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Gilbert V, Chakir S, Peeters JB, Hage GE, Labidi M, Jabre R, Chaalala C, Bojanowski MW. Craniovertebral and spinal adhesive arachnoiditis: a late complication of ruptured vertebral and posterior inferior cerebellar arteries aneurysms. Neurochirurgie 2024; 70:101535. [PMID: 38324943 DOI: 10.1016/j.neuchi.2024.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Adhesive arachnoiditis is a rare yet serious complication that may occur following subarachnoid hemorrhage (SAH). In this circumstance, it is mainly due to ruptured vertebral artery (VA) or posterior inferior artery (PICA) aneurysms. It disrupts cerebrospinal fluid (CSF) flow leading to complications such as spinal arachnoiditis, syringomyelia, trapped 4th ventricle, or a combination of these conditions. Evidence for effective treatment strategies is currently limited. We aimed to review the epidemiology, clinical characteristics, treatment, complications, outcomes, and prognosis of cranio-vertebral junction and spinal adhesive arachnoiditis resulting from ruptured VA and PICA aneurysms. METHODS This study involved a comprehensive literature review and complemented by our own case. We focused on adult cases of arachnoiditis, syringomyelia, and trapped 4th ventricle with SAH caused by ruptured VA or PICA aneurysms, excluding cases unrelated to these aneurysms and those with insufficient data. RESULTS The study included 22 patients, with a mean age of 52.4 years. Symptoms commonly manifest within the first year after SAH and timely diagnosis requires a high index of suspicion. Treatment approaches included lysis of adhesions and various shunt procedures. Most patients showed improvement post-treatment, though symptom recurrence is significant. CONCLUSION Adhesive arachnoiditis is a critical complication following SAH, most commonly from ruptured VA and PICA aneurysms. Early detection and individualized treatment based on the type of arachnoiditis and CSF flow impact are crucial for effective management. This study underscores the need for tailored treatment strategies and further research in this field.
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Affiliation(s)
- Valérie Gilbert
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Sara Chakir
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Jean-Baptiste Peeters
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Gilles El Hage
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Moujahed Labidi
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Roland Jabre
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Chiraz Chaalala
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada
| | - Michel W Bojanowski
- Division of Neurosurgery, Department of Surgery, University of Montreal, Quebec, Canada.
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Zheng D, Lin Z, Lin F, Ren X, Lin Y, Jiang Z. Trapped temporal horn: an underestimated complication after surgical removal of lesion within or adjacent to the lateral ventricular trigone. Neurosurg Rev 2023; 46:285. [PMID: 37882853 DOI: 10.1007/s10143-023-02195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
| | - Zhiqin Lin
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Fuxin Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China
| | - Yuanxiang Lin
- Department of Neurosurgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Road of the South 4th Ring, No. 119, Fengtai District, Beijing, 100160, China.
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Zheng D, Lin Z, Jiang Z. Letter to the Editor Regarding "Prophylactic Intraventricular Piping Method Prevents Entrapped Temporal Horn After Removal of Ventricle Trigone Meningioma: Technical Note". World Neurosurg 2023; 176:256. [PMID: 37550931 DOI: 10.1016/j.wneu.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Dao Zheng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhiqin Lin
- Department of Neurosurgery, Longyan First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Laurent D, Small C, Lucke-Wold B, Dodd WS, Chalouhi N, Hu YC, Hosaka K, Motwani K, Martinez M, Polifka A, Koch M, Busl KM, Maciel CB, Hoh B. Understanding the genetics of intracranial aneurysms: A primer. Clin Neurol Neurosurg 2022; 212:107060. [PMID: 34863053 PMCID: PMC10116189 DOI: 10.1016/j.clineuro.2021.107060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/21/2021] [Indexed: 02/08/2023]
Abstract
The genetics of intracranial aneurysms is complex. Much work has been done looking at the extracellular matrix surrounding cerebral vasculature as well as the role of matrix metalloproteinases. This comprehensive review summarizes what is known to date about the important genetic components that predispose to aneurysm formation and critically discusses the published findings. We discuss promising pre-clinical models of aneurysm formation and subarachnoid hemorrhage, and highlight avenues for future discovery, while considering limitations in the research to date. This review will further serve as a comprehensive reference guide to understand the genetic underpinnings for aneurysm pathophysiology and act as a primer for further investigation.
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Affiliation(s)
- Dimitri Laurent
- Department of Neurosurgery, University of Florida, Gainesville, United States.
| | - Coulter Small
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - William S Dodd
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Nohra Chalouhi
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Yin C Hu
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Koji Hosaka
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Kartik Motwani
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Melanie Martinez
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Adam Polifka
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Matthew Koch
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Katharina M Busl
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Carolina B Maciel
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Brian Hoh
- Department of Neurosurgery, University of Florida, Gainesville, United States.
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Lin Z, Zhang X, Shen S, Gao Z, Guan C, Liu T, Guo D, Qi X, Ren X, Jiang Z. Postoperative delayed trapped temporal horn in patients with lateral ventricular trigone meningioma: Risk factors, surgical management, and literature review. Eur J Surg Oncol 2020; 46:2324-2330. [PMID: 32371042 DOI: 10.1016/j.ejso.2020.04.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/15/2020] [Accepted: 04/16/2020] [Indexed: 02/09/2023] Open
Abstract
OBJECT To assess the risk factors for and surgical treatment of delayed trapped temporal horn (dTTH) in patients who had undergone removal of lateral ventricular trigone meningioma. METHOD Patients with lateral ventricular trigone meningioma treated at our institution from 2011 to 2015 were identified. Predictors for dTTH were determined using logistic regression. Literature review and pooled analysis were also conducted to evaluate the comparative effectiveness of surgical treatment for dTTH. RESULTS A total of 110 cases were included in the analysis. Thirteen (11.8%) cases developed dTTH following surgery. Multivariable logistic regression demonstrated an association of longer operative duration with higher incidence of dTTH (OR, 1.34; 95% CI, 1.00-1.80; p = 0.049). As surgical duration prolonged from less than 3 hours to 5 hours or more, the incidence of dTTH increased in a consistent, linear fashion from 7.7% to 13.9% (p = 0.03). Six cases (46.2%, 6/13) of dTTH underwent surgical treatment for their life-threatening symptoms. Seven studies including 13 cases of dTTH in the literature were identified. Literature data, including the current series, revealed a total of 24 procedures were performed in 19 cases. Endoscopic fenestration trended toward fewer complications than shunt (7.7% vs 25.0%, p = 0.530). There were no significant differences in failure rates between the two groups (23.1% vs 25.0%, p = 1.000). CONCLUSION Patients with prolonged operative duration may be at higher risk of dTTH. Endoscopic fenestration is considered in preference to shunt placement, since it possesses equivalent success rates with fewer complications and avoids the need for a permanent implant.
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Affiliation(s)
- Zhiqin Lin
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaohui Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shaoshan Shen
- Department of Neurosurgery, Zhangzhou Hospital, Fujian Medical University, Fujian, China
| | - Zhenwen Gao
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Celin Guan
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Tianqing Liu
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Dongbin Guo
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaolong Qi
- Department of Neurosurgery, Longyan First Hospital, Fujian Medical University, Fujian, China
| | - Xiaohui Ren
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongli Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Lyu J, Wang JB, Quan Y, Gong S. Disproportionately large communicating fourth ventricle: two case reports. J Med Case Rep 2019; 13:222. [PMID: 31325957 PMCID: PMC6642738 DOI: 10.1186/s13256-019-2158-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/10/2019] [Indexed: 11/21/2022] Open
Abstract
Background Management of the disproportionately large communicating fourth ventricle is still problematic. Case presentation Two cases of disproportionately large communicating fourth ventricle were treated successfully. One was a case of a 51-year-old Han Chinese woman with a complaint of headache and dizziness of 1 year’s duration. Magnetic resonance imaging (MRI) demonstrated hydrocephalus with a disproportionately large fourth ventricle. She underwent a ventriculo-peritoneal shunt of the right lateral ventricle. Her symptoms were relieved totally. Five years later, magnetic resonance imaging showed she had a normal ventricular system. The other case was a 24-year-old Han Chinese man with a 2-month history of headache and dizziness accompanied by progressive loss of bilateral vision. Magnetic resonance imaging revealed hydrocephalus with a disproportionately large fourth ventricle, crowded posterior cranial fossa, and syringomyelia extending from C1 to C5. He underwent suboccipital and C1 decompression and duraplasty. Shortly after the surgery, his symptoms were relieved completely, the syringomyelia completely disappeared, and the fourth ventricle became significantly smaller. Conclusions The management of the disproportionately large communicating fourth ventricle should be individualized. If it coexists with crowded posterior cranial fossa or syringomyelia, posterior fossa decompression could be an option for initial management. If there is no sign of crowded posterior cranial fossa or syringomyelia, shunt of the lateral ventricles might be the first choice.
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Affiliation(s)
- Jian Lyu
- Neurosurgical Department, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China.
| | - Ju-Bo Wang
- Neurosurgical Department, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Yu Quan
- Neurosurgical Department, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
| | - Shouping Gong
- Neurosurgical Department, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China
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Nigri F, Gobbi GN, da Costa Ferreira Pinto PH, Simões EL, Caparelli-Daquer EM. Hydrocephalus caused by unilateral foramen of Monro obstruction: A review on terminology. Surg Neurol Int 2016; 7:S307-13. [PMID: 27274402 PMCID: PMC4879846 DOI: 10.4103/2152-7806.182392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/16/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Hydrocephalus caused by unilateral foramen of Monro (FM) obstruction has been referred to in literature by many different terminologies. Precise terminology describing hydrocephalus confined to just one lateral ventricle has a very important prognostic value and determines whether or not the patient can be shunt free after an endoscopic procedure. Methods: Aiming to define the best term for unilateral FM obstruction, 19 terms were employed on PubMed database (http://www.ncbi.nlm.nih.gov/pubmed) as quoted phrases. Results: A total of 194 articles were found. Four patterns of hydrocephalus were discriminated as a result of our research term query and were divided by types for didactic purpose. Type A - partial dilation of the lateral ventricle; Type B - pure unilateral obstruction of the FM; Type C - previously shunted patients with secondary obstruction of the FM; and Type D - asymmetric lateral ventricles with patent FM. 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.
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Affiliation(s)
- Flavio Nigri
- Department of Surgical Specialties, Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil; Nervous System Electric Stimulation Laboratory (LabEEL) - Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Gabriel Neffa Gobbi
- Department of Surgical Specialties, Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Pedro Henrique da Costa Ferreira Pinto
- Department of Surgical Specialties, Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Elington Lannes Simões
- Department of Surgical Specialties, Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Egas Moniz Caparelli-Daquer
- Nervous System Electric Stimulation Laboratory (LabEEL) - Neurosurgery Teaching and Assistance Unit, Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil; Physiological Sciences Department, Roberto Alcântara Gomes Biology Institute, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
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Robba C, Bacigaluppi S, Bragazzi NL, Bilotta F, Sekhon MS, Bertuetti R, Ercole A, Bertuccio A, Czosnyka M, Matta B. Aneurysmal Subarachnoid Hemorrhage in Pregnancy-Case Series, Review, and Pooled Data Analysis. World Neurosurg 2015; 88:383-398. [PMID: 26724616 DOI: 10.1016/j.wneu.2015.12.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy represents an important cause of maternal and fetal morbidity and mortality. Approaches to diagnostics and treatment are still controversial, and there are only a limited number of cases described in the literature. Our study examines the management of aSAH in pregnant patients, creating a case series by combining patients from our hospital records with those from the limited available literature. METHODS Data collected from Addenbrooke's Hospital records and cases published between January 1995 and January 2015 were studied. Chi-square test, exact Fisher's test, and chi-square test for trend were used for analyzing categorical data, while the t-test and Mann-Whitney-Wilcoxon test were used for continuous data. RESULTS Fifty-two patients were included. The mean age was 31.47 ± 5.80, and most patients were in their third trimester. A univariate pooled data analysis suggested that the maternal outcome may depend on the mother's age, mother's Hunt and Hess scale score, Glasgow Coma Scale at arrival, treatment modality for the aneurysm, mode, and timing of delivery. However, at the multivariate analysis only the presence of general complications resulted in a significant impact on maternal outcome. CONCLUSIONS Ruptured aneurysms in pregnant patients with aSAH may be safely secured in a timely manner. The diagnostic and treatment strategy for each of these patients should consider peculiar maternal and obstetric factors and requires a multidisciplinary assessment involving obstetrics, neurosurgeons, and intensivists. Considering the observed statistical power of our series, our findings should be taken with caution and should be supported by further systematic data collection.
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Affiliation(s)
- Chiara Robba
- Neurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
| | - Susanna Bacigaluppi
- Department of Neurosurgery, Galliera Hospital, University of Genova, Genova, Italy
| | | | - Federico Bilotta
- Department of Anaesthesiology, University of Rome "La Sapienza", Rome, Italy
| | - Mypinder S Sekhon
- Department of Medicine, Division of Critical Care Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Rita Bertuetti
- Neurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ari Ercole
- Neurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Alessandro Bertuccio
- Department of Neurosurgery, St. George's Hospital, University of London, London, United Kingdom
| | - Marek Czosnyka
- Division of Neurosurgery, Brain Physics Laboratory, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
| | - Basil Matta
- Neurosciences Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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Abstract
BACKGROUND Focal ventricular obstruction--trapped ventricle--results in cerebrospinal fluid accumulation, mass effect and possible clinical deterioration. There are no systematic studies on the benefit of surgical decompression in adults. METHODS We reviewed patients admitted with acutely trapped ventricle on brain imaging to assess their prognosis and the effect of surgical intervention on 30-day mortality. RESULTS Of the 392 patients with trapped ventricle, the most common causes were brain tumor (45%), intracerebral hemorrhage (ICH) (20%), and subdural hematoma (SDH) (14%). Lateral ventricle trapping accounted for 97% of cases. Two hundred and twenty-one patients (56%) received a surgical intervention for trapped ventricle or its causes; 126 (83%) were treated with craniotomy, 26 (17%) with craniectomy, 30 (14%) with external ventricular drain (EVD) alone, 23 (10%) with ventriculoperitoneal shunt alone, and 16 (7%) with endoscopic fenestration of the septum pellucidum. Surgical intervention was associated with mortality reduction from 95% (n = 54) to 48% (n = 11) in the ICH group, from 47% (n = 27) to 12% (n = 15) in the tumor group and from 90% (n = 18) to 20% (n = 7) in the SDH group (p < 0.001 for all comparisons). Univariate logistic analysis showed that surgical intervention and tumor etiology were associated with decreased mortality while age, ICH etiology, intraventricular hemorrhage, midline shift, and anticoagulation were associated with increased mortality. On multivariate logistic regression, surgical intervention remained associated with decreased mortality (p < 0.0001; OR 0.20, 95% CI 0.09-0.42). On subgroup analysis of the ICH cohort, surgical intervention was also associated with decreased mortality (p = 0.028). CONCLUSIONS Neurosurgical intervention for decompression in patients with trapped ventricle can have a measurable beneficial effect on early mortality.
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Morina D, Petridis AK, Fritzsche FS, Ntoulias G, Scholz M. Syringomyelia regression after shunting of a trapped fourth ventricle. Clin Pract 2013; 3:e1. [PMID: 24765489 PMCID: PMC3981231 DOI: 10.4081/cp.2013.e1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/14/2012] [Accepted: 12/06/2012] [Indexed: 11/25/2022] Open
Abstract
We describe a case of progressive syringomyelia following post-infectious trapped fourth ventricle (TFV), which resolved after shunting of the fourth ventricle. A 28-year-old female who had previously undergone treatment of intracerebral hemorrhage and meningitis developed a hydrocephalus with TFV. After 3 years she developed disturbance of walking and coordination. Cranial-CT revealed an enlargement of the shunted fourth ventricle as a result of shunt dysfunction. Furthermore a cervical syringomyelia developed. The patient underwent a revision of a failed fourth ventriculo-peritoneal shunt. Postoperatively, syringomyelia resolved within 6 months and the associated neurological deficits improved significantly. An insufficiency of cerebrospinal fluid draining among patients with TFV can be associated with communicating syringomyelia. An early detection and treatment seems important on resolving syringomyelia and avoiding permanent neurological deficits. Ventriculo-peritoneal shunt in trapped fourth ventricles can resolve a secondary syringomyelia.
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Affiliation(s)
- Dukagjin Morina
- Department of Neurosurgery, Wedau Kliniken Duisburg , Germany
| | | | | | | | - Martin Scholz
- Department of Neurosurgery, Wedau Kliniken Duisburg , Germany
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