Maternal shunt dependency: implications for obstetric care, neurosurgical management, and pregnancy outcomes and a review of selected literature.

Abstract:

OBJECTIVE:Because more women with cerebrospinal fluid shunts are surviving to child-bearing age, neurosurgeons, obstetricians, and other health care professionals require information about the care of these patients, especially during pregnancy and delivery. The purpose of this study was to gather comprehensive data from women with shunts regarding their clinical histories during and immediately after pregnancy. The following questions were addressed. 1) How does maternal shunt dependency influence the course of pregnancies and pregnancy outcomes? 2) What neurosurgical complications characterize this population of patients? 3) What complications of shunt dependency influence obstetric management, including prenatal testing and delivery? METHODS:A total of 37 respondents (age, 18-41 yr), accounting for 77 pregnancies, completed a questionnaire providing information on maternal background and medical history, shunt performance during pregnancy, management of delivery, pregnancy outcomes, and unusual complications. RESULTS:Fifty-six pregnancies resulted in live births; of these, 47 occurred in women with ventriculoperitoneal shunts. Three women underwent therapeutic abortions, 1 experienced preterm delivery, and 8 experienced 17 miscarriages. Four women experienced seizures during pregnancy, five reported third-trimester headaches, and eight described abdominal pains during the first and third trimesters. Four babies were diagnosed as having congenital defects. Shunt malfunctions and revisions occurred 10 times in 7 women, either during pregnancy or within 6 months after delivery. No acute malfunctions occurred during delivery. Forty-seven cases, representing 84% of all pregnancies, exhibited no shunt malfunctions or revisions. CONCLUSION:This study extends previous observations to a larger population of shunt-dependent mothers. The results suggest that maternal shunt dependency entails a relatively high incidence of complications but that proper care of these patients can lead to normal pregnancies and deliveries.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Bradley NK,Liakos AM,McAllister JP 2nd,Magram G,Kinsman S,Bradley MK

doi

10.1097/00006123-199809000-00030

subject

Has Abstract

pub_date

1998-09-01 00:00:00

pages

448-60; discussion 460-1

issue

3

eissn

0148-396X

issn

1524-4040

journal_volume

43

pub_type

杂志文章,评审
  • The Camino intracranial pressure sensor: is it optimal technology? An internal audit with a review of current intracranial pressure monitoring technologies.

    abstract:OBJECTIVE:To audit the reliability of the Camino intracranial pressure (ICP) sensor (Camino Laboratories, San Diego, CA) in our clinical practice as part of a continuing quality assurance program, and to assess its relative usefulness as compared with currently available ICP monitoring technologies that we reviewed. D...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200111000-00026

    authors: Piper I,Barnes A,Smith D,Dunn L

    更新日期:2001-11-01 00:00:00

  • Neurosurgical Patients as Human Research Subjects: Ethical Considerations in Intracranial Electrophysiology Research.

    abstract::Intracranial electrical recordings and stimulation of neurosurgical patients have been central to the advancement of human neuroscience. The use of these methods has rapidly expanded over the last decade due to theoretical and technical advances, as well as the growing number of neurosurgical patients undergoing funct...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyx361

    authors: Chiong W,Leonard MK,Chang EF

    更新日期:2018-07-01 00:00:00

  • Positron emission tomographic studies on cerebral hemodynamics in patients with cerebral contusion.

    abstract::Positron emission tomography is currently one of the most useful methods for measurements of cerebral hemodynamics and oxygen metabolism, because it facilitates accurate analysis of the local cerebral circulation in three-dimensional quantitative images. In this study, we performed positron emission tomography studies...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199006000-00009

    authors: Tenjin H,Ueda S,Mizukawa N,Imahori Y,Hino A,Yamaki T,Kuboyama T,Ebisu T,Hirakawa K,Yamashita M

    更新日期:1990-06-01 00:00:00

  • Near-real-time guidance using intraoperative magnetic resonance imaging for radical evacuation of hypertensive hematomas in the basal ganglia.

    abstract:OBJECTIVE:To report our preliminary clinical experience in treating patients with hypertensive hemorrhage in the basal ganglia using a minimally invasive approach facilitated by intraoperative real-time imaging of an open magnetic resonance imaging (MRI) system and a newly designed cutting suction device. METHODS:We d...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200011000-00010

    authors: Bernays RL,Kollias SS,Romanowski B,Valavanis A,Yonekawa Y

    更新日期:2000-11-01 00:00:00

  • Retained language in dysgenic cortex: case report.

    abstract::Since the advent of magnetic resonance imaging, there has been renewed interest in disorders of cortical migration in the cause of focal epilepsy. The function of dysplastic cortex is poorly understood. We report a 46-year-old woman in whom this was assessed by intraoperative stimulation. This left-handed patient had ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199511000-00020

    authors: Leblanc R,Robitaille Y,Andermann F,Ptito A

    更新日期:1995-11-01 00:00:00

  • MIB-1 staining index of pediatric meningiomas.

    abstract:OBJECTIVE:For adult meningiomas, the staining index (SI) for the anti-Ki-67 monoclonal antibody MIB-1 is well correlated with histological atypia and tumor recurrence. MIB-1 SIs for meningiomas in the pediatric population have not been previously reported. Meningiomas tend to be more histologically aggressive and to re...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200103000-00027

    authors: Sandberg DI,Edgar MA,Resch L,Rutka JT,Becker LE,Souweidane MM

    更新日期:2001-03-01 00:00:00

  • The time course of myosin light-chain phosphorylation in blood-induced vasospasm.

    abstract::The phosphorylation of an M(r) 20,000 myosin light chain (MLC20) promotes the generation of contractile force through actin-myosin adenosine triphosphatase in most agonist-mediated vascular smooth muscle cell contraction. However, the role of calcium-mediated contractile processes in sustained arterial narrowing after...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199506000-00018

    authors: Harada T,Seto M,Sasaki Y,London S,Luo Z,Mayberg M

    更新日期:1995-06-01 00:00:00

  • Simvastatin attenuates microglial cells and astrocyte activation and decreases interleukin-1beta level after traumatic brain injury.

    abstract:OBJECTIVE:Our previous studies demonstrated that simvastatin promotes neurological functional recovery after traumatic brain injury (TBI) in rat; however, the underlying mechanisms remain poorly understood. The purpose of this study was to investigate the anti-inflammatory effect of simvastatin by measuring the level o...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000346272.76537.DC

    authors: Li B,Mahmood A,Lu D,Wu H,Xiong Y,Qu C,Chopp M

    更新日期:2009-07-01 00:00:00

  • Pontine cavernous angioma resected using the subtemporal, anterior transpetrosal approach determined using three-dimensional anisotropy contrast imaging: technical case report.

    abstract:OBJECTIVE AND IMPORTANCE:We describe a case of brainstem cavernous angioma resected by the subtemporal, anterior transpetrosal approach, selected on the basis of three-dimensional anisotropy contrast (3-DAC) imaging. CLINICAL PRESENTATION:A 64-year-old woman presented with sudden headache and gait disturbance. Anatomi...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000193531.59606.CB

    authors: Kashimura H,Inoue T,Ogasawara K,Ogawa A

    更新日期:2006-02-01 00:00:00

  • Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial.

    abstract:OBJECTIVE:We evaluated long-term clinical outcomes and postoperative physiological findings in acutely comatose patients with nonmissile surgical intraparenchymal temporal lobe hemorrhages and abnormal pupillary widening who received early preoperative high-dose mannitol (HDM) versus conventional dose mannitol treatmen...

    journal_title:Neurosurgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Cruz J,Minoja G,Okuchi K

    更新日期:2002-09-01 00:00:00

  • Neurosurgery and Manned Spaceflight.

    abstract::There has been a renewed interest in manned spaceflight due to endeavors by private and government agencies. Publicized goals include manned trips to or colonization of Mars. These missions will likely be of long duration, exceeding existing records for human exposure to extra-terrestrial conditions. Participants will...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1093/neuros/nyy531

    authors: Panesar SS,Fernandez-Miranda JC,Kliot M,Ashkan K

    更新日期:2020-03-01 00:00:00

  • Contribution of magnetic resonance spectroscopic imaging and L-[1-11C]tyrosine positron emission tomography to localization of cerebral gliomas for biopsy.

    abstract::Proton magnetic resonance spectroscopic imaging (1H-MRSI) and positron emission tomography with the tracer L-[1-11C]tyrosine (11C-TYR) were used to localize gliomas for biopsy or resection. This is especially helpful in cases of low-grade gliomas, if these lesions are not visualized by contrast-enhanced computed tomog...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199406000-00007

    authors: Go KG,Keuter EJ,Kamman RL,Pruim J,Metzemaekers JD,Staal MJ,Paans AM,Vaalburg W

    更新日期:1994-06-01 00:00:00

  • Higher cortical disorders: an unusual presentation of an arteriovenous malformation.

    abstract::The authors present a patient with a large arteriovenous malformation in the temperoparietooccipital region of the dominant hemisphere that caused seizures, a homonymous hemianopia, and broad neuropsychological disturbances probably caused by a cerebral steal syndrome. There was no history of hemorrhage. Surgical rese...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-198712000-00009

    authors: von Overbeeke JJ,Bosma NJ,Verdonck AF,von Huffelen AC

    更新日期:1987-12-01 00:00:00

  • Current status of carotid endarterectomy for atheromatous disease.

    abstract::The authors discuss the indications for both elective and emergency carotid endarterectomy. Reports on the surgical treatment of asymptomatic bruit and contralateral carotid stenosis are reviewed. The results of endarterectomy for symptomatic carotid disease, including transient ischemic attacks, acute neurological de...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/00006123-198312000-00021

    authors: Loftus CM,Quest DO

    更新日期:1983-12-01 00:00:00

  • The Impact of Intra-Arterial Papaverine-Hydrochloride on Cerebral Metabolism and Oxygenation for Treatment of Delayed-Onset Post-Subarachnoid Hemorrhage Vasospasm.

    abstract:BACKGROUND:Delayed posthemorrhagic vasospasm remains among the major complications after aneurysmal subarachnoid hemorrhage (SAH) and can result in devastating ischemic strokes. As rescue therapy, neurointerventional procedures are used for selective vasodilatation. OBJECTIVE:To investigate the effects of intra-arteri...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyz500

    authors: Hosmann A,Wang WT,Dodier P,Bavinzski G,Engel A,Herta J,Plöchl W,Reinprecht A,Gruber A

    更新日期:2020-09-15 00:00:00

  • Cerebral syphilitic gummata: a case presentation and analysis of 156 reported cases.

    abstract:OBJECTIVE:Cerebral syphilitic gummata are rare manifestations of tertiary, meningovascular syphilis. No extensive characterization of these lesions has been published recently, and only a few small reviews containing imaging findings have been published to date. To better characterize cerebral gummata, we present a cas...

    journal_title:Neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1227/01.NEU.0000337079.12137.89

    authors: Fargen KM,Alvernia JE,Lin CS,Melgar M

    更新日期:2009-03-01 00:00:00

  • Syndrome of inappropriate antidiuretic hormone secretion after spontaneous subarachnoid hemorrhage: a reversible cause of clinical deterioration.

    abstract::The syndrome of inappropriate antidiuretic hormone secretion (SIADH) developed approximately 7 days after a spontaneous subarachnoid hemorrhage in a 63-year-old woman with an anterior cerebral artery aneurysm. The hyponatremia associated with this syndrome resulted in a deterioration of the patient's clinical conditio...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-197811000-00016

    authors: Wise BL

    更新日期:1978-11-01 00:00:00

  • Intracerebral hematoma related to thrombolysis for myocardial infarction.

    abstract::The incidence of intracerebral hematomas after myocardial infarction increases after thrombolysis. As noted in the case described, clots formed after the administration of thrombolytic agents may remain liquid, and this blood can be drained by a catheter. However, in this case, the patient continued to bleed locally. ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199311000-00019

    authors: Kaufman HH,McAllister P,Taylor H,Schmidt S

    更新日期:1993-11-01 00:00:00

  • Effect of subarachnoid hemorrhage on serotonin uptake and release in the rabbit basilar artery.

    abstract::This study analyzes the changes induced by subarachnoid hemorrhage (SAH) on the serotonin (5-hydroxytryptamine, 5-HT) uptake and release evoked in rabbit basilar arteries by tyramine. Rabbits were injected with 5 ml of autologous arterial blood into the cisterna magna to produce SAH. Tritium accumulation in basilar ar...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Tanaka Y,Machi T,Nihei H,Kassell NF

    更新日期:1991-03-01 00:00:00

  • p53 in nonneoplastic central nervous system lesions: an immunohistochemical and genetic sequencing study.

    abstract:OBJECTIVE:Immunostaining for p53 commonly is considered a marker of neoplasia. Previous studies of nonneoplastic processes have yielded conflicting results. METHODS:To test the assumption that p53 immunoreactivity indicates neoplasia, we examined 60 formalin-fixed, paraffin-embedded biopsies of nonneoplastic central n...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-200211000-00021

    authors: Kurtkaya-Yapicier O,Scheithauer BW,Hebrink D,James CD

    更新日期:2002-11-01 00:00:00

  • Combined pretemporal and endovascular approach to the cavernous sinus for the treatment of carotid-cavernous dural fistulae: technical case report.

    abstract:OBJECTIVE AND IMPORTANCE:The endovascular treatment of carotid-cavernous dural fistulae is becoming the prominent treatment modality for these lesions. The intractability of these lesions and their tendency to recur, especially after previous endovascular treatment sessions, exhausts the available routes and tends to p...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199902000-00113

    authors: Krisht AF,Burson T

    更新日期:1999-02-01 00:00:00

  • Familial Predisposition and Differences in Radiographic Patterns in Spontaneous Nonaneurysmal Subarachnoid Hemorrhage.

    abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) from an intracranial aneurysmal rupture is the most common nontraumatic etiology for SAH, but up to 15% of patients with SAH have no identifiable source. OBJECTIVE:To assess familial predisposition to spontaneous nonaneurysmal SAH (naSAH) and to evaluate whether family history ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa396

    authors: Lai PMR,Ng I,Gormley WB,Patel NJ,Frerichs KU,Aziz-Sultan MA,Du R

    更新日期:2021-01-13 00:00:00

  • Prolonged target deprivation reduces the capacity of injured motoneurons to regenerate.

    abstract:OBJECTIVE:To investigate whether or not it is the frustrated growth state (no axon growth) that reduces regenerative capacity or the inability of axotomized motoneurons to remake muscle connections (axon growth-no muscle contact) that accounts for poor regenerative capacity of chronically axotomized motoneurons. METHO...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000255412.63184.CC

    authors: Furey MJ,Midha R,Xu QG,Belkas J,Gordon T

    更新日期:2007-04-01 00:00:00

  • Cystic meningioma: report of three patients.

    abstract::Three patients with cystic meningioma are reported. The computed tomographic scans or magnetic resonance images of these tumors resembled those of a glial or metastatic tumor with cystic or necrotic changes. There is no definitive method for preoperatively differentiating cystic meningiomas from the more common malign...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/00006123-199206000-00023

    authors: Odake G

    更新日期:1992-06-01 00:00:00

  • Concussion in professional football: brain responses by finite element analysis: part 9.

    abstract:OBJECTIVE:Brain responses from concussive impacts in National Football League football games were simulated by finite element analysis using a detailed anatomic model of the brain and head accelerations from laboratory reconstructions of game impacts. This study compares brain responses with physician determined signs ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.neu.0000186950.54075.3b

    authors: Viano DC,Casson IR,Pellman EJ,Zhang L,King AI,Yang KH

    更新日期:2005-11-01 00:00:00

  • Transsylvian-transinsular approaches to the insula and basal ganglia: operative techniques and results with vascular lesions.

    abstract:BACKGROUND:Lesions in the insula and basal ganglia can be risky to resect because of their depth and proximity to critical structures, particularly in the dominant hemisphere. Transsylvian approaches shorten the surgical distance to these lesions, preserve perisylvian temporal and frontal cortex, and minimize brain tra...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/NEU.0b013e318236760d

    authors: Potts MB,Chang EF,Young WL,Lawton MT,UCSF Brain AVM Study Project.

    更新日期:2012-04-01 00:00:00

  • Occurrence, Risk Factors, and Time Trends for Late Reoperations due to Degenerative Cervical Spine Disease: A Finnish National Register Study of 19 377 Patients Operated on Between 1999 and 2015.

    abstract:BACKGROUND:Surgery for degenerative cervical spine disease has escalated since the 1990s. Fusion has become the mainstay of surgery despite concerns regarding adjacent segment degeneration. The patient-specific trends in reoperations have not been studied previously. OBJECTIVE:To analyze the occurrence, risk factors, ...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1093/neuros/nyaa464

    authors: Kotkansalo A,Leinonen V,Korajoki M,Korhonen K,Rinne J,Malmivaara A

    更新日期:2020-12-28 00:00:00

  • The surgical management of symptomatic peripheral nerve sheath tumors.

    abstract:OBJECTIVE:To determine the clinical presentation and morbidity of the surgical management of peripheral nerve sheath tumors (PNSTs). METHODS:We performed a retrospective chart review of surgically treated PNSTs at the University of Miami between 1991 and 2008. RESULTS:There were a total of 140 cases, including 87 sch...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000367636.91555.70

    authors: Levi AD,Ross AL,Cuartas E,Qadir R,Temple HT

    更新日期:2010-04-01 00:00:00

  • Efficacy of tissue plasminogen activator in the lysis of thrombosis of the cerebral venous sinus.

    abstract::Therapy for thrombo-occlusive disease of the cerebral venous sinuses remains controversial. Although several thrombolytic agents, such as urokinase and anticoagulants, are recommended for treatment, major significant risks include cerebral hemorrhage, especially in patients with venous infarction. Tissue plasminogen a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1097/00006123-199004000-00001

    authors: Alexander LF,Yamamoto Y,Ayoubi S,al-Mefty O,Smith RR

    更新日期:1990-04-01 00:00:00

  • Surface landmarks for the junction between the transverse and sigmoid sinuses: application of the "strategic" burr hole for suboccipital craniotomy.

    abstract:OBJECTIVE:Localization of internal cranial anatomy based on superficial landmarks is paramount in identifying and avoiding various important structures and, thus, decreasing surgical morbidity. We have studied external skull bony landmarks to facilitate the placement of the initial "strategic" burr hole just inferior a...

    journal_title:Neurosurgery

    pub_type: 杂志文章

    doi:10.1227/01.NEU.0000341517.65174.63

    authors: Tubbs RS,Loukas M,Shoja MM,Bellew MP,Cohen-Gadol AA

    更新日期:2009-12-01 00:00:00