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Search on : Slit and Ventricle and Syndrome [Words]
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[PMID]: 29483013
[Au] Autor:Waqar M; Ellenbogen JR; Mallucci C
[Ad] Address:Department of Neurosurgery, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK. Electronic address: mueez.waqar@manchester.ac.uk.
[Ti] Title:Endoscopic third ventriculostomy for shunt malfunction in children: A review.
[So] Source:J Clin Neurosci;, 2018 Feb 23.
[Is] ISSN:1532-2653
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:Endoscopic third ventriculostomy (ETV) is increasingly used in place of shunt revision for shunt malfunction (secondary ETV). This review provides a comprehensive overview of preoperative, operative and postoperative considerations for patients undergoing a secondary ETV. Preoperatively, patient selection is vital and there is evidence that secondary ETV is more effective than primary ETV in certain hydrocephalic aetiologies. Operative considerations include use of neuronavigation and consideration of surgeon technical experience due to anatomical differences that are likely to accompany chronic shunting, management of existing shunt hardware and the use of temporary external ventricular drains or short/long-term ventricular access devices. Postoperatively, there are varying institutional practices with regards to ICP monitoring and length of follow-up after discharge. Finally, this review examines the slit ventricle syndrome as a special case requiring a different approach.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:Publisher

  2 / 175 MEDLINE  
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[PMID]: 29350598
[Au] Autor:Tan K; Meiri A; Mowrey WB; Abbott R; Goodrich JT; Sandler AL; Suri AK; Lipton ML; Wagshul ME
[Ad] Address:Department of Radiology, Gruss Magnetic Resonance Research Center, and.
[Ti] Title:Diffusion tensor imaging and ventricle volume quantification in patients with chronic shunt-treated hydrocephalus: a matched case-control study.
[So] Source:J Neurosurg;:1-12, 2018 Jan 19.
[Is] ISSN:1933-0693
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE The object of this study was to use diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) to characterize the long-term effects of hydrocephalus and shunting on white matter integrity and to investigate the relationship of ventricular size and alterations in white matter integrity with headache and quality-of-life outcome measures. METHODS Patients with shunt-treated hydrocephalus and age- and sex-matched healthy controls were recruited into the study and underwent anatomical and DTI imaging on a 3-T MRI scanner. All patients were clinically stable, had undergone CSF shunt placement before 2 years of age, and had a documented history of complaints of headaches. Outcome was scored based on the Headache Disability Inventory and the Hydrocephalus Outcome Questionnaire. Fractional anisotropy (FA) and other DTI-based measures (axial, radial, and mean diffusivity; AD, RD, and MD, respectively) were extracted in the corpus callosum and internal capsule with manual region-of-interest delineation and in other regions with TBSS. Paired t-tests, corrected with a 5% false discovery rate, were used to identify regions with significant differences between patients and controls. Within the patient group, linear regression models were used to investigate the relationship between FA or ventricular volume and outcome, as well as the effect of shunt-related covariates. RESULTS Twenty-one hydrocephalus patients and 21 matched controls completed the study, and their data were used in the final analysis. The authors found significantly lower FA for patients than for controls in 20 of the 48 regions, mostly posterior white matter structures, in periventricular as well as more distal tracts. Of these 20 regions, 17 demonstrated increased RD, while only 5 showed increased MD and 3 showed decreased AD. No areas of increased FA were observed. Higher FA in specific periventricular white matter tracts, tending toward FA in controls, was associated with increased ventricular size, as well as improved clinical outcome. CONCLUSIONS The study shows that TBSS-based DTI is a sensitive technique for elucidating changes in white matter structures due to hydrocephalus and chronic CSF shunting and provides preliminary evidence that DTI may be a valuable tool for tailoring shunt procedures to monitor ventricular size following shunting and achieve optimal outcome, as well as for guiding the development of alternate therapies for hydrocephalus.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180119
[Lr] Last revision date:180119
[St] Status:Publisher
[do] DOI:10.3171/2017.6.JNS162784

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[PMID]: 29042922
[Au] Autor:Zheng J; Chen G; Xiao Q; Huang Y; Guo Y
[Ad] Address:Department of Neurosurgery, Aviation General Hospital of China Medical University, Beijing 100012, P.R. China.
[Ti] Title:Endoscopy in the treatment of slit ventricle syndrome.
[So] Source:Exp Ther Med;14(4):3381-3386, 2017 Oct.
[Is] ISSN:1792-0981
[Cp] Country of publication:Greece
[La] Language:eng
[Ab] Abstract:The present study aimed to investigate the efficacy of endoscopy in the treatment of post-shunt placement for slit ventricle syndrome (SVS). Endoscopic surgery was performed on 18 patients with SVS between October 2004 and December 2012. Sex, age, causes of the hydrocephalus, ventricular size and imaging data were collected and analyzed. All patients were divided into two groups according to ventricular size and underwent endoscopic surgeries, including endoscopic third ventriculostomy (ETV), endoscopic aqueductoplasty and cystocisternostomy. All treated patients were observed postoperatively for a period of 2 to 3 weeks, and outpatient follow-up was subsequently scheduled for >12 months. Clinical results, including catheter adherence, shunt removal and complications, were analyzed during the follow-up period. The success rate of endoscopic surgery was indicated to be 82.7%. Syndromes caused by aqueductal stenosis in 15 patients who underwent ETV were relieved; however, syndromes in the 3 patients with cerebral cysticercosis, suprasellar arachnoid cysts, pinea larea glioma and communicating hydrocephalus, respectively, were not relieved and underwent shunt placement again. Brain parenchyma, choroid plexus and ependymal tissue were the predominant causes for catheter obstruction and the obstruction rate was indicated to be 77.8% (14/18). Complications, such as pseudobulbar paralysis, infection and intraventricular hemorrhage arose in 3 patients. The present study indicates that endoscopic treatments are effective and ETV may be considered as a recommended option in the treatment of post-shunt placement SVS in hydrocephalus patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171020
[Lr] Last revision date:171020
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.3892/etm.2017.4973

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[PMID]: 28914870
[Au] Autor:Kim SA; Letyagin GV; Danilin VE; Sysoeva AA
[Ad] Address:Federal Neurosurgical Center, Novosibirsk, Russia.
[Ti] Title:Shunt-indutsirovannyi kraniosinostoz: aktual'nost' problemy, vybor taktiki, osobennosti khirurgicheskogo lecheniia. [Shunt-induced craniosynostosis: topicality of the problem, choice of the approach, and features of surgical treatment].
[So] Source:Zh Vopr Neirokhir Im N N Burdenko;81(4):45-55, 2017.
[Is] ISSN:0042-8817
[Cp] Country of publication:Russia (Federation)
[La] Language:rus
[Ab] Abstract:RATIONALE: Shunt-induced craniosynostosis is one of the late complications of CSF shunting surgery, which affects the patient's condition, clinical picture, and treatment approach. OBJECTIVE: to evaluate the prevalence rate and clinical significance of this disease, define the indications for surgery, and choose the optimal surgical approach. MATERIAL AND METHODS: The study included 59 children with shunt system dysfunction, aged 1 to 14 years, who were treated at the Department in the period from 2014 to 2016. The inclusion criteria were as follows: 1) age at the time of examination is older than 1 year; 2) implantation of a shunt system in the first 12 months of life. The state of cranial sutures was assessed using three-dimensional reconstruction of patient's computerized tomography images. Images obtained before or in the first months after primary implantation of a shunt system were used to exclude cases of primary craniosynostosis. RESULTS: Premature synostosis of the cranial sutures was detected in 27 (46%) cases. Of these, 3 (11%) patients with clinical symptoms of increased intracranial pressure and radiographic signs of craniocerebral disproportion underwent cranial vault remodeling surgery: two biparietal craniotomies and one fronto-parieto-occipital reconstruction. In two cases, simultaneous replacement of a valve with a programmable one was performed. There were no complications after reconstructive surgery. CONCLUSION: Shunt-associated craniosynostosis is one of the late complications of CSF shunting surgery. However, its presence is not an indication for surgery and should not be a reason for surgical aggression. Surgery for increasing the intracranial volume is indicated only for secondary craniosynostosis combined with signs of craniocerebral disproportion. In these cases, reconstructive surgery is an effective treatment option for improving the patient's condition.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170915
[Lr] Last revision date:170915
[St] Status:In-Data-Review
[do] DOI:10.17116/neiro201781445-55

  5 / 175 MEDLINE  
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[PMID]: 28793912
[Au] Autor:Crucean A; Alqahtani A; Barron DJ; Brawn WJ; Richardson RV; O'Sullivan J; Anderson RH; Henderson DJ; Chaudhry B
[Ad] Address:Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, B4 6NH, UK.
[Ti] Title:Re-evaluation of hypoplastic left heart syndrome from a developmental and morphological perspective.
[So] Source:Orphanet J Rare Dis;12(1):138, 2017 Aug 10.
[Is] ISSN:1750-1172
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Hypoplastic left heart syndrome (HLHS) covers a spectrum of rare congenital anomalies characterised by a non-apex forming left ventricle and stenosis/atresia of the mitral and aortic valves. Despite many studies, the causes of HLHS remain unclear and there are conflicting views regarding the role of flow, valvar or myocardial abnormalities in its pathogenesis, all of which were proposed prior to the description of the second heart field. Our aim was to re-evaluate the patterns of malformation in HLHS in relation to recognised cardiac progenitor populations, with a view to providing aetiologically useful sub-groupings for genomic studies. RESULTS: We examined 78 hearts previously classified as HLHS, with subtypes based on valve patency, and re-categorised them based on their objective ventricular phenotype. Three distinct subgroups could be identified: slit-like left ventricle (24%); miniaturised left ventricle (6%); and thickened left ventricle with endocardial fibroelastosis (EFE; 70%). Slit-like ventricles were always found in combination with aortic atresia and mitral atresia. Miniaturised left ventricles all had normally formed, though smaller aortic and mitral valves. The remaining group were found to have a range of aortic valve malformations associated with thickened left ventricular walls despite being described as either atresia or stenosis. The degree of myocardial thickening was not correlated to the degree of valvar stenosis. Lineage tracing in mice to investigate the progenitor populations that form the parts of the heart disrupted by HLHS showed that whereas Nkx2-5-Cre labelled myocardial and endothelial cells within the left and right ventricles, Mef2c-AHF-Cre, which labels second heart field-derived cells only, was largely restricted to the endocardium and myocardium of the right ventricle. However, like Nkx2-5-Cre, Mef2c-AHF-Cre lineage cells made a significant contribution to the aortic and mitral valves. In contrast, Wnt1-Cre made a major contribution only to the aortic valve. This suggests that discrete cardiac progenitors might be responsible for the patterns of defects observed in the distinct ventricular sub-groups. CONCLUSIONS: Only the slit-like ventricle grouping was found to map to the current nomenclature: the combination of mitral atresia with aortic atresia. It appears that slit-like and miniature ventricles also form discrete sub-groups. Thus, reclassification of HLHS into subgroups based on ventricular phenotype, might be useful in genetic and developmental studies in investigating the aetiology of this severe malformation syndrome.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170815
[Lr] Last revision date:170815
[St] Status:In-Process
[do] DOI:10.1186/s13023-017-0683-4

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[PMID]: 28780589
[Au] Autor:Korzh V
[Ad] Address:International Institute of Molecular and Cell Biology, Warsaw, Poland. vkorzh@iimcb.gov.pl.
[Ti] Title:Development of brain ventricular system.
[So] Source:Cell Mol Life Sci;, 2017 Aug 05.
[Is] ISSN:1420-9071
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:The brain ventricular system (BVS) consists of brain ventricles and channels connecting ventricles filled with cerebrospinal fluid (CSF). The disturbance of CSF flow has been linked to neurodegenerative disease including hydrocephalus, which manifests itself as an abnormal expansion of BVS. This relatively common developmental disorder has been observed in human and domesticated animals and linked to functional deficiency of various cells lineages facing BVS, including the choroid plexus or ependymal cells that generate CSF or the ciliated cells that cilia beating generates CSF flow. To understand the underlying causes of hydrocephalus, several animal models were developed, including rodents (mice, rat, and hamster) and zebrafish. At another side of a spectrum of BVS anomalies there is the "slit-ventricle" syndrome, which develops due to insufficient inflation of BVS. Recent advances in functional genetics of zebrafish brought to light novel genetic elements involved in development of BVS and circulation of CSF. This review aims to reveal common elements of morphologically different BVS of zebrafish as a typical representative of teleosts and other vertebrates and illustrate useful features of the zebrafish model for studies of BVS. Along this line, recent analyses of the two novel zebrafish mutants affecting different subunits of the potassium voltage-gated channels allowed to emphasize an important functional convergence of the evolutionarily conserved elements of protein transport essential for BVS development, which were revealed by the zebrafish and mouse studies.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1708
[Cu] Class update date: 170806
[Lr] Last revision date:170806
[St] Status:Publisher
[do] DOI:10.1007/s00018-017-2605-y

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[PMID]: 28665241
[Au] Autor:Kraemer MR; Sandoval-Garcia C; Bragg T; Iskandar BJ
[Ad] Address:Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin.
[Ti] Title:Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons.
[So] Source:J Neurosurg Pediatr;20(3):216-224, 2017 Sep.
[Is] ISSN:1933-0715
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS). RESULTS Respondents agreed that shunt malfunction occurs most often as the result of ventricular catheter obstruction. Despite contrary evidence in the literature, most respondents (66%) also believed that choroid plexus is the tissue most often found in obstructed proximal catheters. However, free-text responses revealed that the respondents' understanding of the underlying pathophysiology of shunt obstruction was highly variable and included growth, migration, or adherence of choroid plexus, CSF debris, catheter position, inflammatory processes, and CSF overdrainage. Most respondents considered chronic CSF overdrainage to be a rare complication of shunting in their practice and reported wide variation in treatment protocols. Moreover, despite a lack of evidence in the literature, most respondents attributed chronic headaches in shunt patients to medical reasons (for example, migraines, tension). Accordingly, most respondents managed headaches with reassurance and/or referral to pain clinics. Lastly, there were variable opinions on the etiology of slit ventricle syndrome (SVS), which included early shunting, chronic overdrainage, and/or loss of brain compliance. Beyond shunt revision, respondents reported divergent SVS treatment preferences. CONCLUSIONS The survey shows that there is wide variability in the understanding and management of shunt-dependent hydrocephalus and its complications. Such discrepancies appear to be derived partly from inconsistent familiarity with existing literature but especially from a paucity of high-quality publications.
[Mh] MeSH terms primary: Cerebrospinal Fluid Shunts
Hydrocephalus/etiology
Hydrocephalus/therapy
[Mh] MeSH terms secundary: Child
Equipment Failure
Headache Disorders, Secondary/etiology
Headache Disorders, Secondary/therapy
Humans
Neurosurgeons
Pediatricians
Slit Ventricle Syndrome/etiology
Slit Ventricle Syndrome/therapy
Societies, Medical
Surveys and Questionnaires
United States
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171115
[Lr] Last revision date:171115
[Js] Journal subset:IM
[Da] Date of entry for processing:170701
[St] Status:MEDLINE
[do] DOI:10.3171/2017.2.PEDS16265

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[PMID]: 28352945
[Au] Autor:Ros B; Iglesias S; Martín Á; Carrasco A; Ibáñez G; Arráez MA
[Ad] Address:Pediatric Neurosurgery Section, Department of Neurosurgery, Regional University Hospital, Malaga, Spain. broslopez@yahoo.es.
[Ti] Title:Shunt overdrainage syndrome: review of the literature.
[So] Source:Neurosurg Rev;, 2017 Mar 29.
[Is] ISSN:1437-2320
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Shunt overdrainage in patients with hydrocephalus still represents a challenge for neurosurgeons, in part due to the lack of agreement or uniformity concerning the entity. Important problems exist relating to the real incidence of the entity, its definition, classification, and the pathophysiological theories behind the various treatment strategies proposed. Recent reports have suggested that the evidence about overdrainage and its consequences is not so robust as presumed. Consequently, the topic requires more detailed examination. In this review, we comment on all the main facets related with shunt overdrainage.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1703
[Cu] Class update date: 170329
[Lr] Last revision date:170329
[St] Status:Publisher
[do] DOI:10.1007/s10143-017-0849-5

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[PMID]: 28243031
[Au] Autor:Kim WJ; Kim MM
[Ad] Address:Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
[Ti] Title:Slit Ventricle Syndrome in Pediatric Patient Presenting with Only Visual Symptoms.
[So] Source:Korean J Ophthalmol;31(1):92-93, 2017 02.
[Is] ISSN:2092-9382
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Mh] MeSH terms primary: Slit Ventricle Syndrome/complications
Vision Disorders/etiology
Visual Acuity
[Mh] MeSH terms secundary: Child
Humans
Male
Slit Ventricle Syndrome/diagnosis
Tomography, X-Ray Computed
Vision Disorders/diagnosis
Vision Disorders/physiopathology
[Pt] Publication type:CASE REPORTS; LETTER
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[Js] Journal subset:IM
[Da] Date of entry for processing:170301
[St] Status:MEDLINE
[do] DOI:10.3341/kjo.2017.31.1.92

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[PMID]: 27888273
[Au] Autor:Yamaguchi J; Watanabe T; Nagata Y; Nagatani T; Seki Y
[Ad] Address:Department of Neurosurgery, Nagoya Daini Red Cross Hospital, Japan.
[Ti] Title:Upward ballooning of the third ventricle floor in a patient with slit ventricle syndrome: A unique magnetic resonance imaging finding.
[So] Source:Neuroradiol J;30(1):62-64, 2017 Feb.
[Is] ISSN:2385-1996
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Slit ventricle syndrome (SVS) is a well-known chronic complication of ventriculoperitoneal shunt (VPS) placement. In this report, we describe a unique anatomical change that we observed on the magnetic resonance (MR) images of the brain acquired from a patient with SVS. The patient was a 40-year-old woman who had undergone VPS placement at 3 months of age. A computed tomography scan of her brain revealed a slit-like ventricle. In addition, an MR image of her brain revealed upward ballooning of the third ventricle floor, which returned to normal after a lumbar puncture. This anatomical change resulted from the pressure gradient between the intra- and extraventricular spaces. We believe our findings will further our understanding of the pathogenesis of SVS. Moreover, we hope our findings will help clinicians to select endoscopic third ventriculostomy as the primary surgical approach in patients with this particular SVS pathogenesis in order to avoid complications.
[Mh] MeSH terms primary: Magnetic Resonance Imaging/methods
Slit Ventricle Syndrome/diagnostic imaging
Slit Ventricle Syndrome/pathology
Third Ventricle/diagnostic imaging
[Mh] MeSH terms secundary: Adult
Female
Humans
Tomography, X-Ray Computed
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1702
[Cu] Class update date: 170829
[Lr] Last revision date:170829
[Js] Journal subset:IM
[Da] Date of entry for processing:161127
[St] Status:MEDLINE
[do] DOI:10.1177/1971400916679189


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