Abstract:
BACKGROUND:Ventriculoatrial shunts were one of the most common treatments of hydrocephalus in pediatric and adult patients up to about 40 years ago. Thereafter, due to the widespread recognition of the severe cardiac and renal complications associated with ventriculoatrial shunts, they are almost exclusively implanted when other techniques fail. However, late infection or atrial thrombi of previously implanted shunts require removal of the atrial catheter several decades after implantation. Techniques derived from management of central venous access catheters can avoid cardiothoracic surgery in such instances. METHODS:We retrospectively investigated all the patients requiring removal of a VA shunt for complications treated in the last 5 years in our institution. RESULTS:We identified two patients that were implanted 28 and 40 years earlier. Both developed endocarditis with a large atrial thrombus and were successfully treated endovascularly. The successful percutaneous removal was achieved by applying, for the first time in this setting, the endoluminal dilation technique as proposed by Hong. After ventriculoatrial shunt removal and its substitution with an external drainage, both patients where successfully weaned from the need for a shunt and their infection resolved. CONCLUSION:Patients carrying a ventriculoatrial shunt are now rarely seen and awareness of long-term ventriculoatrial shunt complications is decreasing. However, these complications must be recognized and treated by shunt removal. Endovascular techniques are appropriate even in the presence of overt endocarditis, atrial thrombi, and tight adherence to the endocardial wall. Moreover, weaning from shunt dependence is possible even decades after shunting.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Magrassi L,Mezzini G,Moramarco LP,Cionfoli N,Shepetowsky D,Seminari E,Di Matteo A,Quaretti Pdoi
10.1007/s00701-020-04675-1subject
Has Abstractpub_date
2021-02-01 00:00:00pages
455-462issue
2eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04675-1journal_volume
163pub_type
杂志文章abstract:BACKGROUND:In terms of response to fractionated radiotherapy, metastatic brain tumors of certain origins are considered radioresistant. OBJECTIVE:To determine the influence of "radioresistant" histology on outcomes of brain metastases treated with radiosurgery. METHODS:Between 2001 and 2017, 121 patients with brain m...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-018-3726-2
更新日期:2018-12-01 00:00:00
abstract::The EC-IC Bypass Study Group could not detect any benefit from surgery compared to medical management in the prevention of stroke in 1985 [15]. During the past years surgical revascularization was re-evaluated and considered as an appropriate treatment for a small subgroup of patients with recurrent focal cerebral isc...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411282
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abstract:PURPOSE:To analyse the intraoperative complications of a single neurosurgeon, with emphasis on devastating intraoperative incidents, and how they possibly could have been avoided. METHODS:All the patients operated upon by the author between 1986 and 2002, i.e. 252 patients with 270 craniotomies for 294 aneurysms, were...
journal_title:Acta neurochirurgica
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doi:10.1007/s00701-009-0452-9
更新日期:2009-09-01 00:00:00
abstract::The management of vestibular schwannomata is controversial. Surveillance remains an acceptable option for elderly patients or those with small lesions. Stereoradiosurgery is also an option, while surgery is often preferred in younger patients with larger lesions. In elderly patients with lesions causing brainstem comp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-009-0493-0
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Vascular Endothelial Growth/Permeability Factor (VEG/PF) has been correlated with angiogenesis and vascular leakage in diverse pathological conditions of the brain. On the other hand, neoformation of capillaries and vascular hyperpermeability have been related to progressive enlargement of chronic subdural h...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010200047
更新日期:2002-04-01 00:00:00
abstract::In the arteriovenous malformations of the posterior fossa the arterial feeders and the dural venous sinuses can be identified in anatomical terminology. The arterialised veins which do not conform to adult anatomical descriptions represent the persistent embryonic veins of the metencephalic and myelencephalic segments...
journal_title:Acta neurochirurgica
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doi:10.1007/BF01406021
更新日期:1979-01-01 00:00:00
abstract::Aneurysms of the vertebro-basilar junction area have been considered the most difficult to be surgically treated because of their deep location, the proximity of the brain stem and the cranial nerves. However, at present, new endovascular techniques and new transbasal surgical approaches offer valuable management stra...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02747192
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Percutaneous radiofrequency trigeminal rhizotomy (RF-TR) is a well-established treatment for patients suffering from trigeminal neuralgia (TN) as a primary modality or for those refractory to medical treatment. However, few existing studies have identified intraoperative parameter or navigation technique tha...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-03941-1
更新日期:2019-07-01 00:00:00
abstract::Somatosensory evoked potentials (SEP) and intracranial pressure (ICP) were studied in cats, suffering from a chronic space-occupying lesion produced by enlargement of an epidural balloon over the left sensomotory cortex. Our study shows that latency alterations of SEP are not dependent on the degree of ICP. Additional...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01446995
更新日期:1993-01-01 00:00:00
abstract::Experience from five cases operated on within one year (among 50 microsurgical operations at the base of the brain) persuades us to discuss the topical relations of the meningiomas of the tuberculum sellae and the modifications in operating techniques necessary. For the two contrasting types of tumour found, which are...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401930
更新日期:1977-01-01 00:00:00
abstract::The authors report on the results obtained on a series of 325 patients operated on for single brain metastasis at the Institute of Neurosurgery of the University of Rome during the period 1951-1979. After analyzing the results vis-à-vis the site of the brain metastasis, the site of the primitive tumour and the surgica...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401183
更新日期:1983-01-01 00:00:00
abstract::We report a case of fibrosarcoma arising in the pineal of a 36-year-old female patient. She died at the age 43 following biopsy, radiation therapy, tumor resection, chemotherapy, and stereotactic radiosurgery. Light microscopic study of all tissues obtained, including immunohistochemistry and electron microscopy of su...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s701-002-8277-6
更新日期:2002-01-01 00:00:00
abstract:PURPOSE:Oculomotor nerve palsy (ONP) occasionally occurs in cases of pituitary apoplexy (PA) associated with pituitary adenoma, but its mechanism remains unclear. Intracranial nerves are clearly visualized by fast-imaging employing with steady-state acquisition (FIESTA). Here, we assessed the oculomotor nerve compressi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04632-y
更新日期:2021-02-01 00:00:00
abstract::The authors have reviewed the literature concerning measures for cerebral protection during carotid endarterectomy, with particular reference to the controversy regarding the use of an intraluminar shunt. The authors use preoperative EEG analysis during the carotid compression test as well as intraoperative EEG monito...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01401154
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Neurofibromatosis type 2 (NF2) is a genetic disorder characterized by mutations of the NF2 tumor suppressor gene that predisposes patients to develop multiple tumors in the peripheral and central nervous system. The most common neoplasms associated with the disease are schwannomas and meningiomas. Both have ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04439-x
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Infratentorial supracerebellar approach via microscope still has some limitations in resection of pineal region tumors. METHODS:The authors describe a purely endoscopic infratentorial supracerebellar approach for resection of pineal region tumors with matched air-driven arm and navigation. The lateral obliq...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2895-0
更新日期:2016-11-01 00:00:00
abstract::Three patients with symmetrical bilateral low-density areas which were the perfusion territories of Heubner's arteries are reported. The infarctions were demonstrated on computed tomography after aneurysm surgery. Two of them had an anterior communicating artery aneurysm and the other one had multiple aneurysms of bot...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418830
更新日期:1987-01-01 00:00:00
abstract::Arrested hydrocephalus probably results from improvement of CSF circulation during growth. Although a generally accepted condition, its mode of onset, its presence in a given patient, and time required to establish the absence of progressive hydrocephalus have not been defined. Five patients are presented with ostensi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01809223
更新日期:1978-01-01 00:00:00
abstract::In 17 primary transnasal operations on Nelson tumours long-term results are assessed measuring ACTH plasma levels and performing regular neuroradiological controls. In small intrasellar adenomas only one recurrent ACTH elevation near to pretreatment levels without symptoms from tumour growth was observed after 10 year...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405437
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:We compared the electrode positions of subthalamic nucleus (STN) deep brain stimulation (DBS) estimated at the immediate postoperative period with those estimated 6 months after surgery. METHODS:Brain CT scans were taken immediately and 6 months after bilateral STN DBS in 53 patients with Parkinson's disease...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0771-x
更新日期:2010-12-01 00:00:00
abstract::We present a rare fatal complication of an occipital condylar fracture. The patient was initially neurologically intact, but showed secondary clinical deterioration. Imaging revealed extensive extra-axial hemorrhage at the craniocervical junction and an acute obstructive hydrocephalus. MR imaging demonstrated a T2 hyp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3165-5
更新日期:2017-06-01 00:00:00
abstract::We report the case of a large osteoblastoma arising in the frontal bone of a 20-year-old female. The lesion was first noted after a fall, and grew steadily in size following further head injury during pregnancy. Initial plain radiography demonstrated an area of radiolucency, with subsequent cross-sectional imaging rev...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-3024-9
更新日期:2017-02-01 00:00:00
abstract::Clinical presentation, diagnosis, surgical technique and results of 25 cases of intramedullary tumours in patients under 16 years of age are analyzed. Pre-operative spinal deformity was present in 9 patients. Surgery was performed in all. After multilaminectomy with preservation of the intervertebral joints, total rem...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02001471
更新日期:1993-01-01 00:00:00
abstract::The case is described of a 52 year old patient admitted for acauda equina compression syndrome (flaccid paraplegia of the lower limbs, bilateral lumbar and sciatic pains, urinary incontinence) of rapid onset and due to narrowing of the lumbar canal from tabetic arthropathy. These vertebral manifestations occur in a lo...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405747
更新日期:1976-01-01 00:00:00
abstract::The brain-type isoenzyme of creatine kinase was determined in serum (S) and cerebrospinal fluid (CSF) in 37 patients with severe head injury, and a correlation was made with the Glasgow coma score and Glasgow outcome score. All patients with normal S-CKBB and CSF-CKBB activities had a coma score of 15, i.e., no neurol...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01418476
更新日期:1985-01-01 00:00:00
abstract::An infrared based frameless stereotactic navigation device (Easy Guide Neuro) was investigated for its clinical applicability, registration/application accuracy and limitations in a standard operating room set-up. In a five-month period 40 frameless stereotactic procedures (23 female, 17 male, mean age 46.4, yrs range...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF02750999
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Multiple intracranial aneurysms (MIAs) are associated with poorer outcomes after rupture than are single intracranial aneurysms (SIAs). Although the risk factors for intracranial aneurysm rupture have been widely investigated, few studies have focused on MIAs. Thus, the present study aimed to determine wheth...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2826-0
更新日期:2016-07-01 00:00:00
abstract:PURPOSE:We present the results of the visualisation of radial oxygen gradients in rats' cortices and their potential use in neurocritical management. METHODS:PO₂ maps of the cortex of ten sedated, intubated and controlled ventilated Wistar rats were obtained with a camera (SensiMOD, PCO, Kelheim, Germany). Those pictu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-010-0777-4
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:The use of distal filter protection alone is associated with a high risk of ischemic complications when vulnerable carotid stenosis is treated by carotid artery stenting (CAS). Double balloon protection, a combination of distal balloon protection and proximal balloon occlusion, can be utilized. We assessed t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2816-2
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:To define the value of electrically elicited motor evoked potentials (MEP), obtained during the initial phase of the coma, for correct prediction of the post-coma motor status. METHODS:Fifty-two patients were investigated by MEP within 72 hours after onset of the coma. It was the aim to correlate the MEP fin...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s007010050385
更新日期:1999-01-01 00:00:00