They also should be congratulated for having provided a quite useful addition to the rich literature concerning hydrocephalus …. All of these identified causes of death should be considered as shunt-unrelated. This review aims to help to establish the current state of knowledge and to identify conflicting data and unanswered questions, in order to direct future studies. Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature. Epilepsy in childhood shunted hydrocephalus.
Success and failure of endoscopic third ventriculostomy in young infants: are there different age distributions? What are the determinants of outcome? Whether such a rate justifies routine shunt series or not is debatable. The mean duration of follow up was 26 months. Quality of life in children with hydrocephalus: results from the Hospital for Sick Children, Toronto. Development of the cerebrospinal fluid pathways during embryonic and fetal life in humans. Throughout the book, the text is clearly presented with subheadings and high-quality illustrations.
We shall therefore categorize hydrocephalus outcomes under the following broad headings: surgical outcome shunt half-life, rate of shunt malfunction, rate of infection, and the issue of shunt-independence and complications of endoscopy; mortality shunt-related as well as related to other causes ; morbidity cognition, motor system, vision, epilepsy, neuroendocrine problems and fertility, chronic headache ; and functional social outcome schooling, social integration, marital status. In fixed brain specimens two areas of relative constriction have been found: one is at the level of the superior colliculus, the other at the level of the intercollicular sulcus; in cross section the lumen is highly changeable, probably owing to the influence of different nuclear masses or fiber tracts surrounding it at different levels. There remain grey areas in which the cause of death can be multiple or be totally unexplained. The chapters on types of hydrocephalus with different etiologies include the diagnosis, treatment and outcomes for posthemorrhagic hydrocephalus, hydrocephalus due to tumors and other space-occupying lesions, hydrocephalus associated with myelomeningocele and with Dandy-Walker malformation, with parasitic and fungal disease and with aqueductal stenosis. After selecting clinical series, searching among related citations, and adding some publications on specific topics, the survey consisted of 122 references. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation.
Complications of endoscopic third ventriculostomy and ventricular shunts. Malfunction includes obstruction, overdrainage, underdrainage, and occult shunt failure including the need for elective revision for tube lengthening. Multiple etiologies are proposed for this condition. Complications of endoscopic third ventriculostomy and ventricular shunts. Factors causing acute shunt infection.
Influence of shunt type on ventricular volume changes in children with hydrocephalus. Long-term outcome after treatment of hydrocephalus in children. Classification of hydrocephalus and prenatal hydrocephalus. Endoscopic placement of a stent in the aqueduct is more effective in preventing the repeated occlusion of the aqueduct than aqueductoplasty alone and should be indicated as the initial treatment in each case of compatible anatomy. Throughout the book, the text is clearly presented with subheadings and high-quality illustrations. Hydrocephalus in neurocysticercosis and other parasitic and infectious diseases. Hydrocephalus in neurocysticercosis and other parasitic and infectious diseases.
Four variables epilepsy, shunt obstruction, shunt infection and endoscopy are listed both as predictive and as dependent variables. These studies included prospective studies, retrospective studies, and cross-sectional surveys. They also should be congratulated for having provided a quite useful addition to the rich literature concerning hydrocephalus. Development of the cerebrospinal fluid pathways during embryonic and fetal life in humans. The correct interpretation of the modern neuroradiologic techniques may help in selecting adequate treatment between the two main options third ventriculostomy or shunting.
What are the ideal modalities of follow-up after endoscopic surgery? Maixner Subject: Ventriculo-peritoneal shunts Subject: Radiology, medical Subject: Neuroendoscopic surgery Subject: Endoscopic third ventriculostomy Subject: Neuroradiology Subject: Neurosurgery. Hydrocephalus in neurocysticercosis and other parasitic and infectious diseases. Despite these barriers, we must continue to strive for randomized trials, where appropriate, and to also take steps to make future retrospective and non-randomized prospective studies more useful. For example, scientific societies and journals should encourage the standardized use of evaluation tools and analytic techniques e. The following data were extracted: the population studied age and cause of hydrocephalus , duration of follow-up, the incidence of shunt malfunction and infection, the mortality and morbidity, the functional outcome schooling, occupation, social integration , and in rare studies, the medical resources available. Fenestration was performed based on the intraoperative findings, either ventriculocystostomy, ventriculocystoventriculostomy, or ventriculocystocisternostomy.
However, these limitations did not preclude the individuation of surgical, and to a minor extent, medical remedies. Abdominal complications of peritoneal shunts. Although postoperative infection is generally defined as occurring with one month of surgery, the rate of infection should also be evaluated over a longer term, since infection can occasionally occur several years after surgery. Effectiveness of a clinical pathway for patients with cerebrospinal fluid shunt malfunction. The advantages of modern imaging techniques both for diagnosis and post-operative assessment are emphasized.
This review summarizes the content and usefulness of this multi-author volume for those involved in the treatment of pediatric hydrocephalus. Early treatment of posthemorrhagic hydrocephalus in low-birth-weight infants with valveless ventriculoperitoneal shunts. In all patients a supratentorial shunt had already been implanted, and in five patients neuroendoscopy had already been performed because other isolated compartments had been present inside the ventricular system. Standards have yet to be established regarding the frequency of visits and imaging. It draws upon the clinical experience of fifty-eight experts. Jones, Cerebrospinal Fluid Research, Vol.
Throughout the book, the text is clearly presented with subheadings and high-quality illustrations. The same degree of ventricular dilation or abnormally increased intraventricular pressure that is apparently well tolerated in some subjects is associated to a catastrophical clinical course in others. In our limited experience, there are two anatomic backgrounds; velum interpositum cistern and quadrigeminal cistern. We found no study on pediatric hydrocephalus using the Rankin 7-grades scale, although this is widely used in adult studies. The findings suggest that old hemorrhage is a cause of chemical arachnoiditis and adhesions causing aqueduct stenosis and hydrocephalus.