Database : MEDLINE
Search on : Choroid and Hemorrhage [Words]
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[PMID]: 29342116
[Au] Autor:Shim JW; Madsen JR
[Ad] Address:Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA. jshim@bu.edu.
[Ti] Title:VEGF Signaling in Neurological Disorders.
[So] Source:Int J Mol Sci;19(1), 2018 Jan 17.
[Is] ISSN:1422-0067
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Vascular endothelial growth factor (VEGF) is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF)-a class of EGF receptor (EGFR) family ligands-contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:In-Process

  2 / 1958 MEDLINE  
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[PMID]: 29243972
[Au] Autor:Kulkarni AV; Riva-Cambrin J; Rozzelle CJ; Naftel RP; Alvey JS; Reeder RW; Holubkov R; Browd SR; Cochrane DD; Limbrick DD; Simon TD; Tamber M; Wellons JC; Whitehead WE; Kestle JRW
[Ad] Address:Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Ontario, Canada.
[Ti] Title:Endoscopic third ventriculostomy and choroid plexus cauterization in infant hydrocephalus: a prospective study by the Hydrocephalus Clinical Research Network.
[So] Source:J Neurosurg Pediatr;21(3):214-223, 2018 Mar.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE High-quality data comparing endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) to shunt and ETV alone in North America are greatly lacking. To address this, the Hydrocephalus Clinical Research Network (HCRN) conducted a prospective study of ETV+CPC in infants. Here, these prospective data are presented and compared to prospectively collected data from a historical cohort of infants treated with shunt or ETV alone. METHODS From June 2014 to September 2015, infants (corrected age ≤ 24 months) requiring treatment for hydrocephalus with anatomy suitable for ETV+CPC were entered into a prospective study at 9 HCRN centers. The rate of procedural failure (i.e., the need for repeat hydrocephalus surgery, hydrocephalus-related death, or major postoperative neurological deficit) was determined. These data were compared with a cohort of similar infants who were treated with either a shunt (n = 969) or ETV alone (n = 74) by creating matched pairs on the basis of age and etiology. These data were obtained from the existing prospective HCRN Core Data Project. All patients were observed for at least 6 months. RESULTS A total of 118 infants underwent ETV+CPC (median corrected age 1.3 months; common etiologies including myelomeningocele [30.5%], intraventricular hemorrhage of prematurity [22.9%], and aqueductal stenosis [21.2%]). The 6-month success rate was 36%. The most common complications included seizures (5.1%) and CSF leak (3.4%). Important predictors of treatment success in the survival regression model included older age (p = 0.002), smaller preoperative ventricle size (p = 0.009), and greater degree of CPC (p = 0.02). The matching algorithm resulted in 112 matched pairs for ETV+CPC versus shunt alone and 34 matched pairs for ETV+CPC versus ETV alone. ETV+CPC was found to have significantly higher failure rate than shunt placement (p < 0.001). Although ETV+CPC had a similar failure rate compared with ETV alone (p = 0.73), the matched pairs included mostly infants with aqueductal stenosis and miscellaneous other etiologies but very few patients with intraventricular hemorrhage of prematurity. CONCLUSIONS Within a large and broad cohort of North American infants, our data show that overall ETV+CPC appears to have a higher failure rate than shunt alone. Although the ETV+CPC results were similar to ETV alone, this comparison was limited by the small sample size and skewed etiological distribution. Within the ETV+CPC group, greater extent of CPC was associated with treatment success, thereby suggesting that there are subgroups who might benefit from the addition of CPC. Further work will focus on identifying these subgroups.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review
[do] DOI:10.3171/2017.8.PEDS17217

  3 / 1958 MEDLINE  
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[PMID]: 28467586
[Au] Autor:Yazgan S; Ayar O; Akdemir O; Koban Y
[Ti] Title:An excellent anatomical and visual recovery after surgical repair of an open eye injury with poor baseline prognostic factors.
[So] Source:Ulus Travma Acil Cerrahi Derg;23(2):167-169, 2017 Mar.
[Is] ISSN:1306-696X
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Presently described is case of a 42-year-old woman with eye injury that was result of gunshot fired by a man at a wedding celebration. Bullet penetrated inferior quadrant of nasal sclera of left eye 7-12 mm behind limbus. Choroid and vitreous were prolapsed around bullet. Hemorrhage, vitreous prolapse and lens subluxation were present in anterior chamber. Presenting visual acuity (VA) was hand motion. Bullet 14x5 mm in size was carefully extracted from the eye. Fifteen days later, argon laser photocoagulation was performed on retina in area of bullet entry point. VA was 20/25 (Snellen) at final visit. In this case, although foreign body was large, area of penetration was Zone III, and initial VA was poor, early and appropriate surgical repair achieved integrity of the globe and good vision prognosis.
[Mh] MeSH terms primary: Eye Injuries, Penetrating
Wounds, Gunshot
[Mh] MeSH terms secundary: Adult
Eye Injuries, Penetrating/diagnosis
Eye Injuries, Penetrating/physiopathology
Eye Injuries, Penetrating/surgery
Female
Humans
Light Coagulation
Prognosis
Visual Acuity
Wounds, Gunshot/diagnosis
Wounds, Gunshot/physiopathology
Wounds, Gunshot/surgery
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[Js] Journal subset:IM
[Da] Date of entry for processing:170504
[St] Status:MEDLINE
[do] DOI:10.5505/tjtes.2016.23790

  4 / 1958 MEDLINE  
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[PMID]: 29397464
[Au] Autor:Mayl JJ; Flores MA; Stelzer JW; Liu B; Messina SA; Murray JV
[Ad] Address:University of Central Florida College of Medicine, Orlando, FL, USA.
[Ti] Title:Recognizing intraventricular silicone.
[So] Source:Emerg Radiol;, 2018 Feb 03.
[Is] ISSN:1438-1435
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Retinal detachment with subsequent silicone oil retinopexy is not uncommon. A known complication of silicone retinopexy is intraventricular migration of the intraocular silicone oil. While the oil itself does not result in direct pathology, misdiagnosis may lead to an unnecessary diagnostic workup and possibly predispose the patient to surgery intervention. Silicone oil typically appears hyperdense on computer tomography (CT) and hyperintense on T1-weighted magnetic resonance (MR). These imaging findings may mimic a mass or blood products. However, MR imaging of silicone results in chemical shift artifact which should help narrow the imaging differential. We present a patient with incidental CT and MRI findings which resulted in a prolonged hospital course following misidentification of intraventricular silicone oil. Although the imaging differential for an intraventricular lesion may include metastasis, lymphoma, hemorrhage, choroid plexus papilloma/carcinoma, meningioma, subependymoma, and ependymoma, secondary imaging findings should be noted to ensure an accurate diagnosis. In patients with evidence of prior silicone retinopexy, visualization of an intraventricular lesion with associated chemical shift artifact should raise the possibility of intraventricular silicone oil migration.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180204
[Lr] Last revision date:180204
[St] Status:Publisher
[do] DOI:10.1007/s10140-018-1582-2

  5 / 1958 MEDLINE  
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[PMID]: 29393809
[Au] Autor:Dewan MC; Lim J; Gannon SR; Heaner D; Davis MC; Vaughn B; Chern JJ; Rocque BG; Klimo P; Wellons JC; Naftel RP
[Ad] Address:Department of Neurosurgery, Vanderbilt University, Division of Pediatric Neurosurgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee.
[Ti] Title:Comparison of hydrocephalus metrics between infants successfully treated with endoscopic third ventriculostomy with choroid plexus cauterization and those treated with a ventriculoperitoneal shunt: a multicenter matched-cohort analysis.
[So] Source:J Neurosurg Pediatr;:1-7, 2018 Feb 02.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE It has been suggested that the treatment of infant hydrocephalus results in different craniometric changes depending upon whether ventriculoperitoneal shunt (VPS) placement or endoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) is performed. Without an objective and quantitative description of expected changes to the infant cranium and ventricles following ETV/CPC, asserting successful treatment of hydrocephalus is difficult. By comparing infants successfully treated via ETV/CPC or VPS surgery, the authors of this study aimed to define the expected postoperative cranial and ventricular alterations at the time of clinical follow-up. METHODS Patients who underwent successful treatment of hydrocephalus at 4 institutions with either VPS placement or ETV/CPC were matched in a 3:1 ratio on the basis of age and etiology. Commonly used cranial parameters (including head circumference [HC], HC z-score, fontanelle status, and frontooccipital horn ratio [FOHR]) were compared pre- and postoperatively between treatment cohorts. First, baseline preoperative values were compared to ensure cohort equivalence. Next, postoperative metrics, including the relative change in metrics, were compared between treatment groups using multivariate linear regression. RESULTS Across 4 institutions, 18 ETV/CPC-treated and 54 VPS-treated infants with hydrocephalus were matched and compared at 6 months postoperatively. The most common etiologies of hydrocephalus were myelomeningocele (61%), followed by congenital communicating hydrocephalus (17%), aqueductal stenosis (11%), and intraventricular hemorrhage (6%). The mean age at the time of CSF diversion was similar between ETV/CPC- and VPS-treated patients (3.4 vs 2.9 months; p = 0.69), as were all preoperative cranial hydrocephalus metrics (p > 0.05). Postoperatively, the ventricle size FOHR decreased significantly more following VPS surgery (-0.15) than following ETV/CPC (-0.02) (p < 0.001), yielding a lower postoperative FOHR in the VPS arm (0.42 vs 0.51; p = 0.01). The HC percentile was greater in the ETV/CPC cohort than in the VPS-treated patients (76th vs 54th percentile; p = 0.046). A significant difference in the postoperative z-score was not observed. With both treatment modalities, a bulging fontanelle reliably normalized at last follow-up. CONCLUSIONS Clinical and radiographic parameters following successful treatment of hydrocephalus in infants differed between ETV/CPC and VPS treatment. At 6 months post-ETV/CPC, ventricle size remained unchanged, whereas VPS-treated ventricles decreased to a near-normal FOHR. The HC growth control between the procedures was similar, although the final HC percentile may be lower after VPS. The fontanelle remained a reliable indicator of success for both treatments. This study establishes expected cranial and ventricular parameters following ETV/CPC, which may be used to guide preoperative counseling and postoperative decision making.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180202
[Lr] Last revision date:180202
[St] Status:Publisher
[do] DOI:10.3171/2017.10.PEDS17421

  6 / 1958 MEDLINE  
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[PMID]: 29386206
[Au] Autor:Li Q; Ding Y; Krafft P; Wan W; Yan F; Wu G; Zhang Y; Zhan Q; Zhang JH
[Ad] Address:Department of Neurology, The Fifth People's Hospital of Chongqing, Chongqing, China.
[Ti] Title:Targeting Germinal Matrix Hemorrhage-Induced Overexpression of Sodium-Coupled Bicarbonate Exchanger Reduces Posthemorrhagic Hydrocephalus Formation in Neonatal Rats.
[So] Source:J Am Heart Assoc;7(3), 2018 Jan 31.
[Is] ISSN:2047-9980
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Germinal matrix hemorrhage (GMH) is a leading cause of mortality and lifelong morbidity in preterm infants. Posthemorrhagic hydrocephalus (PHH) is a common complication of GMH. A sodium-coupled bicarbonate exchanger (NCBE) encoded by solute carrier family 4 member 10 gene is expressed on the choroid plexus basolateral membrane and may play a role in cerebrospinal fluid production and the development of PHH. Following GMH, iron degraded from hemoglobin has been linked to PHH. Choroid plexus epithelial cells also contain iron-responsive element-binding proteins (IRPs), IRP1, and IRP2 that bind to mRNA iron-responsive elements. The present study aims to resolve the following issues: (1) whether the expression of NCBE is regulated by IRPs; (2) whether NCBE regulates the formation of GMH-induced hydrocephalus; and (3) whether inhibition of NCBE reduces PHH development. METHODS AND RESULTS: GMH model was established in P7 rat pups by injecting bacterial collagenase into the right ganglionic eminence. Another group received iron trichloride injections instead of collagenase. Deferoxamine was administered intraperitoneally for 3 consecutive days after GMH/iron trichloride. Solute carrier family 4 member 10 small interfering RNA or scrambled small interfering RNA was administered by intracerebroventricular injection 24 hours before GMH and followed with an injection every 7 days over 21 days. NCBE expression increased while IRP2 expression decreased after GMH/iron trichloride. Deferoxamine ameliorated both the GMH-induced and iron trichloride-induced decrease of IRP2 and decreased NCBE expressions. Deferoxamine and solute carrier family 4 member 10 small interfering RNA improved cognitive and motor functions at 21 to 28 days post GMH and reduced cerebrospinal fluid production as well as the degree of hydrocephalus at 28 days after GMH. CONCLUSIONS: Targeting iron-induced overexpression of NCBE may be a translatable therapeutic strategy for the treatment of PHH following GMH.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180201
[Lr] Last revision date:180201
[St] Status:In-Data-Review

  7 / 1958 MEDLINE  
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[PMID]: 29188462
[Au] Autor:Kim JH; Chang YS; Lee DW; Kim CG; Kim JW
[Ad] Address:Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea. kimoph@gmail.com.
[Ti] Title:Quantification of retinal changes after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy.
[So] Source:Jpn J Ophthalmol;62(1):54-62, 2018 Jan.
[Is] ISSN:1613-2246
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:PURPOSE: To evaluate changes in the thickness of retinal layers after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Retrospective, observational study. METHODS: This study included 21 patients (21 eyes) who had been diagnosed with submacular hemorrhage secondary to PCV and treated using anti-vascular endothelial growth factor monotherapy. After the hemorrhage had resolved, the thicknesses of the retinal layers were measured on horizontal- and vertical-crosshair optical coherence tomography scan images. The thickness of each layer in the region affected by the hemorrhage was compared with the thickness of the layer in the corresponding region in the fellow eye, as well as between an unaffected region in the eye with the hemorrhage and the corresponding region in the fellow eye. RESULTS: Optical coherence tomography (OCT) was performed 5.5±2.8 months after diagnosis. In the horizontal OCT images, the outer plexiform layer (OPL) and outer nuclear layer (ONL) + photoreceptor layer (PRL) were significantly thinner in the affected region than in the corresponding region (P = 0.019 and P <0.001, respectively). In the vertical OCT image, the ONL+PRL was significantly thinner in the affected region than in the corresponding region (P <0.001). The thickness of the retinal layer in the unaffected region did not differ from that in the corresponding region of the fellow eye. CONCLUSIONS: The significant thinning of the outer retinal layers in the regions affected by submacular hemorrhage suggests that the hemorrhage induces marked damage in the outer retinal layers, explaining the poor visual prognosis of submacular hemorrhage.
[Mh] MeSH terms primary: Choroidal Neovascularization/physiopathology
Polyps/physiopathology
Retinal Hemorrhage/physiopathology
Retinal Neurons/pathology
[Mh] MeSH terms secundary: Aged
Aged, 80 and over
Angiogenesis Inhibitors/therapeutic use
Choroidal Neovascularization/complications
Choroidal Neovascularization/drug therapy
Coloring Agents/administration & dosage
Female
Fluorescein Angiography
Humans
Indocyanine Green/administration & dosage
Intravitreal Injections
Male
Middle Aged
Polyps/complications
Polyps/drug therapy
Ranibizumab/therapeutic use
Receptors, Vascular Endothelial Growth Factor/therapeutic use
Recombinant Fusion Proteins/therapeutic use
Retinal Hemorrhage/drug therapy
Retinal Hemorrhage/etiology
Retrospective Studies
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A/antagonists & inhibitors
Visual Acuity
[Pt] Publication type:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Name of substance:0 (Angiogenesis Inhibitors); 0 (Coloring Agents); 0 (Recombinant Fusion Proteins); 0 (VEGFA protein, human); 0 (Vascular Endothelial Growth Factor A); 15C2VL427D (aflibercept); EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor); IX6J1063HV (Indocyanine Green); ZL1R02VT79 (Ranibizumab)
[Em] Entry month:1801
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[Js] Journal subset:IM
[Da] Date of entry for processing:171201
[St] Status:MEDLINE
[do] DOI:10.1007/s10384-017-0549-2

  8 / 1958 MEDLINE  
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[PMID]: 29260502
[Au] Autor:Dikmetas Ö; Abaza A; Gelisken F
[Ad] Address:Department of Ophthalmology, University of Kastamonu, Kastamonu, Turkey.
[Ti] Title:Posttraumatic acute choroidopathy.
[So] Source:Int Ophthalmol;, 2017 Dec 19.
[Is] ISSN:1573-2630
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:PURPOSE: To report a case of acute choroidopathy following a blunt ocular trauma. METHODS: Ocular examination included dilated fundus examination and optical coherence tomography enhanced depth imaging (OCT-EDI). PATIENTS: Single-patient case report. CASE REPORT: A 10-year-old boy was referred following a blunt trauma to the right eye. The visual acuity diminished to 20/200 and mild hemorrhage was found in the anterior chamber. The fundoscopy was unremarkable. An OCT-EDI revealed a choroidal thickening and detachment at the macula. Six month later, the choroidal morphology resolved and the visual acuity improved. CONCLUSIONS: This study reported a case of acute choroidopathy associated with temporary thickening of the choroid and separation of the Haller's layer from the sclera. OCT-EDI helped to detect and monitor the morphological changes in the apparently normal-looking macular choroid after ocular trauma. Further case reports with long term follow-up are needed to clarify the clinical impact of posttraumatic acute choroidopathy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171220
[Lr] Last revision date:171220
[St] Status:Publisher
[do] DOI:10.1007/s10792-017-0810-1

  9 / 1958 MEDLINE  
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[PMID]: 29160784
[Au] Autor:van Romunde SHM; Polito A; Peroglio Deiro A; Guerriero M; Pertile G
[Ad] Address:*Sacro Cuore Hospital, Department of Ophthalmology, Negrar (Verona), Italy; and†Department Computer Science, University of Verona, Verona, Italy.
[Ti] Title:RETINAL PIGMENT EPITHELIUM-CHOROID GRAFT WITH A PERIPHERAL RETINOTOMY FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION: Long-Term Outcome.
[So] Source:Retina;, 2017 Nov 16.
[Is] ISSN:1539-2864
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To investigate the long-term outcome of autologous retinal pigment epithelium -choroid transplantation with a peripheral retinotomy for exudative age-related macular degeneration. METHODS: In a retrospective study, we selected all patients who underwent a retinal pigment epithelium-choroid transplantation from 2007 through 2013. Exclusion criteria were age <60 years, <12 months of follow-up, and retinal pigment epithelium-choroid graft for other diseases than age-related macular degeneration. The main outcome measure was best-corrected visual acuity converted into logarithm of the minimum angle of resolution. RESULTS: In this study, 81 patients were included with a mean follow-up of 38 months (SD = 19). Median best-corrected visual acuity improved from 1.30 logarithm of the minimum angle of resolution (20/400 Snellen) to 0.90 logarithm of the minimum angle of resolution (20/160 Snellen) 1 year after surgery (P < 0.001). A ≥3-line gain was achieved in 43 patients (53%) 1 year postoperatively and 37 patients (46%) preserved their visual gain until last visit. Of 4 patients with an 8-year follow-up, 3 patients had a ≥6-line gain at last visit. Severe complications were submacular hemorrhage (n = 8, 10%), macular hole (n = 6, 7%), and proliferative vitreoretinopathy (n = 3, 4%). CONCLUSION: Best-corrected visual acuity improved significantly after retinal pigment epithelium-choroid transplantation in patients with age-related macular degeneration and preservation of visual gain was possible in the long term.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171121
[Lr] Last revision date:171121
[St] Status:Publisher
[do] DOI:10.1097/IAE.0000000000001945

  10 / 1958 MEDLINE  
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[PMID]: 29125447
[Au] Autor:Shah AH; Ibrahim GM; Sasaki J; Ragheb J; Bhatia S; Niazi TN
[Ad] Address:Divisions of 1 Neurosurgery and.
[Ti] Title:Multiple echocardiography abnormalities associated with endoscopic third ventriculostomy failure.
[So] Source:J Neurosurg Pediatr;:1-6, 2017 Nov 10.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE Although endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) has gained increasing prominence in the management of hydrocephalus caused by intraventricular hemorrhage of prematurity, the rates of long-term shunt independence remain low. Furthermore, limited evidence is available to identify infants who might benefit from the procedure. The authors tested the hypothesis that elevated venous pressure that results from comorbid cardiac disease might predispose patients to ETV/CPC failure and shunt dependence. METHODS A retrospective analysis was performed on a consecutive series of 48 infants with hydrocephalus who underwent ETV/CPC and also underwent preoperative echocardiography between 2007 and 2014. Comorbid cardiac abnormalities that are known to result in elevated right heart pressure were reviewed. Associations between ETV/CPC success and the presence of pulmonary hypertension, right ventricular hypertrophy, left-to-right shunting, ventricular septal defect, or patent ductus arteriosus were determined using multivariate logistic regression analysis. RESULTS Of the 48 children who met the inclusion criteria, ETV/CPC failed in 31 (65%). In univariate analysis, no single echocardiogram abnormality was associated with shunt failure, but the presence of 2 or more concurrent echocardiogram abnormalities was associated with ETV/CPC failure (17 [85%] of 20 vs 14 [50%] of 28, respectively; p = 0.018). In multivariate logistic regression analysis, when the authors adjusted for the child's ETV success score, the presence of 2 abnormalities remained independently associated with poor outcome (2 or more echocardiogram abnormalities, OR 0.13, 95% CI 0.01-0.7, p = 0.032; ETV success score, OR 1.1, 95% CI 1-1.2, p = 0.05). CONCLUSIONS In this study, cardiac abnormalities were inversely associated with the success of ETV/CPC in infants with hydrocephalus of prematurity. ETV/CPC might not be as efficacious in patients with significant cardiac anomalies. These results provide a basis for future efforts to stratify surgical candidacy for ETV/CPC on the basis of comorbid abnormalities. Proper cardiac physiological pressure monitoring might help elucidate the relationship between cardiac abnormalities and hydrocephalus.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171110
[Lr] Last revision date:171110
[St] Status:Publisher
[do] DOI:10.3171/2017.7.PEDS17132


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