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Mondragon-Soto MG, Elkaim L, Weil AG. Transient ventriculoperitoneal shunt malfunction in a pediatric patient: An illustrative case. Surg Neurol Int 2022; 13:6. [PMID: 35127206 PMCID: PMC8813616 DOI: 10.25259/sni_636_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Ventriculoperitoneal shunt (VPS), the mainstay of the treatment for hydrocephalus, is associated with relatively high revision rates. Transient hydrocephalus due to intermittent VPS obstruction should be recognized as a cause of VPS malfunction. While transient VPS dysfunction is well-recognized complication, there is a relative paucity of well-documented cases in the literature. Case Description: We present the case of a 4-year-old boy with a history of vascular malformation and hydrocephalus secondary to intraventricular hemorrhage. The patient presented with transient, self-resolving hydrocephalus (without intervention), as documented by clinical and radiological findings. Conclusion: Transient hydrocephalus due to intermittent VPS dysfunction in children is a rare entity, but it should be suspected in certain patients with VPS presenting with transient or self-improving symptoms.
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Affiliation(s)
| | - Lior Elkaim
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Alexander G. Weil
- Division of Neurosurgery, Centre Hospitalier Saint-Justine, Montreal, Quebec, Canada
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Togher Z, Walsh MC, Fullam S, Cotter P, Crowley P. Now you see me, now you don't! Rapid spontaneous resolution of aqueductal obstruction. J R Coll Physicians Edinb 2021; 51:65-66. [PMID: 33877139 DOI: 10.4997/jrcpe.2021.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Zara Togher
- Neurology Department, Hospital 5, St James Hospital, James' Street, Dublin 8, Ireland,
| | | | - Sarah Fullam
- Department of Medicine, St Luke's General Hospital, Kilkenny, Ireland
| | - Paul Cotter
- Department of Medicine, St Luke's General Hospital, Kilkenny, Ireland
| | - Paul Crowley
- Department of Neurology, St Luke's General Hospital, Kilkenny, Ireland
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Govindarajulu M, Pinky PD, Steinke I, Bloemer J, Ramesh S, Kariharan T, Rella RT, Bhattacharya S, Dhanasekaran M, Suppiramaniam V, Amin RH. Gut Metabolite TMAO Induces Synaptic Plasticity Deficits by Promoting Endoplasmic Reticulum Stress. Front Mol Neurosci 2020; 13:138. [PMID: 32903435 PMCID: PMC7437142 DOI: 10.3389/fnmol.2020.00138] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/09/2020] [Indexed: 01/26/2023] Open
Abstract
Dysbiosis of gut microbiota is strongly associated with metabolic diseases including diabetes mellitus, obesity, and cardiovascular disease. Recent studies indicate that Trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite is implicated in the development of age-related cognitive decline. However, the mechanisms of the impact of TMAO on neuronal function has not been elucidated. In the current study, we investigated the relationship between TMAO and deficits in synaptic plasticity in an Alzheimer’s model (3×Tg-AD) and insulin resistance (Leptin deficient db/db) mouse by measuring plasma and brain levels of TMAO. We observed increased TMAO levels in the plasma and brain of both db/db and 3×Tg-AD mice in comparison to wild-type mice. Besides, TMAO levels further increased as mice progressed in age. Deficits in synaptic plasticity, in the form of reduced long-term potentiation (LTP), were noted in both groups of mice in comparison to wild-type mice. To further explore the impact of TMAO on neuronal function, we utilized an ex-vivo model by incubating wild-type hippocampal brain slices with TMAO and found impaired synaptic transmission. We observed that TMAO induced the PERK-EIF2α-ER stress signaling axis in TMAO treated ex-vivo slices as well as in both db/db and 3×Tg-AD mice. Lastly, we also observed altered presynaptic and reduced postsynaptic receptor expression. Our findings suggest that TMAO may induce deficits in synaptic plasticity through the ER stress-mediated PERK signaling pathway. Our results offer novel insight into the mechanism by which TMAO may induce cognitive deficits by promoting ER stress and identifies potential targets for therapeutic intervention.
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Affiliation(s)
- Manoj Govindarajulu
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Priyanka D Pinky
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Ian Steinke
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States
| | - Jenna Bloemer
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Department of Pharmaceutical and Biomedical Sciences, Touro College of Pharmacy, New York, NY, United States
| | - Sindhu Ramesh
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Thiruchelvan Kariharan
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States
| | - Robert T Rella
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States
| | - Subhrajit Bhattacharya
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Muralikrishnan Dhanasekaran
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Vishnu Suppiramaniam
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
| | - Rajesh H Amin
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, United States.,Center for Neuroscience, Auburn University, Auburn, AL, United States
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Lusis EA, Vellimana AK, Ray WZ, Chicoine MR, Jost SC. Transient Obstructive Hydrocephalus due to Intraventricular Hemorrhage: A Case Report and Review of Literature. J Clin Neurol 2013; 9:192-5. [PMID: 23894243 PMCID: PMC3722471 DOI: 10.3988/jcn.2013.9.3.192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 07/09/2012] [Accepted: 07/09/2012] [Indexed: 11/17/2022] Open
Abstract
Background Acute transient obstructive hydrocephalus is rare in adults. We describe a patient with intraventricular hemorrhage (IVH) who experienced the delayed development of acute transient hydrocephalus. Case Report A 33-year-old man with a previously diagnosed Spetzler-Martin Grade 5 arteriovenous malformation presented with severe headache, which was found to be due to IVH. Forty hours after presentation he developed significant obstructive hydrocephalus due to the thrombus migrating to the cerebral aqueduct, and a ventriculostomy placement was planned. However, shortly thereafter his headache began to improve spontaneously. Within 4 hours after onset the headache had completely resolved, and an interval head CT scan revealed resolution of hydrocephalus. Conclusions In patients with IVH, acute obstructive hydrocephalus can develop at any time after the ictus. Though a delayed presentation of acute but transient obstructive hydrocephalus is unusual, it is important to be aware of this scenario and ensure that deterioration secondary to thrombus migration and subsequent obstructive hydrocephalus do not occur.
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Affiliation(s)
- Eriks A Lusis
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
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Yaghi S, Hinduja A. Spontaneous resolution of obstructive hydrocephalus from blood in the cerebral aqueduct. Clin Pract 2011; 1:e15. [PMID: 24765269 PMCID: PMC3981214 DOI: 10.4081/cp.2011.e15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Accepted: 03/30/2011] [Indexed: 11/23/2022] Open
Abstract
Obstructive hydrocephalus is a neurological emergency that needs to be immediately identified and treated. It very rarely resolves without treatment. We report about an 86-year-old man with right frontal stroke who developed obstructive hydrocephalus caused by blood in the cerebral aqueduct. The patient had sudden and immediate clinical improvement and a repeated head computed tomography (CT) scan showing spontaneous resolution of hydrocephalus. Spontaneous resolution of obstructive hydrocephalus is possible when the cause is minimal blood in the cerebral aqueduct without any blood in the fourth ventricle.
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Affiliation(s)
- Shadi Yaghi
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Archana Hinduja
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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