Abstract:
:OBJECTIVE The introduction of ventriculoperitoneal shunts changed the way hydrocephalus was treated. Whereas much is known about the causes of shunt failure in the first few years, there is a paucity of data in the literature regarding the cause of late shunt failures. The authors conducted a study to find out the different causes of late shunt failures in their institution. METHODS A 10-year retrospective study of all the patients who were treated in the authors' hospital between 2006 and 2015 was conducted. Late shunt failures included those in patients who had to undergo shunt revision more than 5 years after their initial shunt insertion. The patient's notes and scans were reviewed to obtain the age and sex of the patient, the time it took for the shunt to fail, the reason for failure, and the patient's follow-up. RESULTS Forty-six patients in the authors' institution experienced 48 late shunt failures in the last 10 years. Their ages ranged from 7 to 26 years (12.23 ± 4.459 years [mean ± SD]). The time it took for the shunts to fail was between 6 and 24 years (mean 10.25 ± 3.77 years). Reasons for failure resulting in shunt revision include shunt fracture in 24 patients (50%), shunt blockage in 14 patients (29.2%), tract fibrosis in 6 patients (12.5%), shunt dislodgement in 2 patients (4.2%), and shunt erosion in 2 patients (4.2%). Postoperative follow-up for the patients ranged from 6 to 138 months (mean 45.15 ± 33.26 months). CONCLUSIONS Late shunt failure is caused by the effects of aging on the shunt, and the complications are different from early shunt failure. A large proportion are complications associated with shunt calcification. The authors advocate a long follow-up for pediatric patients with shunts in situ to monitor them for various causes of late shunt failure.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Lee L,Low S,Low D,Ng LP,Nolan C,Seow WTdoi
10.3171/2016.8.FOCUS16277subject
Has Abstractpub_date
2016-11-01 00:00:00pages
E7issue
5issn
1092-0684journal_volume
41pub_type
杂志文章abstract::Craniosynostosis is the premature fusion of one or more cranial sutures. When a cranial suture fuses prematurely, skull growth is altered and the head takes on a characteristic pathological shape determined by the suture(s) that fuses. Numerous treatment options have been proposed, but until recently there were no par...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2011.6.FOCUS1192
更新日期:2011-08-01 00:00:00
abstract::In this review of the literature the goal was to determine the frequency and relevance of hemodynamic instability after carotid artery (CA) angioplasty and stent placement. Hemodynamic instability after CA angioplasty and stent placement is a well-recognized phenomenon that occurs in 29 to 51% of patients undergoing t...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.18.1.7
更新日期:2005-01-15 00:00:00
abstract:OBJECT:Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS:The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 an...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2002.12.5.3
更新日期:2002-05-15 00:00:00
abstract::The diagnosis and treatment of a patient with a pituitary adenoma or another type of pituitary lesion requires a team approach involving the neurosurgeon, endocrinologist, primary care physician, and, in some patients, an ophthalmologist and radiation therapist. The diagnosis of excessive pituitary hormone secretion a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2004.16.4.2
更新日期:2004-04-15 00:00:00
abstract::OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumo...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.6.FOCUS16125
更新日期:2017-01-01 00:00:00
abstract::Vein of Galen malformations are rare congenital intracranial vascular malformations. Based on reports in the literature, spontaneous thrombosis or regression of these lesions is rare. Patients have variable outcomes from an asymptomatic course to death. The reasons behind spontaneous thrombosis are not entirely unders...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.8.FOCUS09162
更新日期:2009-11-01 00:00:00
abstract:OBJECT:The supraorbital eyebrow approach is a minimally invasive technique that offers wide access to the anterior skull base region and parasellar area through asubfrontal corridor. The use of neuroendoscopy allows one to extend the approach further to the pituitary fossa, the anterior third ventricle, the interpedunc...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2014.7.FOCUS14203
更新日期:2014-01-01 00:00:00
abstract:OBJECT:An experimental study was performed to determine the biomechanical end-mounting configurations that replicate in vivo physiological motion of the cervical spine in a multiple-level human cadaveric model. The vertebral motion response for the modified testing protocol was compared to in vivo motion data and tradi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:
更新日期:2004-09-15 00:00:00
abstract::Over the past century pituitary surgery has undergone multiple revolutions in surgical technique and technological advancements that have resulted in what is now recognized as modern transsphenoidal surgery. Although the procedure is well established in the current neurosurgical literature, the historical maze that le...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2001.11.4.8
更新日期:2001-10-15 00:00:00
abstract::Cervical dural arteriovenous fistulas (dAVFs) are a rare cause of intracranial subarachnoid hemorrhage (SAH) but should be considered when other sources are not found. Subarachnoid hemorrhage caused by dAVF is thought to occur as a result of venous hypertension in most cases. The clinical presentation, acute onset of ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC.2009.26.1.E4
更新日期:2009-01-01 00:00:00
abstract::Cerebral revascularization procedures have been used in the clinical management of actual or threatened cerebral ischemic states and unclippable cerebral aneurysms. An alternative to a low-flow bypass graft (for example, with the superficial temporal artery) is the use of high-flow grafts created using the saphenous v...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC/2008/24/2/E5
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:The recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be consider...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.12.FOCUS19448
更新日期:2020-03-01 00:00:00
abstract:OBJECT:Angiogram-negative subarachnoid hemorrhage (SAH) accounts for 15% of nontraumatic SAH and has been reported with low morbidity and mortality rates. We report on a large series of patients with angiogram-negative SAH who experienced an atypical nonbenign clinical course. METHODS:Between December 2001 and Novembe...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2009.2.FOCUS092
更新日期:2009-05-01 00:00:00
abstract:OBJECT:Mild traumatic brain injury (MTBI), often referred to as concussion when it occurs in sports, produces persistent cognitive problems in at least 15% of patients. Unfortunately, conventional neuropsychological tests usually yield results within normal limits in this population. The main objective of this event-re...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.10.FOCUS12253
更新日期:2012-12-01 00:00:00
abstract::Occipital plagiocephaly caused by lambdoid synostosis is rare. Positional flattening is more common and will most often respond to conservative measures. Surgical correction of a flat occiput is warranted if the deformity is profound. Skull molding devices may be effective for treating mild abnormalities but are ineff...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1997.2.2.9
更新日期:1997-02-15 00:00:00
abstract::Cerebral cavernous malformations (CCMs) are common vascular lesions of the CNS that may lead to seizures, focal neurological deficits, and fatal hemorrhagic stroke. Human genetic studies have identified 3 genes associated with CCM, and biochemical and molecular studies in mice have elucidated signaling pathways with i...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2010.6.FOCUS10135
更新日期:2010-09-01 00:00:00
abstract:OBJECT:Tumors involving the cervicothoracic junction can have a high propensity for causing instability, with kyphosis and spinal cord compression resulting. Treatment with decompression only can lead to further instability and worsening neurological status. In this article, the authors review their surgical experience...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2003.15.5.3
更新日期:2003-11-15 00:00:00
abstract:OBJECTIVE:Nerve root injuries associated with anterior lumbar interbody fusion (ALIF) are uncommonly reported in the literature. This case series and review aims to describe the etiology of L5 nerve root injury following ALIF at L5-S1. METHODS:The authors performed a single-center retrospective review of prospectively...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.6.FOCUS20315
更新日期:2020-09-01 00:00:00
abstract::This paper describes some of the more common patterns in neurobehavioral deficits and their underlying neuroanatomical basis in myelomeningocele (MMC). Patients with MMC can face a lifetime of specific organ system dysfunction, chief among them spinal cord malformations, orthopedic issues, hydrocephalus, and urologica...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19445
更新日期:2019-10-01 00:00:00
abstract::Surgery of the mind has a rather checkered past. Though its history begins with the prehistoric trephination of skulls to allow "evil spirits" to escape, the early- to mid-20th century saw a surge in the popularity of psychosurgery. The 2 prevailing operations were topectomy and leukotomy for the treatment of certain ...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2017.6.FOCUS17259
更新日期:2017-09-01 00:00:00
abstract::Both the history of headache and the practice of craniotomy can be traced to antiquity. From ancient times through the present day, numerous civilizations and scholars have performed craniotomy in attempts to treat headache. Today, surgical intervention for headache management is becoming increasingly more common due ...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2014.1.FOCUS13549
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:Acute traumatic subdural hematoma (atSDH) can be a life-threatening neurosurgical emergency that necessitates immediate evacuation. The elderly population can be particularly vulnerable to tearing bridging veins. The aim of this study was to evaluate inpatient morbidity and mortality, as well as predictors of...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2020.7.FOCUS20439
更新日期:2020-10-01 00:00:00
abstract:OBJECT:Simultaneous endoscopic third ventriculostomy (ETV) and tumor biopsy is a widely accepted therapeutic and diagnostic procedure for patients with noncommunicating hydrocephalus secondary to a pineal region tumor. Multiple approaches have been advocated, including the use of a steerable fiberoptic or rigid lens en...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.2.FOCUS10301
更新日期:2011-04-01 00:00:00
abstract:OBJECT:Diagnosis of cervical spinal injury (CSI) is an essential aspect of the trauma evaluation. This task is especially difficult in patients who are not clinically able to be evaluated (unevaluable) because of distracting painful injuries, intoxication, or concomitant head injury. For this population, the appropriat...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC.2008.25.11.E10
更新日期:2008-01-01 00:00:00
abstract::OBJECTIVE Stereotactic needle biopsies are usually performed for histopathological confirmation of intracranial lymphomas to guide adequate treatment. During biopsy, intraoperative histopathology is an effective tool to avoid acquisition of nondiagnostic samples. In the last years, 5-aminolevulinic acid (5-ALA)-induce...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.3.FOCUS1859
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Convection-enhanced delivery (CED) and osmotic pump delivery both have been promoted as promising techniques to deliver drugs to pediatric diffuse intrinsic pontine gliomas (DIPGs). Correspondingly, the aim of this study was to understand how infusate molecular weight (MW), duration of delivery, and mechanism...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.10.FOCUS19703
更新日期:2020-01-01 00:00:00
abstract::Since the earliest recorded history of medicine, physicians have been challenged by the difficulty in relieving the great pain experienced by individuals suffering from trigeminal neuralgia (TN). The nature of the pain and the events that incite it have been well described, but effective treatments with acceptable lev...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/foc.2005.18.5.5
更新日期:2005-05-15 00:00:00
abstract::Stereotactic radiosurgery is an effective management strategy for properly selected patients with arteriovenous malformations (AVMs). However, the risk of postradiosurgical radiation-related injury is higher in patients with large AVMs. Multistaged volumetric management of large AVMs was undertaken to limit the radiat...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2014.6.FOCUS14217
更新日期:2014-09-01 00:00:00
abstract::OBJECT Bevacizumab (Avastin), an antibody to vascular endothelial growth factor (VEGF), alone or in combination with irinotecan (Camptosar [CPT-11]), is a promising treatment for recurrent glioblastoma. However, the intravenous (IV) administration of bevacizumab produces a number of systemic side effects, and the incr...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.1.FOCUS14743
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:Treatment failure and inevitable tumor recurrence are the main reasons for the poor prognosis of glioblastoma (GB). Gross-total resection at repeat craniotomy for GB recurrence improves patient overall survival but requires early and reliable detection. It is known, however, that even advanced MRI approaches ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.9.FOCUS19613
更新日期:2019-12-01 00:00:00