Vertebrobasilar Dolichoectasia Causing Symptomatic Hydrocephalus Due to Third Ventricular Compression

Vertebrobasilar dolichoectasia sometimes presents with symptoms related to mass effect like cranial nerve palsies, or with ischemia or hemorrhage. Symptomatic hydrocephalus as a complication of vertebrobasilar dolichoectasia is extremely uncommon. Furthermore, there are few cases of vertebrobasilar dolichoectasia, in which cerebrospinal fluid flow disorder mechanisms are clearly demonstrated in neuroimaging findings. Here, we describe a patient with vertebrobasilar dolichoectasia who presented with symptomatic hydrocephalus due to direct compression against the third ventricle, which was immediately relieved by ventriculoperitoneal shunt.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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AbstractIntracerebral hemorrhage in combination with intraventricular hemorrhage (IVH) is a severe type of stroke frequently leading to prolonged clinical care, continuous disability, shunt dependency, and high mortality. The molecular mechanisms induced by IVH are complex and not fully understood. Moreover, the treatment options for IVH are limited. Intraventricular recombinant tissue plasminogen activator (rt-PA) dissolves the blood clot in the ventricular system; however, whether the clinical outcome is thereby positively affected is still being debated. The mechanistic cascade induced by intraventricular rt-PA therapy ...
Source: Translational Stroke Research - Category: Neurology Source Type: research
Conclusions A patient with subarachnoid and intraventricular hemorrhage showed recovery of an injured ARAS and consciousness after a shunt operation for hydrocephalus. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - Category: Neurosurgery Authors: Tags: Case Report Source Type: research
Conclusion: Children who underwent VP shunt face various health-related problems in different domains and low QOL. Although cognitive domain was the most affected, multiple surgeries had the most significant impact on QOL. Appropriately focused interventions and holistic management are essential to improve the QOL of children undergoing VP shunt.
Source: Journal of Pediatric Neurosciences - Category: Neuroscience Authors: Source Type: research
Abstract OBJECTIVE Shunt-dependent hydrocephalus (SDHC) may arise after aneurysmal subarachnoid hemorrhage (aSAH) as CSF resorptive mechanisms are disrupted. Using propensity score analysis, the authors aimed to investigate which treatment modality, surgical clipping or endovascular treatment, is superior in reducing rates of SDHC after aSAH. METHODS The authors' multicenter SAH database, comprising 3 stroke centers affiliated with Kyoto University, Japan, was used to identify patients treated between January 2009 and July 2016. Univariate and multivariate analyses were performed to characterize risk factors for S...
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
We report on a stroke patient who showed restoration of discontinued corticoreticular pathways (CRPs) on serial diffusion tensor tractography (DTT) concurrent with recovery of gait disturbance following shunt operation for hydrocephalus.Patient concerns:A 67-year-old female patient underwent stereotactic drainage for management of intraventricular hemorrhage due to a rupture of the left posterior communicating artery.Diagnoses:After 4 weeks from onset, the patient exhibited quadriparesis with more severe weakness in the proximal muscles and could not even stand or walk. She underwent comprehensive rehabilitation for 3 week...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Rationale: A 76-year-old female patient was diagnosed with an aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Patient concerns: She was treated surgically with clipping of the aneurysmal neck. Six months after onset, when starting rehabilitation at our hospital, she showed no spontaneous movement or speech. Diagnoses: aneurysmal subarachnoid hemorrhage following rupture of a right posterior communicating artery aneurysm. Interventions: During 2 months’ rehabilitation, her AM did not improve significantly. As there was no apparent change, she underwen...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
This study included 83 consecutive patients diagnosed with aneurysmal SAH of resuscitated World Federation of Neurological Surgeons (WFNS) grades 1 –3. Plasma galectin-3 levels were once measured on days 1–3 (the day after clipping or coiling). Fifteen patients had poor outcomes, which were associated with increasing age, female, pre-onset morbidity, worse WFNS grade, modified Fisher computed tomography scale, acute hydrocephalus, and highe r galectin-3 levels compared with good outcomes. Multivariate analyses revealed that plasma galectin-3 was an independent determinant for poor outcome (odds ratio, 3.08; 95%...
Source: Translational Stroke Research - Category: Neurology Source Type: research
CONCLUSIONS PTV presents early after NAHT, particularly after a DC has been performed. However, the authors found that only a few PTV/NAHT patients developed shunt-dependent hydrocephalus. PMID: 27798981 [PubMed - in process]
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Conclusions— Shunt dependency after aSAH is associated with higher morbidity and mortality, and prediction modeling of shunt dependency is feasible with clinically useful yields. It is important to identify and understand the factors that increase risk for shunting and to eliminate or mitigate the reversible factors. The aSAH-PARAS Consortium (Aneurysmal Subarachnoid Hemorrhage Patients’ Risk Assessment for Shunting) has been initiated to pool the collective insights and resources to address key questions in post-aSAH shunt dependency to inform future aSAH treatment guidelines.
Source: Stroke - Category: Neurology Authors: Tags: Epidemiology, Risk Factors, Complications, Quality and Outcomes, Cerebral Aneurysm Clinical Sciences Source Type: research
CONCLUSIONS Secondary NPH encompasses a diverse group of clinical manifestations associated with a subset of patients with acquired hydrocephalus. The most common etiologies of sNPH include SAH and traumatic brain injury. Secondary NPH does indeed exist, and should be differentiated from idiopathic NPH based on outcome and on clinical, pathophysiological, and epidemiological characteristics, but should not be considered as a separate entity. PMID: 27581318 [PubMed - in process]
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
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