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intraventricular neurocysticercosis: Presentation, diagnosis and management

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Asian Pacific Journal of Tropical Medicine 2016年第8期9卷 792-795页

作者： Tomas Ostergaard Jensen Jeffrey John Post Department of Infectious Diseases Prince of Wales Hospital

Neurocysticercosis is thought to be the most common helminthic infection of the central nervous system and its epidemiology is changing due to increasing travel and migration.Evidence to guide management of the intraventricular form is limited.We aimed to review the clinical presentation,diagnosis and treatment of intraventricular neurocysticercosis with reference to two recent cases seen at our institution.The intraventricular variant of neurocysticercosis is less common than parenchymal disease and usually presents with acutely raised intracranial pressure and untreated it progresses rapidly with high mortality.The diagnosis is based on imaging and serological tests but more invasive testing including histopathological examination of surgically acquired tissue specimens is sometimes required.Treatment is mainly surgical,using a neuroendoscopic approach if possible.Patients should also receive antihelmintic treatment with concomitant corticosteroids to reduce the incidence of shunt failure if a ventricular shunt is inserted and to treat viable lesions elsewhere.

关键词： Taenia solium Cysticercosis Neurocysticercosis intraventricular Human Adult

Endoscopic Surgery versus External Ventricular Drainage Surgery for Severe intraventricular Hemorrhage

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Current Medical Science 2018年第5期38卷 880-887页

作者： Ping SONG Fa-liang DUAN Qiang CAI Jing-lei WU Xiao-bin CHEN Yuan WANG Cong-gang HUANG Ji-qiang LI Zhu-qiang HE Qiao-chun HUANG Mei LIU Yan-gao ZHANG Ming LUO Department of Neurosurgery the First Hospital of WuhanWuhan 430022China Department of Neurosurgery Renmin Hospital of Wuhan UniversityWuhan 430060China Intensive Care Unit the First Hospital of WuhanWuhan 430022China

The efficacy and applied value of endoscopic hematoma evacuation vs. external ventricular drainage (EVD) in the treatment of severe ventficular hemorrhage (IVH) were explored and compared.From Jan.2015 to Dec.2016,the clinical data of 42 cases of IVH were retrospectively analyzed,including 18 patients undergoing endoscopic hematoma evacuation (group A),and 24patients receiving EVD (group B).The hematoma clearance rate was calculated by 3D Slicer software,and complications and outcomes were compared between the two groups.There were no significant differences in age,sex and Graeb score between groups A and B (P>0.05).The hematoma clearance rate was 70.81%±27.64% in group A and 48.72%±36.58% in group B with a statistically significant difference (P<0.05).The operative time in groups A and B was 72.45±25.26 min and 28.54±15.27min,respectively (P<0.05).The Glasgow Coma Scale (GCS) score increased from 9.28±2.72 at baseline to 11.83±2.91 at 1 week postoperatively in group A,and from 8.25±2.62 at baseline to 10.79±4.12 at 1 week postoperatively in group B (P<0.05).The length of hospital stay was 12.67±5.97 days in group A and 17.33±8.91 days in group B with a statistically significant difference (P<0.05).The GOS scores at 6 months after surgery were 3.83±1.12 in group A,and 2.75±1.23 in group B (P<0.05). These results suggested that endoscopic hematoma evacuation has an advantage of a higher hematoma clearance rate,fewer complications and better outcomes in the treatment of severe IVH,indicating it is a safe,effective and promising approach for severe IVH.

关键词： endoscopic surgery severe intraventricular hemorrhage external ventricular drainage

Entrapment of the temporal horn secondary to postoperative gamma-knife radiosurgery in intraventricular meningioma: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2894-2898页

作者： Jia Liu Sheng-Rong Long Guang-Yu Li Department of Neurosurgery the First Hospital of China Medical University

BACKGROUND Entrapment of the temporal horn (ETH) is a rare pathologic condition. It is a kind of focal hydrocephalus caused by obstruction of flow pathway of cerebrospinal fluid. It is caused by various conditions, but ETH secondary to postoperative gamma-knife radiosurgery (GKS) is extremely rare. CASE SUMMARY A 52-year old previously healthy woman underwent resection of a large intraventricular meningioma. A small fragment of residual tumor with no obvious enlargement of the temporal horn was observed 3 mo after surgery, and she was referred for GKS. Two months after GKS, she complained of headache and progressive paralysis of the left limb. Magnetic resonance imaging revealed enlargement of the temporal horn. There was a second procedure to resect the residual tumor 8 mo after GKS. After the second procedure, she recovered smoothly. As of the date of this writing, she has remained in good condition. CONCLUSION This case reminds us that ETH should be considered in the treatment of intraventricular meningiomas, especially before GKS.

关键词： Entrapment of the temporal horn Gamma-knife radiosurgery intraventricular meningioma Case report

Reversible cerebral vasoconstriction syndrome presenting as an isolated primary intraventricular hemorrhage

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Chinese Neurosurgical Journal 2018年第4期4卷 239-242页

作者： Katarina Dakay Ryan A.McTaggart Mahesh V.Jayaraman Shadi Yaghi Linda C.Wendell Department of Neurology Rhode Island Hospital/The Warren Alpert Medical School of Brown UniversityProvidenceRIUSA Departments of Radiology Neurologyand NeurosurgeryRhode Island Hospital/The Warren Alpert Medical School of Brown UniversityProvidenceRIUSA Department of Neurology Neurosurgery and Medical EducationRhode Island Hospital/The Warren Alpert Medical School of Brown University593 Eddy St APC 712ProvidenceRI 02903USA

Background: Primary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension. Reversible cerebral vasoconstriction is also an uncommon condition characterized by reversible constriction of intracerebral vessels, which can lead to ischemic or hemorrhagic strokes. Case presentation: We describe a case of isolated primary intraventricular hemorrhage secondary to reversible cerebral vasoconstriction syndrome triggered by pseudoephedrine. Conclusions: Reversible cerebral vasoconstriction syndrome is a rare cause of primary intraventricular hemorrhage and should be considered in the differential in angiography-negative IVH when there is a history of vasoactive substance use.

关键词： Reversible cerebral vasoconstriction syndrome Pseudoephedrine Primary intraventricular hemorrhage

intraventricular tuberculoma: A case report

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Case Reports in Clinical Medicine 2013年第1期2卷 81-84页

作者： O. Coulibaly S. Diawara K. Quénum Y. Sogoba M. Boutarbouch A. Melhaoui L. Rifi Y. Arkha S. Derraz A. El Ouahabi A. El Khamlichi Department of Neurosurgery CHU IbnSina Rabat Morocco

Intracranial tuberculomas are one of the most serious formsof tuberculosis disease after meningitis tuberculosis. It incidence varies around 0.15% - 0.18% in the development world to 5% - 30% of intracranial masses in some under developments areas. These tuberculomas, of course ubiquitous, are mostly diagnosed in the adulthood and usually located in the cerebellum and the cerebral hemispheres. Intra ventricular involving is uncommon and just 10 cases had been described in the literature. We report a case of an intraventricular tuberculoma in a 26- year-old man and we discuss the pathogenesis and the radiological findings according this location.

关键词： Intracranial Tuberculosis intraventricular Tuberculoma Antituberculous Treatment

Adrenal Hemorrhage as a Rare Cause of Neonatal Anemia Associated with Hydrocephalus Secondary to intraventricular Hemorrhage—A Case Report

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International Journal of Clinical Medicine 2013年第10期4卷 455-458页

作者： Krushnakumar Kesan Rahul Kumar Gupta Paras Kothari Abhaya Gupta Ritesh Ranjan Kedar Mudkhedkar Parag Karkera MCh Pediatric Surgery Department of Pediatric Surgery LTMMC & LTMGH Sion Mumbai India

Neonatal adrenal hemorrhage is frequently associated with birth trauma, perinatal asphyxia, intrauterine infection, coagulation defects and thromboembolism. It has varied clinical presentation depending on degree of hemorrhage and amount of adrenal cortex compromised by hemorrhage. The most common clinical presentations are persistent jaundice and flank mass. We report a case of left sided adrenal hemorrhage in a breech delivered male neonate with perinatal asphyxia presented with anemia and fever. On further evaluation, he was also having moderate communicating hydrocephalus secondary to intraventricular hemorrhage. The adrenal hemorrhage was managed conservatively. Subsequent abdominal ultrasound showed resolving adrenal hemorrhage. Right ventriculoperitoneal shunt was done for hydrocephalus. Postoperative course was uneventful. The patient is asymptomatic at follow-up.

关键词： Adrenal Hemorrhage Neonatal Anemia Hydrocephalus intraventricular Hemorrhage

Evacuation of Spontaneous Thalamic and intraventricular Hemorrhage under the Operating Microscope Improves Mortality Compared with External Ventricular Drainage——Mini-Cranioctomy for Thalamic and Ventricular Hemorrhage

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Open Journal of Modern Neurosurgery 2011年第1期1卷 1-4页

作者： Tomonori Tamaki Yoji Node Akira Teramoto 不详

We performed direct hematoma evacuation of thalamic and intraventricular hemorrhage using mini-craniotomy in recent years. The present study evaluated the outcome and complications in 18 patients with spontaneous thalamic and intraventricular hemorrhage treated by mini-craniotomy hematoma evacuation with external ventricular drainage and 24 patients treated by only external ventricular drainage. Patients treated by mini-craniotomy were less likely to require days of ventricular drainage settlement, had a less suffering meningitis, had good hematoma evacuation rate and had a less mortality rate compared with those undergoing only external ventricular drainage. Frontal mini-craniotomy microscope operation is a simple and effective method for hematoma evacuation that causes fewer complications.

关键词： Thalamic Hemorrhage intraventricular Hemorrhage Hydrocephalus

Intra-Ventricular Tumors: Assessment of 40 Cases

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Open Journal of Modern Neurosurgery 2014年第2期4卷 53-58页

作者： Lutfi SPostalci Omur Günaldi Bulent Demirgil Serhat Baydin Ender Ofluoglu Bekir Tugcu Meral Gunaldi Bakirkoy Research and Training Hospital for Neurology Neurosurgery and PhsychiatryNeurosurgery ClinicistanbulTurkey Bakirkoy Research and Training Hospital Medical Oncology ClinicBakirkoyistanbulTurkey

Objective: Intra-ventricular mass lesion has a significant position at diagnostic and therapeutic stage since they have deep localization and they are in close proximity with important neurovascular structures. We examined 40 patients who had surgical treatment for intraventricular mass lesion with respect to localization, symptoms, pathology, surgery method and outcomes. Method: 40 patients who were operated due to the ventricular mass lesion were examined with respect to the clinical picture and radiologic and pathologic findings as well as surgical methods and outcomes. Results: Of the mass lesions, 20 were located at lateral ventricle, 15 had 3rd ventricle localization and 7 were located at 4th ventricle. Ages of the patient ranged from 3 years to 67 years. The most common symptom was headache and nausea/vomiting. Interhemispheric transcallosal approach was preferred for 19 patients, while transcortical approach and other methods were used for 12 patients and 9 patients, respectively. Conclusion: Considering the surgical methods and outcomes, the aim should be extraction of the mass lesion with minimum damage. Transcortical approach is more common for mass lesion located at lateral ventricle. Recently, endoscopic methods are more commonly and successfully used.

关键词： intraventricular Tumor Mass

Minimally invasive puncture and drainage or patients with hypertensive spontaneous basal ganglia intracerebral hemorrhage: A prospective non-randomized comparative study of 198 cases

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Journal of Medical Colleges of PLA(China) 2014年第1期29卷 19-31页

作者： Guo-Qiang Wang Shi-Qiang Li Wei-Wei Zhang Yong-Hua Huang Wen-Wei Ruan Jia-Zhen Qin Ying Li Wei-Min Yin Yun-Jun Li Zheng-Jun Ran Ji-Qiang Zhu Yun-Yan Ding Jun-Qi Peng Pei-Jian Li Department of Neurology General Hospital of Beijing Military Command Department of Neurology Xianghe Hospital of Traditional Chinese Medicine Department of Neurosurgery General Hospital of Beijing Military Command Department of Neurology General Hospital of Beijing Military Command

Background: The treatment of hypertensive spontaneous intracranial hemorrhage(ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage(MIPD) could provide improved patient outcome compared with decompressive craniectomy(DC).Methods: Eligible, consecutive patients with ICH(≥30 ml, in basal ganglia, within 24 hours of ictus) were nonrandomly assigned to receive MIPD(group A) or to undergo DC(group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale(GOS, scores range from 1 to 5, score 1 indicating death, ≥4 indicating functional independence, with lower scores indicating greater disability). Results: A total of 198 patients met the per protocol analysis(84 cases in group A and 114 cases in group B), including 9 cases lost during follow-up(2 cases in group A and 7 cases in group B). For these 9 patients, their last observed data were used as their final results for intention-to-treat analysis. The mean age of all patients was 57.1 years(range of 31-95 years), and 114 patients were male. The initial Glasgow Coma Scale(GCS) score was 8.1±3.4, and the National Institutes of Health Stroke Scale(NIHSS) score was 20.8±5.3. The mean hematoma volume(HV) was 56.7±23.0 ml(range of 30-144 ml), and there was extended intraventricular hemorrhage(IVH) in 134 patients(67.7%). There were no significant intergroup differences in the above baseline data, except group A had a higher mean age(59.4±14.5years) than the mean age of group B(55.3±11.1 years, P=0.025). The total cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%, respectively, and there were no significant differences between groups A and B(30 days: 27.4% vs. 36.0%, P=0.203; 1 year: 36.1% vs. 48.2%, P=0.112, respectively). However, the mortality for patients ≤60 years, NIHSS<15 or HV≤60 ml was significantly lower in group A than that in group B(all P<0.05). The total cumulative functio

关键词： intracerebral hemorrhage intraventricular hemorrha