Tonsillar herniation: the rule rather than the exception after lumboperitoneal shunting in the pediatric population.

Abstract:

:Although the development of tonsillar herniation (acquired Chiari malformation) in association with lumboperitoneal (LP) shunting is well recognized, it has previously been considered rare. In order to ascertain the incidence of this complication after LP shunting, the authors undertook a retrospective study of all patients in whom this form of shunt had been inserted between 1974 and 1991 at The Hospital for Sick Children, Toronto. In the 143 patients, the mean age at insertion was 3.3 years and the indications for shunt placement were hydrocephalus (81%), pseudotumor cerebri (7%), cerebrospinal fluid fistula (6%), and posterior fossa pseudomeningocele (6%). The mean follow-up period was 5.7 years, during which time there was one shunt-related death due to unsuspected tonsillar herniation. Five other patients developed symptomatic tonsillar herniation treated by suboccipital decompression. Review of all computerized tomography (CT) scans not degraded by artifact showed evidence of excess soft tissue at the level of the foramen magnum in 38 (70%) of 54 patients so studied. In order to confirm that this CT finding represented hindbrain herniation, sagittal and axial magnetic resonance (MR) images were obtained for 17 asymptomatic patients and revealed tonsillar herniation (range 2 to 21 mm) in 12 (70.6%). In addition, some of these asymptomatic patients had evidence of uncal herniation and mesencephalic distortion. Similarities and distinctions are drawn between the morphological changes occurring after LP shunting and those seen in association with the Chiari I and II malformations. Although less than 5% of this study population required treatment for tonsillar herniation, the incidence of this complication was high in asymptomatic patients; MR imaging surveillance for patients with LP shunts is therefore recommended.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Chumas PD,Armstrong DC,Drake JM,Kulkarni AV,Hoffman HJ,Humphreys RP,Rutka JT,Hendrick EB

doi

10.3171/jns.1993.78.4.0568

subject

Has Abstract

pub_date

1993-04-01 00:00:00

pages

568-73

issue

4

eissn

0022-3085

issn

1933-0693

journal_volume

78

pub_type

杂志文章
  • Effect of intrathecal fibrinolysis on cerebrospinal fluid absorption after experimental subarachnoid hemorrhage.

    abstract::The effect of intrathecal fibrinolysis on cerebrospinal fluid (CSF) absorption was investigated after experimental subarachnoid hemorrhage (SAH). In 11 cats, SAH was induced by intracisternal application of 1 to 4 ml of fresh autologous blood. Thirty minutes after the experimental SAH, the CSF outflow resistance was f...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1991.74.5.0789

    authors: Brinker T,Seifert V,Stolke D

    更新日期:1991-05-01 00:00:00

  • Efficacy of intraarterial superselective indocyanine green videoangiography in cerebral arteriovenous malformation surgery in a hybrid operating room.

    abstract:OBJECTIVE:Although intravenous indocyanine green (ICG) videoangiography has been reported to be useful when applied to cerebral arteriovenous malformation (AVM) surgery, the ICG that remains after the procedure makes it difficult to understand the anatomy, to evaluate nidus blood flow changes, and to repeat ICG videoan...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2020.3.JNS20319

    authors: Shimada K,Yamaguchi T,Miyamoto T,Sogabe S,Korai M,Okazaki T,Kanematsu Y,Satomi J,Nagahiro S,Takagi Y

    更新日期:2020-05-22 00:00:00

  • Spinal deformities following selective dorsal rhizotomy.

    abstract:OBJECT:Selective dorsal rhizotomy (SDR) has been shown to provide considerable benefit to children with spastic cerebral palsy (CP). The authors sought to evaluate the risks of postoperative spinal deformities in patients following SDR. METHODS:All patients who underwent SDR at McGill University between 1991 and 2001 ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2007.106.6.441

    authors: Golan JD,Hall JA,O'Gorman G,Poulin C,Benaroch TE,Cantin MA,Farmer JP

    更新日期:2007-06-01 00:00:00

  • Distal posterior inferior cerebellar artery aneurysms: clinical features and management.

    abstract:OBJECT:Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are uncommon, and their underlying pathology, natural history, and clinical management are poorly understood. To clarify these lesions more fully, the authors undertook a retrospective analysis of the clinical features and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2002.97.4.0756

    authors: Lewis SB,Chang DJ,Peace DA,Lafrentz PJ,Day AL

    更新日期:2002-10-01 00:00:00

  • Scar formation in the carotid sheath identified during carotid endarterectomy in patients with previous cardiac surgery: significance of history of intraoperative Swan-Ganz catheter insertion. Clinical article.

    abstract:OBJECT:Scar formation in the carotid sheath is often identified during carotid endarterectomy (CEA) in patients with previous cardiac surgery, and dissection of the carotid sheath and exposure of the carotid arteries in such patients are difficult. The purpose of the present study was to investigate factors related to ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2010.4.JNS091819

    authors: Yoshida K,Ogasawara K,Kobayashi M,Tsuboi J,Okabayashi H,Ogawa A

    更新日期:2010-10-01 00:00:00

  • A refined experimental model of fusiform aneurysms in a rabbit carotid artery.

    abstract:OBJECTIVE:Reliable animal models are an important aspect of translational research, especially for relatively uncommon clinical entities such as fusiform aneurysms. While several animal models exist, very few are tailored to cerebral fusiform aneurysms, which have unique attributes compared to abdominal fusiform aneury...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.2.JNS173168

    authors: Avery MB,Alaqeel A,Bromley AB,Chen YX,Wong JH,Eesa M,Mitha AP

    更新日期:2018-07-27 00:00:00

  • Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae.

    abstract:OBJECT:The goal of this study was to quantify volumetrically cement fill and leakage in patients with osteoporotic and metastatic vertebral lesions undergoing percutaneous vertebroplasty and to establish whether these factors have any clinical significance at follow up. METHODS:Digital computerized tomography data wer...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2003.99.1.0056

    authors: Mousavi P,Roth S,Finkelstein J,Cheung G,Whyne C

    更新日期:2003-07-01 00:00:00

  • Balloon-assisted coil placement in wide-necked aneurysms. Technical note.

    abstract::Saccular intracranial aneurysms are a common and often fatal lesion. Whereas surgical treatment of these aneurysms continues to be the gold standard of care, certain situations arise for which surgery may not be the best option. In some of these cases, electrolytically detachable coils have been proven to provide outc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1997.86.4.0724

    authors: Levy DI,Ku A

    更新日期:1997-04-01 00:00:00

  • The relationship of blood flow velocity fluctuations to intracranial pressure B waves.

    abstract::Intracranial pressure (ICP) and continuous transcranial Doppler ultrasound signals were monitored in 20 head-injured patients and simultaneous synchronous fluctuations of middle cerebral artery (MCA) velocity and B waves of the ICP were observed. Continuous simultaneous monitoring of MCA velocity, ICP, arterial blood ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1992.76.3.0415

    authors: Newell DW,Aaslid R,Stooss R,Reulen HJ

    更新日期:1992-03-01 00:00:00

  • Management of symptomatic deep venous thrombosis and pulmonary embolism on a neurosurgical service.

    abstract::The authors present a retrospective analysis of the management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurosurgical patients at the Massachusetts General Hospital from January, 1978, through June, 1982. There were 44 cases of DVT and 13 cases of PE. Management modalities included observation only...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.64.4.0563

    authors: Swann KW,Black PM,Baker MF

    更新日期:1986-04-01 00:00:00

  • Cell-mediated allergy to cerebral aneurysm clip causing extensive cerebral edema.

    abstract::The authors report the first case of vasogenic cerebral edema due to a cell-mediated hypersensitivity reaction to a nickel-containing aneurysm clip. The patient initially presented for elective clipping of a right middle cerebral artery aneurysm, and on long-term follow-up she demonstrated relapsing-remitting cerebral...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.6.JNS132405

    authors: Tan T,Tee JW,Han TF

    更新日期:2014-10-01 00:00:00

  • Central neurocytoma of the fourth ventricle. Case report.

    abstract::The authors report on a 17-year-old boy who suffered from slowly progressive and long-standing symptoms of ataxia, neck pain, and headache. Computerized tomography (CT) and magnetic resonance (MR) imaging revealed a tumor arising from the floor of the fourth ventricle that resulted in a moderate hydrocephalus. A parti...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1999.91.3.0506

    authors: Warmuth-Metz M,Klein R,Sörensen N,Solymosi L

    更新日期:1999-09-01 00:00:00

  • Distribution of genes for bone morphogenetic protein-4, -6, growth differentiation factor-5, and bone morphogenetic protein receptors in the process of experimental spondylosis in mice.

    abstract:OBJECT:Because little is known about the molecular mechanisms underlying the process of spondylosis, the authors examined the extent of genetic localization of several members of bone morphogenetic protein (BMP) and BMP receptors in chondrogenesis during the process of inducing spondylosis in their previously establish...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2001.94.1.0068

    authors: Nakase T,Ariga K,Miyamoto S,Okuda S,Tomita T,Iwasaki M,Yonenobu K,Yoshikawa H

    更新日期:2001-01-01 00:00:00

  • Anatomic variations of venous sinuses in the region of the torcular Herophili.

    abstract::In this study of 110 cranial cavities from adult cadavers, the superior sagittal sinus was found to divide into two channels. In most cases, the division was associated with a dural partition. Essentially, the variations as observed in this study could be grouped into three types: Type 1 includes those specimens in wh...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.62.1.0090

    authors: Bisaria KK

    更新日期:1985-01-01 00:00:00

  • Combined treatment of advanced stages of recurrent skin cancer of the head.

    abstract:OBJECT:The authors investigated whether skull base resection and primary free-flap reconstruction in a single-stage surgery is oncologically effective for treating advanced stages of recurrent skin cancer (RSC) of the head. METHODS:Eighteen consecutive patients were surgically treated. Twelve of them underwent an ante...

    journal_title:Journal of neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.3171/jns.2004.100.4.0652

    authors: Pompucci A,Rea G,Farallo E,Salgarello M,Campanella A,Fernandez E

    更新日期:2004-04-01 00:00:00

  • Late complications of Silastic duraplasty: low-virulence infections. Case report.

    abstract::The authors describe three patients with expanding hemorrhagic mass lesions who presented 13 to 18 years after undergoing Silastic duraplasty. In all patients, results of bacteriological cultures of the masses obtained intraoperatively were positive, revealing low-virulence bacteria. Two of the patients were treated w...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1999.90.3.0559

    authors: Ekseth K,Boström S

    更新日期:1999-03-01 00:00:00

  • Coil embolization of posttraumatic pseudoaneurysm of the ophthalmic artery causing subarachnoid hemorrhage. Case report.

    abstract::The authors report a unique case of subarachnoid hemorrhage caused by a traumatic pseudoaneurysm of the ophthalmic artery, which was successfully treated with coil embolization. Clinical and imaging features, as well as the relevant literature, are described. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/JNS-07/11/1043

    authors: Hopkins JK,Shaibani A,Ali S,Khawar S,Parkinson R,Futterer S,Russell EJ,Getch C

    更新日期:2007-11-01 00:00:00

  • Electrospinogram and spinal and cortical evoked potentials in experimental spinal cord trauma.

    abstract::Studies in 28 traumatized cats showed the following acute changes after spinal cord compression in the cord segment below the trauma: 1) increase in size of the spinal cord evoked potential; 2) increase in size of the electrospinogram; and 3) increase in frequency of the electrospinogram. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1975.43.6.0737

    authors: Morrison G,Lorig RJ,Brodkey J,Nulsen FE

    更新日期:1975-12-01 00:00:00

  • Computerized tomography and pathological correlation in cystic meningiomas. Report of two cases.

    abstract::Meningiomas have been reported to have associated areas of surrounding low density on computerized tomography (CT). These low-density areas may represent edema, widened subarachnoid spaces, loculated cerebrospinal fluid, demyelination, or adjacent tumor. Two cases are presented in which this adjacent area of low densi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1979.50.1.0103

    authors: Becker D,Norman D,Wilson CB

    更新日期:1979-01-01 00:00:00

  • Single-fraction radiosurgery of benign cavernous sinus meningiomas.

    abstract:OBJECT:Stereotactic radiosurgery (SRS) is an important treatment option for patients with cavernous sinus meningiomas (CSM). To analyze factors associated with local tumor control and complications after single-fraction SRS, the authors reviewed cases involving patients treated with Gamma Knife SRS between 1990 and 200...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2013.5.JNS13206

    authors: Pollock BE,Stafford SL,Link MJ,Garces YI,Foote RL

    更新日期:2013-09-01 00:00:00

  • Visceral and vascular complications resulting from anterior lumbar interbody fusion.

    abstract:OBJECT:The literature on abdominal and general surgery-related complications following anterior lumbar interbody fusion (ALIF) is scant. In this retrospective review of 60 patients in whom ALIF was performed at their institutions between 1996 and 1998, the authors detail the associated complications and their correlati...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.1999.91.1.0060

    authors: Rajaraman V,Vingan R,Roth P,Heary RF,Conklin L,Jacobs GB

    更新日期:1999-07-01 00:00:00

  • Role of the mode of sensory stimulation in presurgical brain mapping in which functional magnetic resonance imaging is used.

    abstract:OBJECT:The aim of this study was to evaluate different types of sensory stimulation used to distinguish between microvasculature and venous drainage on functional magnetic resonance (fMR) images with blood oxygen level-dependent (BOLD) contrast. METHODS:Seven volunteers received three sensory stimulations. One consist...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.93.3.0427

    authors: Le Rumeur E,Allard M,Poiseau E,Jannin P

    更新日期:2000-09-01 00:00:00

  • Destructive procedures for control of cancer pain: the case for cordotomy.

    abstract:OBJECT:Historically, destructive procedures for cancer pain were the main line of treatment therapy. However, the use of high-dose opioids has essentially replaced such procedures. Recognition of the limits of medical therapy to treat cancer pain effectively is growing, while conversely, in regions with limited access ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/2010.6.JNS10119

    authors: Raslan AM,Cetas JS,McCartney S,Burchiel KJ

    更新日期:2011-01-01 00:00:00

  • Diffuse cerebral swelling following head injuries in children: the syndrome of "malignant brain edema".

    abstract::The commonest initial computerized tomography (CT) finding in head-injured children is bilateral diffuse cerebral swelling. Cerebral blood flow and CT density studies suggest that this swelling is due to cerebral hyperemia and increased blood volume, not to edema. The clinical history, course, and outcome of 63 childr...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.54.2.0170

    authors: Bruce DA,Alavi A,Bilaniuk L,Dolinskas C,Obrist W,Uzzell B

    更新日期:1981-02-01 00:00:00

  • The effects of deep barbiturate coma on multimodality evoked potentials.

    abstract::The authors report their investigation of the effects of high-dose barbiturates on the multimodality evoked response in 9 cats. After baseline evoked responses were obtained, boluses of pentobarbital were infused intravenously at regular intervals, amounting to cumulative total doses of 9, 18, 27, 45, 63, 123, and 183...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1982.57.2.0178

    authors: Sutton LN,Frewen T,Marsh R,Jaggi J,Bruce DA

    更新日期:1982-08-01 00:00:00

  • Bow hunter stroke caused by cervical disc herniation. Case report.

    abstract::Bow hunter stroke, which is characterized by transient vertebrobasilar ischemia brought on by head turning, is an unusual condition usually caused by structural abnormalities at the craniocervical junction. The authors present a case in which compression of the left vertebral artery (VA) at the C4-5 level was caused b...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2002.96.1.0090

    authors: Vates GE,Wang KC,Bonovich D,Dowd CF,Lawton MT

    更新日期:2002-01-01 00:00:00

  • Long-term intrathecal baclofen infusion for treatment of spasticity.

    abstract::Seven patients with spasticity of spinal cord origin have been maintained for up to 2 years with continuous spinal intrathecal infusion of baclofen. Prior to treatment, all of the patients had severe rigidity in their lower limbs and most had frequent and extensive spontaneous spasms, all of which greatly interfered w...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1987.66.2.0181

    authors: Penn RD,Kroin JS

    更新日期:1987-02-01 00:00:00

  • Endoscopic endonasal transplanum transtuberculum approach for resection of retrochiasmatic craniopharyngioma.

    abstract::Retrochiasmatic craniopharyngiomas are formidable cranial base tumors to resect because of their intimate relationship with neighboring critical neurovascular structures, particularly the undersurface of the optic chiasm and hypothalamus. Radical resection offers the best chance of minimizing tumor recurrence, althoug...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:

    authors: Liu JK,Eloy JA

    更新日期:2012-01-01 00:00:00

  • Intentional body clipping of wide-necked basilar artery bifurcation aneurysms.

    abstract:OBJECT:Neck clipping or coil embolization cannot always achieve complete neck obstruction in wide-necked basilar artery (BA) bifurcation aneurysms. Clipping of the aneurysm body, leaving a small aneurysm rest, is one clipping method used for this kind of aneurysm to maintain the patency of the posterior cerebral arteri...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2000.93.2.0169

    authors: Tanaka Y,Kobayashi S,Hongo K,Tada T,Nagashima H,Kakizawa Y

    更新日期:2000-08-01 00:00:00

  • Hemifacial spasm caused by a spontaneous dissecting aneurysm of the vertebral artery. Case report.

    abstract::The authors describe the first reported case of dissecting aneurysm presenting with hemifacial spasm. The patient was a 58-year-old woman with left hemifacial spasm of 2 years' duration. Cranial nerve examination was otherwise normal and no other clinical symptoms were observed. Vertebral angiography revealed a fusifo...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1991.74.4.0650

    authors: Matsumoto K,Saijo T,Kuyama H,Asari S,Nishimoto A

    更新日期:1991-04-01 00:00:00