المؤلفون: Finneran, Megan M, Nardone, Emilio, Marotta, Dario A, Smith, Glen B, Gordhan, Ajeet

المصدر: Neurosurgery

مصطلحات موضوعية: cardiopulmonary vasculature, catheter migration, venous system, ventriculoperitoneal shunt

الوصف: Ventriculoperitoneal shunt catheter migration is a rare but documented complication. The exact mechanism of this occurrence is not well understood. We report the case of an 81-year-old male who initially presented with symptoms consistent with normal pressure hydrocephalus. A ventriculoperitoneal shunt was placed uneventfully. Four months later, the patient presented complaining of a persistent headache despite multiple adjustments in the shunt setting. Shunt series radiographs demonstrated the distal catheter passing through the superior vena cava and looping into the right cardiac atrium and ventricle. Catheter retrieval was attempted from a proximal retroauricular incision but required a combination of snare technique by interventional radiology and, ultimately, surgical venotomy by a cardiothoracic surgeon. The distal catheter was replaced in the abdomen, and the patient had no further complications. This case is the first of its kind reported in the literature that includes a treatment team comprising neurosurgery, interventional radiology, and cardiothoracic surgery. We highlight the importance of a multidisciplinary approach to best address the migrated catheter.

العلاقة: https://institutionalrepository.aah.org/neurosurg/31Test; https://xk8bg6rv9a.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Spontaneous+Migration+of+a+Ventriculoperitoneal+Shunt+into+the+Venous+System%3A+A+Multidisciplinary+Approach&rft.jtitle=Cur%C4%93us+%28Palo+Alto,+CA%29&rft.au=Finneran,+Megan+M&rft.auTest=Nardone,+Emilio&rft.au=Marotta,+Dario+A&rft.au=Smith,+Glen+B&rft.date=2020-04-22&rft.issn=2168-8184&rft.eissn=2168-8184&rft_id=info:doi/10.7759%2Fcureus.7779&rft.externalDBID=n%2Fa&rft.externalDocID=10_7759_cureus_7779¶mdict=en-US

الإتاحة: https://doi.org/10.7759/cureus.7779Test
https://institutionalrepository.aah.org/neurosurg/31Test

المؤلفون: Finneran, Megan, Marotta, Dario A, Altenburger, Dana, Nardone, Emilio

المصدر: Neurosurgery

مصطلحات موضوعية: bgbm, butterfly, glioblastoma, long-term survival, Oncology

الوصف: Butterfly glioblastoma (bGBM) is a malignant glioma that crosses the corpus callous with bilateral cerebral hemisphere involvement. Literature reports are scarce and highlight a dismal prognosis with limited successful treatment options. We describe a patient who survived more than five years from the initial diagnosis. A 44-year-old woman presented to the emergency room for evaluation one day after a motor vehicle collision at the insistence of her husband, with four weeks of confusion, behavioral changes, and increased fatigue. Magnetic resonance imaging (MRI) of the brain revealed an enhancing, heterogeneous mass with significant necrosis, centered in the septum pellucidum and corpus callosum with intraventricular extension. She underwent a stereotactic biopsy of the lesion. Pathology was consistent with glioblastoma, WHO grade IV. She underwent standard radiation treatment and adjuvant temozolomide, demonstrating a near-complete disappearance of the tumor on imaging for the subsequent two years. Upon recurrence, she underwent additional chemotherapy with limited response. A repeat biopsy was positive for a BRAF mutation and she was treated with lomustine. After two cycles, she developed thrombocytopenia and shortly after elected to discontinue treatment. She succumbed to the progression of disease five years and two months after the initial presentation. bGBMs are uncommon and highly aggressive brain tumors. A tailored treatment protocol may improve survival. This case marks an unusually long survival of a patient with bGBM and may prompt further research to better understand the behavior of these tumors and how to improve treatment response and survival.

العلاقة: https://institutionalrepository.aah.org/neurosurg/28Test; https://xk8bg6rv9a.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Long-term+Survival+in+a+Patient+with+Butterfly+Glioblastoma%3A+A+Case+Report&rft.jtitle=Cur%C4%93us+%28Palo+Alto,+CA%29&rft.au=Finneran+Megan&rft.au=Marotta+Dario+A&rft.au=Altenburger+Dana&rft.auTest=Nardone+Emilio&rft.date=2020-01-01&rft.pub=Cureus+Inc&rft.eissn=2168-8184&rft.volume=12&rft.issue=2&rft_id=info:doi/10.7759%2Fcureus.6914¶mdict=en-US

الإتاحة: https://doi.org/10.7759/cureus.6914Test
https://institutionalrepository.aah.org/neurosurg/28Test