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1دورية أكاديمية
المؤلفون: Craven, Claudia, Jankovic, Ivana, Dyson, Edward, Boyd, Stewart G, D'Arco, Felice, Cheung, Moira Shang-Mei, Thompson, Dominic
مصطلحات موضوعية: Neurology, Neurosurgery, Paediatrics, Physiology
الوصف: Peer reviewed: True ; INTRODUCTION: Foramen magnum stenosis in achondroplasia carries a risk of sudden death. A proportion of these patients benefit from foramen magnum decompression (FMD). The Achondroplasia Foramen Magnum Score (AFMS) was developed to stratify those most at risk. We hypothesise that this score may be reflected in neurophysiological findings. METHODS: Patients with achondroplasia who had undergone FMD (n=20) were retrospectively grouped into AFMS 2, 3 and 4. Amplitude from tibialis anterior (TA) and the percentage change in somatosensory evoked potential (SSEP) latency after FMD were reported. RESULTS: Baseline motor evoked potential amplitudes for patients with AFMS=4 were significantly lower left (p=0.0017 and p=0.02 for right and left TA, respectively) compared with AFMS grades 2 and 3. Median reduction (% change) in SSEP latency (ms) after surgery was not significantly different in any of the patients. CONCLUSIONS: This short report cross-references AFMS to intraoperative neuromonitoring. Baseline amplitudes were noticeably lower in the most severe AFMS group. This observation supports the notion that AFMS can help risk stratify patients and aid in surgical selection.
وصف الملف: application/pdf; text/xml
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2دورية أكاديمية
المؤلفون: Craven, Claudia L, Gissen, Paul, Bower, Rebecca, Lee, Laura, Aquilina, Kristian, Thompson, Dominic NP
المصدر: Journal of Neurosurgery: Pediatrics , 29 (1) pp. 115-121. (2022)
مصطلحات موضوعية: Cerliponase alfa, intracerebroventricular, drug delivery, neurosurgery, neuronal ceroid lipofuscinosis, ventricular access devices, punctures, complications, surgical technique
الوصف: OBJECTIVE: Late infantile neuronal ceroid lipofuscinosis type 2 (CLN2) is a rare autosomal recessive disease caused by tripeptidyl peptidase 1 enzyme deficiency. At the authors' center, the medication cerliponase alfa is administered every 2 weeks via the intracerebroventricular (ICV) route. This requires the placement of a ventricular access device (VAD) or reservoir and frequent percutaneous punctures of this device over the child's lifetime. In this study, the authors audited the longevity and survival of these VADs and examined the causes of device failure. METHODS: A single-center survival analysis of VAD insertions and revisions (January 2014 through June 2020) was conducted. All children received cerliponase alfa infusions through a VAD. Patient characteristics and complications were determined from a prospectively maintained surgical database and patient records. For the VAD survival analysis, the defined endpoint was when the device was removed or changed. Reservoir survival was assessed using Kaplan-Meier curves and the log-rank (Cox-Mantel) test. RESULTS: A total of 17 patients had VADs inserted for drug delivery; median (range) age at first surgery was 4 years 4 months (1 year 8 months to 15 years). Twenty-six VAD operations (17 primary insertions and 9 revisions) were required among these 17 patients. Twelve VAD operations had an associated complication, including CSF infection (n = 6) with Propionibacterium and Staphylococcus species being the most prevalent organisms, significant surgical site swelling preventing infusion (n = 3), leakage/wound breakdown (n = 2), and catheter obstruction (n = 1). There were no complications or deaths associated with VAD insertion. The median (interquartile range) number of punctures was 59.5 (7.5-82.0) for unrevised VADs (n = 17) versus 2 (6-87.5) for revised VADs (n = 9) (p = 0.70). The median survival was 301 days for revisional reservoirs (n = 9) versus 2317 days for primary inserted reservoirs (n = 17) (p = 0.019). CONCLUSIONS: In the context of the current ...
وصف الملف: text
العلاقة: https://discovery.ucl.ac.uk/id/eprint/10145763/2/Gissen_Battens%20manuscript.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10145763Test/
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3دورية أكاديمية
المؤلفون: Chau, Charlene YC, Craven, Claudia L, Rubiano, Andres M, Adams, Hadie, Tülü, Selma, Czosnyka, Marek, Servadei, Franco, Ercole, Ari, Hutchinson, Peter J, Kolias, Angelos G
مصطلحات موضوعية: EVD, ICP, TBI, intracranial pressure, neurosurgery, neurotrauma, ventriculostomy
الوصف: External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.
وصف الملف: Electronic; application/pdf
الإتاحة: https://doi.org/10.17863/CAM.43789Test
https://www.repository.cam.ac.uk/handle/1810/296746Test -
4دورية أكاديمية
المؤلفون: Fernández-Méndez, Rocío, Richards, Hugh K, Seeley, Helen M, Pickard, John D, Joannides, Alexis J, UKSR collaborators, Allcutt, David, Arnold, Fiona, Ashpole, Richard, Ballantyne, Eric, Bleil, Cristina, Brydon, Howard, Bulters, Diederik, Byrne, Marian, Cadoux-Hudson, Tom, Cairns, Claire, Cameron, Kerry, Cartmill, Maria, Chandler, Christopher, Choksey, Munchi S, Collins, Sally-Ann, Colthrust, Kimona, Craven, Claudia, Crimmins, Darach, Critchley, Giles, Crocker, Matthew, Cudlip, Simon, Czosnyka, Marek, Czosnyka, Zofia, D’Antona, Linda, Dewhurst, Emma, Dunn, Laurence, Edwards, Richard, Evans, Fiona, Fernandes, Helen, Fieldsend, Amy, Flint, Graham, Garnett, Matthew, Golash, Aprajay, Goodden, John, Gourley, Lois, Hallet, Jennifer, Hardy, Jan, Hennigan, Dawn, Herbert, Katie, Hinde, Liz, Holliman, Damian, Hutchinson, Peter, Jenkinson, Michael, Kamaly, Ian, Kandasamy, Jothy, Keong, Nicole, Kewin, Sara, King, Andrew, Kolias, Angelos, Kvedaras, Sarah, Lalou, Afroditi, Leach, Paul, MacArthur, Donald, Mallucci, Conor, Martin, John, Mathew, Bruce, McConnell, Roy, McMahon, Catherine, McMullan, John, Moran, Emma, Mukerji, Nitin, Nabbanja, Eva, O'Kane, Roddy, O’Connor, Jody, O’Reilly, Gerry, Papadopoulos, Marios, Pople, Ian, Rajaraman, Chittoor, Ramirez, Roberto, Ramos, Joana, Ross, Sheila, Ross, Nicholas, Santarius, Thomas, Saxena, Amar, Shanmuganathan, Mano, Sinha, Saurabh, Solanki, Guirish, Strachan, Roger, Thompson, Dominic, Thompson, Simon, Thorne, John, Thorne, Lewis, Thurlby, Kim, Tisdall, Martin, Tizzard, Simon, Todd, Lorraine, Toma, Ahmed, Turner, Carole, Ushewokunze, Shungu, Vindlacheruvu, Raghu, Wadley, John, Watkins, Laurence, Whitfield, Peter, Wilson, Mark, Zebian, Bassel
مصطلحات موضوعية: Neurosurgery
الوصف: Objectives To determine current epidemiology and clinical characteristics of cerebrospinal fluid (CSF) shunt surgery, including revisions. Methods A retrospective, multicentre, registry-based study was conducted based on 10 years’ data from the UK Shunt Registry, including primary and revision shunting procedures reported between 2004 and 2013. Incidence rates of primary shunts, descriptive statistics and shunt revision rates were calculated stratified by age group, geographical region and year of operation. Results 41 036 procedures in 26 545 patients were submitted during the study period, including 3002 infants, 4389 children and 18 668 adults. Procedures included 20 947 (51.0%) primary shunt insertions in 20 947 patients, and 20 089 (49.0%) revision procedures. Incidence rates of primary shunt insertions for infants, children and adults were 39.5, 2.4 and 3.5 shunts per 100 000 person-years, respectively. These varied by geographical subregion and year of operation. The most common underlying diagnoses were perinatal intraventricular haemorrhage (35.3%) and malformations (33.9%) in infants, tumours (40.5%) and malformations (16.3%) in children, and tumours (24.6%), post-haemorrhagic hydrocephalus (16.2%) and idiopathic normal pressure hydrocephalus (14.2%) in adults. Ninety-day revision rates were 21.9%, 18.6% and 12.8% among infants, children and adults, respectively, while first-year revision rates were 31.0%, 25.2% and 17.4%. The main reasons for revision were underdrainage and infection, but overdrainage and mechanical failure continue to pose problems. Conclusions Our report informs patients, carers, clinicians, providers and commissioners of healthcare, researchers and industry of the current epidemiology of shunting for CSF disorders, including the potential risks of complications and frequency of revision.
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العلاقة: http://jnnp.bmj.com/cgi/content/short/90/7/747Test; http://dx.doi.org/10.1136/jnnp-2018-319927Test
الإتاحة: https://doi.org/10.1136/jnnp-2018-319927Test
http://jnnp.bmj.com/cgi/content/short/90/7/747Test
