalus in four regions of Uganda. Focus group discussions and semi-structured interviews were held with parents of children with spina bifida and hydrocephalus, policy-makers, and service…

  4. Abnormal structural connectivity in the brain networks of children with hydrocephalus.

    Science.gov (United States)

    Yuan, Weihong; Holland, Scott K; Shimony, Joshua S; Altaye, Mekibib; Mangano, Francesco T; Limbrick, David D; Jones, Blaise V; Nash, Tiffany; Rajagopal, Akila; Simpson, Sarah; Ragan, Dustin; McKinstry, Robert C

    2015-01-01

    Increased intracranial pressure and ventriculomegaly in children with hydrocephalus are known to have adverse effects on white matter structure. This study seeks to investigate the impact of hydrocephalus on topological features of brain networks in children. The goal was to investigate structural network connectivity, at both global and regional levels, in the brains in children with hydrocephalus using graph theory analysis and diffusion tensor tractography. Three groups of children were included in the study (29 normally developing controls, 9 preoperative hydrocephalus patients, and 17 postoperative hydrocephalus patients). Graph theory analysis was applied to calculate the global network measures including small-worldness, normalized clustering coefficients, normalized characteristic path length, global efficiency, and modularity. Abnormalities in regional network parameters, including nodal degree, local efficiency, clustering coefficient, and betweenness centrality, were also compared between the two patients groups (separately) and the controls using two tailed t-test at significance level of p path length and lower modularity. At regional level, significant group differences (or differences at trend level) in regional network measures were found between hydrocephalus patients and the controls in a series of brain regions including the medial occipital gyrus, medial frontal gyrus, thalamus, cingulate gyrus, lingual gyrus, rectal gyrus, caudate, cuneus, and insular. Our data showed that structural connectivity analysis using graph theory and diffusion tensor tractography is sensitive to detect abnormalities of brain network connectivity associated with hydrocephalus at both global and regional levels, thus providing a new avenue for potential diagnosis and prognosis tool for children with hydrocephalus.

  5. Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

    NARCIS (Netherlands)

    HOLTZER, G.J.; de LANGE, S.A.; ORBAAN, I.J.C.; GELSEMA, R.

    1971-01-01

    textabstractMeasurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the

  6. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

    NARCIS (Netherlands)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M. A.; Hoving, Eelco W.

    2014-01-01

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. Duri

  7. Morphological and behavioral changes in the pathogenesis of a novel mouse model of communicating hydrocephalus.

    Directory of Open Access Journals (Sweden)

    Allison B McMullen

    Full Text Available The Ro1 model of hydrocephalus represents an excellent model for studying the pathogenesis of hydrocephalus due to its complete penetrance and inducibility, enabling the investigation of the earliest cellular and histological changes in hydrocephalus prior to overt pathology. Hematoxylin and eosin staining, immunofluorescence and electron microscopy were used to characterize the histopathological events of hydrocephalus in this model. Additionally, a broad battery of behavioral tests was used to investigate behavioral changes in the Ro1 model of hydrocephalus. The earliest histological changes observed in this model were ventriculomegaly and disorganization of the ependymal lining of the aqueduct of Sylvius, which occurred concomitantly. Ventriculomegaly led to thinning of the ependyma, which was associated with periventricular edema and areas of the ventricular wall void of cilia and microvilli. Ependymal denudation was subsequent to severe ventriculomegaly, suggesting that it is an effect, rather than a cause, of hydrocephalus in the Ro1 model. Additionally, there was no closure of the aqueduct of Sylvius or any blockages within the ventricular system, even with severe ventriculomegaly, suggesting that the Ro1 model represents a model of communicating hydrocephalus. Interestingly, even with severe ventriculomegaly, there were no behavioral changes, suggesting that the brain is able to compensate for the structural changes that occur in the pathogenesis of hydrocephalus if the disorder progresses at a sufficiently slow rate.

  8. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

    NARCIS (Netherlands)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M. A.; Hoving, Eelco W.

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle.

  9. X-linked hydrocephalus : A novel missense mutation in the L1CAM gene

    NARCIS (Netherlands)

    Sztriha, L; Vos, YJ; Verlind, E; Johansen, J; Berg, B

    2002-01-01

    X-linked hydrocephalus is associated with mutations in the L1 neuronal cell adhesion molecule gene. L1 protein plays a key role in neurite outgrowth, axonal guidance, and pathfinding during the development of the nervous system. A male is described with X-linked hydrocephalus who had multiple small

  10. Hydrocephalus following severe traumatic brain injury in adults. Incidence, timing, and clinical predictors during rehabilitation

    DEFF Research Database (Denmark)

    Kammersgaard, Lars Peter; Linnemann, Mia; Tibæk, Maiken

    2013-01-01

    To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI).......To investigate timing and clinical predictors that might predict hydrocephalus emerging during rehabilitation until 1 year following severe traumatic brain injury (TBI)....

  11. Discourse after early-onset hydrocephalus: core deficits in children of average intelligence.

    Science.gov (United States)

    Barnes, M A; Dennis, M

    1998-02-15

    A review of our studies of oral and written language in children with early-onset hydrocephalus suggests that hydrocephalus is associated with specific deficits in discourse as opposed to generalized linguistic deficit. It is proposed that the language skills that are impaired in hydrocephalus are those that require context to derive meaning, while those that are intact may function relatively independent of particular discourse contexts. This hypothesis was tested in two discourse studies comparing children with hydrocephalus of average verbal IQ to age-matched controls. Study 1 investigated narrative economy, syntactic complexity, and semantic content in the retellings of familiar and less familiar fairy tales. Despite producing quantities of story content similar to controls and using syntactic economy similar to controls, the hydrocephalus group produced less of the core semantic content of both familiar and less familiar tales. Study 2 investigated inferencing and figurative language understanding in a narrative comprehension task. Even when prior knowledge was controlled, the hydrocephalus group had difficulty making inferences and recalling factual information from the story. In contrast to their ability to understand idiomatic figurative expressions, the hydrocephalus group had difficulty interpreting novel figurative expressions. The results are compatible with the hypothesis that the core discourse deficits characteristic of children with hydrocephalus are concerned with computing meaning from context. Putative processing features underlying the proposed core discourse deficit are discussed.

  12. Evolution of surgical interventions for hydrocephalus: patient preferences and the need for proper information

    Directory of Open Access Journals (Sweden)

    Dr. P. O. Eghwrudjakpor MBBS, DMS, FICS

    2010-07-01

    Full Text Available The treatment of hydrocephalus has undergone remarkable transformation since it was first documented over two thousand years ago. Currently, the focus of hydrocephalus research is on minimally invasive techniques of treatment. This article reviews the evolution of hydrocephalus therapy, and examines current attitudes towards modern methods. We relied on journal publications, as well as literature on hydrocephalus obtained from the Internet (Google, Yahoo and PUBMED search making use of the following search terms: “hydrocephalus: history; treatment; complications”, “cerebrospinal fluid shunt”, “endoscopic third ventriculostomy: indications of; complications of; advantages; disadvantages; successes; failure”. Numerous medical and surgical approaches have been adopted in the treatment of hydrocephalus in the past. However, the breakthrough that ushered in the modern era of hydrocephalus treatment was the introduction of valve-regulated systems in the middle of the last century. Endoscopic third ventriculostomy has evolved to become an alternative to traditional shunts. Cerebrospinal fluid shunt procedures are very effective in the treatment of hydrocephalus and have radically transformed the outcome of the disorder. However, they have a number of limitations. The alternative to shunts, endoscopic third ventriculostomy, is relatively safe, effective and durable. It does not, however, succeed in every patient; and also has some potentially devastating complications. Preoperative counseling is imperative to ensure that patients are properly guided.

  13. Delayed hydrocephalus associated with traumatic atlanto-occipital dislocation: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Ashish Sharma

    2016-01-01

    Conclusion: Manifestations of hydrocephalus after AOD can be variable, ranging from interval ventricular dilatation to pseudomeningoceles and syringomyelia. In addition, the timing of presentation can be acute, requiring emergent external ventricular drainage, or delayed, requiring ongoing vigilance. Consequently, as more patients survive this once thought to be fatal injury, caution for hydrocephalus is stressed.

  14. Using Compton scattering for random coincidence rejection

    Science.gov (United States)

    Kolstein, M.; Chmeissani, M.

    2016-12-01

    The Voxel Imaging PET (VIP) project presents a new approach for the design of nuclear medicine imaging devices by using highly segmented pixel CdTe sensors. CdTe detectors can achieve an energy resolution of ≈ 1% FWHM at 511 keV and can be easily segmented into submillimeter sized voxels for optimal spatial resolution. These features help in rejecting a large part of the scattered events from the PET coincidence sample in order to obtain high quality images. Another contribution to the background are random events, i.e., hits caused by two independent gammas without a common origin. Given that 60% of 511 keV photons undergo Compton scattering in CdTe (i.e. 84% of all coincidence events have at least one Compton scattering gamma), we present a simulation study on the possibility to use the Compton scattering information of at least one of the coincident gammas within the detector to reject random coincidences. The idea uses the fact that if a gamma undergoes Compton scattering in the detector, it will cause two hits in the pixel detectors. The first hit corresponds to the Compton scattering process. The second hit shall correspond to the photoelectric absorption of the remaining energy of the gamma. With the energy deposition of the first hit, one can calculate the Compton scattering angle. By measuring the hit location of the coincident gamma, we can construct the geometric angle, under the assumption that both gammas come from the same origin. Using the difference between the Compton scattering angle and the geometric angle, random events can be rejected.

  15. Coincidence velocity map imaging using a single detector

    Science.gov (United States)

    Zhao, Arthur; Sándor, Péter; Weinacht, Thomas

    2017-07-01

    We demonstrate a single-detector velocity map imaging setup which is capable of rapidly switching between coincidence and non-coincidence measurements. By rapidly switching the extraction voltages on the electrostatic lenses, both electrons and ions can be collected in coincidence with a single detector. Using a fast camera as the 2D detector avoids the saturation problem associated with traditional delay line detectors and allows for easy transitions between coincidence and non-coincidence data collection modes. This is a major advantage in setting up a low-cost and versatile coincidence apparatus. We present both coincidence and non-coincidence measurements of strong field atomic and molecular ionization.

  16. Analysis of intracranial infection in hydrocephalus shunt%脑积水分流术后颅内感染原因分析

    Institute of Scientific and Technical Information of China (English)

    宋志伟; 侯凯

    2013-01-01

    目的 探讨脑积水分流术后感染的相关因素及预防措施.方法 回顾性分析2008年12月至2010年12月脑积水分流术后感染的28例临床资料.结果 28例患者金黄色葡萄球菌感染为48%,表皮葡萄球菌感染为25%,肠道菌、铜绿假单胞菌及肺炎克雷伯杆菌检出率分别为11%、14%和4%.颅内肿瘤、脑出血进行脑积水分流术术后更易发生感染.结论 脑积水分流术后颅内感染以革兰阳性菌为主,全身预防性应用抗生素及对高危人群严密监测有助于降低感染的发生率.%Objective To study the risk factors and prevention methods of infection in hydrocephalus shunt. Methods The records of 28 patients treated with hydrocephalus shunt between Dec. 2008 and Dec. 2010 were retrospectively reviewed. Results Cerebrospinal fluid bacterial culture showed that infection rate of staphylococcus aureus was 48% , staphylococcus epidermidis was 25% , and the detection rate of intestinal bacteria, pseudomonas acruginosa and Klcbsiella pneumonia was 11% , 14% , and 4% respectively among 28 patients. It was more susceptible for patients with intracranial tumors and cerebral hemorrhage treated with hydrocephalus shunt to get infected. Conclusion Gram - positive bacteria account for the majority during intracranial infection in hydrocephalus shunts. Besides, systemic antibioticprophylaxis and close monitoring of high - risk groups arc; very hclpful to reduce the incidence of infection.

  17. [Posthaemorrhagic hydrocephalus in newborns--current concepts of formation and treatment possibilities].

    Science.gov (United States)

    Wróblewska, Jolanta; Swietliński, Janusz

    2005-01-01

    Intracranial haemorrhage is still one of major complications of preterm birth. Transfontanel ultrasonographic examination is a recognized method of peri/intraventricular haemorrhage imaging. Haemorrhages are distinguished according to four degrees Papile classification. Early diagnosis of posthaemorrhagic hydrocephalus is a very important task for neonatologist. Traditional clinical symptoms of ventricular expansion are useless criteria for posthaemorrhagic hydrocephalus diagnosis. Early diagnosis of posthaemorrhagic hydrocephalus is possible with ultrasonographic measurement of ventricular size--for example with ventricular index of Levine. There are four mechanisms responsible for posthaemorrhagic hydrocephalus formation: blockage of cerebro-spinal fluid circulation and its absorption, fibrosis and scarring around the medulla and in subarachnoid spaces and endogenic fibrinolytic mechanisms insufficiency. Authors decribe current known and used methods of neonatal and neurosurgical interventions in posthaemorrhagic hydrocephalus, as well as a new method involving drainage, irigation and fibrinolytic therapy (DRIFT), which seems to be promising in clinical neonatal care.

  18. Ventriculoperitoneal Shunting Surgery with Open Distal Shunt Catheter Placement in the Treatment of Hydrocephalus.

    Science.gov (United States)

    Zhang, Yang; Zhu, Xiaobo; Zhao, Jinchuan; Hou, Kun; Gao, Xianfeng; Sun, Yang; Wang, Wei; Zhang, Xiaona

    2015-11-01

    Ventriculoperitoneal shunting (VPS) is a major therapy for hydrocephalus, but has a significant risk of device malfunctioning. In this study, we explored a novel distal shunt catheter placement method in VPS for the treatment of hydrocephalus. Five patients with different etiologies of hydrocephalus underwent VPS with open distant shunt catheter attached outside. We analyzed different variables (age, gender, medical history, clinical presentation, indication for surgery and surgical technique, postoperative complications) and occurrence of shunt failure and infection. All hydrocephalus patients who received the distal shunt catheter placed outside can undergo regular VPS again after the condition improves. The modified VPS in the treatment of hydrocephalus with the distal shunt catheter placed outside could potentially reduce the necessity of repeat surgery for addressing the complications caused by catheter obstruction and infections, reduce the chance of adhesions, and would be of benefit to those patients who need future revisions.

  19. Analysis of Risk Factors of Occurrence of Post-Truaumatic Hydrocephalus%脑外伤后脑积水发生的风险因素分析

    Institute of Scientific and Technical Information of China (English)

    黄强

    2016-01-01

    Objective To discuss the risk factors of occurrence of post-truaumatic hydrocephalus. Methods 62 cases of pa-tients with cerebral trauma treated in our hospital from January 2008 to December 2014 were selected and divided into the hydrocephalus group and the non-hydrocephalus group with 31 cases in each according to whether the hydrocephalus oc-curred or not, the risk factors of occurrence of post-truaumatic hydrocephalus were observed. Results In the hydrocephalus group, 25 cases were with cerebralcontusion and laceration(80.65%), 24 cases were with ventricular hemorrhage(77.42%), 22 cases were with subdural hematoma (70.96%), 24 cases were with coma (77.42%), 26 cases were with craniotomy (83.87%), 8 cases were with TSAH (25.81%),6 cases with increased cerebrospinal pressure(19.35%),which were obvious-ly different from those in the non- hydrocephalus group, P﹤0.05,Logistic regression analysis showed that the independent factors of occurrence of hydrocephalus were ventricular hemorrhage, increased cerebrospinal pressure, TSAH and subdural hematoma. Conclusion Ventricular hemorrhage, increased cerebrospinal pressure, TSAH and subdural hematoma were the independent risk factors of occurrence of hydrocephalus.%目的:探析脑外伤后脑积水发生的风险因素。方法整群选取该院2008年1月—2014年12月收治的62例脑外伤患者,根据患者是否发生脑积水将其分为脑积水组与非脑积水组,各31例,观察脑外伤后脑积水发生的风险因素。结果脑积水组脑挫裂伤发生25例(80.65%),脑室出血24例(77.42%),硬膜下血肿22例(70.96%),昏迷24例(77.42%),开颅手术26例(83.87%),TSAH 8例(25.81%),脑脊液压力升高6例(19.35%)与非脑积水组比较差异显著,P﹤0.05;Logistic回归分析得知发生脑积水的独立因素是脑室出血、脑脊液压力升高、TSAH及硬膜下血肿。结论脑室出血、脑脊液压力升高、TSAH及硬膜下血肿是脑外伤患者发生脑积水的独立风险因素。

  20. Grain-boundary structures in hexagonal materials: Coincident and near coincident grain boundaries

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, D. (Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States). Dept. of Materials Science and Engineering)

    1994-07-01

    Embedded atom method (EAM) simulations of the structure of grain boundaries in hexagonal metal, are presented. The simulations use recently developed interatomic potentials for Ti and Co. Structures were calculated for various symmetrical tilt boundaries with the [1,100] tilt axis. The structures obtained for both metals are very similar. The energies for the Co boundaries are higher than those for Ti by a factor of 2. The structural unit model was applied to the computed grain-boundary structures in these hexagonal materials. As in cubic materials, the structural unit model can describe a series of symmetrical tilt coincident boundaries. In addition, when the coincidence ratio in the grain-boundary plane varies with the c/a ratio, a structural unit-type model can describe the variation of grain-boundary structure with c/a ratio. This model is adequate for describing series of symmetrical tilt boundaries with the grain-boundary plane oriented perpendicular to a fixed crystallographic direction and varying c/a ratios. For the structures of the so-called near coincident boundaries that appear in these materials, it was concluded that near coincident boundaries behave similarly to exact coincidence boundaries if there is a coincident periodic structure in the grain-boundary plane. This may occur even without a three-dimensional (3-D) coincident site lattice.

  1. Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients.

    Science.gov (United States)

    Bir, Shyamal C; Patra, Devi Prasad; Maiti, Tanmoy K; Sun, Hai; Guthikonda, Bharat; Notarianni, Christina; Nanda, Anil

    2016-09-01

    OBJECTIVE Adult-onset hydrocephalus is not commonly discussed in the literature, especially regarding its demographic distribution. In contrast to pediatric hydrocephalus, which is related to a primary CSF pathway defect, its development in adults is often secondary to other pathologies. In this study, the authors investigated the epidemiology of adult-onset hydrocephalus as it pertains to different etiologies and in reference to age, sex, and race distributions. METHODS The authors retrospectively reviewed the clinical notes of 2001 patients with adult-onset hydrocephalus who presented to Louisiana State University Health Sciences Center within a 25-year span. Significant differences between the groups were analyzed by a chi-square test; p hydrocephalus in this population was 77 ± 30 per year, with a significant increase in incidence in the past decade (55 ± 3 [1990-2003] vs 102 ± 6 [2004-2015]; p Hydrocephalus in a majority of the patients had a vascular etiology (45.5%) or was a result of a tumor (30.2%). The incidence of hydrocephalus in different age groups varied according to various pathologies. The incidence was significantly higher in males with normal-pressure hydrocephalus (p = 0.03) or head injury (p = 0.01) and higher in females with pseudotumor cerebri (p hydrocephalus was significantly higher in Caucasian patients (p = 0.0002) than in those of any other race. CONCLUSIONS Knowledge of the demographic variations in adult-onset hydrocephalus is helpful in achieving better risk stratification and better managing the disease in patients. For general applicability, these results should be validated in a large-scale meta-analysis based on a national population database.

  2. Abnormal structural connectivity in the brain networks of children with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Weihong Yuan

    2015-01-01

    Full Text Available Increased intracranial pressure and ventriculomegaly in children with hydrocephalus are known to have adverse effects on white matter structure. This study seeks to investigate the impact of hydrocephalus on topological features of brain networks in children. The goal was to investigate structural network connectivity, at both global and regional levels, in the brains in children with hydrocephalus using graph theory analysis and diffusion tensor tractography. Three groups of children were included in the study (29 normally developing controls, 9 preoperative hydrocephalus patients, and 17 postoperative hydrocephalus patients. Graph theory analysis was applied to calculate the global network measures including small-worldness, normalized clustering coefficients, normalized characteristic path length, global efficiency, and modularity. Abnormalities in regional network parameters, including nodal degree, local efficiency, clustering coefficient, and betweenness centrality, were also compared between the two patients groups (separately and the controls using two tailed t-test at significance level of p < 0.05 (corrected for multiple comparison. Children with hydrocephalus in both the preoperative and postoperative groups were found to have significantly lower small-worldness and lower normalized clustering coefficient than controls. Children with hydrocephalus in the postoperative group were also found to have significantly lower normalized characteristic path length and lower modularity. At regional level, significant group differences (or differences at trend level in regional network measures were found between hydrocephalus patients and the controls in a series of brain regions including the medial occipital gyrus, medial frontal gyrus, thalamus, cingulate gyrus, lingual gyrus, rectal gyrus, caudate, cuneus, and insular. Our data showed that structural connectivity analysis using graph theory and diffusion tensor tractography is sensitive to

  3. The clinical application and nursing experience of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    YANG Li-rong

    2012-02-01

    Full Text Available Objective To introduce the application of adjustable shunt valve in treatment for patients with normal pressure hydrocephalus. Methods Twenty-four patients with normal pressure hydrocephalus implanted adjustable shunt valve underwent ventriculo-peritoneal shunt surgery and nursing care. Results After operation, cerebrospinal pressure was regulated for 0-6 (1.88 ± 1.52 times. Clinical symptoms were improved, especially in gait disturbance. Conclusion Treatment of normal pressure hydrocephalus with adjustable shunt valve can alleviate symptoms of hydrocephalus. It is especially suitable for patients with short course and secondary normal hydrocephalus patients.

  4. A Rare Complication of Acute Otitis Media: Otitic Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Ahmet Mutlu

    2013-06-01

    Full Text Available Acute otitis media is very common disorder in childhood. In this article we present a 6-years old boy who applied with diplopia, dysfunction of lateral eye movements on left eye, nausea, at 10th day of acute otitis media treatment. After the radiological images case was described as an otitic hydrocephalus clinic. Patient underwent medical treatment, lomboperitoneal shunt operation and simple mastoidectomy. We wanted to share the evaluation and the management steps of this very rare complication of acute otitis media.

  5. Ion beam sputter-etched ventricular catheter for hydrocephalus shunt

    Science.gov (United States)

    Banks, B. A. (Inventor)

    1983-01-01

    A cerebrospinal fluid shunt in the form of a ventricular catheter for controlling the condition of hydrocephalus by relieving the excessive cerebrospinal fluid pressure is described. A method for fabrication of the catheter and shunting the cerebral fluid from the cerebral ventricles to other areas of the body is also considered. Shunt flow failure occurs if the ventricle collapse due to improper valve function causing overdrainage. The ventricular catheter comprises a multiplicity of inlet microtubules. Each microtubule has both a large openings at its inlet end and a multiplicity of microscopic openings along its lateral surfaces.

  6. Neonatal Bartter syndrome with cholelithiasis and hydrocephalus: Rare association.

    Science.gov (United States)

    Özdemir, Özmert Ma; Çıralı, Ceren; Yılmaz Ağladıoğlu, Sebahat; Evrengül, Havva; Tepeli, Emre; Ergin, Hacer

    2016-09-01

    Neonatal Bartter syndrome (NBS) is a rare autosomal recessive renal tubular disorder. This disease is characterized by hypokalemia, hypochloremia, and metabolic alkalosis that is often associated with failure to thrive and recurrent episodes of dehydration. The combination of BS and cholelithiasis in an infant is very rare. Herein, we report a premature male infant with NBS who developed cholelithiasis and hydrocephalus on clinical follow up. We recommend that periodic routine hepatobiliary ultrasonograpic screening for cholelithiasis should be performed in patients with NBS. © 2016 Japan Pediatric Society.

  7. Unilateral hydrocephalus in paediatric patients, a trial of endoscopic fenestration.

    Directory of Open Access Journals (Sweden)

    Kumar R

    1999-10-01

    Full Text Available Two uncommon cases of unilateral, asymmetrical hydrocephalus secondary to membranous occlusion of foramen of monro are described. Both the cases presented with clinical features of raised intracranial pressure and their cranial computerized scans (CT revealed asymmetrical dilatation of lateral ventricles with displacement of septum pellucidum towards the side of smaller ventricle. Neuroendoscopic fenestration of septum pellucidum and foramen of monro was tried in both the cases, which remained successful in first, while the second case required unilateral ventriculoperitoneal shunt, due to failed endoscopic negotiation of narrowed foramen of monro and intraoperative bleeding during endoscopic intervention.

  8. Kinematical coincidence method in transfer reactions

    Energy Technology Data Exchange (ETDEWEB)

    Acosta, L.; Amorini, F. [INFN—Laboratori Nazionali del Sud, Via S. Sofia, Catania (Italy); Auditore, L. [INFN Gruppo Collegato di Messina and Dipartimento di Fisica, Università di Messina (Italy); Berceanu, I. [Institute for Physics and Nuclear Engineering, Bucharest (Romania); Cardella, G., E-mail: cardella@ct.infn.it [INFN—Sezione di Catania, Via S. Sofia, 95123 Catania (Italy); Chatterjiee, M.B. [Saha Institute for Nuclear Physics, Kolkata (India); De Filippo, E. [INFN—Sezione di Catania, Via S. Sofia, 95123 Catania (Italy); Francalanza, L.; Gianì, R. [INFN—Laboratori Nazionali del Sud, Via S. Sofia, Catania (Italy); Dipartimento di Fisica e Astronomia, Università di Catania, Via S. Sofia, Catania (Italy); Grassi, L. [INFN—Sezione di Catania, Via S. Sofia, 95123 Catania (Italy); Rudjer Boskovic Institute, Zagreb (Croatia); Grzeszczuk, A. [Institut of Physics, University of Silesia, Katowice (Poland); La Guidara, E. [INFN—Sezione di Catania, Via S. Sofia, 95123 Catania (Italy); Centro Siciliano di Fisica Nucleare e Struttura della Materia, Catania (Italy); Lanzalone, G. [INFN—Laboratori Nazionali del Sud, Via S. Sofia, Catania (Italy); Facoltà di Ingegneria e Architettura, Università Kore, Enna (Italy); Lombardo, I. [INFN—Laboratori Nazionali del Sud, Via S. Sofia, Catania (Italy); Dipartimento di Scienze Fisiche, Università Federico II and INFN Sezione di Napoli (Italy); Loria, D.; Minniti, T. [INFN Gruppo Collegato di Messina and Dipartimento di Fisica, Università di Messina (Italy); Pagano, E.V. [INFN—Laboratori Nazionali del Sud, Via S. Sofia, Catania (Italy); Dipartimento di Fisica e Astronomia, Università di Catania, Via S. Sofia, Catania (Italy); and others

    2013-07-01

    A new method to extract high resolution angular distributions from kinematical coincidence measurements in binary reactions is presented. Kinematics is used to extract the center of mass angular distribution from the measured energy spectrum of light particles. Results obtained in the case of {sup 10}Be+p→{sup 9}Be+d reaction measured with the CHIMERA detector are shown. An angular resolution of few degrees in the center of mass is obtained. The range of applicability of the method is discussed.

  9. VEGF, which is elevated in the CSF of patients with hydrocephalus, causes ventriculomegaly and ependymal changes in rats.

    Science.gov (United States)

    Shim, Joon W; Sandlund, Johanna; Han, Carin H; Hameed, Mustafa Q; Connors, Susan; Klagsbrun, Michael; Madsen, Joseph R; Irwin, Nina

    2013-09-01

    Hydrocephalus is a condition characterized primarily by excessive accumulation of fluid in the ventricles of the brain for which there is currently no effective pharmacological treatment. Surgery, often accompanied by complications, is the only current treatment. Extensive research in our laboratory along with work from others has suggested a link between hydrocephalus and vascular function. We hypothesized that vascular endothelial growth factor (VEGF), the major angiogenic factor, could play a role in the pathogenesis of hydrocephalus. We tested this hypothesis by examining two predictions of such a link: first, that VEGF is present in many cases of clinical hydrocephalus; and second, that exogenous VEGF in an animal model could cause ventricular enlargement and tissue changes associated with hydrocephalus. Our results support the idea that VEGF elevation can potentiate hydrocephalus. The clinical relevance of this work is that anti-angiogenic drugs may be useful in patients with hydrocephalus, either alone or in combination with the currently available surgical treatments.

  10. Application of Ommaya reservoir in brain tumors with hydrocephalus%Ommaya储液囊在脑肿瘤并发脑积水中的应用

    Institute of Scientific and Technical Information of China (English)

    魏文锋; 袁雪松; 卞晓星; 刘平; 张敬

    2016-01-01

    目的 探讨Ommaya储液囊在脑肿瘤并发脑积水中的临床应用效果.方法 回顾分析江苏大学附属武进医院神经外科2012年6月至2014年6月收治的4例颅内肿瘤并发脑积水患者,应用Ommaya储液囊治疗.结果 1例患者的症状完全缓解,2例好转,1例自动出院.结论 Ommaya储液囊在脑肿瘤并发脑积水中的临床应用效果良好,临床安全性可靠.%Objective To study the application of Ommaya reservoir in brain tumors with hydrocephalus . Methods The clinical data of 4 patients with intracranial tumor complicated with hydrocephalus treated by sac Ommaya reservoir in our department from June 2012 to June 2014, were analyzed retrospectively .Results Symptom relieved in 1 case and improved in 2 and 1 discharged against edical advice .Conclusions Capsule Ommaya reservoir applied for brain tumor patients with hydrocephalus is good , safe and reliable .

  11. Guidelines for the management of obstructive hydrocephalus from suprasellar-prepontine arachnoid cysts using endoscopic third ventriculocystocisternostomy.

    Science.gov (United States)

    Mattox, Austin; Choi, Jonathan D; Leith-Gray, Linda; Grant, Gerald A; Adamson, D Cory

    2010-09-01

    Intracranial endoscopy has emerged as an innovative surgical tool for various intracranial procedures, but its use remains limited to neurosurgeons trained in this minimally invasive technique. Complex, skull base arachnoid cysts represent one entity that is challenging to treat because of adjacent critical neurovascular structures; however, the advent of intracranial endoscopic techniques has revolutionized treatment. Arachnoid cysts located in the suprasellar-prepontine skull base region can cause obstructive hydrocephalus or symptomatic mass effect and require urgent decompression. These patients may present with nonfocal symptoms that can quickly lead to a life-threatening condition if not accurately diagnosed and treated. The authors present a summary of the world literature of suprasellar-prepontine arachnoid cysts (SPACs) to ascertain clinical presentations and provide class III evidentiary treatment guidelines for this uniquely challenging type of arachnoid cyst. Urgent endoscopic third ventriculostomy results in normalization of intracranial pressure, return of normal CSF flow, and relief of symptoms.

  12. Large vestibular schwannomas and hydrocephalus: Lessons learnt from a single centre experience

    Directory of Open Access Journals (Sweden)

    Prakash Nair

    2014-01-01

    Full Text Available Aim: The aim of the following study is to analyze the outcome following surgery in 169 patients with large vestibular schwannoma (VS and to evaluate hydrocephalus as a prognostic factor in patients of the VSs. Subjects and Methods: Retrospective analysis of all cases of VSs admitted to our tertiary neurosurgical center from January 2005 to December 2010 was performed. Comparison of patients who underwent pre-operative cerebrospinal fluid (CSF diversion and those who underwent primary surgery was carried out for post-operative complications and delayed hydrocephalus. Results: A total of 169 patients of VS were seen. The mean age at presentation was 39.03 years (12-72 years. The most common symptom was hearing loss seen in 161 (95.2% cases. Giant VS was seen in 130 (75.5% and hydrocephalus was present in 110 (63.9%. Pre-operative CSF diversion was done in 23 (13.1% patients; 8 (4.6% patients developed gradually symptomatic hydrocephalus following surgery and underwent ventriculoperitoneal shunt. Total surgical excision was done in 92.9% patients and subtotal excision was done in 7% patients. Conclusions: Hydrocephalus occurs in longstanding untreated cases of VS. Hydrocephalus causes no statistically significant increase in post-operative complications like CSF leak and post-operative hematoma. Patients with hydrocephalus presenting with acute symptoms of raised intracranial pressure benefit from CSF diversion. In most patients, tumor resection will restore patency of the CSF pathway and CSF diversion can be avoided.

  13. Hydrocephalus 2008, 17–20th September, Hannover Germany: a conference report

    Directory of Open Access Journals (Sweden)

    Klinge Petra M

    2008-12-01

    Full Text Available Abstract Hydrocephalus 2008 was held 17–20 September in Hannover, Germany, at the invitation of Petra M Klinge (President, co-hosted by Joachim K. Krauss (Vice President, and Madjid Samii (Honorary President. This meeting was a successor to Hydrocephalus 2006 held in Göteborg, Sweden, organised by Past-President, Carsten Wikkelso. The conference began with a general introductory session of six talks including three invited lectures, followed by eighteen parallel sessions. Subjects covered were hydrocephalus signs, symptoms and diagnosis, especially in normal pressure hydrocephalus; cerebrospinal fluid (CSF physics and dynamics; CSF function and modelling of function; dementia and quality of life, economy, health care and rehabilitation; neuropsychology, cognition and outcome assessment; neuroimaging, functional imaging and non-invasive diagnostics; paediatric and adolescent hydrocephalus; intelligent shunt and valve design (e.g. telemetry, adjustable and antimicrobial shunts; endoscopic third ventriculostomy; technical advances and image-guided surgical approaches in the treatment of hydrocephalus; brain metabolism, biomarkers and biophysics; co-morbidity, classification and aetiology; epidemiology, registries and clinical trials; experimental hydrocephalus; and pharmaceutical modulation of central nervous system function (CNS drug delivery. Each session began with introductory talks from the invited chairpersons followed by six to eight submitted oral presentations. Overall, 136 oral presentations and 18 posters were presented, the abstracts of which were published elsewhere 1. We present here an account of the introductory session, the invited chairperson's talks and the concluding remarks by Anthony Marmarou.

  14. Changes in neural stem cells in the subventricular zone in a rat model of communicating hydrocephalus.

    Science.gov (United States)

    Li, Yan; Wu, Dongxue; Wu, Chunming; Qu, Zhenyun; Zhao, Yongshun; Li, Weihua; Wang, Jian; Li, Zhongmin

    2014-08-22

    Communicating hydrocephalus is a common type of hydrocephalus. At present, the prevalent treatment is to perform a ventriculo-peritoneal shunt, which, for reasons that are not clear, is sometimes ineffective. The subventricular zone (SVZ) of the lateral ventricles has been established as the primary site of adult neurogenesis. Following cerebral ischemia or brain injury, neural stem cells (NSCs) increase in the SVZ and can both differentiate into neurons and glial cells and respond to the injury. Neural stem cells, enabled by a complex repertoire of factors that precisely regulate the activation, proliferation, differentiation and integration of newborn cells, continuously generate new neurons. However, only a few systematic studies of the role of NSCs in hydrocephalus have been reported. In a rat model of communicating hydrocephalus, we recently showed that hydrocephalus caused the ventricular system to expand over time. We found that the number of NSCs in the SVZ peaked rapidly after hydrocephalus was established and decreased gradually over time until the cells disappeared. NSCs may be involved in the pathophysiology changes and repair process of hydrocephalus.

  15. Impaired methylation modifications of FZD3 alter chromatin accessibility and are involved in congenital hydrocephalus pathogenesis.

    Science.gov (United States)

    Wang, Li; Shangguan, Shaofang; Chang, Shaoyan; Wang, Zhen; Lu, Xiaolin; Wu, Lihua; Li, Rui; Bao, Yihua; Qiu, Zhiyong; Niu, Bo; Zhang, Ting

    2014-06-20

    Congenital hydrocephalus is heterogeneous in its etiology, and in addition to a genetic component, has been shown to be caused by environmental factors. Until now, however, no methylation alterations of target genes have been connected with congenital hydrocephalus in humans. Frizzled 3(FZD3) is a planar cell polarity (PCP) gene required for PCP signaling. Partial restoration of frizzled 3 activities in FZD3 mutant mice results in hydrocephalus. To analyze the possible roles of epigenetic modifications of the FZD3 gene in congenital hydrocephalus pathogenesis, DNA methylation in the promoter region of FZD3 was assayed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Gene expression and chromatin accessibility were also determined to assess the role of methylation alterations. Our study found methylation levels of the FZD3 gene were increased in congenital hydrocephalus, especially in males (10.57 ± 3.90 vs. 7.08 ± 0.94, p=0.001). Hypermethylation of FZD3 increased congenital hydrocephalus risk, with an odds ratio of 10.125 (p=0.003). Aberrant methylation modification of FZD3 altered both chromatin structure in this region and FZD3 expression levels. Totally, aberrant methylation modification of the FZD3 gene increases the risk of congenital hydrocephalus by altering chromatin structure and disturbing gene expression.

  16. Influencing factors for posttraumatic hydrocephalus in patients suffering from severe traumatic brain injuries

    Institute of Scientific and Technical Information of China (English)

    JIAO Qing-fang; LIU Zhan; LI Song; ZHOU Liang-xue; LI San-zhong; TIAN Wei; YOU Chao

    2007-01-01

    Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods:Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups: hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results:Posttraumatic hydrocephalus was found in 19.42% of patients. Age(OR=1.050, 95% CI: 1.012-1.090), decompressive craniectomy (OR=4.312, 95% CI: 1.127-16.503), subarachnoid hemorrhage(OR=43.421, 95% CI: 7.835-240.652) and continuous lumbar drainage of cerebrospinal fluid (OR=0.045, 95% CI: 0.011-0.175) were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions:Risk factors for PTH are as follows: age, decompressive craniectomy and subarachnoid hemorrhage (SAH). Continuous lumbar drainage of cerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.

  17. 20 Cases of Surgical Treatment of Hydrocephalus%20例脑积水的手术治疗

    Institute of Scientific and Technical Information of China (English)

    谢勇

    2015-01-01

    目的:对手术治疗脑积水的治疗方法及效果进行分析研究。方法随机选取我院2012年6月~2014年6月间收治的本病确诊患者20例进行回顾分析。结果经治疗在20例患者中有14例疗效显著,4例有明显改善好转,2例患者效果不理想,治疗总有效率为90%。结论使用手术方法对脑积水进行治疗,其效果较理想,并发症较少且创伤轻微。%Objective Surgical treatment of hydrocephalus and cerebral treatment effect analysis.Methods Randomly selected patients diagnosed with this disease in our hospital between June 2012 to June 2014 were treated 20 cases were analyzed retrospectively.Results After treatment in 20 patients 14 cases a significant effect, four cases have improved signiifcantly improved, 2 patients are not effective, the total effective rate was 90%.Conclusion The use of surgical methods for the treatment of hydrocephalus, the effect is more ideal, fewer complications and minor trauma.

  18. Ongoing search for diagnostic biomarkers in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Tarnaris, Andrew; Toma, Ahmed K; Kitchen, Neil D; Watkins, Laurence D

    2009-12-01

    Idiopathic normal pressure hydrocephalus is a syndrome, which typically has a clinical presentation of gait/balance disturbance, often accompanied by cognitive decline and/or urinary incontinence. Its diagnosis is based on relevant history and clinical examination, appropriate imaging findings and physiological testing. The clinical picture of idiopathic normal pressure hydrocephalus may occasionally be difficult to distinguish from that of Alzheimer's dementia, subcortical ischemic vascular dementia and Parkinson's disease. The aim of this article is to systematically review the literature from the last 29 years in order to identify cerebrospinal fluid (CSF) or imaging biomarkers that may aid in the diagnosis of the syndrome. The authors concluded that no CSF or imaging biomarker is currently fulfilling the criteria required to aid in the diagnosis of the condition. However, a few studies have revealed promising CSF and imaging markers that need to be verified by independent groups. The reasons that the progress in this field has been slow so far is also commented on, as well as steps required to apply the current evidence in the design of future studies within the field.

  19. Conductance to outflow of CSF in normal pressure hydrocephalus.

    Science.gov (United States)

    Børgesen, S E

    1984-01-01

    Normal pressure hydrocephalus (NPH) is defined as a combination of dementia, gait disturbances and/or urinary incontinence, hydrocephalus, and a normal intracranial mean pressure. The clinical effect of CSF shunting in patients with this syndrome is sometimes striking, but generally only 50-60% of the shunted patients benefit from the treatment. It is assumed that the condition is caused by reduced conductance to outflow of CSF ( Cout ). A clinically usable method for the measurement of Cout has been developed. Cout has been measured in 80 patients with NPH. The results of clinical examination, computed tomography (CT), long-term intracranial pressure recording, isotope cisternography (ICG), and Cout have been compared to the clinical results of shunting 3 and 12 months after operation. Among the preoperative investigations Cout proved to have the best diagnostic specificity and sensitivity. Thus, selection of patients for shunting on the basis of Cout should lead to a satisfyingly high success rate. The different methods for measurement of Cout are discussed, and a theory on the pathophysiology of NPH is proposed. A clinical investigational programme, based on the results from clinical examination, CT, pressure recording, and measurements of Cout is suggested.

  20. Control volume based hydrocephalus research; a phantom study

    Science.gov (United States)

    Cohen, Benjamin; Voorhees, Abram; Madsen, Joseph; Wei, Timothy

    2009-11-01

    Hydrocephalus is a complex spectrum of neurophysiological disorders involving perturbation of the intracranial contents; primarily increased intraventricular cerebrospinal fluid (CSF) volume and intracranial pressure are observed. CSF dynamics are highly coupled to the cerebral blood flows and pressures as well as the mechanical properties of the brain. Hydrocephalus, as such, is a very complex biological problem. We propose integral control volume analysis as a method of tracking these important interactions using mass and momentum conservation principles. As a first step in applying this methodology in humans, an in vitro phantom is used as a simplified model of the intracranial space. The phantom's design consists of a rigid container filled with a compressible gel. Within the gel a hollow spherical cavity represents the ventricular system and a cylindrical passage represents the spinal canal. A computer controlled piston pump supplies sinusoidal volume fluctuations into and out of the flow phantom. MRI is used to measure fluid velocity and volume change as functions of time. Independent pressure measurements and momentum flow rate measurements are used to calibrate the MRI data. These data are used as a framework for future work with live patients and normal individuals. Flow and pressure measurements on the flow phantom will be presented through the control volume framework.

  1. Characteristics and Reversibility of Dementia in Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Priyanka Chaudhry

    2007-01-01

    Full Text Available Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions improve with shunt insertion. We also administered a subset of cognitive tests before and after temporary controlled drainage of cerebrospinal fluid to determine if change on this brief subset of tests after drainage could predict which patients would show cognitive improvement three to six months after shunt insertion. There was a significant improvement in learning, retention, and delayed recall of verbal memory three to six months after surgery (using paired t-tests. The majority (74% of patients showed significant improvement (by at least one standard deviation on at least one of the memory tests. Absence of improvement on verbal memory after temporary drainage of cerebrospinal fluid had a high negative predictive value for improvement on memory tests at 3–6 months after surgery (96%; p = 0.0005. Also, the magnitude of improvement from Baseline to Post-Drainage on few specific tests of learning and recall significantly predicted the magnitude of improvement after shunt surgery on the same tests (r2 = 0.32–0.58; p = 0.04–0.001. Results indicate that testing before and after temporary drainage may be useful in predicting which patients are less likely to improve in memory with shunting.

  2. Anxiety responses and neurochemical changes in a kaolin-induced rat model of hydrocephalus.

    Science.gov (United States)

    Hwang, Yong Sup; Shim, Insop; Chang, Jin Woo

    2011-04-01

    Hydrocephalus is a pathological enlargement of the ventricles of the brain, which can result from various diseases of the central nervous system. Patients with hydrocephalus frequently show motor abnormalities, such as abnormal gait and posture, as well as intellectual and emotional impairment. The present study was designed to investigate anxiety responses in rats with kaolin-induced hydrocephalus. A total of 26 Sprague-Dawley rats were used for this study. Hydrocephalus was induced in 14 Sprague-Dawley rats by injecting 0.1 ml of 20% kaolin solution into the cisterna magna; 12 rats were administered the same volume of saline in the same fashion and served as controls. Seven of the rats that were injected with kaolin and 6 of the rats injected with saline were killed 3 days after injection (Group 1); the remaining rats were killed 4 weeks after injection (Group 2) to evaluate effects related to acute and chronic hydrocephalus. The rats were tested in an elevated plus maze after induction of hydrocephalus by kaolin injection. After the animals were killed, brain sections were immunostained for cholecystokinin and neuropeptide Y. In addition, tyrosine hydroxylase immunoreactivity in the ventral tegmental area was evaluated by immunohistological staining. The rats with acute hydrocephalus showed decreased entry into and spent less time in the open arms of the elevated plus maze as compared with the control rats. The hydrocephalic rats had significantly more cholecystokinin-immunoreactive neurons and fewer neuropeptide Y-immunoreactive neurons in their brains. In addition, hydrocephalus progress in this model was positively correlated with the anxiety response. The numbers of tyrosine hydroxylase-immunoreactive neurons were decreased significantly in the hydrocephalic rats as compared with the control rats. These results suggest that the rat model of hydrocephalus is characterized by increased anxiety response and is associated with the functional impairment of the

  3. Long-term hydrocephalus alters the cytoarchitecture of the adult subventricular zone.

    Science.gov (United States)

    Campos-Ordoñez, Tania; Herranz-Pérez, Vicente; Chaichana, Kaisorn L; Rincon-Torroella, Jordina; Rigamonti, Daniele; García-Verdugo, Jose M; Quiñones-Hinojosa, Alfredo; Gonzalez-Perez, Oscar

    2014-11-01

    Hydrocephalus can develop secondarily to a disturbance in production, flow and/or absorption of cerebrospinal fluid. Experimental models of hydrocephalus, especially subacute and chronic hydrocephalus, are few and limited, and the effects of hydrocephalus on the subventricular zone are unclear. The aim of this study was to analyze the effects of long-term obstructive hydrocephalus on the subventricular zone, which is the neurogenic niche lining the lateral ventricles. We developed a new method to induce hydrocephalus by obstructing the aqueduct of Sylvius in the mouse brain, thus simulating aqueductal stenosis in humans. In 120-day-old rodents (n=18 per group), the degree of ventricular dilatation and cellular composition of the subventricular zone were studied by immunofluorescence and transmission electron microscopy. In adult patients (age>18years), the sizes of the subventricular zone, corpus callosum, and internal capsule were analyzed by magnetic resonance images obtained from patients with and without aqueductal stenosis (n=25 per group). Mice with 60-day hydrocephalus had a reduced number of Ki67+ and doublecortin+cells on immunofluorescence, as well as decreased number of neural progenitors and neuroblasts in the subventricular zone on electron microscopy analysis as compared to non-hydrocephalic mice. Remarkably, a number of extracellular matrix structures (fractones) contacting the ventricular lumen and blood vessels were also observed around the subventricular zone in mice with hydrocephalus. In humans, the widths of the subventricular zone, corpus callosum, and internal capsule in patients with aqueductal stenosis were significantly smaller than age and gender-matched patients without aqueductal stenosis. In summary, supratentorial hydrocephalus reduces the proliferation rate of neural progenitors and modifies the cytoarchitecture and extracellular matrix compounds of the subventricular zone. In humans, this similar process reduces the subventricular

  4. Application of the ommaya reservoir in the treatment of hydrocephalus in prematurely born children: Correlation with animal results

    Directory of Open Access Journals (Sweden)

    Mihajlović Miljan

    2013-01-01

    Full Text Available Introduction. Intraventricular hemorrhage occurs in almost one fifth of prematurely born children. Due to present complications, such as hydrocephalus and neurological deficit, it endangers the child’s life, therefore there is the need for understanding and prevent risk factors as well as the need for finding most optimal methods of treatment. Objective. The aim of the study was to point out the current therapeutic modalities of the treatment of posthemorrhagic hydrocephalus in prematurely born children. Methods. The study included 60 patients divided into two groups of 30 patients treated at the University Children’s Hospital of Belgrade in the period 2003-2008. Results. Treatment outcome of the control group of patients treated by standard methods was influenced by gestational age (p=0.024, head circumference on birth (p=0.043, body mass on birth (p=0.006, Apgar score on birth (p<0.001, peripartum asphyxia (p<0.001, cardiorespiratory arrest (p<0.001, respiratory distress (p=0.002 and intraventricular hemorrhagic grade (p<0.001. As statistically significant predictors of the poor treatment outcome of the experimental group of patients treated by using Ommaya reservoir were identified: low body mass on birth (p<0.05, low Apgar score (p<0.05, prolonged number of days on assisted ventilation (p<0.05, presence of peripartum asphyxia (p<0.05 and cardiorespiratory arrest (p<0.05. Conclusion. No statistically significant difference was detected in the outcome between the patients treated by the standard method and those with installed Ommaya reservoir. However, the difference of 10% in mortality between the two groups may be clinically significant so that further studies of larger samples are necessary.

  5. A method for coincidence timing resolution enhancement

    Science.gov (United States)

    Ermis, E. E.; Celiktas, C.; Pilicer, E.

    2016-05-01

    A method including the coincidence time resolution improvement for a TOF/positron emission tomography system was suggested. The spectrometer for this aim was composed of two NaI(Tl) and two plastic scintillation detectors. Experimental results were supported by FLUKA Monte Carlo simulation program by constructing the detector setup in software medium. Present experimental results verified our previous results and conclusions obtained from the suggested method. It was concluded that better resolutions would help the improvement not only on the TOF gain but also on the spatial resolution, leading to better images and helping the Physician in his/her diagnosis and treatment.

  6. A Case of Congenital Syndromic Hydrocephalus: A Subtype of ‘Game-Friedman-Paradice Syndrome'

    Directory of Open Access Journals (Sweden)

    Tapan Kumar Jana

    2013-01-01

    Full Text Available Human hydrocephalus is a disorder of abnormality in CSF flow or resorption, which has been classified in pertinent literature as congenital and acquired. Congenital hydrocephalus can present as an isolated phenomenon which is common; or with associated anomalies affecting other organs, disturbing physiology or presenting as a syndrome. This report describes a case with congenital foetal hydrocephalus, hypoplastic lungs with super-numery lobations and large left lobe of liver compared to right. Thus far, a review of the literature indicates that this case can be postulated as a subtype of Game-Friedman-Paradice syndrome.

  7. Diagnosis and treatment of the chronic hydrocephalus following aneurysmal subarachnoid hemorrhage%动脉瘤性蛛网膜下腔出血后慢性脑积水的诊治

    Institute of Scientific and Technical Information of China (English)

    吴志敏; 李俊

    2011-01-01

    Objective To explore the diagnosis and treatment of chronic hydrocephalus following aneurysmal subarachnoid hemorrhage (aSAH). Method The clinical data of 33 patients with hydrocephalus following aSAH who underwent ventriculo-peritoneal shunt in our department were analyzed retrospectively. Result Of 33 patients, 27 were recovered well, 3 mild disabled, 2 severely disabled and 1 died. Conclusions The chronic hydrocephalus is a common complication following aSAH. The ventriculo-peritoneal shunt is an effective method to treat the chronic hydrocephalus following aSAH.%目的 探讨动脉瘤性蛛网膜下腔出血(aSAH)后慢性脑积水的诊断与治疗方法.方法 回顾性分析33例经手术治疗的aSAH后慢性脑积水患者的临床资料.结果 治疗后随访6月~2年,按GOS评分,恢复良好27例,轻残3例,重残2例,死亡1例.结论 慢性脑积水是aSAH后的常见并发症,脑室-腹腔分流术是aSAH后慢性脑积水的有效治疗方法.

  8. A coincidence detection system based on real-time software

    Science.gov (United States)

    Ayuso, Sindulfo; José Blanco, Juan; Medina, José; Gómez-Herrero, Raúl; García-Población, Oscar; García Tejedor, Ignacio

    2016-09-01

    Conventional real-time coincidence systems use electronic circuitry to detect coincident pulses (hardware coincidence). In this work, a new concept of coincidence system based on real-time software (software coincidence) is presented. This system is based on the recurrent supervision of the analogue-to-digital converters status, which is described in detail. A prototype has been designed and built using a low-cost development platform. It has been applied to two different experimental sets for cosmic ray muon detection. Experimental muon measurements recorded simultaneously using conventional hardware coincidence and our software coincidence system have been compared, yielding identical results. These measurements have also been validated using simultaneous neutron monitor observations. This new software coincidence system provides remarkable advantages such as higher simplicity of interconnection and adjusting. Thus, our system replaces, at least, three Nuclear Instrument Modules (NIMs) required by conventional coincidence systems, reducing its cost by a factor of 40 and eliminating pulse delay adjustments.

  9. Monte Carlo calculations of the neutron coincidence gate utilisation factor for passive neutron coincidence counting

    CERN Document Server

    Bourva, L C A

    1999-01-01

    The general purpose neutron-photon-electron Monte Carlo N-Particle code, MCNP sup T sup M , has been used to simulate the neutronic characteristics of the on-site laboratory passive neutron coincidence counter to be installed, under Euratom Safeguards Directorate supervision, at the Sellafield reprocessing plant in Cumbria, UK. This detector is part of a series of nondestructive assay instruments to be installed for the accurate determination of the plutonium content of nuclear materials. The present work focuses on one aspect of this task, namely, the accurate calculation of the coincidence gate utilisation factor. This parameter is an important term in the interpretative model used to analyse the passive neutron coincidence count data acquired using pulse train deconvolution electronics based on the shift register technique. It accounts for the limited proportion of neutrons detected within the time interval for which the electronics gate is open. The Monte Carlo code MCF, presented in this work, represents...

  10. Measurement of accidental coincidences in beta-gamma coincidence counting using non-equal dead times

    CERN Document Server

    Hwang, H Y; Cho, Y H; Byun, J I; Kim, T S; Park, T S; Lee, J M

    2002-01-01

    It is shown that the multi-channel time-scaling (MCTS) method is particularly suitable for the direct measurement of accidental coincidences even if the dead times of the two counting channels are of different length. We prepared five samples, with activities from 900 to 2100 s sup - sup 1. The dead time of the gamma channel was 12 mu s for all measurements, but for the beta channel it varied from 12 to 20 mu s. The true coincidence rates determined by the MCTS method are compared with those obtained by using conventional technique.

  11. Fever after aneurysmal subarachnoid hemorrhage : relation with extent of hydrocephalus and amount of extravasated blood

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M; Luitse, Merel J A; van den Bergh, Walter M; Rinkel, Gabriel J E

    2008-01-01

    BACKGROUND AND PURPOSE: Fever after aneurysmal subarachnoid hemorrhage is associated with poor outcome. Because hydrocephalus and extravasated blood may influence thermoregulation, we determined whether these factors increase the risk for fever after subarachnoid hemorrhage. METHODS: Fever within 14

  12. Immunohistochemical Study of Aquaporins in an African Grey Parrot (Psittacus erithacus) With Hydrocephalus.

    Science.gov (United States)

    Blasco, Ester; Martorell, Jaime; De la Fuente, Cristian; Pumarola, Martí

    2014-12-01

    A 5-month-old African grey parrot (Psittacus erithacus) was examined after 3 weeks of weakness, ataxia, mental depression, and seizures. Results of a complete blood cell count and plasma biochemical analysis were unremarkable. Magnetic resonance imaging revealed a severe bilateral hydrocephalus. The bird failed to improve with supportive care, and the owner requested euthanasia. Necropsy findings were severe bilateral hydrocephalus with no evidence of cerebrospinal fluid obstruction. Histologic examination of the brain revealed microspongiosis, edema, gliosis, and neuronal chromatolysis of surrounding periventricular tissue. Aquaporins (AQP) and astrocytes were examined to elucidate the participation of these water channel proteins and glial cells in the pathophysiology and resolution of hydrocephalus. Results showed AQP4 and glial fibrillary acidic protein were overexpressed, especially near the ventricles, but expression of AQP1 was decreased. This is the first report, to our knowledge, of AQP immunolabeling in hydrocephalus in avain species.

  13. Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. Part 1: Introduction and methodology.

    Science.gov (United States)

    Flannery, Ann Marie; Mitchell, Laura

    2014-11-01

    This clinical systematic review of and evidence-based guidelines for the treatment of pediatric hydrocephalus were developed by a physician volunteer task force. They are provided as an educational tool based on an assessment of current scientific and clinical information as well as accepted approaches to treatment. They are not intended to be a fixed protocol, because some patients may require more or less treatment. In Part 1, the authors introduce the reader to the complex topic of hydrocephalus and the lack of consensus on its appropriate treatment. The authors describe the development of the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force charged with reviewing the literature and recommending treatments for hydrocephalus, and they set out the basic methodology used throughout the specific topics covered in later chapters.

  14. Diffuse choroid plexus hyperplasia: an under-diagnosed cause of hydrocephalus in children?

    Energy Technology Data Exchange (ETDEWEB)

    Aziz, Azian Abd.; Coleman, Lee [Royal Children' s Hospital Melbourne, Department of Medical Imaging, Parkville, Victoria (Australia); Morokoff, Andrew; Maixner, Wirginia [Royal Children' s Hospital Melbourne, Department of Neurosurgery, Parkville (Australia)

    2005-08-01

    Hydrocephalus is a common neurological disorder in children and the result of a variety of causes. However, with the advancement of imaging modalities, particularly MRI, previously reported rarer causes of hydrocephalus in children are now being more readily appreciated. We report an 11-year-old boy with diffuse villous hyperplasia of the choroid plexus. He had a ventriculo-peritoneal (VP) shunt in-situ and a prior diagnosis from infancy of congenital aqueduct stenosis as the cause of his hydrocephalus. His current presentation was with further shunt dysfunction. CT and MRI demonstrated enlarged choroid plexuses but did not confirm aqueduct stenosis. CSF overproduction was demonstrated from the externalized ventricular drain. The enlarged choroid plexuses were surgically resected and histology confirmed choroid plexus hyperplasia. Identification of choroid plexus hyperplasia is important since the neurosurgical management of hydrocephalus is not VP shunt insertion, but resection of the hyperplastic choroid plexus. (orig.)

  15. Congenital hydrocephalus - prevalence, prenatal diagnosis and outcome of pregnancy in four European regions

    DEFF Research Database (Denmark)

    Garne, Ester; Loane, Maria; Addor, Marie-Claude

    2009-01-01

    OBJECTIVE: To describe prevalence, prenatal diagnosis and outcome for fetuses and infants with congenital hydrocephalus. METHODS: Data were taken from four European registries of congenital malformations (EUROCAT). The registries included are based on multiple sources of information and include...... information about livebirths, fetal deaths with GA>/=20weeks and terminations of pregnancy for fetal anomaly (TOPFA). All cases from the four registries diagnosed with congenital hydrocephalus and born in the period 1996-2003 were included in the study. Cases with hydrocephalus associated with neural tube...... defects were not included in the study. RESULTS: Eighty-seven cases with congenital hydrocephalus were identified during the study period giving an overall prevalence of 4.65 per 10,000 births. There were 41 livebirths (47%), four fetal deaths (5%) and 42 TOPFA (48%). Nine percent of all cases were from...

  16. Multiloculated hydrocephalus: a review of current problems in classification and treatment

    DEFF Research Database (Denmark)

    Andresen, Morten; Juhler, Marianne

    2012-01-01

    PURPOSE: Loculated hydrocephalus is a condition in which discrete fluid-filled compartments form in or in relation to the ventricular system of the brain. Both uni- and multiloculated variants exist, with marked differences in outcome. However, several competing and seemingly interchangeable...... of Systematic Reviews, and the U.S. NIH ClinicalTrials.gov database was carried out with the search terms: "multicystic," "multiloculated," "multicompartment," "uniloculated," and "loculated." All were used in conjunction with the search term "hydrocephalus." RESULTS: A single study with a control group......, evidence is in favor of the neuroendoscopic approach. CONCLUSIONS: In order to ensure a consistent nomenclature as well as to guide future research, we propose a new system of classification for loculated hydrocephalus. It acknowledges the differences between uniloculated and multiloculated hydrocephalus...

  17. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis.

    Science.gov (United States)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M A; Hoving, Eelco W

    2014-06-01

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle. During ventriculoscopy, the cyst had all aspects of an arachnoid cyst. An endoscopic fenestration and partial removal of the cyst was performed, combined with a ventriculocisternostomy. The coincidental finding of viral meningitis and a third ventricle arachnoid cyst in a patient with acute hydrocephalus has, to our knowledge, not been described in literature before. If there is a relation between the enteroviral meningitis, the arachnoid cyst (possibly causing a pre-existing subclinical hydrocephalus) and the rapidly evolving neurological deterioration, remains speculative. Proposed mechanisms, by which the viral meningitis could accelerate the disease process, are slight brain swelling or increased CSF production. This rare combination of diagnoses could also be coincidental.

  18. Serendipity in Cancer Drug Discovery: Rational or Coincidence?

    Science.gov (United States)

    Prasad, Sahdeo; Gupta, Subash C; Aggarwal, Bharat B

    2016-06-01

    Novel drug development leading to final approval by the US FDA can cost as much as two billion dollars. Why the cost of novel drug discovery is so expensive is unclear, but high failure rates at the preclinical and clinical stages are major reasons. Although therapies targeting a given cell signaling pathway or a protein have become prominent in drug discovery, such treatments have done little in preventing or treating any disease alone because most chronic diseases have been found to be multigenic. A review of the discovery of numerous drugs currently being used for various diseases including cancer, diabetes, cardiovascular, pulmonary, and autoimmune diseases indicates that serendipity has played a major role in the discovery. In this review we provide evidence that rational drug discovery and targeted therapies have minimal roles in drug discovery, and that serendipity and coincidence have played and continue to play major roles. The primary focus in this review is on cancer-related drug discovery.

  19. Fabry's disease and psychosis: causality or coincidence?

    Science.gov (United States)

    Gairing, S; Wiest, R; Metzler, S; Theodoridou, A; Hoff, P

    2011-01-01

    A 21-year-old female with Fabry's disease (FD) presented acute psychotic symptoms such as delusions, auditory hallucinations and formal thought disorders. Since the age of 14, she had suffered from various psychiatric symptoms increasing in frequency and intensity. We considered the differential diagnoses of prodromal symptoms of schizophrenia and organic schizophrenia-like disorder. Routine examinations including cognitive testing, electroencephalography and structural magnetic resonance imaging revealed no pathological findings. Additional structural and functional imaging demonstrated a minor CNS involvement of FD, yet without functional limitations. In summary our examination results support the thesis that in the case of our patient a mere coincidence of FD and psychotic symptoms is more likely than a causal connection.

  20. Dark energy, curvature and cosmic coincidence

    CERN Document Server

    Franca, U

    2006-01-01

    The fact that the energy densities of dark energy and matter are similar currently, known as the coincidence problem, is one of the main unsolved problems of cosmology. We present here a phenomenological model in which a spatial curvature of the universe can lead to a transition in the present epoch from a matter dominated universe to a scaling dark energy dominance in a very natural way. In particular, we show that if the exponential potential of the dark energy field depends linearly on the spatial curvature density of a closed universe, the observed values of some cosmological parameters can be obtained assuming acceptable values for the present spatial curvature of the universe, and without fine tuning in the only parameter of the model. We also comment on possible variations of this model.

  1. The Coincident Fission Fragment Detector (CFFD)

    Science.gov (United States)

    Wakhle, A.; Hammerton, K.; Kohley, Z.; Yurkon, J.; Stiefel, K.

    2017-08-01

    A Parallel Plate Avalanche Counter (PPAC) based fission detector system, called the Coincident Fission Fragment Detector (CFFD), has been developed for the ReA3 re-accelerator facility of the National Superconducting Cyclotron Laboratory (NSCL). Binary reaction kinematics are reconstructed based on position and time-of-flight measurements of fission fragments. Large area PPACs provide 1 ns level time resolution and mm level position resolution. The detectors allow measurements of fission product angular and mass distributions of heavy-ion induced fusion reactions. The 30 cm by 40 cm active area of each PPAC provides large solid angle coverage well suited for measurements of low intensity rare-isotope beams (RIBs).

  2. Primary and Reversible Pisa Syndrome in Juvenile Normal Pressure Hydrocephalus

    Science.gov (United States)

    Leon-Sarmiento, Fidias E.; Pradilla, Gustavo; del Rosario Zambrano, Maria

    2012-01-01

    Objective To report a case of Pisa syndrome in a patient with idiopathic normal pressure hydrocephalus, who had never been exposed to psychotropic medications. Methods A 26 years-old, Colombian, male patient, was referred because he had cognitive abnormalities, gait disturbances and urinary incontinence. This patient also displayed pleurothotonos. Neurofunctional evaluation of sensory and motor integration at peripheral and central nervous system levels were done. Results Pisa syndrome disappeared after spinal tap drainage with further gait, balance and behavioral improvement. A brainstem-thalamocortical deregulation of the central sensory and motor programming, due to the chaotic enlargement of brain ventricles was thought to be the pathophysiological mechanism underlying this case. Conclusion NPH must not be longer considered as an exclusive geriatric disorder. Further, uncommon movement disorders may appear with this disorder, which should be carefully approached to avoid iatrogenic and deleterious pharmacological interventions. PMID:23794788

  3. Hydrocephalus after Subarachnoid Hemorrhage: Pathophysiology, Diagnosis, and Treatment

    Directory of Open Access Journals (Sweden)

    Sheng Chen

    2017-01-01

    Full Text Available Hydrocephalus (HCP is a common complication in patients with subarachnoid hemorrhage. In this review, we summarize the advanced research on HCP and discuss the understanding of the molecular originators of HCP and the development of diagnoses and remedies of HCP after SAH. It has been reported that inflammation, apoptosis, autophagy, and oxidative stress are the important causes of HCP, and well-known molecules including transforming growth factor, matrix metalloproteinases, and iron terminally lead to fibrosis and blockage of HCP. Potential medicines for HCP are still in preclinical status, and surgery is the most prevalent and efficient therapy, despite respective risks of different surgical methods, including lamina terminalis fenestration, ventricle-peritoneal shunting, and lumbar-peritoneal shunting. HCP remains an ailment that cannot be ignored and even with various solutions the medical community is still trying to understand and settle why and how it develops and accordingly improve the prognosis of these patients with HCP.

  4. Control volume based hydrocephalus research; analysis of human data

    Science.gov (United States)

    Cohen, Benjamin; Wei, Timothy; Voorhees, Abram; Madsen, Joseph; Anor, Tomer

    2010-11-01

    Hydrocephalus is a neuropathophysiological disorder primarily diagnosed by increased cerebrospinal fluid volume and pressure within the brain. To date, utilization of clinical measurements have been limited to understanding of the relative amplitude and timing of flow, volume and pressure waveforms; qualitative approaches without a clear framework for meaningful quantitative comparison. Pressure volume models and electric circuit analogs enforce volume conservation principles in terms of pressure. Control volume analysis, through the integral mass and momentum conservation equations, ensures that pressure and volume are accounted for using first principles fluid physics. This approach is able to directly incorporate the diverse measurements obtained by clinicians into a simple, direct and robust mechanics based framework. Clinical data obtained for analysis are discussed along with data processing techniques used to extract terms in the conservation equation. Control volume analysis provides a non-invasive, physics-based approach to extracting pressure information from magnetic resonance velocity data that cannot be measured directly by pressure instrumentation.

  5. Dynamic CT in patients with normal pressure hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Horibe, Kunio; Akagi, Katsuhito; Go, Junto; Kohmura, Eiji; Yamazaki, Mami

    1984-11-01

    In order to elucidate the cerebral circulation before and after shunt in patients with normal pressure hydrocephalus(NPH), a comparative study of 12 cases was performed using dynamic CT. In the effective shunt group, blood flow in the frontal gray matter and PVL was improved. The improvement in PVL was particularly marked. On the other hand, in the non-effective group, blood flow in the frontal gray matter was reduced compared with that before operation. In regard to predicting the effectiveness of the shunt from the features of preoperative dynamic CT study in NPH, it is suggested that blood flow in the frontal gray matter was lower in the effective shunt group than in the non-effective group. This cerebral circulation study using dynamic CT, which can be easily manipulated, is non-invasive, and is thought to be a useful method when highly reproducible parameters are chosen. (Author).

  6. Quantitative determination of volume on MR tomograms in communicating hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Langkowski, J.H.; Palmie, S.G.; Koschitzky, H. v.; Imme, M.; Maas, R.; Schmidt, K.H.; Heller, M.

    1989-02-01

    For patients with communicating hydrocephalus the implementation of a cardioventricular shunt is mostly an approved therapy. The proof of periventricular oedemas in addition to clinical signs seems to be a criterion for an indication for implantation and for the selection of a special valve. With the aid of a newly developed computer programme volume estimation of the ventricular system and the periventricular oedemas has been effected for six patients on T/sub 2/-weighted MR-tomograms (1.5 tesla). Quotients of the different volumina are correlated with cerebrospinal fluid (CSF) pressure obtained during shunt implantation or lumbar measurement. Distinct indications have been found for a correlation between the volume of the periventricular oedemas and the pressure measurements. (orig./GDG).

  7. Pathogenesis of normal-pressure hydrocephalus--preliminary observations

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, J.S.; Kitagawa, Y.; Tanahashi, N.; Tachibana, H.; Kandula, P.; Cech, D.A.; Rose, J.E.; Grossman, R.G.

    1985-02-01

    Eight cases with well-documented normal-pressure hydrocephalus were studied prospectively for 6 months by history, neurological examinations, Mini-Mental Status tests, xenon-contrast computed tomography measurements of local cerebral blood flow, and cerebral xenon solubility expressed as partition coefficients. Local cerebral blood flow and local partition coefficients were reduced throughout frontal and temporal lobes, basal ganglia, and thalamus. Cerebrospinal fluid shunting procedures were carried out in seven cases. As a result, local cerebral blood flow and local partition coefficients increased toward normal, particularly in frontal white matter, frontotemporal cortex, and basal ganglia. Ventricular size became reduced and mental status improved. Local partition coefficient values were reduced by increased tissue water because low values confirmed cerebrospinal fluid diffusion into white matter, which resolved after shunting. Patients likely to benefit from shunting, including shunt failures requiring revision, were detected.

  8. Miniaturized passive hydrogel check valve for hydrocephalus treatment.

    Science.gov (United States)

    Schwerdt, Helen N; Bristol, Ruth E; Junseok Chae

    2014-03-01

    Improvements in cerebrospinal fluid (CSF) draining techniques for treatment of hydrocephalus are urgently sought after to substitute for current CSF shunts that are plagued by high failure rates. The passive check valve aims to restore near natural CSF draining operations while mitigating possible failure mechanisms caused by finite leakage or low resilience that frequently constrain practical implementation of miniaturized valves. A simple hydrogel diaphragm structures core passive valve operations and enforce valve sealing properties to substantially lower reverse flow leakage. Experimental measurements demonstrate realization of targeted cracking pressures (PT ≈ 20-110 mmH2O) and operation at -800 <; ΔP <; 600 mmH2O without observable degradation or leakage.

  9. Priorities for hydrocephalus research: report from a National Institutes of Health-sponsored workshop.

    Science.gov (United States)

    Williams, Michael A; McAllister, James P; Walker, Marion L; Kranz, Dory A; Bergsneider, Marvin; Del Bigio, Marc R; Fleming, Laurel; Frim, David M; Gwinn, Katrina; Kestle, John R W; Luciano, Mark G; Madsen, Joseph R; Oster-Granite, Mary Lou; Spinella, Giovanna

    2007-11-01

    Treatment for hydrocephalus has not advanced appreciably since the advent of cerebrospinal fluid (CSF) shunts more than 50 years ago. Many questions remain that clinical and basic research could address, which in turn could improve therapeutic options. To clarify the main issues facing hydrocephalus research and to identify critical advances necessary to improve outcomes for patients with hydrocephalus, the National Institutes of Health (NIH) sponsored a workshop titled "Hydrocephalus: Myths, New Facts, and Clear Directions." The purpose of this paper is to report on the recommendations that resulted from that workshop. The workshop convened from September 29 to October 1, 2005, in Bethesda, Maryland. Among the 150 attendees was an international group of participants, including experts in pediatric and adult hydrocephalus as well as scientists working in related fields, neurosurgeons, laboratory-based neuroscientists, neurologists, patient advocates, individuals with hydrocephalus, parents, and NIH program and intramural staff. Plenary and breakout sessions covered injury and recovery mechanisms, modeling, biomechanics, diagnosis, current treatment and outcomes, complications, quality of life, future treatments, medical devices, development of research networks and information sharing, and education and career development. The conclusions were as follows: 1) current methods of diagnosis, treatment, and outcomes monitoring need improvement; 2) frequent complications, poor rate of shunt survival, and poor quality of life for patients lead to unsatisfactory outcomes; 3) investigators and caregivers need additional methods to monitor neurocognitive function and control of CSF variables such as pressure, flow, or pulsatility; 4) research warrants novel interdisciplinary approaches; 5) understanding of the pathophysiological and recovery mechanisms of neuronal function in hydrocephalus is poor, warranting further investigation; and 6) both basic and clinical aspects

  10. Hydrocephalus, skeletal anomalies, and mental disturbances in a mother and three daughters: A new syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ferlini, A.; Zanetti, A.; Milan, M.; Calzolari, E. [Universita di Ferrara, London (United Kingdom)] [and others

    1995-12-04

    We report on a family in which a mother and her 3 daughters have delayed psychomotor development and/or psychosis, hydrocephalus with white matter alterations, arachnoid cysts, skeletal anomalies consisting of brachydactyly, and Sprengel anomaly. Biochemical and cytogenetic analyses were normal on all 4 patients. The pattern of inheritance, clinical manifestations, and variability of expression suggest that this is a new hydrocephalus syndrome possibly transmitted as an X-linked dominant trait. 24 refs., 6 figs., 1 tab.

  11. Ultrastructural study of the lateral ventricle choroid plexus in experimental hydrocephalus in Wistar rats

    OpenAIRE

    Daniela Pretti da Cunha Tirapelli; Luiza da Silva Lopes; João José Lachat; Benedicto Oscar Colli; Luís Fernando Tirapelli

    2007-01-01

    Hydrocephalus is one of the most frequent and complex neurological diseases characterized by the abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain, due to an altered CSF dynamics. To detect possible ultrastructural alterations of the lateral ventricles choroid plexus (responsible for the CSF production), rats seven days after birth were submitted to an intracisternal injection of 20% kaolim (hydrated aluminum silicate) for the hydrocephalus induction. Twenty-eight o...

  12. [Hydrocephalus as initial presentation of a spinal cord tumour in a child

    DEFF Research Database (Denmark)

    Jorgensen, L.M.; Nysom, K.; Lavard, L.D.

    2008-01-01

    We report a previously healthy two-year-old girl who initially presented with signs of increased intracranial pressure of vomiting, lethargy and unstable gait. She had communicating hydrocephalus and a ventriculoperitoneal shunt was placed. Two years later the girl developed signs of myelopathy...... and was diagnosed with a spinal cord tumour between Th3 and Th9. We suggest that spinal cord tumour should be considered in patients with increased intracranial pressure or hydrocephalus of unknown origin Udgivelsesdato: 2008/9/15...

  13. Karakteristik Penderita Hydrocephalus Rawat Inap di RSUP H. Adam Malik Medan Tahun 2005-2009

    OpenAIRE

    Sitepu, Vilino Melda

    2011-01-01

    Hydrocephalus is a state of brain pathology that resulted in increased cerebrospinal fluid (CSF) with a rising intrakarnial pressure so that there is widening of the room where the flow of CSF. In H. Adam Malik Medan Hospital Centre there were 141 patients in 2005 to 2009. This is descriptive research with case series design. The population is 141 hydrocephalus patients hospitalized in H. Adam Malik Medan Hospital Centre in 2005-2009. Sample is the entire population data (total sampling)...

  14. Neurocysticercosis (NCC) with Hydrocephalus, Optic Atrophy and Vision Loss: A Rare Presentation.

    Science.gov (United States)

    Chaudhary, Nagendra; Mahato, Shyam Kumar; Khan, Salamat; Pathak, Santosh; Bhatia, B D

    2015-02-01

    Neurocysticercosis (NCC) is one of the most common parasitic infestations (Taenia solium) of central nervous system (CNS) in children. Seizures are the common presenting symptoms. Hydrocephalus and optic atrophy are rare complications which may require neurosurgical interventions. We report a case of NCC with hydrocephalus and bilateral optic atrophy associated with vision loss in a Nepalese patient who improved with anti-parasitic therapy followed by ventriculo-peritoneal (VP) shunting.

  15. Maternal environmental risk factors for congenital hydrocephalus: a systematic review.

    Science.gov (United States)

    Kalyvas, Aristotelis V; Kalamatianos, Theodosis; Pantazi, Mantha; Lianos, Georgios D; Stranjalis, George; Alexiou, George A

    2016-11-01

    OBJECTIVE Congenital hydrocephalus (CH) is one of the most frequent CNS congenital malformations, representing an entity with serious pathological consequences. Although several studies have previously assessed child-related risk factors associated with CH development, there is a gap of knowledge on maternal environmental risk factors related to CH. The authors have systematically assessed extrinsic factors in the maternal environment that potentially confer an increased risk of CH development. METHODS The Cochrane Library, MEDLINE, and EMBASE were systematically searched for works published between 1966 and December 2015 to identify all relevant articles published in English. Only studies that investigated environmental risk factors concerning the mother-either during gestation or pregestationally-were included. RESULTS In total, 13 studies (5 cohorts, 3 case series, 3 case-control studies, 1 meta-analysis, and 1 case report) meeting the inclusion criteria were identified. Maternal medication or alcohol use during gestation; lifestyle modifiable maternal pathologies such as obesity, diabetes, or hypertension; lack of prenatal care; and a low socioeconomic status were identified as significant maternal environmental risk factors for CH development. Maternal infections and trauma to the mother during pregnancy have also been highlighted as potential mother-related risk factors for CH. CONCLUSIONS Congenital hydrocephalus is an important cause of serious infant health disability that can lead to health inequalities among adults. The present study identified several maternal environmental risk factors for CH, thus yielding important scientific information relevant to prevention of some CH cases. However, further research is warranted to confirm the impact of the identified factors and examine their underlying behavioral and/or biological basis, leading to the generation of suitable prevention strategies.

  16. Dynamic CT study of normal-pressure hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, Norihiko; Kojima, Noriaki; Shirakuni, Takayuki; Matsumoto, Satoshi

    1984-08-01

    A dynamic CT study was performed in 14 patients with presumed normal-pressure hydrocephalus, of which diagnosis had been made by clinical symptomatology, CT findings, the results of the continuous monitoring of intracranial pressure, and CT cisternographic findings. It is demonstrated by serial CT scans that the cerebral arteries and arterioles were initially filled with contrast media, which were followed by the symmetrical and homogeneous staining of the cortical gray matter and basal ganglia, the diencephalia, and then the white matter. The venous system was stained in the late phase. The contrast media was finally cleared out from the intracranial space. Thus, the staining of the cerebral vessels and brain parenchym showed a uniform pattern in all cases. Functional CT images revealed that the patients with normal-pressure hydrocephalus who responded well to the shunt procedure had areas of prolonged mean circulation time scattered diffusely not only in the paraventricular structures, but also in the cortical gray matter of all the cerebral hemispheres. Following the shunt procedure, the hemodynamic conditions improved in almost all the areas mentioned above, but especially in the frontal and temporal gray matters and the paraventricular structures. In the patients who did not benefit from the shunt operation, however, there was no special abnormality of hemodynamic distribution. The analysis of the mean circulation time in the region of interest demonstrated that a significant improvement in cerebral hemodynamics was noted in the regions of the frontal and temporal gray matters, the periventricular white matter, and the caudate nucleus in patients who benefitted from the shunt operation. In patients who did not improve after the ventriculo-peritoneal shunt, however, there was no statistically significant difference between pre- and post-shunt mean circulation times. (J.P.N.).

  17. Endoscopic third ventriculostomy (ETV) for idiopathic normal pressure hydrocephalus (iNPH).

    Science.gov (United States)

    Tudor, Katarina Ivana; Tudor, Mario; McCleery, Jenny; Car, Josip

    2015-07-29

    Idiopathic normal pressure hydrocephalus (iNPH) is a type of communicating hydrocephalus also known as non-obstructive hydrocephalus. This type of hydrocephalus is caused by impaired cerebrospinal fluid reabsorption without any obstruction in the ventricular system and is associated with normal cerebrospinal fluid pressure. It is characterised clinically by gait disturbance, cognitive dysfunction, and urinary incontinence (known as the Hakim-Adams triad). The exact cause of iNPH is unknown. It may be managed conservatively or treated surgically by inserting a ventriculoperitoneal (VP) or ventriculoatrial (VA) shunt. However, a substantial number of patients do not respond well to surgical treatment, complication rates are high and there is often a need for further surgery. Endoscopic third ventriculostomy (ETV) is an alternative surgical intervention. It has been suggested that ETV may lead to better outcomes, including fewer complications. To determine the effectiveness of ETV for treatment of patients with iNPH compared to conservative therapy, or shunting of CSF using VP or VA shunts.To assess the perioperative and postoperative complication rates in patients with iNPH after ETV compared to conservative therapy, VP or VA shunting. We searched for eligible studies using ALOIS: a comprehensive register of dementia studies, The Cochrane Central Register of Controlled Trials (CENTRAL) and several bibliographic databases such as MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost) and LILACS (BIREME).We also searched the Database of Abstracts of Reviews of Effects (DARE) to identify potentially relevant reviews. The search strategy was adapted for other databases, using the most appropriate controlled vocabulary for each. We did not apply any language or time restrictions. The searches were performed in August 2014. We included randomised controlled trials (RCTs) of ETV treatment of iNPH. Patients had to have at least two symptoms of the Hakim

  18. Changes caused by hydrocephalus, induced by kaolin, in the corpus callosum of adult dogs.

    Science.gov (United States)

    Cardoso, Edvaldo José Rodrigues; Lachat, João José; Lopes, Luiza Silva; Santos, Antonio Carlos dos; Colli, Benedicto Oscar

    2011-01-01

    To analyze the ventricular enlargement and myelination of the corpus callosum in adult dogs after four and eight weeks of kaolin-induction of hydrocephalus. 36 dogs were randomly divided into 3 groups: 1 - without hydrocephalus, 2 - kaolin-induction of hydrocephalus until the fourth week, and 3 - kaolin-induction of hydrocephalus until the eighth week. Ventricular ratios and volumes were calculated using magnetic resonance images, and myelination of the corpus callosum were histologically evaluated using solocromo-cianin stain. Radiological hydrocephalus was observed in 93.75% and overall mortality was 38.4%. Ventricular volumes and ratios were higher in groups 2 and 3 compared to group 1 and similar when measures in the fourth and eighth weeks were compared in the group 3. Indices of luminescence in the knee and in the splenium of the corpus callosum were higher in group 2 than in group 1 indicating that there was loss of myelin in group 2, and similar in groups 1 and 3, showing a tendency to remyelination after 8 weeks. The corpus callosum of dogs with kaolin-induced hydrocephalus responds with demyelination of the knee and splenium by the fourth week with a tendency to remyelination by the eighth week.

  19. Hydrocephalus: the role of cerebral aquaporin-4 channels and computational modeling considerations of cerebrospinal fluid.

    Science.gov (United States)

    Desai, Bhargav; Hsu, Ying; Schneller, Benjamin; Hobbs, Jonathan G; Mehta, Ankit I; Linninger, Andreas

    2016-09-01

    Aquaporin-4 (AQP4) channels play an important role in brain water homeostasis. Water transport across plasma membranes has a critical role in brain water exchange of the normal and the diseased brain. AQP4 channels are implicated in the pathophysiology of hydrocephalus, a disease of water imbalance that leads to CSF accumulation in the ventricular system. Many molecular aspects of fluid exchange during hydrocephalus have yet to be firmly elucidated, but review of the literature suggests that modulation of AQP4 channel activity is a potentially attractive future pharmaceutical therapy. Drug therapy targeting AQP channels may enable control over water exchange to remove excess CSF through a molecular intervention instead of by mechanical shunting. This article is a review of a vast body of literature on the current understanding of AQP4 channels in relation to hydrocephalus, details regarding molecular aspects of AQP4 channels, possible drug development strategies, and limitations. Advances in medical imaging and computational modeling of CSF dynamics in the setting of hydrocephalus are summarized. Algorithmic developments in computational modeling continue to deepen the understanding of the hydrocephalus disease process and display promising potential benefit as a tool for physicians to evaluate patients with hydrocephalus.

  20. Magnetic resonance velocity mapping of 3D cerebrospinal fluid flow dynamics in hydrocephalus: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Stadlbauer, Andreas [Landesklinikum St. Poelten, MR Physics Group, Department of Radiology, St. Poelten (Austria); University of Erlangen-Nuremberg, Department of Neurosurgery, Erlangen (Germany); Salomonowitz, Erich [Landesklinikum St. Poelten, MR Physics Group, Department of Radiology, St. Poelten (Austria); Brenneis, Christian [Landesklinikum St. Poelten, Department of Neurology, St. Poelten (Austria); Ungersboeck, Karl [Landesklinikum St. Poelten, Department of Neurosurgery, St. Poelten (Austria); Riet, Wilma van der [European MRI Consultancy (EMRIC), Strasbourg (France); Buchfelder, Michael; Ganslandt, Oliver [University of Erlangen-Nuremberg, Department of Neurosurgery, Erlangen (Germany)

    2012-01-15

    To investigate the detectability of CSF flow alterations in the ventricular system of patients with hydrocephalus using time-resolved 3D MR velocity mapping. MR velocity mapping was performed in 21 consecutive hydrocephalus patients and 21 age-matched volunteers using a 3D phase-contrast (PC) sequence. Velocity vectors and particle path lines were calculated for visualisation of flow dynamics. CSF flow was classified as ''hypomotile flow'' if it showed attenuated dynamics and as ''hypermotile flow'' if it showed increased dynamics compared with volunteers. Diagnostic efficacy was compared with routine 2D cine PC-MRI. Seven patients showed hypomotile CSF flow: six had non-communicating hydrocephalus due to aqueductal stenosis. One showed oscillating flow between the lateral ventricles after craniotomy for intracranial haemorrhage. Seven patients showed normal flow: six had hydrocephalus ex vacuo due to brain atrophy. One patient who underwent ventriculostomy 10 years ago showed a flow path through the opening. Seven patients showed hypermotile flow: three had normal pressure hydrocephalus, three had dementia, and in one the diagnosis remained unclear. The diagnostic efficacy of velocity mapping was significantly higher except for that of aqueductal stenosis. Our approach may be useful for diagnosis, therapy planning, and follow-up of different kinds of hydrocephalus. (orig.)

  1. Incidence of Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus in Preterm Infants

    Directory of Open Access Journals (Sweden)

    Negar Sajjadian

    2010-07-01

    Full Text Available "nGerminal matrix-intraventricular hemorrhage (IVH is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus. Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500g and gestational age equal or less than 37 weeks who admitted in Mofid Hospital NICU (Tehran, Iran during a one year period. For all neonate (including criteria brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventicular-germinal matrix hemorrhage was seen in 64.4% (35 patients. Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.

  2. Management and outcome of infantile hydrocephalus in a tertiary health institution in Nigeria

    Directory of Open Access Journals (Sweden)

    Ayodeji Salman Yusuf

    2017-01-01

    Full Text Available Background: Hydrocephalus is a leading cause of disability among children worldwide. The outcome depends on morphology and whether insult is pre- or post-natal. There has been improvement in morbidity in developed countries due to improved surgical care. A paucity of trained personnel impacts negatively on care and outcome of infants with hydrocephalus in many low-income countries resulting poorer outcome. We conducted an audit of patients with hydrocephalus managed in our institution to determine common etiology and outcome. Object: The objective of this retrospective review was to conduct an audit of hydrocephalus care in our institution. Materials and Methods: Information was retrieved from case notes, ward records, imaging results, operation notes, and follow-up clinic charts. Type of hydrocephalus, onset, treatment offered, outcome, complications, and follow-up duration were documented. Results: Management of 58 infants with complete data was analyzed. Most hydrocephalus 40 (69% were congenital with 14 (35% occurring in association with myelomeningocele and 8 patients confirmed with aqueductal stenosis. Ventriculoperitoneal shunts insertion 53 (91% was the most common treatment modality. Conclusions: There is need to improve surgical intervention in the form of endoscopic third ventriculostomy in suitable patients. Subsiding cost of care may be considered for indigent patients.

  3. CSF Flow in the Brain in the Context of Normal Pressure Hydrocephalus.

    Science.gov (United States)

    Bradley, W G

    2015-05-01

    CSF normally flows back and forth through the aqueduct during the cardiac cycle. During systole, the brain and intracranial vasculature expand and compress the lateral and third ventricles, forcing CSF craniocaudad. During diastole, they contract and flow through the aqueduct reverses. Hyperdynamic CSF flow through the aqueduct is seen when there is ventricular enlargement without cerebral atrophy. Therefore, patients presenting with clinical normal pressure hydrocephalus who have hyperdynamic CSF flow have been found to respond better to ventriculoperitoneal shunting than those with normal or decreased CSF flow. Patients with normal pressure hydrocephalus have also been found to have larger intracranial volumes than sex-matched controls, suggesting that they may have had benign external hydrocephalus as infants. While their arachnoidal granulations clearly have decreased CSF resorptive capacity, it now appears that this is fixed and that the arachnoidal granulations are not merely immature. Such patients appear to develop a parallel pathway for CSF to exit the ventricles through the extracellular space of the brain and the venous side of the glymphatic system. This pathway remains functional until late adulthood when the patient develops deep white matter ischemia, which is characterized histologically by myelin pallor (ie, loss of lipid). The attraction between the bare myelin protein and the CSF increases resistance to the extracellular outflow of CSF, causing it to back up, resulting in hydrocephalus. Thus idiopathic normal pressure hydrocephalus appears to be a "2 hit" disease: benign external hydrocephalus in infancy followed by deep white matter ischemia in late adulthood.

  4. Application Ommaya pump in acute obstructive hydrocephalus in children%Ommaya储液囊在儿童急性梗阻性脑积水中的应用

    Institute of Scientific and Technical Information of China (English)

    林坚; 林振浪; 尹波; 林逢春; 张弩

    2011-01-01

    目的 探讨Ommaya储液囊在儿童急性梗阻性脑积水中的应用.方法 回顾性分析我科2006至2009年22例晚发维生素K依赖因子缺乏性脑室出血和结脑致急性梗阻性脑积水患儿,行Ommaya储液囊植入手术,观察脑室大小、脑脊液细胞数、蛋白含量变化.结果 结核性脑膜炎7例经储液囊植入行泵内多次注射抗生素,治疗2~4个月、随访脑脊液恢复正常,6例脑积水消失;晚发维生素K依赖因子缺乏性脑室出血伴脑积水15例植入脑室内行泵内穿刺冲洗引流,1~2周头颅CT复查脑室积血消失,脑积水减轻,2例行侧脑室腹腔分流术,无一例发生颅内感染.结论 Ommaya储液囊植入术治疗儿童急性梗阻性脑积水效果良好,手术简便、创伤小、并发症少,值得临床广泛应用.%Objective To review the Ommaya pump application in acute obstructive hydrocephalus in children. Methods We carried out a retrospective analysis of 22 children with obstructive hydrocephalus admitted into our department between 2006 2009. The causes of hydrocephalus included intraventricular hemorrhage secondary to vitamin K deficiency and tuberculous meningitis. Ommaya pump were implanted and the ventricle size and cerebrospinal fluid cell count, protein content were studied. Results Seven children had intracranial infection and treated with antibiotic injection into pump for 2-4 months. Follow-up revealed no recurrence. Fifteen children with ventricle hemorrhage and hydrocephalus underwent drainage from the pump. CT scan after 1-2 weeks demonstrated disappearance of ventricle hemorrhage. There was, no intracranial infection. Conclusions Ommaya pump for the treatment of acute obstructive hydrocephalus produces good result. The surgery is simple. It incurs less trauma and has less complications.

  5. Lower rates of symptom recurrence and surgical revision after primary compared with secondary endoscopic third ventriculostomy for obstructive hydrocephalus secondary to aqueductal stenosis in adults.

    Science.gov (United States)

    Sankey, Eric W; Goodwin, C Rory; Jusué-Torres, Ignacio; Elder, Benjamin D; Hoffberger, Jamie; Lu, Jennifer; Blitz, Ari M; Rigamonti, Daniele

    2016-05-01

    OBJECT Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus; however, the success of ETV in patients who have previously undergone shunt placement remains unclear. The present study analyzed 103 adult patients with aqueductal stenosis who underwent ETV for obstructive hydrocephalus and evaluated the effect of previous shunt placement on post-ETV outcomes. METHODS This study was a retrospective review of 151 consecutive patients who were treated between 2007 and 2013 with ETV for hydrocephalus. One hundred three (68.2%) patients with aqueductal stenosis causing obstructive hydrocephalus were included in the analysis. Postoperative ETV patency and aqueductal and cisternal flow were assessed by high-resolution, gradient-echo MRI. Post-ETV Mini-Mental State Examination, Timed Up and Go, and Tinetti scores were compared with preoperative values. Univariate and multivariate analyses were performed comparing the post-ETV outcomes in patients who underwent a primary (no previous shunt) ETV (n = 64) versus secondary (previous shunt) ETV (n = 39). RESULTS The majority of patients showed significant improvement in symptoms after ETV; however, no significant differences were seen in any of the quantitative tests performed during follow-up. Symptom recurrence occurred in 29 (28.2%) patients after ETV, after a median of 3.0 (interquartile range 0.8-8.0) months post-ETV failure. Twenty-seven (26.2%) patients required surgical revision after their initial ETV. Patients who received a secondary ETV had higher rates of symptom recurrence (p = 0.003) and surgical revision (p = 0.003), particularly in regard to additional shunt placement/revision post-ETV (p = 0.005). These differences remained significant after multivariate analysis for both symptom recurrence (p = 0.030) and surgical revision (p = 0.043). CONCLUSIONS Patients with obstructive hydrocephalus due to aqueductal stenosis exhibit symptomatic improvement after ETV, with a

  6. Intracranial pressure and conductance to outflow of cerebrospinal fluid in normal-pressure hydrocephalus.

    Science.gov (United States)

    Børgesen, S E; Gjerris, F; Sørensen, S C

    1979-04-01

    Forty patients with clinical evidence of normal-pressure hydrocephalus were studied by monitoring intraventricular pressure during a 24-hour period, and by a lumboventricular perfusion test for measurement of the conductance to outflow of cerebrospinal fluid (CSF). The purpose of the study was to investigate whether there is a relationship between intraventricular pressure and conductance to outflow of CSF, and whether it is possible to use the results from pressure monitoring in the selection of patients who may be expected to benefit from shunting therapy. The conductance to outflow was used as an evaluation factor in the selection of patients to be treated by a shunt. The conductance to CSF outflow differed by twelvefold between the lowest and highest values. The level of resting intraventricular pressure was within normal limits in all patients. Accordingly, there was no evidence of a relationship between conductance to outflow and intraventricular pressure. So-called B-waves were seen more frequently in patients with decreased conductance to outflow, but were also present in patients with high conductance to outflow. Therefore, the presence of B-waves does not imply a low conductance to outflow of CSF.

  7. In vitro hydrodynamic, transient, and overtime performance of a miniaturized valve for hydrocephalus.

    Science.gov (United States)

    Schwerdt, Helen N; Amjad, Usamma; Appel, Jennie; Elhadi, Ali M; Lei, Ting; Preul, Mark C; Bristol, Ruth E; Chae, Junseok

    2015-03-01

    Reliable cerebrospinal fluid (CSF) draining methods are needed to treat hydrocephalus, a chronic debilitating brain disorder. Current shunt implant treatments are characterized by high failure rates that are to some extent attributed to their length and multiple components. The designed valve, made of hydrogel, steers away from such protracted schemes and intends to provide a direct substitute for faulty arachnoid granulations, the brain's natural CSF draining valves, and restore CSF draining operations within the cranium. The valve relies on innate hydrogel swelling phenomena to strengthen reverse flow sealing at idle and negative pressures thereby alleviating common valve failure mechanisms. In vitro measurements display operation in range of natural CSF draining (cracking pressure, PT ~ 1-110 mmH2O and outflow hydraulic resistance, Rh ~ 24-152 mmH2O/mL/min), with negligible reverse flow leakage (flow, QO > -10 µL/min). Hydrodynamic measurements and over-time tests under physically relevant conditions further demonstrate the valve's operationally-reproducible properties and strengthen its validity for use as a chronic implant.

  8. Ventriculoatrial Shunt for Infantile Hydrocephalus%脑室心房引流术治疗小儿脑积水

    Institute of Scientific and Technical Information of China (English)

    陈张根; 郑瑞森; 金百祥

    1983-01-01

    Ventriculoatrial shunt was employed in treating 13 cases of infantile hydroencephalus at our department from Apr.,1979 to Aug., 1981. Model NJS-6 infantile hydrocephalus shunting device (made in Shanghai) was applied. Follow-ups (missed in 3 cases) which lasted 1-34 months showed that 6 patients were alive and well. Among them, 5 were normal or approximately normal in in-tellegence. 4 died either of the said condition or of other diseases.Also discussed are the diagnosis, surgical approach, postoperative care and complications.%@@ 自五十年代末带瓣硅胶管应用于脑室心房引流术获得成功以来,脑积水的手术治疗取得进展(1、2).

  9. Hemiballismus and Normal Pressure Hydrocephalus as Long-Term Sequelae following a Hemispherectomy for Intractable Epilepsy in a Man with a Learning Disability

    Directory of Open Access Journals (Sweden)

    Joseph Joyce

    1997-01-01

    Full Text Available We report here a case of a 48-year-old gentleman with mild/moderate learning disability who developed late complications of hemispherectomy 28 years following the operation. The original operation was performed to treat intractable epilepsy (both generalized tonic/clonic and complex partial seizures in an 8-year-old boy. After a 28 year seizure-free period, the patient developed cognitive decline, seizures, hemiballismus and a subacute confusional state, possibly related to normal pressure hydrocephalus. A ventriculo-peritoneal shunt operation, along with treatment with high doses of sulpiride, brought improvement in both mental state and hemiballismus.

  10. Near Threshold Coincident Electrofission of Uranium -238.

    Science.gov (United States)

    Dowell, David Harry

    Using the 100% duty cycle electron beam from the University of Illinois MUSL-2 accelerator, inelastic electron scattering form factors have been measured in coincidence with the fission decay of ('238)U. Data was taken at effective elastic momentum transfers of .36, .41 .45 and .59 fm(' -1) and electron-fission fragment angular correlations were measured perpendicular to and along the momentum transfer axis. The beam energies used were 67.11, 56.91 and 46.49 MeV, with the outgoing electron detected at 60(DEGREES) and 80(DEGREES), relative to the beam direction. The electron energy resolution was .1% and the form factors were measured for excitation energies from 2 to 12 MeV. Thin films of scintillator plastic (.5 mg/cm('2)) were used to detect the fission fragments from a 1 mg/cm('2) UF(,4) target evaporated onto a .240 mg/cm('2) aluminum backing. A prominent, anisotropic threshold peak is seen in the coincident form factors. An analysis of the q-dependence of the data and of the angular correlation indicates the observed strength is E2. Fission threshold for this E2 strength is about 5.7 MeV as compared with 6 MeV for E1 decays. The peak itself is due to the onset of neutron competition at 6.15 MeV. The threshold region, when analyzed using a Gaussian K-distribution to describe the statistical density of K -states near the fission barrier, exhibits a step-like change in the value of K(,0)('2) at .7 MeV above threshold. This indicates a possible energy gap in the E2 transition states. The decay is isotropic above 7.5 MeV excitation energy. From 7 to 11.7 MeV, the distribution of E2/EO strength is relatively flat with the total strength in this region exhausting approximately 10% of an energy weighted sum rule. A comparison with hadron scattering experiments suggests that some of the strength near 11.5 MeV is due to the fission decay of the giant monopole resonance with a fission probability similar to that of E2 transitions.

  11. Complex Action Support from Coincidences of Couplings

    CERN Document Server

    Nielsen, Holger Bech

    2011-01-01

    The model of Ninomiya and myself of complex action in a functional integral formulation interpreted by means of path integrals extending over all times, both past and future, is reviewed. A few numerical relations between coupling constants and masses are taken as supporting evidences. The new one such supporting ev- idence among the mentioned "coincidences" is that our model is able to explain (suggestively) that a) the Higgs field expectation value is very small ("scale problem") compared to say some fundamental scale that might be the Planck scale, b) This Higgs VEV scale need not be just zero, but rather is predicted to be so that the running top-quark Yukawa coupling just is about unity at this scale. In this way it is easily becoming an "exponentially" small scale. Instead of the top-Yukawa we should rather here say the highest flavour Yukawa coupling. These predictions are only achieved by allowing the principle of minimization of the imaginary part of the action SI(history) to to a certain extent adju...

  12. Coincident photoelectron spectroscopy on superconductors; Koinzidente Photoelektronenspektroskopie an Supraleitern

    Energy Technology Data Exchange (ETDEWEB)

    Voss, Stefan

    2011-07-01

    Aim of the performed experiments of this thesis was to attempt to detect Cooper pairs as carriers of the superconducting current directly by means of the photoelectric effect. The method of the coincident photoelectron spectroscopy aims thereby at the detection of two coherently emitted electrons by the interaction with a photon. Because electrostatic analyzers typically cover only a very small spatial angle, which goes along with very low coincidence rates, in connection with this thesis a time-of-flight projection system has been developed, which maps nearly the whole spatial angle on a position-resolving detector. The pulsed light source in form of special synchrotron radiation necessary for the measurement has been adjusted so weak, that only single photons could arrive at the sample. Spectroscoped were beside test measurements on silver layers both a lead monocrystal as representative of the classical BCS superconductors and monocrystalline Bi{sub 2}Sr{sub 2}CaCu{sub 2}O{sub 8} from the family of the high-temperature superconductors. With excitation energies up to 40 eV could be shown that sufficiently smooth and clean surfaces in the superconducting phase exhibit within the resolving power of about 0.5 eV no recognizable differences in comparison to the normally conducting phase. Beside these studies furthermore the simple photoemission at the different samples and especially in the case of the lead crystal is treated, because here no comparable results are known. Thereby the whole momentum space is discussed and the Fermi surface established as three-dimensional model, by means of which the measurement results are discussed. in the theoretical descriptions different models for the Cooper-pair production are presented, whereby to the momentum exchange with the crystal a special role is attributed, because this can only occur in direct excitations via discrete lattice vectors.

  13. Initial brain CT scan and shunting outcomes in children with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Andi Anita Utami

    2013-04-01

    Full Text Available Background Hydrocephalus is one of the most common clinical conditions affecting the central nervous system, with a congenital hydrocephalus incidence of 3-4 per 1000 births. Incidence of acquired types of hydrocephalus is unknown. Brain computerised tomography (CT scan can be used to assess the size of ventricles and other structures. Shunting has long been performed to alleviate hydrocephalus. Shunting has dramatically changed the outlook of children with hydrocephalus, with many of them having normal life expectancies and attaining normal intelligence. Objective To determine the outcomes of shunting in children with hydrocephalus based on initial brain CT scan. Methods We performed a cross-sectional study in Dr. Kariadi Hospital. Initial brain CT scan data were collected from the medical records of children admitted to the Neurosurgery Ward for ventriculoperitoneal (VP shunt surgery from January 2009 to December 2010. We studied the brain CT scan findings before VP shunt surgery and the outcomes of the children after VP shunt surgery. Radiological findings were determined by a radiologist responsible at that time. Results This study consisted of 30 subjects, 19 boys and 11 girls. Initial brain CT scans to assess disease severity revealed the following conditions: lateral ventricle dilatation in 7 subjects, lateral and third ventricle dilatation in 16 subjects, and lateral, third and fourth ventricle dilatation in 7 subjects. After VP shunt surgery, 3 subjects in the lateral, third and fourth ventricle dilatation category died. They were grouped according to their condition. Group 1 consisted of subjects with only lateral ventricle dilatation and subjects with lateral and third ventricle dilatation (23 subjects, while group 2 consisted of subjects with lateral, third and fourth ventricle dilatation (7 subjects. More survivors were found in group 1 than those in group 2. Conclusion Less severe initial brain CT scan findings are associated with

  14. NPH Log: Validation of a New Assessment Tool Leading to Earlier Diagnosis of Normal Pressure Hydrocephalus.

    Science.gov (United States)

    Jusué-Torres, Ignacio; Lu, Jennifer; Robison, Jamie; Hoffberger, Jamie B; Hulbert, Alicia; Sanyal, Abanti; Wemmer, Jan; Elder, Benjamin D; Rigamonti, Daniele

    2016-06-27

    Early treatment of normal pressure hydrocephalus (NPH) yields better postoperative outcomes. Our current tests often fail to detect significant changes at early stages. We developed a new scoring system (LP log score) to determine if this tool is more sensitive in detecting clinical differences than current tests. Sixty-two consecutive new patients with suspected idiopathic NPH were studied. Secondary, previously treated and obstructive cases were not included. We collected age, pre- and post-lumbar puncture (LP) Tinetti, Timed Up and Go (TUG) Test, European NPH scale, and LP log scores. The LP log score is recorded at baseline and for seven consecutive days after removing 40 cc of cerebrospinal fluid (CSF) via LP. We studied the diagnostic accuracy of the tests for surgical indication. The post-LP log showed improvement in 90% of people with good baseline gait tests and in 93% of people who did not show any pre-LP and post-LP change in gait tests. Sensitivity, specificity, and accuracy to detect intention to treat when positive post-LP improvements were 4%, 100%, and 24%, respectively, for TUG, 21%, 86%, and 34%, respectively, for the Tinetti Mobility Test, 66%, 29%, and 58%, respectively, for Medical College of Virginia (MCV) grade, and 98%, 33%, and 85%, respectively, for LP log score. Pre-LP and post-LP TUG improvement and pre-LP and post-LP Tinetti improvement were not associated with a surgical indication (p > 0.05). LP log improvement was associated with surgical indication odds ratio (OR): 24.5 95% CI (2.4-248.12) (p = 0.007). LP log showed better sensitivity, diagnostic accuracy, and association with surgical indication than the current diagnostic approach. An LP log may be useful detecting NPH patients at earlier stages and, therefore, yield better surgical outcomes.

  15. NPH Log: Validation of a New Assessment Tool Leading to Earlier Diagnosis of Normal Pressure Hydrocephalus

    Science.gov (United States)

    Lu, Jennifer; Robison, Jamie; Hoffberger, Jamie B; Hulbert, Alicia; Sanyal, Abanti; Wemmer, Jan; Elder, Benjamin D; Rigamonti, Daniele

    2016-01-01

    Introduction: Early treatment of normal pressure hydrocephalus (NPH) yields better postoperative outcomes. Our current tests often fail to detect significant changes at early stages. We developed a new scoring system (LP log score) to determine if this tool is more sensitive in detecting clinical differences than current tests. Material and Methods: Sixty-two consecutive new patients with suspected idiopathic NPH were studied. Secondary, previously treated and obstructive cases were not included. We collected age, pre- and post-lumbar puncture (LP) Tinetti, Timed Up and Go (TUG) Test, European NPH scale, and LP log scores. The LP log score is recorded at baseline and for seven consecutive days after removing 40 cc of cerebrospinal fluid (CSF) via LP. We studied the diagnostic accuracy of the tests for surgical indication. Results: The post-LP log showed improvement in 90% of people with good baseline gait tests and in 93% of people who did not show any pre-LP and post-LP change in gait tests. Sensitivity, specificity, and accuracy to detect intention to treat when positive post-LP improvements were 4%, 100%, and 24%, respectively, for TUG, 21%, 86%, and 34%, respectively, for the Tinetti Mobility Test, 66%, 29%, and 58%, respectively, for Medical College of Virginia (MCV) grade, and 98%, 33%, and 85%, respectively, for LP log score. Pre-LP and post-LP TUG improvement and pre-LP and post-LP Tinetti improvement were not associated with a surgical indication (p > 0.05). LP log improvement was associated with surgical indication odds ratio (OR): 24.5 95% CI (2.4-248.12) (p = 0.007). Conclusions: LP log showed better sensitivity, diagnostic accuracy, and association with surgical indication than the current diagnostic approach. An LP log may be useful detecting NPH patients at earlier stages and, therefore, yield better surgical outcomes. PMID:27489752

  16. Diffusion-weighted imaging in the diagnostic evaluation of the hydrocephalus in patients with acute or chronic increase in cerebral pressure; Diffusionsgewichtete Bildgebung in der Diagnostik des Hydrocephalus - Untersuchungen an Patienten mit akuter und ohne akute Hirndrucksymptomatik

    Energy Technology Data Exchange (ETDEWEB)

    Dorenbeck, U. [Abt. fuer Neuroradiologie, Universitaetskliniken des Saarlandes, Homburg/Saar (Germany); Inst. fuer Roentgendiagnostik, Universitaetsklinik Regensburg (Germany); Schlaier, J. [Klinik und Poliklinik fuer Neurochirurgie, Universitaetsklinik Regensburg (Germany); Feuerbach, S.; Seitz, J. [Inst. fuer Roentgendiagnostik, Universitaetsklinik Regensburg (Germany)

    2005-01-01

    Purpose: to investigate whether diffusion-weighted imaging (DWI) in magnetic resonance imaging (MRI) provides additional information about the periventricular white matter for the assessment of hydrocephalus. Materials and methods: sixteen MRI examinations (11 with acutely increased cerebral pressure, 5 without symptoms) on 15 patients with hydrocephalus (4 patients with communicating hydrocephalus and 11 patients with obstructive hydrocephalus) were analyzed. One symptomatic patient subsequently became asymptomatic. We investigated the ''apparent diffusion coefficient'' (ADC) in the subcortical and periventricular white matter. The ADCs of the study patients were compared with those of a healthy control group. Results: symptomatic patients with hydrocephalus, 6/11 showed periventricular edema and a significantly higher ADC values in the periventricular region than in the subcortical white matter. 5/11 symptomatic patients showed significantly higher ADC values even in the absence of periventricular interstitial edema (both groups contained patients with communicating and obstructive hydrocephalus). All 5 asymptomatic patients with hydrocephalus did not have a significantly higher ADC values in the periventricular region. Conclusion: in patients with hydrocephalus and acutely increased cerebral pressure, DWI showed a significantly higher ADC values in the periventricular region even without visible interstitial edema on conventional MRI sequences. (orig.)

  17. Neutron coincidence counting with digital signal processing

    Energy Technology Data Exchange (ETDEWEB)

    Bagi, Janos [Institute of Isotopes (IKI)-Budapest (Hungary); Dechamp, Luc; Dransart, Pascal; Dzbikowicz, Zdzislaw [European Commission, Joint Research Centre, IPSC-Ispra, VA (Italy); Dufour, Jean-Luc [Institut de Radioprotection et Surete Nucleaire-Fontenay-aux-Roses (France); Holzleitner, Ludwig [European Commission, Joint Research Centre, IPSC-Ispra (Italy); Huszti, Joseph [Institute of Isotopes (IKI)-Budapest (Hungary); Looman, Marc [Consulenze Tecniche-Cocquio Trevisago (Italy); Marin Ferrer, Montserrat [European Commission, Joint Research Centre, IPSC-Ispra (Italy); Lambert, Thierry [Institut de Radioprotection et Surete Nucleaire-Fontenay-aux-Roses (France); Peerani, Paolo [European Commission, Joint Research Centre, IPSC-Ispra (Italy)], E-mail: paolo.peerani@jrc.it; Rackham, Jamie [VT Nuclear Services-Sellafield, Seascale (United Kingdom); Swinhoe, Martyn; Tobin, Steve [N-1, Safeguards Science and Technology Group, LANL-Los Alamos, NM (United States); Weber, Anne-Laure [Institut de Radioprotection et Surete Nucleaire-Fontenay-aux-Roses (France); Wilson, Mark [VT Nuclear Services-Sellafield, Seascale (United Kingdom)

    2009-09-11

    Neutron coincidence counting is a widely adopted nondestructive assay (NDA) technique used in nuclear safeguards to measure the mass of nuclear material in samples. Nowadays, most neutron-counting systems are based on the original-shift-register technology, like the (ordinary or multiplicity) Shift-Register Analyser. The analogue signal from the He-3 tubes is processed by an amplifier/single channel analyser (SCA) producing a train of TTL pulses that are fed into an electronic unit that performs the time- correlation analysis. Following the suggestion of the main inspection authorities (IAEA, Euratom and the French Ministry of Industry), several research laboratories have started to study and develop prototypes of neutron-counting systems with PC-based processing. Collaboration in this field among JRC, IRSN and LANL has been established within the framework of the ESARDA-NDA working group. Joint testing campaigns have been performed in the JRC PERLA laboratory, using different equipment provided by the three partners. One area of development is the use of high-speed PCs and pulse acquisition electronics that provide a time stamp (LIST-Mode Acquisition) for every digital pulse. The time stamp data can be processed directly during acquisition or saved on a hard disk. The latter method has the advantage that measurement data can be analysed with different values for parameters like predelay and gate width, without repeating the acquisition. Other useful diagnostic information, such as die-away time and dead time, can also be extracted from this stored data. A second area is the development of 'virtual instruments.' These devices, in which the pulse-processing system can be embedded in the neutron counter itself and sends counting data to a PC, can give increased data-acquisition speeds. Either or both of these developments could give rise to the next generation of instrumentation for improved practical neutron-correlation measurements. The paper will

  18. An algorithmic approach to the management of unrecognized hydrocephalus in pediatric candidates for intrathecal baclofen pump implantation

    Science.gov (United States)

    Hanak, Brian W.; Tomycz, Luke; Oxford, Robert G.; Hooper, Erin; Apkon, Susan D.; Browd, Samuel R.

    2016-01-01

    Background: Complications of intrathecal baclofen (ITB) pump implantation for treatment of pediatric patients with spasticity and dystonia associated with cerebral palsy remain unacceptably high. To address the concern that some patients may have underlying arrested hydrocephalus, which is difficult to detect clinically because of a low baseline level of neurological function, and may contribute to the high rates of postoperative cerebrospinal fluid leak, wound breakdown, and infection associated with ITB pump implantation, the authors implemented a standardized protocol including mandatory cranial imaging and assessment of intracranial pressure (ICP) by lumbar puncture prior to ITB pump implantation. Methods: A retrospective case series of patients considered for ITB pump implantation between September 2012 and October 2014 at Seattle Children's Hospital is presented. All patients underwent lumbar puncture under general anesthesia prior to ITB pump implantation and, if the opening pressure was greater than 21 cmH2O, ITB pump implantation was aborted and alternative management options were presented to the patient's family. Results: Eighteen patients were treated during the study time period. Eight patients (44.4%) who had ICPs in excess of 21 cmH2O on initial LP were identified. Eleven patients (61.1%) ultimately underwent ITB pump implantation (9/10 in the “normal ICP” group and 2/8 in the “elevated ICP” group following ventriculoperitoneal shunt placement), without any postoperative complications. Conclusions: Given the potentially high rate of elevated ICP and arrested hydrocephalus, the authors advocate pre-implantation assessment of ICP under controlled conditions and a thoughtful consideration of the neurosurgical management options for patients with elevated ICP. PMID:28168091

  19. High signal intensity of the septum pellucidum at MR imaging; Significance in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Jeong Hee; Kim, Eun Ha; Chung, Chun Phil; Kim, Chang Soo [Maryknoll Hospital, Pusan (Korea, Republic of)

    1994-05-15

    To evaluate the significance of high signal intensity of the septum pellucidum in hydrocephalus on proton density-weighted brain MR images. Authors reviewed the MR images of 418 cases of patients with normal (175 case), hydrocephalic(35 cases), atrophic(58 cases), and other groups(150 cases) retrospectively. We analyzed the signal intensity of the septum pellucidum in the normal group and the incidences of high signal intensities of periventricular area of frontal horn of lateral ventricle(area 1), periventricular area except area 1 (area 2), callososeptal area(area 3), and septum pellucidum(area 4) in the normal and abnormal groups. In the normal group, the septum pellucidum was isointense to the head of caudate nucleus on proton density-weighted image. High signal intensity of the septum pellucidum was seen in 31 cases (22 cases of hydrocephalus, 5 cases of brain atrophy, and 4 cases of others), and showed high specificity(91.4%) for hydrocephalus in spite of low sensitivity(62.9%), as compared with periventricular hyperintensities of other areas. High signal intensity of the septum pellucidum on proton density- weighted image may be caused by transependymal CSF migration in the patients with hydrocephalus, and considered as an additional finding of hydrocephalus in the cases of ventriculomegaly.

  20. Changes in Rat Brain Tissue Microstructure and Stiffness during the Development of Experimental Obstructive Hydrocephalus.

    Science.gov (United States)

    Jugé, Lauriane; Pong, Alice C; Bongers, Andre; Sinkus, Ralph; Bilston, Lynne E; Cheng, Shaokoon

    2016-01-01

    Understanding neural injury in hydrocephalus and how the brain changes during the course of the disease in-vivo remain unclear. This study describes brain deformation, microstructural and mechanical properties changes during obstructive hydrocephalus development in a rat model using multimodal magnetic resonance (MR) imaging. Hydrocephalus was induced in eight Sprague-Dawley rats (4 weeks old) by injecting a kaolin suspension into the cisterna magna. Six sham-injected rats were used as controls. MR imaging (9.4T, Bruker) was performed 1 day before, and at 3, 7 and 16 days post injection. T2-weighted MR images were collected to quantify brain deformation. MR elastography was used to measure brain stiffness, and diffusion tensor imaging (DTI) was conducted to observe brain tissue microstructure. Results showed that the enlargement of the ventricular system was associated with a decrease in the cortical gray matter thickness and caudate-putamen cross-sectional area (P hydrocephalus development, increased space between the white matter tracts was observed in the CC+PVWM (P hydrocephalus development.

  1. A 2-D simulation of hydrocephalus in the Foramens of Monro of the human ventricular system

    Energy Technology Data Exchange (ETDEWEB)

    Ammourah, S.; Aroussi, A. [Univ. of Nottingham, School of Mechanical, Materials, Manufacturing and Management, University Park, Nottingham (United Kingdom)]. E-mail: eaxsaka@nottingham.ac.uk; Vloeberghs, M. [Queen' s Medical Centre, Dept. of Child Health, Nottingham (United Kingdom)

    2004-07-01

    This study investigates the Cerebrospinal fluid (CSF) flow behavior in a two-dimensional plane (2-D) of the human ventricular system when the hydrocephalus in the Foramens of Monro (F.O.M) occurs. In order to understand the CSF behaviour when the hydrocephalus occurs, it is essential to comprehend its normal flow dynamics i.e. the healthy case with no hydrocephalus. This had been done numerically by reconstructing the ventricular system geometry from the MRI scans and then made a 15{sup o} degree cut in the surgical line to obtain the outlines of the 2-D plane. The healthy cases were solved for the CSF actual flow rate, which is between 100-500 ml/day in 100 incremental steps. The unhealthy cases were studied for the average flow rate, which is 300 ml/day but for blockage ratios of the Foramen diameter of 20%, 50% and 75%. These obstructions are designed to simulate the hydrocephalus. The results show that as the flow rate increases the pressure and the velocity values increases, but no changes in the flow pattern occurs. The maximum pressure on the normal cases occurred in the lateral ventricles and the maximum velocity occurred in the aqueduct neck. The results of the hydrocephalus cases show that as the obstruction degree increases the pressure in the lateral ventricle increases accompanied with a velocity increase in the obstructed Foramen, which may cause unwanted stress on the neighboring tissues. (author)

  2. Performance of fixed-pressure valve with antisiphon device SPHERA® in hydrocephalus treatment and overdrainage prevention

    Directory of Open Access Journals (Sweden)

    Fernando Campos Gomes Pinto

    2012-09-01

    Full Text Available Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA® in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%, 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome, 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure <5 cm H2O after tap test (40 mL, 6 had pseudotumor cerebri, and 7 had hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT evidence of hypo or overdrainage, and no immediate early or late significant complications.

  3. Hydrocephalus and Ventriculoperitoneal Shunts: Modes of Failure and Opportunities for Improvement.

    Science.gov (United States)

    Jorgensen, Julianne; Williams, Corin; Sarang-Sieminski, Alisha

    2016-01-01

    Between 0.5 and 4 of every 1000 children are born with hydrocephalus. Hydrocephalus is an over-accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain, which can affect cognitive function, vision, appetite, and cranial nerve function. Left untreated, hydrocephalus can result in death. The current treatment for hydrocephalus uses ventriculoperitoneal (VP) shunts with valves to redirect CSF from the ventricles into the peritoneum. Shunt technology is limited by a number of complications, which include infection after implantation, shunt obstruction due to clot formation or catheter obstruction by scar tissue or choroid plexus, disconnection and tubing migration, and overdrainage or underdrainage of CSF due to valve malfunction. While modifications to surgical procedures and shunt design have been introduced, only modest improvements in outcomes have been observed. Here we provide an overview of hydrocephalus, VP shunts, and their modes of failure, and we identify numerous areas of opportunity for biomedical engineers and physicians to collaborate to improve the performance of VP shunts.

  4. Cerebrospinal Fluid Biomarkers in Idiopathic Normal Pressure Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Ville Leinonen

    2011-01-01

    Full Text Available The diagnosis of idiopathic normal pressure hydrocephalus (iNPH is still challenging. Alzheimer's disease (AD, along with vascular dementia, the most important differential diagnosis for iNPH, has several potential cerebrospinal fluid (CSF biomarkers which might help in the selection of patients for shunt treatment. The aim of this study was to compare a battery of CSF biomarkers including well-known AD-related proteins with CSF from patients with suspected iNPH collected from the external lumbar drainage test (ELD. A total of 35 patients with suspected iNPH patients were evaluated with ELD. CSF was collected in the beginning of the test, and the concentrations of total tau, ptau181, Aβ42, NFL, TNF-α, TGFβ1, and VEGF were analysed by ELISA. Twenty-six patients had a positive ELD result—that is, their gait symptoms improved; 9 patients had negative ELD. The levels of all analyzed CSF biomarkers were similar between the groups and none of them predicted the ELD result in these patients. Contrary to expectations lumbar CSF TNF-α concentration was low in iNPH patients.

  5. Executive Function Improvement in Normal Pressure Hydrocephalus Following Shunt Surgery

    Directory of Open Access Journals (Sweden)

    Ezequiel Gleichgerrcht

    2009-01-01

    Full Text Available The aim of this investigation was to evaluate improvement of executive functions after shunt surgery in patients with early normal pressure hydrocephalus (NPH. Patients with NPH were assessed before and after shunt surgery with tests shown to be sensitive to damage to the prefrontal cortex (PFC. Significant differences were found between basal and follow-up performances on the Boston Naming Test, the backwards digits span, Part B of the Trail Making Test, and the number of words produced on the phonological fluency task. In conclusion, our study reveals that patients with NPH who respond positively to continuous slow lumbar cerebral spinal fluid drainage and receive a ventriculoperitoneal shunt implant, improve their performance on tasks of executive function. Due to the high demand for this form of mental processing in real-life complex scenarios, and based on the severe executive deficits present in both demented and non-demented NPH patients, we encourage the assessment of executive functions in this clinical group.

  6. [Infusion test in the normal pressure hydrocephalus (author's transl)].

    Science.gov (United States)

    Kondo, T; Tsubokawa, T; Doi, N; Sugawara, T; Moriyasu, N

    1981-02-01

    Continuous monitoring of the intracranial pressure and ventricular infusion test were carried out in 13 cases in which normal pressure hydrocephalus (NPH) was suspected. The infusion test was performed by intraventricular bolus injection of 8 ml of saline. The result was collated with the effect of shunting operation, which was judged by means of the improvement in the clinical symptoms and the amplitude of contingent negative variation. The excellent effect of shunting operation was obtained in the patients who showed the T of more than 200 sec, the compliance of less than 1.0 ml/mmHg, the conductance to outflow of less than 0.8 ml/mmHg/min and CSF outflow resistance of more than 15 mmHg/ml/min. In 3 cases out of the 5 effective cases, A or B wave was seen. However, appreciable variation of the values was shown among the cases so that it was concluded that the all-round-consideration must be done to select the case for the shunting operation with the findings in RI-cisternography, pneumoencephalography, computerized tomography and so on. This fact might indicate the existence of the complicated pathophysiology in NPH resulted from not only the impairment of cerebrospinal fluid circulation but also the disturbance of cerebral blood flow, changes in plasticity of the brain and so on.

  7. Evaluation of periventricular radiolucency in hydrocephalus by dynamic CT studies

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Hideki; Bandou, Kuniaki; Miyaoka, Makoto (Fujisawa City Hospital, Kanagawa (Japan))

    1994-06-01

    The association of periventricular radiolucency (PVL) in normal pressure hydrocephalus (NPH) on CT scan is a common finding. However, it is difficult to differentiate NPH from atrophy or infarctions in which shunt surgery does not reverse these conditions. To distinguish NPH from these, we examined PVL by means of dynamic CT (DCT) studies. We investigated 12 elderly patients presenting with gait disturbance, urinary incontinence and mental dysfunction who had both enlarged lateral ventricles and PVL. All patients had laboratory investigations, including radioisotope and CT cisternography and Xenon CBF studies. Nine patients were shunted because of abnormal CSF dynamics. Varying degrees of clinical improvement after surgery were observed in 6 cases. A difference of arrival time (AT) between PVL and thalamus obtained from time-density-curve was calculated in each patient. The AT difference was 6.2[+-]1.5 sec. in the shunt-effective group, and 1.4[+-]1.3 sec. in both, the shunt in effective and ineligible group, this was highly significant (p<0.01). We also measured peak time (PT) in PVL, of the thalamus and anterior cerebral artery, but no significant correlation was obtained. An AT difference between PVL and thalamus obtained from DCT studies is a clinically useful diagnostic tool for the evaluation of NPH. (author).

  8. Passive flow regulators for drug delivery and hydrocephalus treatment

    Science.gov (United States)

    Chappel, E.; Dumont-Fillon, D.; Mefti, S.

    2014-03-01

    Passive flow regulators are usually intended to deliver or drain a fluid at a constant rate independently from pressure variations. New designs of passive flow regulators made of a stack of a silicon membrane anodically bonded to a Pyrex substrate are proposed. A first design has been built for the derivation of cerebrospinal fluid (CSF) towards peritoneum for hydrocephalus treatment. The device allows draining CSF at the patient production rate independently from postural changes. The flow rate is regulated at 20 ml/h in the range 10 to 40 mbar. Specific features to adjust in vivo the nominal flow rate are shown. A second design including high pressure shut-off feature has been made. The intended use is drug delivery with pressurized reservoir of typically 100 to 300 mbar. In both cases, the membrane comprises several holes facing pillars in the Pyrex substrate. These pillars are machined in a cavity which ensures a gap between the membrane and the pillars at rest. The fluid in the pressurized reservoir is directly in contact with the top surface of the membrane, inducing its deflection towards Pyrex substrate and closing progressively the fluidic pathway through each hole of the membrane. Since the membrane deflection is highly non-linear, FEM simulations have been performed to determine both radial position and diameter of the membrane holes that ensure a constant flow rate for a given range of pressure.

  9. The APOE Genotype in Idiopathic Normal Pressure Hydrocephalus.

    Directory of Open Access Journals (Sweden)

    Yi Yang

    Full Text Available Amyloid plaque has been reported in brain biopsies from patients with idiopathic normal-pressure hydrocephalus (iNPH and proposed as a significant feature of the pathophysiology. Presence of the apolipoprotein E ε4 (APOE ε4 allele is associated with increased risk of Alzheimer's disease (AD.To compare the distribution of APOE genotype in iNPH patients with an age-matched population-based control group and with Alzheimer's disease (AD patients.APOE genotype frequencies were determined in 77 iNPH patients (50 men and 27 women, mean age 71.7 years diagnosed with iNPH, a sample of 691 AD patients and 638 age-matched population controls (299 men and 339 women from the INTERGENE cohort.The APOE distribution did not differ significantly between the iNPH patients and the control population. The per e4-allele odds-ratio (OR of iNPH was given by OR = 0.90, 95% confidence interval (CI = (0.50, 1.60 that was considerably smaller than the per-allele OR of AD, OR = 5.34 (4.10, 7.00.The results suggest that the APOE-related risk of AD in patients with iNPH is not higher than in the general population.

  10. Evidences in the treatment of idiopathic normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    Matheus Fernandes de Oliveira

    2015-06-01

    Full Text Available Summary Introduction: idiopathic normal pressure hydrocephalus (INPH is characterized by gait apraxia, cognitive dysfunction and urinary incontinence. There are two main treatment options: ventriculoperitoneal shunt (VPS and endoscopic third ventriculostomy (ETV. However, there are doubts about which modality is superior and what type of valve should be applied. We are summarizing the current evidence in INPH treatment. Methods: an electronic search of the literature was conducted on the Medline, Embase, Scielo and Lilacs databases from 1966 to the present to obtain data published about INPH treatment. Results: the treatment is based on three pillars: conservative, ETV and VPS. The conservative option has fallen into disuse after various studies showing good results after surgical intervention. ETV is an acceptable mode of treatment, but the superiority of VPS has made the latter the gold standard. Conclusion: well-designed studies with a high level of appropriate evidence are still scarce, but the current gold standard for treatment of INPH is conducted using VPS.

  11. Multi-Electron Coincidence Studies of Atoms and Molecules

    OpenAIRE

    Andersson, Egil

    2010-01-01

    This thesis concerns multi-ionization coincidence measurements of atoms and small molecules using a magnetic bottle time-of-flight (TOF) spectrometer designed for multi-electron coincidence studies. Also, a time-of-flight mass spectrometer has been used together with the TOF electron  spectrometer for electron-ion coincidence measurements. The multi-ionization processes have been studied by employing a pulsed discharge lamp in the vacuum ultraviolet spectral region and synchrotron radiation i...

  12. The Nature of Hyperactivity in Children and Adolescents With Hydrocephalus: A Test of the Dual Pathway Model

    Directory of Open Access Journals (Sweden)

    Jim Stevenson

    2004-01-01

    affected by sex or age. Variation in the clinical features of hydrocephalus was not related to the severity of hyperactivity. Path analysis was used to examine the relation between IQ, delay aversion, and executive function. In accordance with the DPM, the effect of hydrocephalus on hyperactivity was completely mediated via delay aversion and executive functions.

  13. Diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life

    NARCIS (Netherlands)

    Dommelen, P. van; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2015-01-01

    Background Increased head circumference is often the first and main sign leading to the diagnosis of hydrocephalus. Our aim is to investigate the diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life. Methods A reference group with longitud

  14. Medfødt hydrocephalus--forekomst og prognose. Mortalitet og morbiditet i en populationsbaseret opgørelse

    DEFF Research Database (Denmark)

    Christensen, Jacob Haaber; Hansen, Lars Kjaersgård; Garne, Ester

    2003-01-01

    The aim was to describe the prevalence and to estimate the prognosis of congenital hydrocephalus (HC) in fetuses and children.......The aim was to describe the prevalence and to estimate the prognosis of congenital hydrocephalus (HC) in fetuses and children....

  15. Diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life

    NARCIS (Netherlands)

    Dommelen, P. van; Deurloo, J.A.; Gooskens, R.H.; Verkerk, P.H.

    2015-01-01

    Background Increased head circumference is often the first and main sign leading to the diagnosis of hydrocephalus. Our aim is to investigate the diagnostic accuracy of referral criteria for head circumference to detect hydrocephalus in the first year of life. Methods A reference group with

  16. BOUNDS ON COINCIDENCE INDICES ON NON-ORIENTABLE SURFACES

    Institute of Scientific and Technical Information of China (English)

    D.VENDR(U)SCOLO

    2005-01-01

    This paper presents some results about bounds for coincidence indices of Nielsen coincidence classes for maps between nonorientable surfaces. Denoting by Kn the nonorientable surface constructed by a connected sum of n torus with a Klein bottle,the author proves: (i) for pairs of maps between two Klein bottles or for pairs of maps from a Klein bottle to a surface Kn the coincidence class index is bounded. (ii) for pairs of maps from Kn to the Klein bottle the coincidence class index is unbounded.Other boundedness results are given for more technical conditions, including one for self maps.

  17. Performance of fixed-pressure valve with antisiphon device SPHERA(®) in hydrocephalus treatment and overdrainage prevention.

    Science.gov (United States)

    Pinto, Fernando Campos Gomes; Pereira, Renan Muralho; Saad, Felippe; Teixeira, Manoel Jacobsen

    2012-09-01

    Patients with hydrocephalus and risk factors for overdrainage may be submitted to ventricular shunt (VS) implant with antisiphon device. The objective of this study was to prospectively evaluate for two years the clinical and tomographic results of the implant of fixed-pressure valves with antisiphon device SPHERA(®) in 35 adult patients, with hydrocephalus and risk factors for overdrainage. Of these, 3 had congenital hydrocephalus in adult patients with very dilated ventricles (Evans index >50%), 3 had symptomatic overdrainage after previous VS implant (subdural hematoma, hygroma or slit ventricle syndrome), 1 had previous chronic subdural hematoma, 15 had normal pressure hydrocephalus with final lumbar pressure hydrocephalus due to other causes. Clinical improvement was observed and sustained in 94.3% of the patients during the two-year period with no computed tomography (CT) evidence of hypo or overdrainage, and no immediate early or late significant complications.

  18. Clinical efficacy of Codman-Hakim programmable valve for hydrocephalus%可调压分流管治疗脑积水的临床疗效

    Institute of Scientific and Technical Information of China (English)

    张成功

    2015-01-01

    目的 探讨可调压分流管治疗脑积水的临床疗效.方法 回顾性分析在我院治疗的36例脑积水患者的临床资料,所有患者均进行脑室-腹腔分流术治疗.其中21例患者采用可调压管进行分流,15例患者采用非可调压分流管分流.比较两组患者的临床疗效.结果 调压组有效率显著高于非调压组(P<0.05).调压组总并发症发生率显著低于非调压组(P<0.05).结论 可调压分流管治疗脑积水具有较好的临床疗效,并且并发症较少,值得临床推广.%Objective To analyze the clinical efficacy of Codman-Hakim programmable valve for hydrocephalus.Methods Clinical data of 36 cases with hydrocephalus treated by ventricular peritoneal shunt were retrospectively analyzed.21 cases used Codman-Hakim programmable valve,and 15 cases used unadjustable voltage shunt.Clinical efficacy of two groups was analyzed.Results Clinical efficacy of adjustable group was better than unadjustable group(P<0.05).Complication probability of adjustable group was higher than unadjustable group(P<0.05).ConclusionCodman-Hakim programmable valve for hydrocephalus shows good clinical efficacy,with less complications,worthy of clinical application.

  19. CSF monoamine metabolites, cholinesterases and lactate in the adult hydrocephalus syndrome (normal pressure hydrocephalus) related to CSF hydrodynamic parameters.

    Science.gov (United States)

    Malm, J; Kristensen, B; Ekstedt, J; Adolfsson, R; Wester, P

    1991-03-01

    Monoamine metabolites, cholinesterases and lactic acid in lumbar cerebrospinal fluid (CSF) were investigated on patients with the adult hydrocephalus syndrome (idiopathic normal pressure syndrome; AHS, n = 15), Alzheimer's disease (AD, n = 14), multi-infarct dementia (MID, n = 13) and controls (n = 21). Patients had clinical and CSF hydrodynamic investigations. Monoamine concentrations were determined by reversed-phase liquid chromatography, cholinesterases and lactate were determined photometrically. In the AHS patients, CSF monoamine concentrations were not significantly different compared with controls, AD or MID patients. AHS and AD patients showed a similar reduction of CSF acetylcholinesterase activity compared with controls. Positive correlations were found in concentrations of CSF homovanillic acid, CSF 5-hydroxyindoleacetic acid and CSF lactic acid versus CSF outflow conductance (that is, resistance against CSF outflow) in the AHS patients. A similar pattern was observed in a subgroup of MID patients characterised by dilated ventricles and disturbed CSF hydrodynamics. These data suggest that a low CSF outflow conductance may facilitate the clearance of acidic substances from the arachnoid space at the probenecid sensitive active transport site. Alternative explanations would be that a pathologically low CSF outflow conductance is accompanied by an inverse caudorostral flow of CSF or a compromised trans-ependymal diffusion.

  20. Myelin Sheath Injury in Kaolin-Induced Hydrocephalus: A Light and Electron Microscopy Study.

    Science.gov (United States)

    Ayannuga, Olugbenga A; Shokunbi, M Temitayo; Naicker, T A

    2016-01-01

    In hydrocephalus, the impairment of cognitive and motor functions is thought to be partly due to injury to the myelin sheath of axons in the central nervous system. The exact nature of this injury is not completely understood. We induced hydrocephalus in 3-week-old rats with an intracisternal injection of kaolin suspension (0.04 ml of 200 mg/ml) and examined paraffin and ultrathin sections of the subcortical white matter from coronal slices of the cerebrum obtained at the level of the optic chiasm after sacrifice at weekly intervals for 4 weeks. Over time, there was a progression of injury to the myelin sheath consisting of attenuation, lamella separation and accumulation of myelin debris, focal degeneration, and the appearance of casts and loops. The results suggest that myelin injury in kaolin-induced hydrocephalus progresses with the duration and severity of ventriculomegaly. © 2016 S. Karger AG, Basel.

  1. Type III occipital condylar fracture presenting with hydrocephalus, vertebral artery injury and vasospasm: case report

    Energy Technology Data Exchange (ETDEWEB)

    Menendez, J.A.; Baskaya, M.K.; Day, M.A.; Nanda, A. [Dept. of Neurosurgery, Louisiana State Univ., Shreveport (United States); Helath Sciences Center, Shreveport, LA (United States)

    2001-03-01

    Occipital condylar fractures (OCF) are rare and have a high mortality rate. We report a patient with OCF who presented with acute hydrocephalus and died from diffuse vasospasm secondary to vertebral artery injury. A 45-year-old man fell 20 feet from a deer stand and landed on his head. CT showed a type III OCF continuing to the anterior rim of the foramen magnum on the left, with a bone fragment pushing into the medulla, causing hydrocephalus. The patient was stabilized, and a four-vessel arteriogram showed diffuse vasospasm with complete occlusion of the left vertebral artery at the level of the OCF. To our knowledge, this is the first documented case of the conjunction of OCF, hydrocephalus, and vasospasm. (orig.)

  2. The predictive value of conductance to outflow of CSF in normal pressure hydrocephalus.

    Science.gov (United States)

    Børgesen, S E; Gjerris, F

    1982-03-01

    Conductance to outflow of CSF was measured in a prospective study of 80 patients with normal pressure hydrocephalus. Measured outflow was compared with clinical findings, computed tomography, intracranial pressure measurements and with the results of shunting. Follow-up time was one year. Outflow measurements predicted the outcome of shunting in 96 per cent of the patients. Patients with the combination of known aetiology, short history, gait disturbances, severe dementia, urinary incontinence and hydrocephalus on CT can be shunted without further investigations. Periventricular hypodensity on CT scanning predicts an excellent result for shunting. Based on results of preoperative investigations and outcome of shunting we propose a programme for the investigation of future patients with normal pressure hydrocephalus.

  3. A Mechanics-Based Framework Leading to Improved Diagnosis and Treatment of Hydrocephalus

    Science.gov (United States)

    Cohen, Benjamin; Soren, Vedels; Wagshul, Mark; Egnor, Michael; Voorhees, Abram; Wei, Timothy

    2007-11-01

    Hydrocephalus is defined as an accumulation of cerebrospinal fluid (CSF) in the cranium, at the expense of brain tissue. The result is a disruption of the normal pressure and/or flow dynamics of the intracranial blood and CSF. We seek to introduce integral control volume analysis to the study of hydrocephalus. The goal is to provide a first principles framework to integrate a broad spectrum of sometimes disparate investigations into a highly complex, multidisciplinary problem. The general technique for the implementation of control volumes to hydrocephalus will be presented. This includes factors faced in choosing control volumes and making the required measurements to evaluate mass and momentum conservation. In addition, the use of our Digital Particle Image Velocimetry (DPIV) processing program has been extended to measure the displacement of the ventricles' walls from Magnetic Resonance (MR) images. This is done to determine the volume change of the intracranial fluid spaces.

  4. Subdural haematoma complicating shunting for normal pressure hydrocephalus in the setting of concomitant antiplatelet medication

    DEFF Research Database (Denmark)

    Birkeland, Peter; Lauritsen, Jens; Poulsen, Frantz Rom

    2016-01-01

    OBJECTIVE: To report on the occurrence and management of subdural haematoma after shunt implantation for normal pressure hydrocephalus and to determine the risk of recurrence in the setting of antiplatelet medication. METHODS: From a consecutive series of 80 patients implanted with a cerebrospinal...... fluid shunt for normal pressure hydrocephalus, records from 11 patients taking antiplatelet drugs, who subsequently had surgery for subdural haematoma were extracted and retrospectively reviewed. RESULTS: Patients were followed up for a mean of 1819 days after shunt implantation. Subdural haematomas...... reoperations done before the subdural collection disappeared. Only one patient had a late recurrence almost 11 years after shunt implantation. CONCLUSIONS: Subdural haematoma in the setting of a ventriculoperitoneal implantation for normal pressure hydrocephalus and concomitant antiplatelet medication can...

  5. [Transfontanellar Doppler ultrasound measurement of cerebral blood velocity before and after surgical treatment of hydrocephalus].

    Science.gov (United States)

    de Assis, M C; Machado, H R

    1999-09-01

    Twenty-seven children with hydrocephalus of different etiologies diagnosed by clinical examination, neurosonography and computerized brain tomography were submitted to transfontanellar US-Doppler evaluation for measurement of blood flow velocity and for the calculation of resistance index (RI) in the anterior and middle cerebral arteries and internal carotids. All children were submitted to evaluation before surgery and on the 1st, 30th and 60th postoperative days. We conclude that neurosonography and US-Doppler technique is useful for determination of hydrocephalus, indication and control of cerebrospinal fluid shunts and monitoring of changes in RI, comparing data obtained immediately before and after surgery and during the late postoperative period. The results obtained when comparing the RI values for the various arteries during the different stages of the study also permitted us to conclude that the anterior cerebral arteries are representative of the maximal alterations that occur in cerebral vascular resistance in pediatric patients with hydrocephalus.

  6. Significance of periventricular lucency on computed tomography: experimental study with canine hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Murata, T.; Handa, H.; Mori, K.; Nakano, Y.

    1981-01-01

    In order to investigate the pathogenesis of periventricular lucency (PVL) in hydrocephalus, CT scans were performed with monitoring of the epidural pressure in a series of dogs with hydrocephalus induced with kaolin. PVL of various degrees was detected in the experimental animals, which disappeared immediately after a shunting operation. Correlations have been attempted between PVL on CT scans and histological examinations, contrast enhancement studies, metrizamide ventriculography, and measurement of regional cerebral blood flow in the periventricular white matter. PVL in hydrocephalus is considered to represent acute edema or chronic CSF retention in the periventricular white matter caused by an increase of water content. In other words, it is regarded as a sign of existing or preceding intraventricular hypertension on CT scan, and seems to be a reversible phenomenon to some extent. PVL may therefore become an indication for a shunt.

  7. Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors.

    Science.gov (United States)

    Reddy, G Kesava; Bollam, Papireddy; Caldito, Gloria; Willis, Brian; Guthikonda, Bharat; Nanda, Anil

    2011-06-01

    Patients with intracranial tumors are predisposed to persistent hydrocephalus, often requiring a permanent CSF diversion procedure with shunts. This study reviews the long-term experience with ventriculoperitoneal shunts for the management of hydrocephalus in patients with intracranial tumors. Patients with intracranial tumors who underwent ventriculoperitoneal shunt placement for hydrocephalus from October 1990 to October 2009 were included in this study. During the 19-year period, medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively for all patients. A total of 187 intracranial tumor patients with hydrocephalus were included. The median follow up was 391 days. Malignant tumors were present in 40% of the patients. Overall shunt failure was 27.8%. Single shunt revision occurred in 13% of the patients and 14% had multiple shunt revision. Tumor histology, age and a procedure prior to shunt placement (ventriculostomy/Ommaya reservoirs) were significantly associated with the shunt revisions. Shunt system replacement and proximal shunt complication were significantly attributed to multiple shunt revisions. The overall shunt revision within 3 months, 6 months, 1 year and 5 years was 17.7%, 18.7%, 19.8% and 24.1%, respectively. The results of the study demonstrate that VP shunting is an effective for the management of hydrocephalus in patients with intracranial tumors. The overall incidence of shunt revision was 27.8%. Age, tumor histology, and a procedure prior to shunt placement (ventriculostomy/Ommaya reservoirs) were significantly associated with the shunt revisions. Additional studies using minimally invasive techniques are being explored for the management of hydrocephalus in patients with intracranial tumors.

  8. An Inexpensive Coincidence Circuit for the Pasco Geiger Sensors

    CERN Document Server

    Fichera, F; Librizzi, F; Riggi, F

    2005-01-01

    A simple coincidence circuit was devised to carry out educational coincidence experiments involving the use of Geiger counters. The system was tested by commercially available Geiger sensors from PASCO, and is intended to be used in collaboration with high school students and teachers

  9. Coincidence Prompt Gamma-Ray Neutron Activation Analysis

    Energy Technology Data Exchange (ETDEWEB)

    R.P. gandner; C.W. Mayo; W.A. Metwally; W. Zhang; W. Guo; A. Shehata

    2002-11-10

    The normal prompt gamma-ray neutron activation analysis for either bulk or small beam samples inherently has a small signal-to-noise (S/N) ratio due primarily to the neutron source being present while the sample signal is being obtained. Coincidence counting offers the possibility of greatly reducing or eliminating the noise generated by the neutron source. The present report presents our results to date on implementing the coincidence counting PGNAA approach. We conclude that coincidence PGNAA yields: (1) a larger signal-to-noise (S/N) ratio, (2) more information (and therefore better accuracy) from essentially the same experiment when sophisticated coincidence electronics are used that can yield singles and coincidences simultaneously, and (3) a reduced (one or two orders of magnitude) signal from essentially the same experiment. In future work we will concentrate on: (1) modifying the existing CEARPGS Monte Carlo code to incorporate coincidence counting, (2) obtaining coincidence schemes for 18 or 20 of the common elements in coal and cement, and (3) optimizing the design of a PGNAA coincidence system for the bulk analysis of coal.

  10. Shift-register coincidence electronics system for thermal neutron counters

    Energy Technology Data Exchange (ETDEWEB)

    Swansen, J.E.; Collinsworth, P.R.; Krick, M.S.

    1980-04-01

    An improved shift-register, coincidence-counting logic circuit, developed for use with thermal neutron well counters, is described in detail. A distinguishing feature of the circuit is its ability to operate usefully at neutron counting rates of several hundred kHz. A portable electronics package incorporating the new coincidence logic and support circuits is also described.

  11. Digital gamma-gamma coincidence HPGe system for environmental analysis

    DEFF Research Database (Denmark)

    Markovic, Nikola; Roos, Per; Nielsen, Sven Poul

    2017-01-01

    The performance of a new gamma-gamma coincidence spectrometer system for environmental samples analysis at the Center for Nuclear Technologies of the Technical University of Denmark (DTU) is reported. Nutech Coincidence Low Energy Germanium Sandwich (NUCLeGeS) system consists of two HPGe detector...

  12. Low levels of amyloid-beta and its transporters in neonatal rats with and without hydrocephalus

    Directory of Open Access Journals (Sweden)

    Silverberg Gerald D

    2009-05-01

    Full Text Available Abstract Background Previous studies in aging animals have shown that amyloid-beta protein (Aβ accumulates and its transporters, low-density lipoprotein receptor-related protein-1 (LRP-1 and the receptor for advanced glycation end products (RAGE are impaired during hydrocephalus. Furthermore, correlations between astrocytes and Aβ have been found in human cases of normal pressure hydrocephalus (NPH and Alzheimer's disease (AD. Because hydrocephalus occurs frequently in children, we evaluated the expression of Aβ and its transporters and reactive astrocytosis in animals with neonatal hydrocephalus. Methods Hydrocephalus was induced in neonatal rats by intracisternal kaolin injections on post-natal day one, and severe ventriculomegaly developed over a three week period. MRI was performed on post-kaolin days 10 and 21 to document ventriculomegaly. Animals were sacrificed on post-kaolin day 21. For an age-related comparison, tissue was used from previous studies when hydrocephalus was induced in a group of adult animals at either 6 months or 12 months of age. Tissue was processed for immunohistochemistry to visualize LRP-1, RAGE, Aβ, and glial fibrillary acidic protein (GFAP and with quantitative real time reverse transcriptase polymerase chain reaction (qRT-PCR to quantify expression of LRP-1, RAGE, and GFAP. Results When 21-day post-kaolin neonatal hydrocephalic animals were compared to adult (6–12 month old hydrocephalic animals, immunohistochemistry demonstrated levels of Aβ, RAGE, and LRP-1 that were substantially lower in the younger animals; in contrast, GFAP levels were elevated in both young and old hydrocephalic animals. When the neonatal hydrocephalic animals were compared to age-matched controls, qRT-PCR demonstrated no significant changes in Aβ, LRP-1 and RAGE. However, immunohistochemistry showed very small increases or decreases in individual proteins. Furthermore, qRT-PCR indicated statistically significant increases in GFAP

  13. Severe hydrocephalus complicated with benign paroxysmal positional vertigo: one case report

    Science.gov (United States)

    Chen, Jian Jun; Cheng, Wei Jin; Rao, Jie; Lu, Ye Fen; Qiu, Wei Wen

    2015-01-01

    In this study, we reported one female patient diagnosed with severe hydrocephalus who presented with benign paroxysmal positional vertigo (BPPV). She presented with progressive headache and dizziness prior to hospitalization as chief complaints. She received Diagnostic Dix-Hallpike and Roll tests to make a definite diagnosis. The patient was cured after Gufoni maneuver and did not recur after 6-month follow-up. The diagnostic procedures of this female case prompted that prior to formal treatment, patients developing severe hydrocephalus complicated with BPPV should receive provocative test for positional dizziness, performed by experienced physicians from the Department of neurology and otolaryngology. PMID:26885146

  14. Increased self-diffusion of brain water in hydrocephalus measured by MR imaging

    DEFF Research Database (Denmark)

    Gideon, P; Thomsen, C; Gjerris, F

    1994-01-01

    We used MR imaging to measure the apparent brain water self-diffusion in 5 patients with normal pressure hydrocephalus (NPH), in 2 patients with high pressure hydrocephalus (HPH), and in 8 age-matched controls. In all patients with NPH significant elevations of the apparent diffusion coefficients...... (ADC) of brain water were found within periventricular white matter, in the corpus callosum, in the internal capsule, within cortical gray matter, and in cerebrospinal fluid, whereas normal ADCs were found within the basal ganglia. In 2 patients with HPH elevated ADCs were found most prominently within...

  15. Neonate with VACTERL Association and a Branchial Arch Anomaly without Hydrocephalus.

    Science.gov (United States)

    Velazquez, Danitza; Pereira, Elaine; Havranek, Thomas

    2016-03-01

    VACTERL (vertebral anomalies, anal atresia, cardiac defect, tracheoesophageal fistula, renal anomaly, limb anomalies) is an association of anomalies with a wide spectrum of phenotypic expression. While the majority of cases are sporadic, there is evidence of an inherited component in a small number of patients as well as the potential influence of nongenetic risk factors (maternal diabetes mellitus). Presence of hydrocephalus has been reported in VACTERL patients (VACTERL-H) in the past, with some displaying branchial arch anomalies. We report the unique case of an infant of diabetic mother with VACTERL association and a branchial arch anomaly-in the absence of hydrocephalus.

  16. Recovery and normalization of triple coincidences in PET

    Energy Technology Data Exchange (ETDEWEB)

    Lage, Eduardo, E-mail: elage@mit.edu; Parot, Vicente; Dave, Shivang R.; Herraiz, Joaquin L. [Madrid-MIT M+Visión Consortium, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Moore, Stephen C.; Sitek, Arkadiusz; Park, Mi-Ae [Division of Nuclear Medicine, Department of Radiology, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts 02115 (United States); Udías, Jose M. [Grupo de Física Nuclear, Departamento de Física Atómica Molecular y Nuclear, Universidad Complutense de Madrid, CEI Moncloa, Madrid 28040 (Spain); Vaquero, Juan J. [Departamento de Ingeniería Biomédica e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés 28911 (Spain)

    2015-03-15

    Purpose: Triple coincidences in positron emission tomography (PET) are events in which three γ-rays are detected simultaneously. These events, though potentially useful for enhancing the sensitivity of PET scanners, are discarded or processed without special consideration in current systems, because there is not a clear criterion for assigning them to a unique line-of-response (LOR). Methods proposed for recovering such events usually rely on the use of highly specialized detection systems, hampering general adoption, and/or are based on Compton-scatter kinematics and, consequently, are limited in accuracy by the energy resolution of standard PET detectors. In this work, the authors propose a simple and general solution for recovering triple coincidences, which does not require specialized detectors or additional energy resolution requirements. Methods: To recover triple coincidences, the authors’ method distributes such events among their possible LORs using the relative proportions of double coincidences in these LORs. The authors show analytically that this assignment scheme represents the maximum-likelihood solution for the triple-coincidence distribution problem. The PET component of a preclinical PET/CT scanner was adapted to enable the acquisition and processing of triple coincidences. Since the efficiencies for detecting double and triple events were found to be different throughout the scanner field-of-view, a normalization procedure specific for triple coincidences was also developed. The effect of including triple coincidences using their method was compared against the cases of equally weighting the triples among their possible LORs and discarding all the triple events. The authors used as figures of merit for this comparison sensitivity, noise-equivalent count (NEC) rates and image quality calculated as described in the NEMA NU-4 protocol for the assessment of preclinical PET scanners. Results: The addition of triple-coincidence events with the

  17. Mean and variance of coincidence counting with deadtime

    CERN Document Server

    Yu, D F

    2002-01-01

    We analyze the first and second moments of the coincidence-counting process for a system affected by paralyzable (extendable) deadtime with (possibly unequal) deadtimes in each singles channel. We consider both 'accidental' and 'genuine' coincidences, and derive exact analytical expressions for the first and second moments of the number of recorded coincidence events under various scenarios. The results include an exact form for the coincidence rate under the combined effects of decay, background, and deadtime. The analysis confirms that coincidence counts are not exactly Poisson, but suggests that the Poisson statistical model that is used for positron emission tomography image reconstruction is a reasonable approximation since the mean and variance are nearly equal.

  18. Control of an electromechanical hydrocephalus shunt--a new approach.

    Science.gov (United States)

    Elixmann, Inga M; Kwiecien, Monika; Goffin, Christine; Walter, Marian; Misgeld, Berno; Kiefer, Michael; Steudel, Wolf-Ingo; Radermacher, Klaus; Leonhardt, Steffen

    2014-09-01

    Hydrocephalus is characterized by an excessive accumulation of cerebrospinal fluid (CSF). Therapeutically, an artificial pressure relief valve (so-called shunt) is implanted which opens in case of increased intracranial pressure (ICP) and drains CSF into another body compartment. Today, available shunts are of a mechanical nature and drainage depends on the pressure drop across the shunt. According to the latest data, craniospinal compliance is considered to be even more important than mean ICP alone. In addition, ICP is not constant but varies due to several influences. In fact, heartbeat-related ICP waveform patterns depend on volume changes in the cranial vessels during a heartbeat and changes its shape as a function of craniospinal compliance. In this paper, we present an electromechanical shunt approach, which changes the CSF drainage as a function of the current ICP waveform. A series of 12 infusion tests in patients were analyzed and revealed a trend between the compliance and specific features of the ICP waveform. For waveform analysis of patient data, an existing signal processing algorithm was improved (using a Moore machine) and was implemented on a low-power microcontroller within the electromechanical shunt. In a test rig, the ICP waveforms were replicated and the decisions of the ICP analysis algorithm were verified. The proposed control algorithm consists of a cascaded integral controller which determines the target ICP from the measured waveform, and a faster inner-loop integral controller that keeps ICP close to the target pressure. Feedforward control using measurement data of the patient's position was implemented to compensate for changes in hydrostatic pressure during change in position. A model-based design procedure was used to lay out controller parameters in a simple model of the cerebrospinal system. Successful simulation results have been obtained with this new approach by keeping ICP within the target range for a healthy waveform.

  19. Twenty-year outcome in young adults with childhood hydrocephalus: assessment of surgical outcome, work participation, and health-related quality of life.

    Science.gov (United States)

    Paulsen, A Henriette; Lundar, Tryggve; Lindegaard, Karl-Fredrik

    2010-12-01

    mortality rate was high: 24 patients died in the 1st decade and 6 died in the 2nd decade after implantation of the initial shunt. In total, 4 deaths (2.9%) were due to shunt failure. Shunt placement to treat childhood hydrocephalus has a substantial effect on social functioning in later life, although perceived health was positively found to be better than expected in young adults with hydrocephalus.

  20. Roles for Coincidence Detection in Coding Amplitude-Modulated Sounds.

    Directory of Open Access Journals (Sweden)

    Go Ashida

    2016-06-01

    Full Text Available Many sensory neurons encode temporal information by detecting coincident arrivals of synaptic inputs. In the mammalian auditory brainstem, binaural neurons of the medial superior olive (MSO are known to act as coincidence detectors, whereas in the lateral superior olive (LSO roles of coincidence detection have remained unclear. LSO neurons receive excitatory and inhibitory inputs driven by ipsilateral and contralateral acoustic stimuli, respectively, and vary their output spike rates according to interaural level differences. In addition, LSO neurons are also sensitive to binaural phase differences of low-frequency tones and envelopes of amplitude-modulated (AM sounds. Previous physiological recordings in vivo found considerable variations in monaural AM-tuning across neurons. To investigate the underlying mechanisms of the observed temporal tuning properties of LSO and their sources of variability, we used a simple coincidence counting model and examined how specific parameters of coincidence detection affect monaural and binaural AM coding. Spike rates and phase-locking of evoked excitatory and spontaneous inhibitory inputs had only minor effects on LSO output to monaural AM inputs. In contrast, the coincidence threshold of the model neuron affected both the overall spike rates and the half-peak positions of the AM-tuning curve, whereas the width of the coincidence window merely influenced the output spike rates. The duration of the refractory period affected only the low-frequency portion of the monaural AM-tuning curve. Unlike monaural AM coding, temporal factors, such as the coincidence window and the effective duration of inhibition, played a major role in determining the trough positions of simulated binaural phase-response curves. In addition, empirically-observed level-dependence of binaural phase-coding was reproduced in the framework of our minimalistic coincidence counting model. These modeling results suggest that coincidence

  1. Curative effect analysis of ventriculoperitoneal shunt in the treatment of 22 cases of hydrocephalus%脑室腹腔分流术治疗脑积水22例疗效分析

    Institute of Scientific and Technical Information of China (English)

    张中华

    2014-01-01

    To explore the curative effect of ventriculoperitoneal shunt in the treatment of hydrocephalus.Methods:22 cases with hydrocephalus were selected from 2009 to 2013.They were treated with ventriculoperitoneal shunt,and we retrospec-tively analyzed the clinical data.Results:Clinical treatment of the total efficiency was 90.9%(20/22);complication rate was 18.2%(4/22).Conclusion:The application of ventriculoperitoneal shunt in the treatment of hydrocephalus has satisfactory clinical treatment effect.The complication rate is not high.It is safe and efficient.%目的:探究对脑积水患者应用脑室腹腔分流术进行治疗的临床效果。方法:2009-2013年收治脑积水患者22例,均采用脑室腹腔分流术治疗,回顾性分析其临床资料。结果:临床治疗总有效率90.9%(20/22),并发症发生率18.2%(4/22)。结论:应用脑室腹腔分流术治疗脑积水临床疗效满意,且并发症发生率不高,具有安全高效的优点。

  2. Rapid resolution of an acute subdural hematoma by increasing the shunt valve pressure in a 63-year-old man with normal-pressure hydrocephalus with a ventriculoperitoneal shunt: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Hayes Jackson

    2012-11-01

    Full Text Available Abstract Introduction Symptomatic subdural hematoma development is a constant concern for patients who have undergone cerebrospinal fluid shunting procedures to relieve symptoms related to normal-pressure hydrocephalus. Acute subdural hematomas are of particular concern in these patients as even minor head trauma may result in subdural hematoma formation. The presence of a ventricular shunt facilitates further expansion of the subdural hematoma and often necessitates surgical treatment, including subdural hematoma evacuation and shunt ligation. Case presentation We present the case of a 63-year-old North American Caucasian man with normal-pressure hydrocephalus with an adjustable valve ventriculoperitoneal shunt who developed an acute subdural hematoma after sustaining head trauma. Conservative treatment was favored over operative evacuation because our patient was neurologically intact, but simple observation was considered to be too high risk in the setting of a low-pressure ventriculoperitoneal shunt. Thus, the valve setting on the ventriculoperitoneal shunt was increased to its maximum pressure setting in order to reduce flow through the shunt and to mildly increase intracranial pressure in an attempt to tamponade any active bleeding and limit hematoma expansion. A repeat computed tomography scan of the head six days after the valve adjustment revealed complete resolution of the acute subdural hematoma. At this time, the valve pressure was reduced to its original setting to treat symptoms of normal-pressure hydrocephalus. Conclusions Programmable shunt valves afford the option for non-operative management of acute subdural hematoma in patients with ventricular shunts for normal-pressure hydrocephalus. As illustrated in this case report, increasing the shunt valve pressure may result in rapid resolution of the acute subdural hematoma in some patients.

  3. Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions.

    Science.gov (United States)

    Muir, Ryan T; Wang, Shelly; Warf, Benjamin C

    2016-11-01

    OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

  4. Introduction to Neutron Coincidence Counter Design Based on Boron-10

    Energy Technology Data Exchange (ETDEWEB)

    Kouzes, Richard T.; Ely, James H.; Lintereur, Azaree T.; Siciliano, Edward R.

    2012-01-22

    The Department of Energy Office of Nonproliferation Policy (NA-241) is supporting the project 'Coincidence Counting With Boron-Based Alternative Neutron Detection Technology' at Pacific Northwest National Laboratory (PNNL) for development of an alternative neutron coincidence counter. The goal of this project is ultimately to design, build and demonstrate a boron-lined proportional tube based alternative system in the configuration of a coincidence counter. This report, providing background information for this project, is the deliverable under Task 1 of the project.

  5. Measurement of accidental coincidences for higher activity sources

    CERN Document Server

    Yull Hwang, H; Jae-Oh, P; Man-Lee, J; Kie-Lee, M

    1999-01-01

    The multi-channel time-scaling (MCTS) technique has been applied for the measurement of accidental coincidences for the cases of higher activity samples in beta-gamma coincidence counting. Two beta samples of sup 1 sup 3 sup 4 Cs were prepared and the nominal activities observed in the beta counter were about 7000 and 11000 s sup - sup 1 , respectively. The obtained true coincidence rates are independent of resolving times and dead times. They are compared with those calculated from the mathematical model derived by Cox and Isham.

  6. Why Do Deconfinement and Chiral Restoration Coincide at High Temperature?

    Institute of Scientific and Technical Information of China (English)

    杨树; 郭华; 赵恩广; 吕晓夫

    2004-01-01

    The global colour model in free space is extended to finite temperature to study the deconfinement and chiral phase transitions at high temperature T and zero chemical potential in the mean field approximation. Both possibilities of coincidence and non-coincidence of the two distinct phase transitions are found when the model parameters are varied in a certain range. The underlying mechanisms of the coincidence and noncoincidence are analysed and discussed. The validity of the T-dependent model propagator as the input is also discussed.

  7. Parvovirus associated cerebellar hypoplasia and hydrocephalus in day-old broiler chickens

    Science.gov (United States)

    Cerebellar hypoplasia and hydrocephalus were detected in day-old broiler chickens. Brains of chickens evaluated at necropsy appeared to be abnormal; some were disfigured and cerebellae appeared to be smaller than normal. Histopathologic examination of brains revealed cerebellar folia that were sho...

  8. Elevated nerve growth factor and neurotrophin-3 levels in cerebrospinal fluid of children with hydrocephalus

    Science.gov (United States)

    Hochhaus, Frederike; Koehne, Petra; Schäper, Christoph; Butenandt, Otfrid; Felderhoff-Mueser, Ursula; Ring-Mrozik, Elfride; Obladen, Michael; Bührer, Christoph

    2001-01-01

    Background Elevated intracranial pressure (ICP) resulting from impaired drainage of cerebrospinal fluid (CSF) causes hydrocephalus with damage to the central nervous system. Clinical symptoms of elevated intracranial pressure (ICP) in infants may be difficult to diagnose, leading to delayed treatment by shunt placement. Until now, no biochemical marker of elevated ICP has been available for clinical diagnosis and monitoring. In experimental animal models, nerve growth factor (NGF) and neurotrophin-3 (NT-3) have been shown to be produced by glial cells as an adaptive response to hypoxia. We investigated whether concentrations of NGF and NT-3 are increased in the CSF of children with hydrocephalus. Methods NGF was determined in CSF samples collected from 42 hydrocephalic children on 65 occasions (taps or shunt placement surgery). CSF samples obtained by lumbar puncture from 22 children with suspected, but unconfirmed bacterial infection served as controls. Analysis was performed using ELISA techniques. Results NGF concentrations in hydrocephalic children were over 50-fold increased compared to controls (median 225 vs 4 pg/mL, p 1 pg/mL) in 14/31 hydrocephalus samples at 2–51 pg/mL but in none of 11 control samples (p = 0.007). Conclusion NGF and NT-3 concentrations are increased in children with hydrocephalus. This may represent an adaptive response of the brain to elevated ICP. PMID:11580868

  9. Elevated nerve growth factor and neurotrophin-3 levels in cerebrospinal fluid of children with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Felderhoff-Mueser Ursula

    2001-08-01

    Full Text Available Abstract Background Elevated intracranial pressure (ICP resulting from impaired drainage of cerebrospinal fluid (CSF causes hydrocephalus with damage to the central nervous system. Clinical symptoms of elevated intracranial pressure (ICP in infants may be difficult to diagnose, leading to delayed treatment by shunt placement. Until now, no biochemical marker of elevated ICP has been available for clinical diagnosis and monitoring. In experimental animal models, nerve growth factor (NGF and neurotrophin-3 (NT-3 have been shown to be produced by glial cells as an adaptive response to hypoxia. We investigated whether concentrations of NGF and NT-3 are increased in the CSF of children with hydrocephalus. Methods NGF was determined in CSF samples collected from 42 hydrocephalic children on 65 occasions (taps or shunt placement surgery. CSF samples obtained by lumbar puncture from 22 children with suspected, but unconfirmed bacterial infection served as controls. Analysis was performed using ELISA techniques. Results NGF concentrations in hydrocephalic children were over 50-fold increased compared to controls (median 225 vs 4 pg/mL, p 1 pg/mL in 14/31 hydrocephalus samples at 2–51 pg/mL but in none of 11 control samples (p = 0.007. Conclusion NGF and NT-3 concentrations are increased in children with hydrocephalus. This may represent an adaptive response of the brain to elevated ICP.

  10. Increased cerebrospinal fluid concentrations of soluble Fas (CD95/Apo-1) in hydrocephalus

    Science.gov (United States)

    Felderhoff-Mueser, U; Herold, R; Hochhaus, F; Koehne, P; Ring-Mrozik, E; Obladen, M; Buhrer, C

    2001-01-01

    BACKGROUND AND AIMS—The ventricular enlargement observed in children with chronically raised intracranial pressure (ICP) causes a secondary loss of brain tissue. In animal studies of hydrocephalus, programmed cell death (apoptosis) has been found as a major mechanism of neuronal injury. One of the regulators of the apoptotic cell death programme is the receptor mediated Fas/Fas ligand interaction.
METHODS—The apoptosis regulating cytokines soluble Fas (sFas) and soluble Fas ligand (sFasL) were studied in the cerebrospinal fluid (CSF) of 31 hydrocephalic children undergoing shunt surgery for symptomatic hydrocephalus and 18controls.
RESULTS—High concentrations of sFas were observed in children with hydrocephalus (median 252 ng/ml); in controls sFas was below the detection limit (0.5 ng/ml). sFasL was undetectable in all but one sample.
CONCLUSION—High concentrations of sFas in the CSF of children with hydrocephalus suggest intrinsic sFas production, potentially antagonising pressure mediated Fas activation.

 PMID:11259245

  11. Characterization of juvenile and young adult mice following induction of hydrocephalus with kaolin.

    Science.gov (United States)

    Lopes, Luiza da Silva; Slobodian, Ili; Del Bigio, Marc R

    2009-09-01

    Hydrocephalus is a common neurological problem in humans, usually caused by an impairment of cerebrospinal fluid (CSF) flow or absorption. A reliable induced model of chronic hydrocephalus in mice would be useful to test hypotheses using genetic mutants. Our goal was to characterize behavioral and histological changes in juvenile and young adult mice with kaolin (aluminum silicate)-induced hydrocephalus. Seven-day old and 7-8 week old mice received injection of kaolin into the cisterna magna. Behavior was assessed repeatedly. Seven or 14 days following kaolin, magnetic resonance (MR) imaging was used to assess ventricle size. In hydrocephalic mice, body weight was significantly lower than in age-matched saline-injected sham controls and the gait and posture score were impaired. Juvenile mice developed severe ventriculomegaly and had reduced corpus callosum thickness with gross white matter destruction by 14 days. Reactive astroglial change in white matter and cortex and reduced cellular proliferation in the subependymal zone were also apparent. Young adult mice developed only moderate ventricular enlargement without overt white matter destruction, although there was corpus callosum atrophy and mild astroglial reaction in white matter. Glial fibrillary acidic protein content was significantly higher in juvenile and young adult hydrocephalic mice at 7 and 14 days, but myelin basic protein content was not significantly altered. In conclusion, hydrocephalus induced by percutaneous injection of kaolin in juvenile and young adult mice is feasible. The associated periventricular alterations are essentially the same as those reported in rats of comparable ages.

  12. The Management and Education of Children with Spina Bifida and Hydrocephalus.

    Science.gov (United States)

    Andrews, Robert J.; Elkins, John

    The report describes the population of children in Australia with spina bifida and/or hydrocephalus, notes their needs and characteristics, reviews their school placement and social circumstances, and considers future educational services for them. Initial chapters review the literature on medical, psychoeducational, and social-family aspects of…

  13. [Current State of Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus].

    Science.gov (United States)

    Kazui, Hiroaki

    2016-04-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a common disease with a prevalence of 1 to 3% in the elderly. The Japanese society of normal pressure hydrocephalus has developed clinical guidelines for the management of idiopathic normal pressure hydrocephalus and conducted two multicenter prospective studies for iNPH, which are called SINPHONI and SINPHONI-2. These guidelines define disproportionately enlarged subarachnoid space hydrocephalus (DESH) as iNPH with the specific MRI features of tight high-convexity, the presense of medial subarachnoid spaces and ventriculomegaly. Patients with DESH are known to be highly responsive to shunt surgery. Specifically, 60 to 70% of patients with DESH see improvements in their daily living activities following shunt surgery. While ventriculo-peritoneal shunt surgery (VPS) is most commonly used in western countries, lumbo-peritoneal shunt surgery (LPS) is increasingly used in Japan, as patients with iNPH and their caregivers are more willing to accept lumbar surgery than cranial surgery. LPS does not produce puncture-induced damage to the brain and has been recently confirmed to be effective for the treatment of iNPH. It is important for physicians to consider iNPH while examining patients with dementia, as iNPH is common, treatable, and easy to diagnose using MRI.

  14. Tubercular meningitis with hydrocephalus with HIV co-infection: role of cerebrospinal fluid diversion procedures.

    Science.gov (United States)

    Sharma, Raman Mohan; Pruthi, Nupur; Arimappamagan, Arivazhagan; Somanna, Sampath; Devi, Bhagavathula Indira; Pandey, Paritosh

    2015-05-01

    OBJECT Hydrocephalus is one of the commonest complications of tubercular meningitis (TBM), and its incidence is increasing with the HIV epidemic. Literature evaluating the role of ventriculoperitoneal shunts in HIV-positive patients with TBM and their long-term prognosis is scarce. METHODS Between June 2002 and October 2012, 30 HIV-positive patients with TBM and hydrocephalus underwent ventriculoperitoneal shunt placement. Thirty age-, sex-, and grade-matched HIV-negative patients with TBM and hydrocephalus were randomly selected as the control group. Outcome was analyzed at discharge (short-term outcome) and at follow-up (long-term outcome). Univariate and multivariate analyses were performed to look for predictors of outcome; p hydrocephalus. A trial of external ventricular drainage should be undertaken in such patients, and shunt treatment should be performed only if there is any improvement. However, HIV-positive patients in good Palur grades should undergo VP shunt placement, as these patients have better outcomes than previously reported.

  15. Factors affecting surgical outcome of endoscopic third ventriculostomy in congenital hydrocephalus.

    Science.gov (United States)

    Bisht, Ajay; Suri, Ashish; Bansal, Sumit; Chandra, P Sarat; Kumar, Rajinder; Singh, Manmohan; Sharma, Bhawani Shankar

    2014-09-01

    Endoscopic third ventriculostomy (ETV) is an accepted modality of treatment for obstructive hydrocephalus, with good results in adult patients. However in the pediatric age group results vary from poor to similar to the adult population. This study evaluates the outcome of ETV in congenital hydrocephalus of both early and delayed presentation, and investigates factors that determine the outcome. Patients with congenital hydrocephalus who underwent ETV between January 2006 and December 2011 were retrospectively analyzed. Any conditions potentially influencing the need for redo surgery (persistent cerebrospinal fluid [CSF] leak not responding to local measures, tense fontanelle, increased ventricular size, recurrence of symptoms or radiological evidence of failure) were analyzed. A total of 102 patients with a mean age of 7.45years were included. Presenting features were increasing head circumference and delayed milestones. Ninety-eight patients had triventricular hydrocephalus due to aqueductal stenosis. Procedures performed were ETV only (n=74), ETV with aqueductoplasty (n=22), ETV with cystoventriculostomy (n=2) and aqueductoplasty only (n=2). Failure of ETV occurred in 11 patients and all were managed with a ventriculoperitoneal shunt. CSF leak in the perioperative period was the only factor that was significantly associated with failure of ETV. ETV is a safe procedure with a good success rate and can be offered to children with aqueductal stenosis. There is a higher chance of failure if there is a CSF leak in the early or late postoperative period.

  16. The Lhx9 homeobox gene controls pineal gland development and prevents postnatal hydrocephalus.

    Science.gov (United States)

    Yamazaki, Fumiyoshi; Møller, Morten; Fu, Cong; Clokie, Samuel J; Zykovich, Artem; Coon, Steven L; Klein, David C; Rath, Martin F

    2015-01-01

    Lhx9 is a member of the LIM homeobox gene family. It is expressed during mammalian embryogenesis in the brain including the pineal gland. Deletion of Lhx9 results in sterility due to failure of gonadal development. The current study was initiated to investigate Lhx9 biology in the pineal gland. Lhx9 is highly expressed in the developing pineal gland of the rat with transcript abundance peaking early in development; transcript levels decrease postnatally to nearly undetectable levels in the adult, a temporal pattern that is generally similar to that reported for Lhx9 expression in other brain regions. Studies with C57BL/6J Lhx9(-/-) mutant mice revealed marked alterations in brain and pineal development. Specifically, the superficial pineal gland is hypoplastic, being reduced to a small cluster of pinealocytes surrounded by meningeal and vascular tissue. The deep pineal gland and the pineal stalk are also reduced in size. Although the brains of neonatal Lhx9(-/-) mutant mice appear normal, severe hydrocephalus develops in about 70% of the Lhx9(-/-) mice at 5-8 weeks of age; these observations are the first to document that deletion of Lhx9 results in hydrocephalus and as such indicate that Lhx9 contributes to the maintenance of normal brain structure. Whereas hydrocephalus is absent in neonatal Lhx9(-/-)mutant mice, the neonatal pineal gland in these animals is hypoplastic. Accordingly, it appears that Lhx9 is essential for early development of the mammalian pineal gland and that this effect is not secondary to hydrocephalus.

  17. Medication overuse as a cause of chronic headache in shunted hydrocephalus patients

    DEFF Research Database (Denmark)

    Willer, Lasse; Jensen, R H; Juhler, M

    2010-01-01

    To highlight the group of hydrocephalus patients known to have a long history of shunt revisions and refractory chronic headache. When a shunt in perfect working order has no effect on headache, other causes of headache should be investigated. In this paper, patients with medication overuse...

  18. Improvement after treatment of hydrocephalus in aneurysmal subarachnoid haemorrhage : implications for grading and prognosis

    NARCIS (Netherlands)

    ter Laan, M; Mooij, JJA

    2006-01-01

    Two patients with aneurysmal subarachnoid haemorrhage and hydrocephalus are presented. On admission they scored E1M4V1 and E1M3Vtube on the Glasgow Coma Scale. The first patient recovered to E3M5Vtube after treatment of hydrocpehalus by extraventricular drainage. The second recovered to E2M5Vtube an

  19. Risk of rebleeding after treatment of acute hydrocephalus in patients with aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Hellingman, Catharine A; van den Bergh, Walter M; Beijer, Inge S; van Dijk, Gert W; Algra, Ale; van Gijn, Jan; Rinkel, Gabriël J E

    2007-01-01

    BACKGROUND AND PURPOSE: Cerebrospinal fluid drainage is often indicated in patients with acute hydrocephalus after aneurysmal subarachnoid hemorrhage but is believed to increase the risk of rebleeding. We studied the risk of rebleeding in patients with subarachnoid hemorrhage during treatment for ac

  20. The Management and Education of Children with Spina Bifida and Hydrocephalus.

    Science.gov (United States)

    Andrews, Robert J.; Elkins, John

    The report describes the population of children in Australia with spina bifida and/or hydrocephalus, notes their needs and characteristics, reviews their school placement and social circumstances, and considers future educational services for them. Initial chapters review the literature on medical, psychoeducational, and social-family aspects of…

  1. Camk2a-Cre-mediated conditional deletion of chromatin remodeler Brg1 causes perinatal hydrocephalus.

    Science.gov (United States)

    Cao, Mou; Wu, Jiang I

    2015-06-15

    Mammalian SWI/SNF-like BAF chromatin remodeling complexes are essential for many aspects of neural development. Mutations in the genes encoding the core subunit Brg1/SmarcA4 or other complex components cause neurodevelopmental diseases and are associated with autism. Congenital hydrocephalus is a serious brain disorder often experienced by these patients. We report a role of Brg1 in the pathogenesis of hydrocephalus disorder. We discovered an unexpected early activity of mouse Camk2a-Cre transgene, which mediates Brg1 deletion in a subset of forebrain neurons beginning in the late embryonic stage. Brg1 deletion in these neurons led to severe congenital hydrocephalus with enlargement of the lateral ventricles and attenuation of the cerebral cortex. The Brg1-deficient mice had significantly smaller subcommissural organs and narrower Sylvian aqueducts than mice that express normal levels of Brg1. Effects were non-cell autonomous and may be responsible for the development of the congenital hydrocephalus phenotype. Our study provides evidence indicating that abnormalities in Brg1 function result in defects associated with neurodevelopmental disorders and autism.

  2. The Arnold-Chiari Malformation and Its Implications for Individuals with Spina Bifida and Hydrocephalus.

    Science.gov (United States)

    Mittler, Joel E.

    1986-01-01

    The Arnold-Chiari malformation is present in most infants born with myelomeningocele (a form of spina bifida) and hydrocephalus. The syndrome is responsible for structural abnormalities in the brain, and peripheral nervous system. Etiology, symptoms, impact on central nervous system structures, surgical treatment, and implications for education…

  3. Improvement after treatment of hydrocephalus in aneurysmal subarachnoid haemorrhage : implications for grading and prognosis

    NARCIS (Netherlands)

    ter Laan, M; Mooij, JJA

    Two patients with aneurysmal subarachnoid haemorrhage and hydrocephalus are presented. On admission they scored E1M4V1 and E1M3Vtube on the Glasgow Coma Scale. The first patient recovered to E3M5Vtube after treatment of hydrocpehalus by extraventricular drainage. The second recovered to E2M5Vtube

  4. Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults

    DEFF Research Database (Denmark)

    Bodilsen, Jacob; Schønheyder, Henrik Carl; Nielsen, Henrik I

    2013-01-01

    BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this ......BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid...... in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region. METHODS: We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13......-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded...

  5. Medication overuse as a cause of chronic headache in shunted hydrocephalus patients

    DEFF Research Database (Denmark)

    Willer, Lasse; Jensen, R H; Juhler, M

    2010-01-01

    To highlight the group of hydrocephalus patients known to have a long history of shunt revisions and refractory chronic headache. When a shunt in perfect working order has no effect on headache, other causes of headache should be investigated. In this paper, patients with medication overuse...

  6. Hydrocephalus and intestinal aganglionosis : Is L1CAM a modifier gene in Hirschsprung disease?

    NARCIS (Netherlands)

    Parisi, MA; Kapur, RP; Neilson, [No Value; Hofstra, RMW; Holloway, LW; Michaelis, RC; Leppig, KA

    2002-01-01

    Congenital hydrocephalus associated with aqueductal stenosis and/or agenesis of the corpus callosum has been described in newborn males with mutations in L1CAM, a gene that encodes a neural cell adhesion molecule. These males usually have severe mental retardation and may have spastic paraplegia and

  7. Treatment and clinical outcome in patients with idiopathic normal pressure hydrocephalus - a systematic review

    DEFF Research Database (Denmark)

    Torsnes, Linnea; Blåfjelldal, Vibeke; Poulsen, Frantz Rom

    2014-01-01

    INTRODUCTION: Treatment of idiopathic normal pressure hydrocephalus (iNPH) is challenging. It is well known that patients with iNPH experience short-term symptom relief after shunt implantation, but the long-term effect of shunting has yielded diverging results. The objective of the present study...

  8. Posthemorrhagic Hydrocephalus in Newborns: Clinical Characteristics and Role of Ventriculoperitoneal Shunts

    Directory of Open Access Journals (Sweden)

    Inn-Chi Lee

    2009-02-01

    Conclusion: Patients who were shunt-dependent had worse neurodevelopmental outcomes and greater mortality than those without shunts. The results appeared to depend on how far the hydrocephalus had progressed and on the degree of IVH, but the necessity of VP shunts requires reevaluation before they are implanted.

  9. Cerebrospinal fluid flow and production in patients with normal pressure hydrocephalus studied by MRI

    DEFF Research Database (Denmark)

    Gideon, P; Ståhlberg, F; Thomsen, C

    1994-01-01

    An interleaved velocity-sensitised fast low-angle shot pulse sequence was used to study cerebrospinal fluid (CSF) flow in the cerebral aqueduct, and supratentorial CSF production in 9 patients with normal pressure hydrocephalus (NPH) and 9 healthy volunteers. The peak aqueduct CSF flow, both caudal...

  10. Cerebral damage following ventricular shunt for infantile hydrocephalus evaluated by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Palmieri, A.; Pasquini, U.; Menichelli, F.; Salvolini, U.

    1981-02-01

    The results of a late CT control of infantile hydrocephalus is reported with an analysis of effects of the catheter on the cerebral tissue in the immediate and late postoperative course. The most frequent finding is blood in the ventricle and/or subependymal or intraparenchymal along the catheter or near its tip.

  11. A mechatronic valve in the management of hydrocephalus: methods and performance.

    Science.gov (United States)

    Momani, Lina; Al-Nuaimy, Waleed; Al-Jumaily, Mohammed; Mallucci, Conor

    2011-01-01

    The problem of excess cerebrospinal fluid in the brain (hydrocephalus) is generally managed using a passive pressure or flow regulated mechanical shunt. Despite the success of such devices, they have been plagued with a number of problems. It is desirable to have a shunt valve that responds dynamically to the changing needs of the patient, opening and closing according to a dynamic physiological pattern, rather than simply to the hydrostatic pressure across the valve. Such a valve would by necessity be mechatronic, electronically controlled by software. In this article, different methods for controlling such a mechatronic valve are explored, and the effect of current hydrocephalus management techniques on the intracranial hydrodynamics of acute hydrocephalus patient compared with those based on a mechatronic valve was investigated using numerical simulation. Furthermore, the performance of these techniques was evaluated based on a proposed multi-dimensional figure of merit. In addition, an empirical valve schedule was proposed based on different criterions. An intelligent shunting system is seen as the future in hydrocephalus management and treatment, and towards this end, suitably programmed mechatronic valves would attempt to mimic normal physiology and potentially overcome many of the problems associated with current mechanical valves.

  12. Changes in Heart Rate Variability in a Premature Infant with Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Zuzana Uhrikova

    2012-11-01

    Full Text Available Objective - To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design - The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge. Results - Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion - Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

  13. Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients

    DEFF Research Database (Denmark)

    Zemack, G.; Rommer, Bertil Roland

    2008-01-01

    OBJECTIVE: We sought to assess the value of adjusting shunt valve opening pressure, complications, and outcomes with the use of an adjustable shunt valve in the treatment of patients with normal-pressure hydrocephalus (NPH). METHODS: In a single-center retrospective study, 231 adjustable valves (...

  14. Ventriculoperitoneal shunt for treatment of hydrocephalus in a French bulldog puppy.

    Science.gov (United States)

    Giacinti, Jolene A

    2016-03-01

    A 6.5-week-old bulldog was presented with lethargy, anorexia, and stunted growth. A domed skull, ventrolateral strabismus, hypermetria, and delayed hopping were observed. Congenital hydrocephalus was diagnosed and a ventriculoperitoneal shunt was placed. After surgery, a shunt obstruction occurred but resolved with treatment. The puppy responded well and neurological deficits continued to improve after surgery.

  15. Changes in heart rate variability in a premature infant with hydrocephalus.

    Science.gov (United States)

    Uhrikova, Zuzana; Kolarovszki, Branislav; Javorka, Kamil; Javorka, Michal; Matasova, Katarina; Kolarovszka, Hana; Zibolen, Mirko

    2012-11-01

    Objective To define changes of heart rate variability in premature infant with hydrocephalus before and after drainage procedure. Study Design The authors report a case of a premature infant with hydrocephalus with analysis of heart rate variability before and after drainage procedure. Three subsequent recordings of the electrocardiography and heart rate variability were done: the first at the age of 22 days before insertion of ventriculoperitoneal shunt, the second at the age of 36 days with functional shunt, the third at the age of 71 days (before discharge). Results Before drainage operation, there was reduced heart rate variability in time and spectral domains, and sympathetic activity was dominant. After surgery, an increase in heart rate variability parameters was found, particularly with spectral analysis. The ratio of low-frequency/high-frequency band and relative power of the low-frequency band decreased, reflecting enhanced parasympathetic activity. Conclusion Results of the heart rate variability analysis in a preterm infant with hydrocephalus before and after drainage procedure showed marked improvement in chronotropic cardiac regulation. Evaluation of heart rate variability in premature infants with hydrocephalus with increased intracranial pressure can be an additional method for monitoring of cardiac dysregulation and improvement of the cardiovascular control after successful drainage procedure.

  16. Paget’s Disease of Bone Presented as Normal Pressure Hydrocephalus: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Abbas Tafakhori

    2012-07-01

    Full Text Available Background: Paget’s disease is a focal bone disorder manifested as bone overgrowth and disrupted bone integrity as a result of accelerated bone remodelling rate. Rarely, Paget’s disease of the base of the skull results in hydrocephalic dementia, and the triad of normal pressure hydrocephalus syndrome is a much more scarce entity.Case Report: Herein, we report an elderly woman who presented in Imam Khomeini Hospital, Tehran, Iran, with normal pressure hydrocephalus syndrome due to Paget’s bone disease. Furthermore, we have reviewed relevant previous studiesConclusion: Paget’s disease can be presented as normal pressure hydrocephalus syndrome

  17. 持续腰大池引流对迟发性脑积水的作用研究%Role of lumbar subarachnoid continuous drainage in delayed hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    张学广; 程刚; 马子勇; 焦盈盈; 张志逖; 侯磊; 种宗雷

    2015-01-01

    目的 探讨持续腰大池引流对脑外伤患者去骨瓣减压术后迟发性脑积水的治疗作用.方法 收集自2009年6月至2013年09月聊城市人民医院神经外科收治的32例脑外伤去骨瓣减压术后恢复期发生迟发性脑积水患者的临床资料;所有患者行持续腰大池置管引流,分析其治疗效果.结果 腰大池置管引流后,14例患者首个引流周期顺利拔出腰大池引流管,5例患者2个引流周期后顺利拔出腰大池引流管,均免除行脑室-腹腔分流手术;另13例患者发展为分流依赖性脑积水,行脑室-腹腔分流手术治疗后比较;置管引流期间无1例发生中枢神经系统感染.结论 持续腰大池置管引流具有创伤小、易操作等优点,能减少迟发性脑积水向分流依赖性脑积水的发生率.%Objective To investigate the treatment effect of lumbar subarachnoid continuous drainage on delayed hydrocephalus in patients with cerebral trauma after decompressive craniectomy.Methods Thirty-two patients with delayed hydrocephalus after decompressive craniectomy,admitted to our hospital from June 2009 to September 2013,were treated by lumbar subarachnoid continuous drainage;and the treatment effect was analyzed.Results After lumbar subarachnoid continuous drainage,14 patients got successful drainage tube being extracted in the first period,5 were in the second cycle;they all got avoidance ofventriculo peritoneal shunt operation.However,the other 13 patients,developed into shunt dependent hydrocephalus,were treated with ventriculoperitoneal shunt operation.No central nervous system infections were noted during the period of draining.Conclusion The treatment of lumbar subarachnoid continuous drainage,with the characteristics of small trauma and easy operating,can reduce the incidence of shunt dependent hydrocephalus,which is developed by delayed hydrocephalus.

  18. 48-channel coincidence counting system for multiphoton experiment

    Science.gov (United States)

    Zhang, Chen; Li, Wei; Hu, Yi; Yang, Tao; Jin, Ge; Jiang, Xiao

    2016-11-01

    In this paper, we demonstrate a coincidence counting system with 48 input channels which is aimed to count all coincidence events, up to 531 441 kinds, in a multiphoton experiment. Using the dynamic delay adjusting inside the Field Programmable Gate Array, the alignment of photon signals of 48 channels is achieved. After the alignment, clock phase shifting is used to sample signal pulses. Logic constraints are used to stabilize the pulse width. The coincidence counting data stored in a 1G bit external random access memory will be sent to the computer to analyze the amount of 2-, 3-, 4-, 5-, and 6-fold coincidence events. This system is designed for multiphoton entanglement experiments with multiple degrees of freedom of photons.

  19. A coincidence theorem for holomorphic maps to G/P

    OpenAIRE

    Sankaran, Parameswaran

    2002-01-01

    We show that any two holomorhpic maps, not both of which are constant, from a generalized Hopf manifold to its base must have a coincidence. We prove a similar result for holomorphic maps from a generalized Calabi-Eckmann manifold.

  20. A digital coincidence measurement system using FPGA techniques

    Energy Technology Data Exchange (ETDEWEB)

    Zhu Fengming; Hsieh, S.C.; Yen, W.W. [Department of Engineering and System Science, National Tsing Hua University, Hsinchu, 30043, Taiwan (China); Chou, H.P., E-mail: hpc@ess.nthu.edu.tw [Department of Engineering and System Science, National Tsing Hua University, Hsinchu, 30043, Taiwan (China)

    2011-10-01

    A field programmable gate array (FPGA) based digital coincidence system has been developed to use with NaI scintillators for field applications. The analog output signal from the photomultiplier anode is directly transferred into digital signals by pulse height for pulse width conversion. The digital signal contains the energy and timing information of the radiation events. The pulse width is then measured by a vernier type of time-to-digital converter (TDC). The timing information of radiation events is recorded and analyzed by a coincidence unit. Both the TDC unit and the coincidence unit are implemented using a commercial available FPGA board. The measured data is then sent to a personal computer for spectrum display. Efficiency as well as energy calibration has been performed. The system showed a timing resolution about 13 ns and an energy resolution of 12% for 0.511 MeV annihilation gammas; it also successfully demonstrated the background rejection ability through coincidence measurement.

  1. Glycinergic inhibition tunes coincidence detection in the auditory brainstem.

    Science.gov (United States)

    Myoga, Michael H; Lehnert, Simon; Leibold, Christian; Felmy, Felix; Grothe, Benedikt

    2014-05-07

    Neurons in the medial superior olive (MSO) detect microsecond differences in the arrival time of sounds between the ears (interaural time differences or ITDs), a crucial binaural cue for sound localization. Synaptic inhibition has been implicated in tuning ITD sensitivity, but the cellular mechanisms underlying its influence on coincidence detection are debated. Here we determine the impact of inhibition on coincidence detection in adult Mongolian gerbil MSO brain slices by testing precise temporal integration of measured synaptic responses using conductance-clamp. We find that inhibition dynamically shifts the peak timing of excitation, depending on its relative arrival time, which in turn modulates the timing of best coincidence detection. Inhibitory control of coincidence detection timing is consistent with the diversity of ITD functions observed in vivo and is robust under physiologically relevant conditions. Our results provide strong evidence that temporal interactions between excitation and inhibition on microsecond timescales are critical for binaural processing.

  2. Computed neutron coincidence counting applied to passive waste assay

    Energy Technology Data Exchange (ETDEWEB)

    Bruggeman, M.; Baeten, P.; De Boeck, W.; Carchon, R. [Nuclear Research Centre, Mol (Belgium)

    1997-11-01

    Neutron coincidence counting applied for the passive assay of fissile material is generally realised with dedicated electronic circuits. This paper presents a software based neutron coincidence counting method with data acquisition via a commercial PC-based Time Interval Analyser (TIA). The TIA is used to measure and record all time intervals between successive pulses in the pulse train up to count-rates of 2 Mpulses/s. Software modules are then used to compute the coincidence count-rates and multiplicity related data. This computed neutron coincidence counting (CNCC) offers full access to all the time information contained in the pulse train. This paper will mainly concentrate on the application and advantages of CNCC for the non-destructive assay of waste. An advanced multiplicity selective Rossi-alpha method is presented and its implementation via CNCC demonstrated. 13 refs., 4 figs., 2 tabs.

  3. Ventricular Volume Load Reveals the Mechanoelastic Impact of Communicating Hydrocephalus on Dynamic Cerebral Autoregulation.

    Directory of Open Access Journals (Sweden)

    Christina Haubrich

    Full Text Available Several studies have shown that the progression of communicating hydrocephalus is associated with diminished cerebral perfusion and microangiopathy. If communicating hydrocephalus similarly alters the cerebrospinal fluid circulation and cerebral blood flow, both may be related to intracranial mechanoelastic properties as, for instance, the volume pressure compliance. Twenty-three shunted patients with communicating hydrocephalus underwent intraventricular constant-flow infusion with Hartmann's solution. The monitoring included transcranial Doppler (TCD flow velocities (FV in the middle (MCA and posterior cerebral arteries (PCA, intracranial pressure (ICP, and systemic arterial blood pressure (ABP. The analysis covered cerebral perfusion pressure (CPP, the index of pressure-volume compensatory reserve (RAP, and phase shift angles between Mayer waves (3 to 9 cpm in ABP and MCA-FV or PCA-FV. Due to intraventricular infusion, the pressure-volume reserve was exhausted (RAP 0.84+/-0.1 and ICP was increased from baseline 11.5+/-5.6 to plateau levels of 20.7+/-6.4 mmHg. The ratio dRAP/dICP distinguished patients with large 0.1+/-0.01, medium 0.05+/-0.02, and small 0.02+/-0.01 intracranial volume compliances. Both M wave phase shift angles (r = 0.64; p<0.01 and CPP (r = 0.36; p<0.05 displayed a gradual decline with decreasing dRAP/dICP gradients. This study showed that in communicating hydrocephalus, CPP and dynamic cerebral autoregulation in particular, depend on the volume-pressure compliance. The results suggested that the alteration of mechanoelastic characteristics contributes to a reduced cerebral perfusion and a loss of autonomy of cerebral blood flow regulation. Results warrant a prospective TCD follow-up to verify whether the alteration of dynamic cerebral autoregulation may indicate a progression of communicating hydrocephalus.

  4. Patient outcomes and surgical complications in coccidioidomycosis-related hydrocephalus: an institutional review.

    Science.gov (United States)

    Hardesty, Douglas A; Ramey, Wyatt; Afrasiabi, Mohammad; Beck, Brian; Gonzalez, Omar; Moran, Ana; Nakaji, Peter

    2014-10-01

    Coccidioidomycosis is a common fungal infection in the southwestern US. Hydrocephalus is a serious complication of cranial coccidioidomycosis, and the surgical management of coccidioidomycosis-related hydrocephalus has unique challenges. The authors reviewed their institutional experience with hydrocephalus in the setting of coccidioidomycosis. The authors retrospectively identified 44 patients diagnosed with coccidioidomycosis-related hydrocephalus at their institution since 1990, who underwent a total of 99 shunting procedures. The authors examined patient demographics, type of shunt and valve used, pressure settings, failure rates, medical treatment, ventricular response to shunting, and other variables. The majority of patients were young (average age 37 years) men (male/female ratio 28:16) with a mean follow-up of 63 months. Patients of Asian and African descent were overrepresented in the cohort compared with regional demographic data. The overall shunt failure rate during follow-up was 50%, and the average number of revisions required if the shunt failed was 2.5 (range 1-8). Low to moderate draining pressures (mean 88 mm H2O) were used in this cohort. Fourteen patients received intrathecal antifungals, and a trend of initiating intrathecal therapy after need for a shunt revision was observed (p = 0.051). The majority of shunt failures (81%) were due to mechanical blockages in the drainage system. Most patients (59%) had at least partial persistent postoperative ventriculomegaly despite successful CSF diversion. Four patients (9%) died due to coccidioidomycosis during the follow-up period. Coccidioidomycosis-related hydrocephalus more often affected young males in the study's cohort, especially those of African and Asian descent. Despite the best medical therapy, there was a high rate of shunt failure due to clogged catheters or valves due to the underlying disease process. Many patients continued to have ventriculomegaly even with adequate CSF diversion. The

  5. The Retrograde Ventriculosinusal Shunt in an Animal Experimental Model of Hydrocephalus.

    Science.gov (United States)

    Pinto, Fernando Campos Gomes; Becco, Rodrigo; Alho, Eduardo Joaquim Lopes; Poli-de-Figueiredo, Luiz Francisco; Souza, Podalyro Amaral de; Oliveira, Matheus Fernandes de; Teixeira, Manoel Jacobsen

    2016-01-01

    Currently, hydrocephalus treatment is performed mainly with ventriculoperitoneal shunting. This experimental study aims at assessing whether the experimental model of hydrocephalus in dogs is applicable to the laboratory study of the retrograde ventriculosinusal shunt (RVSS). Four mongrel dogs were assessed. After randomization, the animals were divided into two groups: an experimental group that underwent the induction of hydrocephalus/RVSS and a control group, for the measurement of the mean arterial pressure, intracranial pressure and pressure in the superior sagittal sinus (SSS). The controls presented a mean arterial pressure of 68 mm Hg (71 and 65), an intracranial pressure of 163 mm H2O (149.6 and 176.8) and a pressure at the SSS of 40 mm H2O (40 and 40). The kaolin injection into the cisterna magna at a concentration of 0.3 mg/ml was capable of inducing the clinical and radiological mechanism of hydrocephalus (intracranial pressure = 250 mm H2O, pressure at the SSS = 50 mm H2O). The caliber of the SSS was 2.5 ± 1.0 mm. The fact that the SSS caliber of the dog was the same size as the external diameter of the catheter used resulted in the complete obstruction of the SSS when the catheter was inserted. We believe we could design and perform an experimental model to test the RVSS. It is applicable and feasible. The model of hydrocephalus, the surgical apparatus and the scenario were adequate, but the shunt system needs to be proportionally made to the canine anatomy.

  6. Coincidence rotations of the root lattice $A_4$

    CERN Document Server

    Baake, Michael; Heuer, Manuela; Zeiner, Peter

    2007-01-01

    The coincidence site lattices of the root lattice $A_4$ are considered, and the statistics of the corresponding coincidence rotations according to their indices is expressed in terms of a Dirichlet series generating function. This is possible via an embedding of $A_4$ into the icosian ring with its rich arithmetic structure, which recently (arXiv:math.MG/0702448) led to the classification of the similar sublattices of $A_4$.

  7. Electron-ion-ion coincidence experiments for photofragmentation of polyatomic molecules using pulsed electric fields: treatment of random coincidences

    CERN Document Server

    Pruemper, G

    2007-01-01

    In molecular photofragmentation processes by soft X-rays, a number of ionic fragments can be produced, each having a different abundance and correlation with the emitted electron kinetic energy. For investigating these fragmentation processes, electron-ion and electron-ion-ion coincidence experiments, in which the kinetic energy of electrons are analyzed using an electrostatic analyzer while the mass of the ions is analyzed using a pulsed electric field, are very powerful. For such measurements, however, the contribution of random coincidences is substantial and affects the data in a non-trivial way. Simple intuitive subtraction methods cannot be applied. In the present paper, we describe these electron-ion and electron-ion-ion coincidence experiments together with a subtraction method for the contribution from random coincidences. We provide a comprehensive set of equations for the data treatment, including equations for the calculation of error-bars. We demonstrate the method by applying it to the fragmenta...

  8. An algorithmic approach to the management of unrecognized hydrocephalus in pediatric candidates for intrathecal baclofen pump implantation

    Directory of Open Access Journals (Sweden)

    Brian W Hanak

    2016-01-01

    Conclusions: Given the potentially high rate of elevated ICP and arrested hydrocephalus, the authors advocate pre-implantation assessment of ICP under controlled conditions and a thoughtful consideration of the neurosurgical management options for patients with elevated ICP.

  9. Hydrocephalus in a patient with an unruptured pial arteriovenous fistula: hydrodynamic considerations, endovascular treatment, and clinical course.

    Science.gov (United States)

    Morales-Gómez, Jesús A; Garza-Oyervides, Vicente V; Arenas-Ruiz, José A; Mercado-Flores, Mariana; Elizondo-Riojas, C Guillermo; Boop, Frederick A; de León, Ángel Martínez-Ponce

    2017-03-01

    Intracranial pial arteriovenous fistulas, also known as nongalenic fistulas, are rare vascular malformations affecting predominantly the pediatric population. Hydrocephalus is an unusual presentation in which the exact pathophysiology is not fully understood. The aim of treatment in these cases is occlusion of the fistula prior to considering ventricular shunting. Here, the authors describe the hydrodynamic considerations of the paravascular pathway and the resolution of hydrocephalus with endovascular treatment of the fistula.

  10. Usefulness of phase contrast cine mode magnetic resonance imaging for surgical decision making in patients with hydrocephalus combined with achondroplasia. Case report.

    Science.gov (United States)

    Miyamoto, Junichi; Tatsuzawa, Kazunori; Sasajima, Hiroyasu; Mineura, Katsuyoshi

    2010-01-01

    A 1-year 9-month-old girl presented with achondroplasia. Serial magnetic resonance (MR) imaging demonstrated mild compression of the medulla oblongata by the occipital bone, macrocrania, and progressive hydrocephalus. Cerebrospinal fluid (CSF) flow study using MR imaging clearly demonstrated CSF flow disturbance at the cervicospinal junction. Foramen magnum decompression was performed for her hydrocephalus and compressed medulla. Postoperative CSF flow study demonstrated improvement of CSF flow at the craniocervical junction. The patient has remained in a stable condition for 7 months postoperatively. Achondroplasia represents hydrocephalus or medullary compression caused by narrowed foramen magnum, which can result in sudden death in some infants. Surgical indications and methods for hydrocephalus combined with achondroplasia remain controversial because the natural history of the hydrocephalus has remained unclear. CSF flow study using MR imaging can provide useful information regarding the surgical indication and methods for the treatment of hydrocephalus combined with achondroplasia.

  11. Phase-contrast magnetic resonance imaging reveals net retrograde aqueductal flow in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Ringstad, Geir; Emblem, Kyrre Eeg; Eide, Per Kristian

    2016-06-01

    OBJECT The objective of this study was to assess the net aqueductal stroke volume (ASV) and CSF aqueductal flow rate derived from phase-contrast MRI (PC-MRI) in patients with probable idiopathic normal pressure hydrocephalus (iNPH) before and after ventriculoperitoneal shunt surgery, and to compare observations with intracranial pressure (ICP) scores. METHODS PC-MRI at the level of the sylvian aqueduct was undertaken in patients undergoing assessment for probable iNPH. Aqueductal flow in the craniocaudal direction was defined as positive, or antegrade flow, and net ASV was calculated by subtracting retrograde from antegrade aqueductal flow. Aqueductal flow rate per minute was calculated by multiplying net ASV by heart rate. During the same hospital admission, clinical examination was performed using NPH score and overnight continuous ICP monitoring. Twelve patients were followed prospectively 12 months after shunt placement with clinical assessment and a second PC-MRI. The study also included 2 healthy controls. RESULTS Among 21 patients examined for iNPH, 17 (81%) received a shunt (shunt group), and 4 were treated conservatively (conservative group). Among the patients with shunts, a clinical improvement was observed in 16 (94%) of the 17. Net ASV was negative in 16 (76%) of 21 patients before shunt placement and in 5 (42%) of 12 patients after shunt placement, and increased from a median of -5 μl (range -175 to 27 μl) to a median of 1 μl (range -61 to 30 μl; p = 0.04). Among the 12 patients with PC-MRI after shunt placement, 11 were shunt responders, and in 9 of these 11 either a reduced magnitude of retrograde aqueductal flow, or a complete reversal from retrograde to antegrade flow, occurred. Net ASV was significantly lower in the shunt group than in the conservative group (p = 0.01). The aqueductal flow rate increased from -0.56 ml/min (range -12.78 to 0.58 ml/min) to 0.06 ml/min (range -4.51 to 1.93 ml/min; p = 0.04) after shunt placement. CONCLUSIONS In

  12. Indication for shunt operation of normal pressure hydrocephalus. Combined assessment of infusion test and dynamic CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Jinnai, Takahiro; Nagao, Seigo [Kagawa Medical Univ., Miki (Japan); Kuyama, Hideyuki

    2000-03-01

    Normal pressure hydrocephalus (NPH) is one of the diseases that causes a neuro-surgically treatable form of dementia. Although patients with NPH can be treated with shunt operation, reliable indications for the surgery are not yet established. In this study, 20 NPH patients diagnosed by clinical symptoms were subjected to combined assessment by infusion test and dynamic CT scan, a useful diagnostic tool to select a shunt responsive cases. Patients were evaluated by measuring sequential changes in the density of the periventricular lucency (PVL) using dynamic CT scan and continuous lumbar subdural pressure monitoring during an infusion manometric test at a rate of 0.8 ml/min for 30 min. The average lumbar subdural pressure during infusion manometric test in the shunt responsive group was 18.4{+-}5.8 mmHg, which was significantly higher than that in the shunt non-responsive group which was 10.0{+-}4.0 mmHg (p<0.01). The relative changes in PVL density in the dynamic CT was also significantly higher in the shunt responsive group (0.99{+-}0.61 HU) compared to the shunt non-responsive group (0.15{+-}0.32) (p<0.01). Dynamic CT scan with infusion manometric test is useful in the selection of patients with NPH who are likely to respond to shunt surgery. (author)

  13. Performance of the fixed pressure valve with antisiphon device SPHERA® in the treatment of normal pressure hydrocephalus and prevention of overdrainage

    Directory of Open Access Journals (Sweden)

    Renan M. Pereira

    2015-01-01

    Full Text Available ABSTRACT Normal pressure hydrocephalus (NPH is characterized by the triad of gait apraxia, dementia and urinary incontinence associated with ventriculomegaly and normal pressure of cerebrospinal fluid. Treatment is accomplished through the implantation of a ventricular shunt (VPS, however some complications are still frequent, like overdrainage due to siphon effect. This study analyses the performance of a valve with anti-siphon device (SPHERA® in the treatment of patients with NPH and compares it with another group of patients with NPH who underwent the same procedure without anti-siphon mechanism (PS Medical® valve. 30 patients were consecutively enrolled in two groups with 15 patients each and followed clinically and radiologically for 1 year. Patients submitted to VPS with SPHERA® valve had the same clinical improvement as patients submitted to VPS with PS Medical®. However, complications and symptomatology due to overdrainage were significantly lower in SPHERA® group, suggesting it as a safe tool to treat NPH.

  14. Performance of the fixed pressure valve with antisiphon device SPHERA® in the treatment of normal pressure hydrocephalus and prevention of overdrainage.

    Science.gov (United States)

    Pereira, Renan M; Suguimoto, Mariane T; Oliveira, Matheus F; Tornai, Juliana B; Amaral, Ricardo A; Teixeira, Manoel Jacobsen; Pinto, Fernando Campos Gomes

    2016-01-01

    Normal pressure hydrocephalus (NPH) is characterized by the triad of gait apraxia, dementia and urinary incontinence associated with ventriculomegaly and normal pressure of cerebrospinal fluid. Treatment is accomplished through the implantation of a ventricular shunt (VPS), however some complications are still frequent, like overdrainage due to siphon effect. This study analyses the performance of a valve with anti-siphon device (SPHERA®) in the treatment of patients with NPH and compares it with another group of patients with NPH who underwent the same procedure without anti-siphon mechanism (PS Medical® valve). 30 patients were consecutively enrolled in two groups with 15 patients each and followed clinically and radiologically for 1 year. Patients submitted to VPS with SPHERA® valve had the same clinical improvement as patients submitted to VPS with PS Medical®. However, complications and symptomatology due to overdrainage were significantly lower in SPHERA® group, suggesting it as a safe tool to treat NPH.

  15. Control of time stability of scintillation spectrometer of delayed coincidences

    CERN Document Server

    Morozov, V A

    2002-01-01

    Paper describes a system to control time stability of a two-detector plastic scintillation spectrometer of three-dimensional coincides. A two-reference control system incorporates a light guide base delay optical line, two light diodes and a two-channel generator of nanosecond pulses. A distinguishing feature of the design system is application of one delay line to form both advance and delay time signal as to the real coincidences in the studied radioactive source. The designed system of control enables to measure periods of half-decay of nuclei excited states within 40-100 ns range ensuring control of position of coincidence curve gravity centers within 4 ps limits

  16. CDL, a Precise, Low-Cost Coincidence Detector Latch

    Directory of Open Access Journals (Sweden)

    Ralf Joost

    2015-12-01

    Full Text Available The electronic detection of the coincidence of two events is still a key ingredient for high-performance applications, such as Positron Emission Tomography and Quantum Optics. Such applications are demanding, since the precision of their calculations and thus their conclusions directly depend on the duration of the interval in which two events are considered coincidental. This paper proposes a new circuitry, called coincidence detector latch (CDL, which is derived from standard RS latches. The CDL has the following advantages: low complexity, fully synthesizable, and high scalability. Even in its simple implementation, it achieves a coincidence window width as short as 115 ps, which is more than 10 times better than that reported by recent research.

  17. Implications on the cosmic coincidence by a dynamical extrinsic curvature

    CERN Document Server

    Capistrano, A J S

    2015-01-01

    In this work, we apply the smooth deformation concept in order to obtain a modification of Friedmann equations. It is shown that the cosmic coincidence can be at least alleviated using the dynamical properties of the extrinsic curvature. We investigate the transition from nucleosynthesis to the coincidence era obtaining a very small variation of the ratio $r=\\frac{\\rho_{m}}{\\rho_{ext}}$, that compares the matter energy density to extrinsic energy density, compatible with the known behavior of the deceleration parameter. We also show that the calculated "equivalence" redshift matches the transition redshift from a deceleration to accelerated phase and the coincidence ceases to be. The dynamics on $r$ is also studied based on Hubble parameter observations as the latest Baryons Acoustic Oscillations/Cosmic Microwave Background Radiation (BAO/CMBR) + SNIa.

  18. The ZEPLIN-III Anti-Coincidence Veto Detector

    CERN Document Server

    Akimov, D Yu; Barnes, E J; Belov, V A; Burenkov, A A; Chepel, V; Currie, A; Edwards, B; Francis, V; Ghag, C; Hollingsworth, A; Horn, M; Kalmus, G E; Kobyakin, A S; Kovalenko, A G; Lebedenko, V N; Lindote, A; Lopes, M I; Lüscher, R; Lyons, K; Majewski, P; Murphy, A St J; Neves, F; Paling, S M; da Cunha, J Pinto; Preece, R; Quenby, J J; Reichhart, L; Scovell, P R; Solovov, V N; Smith, N J T; Smith, P F; Stekhanov, V N; Sumner, T J; Taylor, R; Thorne, C; Walker, R J

    2010-01-01

    The design, optimisation and construction of an anti-coincidence veto detector to complement the ZEPLIN-III direct dark matter search instrument is described. One tonne of plastic scintillator is arranged into 52 bars individually read out by photomultipliers and coupled to a gadolinium-loaded passive polypropylene shield. Particular attention has been paid to radiological content. The overall aim has been to achieve a veto detector of low threshold and high efficiency without the creation of additional background in ZEPLIN-III, all at a reasonable cost. Extensive experimental measurements of the components have been made, including radioactivity levels and performance characteristics. These have been used to inform a complete end-to-end Monte Carlo simulation that has then been used to calculate the expected performance of the new instrument, both operating alone and as an anti-coincidence detector for ZEPLIN-III. The veto device will be capable of rejecting over 65% of coincident nuclear recoil events from ...

  19. 正常压力脑积水的临床特征和手术治疗%Clinical characteristics and surgical treatment of normal pressure hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    赵希敏; 刘勇; 刘霞

    2011-01-01

    目的 探讨正常压力脑积水(NPH)的临床特征和手术治疗效果.方法 NPH患者32例,其中17例应用中压分流管、15例用可调压分流管行脑室-腹腔分流术治疗.结果 应用可调压分流管分流者的症状改善率为86.7%(13/15),应用中压分流管者为41.2%(7/17),两者相差显著(P<0.01).结论 应用可调压分流管行脑室-腹腔分流是治疗NPH的有效方法.%Objective To study the clinical characteristics, surgical strategy of normal pressure hydrocephalus (NPH) based on our experience. Method The clinical data of 32 patients with NPH who were treated by ventriculo-peritoneal (V-P) shunt were analyzed respectively. Results Of 32 patients, 15 received V-P shunt with adjustable valves and 17 with middle pressure and non-adjustable valves. The effective rate (86.7%, 13/15) of patients undergoing the adjustable valve shunt was significantly higher than that (42.1%, 7/ 17) in the patients undergoing middle pressure and non-adjustable valve shunt (P<0.05). Conclusion V-P shunt with an adjustable valve is an effective method to treat normal pressure hydrocephalus.

  20. Non-coincident multi-wavelength emission absorption spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, L.E.

    1995-02-01

    An analysis is presented of the effect of noncoincident sampling on the measurement of atomic number density and temperature by multiwavelength emission absorption. The assumption is made that the two signals, emission and transmitted lamp, are time resolved but not coincident. The analysis demonstrates the validity of averages of such measurements despite fluctuations in temperature and optical depth. At potassium-seeded MHD conditions, the fluctuations introduce additional uncertainty into measurements of potassium atom number density and temperature but do not significantly bias the average results. Experimental measurements in the CFFF aerodynamic duct with coincident and noncoincident sampling support the analysis.

  1. Optical Bell-state analysis in the coincidence basis

    CERN Document Server

    Walborn, S P; Pádua, S; Monken, C H

    2003-01-01

    Many quantum information protocols require a Bell-state measurement of entangled systems. Most optical Bell-state measurements utilize two-photon interference at a beam splitter. By creating polarization-entangled photons with spontaneous parametric down-conversion using a first-order Hermite-Gaussian pump beam, we invert the usual interference behavior and perform an incomplete Bell-state measurement in the coincidence basis. We discuss the possibility of a complete Bell-state measurement in the coincidence basis using hyperentangled states [Phys. Rev. A, \\textbf{58}, R2623 (1998)].

  2. Radiological findings in complications of CSF-draining shunts in infantile hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Faerber, D.

    1984-11-01

    A CSF-draining system functioning free form disturbances is the precondition for age-appropriate further development of the brain in the treatment of infantile hydrocephalus. Shunt dysfuncion may be caused by infection but also by mechanical or functional disturbances with the latter two being summarized under the generic term of 'shunt insufficiency'. Imaging techniques rank first in diagnosis. Plain film X-raying will discover a possible misalignment of the system, a disconnection or a rupture with or without embolization of a valve section. Patency of the system can be verified by valvography using contrast medium or isotopes. CT plays a significant part in the diagnosis of 'hyperdrained' hydrocephalus. In rare cases, pulmonary hyperpressure with cor pulmonale due to chronic micro-embolization of the pulmonary vessels will be a late sequela, even if the position of the distal catheter part is correct.

  3. Neuroendoscopic surgery for unilateral hydrocephalus due to inflammatory obstruction of the Monro foramen

    Directory of Open Access Journals (Sweden)

    Francisco A. Vaz-Guimarães Filho

    2011-04-01

    Full Text Available OBJECTIVE: Unilateral hydrocephalus (UH is characterized by enlargement of just one lateral ventricle. In this paper, the authors will demonstrate their experiences in the neuroendoscopic management of this uncommon type of hydrocephalus. METHOD: The authors retrospectively reviewed a serie of almost 800 neuroendoscopic procedures performed from September 1995 to July 2010 and selected seven adult patients with UH. Clinical and radiological charts were reviewed and analyzed. RESULTS: Six patients had intraventricular neurocysticercosis and one patient had congenital stenosis of the foramen of Monro. Headaches were the most common symptom. A septostomy restored cerebrospinal fluid circulation. During follow-up period (65.5 months, range 3-109 no patient has presented clinical recurrence as well as no severe complications have been observed. CONCLUSION: UH is a rare condition. A successful treatment can be accomplished through a neuroendoscopic approach avoiding the use of ventricular shunts.

  4. Neurolues congênita associada a hidrocefalia Congenital neurosyphilis associated with hydrocephalus

    Directory of Open Access Journals (Sweden)

    Julinho Aisen

    1970-09-01

    Full Text Available É apresentado um caso de neurolues congênita (meningovascular e parenquimatosa associada a hidrocefalia do tipo bloqueado. A natureza luética da afecção foi confirmada por exames paraclínicos e histopatológico. O registro do caso se justifica pelo fato da não existência na literatura compulsada de outro semelhante comprovado histopatològicamente. A hidrocefalia ocorreu em conseqüência do bloqueio do sistema ventricular pelo processo inflamatório de natureza crônica.A case of meningovascular and parenchymatous neurosyphilis associated with a non-communicating hydrocephalus is reported. The syphilitic nature of the disease was confirmed by laboratory and histopathological findings. The authors were unable to find in the medical literature other reports of histologically documented cases of hydrocephalus secondary to a block of the ventricular system determined by neurosyphilis.

  5. Rectification of pulsatile stress on soft tissues: a mechanism for normal-pressure hydrocephalus

    Science.gov (United States)

    Jalikop, Shreyas; Hilgenfeldt, Sascha

    2011-11-01

    Hydrocephalus is a pathological condition of the brain that occurs when cerebrospinal fluid (CSF) accumulates excessively in the brain cavities, resulting in compression of the brain parenchyma. Counter-intuitively, normal-pressure hydrocephalus (NPH) does not show elevated pressure differences across the compressed parenchyma. We investigate the effects of nonlinear tissue mechanics and periodic driving in this system. The latter is due to the cardiac cycle, which provides significant intracranial pressure and volume flow rate fluctuations. Nonlinear rectification of the periodic driving within a model of fluid flow in poroelastic material can lead to compression or expansion of the parenchyma, and this effect does not rely on changes in the mean intracranial pressure. The rectification effects can occur gradually over several days, in agreement with clinical studies of NPH.

  6. Hydrocephalus caused by conditional ablation of the Pten or beta-catenin gene

    Directory of Open Access Journals (Sweden)

    Ohtoshi Akihira

    2008-10-01

    Full Text Available Abstract To investigate the roles of Pten and β-Catenin in the midbrain, either the Pten gene or the β-catenin gene was conditionally ablated, using Dmbx1 (diencephalon/mesencephalon-expressed brain homeobox gene 1-Cre mice. Homozygous disruption of the Pten or β-catenin gene in Dmbx1-expressing cells caused severe hydrocephalus and mortality during the postnatal period. Conditional deletion of Pten resulted in enlargement of midbrain structures. β-catenin conditional mutant mice showed malformation of the superior and inferior colliculi and stenosis of the midbrain aqueduct. These results demonstrate that both Pten and β-Catenin are essential for proper midbrain development, and provide the direct evidence that mutations of both Pten and β-catenin lead to hydrocephalus.

  7. Predicting ventriculoperitoneal shunt infection in children with hydrocephalus using artificial neural network.

    Science.gov (United States)

    Habibi, Zohreh; Ertiaei, Abolhasan; Nikdad, Mohammad Sadegh; Mirmohseni, Atefeh Sadat; Afarideh, Mohsen; Heidari, Vahid; Saberi, Hooshang; Rezaei, Abdolreza Sheikh; Nejat, Farideh

    2016-11-01

    The relationships between shunt infection and predictive factors have not been previously investigated using Artificial Neural Network (ANN) model. The aim of this study was to develop an ANN model to predict shunt infection in a group of children with shunted hydrocephalus. Among more than 800 ventriculoperitoneal shunt procedures which had been performed between April 2000 and April 2011, 68 patients with shunt infection and 80 controls that fulfilled a set of meticulous inclusion/exclusion criteria were consecutively enrolled. Univariate analysis was performed for a long list of risk factors, and those with p value artificial neural networks can predict shunt infection with a high level of accuracy in children with shunted hydrocephalus. Also, the contribution of different risk factors in the prediction of shunt infection can be determined using the trained network.

  8. Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

    Directory of Open Access Journals (Sweden)

    Matheus F. Oliveira

    2014-06-01

    Full Text Available Normal pressure hydrocephalus (NPH is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.

  9. Junctional adhesion molecule (JAM-C deficient C57BL/6 mice develop a severe hydrocephalus.

    Directory of Open Access Journals (Sweden)

    Lena Wyss

    Full Text Available The junctional adhesion molecule (JAM-C is a widely expressed adhesion molecule regulating cell adhesion, cell polarity and inflammation. JAM-C expression and function in the central nervous system (CNS has been poorly characterized to date. Here we show that JAM-C(-/- mice backcrossed onto the C57BL/6 genetic background developed a severe hydrocephalus. An in depth immunohistochemical study revealed specific immunostaining for JAM-C in vascular endothelial cells in the CNS parenchyma, the meninges and in the choroid plexus of healthy C57BL/6 mice. Additional JAM-C immunostaining was detected on ependymal cells lining the ventricles and on choroid plexus epithelial cells. Despite the presence of hemorrhages in the brains of JAM-C(-/- mice, our study demonstrates that development of the hydrocephalus was not due to a vascular function of JAM-C as endothelial re-expression of JAM-C failed to rescue the hydrocephalus phenotype of JAM-C(-/- C57BL/6 mice. Evaluation of cerebrospinal fluid (CSF circulation within the ventricular system of JAM-C(-/- mice excluded occlusion of the cerebral aqueduct as the cause of hydrocephalus development but showed the acquisition of a block or reduction of CSF drainage from the lateral to the 3(rd ventricle in JAM-C(-/- C57BL/6 mice. Taken together, our study suggests that JAM-C(-/- C57BL/6 mice model the important role for JAM-C in brain development and CSF homeostasis as recently observed in humans with a loss-of-function mutation in JAM-C.

  10. Low-dose kaolin-induced feline hydrocephalus and feline ventriculostomy: an updated model

    Science.gov (United States)

    Lollis, S. Scott; Hoopes, P. Jack; Kane, Susan; Paulsen, Keith; Weaver, John; Roberts, David W.

    2013-01-01

    Object Intracisternal injection of kaolin is a well-described model of feline hydrocephalus. Its principal disadvantage is a high rate of procedure-related morbidity and mortality. The authors describe a series of modifications to a commonly used protocol, intended to ameliorate animal welfare concerns without compromising the degree of ventricular enlargement. Methods In 11 adult cats, hydrocephalus was induced by injection of kaolin into the cisterna magna. Kaolin doses were reduced to 10 mg, compared with historical doses of ~ 200 mg, and high-dose dexamethasone was used to reduce the severity of meningeal irritation. A control cohort of 6 additional animals received injections of isotonic saline into the cisterna magna. Results The mean ventricular volume increased from a baseline of 0.183 ± 0.068 ml to 1.43 ± 0.184 ml. Two animals were killed prior to completion of the study. Of the remaining animals, all were ambulatory by postinjection Day 1, and all had resumed normal oral intake by postinjection Day 3. Two animals required subcutaneous fluid supplementation. Ventriculostomy using anatomical landmarks was performed to ascertain intraventricular pressure. The mean intraventricular pressure after hydrocephalus was 15 cm H2O above the ear (range 11–20 cm H2O). Conclusions Reduction in kaolin dosage and the postoperative administration of high-dose corticosteroid therapy appear to reduce morbidity and mortality rates compared with historical experiences. Hydrocephalus is radiographically evident as soon as 3 days after injection, but it does not substantially interfere with feeding and basic self-care. To the extent that animal welfare concerns may have limited the use of this model in recent years, the procedures described in the present study may offer some guidance for its future use. PMID:19834994

  11. Influence of the hole geometry on the flow distribution in ventricular catheters for hydrocephalus

    OpenAIRE

    Giménez, Ángel; Galarza, Marcelo; Pellicer, Olga; Valero, José; Amigó, José M.

    2016-01-01

    Background Hydrocephalus is a medical condition consisting of an abnormal accumulation of cerebrospinal fluid within the brain. A catheter is inserted in one of the brain ventricles and then connected to an external valve to drain the excess of cerebrospinal fluid. The main drawback of this technique is that, over time, the ventricular catheter ends up getting blocked by the cells and macromolecules present in the cerebrospinal fluid. A crucial factor influencing this obstruction is a non-uni...

  12. Congenital hydrocephalus in an Egyptian baby with trisomy 18: a case report

    OpenAIRE

    Metwalley Kotb A; Farghalley Hekma S; Abd-Elsayed Alaa A

    2009-01-01

    Abstract Introduction Trisomy 18 is the second most common autosomal trisomy after Down syndrome (trisomy 21). A variety of anomalies of the central nervous system are observed in cases of trisomy 18. The association between trisomy 18 and congenital hydrocephalus is very rare. Case presentation A 4-month-old male Egyptian baby boy was referred to Assiut University hospital for evaluation of his large-sized head. The initial clinical examination revealed facial dysmorphism including a promine...

  13. Junctional adhesion molecule (JAM)-C deficient C57BL/6 mice develop a severe hydrocephalus.

    Science.gov (United States)

    Wyss, Lena; Schäfer, Julia; Liebner, Stefan; Mittelbronn, Michel; Deutsch, Urban; Enzmann, Gaby; Adams, Ralf H; Aurrand-Lions, Michel; Plate, Karl H; Imhof, Beat A; Engelhardt, Britta

    2012-01-01

    The junctional adhesion molecule (JAM)-C is a widely expressed adhesion molecule regulating cell adhesion, cell polarity and inflammation. JAM-C expression and function in the central nervous system (CNS) has been poorly characterized to date. Here we show that JAM-C(-/-) mice backcrossed onto the C57BL/6 genetic background developed a severe hydrocephalus. An in depth immunohistochemical study revealed specific immunostaining for JAM-C in vascular endothelial cells in the CNS parenchyma, the meninges and in the choroid plexus of healthy C57BL/6 mice. Additional JAM-C immunostaining was detected on ependymal cells lining the ventricles and on choroid plexus epithelial cells. Despite the presence of hemorrhages in the brains of JAM-C(-/-) mice, our study demonstrates that development of the hydrocephalus was not due to a vascular function of JAM-C as endothelial re-expression of JAM-C failed to rescue the hydrocephalus phenotype of JAM-C(-/-) C57BL/6 mice. Evaluation of cerebrospinal fluid (CSF) circulation within the ventricular system of JAM-C(-/-) mice excluded occlusion of the cerebral aqueduct as the cause of hydrocephalus development but showed the acquisition of a block or reduction of CSF drainage from the lateral to the 3(rd) ventricle in JAM-C(-/-) C57BL/6 mice. Taken together, our study suggests that JAM-C(-/-) C57BL/6 mice model the important role for JAM-C in brain development and CSF homeostasis as recently observed in humans with a loss-of-function mutation in JAM-C.

  14. Calcified subdural haematomas associated with arrested hydrocephalus - late sequelae of shunt operation in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Barmeir, E.P.; Stern, D.; Harel, S.; Holtzman M.; Krije, T.J.

    1985-08-01

    Calcified chronic subdural haematoms (SDH) and features of arrested (compensated) hydrocephalus were demonstrated by skull radiography and cranial computed tomography (CT) in two children who had no neurological deficit. Ventricular surgical drainage had been performed 8 and 11 years prior to admission and the haematomas remained subsequently undetected. The following presentation will serve to illustrate the characteristic radiological features of this entity, the issue of management, and includes a review of the literature.

  15. The value of baseline CT head scans in the assessment of shunt complications in hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Cantrell, P. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Fraser, F. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Pilling, D. (Alder Hey Children' s Hospital, Liverpool (United Kingdom)); Carty, H. (Alder Hey Children' s Hospital, Liverpool (United Kingdom))

    1993-10-01

    The purpose of this study was to determine the value of a baseline CT head scan in the assessment of patients who subsequently presented with symptoms which may have been due to shunt complications (such as blockage or infection). In all these patients the shunt had been inserted in the treatment of hydrocephalus. We conclude that the presence of a baseline scan does not add to the interpretation of CT scans done when the patient presents with symptoms of possible shunt malfunction. (orig.)

  16. Communicating hydrocephalus subsequent to purulent meningitis. Study on prognostic factors based on CT findings following shunting

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Hiroshi; Ogawa, Kimio; Hibio, Shuichi; Goto, Kazuhiko; Shiihara, Hiroaki (Nihon Univ., Tokyo. School of Medicine)

    1984-08-01

    Based on CT findings one year after shunting, ventricular dialtion was classified into five degrees for examining prognosis of communicating hydrocephalus subsequent to purulent meningitis. Factors causing and aggravating hydrocephalus were also examined. Patients with hydrocephalus tended to have spasms frequently as the first symptom within one month after birth when there were few characteristic findings. Spasm and disturbance of consciousness occurred frequently during the first week of the occurrence of disease. Large numbers of cells in the spinal fluid and high volume of spinal cord protein were persistent in patients aged one month or less. Chloride transport decreased in patients aged two months or more. The occurrence of syndrome of the pyramidal tract, eye symptoms, movement of head to the left and right, and involuntary movement suggested serious conditions of the disease. Disturbance of movement could be relieved by giving adequate antibiotics as soon as meningitis was discovered within one month after birth and by giving chloramphenicol when symptoms suggesting the development of serious conditions occurred. However, mental retardation and epilepsy could not be prevented.

  17. Longitudinal Changes in the Brain Following Third Ventriculostomy in a Child With Hydrocephalus

    Science.gov (United States)

    Li, Yongxin; Zhao, Cailei; Tan, Zhen; Wang, Ya; Zhang, Heye; Wang, Jinyang; Guo, Honghua; Zeng, Baozhen; Huang, Wenhua

    2015-01-01

    Abstract The goal of this study was to detect the long-term effect of shunting on the integrity of white matter in young children with hydrocephalus. The authors reported the case of a 6-month-old boy with hydrocephalus who was evaluated by diffusion tensor imaging (DTI) before and after a shunt operation. When compared with normal children, the structures of the corpus callosum, internal capsule, and corona radiata in the patient showed a decrease in fractional anisotropy and an increase in radial diffusivity values before the shunt operation. Following successful cerebrospinal fluid shunting, long-term follow-up DTI demonstrated a trend toward normalization of the fractional anisotropy and radial diffusivity values. Shunt treatment can prevent further damage to the brain and grossly reconstitute the distorted anatomy. DTI could be a useful tool in detecting longitudinal changes after a shunt operation. Further studies involving larger case numbers are needed to detect the long-term effect of shunting on the brains of children with hydrocephalus. PMID:26632724

  18. Evaluation of periventricular hypodensity in adult hydrocephalus with CT cisternography and xenon-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Aoyagi, Masaru (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1984-06-01

    Metrizamide CT cisternography and Xenon-enhanced CT were employed to evaluate the periventricular hypodensity (PVH). CT cisternography was performed on adult cases with suspected communicating hydrocephalus, of which 43 cases showing ventricular reflux were investigated. In those cases in which significant transition of metrizamide into the area of PVH was followed after the ventricular reflux and stasis, the shunt operation was effective. The PVH disappeared post-operatively. However, in cases with PVH in which the metrizamide penetration did not occur, the PVH did not disappear post-operatively and clinical improvement was not detected. Xenon-enhanced CT was performed in six cases. Three cases exhibited communicating hydrocephalus, in which the area of PVH was not enhanced by metrizamide with CT cisternography. The other cases demonstrated acute high pressure hydrocephalus. The PVH in the former cases was neither enhanced by Xenon nor metrizamide, while the latter was enhanced significantly. Studies suggested that the reversible PVH was the result of an abnormally increased transition of cerebrospinal fluid through the ependymal layer, while the irreversible PVH resulted from the axonal destruction or demyelination of the periventricular white matter.

  19. Outcome of endoscopic third ventriculostomy and Chhabra shunt system in noncommunicating non-tumor childhood hydrocephalus

    Directory of Open Access Journals (Sweden)

    O E Idowu

    2009-01-01

    Full Text Available Background : Endoscopic third ventriculostomy (ETV the main alternative to ventriculoperitoneal shunt (VPS is just beginning to have a foothold in West Africa. It provides a great opportunity for a hydrocephalic child to be shunt free. The purpose of this paper is to compare outcome following ETV and VPS (using the cheap Chhabra shunt in children with noncommunicating non-tumoral hydrocephalus in an environment where late presentation is the norm. Materials and Methods : Sixty-three pediatric patients (< 6 years with hydrocephalus who underwent a VPS or ETV at our hospital were included in this study. The study period was of 30 months (January 2006 till June 2008. Clinically successful outcome was defined as no event occurring during or after surgery that resulted in an alternate surgical procedure, or significant post-operative complication that includes death. All complications related to the procedures were also analyzed. Results : The outcome of surgical intervention was not significantly related to the gender, age of the patient at surgery, or type of surgery. The post-operative complication rate was similar in both groups. Conclusions : The clinical outcome of ETV is comparable to that of VPS, with the added benefit of no shunt-related problems; and being a short procedure, patient anesthesia and operation time, hospital stay, and cost are significantly reduced. We consider ETV to be the procedure of choice for the treatment of noncommunicating nontumoral hydrocephalus in the pediatric population.

  20. Acute two-compartment low pressure hydrocephalus--a case report.

    Science.gov (United States)

    Preuß, M; Evangelou, P; Hirsch, W; Reiss-Zimmermann, M; Fischer, L; Merkenschlager, A; Kieß, W; Siekmeyer, M; Meixensberger, J; Nestler, U

    2013-12-01

    A case of an 8-year-old-boy with shunt-dependent occlusive hydrocephalus after resection of a cerebellar medulloblastoma is presented, who experienced repeated episodes of severe neurologic deterioration with signs and symptoms of raised intracranial pressure after spinal tapping. However, intracranial pressure was recorded within low ranges, only up to the opening pressure of the implanted adjustable shunt valve. Multiple shunt revisions were performed, until the condition was recognized as acute normal pressure hydrocephalus. Either enforced recumbency and downadjustment of the valve system to 0 cm H(2)O alone or external ventricular drainage seems to be successful to resolve the critical condition, depending on severity of the symptoms. The case illustrates that acute pathologic enlargement of the ventricular system is not always associated with increased intracranial pressure, even when typical signs and symptoms are present. The very rare entity of acute normal pressure hydrocephalus by two separated compartments is postulated based on the pulsatile vector force theory of brain water circulation.

  1. Normal pressure hydrocephalus in the spectrum of neurological complications of systemic lupus erythematosus.

    Science.gov (United States)

    de Oliveira, Fabricio Ferreira; Cardoso, Tania Aparecida Marchiori; Sampaio-Barros, Percival Degrava; Damasceno, Benito Pereira

    2013-06-01

    Normal pressure hydrocephalus is an unusual manifestation of systemic lupus erythematosus and its pathogenesis is still unclear. We report the case of a 39-year-old white woman with systemic lupus erythematosus who developed magnetic gait, speech difficulties, progressive memory impairment, urinary incontinence and episodes of involuntary closure of the eyelids. Signs and symptoms, associated with ventriculomegaly and normal cerebrospinal fluid pressure, suggested normal pressure hydrocephalus, which as a complication of systemic lupus erythematosus believably develops due to the insidious inflammatory process that occurs in the meningeal tissues or to the vasculitis itself. Normal pressure hydrocephalus tends to develop secondary to trauma, infection or subarachnoid haemorrhage, but in 50 % of patients no aetiology is found. Shunt surgery is the only effective treatment, specifically for the gait disorder, which usually improves more than the cognitive symptoms. Since the tap-test showed a strongly positive result, a medium pressure ventriculoperitoneal shunt was inserted, further replaced by a high pressure one in view of the complications, with less than expected improvement. Subdural hematomas and empyemas developed, requiring surgery and antibiotic therapy. A new tap-test was positive, and the patient improved only after a programmable valve was finally placed. However, pressure regulation shall be continuously required, and shunt dysfunction might still develop in the long term. The few similar case reports in the literature are reviewed, confirming the rarity of this neurological complication of systemic lupus erythematosus.

  2. Assessment of hydrocephalus in children based on digital image processing and analysis

    Directory of Open Access Journals (Sweden)

    Fabijańska Anna

    2014-06-01

    Full Text Available Hydrocephalus is a pathological condition of the central nervous system which often affects neonates and young children. It manifests itself as an abnormal accumulation of cerebrospinal fluid within the ventricular system of the brain with its subsequent progression. One of the most important diagnostic methods of identifying hydrocephalus is Computer Tomography (CT. The enlarged ventricular system is clearly visible on CT scans. However, the assessment of the disease progress usually relies on the radiologist’s judgment and manual measurements, which are subjective, cumbersome and have limited accuracy. Therefore, this paper regards the problem of semi-automatic assessment of hydrocephalus using image processing and analysis algorithms. In particular, automated determination of popular indices of the disease progress is considered. Algorithms for the detection, semi-automatic segmentation and numerical description of the lesion are proposed. Specifically, the disease progress is determined using shape analysis algorithms. Numerical results provided by the introduced methods are presented and compared with those calculated manually by a radiologist and a trained operator. The comparison proves the correctness of the introduced approach.

  3. Protein and synthetic polymer injection for induction of obstructive hydrocephalus in rats

    Directory of Open Access Journals (Sweden)

    Del Bigio Marc R

    2007-09-01

    Full Text Available Abstract Background The objective of this study was to develop a simple and inexpensive animal model of induced obstructive hydrocephalus with minimal tissue inflammation, as an alternative to kaolin injection. Materials Two-hundred and two male Sprague-Dawley rats aged 3 weeks received intracisternal injections of kaolin (25% suspension, Matrigel, type 1 collagen from rat tail, fibrin glue (Tisseel, n-butyl-cyanoacrylate (NBCA, or ethylene vinyl alcohol copolymer (Onyx-18 and Onyx-34. Magnetic resonance imaging was used to assess ventricle size. Animals were euthanized at 2, 5, 10 and 14 days post-injection for histological analysis. Results Kaolin was associated with 10% mortality and successful induction of hydrocephalus in 97% of survivors (ventricle area proportion 0.168 ± 0.018. Rapidly hardening agents (fibrin glue, NBCA, vinyl polymer had high mortality rates and low success rates in survivors. Only Matrigel had relatively low mortality (17% and moderate success rate (20%. An inflammatory response with macrophages and some lymphocytes was associated with kaolin. There was negligible inflammation associated with Matrigel. A severe inflammatory response with giant cell formation was associated with ethylene vinyl alcohol copolymer. Conclusion Kaolin predictably produces moderate to severe hydrocephalus with a mild chronic inflammatory reaction and fibrosis of the leptomeninges. Other synthetic polymers and biopolymers tested are unreliable and cause different types of inflammation.

  4. A comparison of coincident GRACE and ICESat data over Antarctica

    NARCIS (Netherlands)

    Gunter, B.; Urban, T.; Riva, R.E.M.; Helsen, M.M.; Harpold, R.; Poole, S.; Nagel, P.; Schutz, B.; Tapley, B.

    2009-01-01

    In this study, we present a comparison of coincident GRACE and ICESat data over Antarctica. The analysis focused on the secular changes over a 4-year period spanning from 2003 to 2007, using the recently reprocessed and publicly available data sets for both missions. The results show that the two in

  5. Limb-nadir matching using non-coincident NO

    NARCIS (Netherlands)

    Adams, Cristen; Normand, Elise N.; McLinden, Chris A.; Bourassa, Adam E.; Lloyd, Nicholas D.; Degenstein, Douglas A.; Krotkov, Nickolay A.; Belmonte Rivas, Maria; Boersma, Folkert; Eskes, Henk

    2016-01-01

    A variant of the limb-nadir matching technique for deriving tropospheric NO2 columns is presented in which the stratospheric component of the NO2 slant column density (SCD) measured by the Ozone Monitoring Instrument (OMI) is removed using non-coincident profiles from the

  6. A {beta} - {gamma} coincidence; Metodo de coincidencias {beta} - {gamma}

    Energy Technology Data Exchange (ETDEWEB)

    Agullo, F.

    1960-07-01

    A {beta} - {gamma} coincidence method for absolute counting is given. The fundamental principles are revised and the experimental part is detailed. The results from {sup 1}98 Au irradiated in the JEN 1 Swimming pool reactor are given. The maximal accuracy is 1 per cent. (Author) 11 refs.

  7. Limb-nadir matching using non-coincident NO

    NARCIS (Netherlands)

    Adams, Cristen; Normand, Elise N.; McLinden, Chris A.; Bourassa, Adam E.; Lloyd, Nicholas D.; Degenstein, Douglas A.; Krotkov, Nickolay A.; Belmonte Rivas, Maria; Boersma, Folkert; Eskes, Henk

    2016-01-01

    A variant of the limb-nadir matching technique for deriving tropospheric NO2 columns is presented in which the stratospheric component of the NO2 slant column density (SCD) measured by the Ozone Monitoring Instrument (OMI) is removed using non-coincident profiles from the Op

  8. Coincident optima for two-facility Weber problems

    DEFF Research Database (Denmark)

    Juel, Henrik

    1983-01-01

    The location problem with two new facilities in continuous space is considered, with distance measured by arbitrary norms. Necessary and sufficient conditions for a proposed solution to be optimal are given for several cases. These cases include situations where the cost function...... is nondifferentiable because facilities coincide...

  9. Trends in hospitalization of preterm infants with intraventricular hemorrhage and hydrocephalus in the United States, 2000-2010.

    Science.gov (United States)

    Christian, Eisha A; Jin, Diana L; Attenello, Frank; Wen, Timothy; Cen, Steven; Mack, William J; Krieger, Mark D; McComb, J Gordon

    2016-03-01

    OBJECT Even with improved prenatal and neonatal care, intraventricular hemorrhage (IVH) occurs in approximately 25%-30% of preterm infants, with a subset of these patients developing hydrocephalus. This study was undertaken to describe current trends in hospitalization of preterm infants with posthemorrhagic hydrocephalus (PHH) using the Nationwide Inpatient Sample (NIS) and the Kids' Inpatient Database (KID). METHODS The KID and NIS were combined to generate data for the years 2000-2010. All neonatal discharges with ICD-9-CM codes for preterm birth with IVH alone or with IVH and hydrocephalus were included. RESULTS There were 147,823 preterm neonates with IVH, and 9% of this group developed hydrocephalus during the same admission. Of patients with Grade 3 and 4 IVH, 25% and 28%, respectively, developed hydrocephalus in comparison with 1% and 4% of patients with Grade 1 and 2 IVH, respectively. Thirty-eight percent of patients with PHH had permanent ventricular shunts inserted. Mortality rates were 4%, 10%, 18%, and 40%, respectively, for Grade 1, 2, 3, and 4 IVH during initial hospitalization. Length of stay has been trending upward for both groups of IVH (49 days in 2000, 56 days in 2010) and PHH (59 days in 2000, 70 days in 2010). The average hospital cost per patient (adjusted for inflation) has also increased, from $201,578 to $353,554 (for IVH) and $260,077 to $495,697 (for PHH) over 11 years. CONCLUSIONS The number of neonates admitted with IVH has increased despite a decrease in the number of preterm births. Rates of hydrocephalus and mortality correlated closely with IVH grade. The incidence of hydrocephalus in preterm infants with IVH remained stable between 8% and 10%. Over an 11-year period, there was a progressive increase in hospital cost and length of stay for preterm neonates with IVH and PHH that may be explained by a concurrent increase in the proportion of patients with congenital cardiac anomalies.

  10. Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients.

    Science.gov (United States)

    Sæhle, Terje; Eide, Per Kristian

    2015-05-01

    OBJECT In patients with hydrocephalus and shunts, lasting symptoms such as headache and dizziness may be indicative of shunt failure, which may necessitate shunt revision. In cases of doubt, the authors monitor intracranial pressure (ICP) to determine the presence of over- or underdrainage of CSF to tailor management. In this study, the authors reviewed their experience of ICP monitoring in shunt failure. The aims of the study were to identify the complications and impact of ICP monitoring, as well as to determine the mean ICP and characteristics of the cardiac-induced ICP waves in pediatric versus adult over- and underdrainage. METHODS The study population included all pediatric and adult patients with hydrocephalus and shunts undergoing diagnostic ICP monitoring for tentative shunt failure during the 10-year period from 2002 to 2011. The patients were allocated into 3 groups depending on how they were managed following ICP monitoring: no drainage failure, overdrainage, or underdrainage. While patients with no drainage failure were managed conservatively without further actions, over- or underdrainage cases were managed with shunt revision or shunt valve adjustment. The ICP and ICP wave scores were determined from the continuous ICP waveforms. RESULTS The study population included 71 pediatric and 75 adult patients. There were no major complications related to ICP monitoring, but 1 patient was treated for a postoperative superficial wound infection and another experienced a minor bleed at the tip of the ICP sensor. Following ICP monitoring, shunt revision was performed in 74 (51%) of 146 patients, while valve adjustment was conducted in 17 (12%) and conservative measures without any actions in 55 (38%). Overdrainage was characterized by a higher percentage of episodes with negative mean ICP less than -5 to -10 mm Hg. The ICP wave scores, in particular the mean ICP wave amplitude (MWA), best differentiated underdrainage. Neither mean ICP nor MWA levels showed any

  11. Changes in Rat Brain Tissue Microstructure and Stiffness during the Development of Experimental Obstructive Hydrocephalus.

    Directory of Open Access Journals (Sweden)

    Lauriane Jugé

    Full Text Available Understanding neural injury in hydrocephalus and how the brain changes during the course of the disease in-vivo remain unclear. This study describes brain deformation, microstructural and mechanical properties changes during obstructive hydrocephalus development in a rat model using multimodal magnetic resonance (MR imaging. Hydrocephalus was induced in eight Sprague-Dawley rats (4 weeks old by injecting a kaolin suspension into the cisterna magna. Six sham-injected rats were used as controls. MR imaging (9.4T, Bruker was performed 1 day before, and at 3, 7 and 16 days post injection. T2-weighted MR images were collected to quantify brain deformation. MR elastography was used to measure brain stiffness, and diffusion tensor imaging (DTI was conducted to observe brain tissue microstructure. Results showed that the enlargement of the ventricular system was associated with a decrease in the cortical gray matter thickness and caudate-putamen cross-sectional area (P < 0.001, for both, an alteration of the corpus callosum and periventricular white matter microstructure (CC+PVWM and rearrangement of the cortical gray matter microstructure (P < 0.001, for both, while compression without gross microstructural alteration was evident in the caudate-putamen and ventral internal capsule (P < 0.001, for both. During hydrocephalus development, increased space between the white matter tracts was observed in the CC+PVWM (P < 0.001, while a decrease in space was observed for the ventral internal capsule (P < 0.001. For the cortical gray matter, an increase in extracellular tissue water was significantly associated with a decrease in tissue stiffness (P = 0.001. To conclude, this study characterizes the temporal changes in tissue microstructure, water content and stiffness in different brain regions and their association with ventricular enlargement. In summary, whilst diffusion changes were larger and statistically significant for majority of the brain regions

  12. Standardization of 64Cu and 68Ga by the 4π(PC)β-γ coincidence method and calibration of the ionization chamber.

    Science.gov (United States)

    Sahagia, M; Luca, A; Antohe, A; Ivan, C

    2012-09-01

    The paper treats the application of the 4π(PC)β-γ coincidence method for the standardization of the radionuclides (64)Cu and (68)Ga. The general coincidence equations are written. Two types of extrapolation were described and used in measurement: the positron-annihilation coincidence, and the counting of all emitted radiations; both methods are compared with respect to results, advantages and drawbacks. The impurities' content correction was applied. The standardized solutions were used to calibrate the ionization chamber CENTRONIC IG12/20A and to determine the gamma-rays emission intensities.

  13. Electron-ion-ion coincidence experiments for photofragmentation of polyatomic molecules using pulsed electric fields: Treatment of random coincidences

    Energy Technology Data Exchange (ETDEWEB)

    Pruemper, G. [Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980 8577 (Japan)]. E-mail: pruemper@tagen.tohoku.ac.jp; Ueda, K. [Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980 8577 (Japan)

    2007-05-01

    In molecular photofragmentation processes by soft X-rays, a number of ionic fragments can be produced, each having a different abundance and correlation with the kinetic energy of the emitted electron. For investigating these fragmentation processes, electron-ion and electron-ion-ion coincidence experiments, in which the kinetic energy of electrons are analyzed using an electrostatic analyzer while the mass of the ions is analyzed using a pulsed electric field, are very powerful. For such measurements, however, the contribution of random coincidences is substantial and affects the data in a non-trivial way. Simple intuitive subtraction methods cannot be applied. In the present paper, we describe these electron-ion and electron-ion-ion coincidence experiments together with a subtraction method for the contribution from random coincidences. We provide a comprehensive set of equations for the data treatment, including equations for the calculation of error-bars. We demonstrate the method by applying it to the fragmentation of free CF{sub 3}SF{sub 5} molecules.

  14. Diffusion tensor imaging study of pediatric patients with congenital hydrocephalus: 1-year postsurgical outcomes.

    Science.gov (United States)

    Mangano, Francesco T; Altaye, Mekibib; McKinstry, Robert C; Shimony, Joshua S; Powell, Stephanie K; Phillips, Jannel M; Barnard, Holly; Limbrick, David D; Holland, Scott K; Jones, Blaise V; Dodd, Jonathan; Simpson, Sarah; Mercer, Deanna; Rajagopal, Akila; Bidwell, Sarah; Yuan, Weihong

    2016-09-01

    OBJECTIVE The purpose of this study was to investigate white matter (WM) structural abnormalities using diffusion tensor imaging (DTI) in children with hydrocephalus before CSF diversionary surgery (including ventriculoperitoneal shunt insertion and endoscopic third ventriculostomy) and during the course of recovery after surgery in association with neuropsychological and behavioral outcome. METHODS This prospective study included 54 pediatric patients with congenital hydrocephalus (21 female, 33 male; age range 0.03-194.5 months) who underwent surgery and 64 normal controls (30 female, 34 male; age range 0.30-197.75 months). DTI and neurodevelopmental outcome data were collected once in the control group and 3 times (preoperatively and at 3 and 12 months postoperatively) in the patients with hydrocephalus. DTI measures, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were extracted from the genu of the corpus callosum (gCC) and the posterior limb of internal capsule (PLIC). Group analysis was performed first cross-sectionally to quantify DTI abnormalities at 3 time points by comparing the data obtained in the hydrocephalus group for each of the 3 time points to data obtained in the controls. Longitudinal comparisons were conducted pairwise between different time points in patients whose data were acquired at multiple time points. Neurodevelopmental data were collected and analyzed using the Adaptive Behavior Assessment System, Second Edition, and the Bayley Scales of Infant Development, Third Edition. Correlation analyses were performed between DTI and behavioral measures. RESULTS Significant DTI abnormalities were found in the hydrocephalus patients in both the gCC (lower FA and higher MD, AD, and RD) and the PLIC (higher FA, lower AD and RD) before surgery. The DTI measures in the gCC remained mostly abnormal at 3 and 12 months after surgery. The DTI abnormalities in the PLIC were

  15. Non-invasive estimation of intracranial pressure. MR-based evaluation in children with hydrocephalus; Nichtinvasive Bestimmung des intrakraniellen Drucks. MR-basierte Untersuchung bei Kindern mit Hydrozephalus

    Energy Technology Data Exchange (ETDEWEB)

    Muehlmann, M.; Steffinger, D.; Ertl-Wagner, B.; Koerte, I.K. [Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Peraud, A. [Ludwig-Maximilians-Universitaet Muenchen, Abteilung fuer Neurochirurgie, Muenchen (Germany); Lehner, M. [Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universitaet Muenchen, Abteilung fuer Kinderchirurgie, Muenchen (Germany); Heinen, F.; Alperin, N. [University Miami, Department of Radiology, Miller School of Medicine, Miami (United States)

    2012-09-15

    The intracranial pressure (ICP) is a crucially important parameter for diagnostic and therapeutic decision-making in patients with hydrocephalus. So far there is no standard method to non-invasively assess the ICP. Various approaches to obtain the ICP semi-invasively or non-invasively are discussed and the clinical application of a magnetic resonance imaging (MRI)-based method to estimate ICP (MR-ICP) is demonstrated in a group of pediatric patients with hydrocephalus. Arterial inflow, venous drainage and craniospinal cerebrospinal fluid (CSF) flow were quantified using phase-contrast imaging to derive the MR-ICP. A total of 15 patients with hydrocephalus (n=9 treated with shunt placement or ventriculostomy) underwent MRI on a 3 T scanner applying retrospectively-gated cine phase contrast sequences. Of the patients six had clinical symptoms indicating increased ICP (age 2.5-14.61 years, mean 7.4 years) and nine patients had no clinical signs of elevated ICP (age 2.1-15.9 years; mean 9.8 years; all treated with shunt or ventriculostomy). Median MR-ICP in symptomatic patients was 24.5 mmHg (25th percentile 20.4 mmHg; 75th percentile 44.6 mmHg). Median MR-ICP in patients without acute signs of increased ICP was 9.8 mmHg (25th percentile 8.6 mmHg; 75th percentile 11.4 mmHg). Group differences were significant (p < 0.001; Mann-Whitney U-test). The MR-ICP technique is a promising non-invasive tool for estimating ICP. Further studies in larger patient cohorts are warranted to investigate its application in children with hydrocephalus. (orig.) [German] Der intrakranielle Druck (''intracranial pressure'' - ICP) ist ein entscheidender Parameter bei der Diagnostik, Therapie und Verlaufsbeurteilung von Patienten mit Hydrozephalus. Derzeit gibt es keine radiologische Standardmethode, um den intrakraniellen Druck quantitativ zu bestimmen. Methoden zur invasiven und nichtinvasiven Einschaetzung des ICP werden diskutiert und die Anwendung eines MR

  16. Neuroendoscopia: Utilidad en el manejo de la hidrocefalia en niños de países en vías de desarrollo Neuroendoscopy: Its usefulness in the hydrocephalus management of children in developing countries

    Directory of Open Access Journals (Sweden)

    Juan C. Jiménez-León

    2007-01-01

    with good sanitarian conditions. In Latinamerica the most common etiological factors of hydrocephalus are associated with bad prenatal controls, neonatal sepsis and consequent meningitis and ventriculitis. The hydrocephalus is a consequence of the damage in the circulation of the cerebrospinal fluid (CSF. Neuroendoscopy specially third ventriculostomy, associated in some patients with choroid plexus cauterization, represents an alternative method to manage this condition avoiding shunts and its complications. Endoscopic third ventriculostomy (ETV alone or with choroid plexus cauterization (CPC is an emerging and very useful technique to manage hydrocephalus specially in children with: ventriculitis as a consequence of meningitis, myelomeningocele, obstructive hydrocephalus idiopathic or seconday to posterior fossa tumors. One hundred consecutive children (100 underwent ventriculoscopy preceding EVT as an initial treatment of hydrocephalus since January 2001 to July 2006, median age was 15.5 months with a range between 2-48 months, 55% are males of our Institution in Valencia, Venezuela. We describe the normal and pathological ventricular anatomy with emphasis in the endoscopic technique and its challenges. We present how the EVT works to prevent the shunt implantation. In the future, neuroendoscopy prevents the use of shunts to treat hydrocephalus in children, avoiding its complications and cost. Neuroendoscopy is a neurosurgical technique everyday most common to manage hydrocephalus and intraventricular lesions in the world. We report an algorythm to use in children younger than 1 year of age with postinfectious hydrocephalus (PIHC or associated with myelomeningocele. We stress the use of EVT as an alternative because of its low cost to treat hydrocephalus avoiding the complications and dependency of shunts.

  17. Feasibility of 3-dimensional sampling perfection with application optimized contrast sequence in the evaluation of patients with hydrocephalus.

    Science.gov (United States)

    Kartal, Merve Gulbiz; Ocakoglu, Gokhan; Algin, Oktay

    2015-01-01

    This study aimed to investigate the effectiveness and additive value of T2W 3-dimensional sampling perfection with application optimized contrast (3D-SPACE) with variant flip-angle mode in imaging of all types of hydrocephalus. Our secondary objective was to assess the reliability of 3D-SPACE sequence and correspondence of the results with phase-contrast magnetic resonance imaging (PC-MRI)-based data. Forty-one patients with hydrocephalus have undergone 3-T MRI. T2W 3D-SPACE sequence has been obtained in addition to routine hydrocephalus protocol. Cerebrospinal fluid circulation, presence/type/etiology of hydrocephalus, obstruction level scores, and diagnostic levels of confidence were evaluated separately by 2 radiologists. In the first session, routine sequences with PC-MRI were evaluated, and in another session, only 3D-SPACE and 3-dimensional magnetization prepared rapid acquisition gradient echo sequences were evaluated. Results obtained in these sessions were compared with each other and those obtained in consensus session. Agreement values were very good for both 3D-SPACE and PC-MRI sequences (P technique providing extensive multiplanar reformatted images with a lower specific absorption rate. These advantages over PC-MRI make 3D-SPACE sequence a promising tool in management of patients with hydrocephalus.

  18. Using CHIMERA detector at LNS for gamma-particle coincidences

    Directory of Open Access Journals (Sweden)

    Cardella G.

    2016-01-01

    Full Text Available We have recently evaluated the quality of γ-ray angular distributions that can be extracted in particle-gamma coincidence measurements using the CHIMERA detector at LNS. γ-rays have been detected using the CsI(Tl detectors of the spherical part of the CHIMERA array. Very clean γ-rays angular distributions were extracted in reactions induced by different stable beams impinging on 12C thin targets. The results evidenced an effect of projectile spin flip on the γ-rays angular distributions. γ-particle coincidence measurements were also performed in reactions induced by neutron rich exotic beams produced through in-flight fragmentation at LNS. In recent experiments also the Farcos array was used to improve energy and angular resolution measurements of the detected charged particles. Results obtained with both stable and radioactive beams are reported.

  19. Data Acquisition System for Electron Energy Loss Coincident Spectrometers

    Institute of Scientific and Technical Information of China (English)

    Zhang Chi; Yu Xiaoqi; Yang Tao

    2005-01-01

    A Data Acquisition System (DAQ) for electron energy loss coincident spectrometers (EELCS) has been developed. The system is composed of a Multiplex Time-Digital Converter (TDC) that measures the flying time of positive and negative ions and a one-dimension positionsensitive detector that records the energy loss of scattering electrons. The experimental data are buffered in a first-in-first-out(FIFO) memory module, then transferred from the FIFO memory to PC by the USB interface. The DAQ system can record the flying time of several ions in one collision, and allows of different data collection modes. The system has been demonstrated at the Electron Energy Loss Coincident Spectrometers at the Laboratory of Atomic and Molecular Physics, USTC. A detail description of the whole system is given and experimental results shown.

  20. Coincidences between gravitational wave interferometers and high energy neutrino telescopes

    Energy Technology Data Exchange (ETDEWEB)

    Pradier, Thierry [Institut Pluridisciplinaire Hubert Curien (IPHC/DRS), University Louis-Pasteur, Strasbourg (France)], E-mail: pradier@in2p3.fr

    2009-04-11

    Sources of gravitational waves (GW) and emitters of high energy neutrinos (HE {nu}) both involve compact objects and matter moving at relativistic speeds. GW emission requires a departure from spherical symmetry, which is the case if clumps of matter are accreted around black holes or neutron stars, and ejected in relativistic jets, where neutrinos are believed to be produced. Both messengers interact weakly with the surrounding matter, hence point directly to the heart of the engines that power these emissions. Coincidences between GW interferometers (e.g. VIRGO) and HE {nu} telescopes (e.g. ANTARES) would then give a unique insight on the physics of the most powerful objects in the Universe. The possibility, observability and detectability for such GW/HE {nu} coincidences are analysed.

  1. Performance of an active well coincidence counter for HEU samples

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, Francesca, E-mail: fra.ferrari@gmail.co [European Commission, Joint Research Centre, Institute for the Protection and the Security of the Citizen (IPSC), 21020 Ispra (Italy); Peerani, Paolo, E-mail: paolo.peerani@jrc.i [European Commission, Joint Research Centre, Institute for the Protection and the Security of the Citizen (IPSC), 21020 Ispra (Italy)

    2010-10-15

    Neutron coincidence counting is the reference NDA technique used in nuclear safeguards to measure the mass of nuclear material in samples. For high-enriched uranium (HEU) samples active neutron interrogation is generally performed and the most common device used by nuclear inspectors is the Active Well Coincidence Counter (AWCC). Within her master thesis at the Polytechnic of Milan, the first author performed an intensive study on the characteristics and performances of the AWCC in order to assess the {sup 235}U mass in HEU oxide samples at the PERLA laboratory of JRC. The work has been summarised in this paper that starts with the optimisation of the use of AWCC for nuclear safeguards, describing the calibration procedure, reporting results of a series of verification measurements, summarising the performances that can be obtained with this instruments during inspections at fuel production plants and concluding with the discussion of uncertainties related to these measurements.

  2. Spatial coincidence modulates interaction between visual and somatosensory evoked potentials.

    Science.gov (United States)

    Schürmann, Martin; Kolev, Vasil; Menzel, Kristina; Yordanova, Juliana

    2002-05-07

    The time course of interaction between concurrently applied visual and somatosensory stimulation with respect to evoked potentials (EPs) was studied. Visual stimuli, either in the left or right hemifield, and electric stimuli to the left wrist were delivered either alone or simultaneously. Visual and somatosensory EPs were summed and compared to bimodal EPs (BiEP, response to actual combination of both modalities). Temporal coincidence of stimuli lead to sub-additive or over-additive amplitudes in BiEPs in several time windows between 75 and 275 ms. Additional effects of spatial coincidence (left wrist with left hemifield) were found between 75 and 300 ms and beyond 450 ms. These interaction effects hint at a temporo-spatial pattern of multiple brain areas participating in the process of multimodal integration.

  3. Subthreshold production of pions in coincidence with light particles

    Energy Technology Data Exchange (ETDEWEB)

    Barbera, R.; Badala, A.; Adorno, A.; Bonasera, A.; Di Toro, M.; Palmeri, A.; Pappalardo, G.S.; Riggi, F.; Russo, G. (Istituto Nazionale di Fisica Nucleare, Catania (Italy)); Bizard, G.; Durand, D.; Laville, J.L. (Caen Univ., 14 (France). Lab. de Physique Corpusculaire); Jin, G.M. (Grand Accelerateur National d' Ions Lourds (GANIL), 14 - Caen (France)); Rosato, E. (Naples Univ. (Italy). Dipt. di Scienze Fisiche Istituto Nazionale di Fisica Nucleare, Naples (Italy))

    1990-12-03

    He ions have been detected in coincidence with charged pions in the reaction {sup 16}O on {sup 27}Al at E{sub lab}=94 MeV/u. We analyse velocity spectra and cross-sections of He ions emitted in the angular range 4deg/150deg in coincidence with charged pions detected at 90deg. A two source emission mechanism of the helium particles and a pion statistical production from an equilibrated participant zone is stressed. The absolute yields at different angles are compared with results of a theoretical model for medium energy heavy ion reactions in the frame of a participant-spectator picture. A comparison of the pion energy spectra with Boltzmann-Nordheim-Vlasov calculations and a discussion on the time scale for pion emission is also presented. (orig.).

  4. 脑膜炎并脑积水临床特点及治疗措施分析%Analysis of clinical characteristics and treatment measures of meningitis complicating with hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    贺晓琴

    2015-01-01

    目的 探讨脑膜炎并脑积水临床特点及治疗措施,为疾病的诊断、治疗及预防提供可靠的参考依据.方法 选取我院2012年1月至2013年1月收治的60例脑膜炎并脑积水患者,通过随机数字表法将其分为对照组和观察组各30例,对照组患者给予甘露醇治疗,观察组患者在此基础上给予甘油果糖治疗,分析脑膜炎并脑积水的临床特点,并探讨两组患者临床治疗效果.结果 观察组患者临床治疗总有效率为93.33%,与对照组治疗总有效率60.00%相比差异有统计学意义(x2=31.0481,P=0.0000).结论 脑积水是脑膜炎常见并发症,临床检查结果可以为临床治疗提供科学有效的治疗方案,应用甘露醇联合甘油果糖治疗脑膜炎并脑积水疗效显著,可明显改善临床症状,减轻患者痛苦,降低死亡率,同时临床应完善治疗脑膜炎并脑积水的方式,积极采取科学合理的治疗措施,最大程度降低疾病的危害,提高患者生活质量.%Objective To explore the clinical characteristics and treatment measures of meningitis complicating with hydrocephalus, and provide reliable reference for the diagnosis, treatment and prevention of the disease.Methods 60 cases of meningitis complicating with hydrocephalus in our hospital from January 2012 to January 2013 were randomly divided into control group (n=30) and observation group (n=30).Control group was treated with mannitol, and observation group was treated with glycerin fructose on the basis of control group.Analyzed the clinical characteristics of meningitis complicating with hydrocephalus and clinical therapeutic effect of two groups.Result The total effective rate in observation group was higher than that in control group (93.33% vs.60.00%;x 2=31.0481, P=0.0000).Conclusions Hydrocephalus is a common kind of complication of meningitis.Clinical examination results can provide reference for scientific and effective clinical treatment.Application of

  5. A coincidence of addiction to "Kratom" and severe primary hypothyroidism.

    Science.gov (United States)

    Sheleg, Sergey V; Collins, Gregory B

    2011-12-01

    Here we present a case of a coincidence of addiction to "Kratom" (botanically known as Mitragyna speciosa Korth) and developed severe primary hypothyroidism. We are discussing a possibility that high dose of indole alkaloid mitragynine (the major alkaloid identified from "Kratom") might reduce the normal response of the thyroid gland to thyroid-stimulating hormone resulting in primary hypothyroidism. Further experimental investigations of mitragynine as a possible suppressor of thyroid gland function would be a matter of interest.

  6. Coincidence of cerebrovascular accident and silent myocardial infarction.

    Science.gov (United States)

    Badui, E; Estañol, B; Garcia-Rubi, D

    1982-11-01

    Although it is well known that a myocardial and a cerebral infarction may be coincident, the nature of this association is not clear. The problem is further complicated because the myocardial infarction may be silent. This is a report of 3 patients with cerebral infarct in whom a silent recent myocardial infarction was found. All patients with cerebrovascular disease should be screened for a possible myocardial lesion.

  7. A catalogue of ULX coincidences with FIRST radio sources

    CERN Document Server

    Sanchez-Sutil, J R; Martí, J; Garrido, J L; Pérez-Ramírez, D; Luque-Escamilla, P

    2006-01-01

    We search for ultra luminous X-ray source (ULXs) radio counterparts located in nearby galaxies in order to constrain their physical nature. Our work is based on a systematic cross-identification of the most recent and extensive available ULX catalogues and archival radio data. A catalogue of 70 positional coincidences is reported. Most of them are located within the galaxy nucleus. Among them, we find 11 new cases of non-nuclear ULX sources with possibly associated radio emission.

  8. Non-minimal quintessence: Dynamics and coincidence problem

    Indian Academy of Sciences (India)

    Fatimah Shojai; Ali Shojai

    2011-12-01

    Brans–Dicke scalar–tensor theory provides a conformal coupling of the scalar field with gravity in Einstein’s frame. This model is equivalent to an interacting quintessence in which dark matter is coupled to dark energy. This provides a natural mechanism to alleviate the coincidence problem. We investigate the dynamics of this model and show that it leads to comparable dark energy and dark matter densities today.

  9. Coincidence Theorems for Certain Classes of Hybrid Contractions

    Directory of Open Access Journals (Sweden)

    Singh SL

    2010-01-01

    Full Text Available Coincidence and fixed point theorems for a new class of hybrid contractions consisting of a pair of single-valued and multivalued maps on an arbitrary nonempty set with values in a metric space are proved. In addition, the existence of a common solution for certain class of functional equations arising in dynamic programming, under much weaker conditions are discussed. The results obtained here in generalize many well known results.

  10. Caristi Type Coincidence Point Theorem in Topological Spaces

    Directory of Open Access Journals (Sweden)

    Jiang Zhu

    2013-01-01

    Full Text Available A generalized Caristi type coincidence point theorem and its equivalences in the setting of topological spaces by using a kind of nonmetric type function are obtained. These results are used to establish variational principle and its equivalences in d-complete spaces, bornological vector space, seven kinds of completed quasi-semimetric spaces equipped with Q-functions, uniform spaces with q-distance, generating spaces of quasimetric family, and fuzzy metric spaces.

  11. Analysis of the influential factors and therapeutic methods for hydrocephalus after surgery for myelomeningocele in infants%婴幼儿脊髓脊膜膨出术后并发脑积水的影响因素及治疗方法分析

    Institute of Scientific and Technical Information of China (English)

    萧凯; 孙振兴; 修波; 崔志强; 段宏宇; 周荣凇

    2012-01-01

    Objective To investigate the influential factors and therapeutic methods for hydrocephalus after surgery for myelomeningocele in infants. Methods Clinical data of 182 infants who received microsurgery for myelomeningocele were analyzed retrospectively. The patients were divided into control group and hydrocephalus group according to whether the patients developed postoperative hydrocephalus, and the influential factors for complicated hydrocephalus were analyzed by multivariate logistic regression. Firstly, dehydration was performed in patients in hydrocephalus group. Then, the procedures such as external ventricular drainage (EVD), endoscopic third ventriculostomy (ETV) and ventriculoperitoneal (V-P) shunt were choose based on the patient's condition. Results The postoperative hydrocephalus occurred in 26 patients. Multivariable logistic regression analysis showed that the factors resulting in postoperative hydrocephalus included myelomeningocele in the cervicothoracic segment, postoperative infection or cerebrospinal fluid leakage, larger circumference and higher intracranial pressure at preoperation. The treatment in hydrocephalus group included single dehydration in 2 cases, dehydration plus EVD in 3, dehydration + EVD + ETV in 3, dehydration + EVD + V-P shunt in 16, dehydration + EVD + ETV + V-P shunt in 2. Twenty-three patients were cured and 3 died. Conclusions Hydrocephalus after surgery for myelomeningocele should be treated by comprehensive treatment according to etiology, which can get good effects.%目的 探讨婴幼儿脊髓脊膜膨出修补术后合并脑积水的影响因素及治疗方法.方法 回顾性分析182例显微外科手术治疗脊髓脊膜膨出病儿的临床资料.根据术后是否并发脑积水分为脑积水组和对照组,多变量Logistic回归分析术后并发脑积水的影响因素;对脑积水组均先采取内科脱水治疗,再根据病情选择脑室外引流术(引流术)、第三脑室底造瘘术(造瘘术)和脑

  12. 低颅内压脑积水的诊断及治疗%Diagnosis and treatment of low pressure hydrocephalus (report of 7 cases)

    Institute of Scientific and Technical Information of China (English)

    周孟; 陈治标; 潘颖; 王军民; 张申起; 毛立武

    2012-01-01

    目的 探讨低颅内压脑积水(LPH)的临床特征、发病机制和诊治方法.方法 2007年1月至2011年10月收治LPH患者7例,均采用可调压分流管行脑室-腹腔分流术(VPS)治疗,其中1例内引流前行脑室外引流术采取负压引流确诊,余6例均为正常压力脑积水内引流后随访中根据症状反复调压后确诊.结果 本组7例VPS后随访3~33个月,除1例高龄患者(73岁)术后1年有轻度头昏、反应迟钝、智力下降外,余6例症状明显缓解,扩大脑室显著回缩.结论 LPH临床少见,发病隐蔽,临床表现与正常颅压脑积水相类似;头部CT及MRI可表现为脑室扩大,部分甚至室周明显水肿;可调压管行VPS是治疗LPH的有效方法.%Objective To explore the clinical symptoms, pathogenesis, diagnosis and treatment of low intracranial pressure hydrocephalus (LPH). Methods The ventriculo-peritoneal shunt (VPS) with pressure- adjustable valves was performed in 7 patients with hydrocephalus. The diagnosis of LPH in 1 patient was definitely made by the suction extraventricular drainage before VPS. LPH developed during the following-up during which the patients' symptoms were not improved untile the drainage under the negative pressure in 6 patients with normal pressure hydrocephalus. Results The following-up from 3 to 33 months after VPS showed that the clinical symptoms were improved and the enlarged ventricles significantly retracted in 6 patients, and the action was slow and intelligence declined possibly due to encephalatrophy 1 year after VPS in 1 patient aged 73 years. Conclusions LPH is uncommon and occultly comes on. LPH is similar to normal pressure hydrocephalus in the clinical manifestation. CT and MRI show that there are ventriculomegaly in all the patients with LPH and periventricular edema in some patients with LPH. VPS with pressure-adjustable valve is an effective method to treat LPH. The perfect threshold value of pressure adjustable valves, which is suitable for

  13. Immunocytochemical study of the subcommissural organ of rats with induced postnatal hydrocephalus.

    Science.gov (United States)

    Irigoin, C; Rodríguez, E M; Heinrichs, M; Frese, K; Herzog, S; Oksche, A; Rott, R

    1990-01-01

    The subcommissural organ (SCO)-Reissner's fiber (RF) complex of rats suffering from postnatal hydrocephalus was investigated immunocytochemically (peroxidase-antiperoxidase technique) by use of an anti-serum against bovine RF. Hydrocephalus was induced by injecting kaolin into the cisterna magna or by intracerebral infection with Borna disease virus. The kaolin-injected, hydrocephalic male rats were divided into two groups: (1) possessing an open communication between the fourth ventricle and the central canal of the spinal cord; (2) enduring an obliteration of this communication. In the latter group of rats the dilation of the ventricular cavities was far greater than in the former group. The Borna disease virus-infected female rats developed a severe hydrocephalus although in these animals all ventricular cavities and the central canal were in fully open communication. All rats belonging to the above-mentioned three groups displayed essentially the same alterations of their SCO-RF complex: (i) A reduction in the size of SCO and in the height of the ependymal secretory cells. (ii) A progressive disappearance of the immunoreactive hypendymal cells. (iii) The amount of AFRU-immunoreactive secretory material located in the rough endoplasmic reticulum was reduced. (iv) In contrast, the amount, location and immunoreactivity of the apical secretory granules did not undergo variations in comparison to sham-operated rats. (v) In the area of the SCO the layer of pre-RF material was thin or missing and a RF was not formed, and thus the central canal was also free of such secretory products. (vi) Clusters of AFRU-immunoreactive material were found attached to the wall of the Sylvian aqueduct.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

    Science.gov (United States)

    Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

    2016-04-01

    OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure.

  15. Acute triventricular hydrocephalus caused by choroid plexus cysts: a diagnostic and neurosurgical challenge.

    Science.gov (United States)

    Spennato, Pietro; Chiaramonte, Carmela; Cicala, Domenico; Donofrio, Vittoria; Barbarisi, Manlio; Nastro, Anna; Mirone, Giuseppe; Trischitta, Vincenzo; Cinalli, Giuseppe

    2016-11-01

    OBJECTIVE Intraventricular choroid plexus cysts are unusual causes of acute hydrocephalus in children. Radiological diagnosis of intraventricular choroid plexus cysts is difficult because they have very thin walls and fluid contents similar to CSF and can go undetected on routine CT studies. METHODS This study reports the authors' experience with 5 patients affected by intraventricular cysts originating from the choroid plexus. All patients experienced acute presentation with rapid neurological deterioration, sometimes associated with hypothalamic dysfunction, and required urgent surgery. In 2 cases the symptoms were intermittent, with spontaneous remission and sudden clinical deteriorations, reflecting an intermittent obstruction of the CSF pathway. RESULTS Radiological diagnosis was difficult in these cases because a nonenhanced CT scan revealed only triventricular hydrocephalus, with slight lateral ventricle asymmetry in all cases. MRI with driven-equilibrium sequences and CT ventriculography (in 1 case) allowed the authors to accurately diagnose the intraventricular cysts that typically occupied the posterior part of the third ventricle, occluding the aqueduct and at least 1 foramen of Monro. The patients were managed by urgent implantation of an external ventricular drain in 1 case (followed by endoscopic surgery, after completing a diagnostic workup) and by urgent endoscopic surgery in 4 cases. Endoscopic surgery allowed the shrinkage and near-complete removal of the cysts in all cases. Use of neuronavigation and a laser were indispensable. All procedures were uneventful, resulting in restoration of normal neurological conditions. Long-term follow-up (> 2 years) was available for 2 patients, and no complications or recurrences occurred. CONCLUSIONS This case series emphasizes the necessity of an accurate and precise identification of the possible causes of triventricular hydrocephalus. Endoscopic surgery can be considered the ideal treatment of choroid plexus

  16. Cerebrospinal fluid absorption disorder of arachnoid villi in a canine model of hydrocephalus

    Directory of Open Access Journals (Sweden)

    Zhao Ke

    2010-01-01

    Full Text Available Background: Hydrocephalus results from inadequate passage of cerebrospinal fluid (CSF from its point of production within the cerebral ventricles to its point of absorption into systemic circulation. Aims: The objective of this study was to investigate the disorders of CSF absorption by arachnoid villi during the different phases of hydrocephalus. Materials and Methods: Silicone oil was injected into the fourth ventricle of 15 canines as an experimental group. Saline solution (0.9% NaCl was injected in another nine canines as a control group. In order to block CSF transport through the cribriform plate, an external ethmoidectomy was performed in five dogs from experimental group and three dogs from control group at three days (acute stage, two weeks (sub-acute stage, and 12 weeks (chronic stage respectively. Tritiated water was injected into the canines′ cortical subarachnoid space and blood levels were measured at intervals of 1h, 4h, 8h, 16h and 48h respectively. Time-concentration curve of tritiated water was drafted. The area under the curve (AUC was calculated for variance analysis and t-testing. Results: In the chronic group, the tritiated water concentration rose slowly to a peak at 16h. It was significantly lower than other groups at 1h, 4h, 8h and 16h, but was higher than other groups at 48h. Analysis of the AUC showed significant differences among all the groups (P<0.01. There were no significant differences in the AUC between control groups, the acute group, and the sub-acute group (P>0.05; however, the AUC of the chronic group was significantly lower than other groups (P<0.05. Conclusions: The CSF absorption ability of arachnoid villi is significantly damaged in a long-term state of hydrocephalus.

  17. Posttraumatic hydrocephalus associated with decompressive cranial defect in severe brain-injured patients

    Directory of Open Access Journals (Sweden)

    SHI Song-sheng

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the occurrence of posttraumatic hydrocephalus (PTH in severe brain- injured patients who underwent decompressive craniectomy (DC and to discuss the management. Methods: A total of 389 patients suffering from severe head trauma between January 2004 and May 2010 were enrolled in this study. Clinical data were analyzed retrospectively. Of them, 149 patients who underwent DC were divided into two groups according to the presence of PTH: hydrocephalus group and nonhydrocephalus group. Clinical factors including preoperative Glasgow Coma Score (GCS, bilateral or unilateral decompression, and duraplasty in DC were assessed by single factor analysis to determine its relationship with the occurrence of PTH. Results: Of the 149 patients undergoing DC, 25 (16.8% developed PTH; while 23 developed PTH (9.6% among the rest 240 patients without DC. Preoperative GCS, bilateral or unilateral decompression, duraplasty in DC were significantly associated with the development of PTH. Ventriculoperitoneal shunt was performed on 23 of 25 patients with PTH after DC. Frontal horn was preferred for the placement of the catheter. Sixteen of them were operated upon via frontal approach and 7 via occipital approach. After shunt surgery, both radiological and clinical improvements were confirmed in 19 patients. Radiological improvement was found in 2 patients. One patient died eventually of severe pneumonia. Shunt-related infection occurred in 1 patient, which led to the removal of the catheter. Conclusions: It is demonstrated that the occurrence of PTH is high in patients with large decompressive skull defect. Patients with low GCS and bilateral decompression tend to develop PTH after DC. Duraplasty in DC might facilitate reducing the occurrence of PTH. Patients with PTH concomitant skull defect should be managed deliberately to restore the anatomical and physiological integrity so as to facilitate the neurological resuscitation. Key

  18. Clinical evaluation of radionuclide cisternography and x-ray CT in normal pressure hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Sui, Osamu; Maeda, Toshio; Matsuda, Hiroshi; Ishida, Hiroko; Michigishi, Takatoshi (Kanazawa Univ. (Japan). School of Medicine)

    1983-06-01

    The retrospective reevaluation of the radionuclide cisternogram and X-ray CT were studied in 14 cases in whom cerebrospinal fluid shunt were installed under the diagnosis of normal pressure hydrocephalus after these examinations. Only half of these cases showed clinical improvement after shunt operation. The most reliable finding of the cisternography was the persistent ventricular visualization with bilateral block at subarachnoid space on 48 hour image. These findings were observed in seven cases, and all of them but one case showed clinical improvement after shunt installation. The exceptional one case in whom shunt was not effective. The cisternogram of the other case whose shunt was effective showed the transient ventricular visualization upto 24 hour, the unilateral subarachnoidal space block upto 48 hour and the prominently delayed clearance of radionuclide from the head. The cisternographic findings of the delayed radionuclide clearance and the ventricular visualization on 24 hour-image were insufficient to help the shunt effect. The most hopeful findings of the X-ray CT was the poor-visualization of Sylvian fissure at least on two cross sections. These findings were observed in eight cases, and six out of them showed clinical improvement after shunt operation. But the poor-visualization of Sylvian fissure is not a specific sign for normal pressure hydrocephalus. We concluded that the abnormal findings on 48 hour-image of cisternography are correlated well with the effect of cerebrospinal fluid shunt in normal pressure hydrocephalus, and the cisternography is still very useful in the chosen patients with clinical and X-ray CT findings.

  19. Posttraumatic hydrocephalus associated with decompressive cranial defect in severe brain-injured patients

    Directory of Open Access Journals (Sweden)

    SHI Song-sheng

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the occurrence of posttraumatic hydrocephalus (PTH in severe brain- injured patients who underwent decompressive craniectomy (DC and to discuss the management. Methods: A total of 389 patients suffering from severe head trauma between January 2004 and May 2010 were enrolled in this study. Clinical data were analyzed retrospectively. Of them, 149 patients who underwent DC were divided into two groups according to the presence of PTH: hydrocephalus group and nonhydrocephalus group. Clinical factors including preoperative Glasgow Coma Score (GCS, bilateral or unilateral decompression, and duraplasty in DC were assessed by single factor analysis to determine its relationship with the occurrence of PTH. Results: Of the 149 patients undergoing DC, 25 (16.8% developed PTH; while 23 developed PTH (9.6% among the rest 240 patients without DC. Preoperative GCS, bilateral or unilateral decompression, duraplasty in DC were significantly associated with the development of PTH. Ventriculoperitoneal shunt was performed on 23 of 25 patients with PTH after DC. Frontal horn was preferred for the placement of the catheter. Sixteen of them were operated upon via frontal approach and 7 via occipital approach. After shunt surgery, both radiological and clinical improvements were confirmed in 19 patients. Radiological improvement was found in 2 patients. One patient died eventually of severe pneumonia. Shunt-related infection occurred in 1 patient, which led to the removal of the catheter. Conclusions: It is demonstrated that the occurrence of PTH is high in patients with large decompressive skull defect. Patients with low GCS and bilateral decompression tend to develop PTH after DC. Duraplasty in DC might facilitate reducing the occurrence of PTH. Patients with PTH concomitant skull defect should be managed deliberately to restore the anatomical and physiological integrity so as to facilitate the neurological resuscitation. Key

  20. Cerebrospinal fluid levels of amyloid precursor protein are associated with ventricular size in post-hemorrhagic hydrocephalus of prematurity.

    Directory of Open Access Journals (Sweden)

    Diego M Morales

    Full Text Available Neurological outcomes of preterm infants with post-hemorrhagic hydrocephalus (PHH remain among the worst in infancy, yet there remain few instruments to inform the treatment of PHH. We previously observed PHH-associated elevations in cerebrospinal fluid (CSF amyloid precursor protein (APP, neural cell adhesion molecule-L1 (L1CAM, neural cell adhesion molecule-1 (NCAM-1, and other protein mediators of neurodevelopment.The objective of this study was to examine the association of CSF APP, L1CAM, and NCAM-1 with ventricular size as an early step toward developing CSF markers of PHH.CSF levels of APP, L1CAM, NCAM-1, and total protein (TP were measured in 12 preterm infants undergoing PHH treatment. Ventricular size was determined using cranial ultrasounds. The relationships between CSF APP, L1CAM, and NCAM-1, occipitofrontal circumference (OFC, volume of CSF removed, and ventricular size were examined using correlation and regression analyses.CSF levels of APP, L1CAM, and NCAM-1 but not TP paralleled treatment-related changes in ventricular size. CSF APP demonstrated the strongest association with ventricular size, estimated by frontal-occipital horn ratio (FOR (Pearson R = 0.76, p = 0.004, followed by NCAM-1 (R = 0.66, p = 0.02 and L1CAM (R = 0.57,p = 0.055. TP was not correlated with FOR (R = 0.02, p = 0.95.Herein, we report the novel observation that CSF APP shows a robust association with ventricular size in preterm infants treated for PHH. The results from this study suggest that CSF APP and related proteins at once hold promise as biomarkers of PHH and provide insight into the neurological consequences of PHH in the preterm infant.

  1. Neurosyphilis With Normal Pressure Hydrocephalus and Dementia Paralytica: Serial Clinical, Laboratory and Radiological Correlations in the 21st Century

    Science.gov (United States)

    Abdool, Kamille; Seegobin, Karan; Ramcharan, Kanterpersad; Alexander, Adrian; Julien-Legen, Leandra; Giddings, Stanley Lawrence; Aboh, Samuel; Rampersad, Fidel

    2016-01-01

    We report a case of a 46-year-old man presenting with a progressive cognitive decline, ataxic gait, urinary incontinence for 4 months and neuroimaging consistent with normal pressure hydrocephalus. The atypical presentation of a progressively worsening dysphasia and a right hemiparesis dismissed as a vascular event 1 month earlier associated with normal pressure hydrocephalus prompted further investigations confirming neurosyphilis also manifesting as dementia paralytica. Treatment using consensus guidelines led to resumption of activities of daily living. Neurosyphilis, considered rare in the neuroimaging era, must still be considered a reversible cause of dementia and other neurological manifestations in contemporary neurological practice. PMID:27761229

  2. Lumbar subcutaneous shunt: a novel technique for therapeutic decision making in normal pressure hydrocephalus (NPH) and benign intracranial hypertension (BIH).

    Science.gov (United States)

    Ushewokunze, S; Haja Mydin, H N; Prasad, R; Mendelow, A D

    2008-10-01

    Selecting patients who will benefit from a permanent CSF diversion procedure in benign intracranial hypertension (BIH) or communicating hydrocephalus due to normal pressure hydrocephalus (NPH) has inherent problems. The percutaneous introduction of a lumbar subcutaneous shunt (LSS) under local anaesthesia facilitates both a prolonged CSF drainage under aseptic conditions and also elicits an adequate clinical response. We describe the technique of a lumbar subcutaneous shunt and our experience with its use in patients with BIH and NPH. Postprocedure changes in the patients' clinical status were noted. Patients with a transient clinical improvement underwent a subsequent definitive CSF diversion; those with a sustained clinical improvement or no change in symptoms had no further procedure.

  3. Reappraisal of the intracranial pressure and cerebrospinal fluid dynamics in patients with the so-called "normal pressure hydrocephalus" syndrome.

    Science.gov (United States)

    Sahuquillo, J; Rubio, E; Codina, A; Molins, A; Guitart, J M; Poca, M A; Chasampi, A

    1991-01-01

    Fifty-four shunt-responsive patients were selected from a prospective protocol directed to study patients with suspected normal pressure hydrocephalus (NPH). Patients with gait disturbances, dementia, non-responsive L-Dopa Parkinsonism, urinary or faecal incontinence and an Evans ratio greater or equal to 0.30 on the CT scan were included in the study. As a part of their work-up all patients underwent intracranial pressure monitoring and hydrodynamic studies using Marmarou's bolus test. According to mean intracranial pressure (ICP) and the percentage of high amplitude B-waves, patients were subdivided in the following categories: 1) Active hydrocephalus (mean ICP above 15 mmHg), which is in fact no tone normal pressure hydrocephalus; 2) Compensated unstable hydrocephalus, when mean ICP was below 15 mmHg and B-waves were present in more than 25% of the total recording time and 3) Compensated stable hydrocephalus when ICP was lower or equal to 15 mmHg and beta waves were present in less than 25% of the total recording time. The majority of the patients in this study (70%) presented continuous high or intermittently raised ICP (active or unstable compensated hydrocephalus group). Mean resistance to outflow of CSF (Rout) was 38.8 mm Hg/ml/min in active hydrocephalus and 23.5 mm Hg/ml/min in the compensated group (Students t-test, p less than 0.05). Higher resistance to outflow was found in patients with obliterated cortical sulci and obliterated Sylvian cisterns in the CT scan. No statistically significant correlation was found when plotting the percentage of beta waves against pressure volume index (PVI), compliance or Rout. An exponential correlation was found when plotting beta waves against the sum of conductance to outflow and compliance calculated by PVI method (r = 0.79). Patients with the so-called normal pressure hydrocephalus syndrome have different ICP and CSF dynamic profiles. Additional studies taking into consideration these differences are necessary

  4. A unifying hypothesis for hydrocephalus, Chiari malformation, syringomyelia, anencephaly and spina bifida

    Directory of Open Access Journals (Sweden)

    Williams Helen

    2008-04-01

    Full Text Available Abstract This work is a modified version of the Casey Holter Memorial prize essay presented to the Society for Research into Hydrocephalus and Spina Bifida, June 29th 2007, Heidelberg, Germany. It describes the origin and consequences of the Chiari malformation, and proposes that hydrocephalus is caused by inadequate central nervous system (CNS venous drainage. A new hypothesis regarding the pathogenesis, anencephaly and spina bifida is described. Any volume increase in the central nervous system can increase venous pressure. This occurs because veins are compressible and a CNS volume increase may result in reduced venous blood flow. This has the potential to cause progressive increase in cerebrospinal fluid (CSF volume. Venous insufficiency may be caused by any disease that reduces space for venous volume. The flow of CSF has a beneficial effect on venous drainage. In health it moderates central nervous system pressure by moving between the head and spine. Conversely, obstruction to CSF flow causes localised pressure increases, which have an adverse effect on venous drainage. The Chiari malformation is associated with hindbrain herniation, which may be caused by low spinal pressure relative to cranial pressure. In these instances, there are hindbrain-related symptoms caused by cerebellar and brainstem compression. When spinal injury occurs as a result of a Chiari malformation, the primary pathology is posterior fossa hypoplasia, resulting in raised spinal pressure. The small posterior fossa prevents the flow of CSF from the spine to the head as blood enters the central nervous system during movement. Consequently, intermittent increases in spinal pressure caused by movement, result in injury to the spinal cord. It is proposed that posterior fossa hypoplasia, which has origins in fetal life, causes syringomyelia after birth and leads to damage to the spinal cord in spina bifida. It is proposed that hydrocephalus may occur as a result of

  5. A unifying hypothesis for hydrocephalus, Chiari malformation, syringomyelia, anencephaly and spina bifida.

    Science.gov (United States)

    Williams, Helen

    2008-04-11

    This work is a modified version of the Casey Holter Memorial prize essay presented to the Society for Research into Hydrocephalus and Spina Bifida, June 29th 2007, Heidelberg, Germany. It describes the origin and consequences of the Chiari malformation, and proposes that hydrocephalus is caused by inadequate central nervous system (CNS) venous drainage. A new hypothesis regarding the pathogenesis, anencephaly and spina bifida is described.Any volume increase in the central nervous system can increase venous pressure. This occurs because veins are compressible and a CNS volume increase may result in reduced venous blood flow. This has the potential to cause progressive increase in cerebrospinal fluid (CSF) volume. Venous insufficiency may be caused by any disease that reduces space for venous volume. The flow of CSF has a beneficial effect on venous drainage. In health it moderates central nervous system pressure by moving between the head and spine. Conversely, obstruction to CSF flow causes localised pressure increases, which have an adverse effect on venous drainage.The Chiari malformation is associated with hindbrain herniation, which may be caused by low spinal pressure relative to cranial pressure. In these instances, there are hindbrain-related symptoms caused by cerebellar and brainstem compression. When spinal injury occurs as a result of a Chiari malformation, the primary pathology is posterior fossa hypoplasia, resulting in raised spinal pressure. The small posterior fossa prevents the flow of CSF from the spine to the head as blood enters the central nervous system during movement. Consequently, intermittent increases in spinal pressure caused by movement, result in injury to the spinal cord. It is proposed that posterior fossa hypoplasia, which has origins in fetal life, causes syringomyelia after birth and leads to damage to the spinal cord in spina bifida. It is proposed that hydrocephalus may occur as a result of posterior fossa hypoplasia, where

  6. The triad of idiopathic normal-pressure hydrocephalus: a clinical practice case report

    Directory of Open Access Journals (Sweden)

    Gross K

    2008-01-01

    Full Text Available An 89-year-old white male presented with memory impairment, slowness in responsiveness, andfrequent falls over a two-year duration. Six months earlier, the patient was believed to have had a"dementia with parkinsonian features," but showed no response to incrementing doses of bothdonepezil and carbidopa-levodopa. Urinary urgency was believed to have been due to prostatehypertrophy. A head CT with contrast revealed moderate ventriculomegaly in the setting of milddiffuse cortical atrophy. A diagnosis of idiopathic normal-pressure hydrocephalus (INPH was made.

  7. Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

    DEFF Research Database (Denmark)

    Watt, Sara; Agerlin, Niels; Romner, Bertil

    2012-01-01

    A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide...... a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS), the "virtual off" setting and compatibility with magnetic...

  8. Atherosclerotic Aneurysm of the Basilar Artery and Hydrocephalus. A Case Report

    Directory of Open Access Journals (Sweden)

    Ania Alvarado Borges

    2014-08-01

    Full Text Available Intracranial aneurysms are fairly common. Many of them produce no symptoms, often remaining undiagnosed during life. At autopsy, aneurysms of the basilar artery appear in 2 to 5% of the cases; among them, saccular and congenital aneurysms are more common than atherosclerotic and fusiform aneurysms. A case of atherosclerotic aneurysm of the basilar artery diagnosed at autopsy in an 88-year-old man is presented. This patient had been admitted with a diagnosis of ischemic stroke, intracranial hypertension and hydrocephalus, which led physicians to consider a posterior fossa tumor. This paper aims at presenting the autopsy findings that showed the presence of an atherosclerotic aneurysm of the basilar artery.

  9. Computed tomography and pneumoencephalography compared to conductance to outflow of CSF in normal pressure hydrocephalus

    Energy Technology Data Exchange (ETDEWEB)

    Borgesen, S.E.; Gyldensted, C.; Gjerris, F.; Lester, J.

    1980-08-01

    The conductance to outflow of CSF (Csub(out)) was measured in 66 patients with normal pressure hydrocephalus (NPH). All patients were investigated with computed tomography (CT); 34 of the patients also had pneumoencephalography (PEG). Periventricular hypodensity on CT indicates a low Csub(out). Cortical sulci smaller than 1.9 mm on CT indicate a low Csub(out), while wide cortical sulci do not exclude a low Csub(out). There was a good correlation between ventricular size on CT and PEG, but the ventricular size is unrelated to Csub(out). No findings on PEG indicate a low Csub(out).

  10. Computed tomography and pneumoencephalography compared to conductance to outflow of CSF in normal pressure hydrocephalus.

    Science.gov (United States)

    Børgesen, S E; Gyldensted, C; Gjerris, F; Lester, J

    1980-08-01

    The conductance to outflow of CSF (Cout) was measured in 66 patients with normal pressure hydrocephalus (NPH). All patients were investigated with computed tomography (CT); 34 of the patients also had pneumoencephalography (PEG). Periventricular hypodensity on CT indicates a low Cout. Cortical sulci smaller than 1.9 mm on CT indicate a low Cout, while wide cortical sulci do not exclude a low Cout. There was a good correlation between ventricular size on CT and PEG, but the ventricular size is unrelated to Cout. No findings on PEG indicate a low Cout.

  11. Endoscopic third ventriculostomy in children: prospective, multicenter results from the Hydrocephalus Clinical Research Network.

    Science.gov (United States)

    Kulkarni, Abhaya V; Riva-Cambrin, Jay; Holubkov, Richard; Browd, Samuel R; Cochrane, D Douglas; Drake, James M; Limbrick, David D; Rozzelle, Curtis J; Simon, Tamara D; Tamber, Mandeep S; Wellons, John C; Whitehead, William E; Kestle, John R W

    2016-10-01

    OBJECTIVE Endoscopic third ventriculostomy (ETV) is now established as a viable treatment option for a subgroup of children with hydrocephalus. Here, the authors report prospective, multicenter results from the Hydrocephalus Clinical Research Network (HCRN) to provide the most accurate determination of morbidity, complication incidence, and efficacy of ETV in children and to determine if intraoperative predictors of ETV success add substantially to preoperative predictors. METHODS All children undergoing a first ETV (without choroid plexus cauterization) at 1 of 7 HCRN centers up to June 2013 were included in the study and followed up for a minimum of 18 months. Data, including detailed intraoperative data, were prospectively collected as part of the HCRN's Core Data Project and included details of patient characteristics, ETV failure (need for repeat hydrocephalus surgery), and, in a subset of patients, postoperative complications up to the time of discharge. RESULTS Three hundred thirty-six eligible children underwent initial ETV, 18.8% of whom had undergone shunt placement prior to the ETV. The median age at ETV was 6.9 years (IQR 1.7-12.6), with 15.2% of the study cohort younger than 12 months of age. The most common etiologies were aqueductal stenosis (24.8%) and midbrain or tectal lesions (21.2%). Visible forniceal injury (16.6%) was more common than previously reported, whereas severe bleeding (1.8%), thalamic contusion (1.8%), venous injury (1.5%), hypothalamic contusion (1.5%), and major arterial injury (0.3%) were rare. The most common postoperative complications were CSF leak (4.4%), hyponatremia (3.9%), and pseudomeningocele (3.9%). New neurological deficit occurred in 1.5% cases, with 0.5% being permanent. One hundred forty-one patients had documented failure of their ETV requiring repeat hydrocephalus surgery during follow-up, 117 of them during the first 6 months postprocedure. Kaplan-Meier rates of 30-day, 90-day, 6-month, 1-year, and 2-year failure

  12. Fibrinolytic agents in the management of posthemorrhagic hydrocephalus in preterm infants: the evidence.

    Science.gov (United States)

    Haines, S J; Lapointe, M

    1999-05-01

    The objective of this study was to review current literature on the management of posthemorrhagic hydrocephalus in preterm infants with intraventricular administration of fibrinolytic agents; to this end a literature search was carried out electronically. The keywords used were "intraventricular hemorrhage" or "posthemorrhagic hydrocephalus" in combination with "fibrinolytic agent," "urokinase," "streptokinase," or "recombinant tissue plasminogen activator" and "intraventricular administration"; the search covered the years 1966-1998 and was restricted to English language papers and human subjects. It was supplemented by a search through the reference lists of the articles identified. Articles dealing with intracerebral hemorrhage or hematoma, intraventricular hemorrhage in adults, nontherapeutic issues and laboratory research were excluded. The articles included are summarized in evidence and evaluation tables. Five scientific publications evaluating the use of a fibrinolytic agent to manage posthemorrhagic hydrocephalus were retrieved. In the studies described in these reports, a total of 62 neonates received streptokinase, urokinase or r-tPA intraventricularly. No two of the regimens were identical in the drug used, method of administration and duration of therapy. The time before therapy was started ranged from 2 to 35 days after the ictus. Among the case series reported, three were small series with a total of 38 neonates. One other case series of 18 neonates compared the treatment group with an historical control group. All case series showed that endoventricular fibrinolytic therapy was practical. The proportion of cases in which shunt placement was performed ranged from 11% to 100%. Only one small prospective, randomized, controlled study was identified. That study was too small to allow useful conclusions. Overall, 3 cases of secondary intraventricular hemorrhage were reported. However, it was not possible to determine with certainty whether these episodes

  13. Study on the Automatic Detection Method and System of Multifunctional Hydrocephalus Shunt

    Science.gov (United States)

    Sun, Xuan; Wang, Guangzhen; Dong, Quancheng; Li, Yuzhong

    2017-07-01

    Aiming to the difficulty of micro pressure detection and the difficulty of micro flow control in the testing process of hydrocephalus shunt, the principle of the shunt performance detection was analyzed.In this study, the author analyzed the principle of several items of shunt performance detection,and used advanced micro pressure sensor and micro flow peristaltic pump to overcome the micro pressure detection and micro flow control technology.At the same time,This study also puted many common experimental projects integrated, and successfully developed the automatic detection system for a shunt performance detection function, to achieve a test with high precision, high efficiency and automation.

  14. CT changes in children with drained hydrocephalus and intermittently raised intracranial pressure

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, H.; Korinthenberg, R.; Erlemann, R.; Lengerke, H.J. von

    1987-10-01

    Seven children with drained hydrocephalus are described who showed increasingly severe and frequent episodes of intermittently raised intracranial pressure. CT examinations during symptom-free intervals, or after conservative treatment, showed collapsed slit-like ventricles. Examination during attacks of raised pressure showed relative dilatation of the ventricles as compared with earlier examinations. Children with ventricular shunts of long duration may develop a shunt-dependent syndrome; CT may show normal or narrow ventricles and this does not exclude the possibility of a rise of intracranial pressure. These findings may help in making the diagnosis by means of CT without any further invasive procedure.

  15. Treating Infertility

    Science.gov (United States)

    ... Education & Events Advocacy For Patients About ACOG Treating Infertility Home For Patients Search FAQs Treating Infertility Page ... Treating Infertility FAQ137, March 2015 PDF Format Treating Infertility Gynecologic Problems What is infertility? What treatment options ...

  16. Posterion fossa decompression for Chiari I malformation with hydrocephalus:a meta-analysis%后颅窝减压术治疗Chiari畸形Ⅰ型合并脑积水疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    张家康; 彭飞; 陈鑫; 侯旭; 张大明; 刘震东; 赵世光

    2016-01-01

    Objective To evaluate the effect of posterior fossa decompression (PFD) on ChiariⅠmalformation associated with hydrocephalus. Methods The data which accorded with the demands of the present study were individually extracted the Chinese and English literature obtained by searching electronic database including EBSCO, PUBMED, EMBASE, CNKI, VIP, Wanfang and OVID from the day when the library was built to 31 May 2015. All the statistical analyses were performed by the STATA software version 13. Results The rate of improvement of Chiari I malformation associated with hydrocephalus was 82.3% (95% CI 74.2%~90.4%). The female patients account for 62.9%(95%CI 52.6%~73.1%)of all the patients with Chiari I malformation associated with hydrocephalus. Conclusion The female patients account for the majority of all the patients with Chiari malformation associated with hydrocephalus, and PFD is an effective method to treat this disease.%目的:评价后颅窝减压术(PFD)治疗合并脑积水的Chiari畸形Ⅰ型的有效性。方法计算机检索EBSCO、PubMed、EmBase、OVID等英文数据库以及中国知网、维普、万方等中文数据库,检索从建库到2015年5月31日发表的文献。采用STATA 13.0软件进行Meta分析。结果共纳入3篇文献,86例,PFD治疗83例;PFD术后好转率为82.3%(95%CI 74.2%~90.4%);合并脑积水的Chiari畸形Ⅰ型中,女性占62.9%(95%CI 52.6%~73.1%)。结论合并脑积水的Chiari畸形Ⅰ型中,女性占大多数;PFD治疗合并脑积水的Chiari畸形Ⅰ型具有较高的有效率。

  17. High-level neutron coincidence counter maintenance manual

    Energy Technology Data Exchange (ETDEWEB)

    Swansen, J.; Collinsworth, P.

    1983-05-01

    High-level neutron coincidence counter operational (field) calibration and usage is well known. This manual makes explicit basic (shop) check-out, calibration, and testing of new units and is a guide for repair of failed in-service units. Operational criteria for the major electronic functions are detailed, as are adjustments and calibration procedures, and recurrent mechanical/electromechanical problems are addressed. Some system tests are included for quality assurance. Data on nonstandard large-scale integrated (circuit) components and a schematic set are also included.

  18. Ulcerative colitis six years after colon cancer: only a coincidence?

    Science.gov (United States)

    Sakellakis, Minas; Makatsoris, Thomas; Gkermpesi, Maria; Peroukidis, Stavros; Kalofonos, Haralabos

    2014-01-01

    The association between inflammatory bowel disease and colorectal cancer is well known. Ulcerative colitis is a risk factor for the development of colorectal cancer, and this risk increases with the activity and duration of bowel inflammation. Here we describe the case of a 52-year-old man who developed ulcerative colitis 6 years after the diagnosis and treatment of colon cancer. Although this could be a coincidence, there could be additional possibilities, like pre-existence of quiescent colitis, late effect of therapy, or maybe the existence of common pathogenetic factors contributing to the development of ulcerative colitis and colorectal cancer. PMID:24855393

  19. Radiative Corrections to Polarized Inelastic Scattering in Coincidence

    Energy Technology Data Exchange (ETDEWEB)

    Igor Akushevich; Andrei Afanasev; G.I. Gakh; Mykola Merenkov

    2001-09-01

    The complete analysis of the model-independent leading radiative corrections to cross-section and polarization observables in semi-inclusive deep-inelastic electron-nucleus scattering with detection of a proton and scattered electron in coincidence has been performed. The basis of the calculations consists of the Drell-Yan like representation in electrodynamics for both spin-independent and spin-dependent parts of the cross-section in terms of the electron structure functions. The applications to the polarization transfer effect from longitudinally polarized electron beam to detected proton as well as to scattering by the polarized target are considered.

  20. Coincidence corrected efficiency calibration of Compton-suppressed HPGe detectors

    Energy Technology Data Exchange (ETDEWEB)

    Aucott, Timothy [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Brand, Alexander [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); DiPrete, David [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-04-20

    The authors present a reliable method to calibrate the full-energy efficiency and the coincidence correction factors using a commonly-available mixed source gamma standard. This is accomplished by measuring the peak areas from both summing and non-summing decay schemes and simultaneously fitting both the full-energy efficiency, as well as the total efficiency, as functions of energy. By using known decay schemes, these functions can then be used to provide correction factors for other nuclides not included in the calibration standard.