Search results for "cerebrospinal fluid [Glucuronidase]"

The Quest for Predictors of Shunt-Dependent Chronic Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage: Toward a Tailored Approach for Permanent …

2021

Abnormal BAEP and internal auditory canal MRI in intracranial hypotension

2017

Intracranial hypotension (IH) is a treatable condition due to cerebrospinal fluid leak, characterised by variable clinical and MRI findings.1 Positional headache, neck stiffness, hearing changes with subdural fluid collection, enhancement of meninges, engorgement of venous structures and brain sagging are among the most frequent clinical and MRI findings. Typical abnormalities are found in 68%–85% of patients1. Hearing alterations (ranging from misperception to severe hearing loss) are known clinical symptoms of IH.1 The mechanism involves secondary perilymph depression due to patency of the cochlear aqueduct, inducing a compensatory expansion of the endolymphatic compartment, decreasing ba…

Surgical complications after endoscopic transsphenoidal pituitary surgery.

2009

Between January 2004 and June 2007 we conducted a retrospective analysis to assess post-operative complications related to endoscopic pituitary surgery in a series of 150 patients. Patients were treated with an endoscopic endonasal transsphenoidal approach to the sellar region for removal of pathological sellar and suprasellar lesions. We analysed the complications in groups according to the anatomical structures of the approach and the functional systems of the pituitary gland (anterior and posterior endocrine systems), and compared them to a large historical series using the traditional microsurgical transsphenoidal approach. Overall, we observed a decreased incidence of complications wit…

Prevention of ventricular catheter obstruction and slit ventricle syndrome by the prophylactic use of the Integra antisiphon device in shunt therapy …

2010

Object This 25-year follow-up study was performed on 120 children with hypertensive hydrocephalus to evaluate the influence of the early prophylactic implantation of the Integra antisiphon device (ASD, Integra Neurosciences Ltd.) on the rate of proximal shunt obstructions and the frequency of symptomatic slit ventricle syndrome (SVS). The adaptability of the ASD to growth, proper positioning of the ASD as a necessity for its successful performance, and the 3 phases of SVS development are discussed. Method Since 1978, the ASD has consistently been implanted either at the time of primary shunt insertion (66 neonates, mean follow-up 11 years) or during revisions of preexisting shunts (54 chil…

PROSAIKA: A prospective multicenter registry with the first programmable gravitational device for hydrocephalus shunting

2015

Abstract Objective Cerebrospinal fluid (CSF) overdrainage is a major problem in shunt therapy for hydrocephalus. The adjustable gravitational valve proSA allows for the first time a targeted compensation for overdrainage in the upright position without interfering with the differential pressure valve. To evaluate benefit, safety and reliability, the multicenter prospective registry PROSAIKA was conducted in 10 German neurosurgical centers. Methods Between March 2009 and July 2010, 120 hydrocephalic patients undergoing first time shunt implantation or shunt revision using proSA entered the study. 93 patients completed the 12 months follow-up. Results Hydrocephalus symptoms were improved in 8…

Management of cerebrospinal fluid otorrhea.

2013

Abstract Introduction Cerebrospinal fluid otorrhea results from an abnormal communication between the subarachnoid space and tympanomastoid compartment; most of them are of traumatic aetiology. They have clinical interest due to the potential risk of meningitis, directly related to the aetiology. Our aim was to show our experience in the management of this process. Methods A total of 17 patients were diagnosed and treated for cerebrospinal fluid otorrhea from 2003 to 2011. Results In our study, the highest percentage of cases was spontaneous cerebrospinal fluid otorrhea, with a wide clinical presentation. The diagnosis was based on the determination of beta-2-transferrin and radiological st…

Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts).

2005

Suprasellar arachnoid cysts represent less than 10% of all intracranial arachnoid cysts. Some of them may be quiescent throughout life, some may become symptomatic as they become enlarged and some disappear spontaneously. In this study we discuss the surgical strategies for endoscopic and endoscope-assisted treatment of suprasellar (Mickey Mouse) cysts and analyze the clinical results and experience collected over some years in our department upon doing these operations routinely. Between December 1996 and December 2003, 13 patients (7 female and 6 male patients), mean age 29 years, underwent endoscopic or endoscope-assisted procedures for suprasellar cysts at our department. The indication…

Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

1978

The development of the intracranial pressure after a subarachnoid haemorrhage was evaluated in 21 patients. A statistically significant relation between the intracranial pressure and the neurological findings was found, whereas vasospasms did not influence the intracranial pressure. In patients in a clinically critical condition, rhythmic pressure waves of a frequency of 1/minute were repeatedly observed.

Delayed chronic intracranial subdural hematoma complicating resection of a tanycytic thoracic ependymoma

2015

Background To demonstrate that the diagnosis of an intracranial subdural hematoma should be considered for patients presenting with acute or delayed symptoms of intracranial pathology following resection of a spinal tumor. Case description We present a case of a 57-year-old woman found to have a chronic subdural hematoma 1 month following resection of a thoracic extramedullary ependymoma. Evacuation of the hematoma through a burr hole relieved the presenting symptoms and signs. Resolution of the hematoma was confirmed with a computed tomography (CT) scan. Conclusion Headache and other symptoms not referable to spinal pathology should be regarded as a warning sign of an intracranial subdural…

Frame-based and frameless endoscopic procedures in the third ventricle.

1997

Stereotactic guidance is useful for planning an accurate trajectory to the third ventricle. A guiding block with a ball joint was developed for frame-based endoscopy and adaptors for arm-based and armless navigation systems. Between 1992 and 1996, 52 patients were operated on endoscopically in the third ventricle under stereotactic guidance. Thirty-eight ventriculostomies, 13 biopsies and 10 cystic lesions were performed. The coordinates of two points were calculated; one in the foramen of Monro and the second in the third ventricle. The ventriculostomy was performed under endoscopic control bluntly with a Fogarty catheter in front of the basilar artery. Twenty-seven (71%) of the patients h…