المؤلفون: Moncur, Eleanor M., Al-Ahmad, Selma, Thom, Maria, Craven, Claudia L., Choi, David

المصدر: Acta Neurologica Belgica ; ISSN 0300-9009 2240-2993

مصطلحات موضوعية: Neurology (clinical), General Medicine

الإتاحة: https://doi.org/10.1007/s13760-023-02459-9Test

المؤلفون: D'Antona, Linda, Craven, Claudia Louise, Haq, Huzaifah, Thorne, Lewis, Matharu, Manjit Singh, Toma, Ahmed Kassem, Watkins, Laurence Dale

المصدر: British Journal of Neurosurgery , 37 (1) pp. 112-115. (2023)

مصطلحات موضوعية: Air travel, cerebrospinal fluid, hydrocephalus, shunt overdrainage, ventriculoperitoneal shunt

الوصف: Shunted patients often complain of headaches after flights. The effect of air travel on shunt systems is unknown. We describe the case of a patient with longstanding hydrocephalus, who suffered flight-induced clinical deterioration and shunt overdrainage in two independent occasions. The patient, clinically stable for 1.5 and 5 years before each episode, reported severe headaches starting during the descent stages of the air travel. On both occasions, brain MRI imaging demonstrated pronounced ventricular size reduction. This case suggests that flight-induced shunt overdrainage can occur and should be suspected in patients with prolonged headaches and/or clinical deterioration triggered by air travel.

وصف الملف: text

العلاقة: https://discovery.ucl.ac.uk/id/eprint/10152999/3/Matharu_Flight%20case%20report.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10152999Test/

الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10152999/3/Matharu_Flight%20case%20report.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10152999Test/

المؤلفون: Khan, Mehdi, Craven, Claudia Louise, Tahir, Muhammad Zubair

المصدر: Pediatric Neurosurgery ; volume 58, issue 6, page 420-428 ; ISSN 1016-2291 1423-0305

مصطلحات موضوعية: Neurology (clinical), General Medicine, Surgery, Pediatrics, Perinatology and Child Health

الوصف: Introduction: Slit ventricle syndrome (SVS) remains a challenging problem in the early-shunted paediatric population. Various surgical and non-surgical treatments have been devised for this condition. However, there is currently no gold standard for its optimal management. Among various treatment modalities, subtemporal decompression (STD) is often performed as a last resort. We present our experience of STD in paediatric patients with SVS in whom initial treatment with programmable valves and anti-syphon device were not successful. Methods: This is a single-centre retrospective observational study and survival analysis. Patients who underwent STD for SVS were included. Pre- and post-operative imaging data and clinical outcomes were collected. Results: There were 20 patients (12 M, 8 F) with a mean age of 9 years (SD: 4) at first STD. 90% ( n = 18) of patients had multiple shunt revisions pre-STD. At first STD, 70% ( n = 14) and 30% ( n = 6) of patients had unilateral or bilateral STD, respectively. STD led to a reduction in the frequency of shunt revisions in 60% ( n = 12) of patients. The median time required before further STD, shunt surgery, or cranial vault surgery was 14 months. The median time before a further STD was required (either revision or contralateral side) was 89 months. At a median follow-up of 66.5 months (range: 1–159), 65% ( n = 13) of patients had improvement in symptoms. Conclusions: A large proportion of patients with persistent SVS symptoms, refractory to multiple shunt revisions, benefitted from STD in combination with shunt optimization. It was also safe and well-tolerated. Therefore, in patients who have multiple failed shunts, STD may reduce the morbidity associated with further shunt revisions and can significantly improve symptomatology.

الإتاحة: https://doi.org/10.1159/000534611Test

المؤلفون: Pradini-Santos, Laura, Craven, Claudia L., Toma, Ahmed K.

المصدر: Brain and Spine ; volume 3, page 102305 ; ISSN 2772-5294

الإتاحة: https://doi.org/10.1016/j.bas.2023.102305Test
https://api.elsevier.com/content/article/PII:S2772529423005933?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772529423005933?httpAccept=text/plainTest

المؤلفون: Fontannaz, Daniel, Craven, Claudia, Nagra, Delwyn, Tucker, Stewart, Thompson, Dominic

المصدر: Brain and Spine ; volume 3, page 102260 ; ISSN 2772-5294

الإتاحة: https://doi.org/10.1016/j.bas.2023.102260Test
https://api.elsevier.com/content/article/PII:S2772529423005489?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2772529423005489?httpAccept=text/plainTest

المؤلفون: Craven, Claudia, Jankovic, Ivana, Dyson, Edward, Boyd, Stewart G, D'Arco, Felice, Cheung, Moira Shang-Mei, Thompson, Dominic

المصدر: Archives of Disease in Childhood ; page archdischild-2023-326360 ; ISSN 0003-9888 1468-2044

الوصف: 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.

الإتاحة: https://doi.org/10.1136/archdischild-2023-326360Test

المؤلفون: Moncur, Eleanor M, Craven, Claudia L, Al-Ahmad, Selma, Jones, Bethany, Robertson, Fergus, Reddy, Ugan, Toma, Ahmed K

مصطلحات موضوعية: Angioplasty, Brain tissue oxygen, Delayed cerebral ischaemia, Vasospasm, Humans, Pilot Projects, Retrospective Studies, Brain Ischemia, Cerebral Infarction, Subarachnoid Hemorrhage, Intracranial

الوصف: Funder: B. Braun Melsungen; doi: http://dx.doi.org/10.13039/100007534Test ; BACKGROUND: Delayed cerebral ischaemia (DCI) is a major cause of morbidity and mortality after aneurysmal subarachnoid haemorrhage (aSAH). Chemical angioplasty (CA) and transluminal balloon angioplasty (TBA) are used to treat patients with refractory vasospasm causing DCI. Multi-modal monitoring including brain tissue oxygenation (PbtO2) is routinely used at this centre for early detection and management of DCI following aSAH. In this single-centre pilot study, we are comparing these two treatment modalities and their effects on PbtO2. METHODS: Retrospective case series of patients with DCI who had PbtO2 monitoring as part of their multimodality monitoring and underwent either CA or TBA combined with CA. PbtO2 values were recorded from intra-parenchymal Raumedic NEUROVENT-PTO® probes. Data were continuously collected and downloaded as second-by-second data. Comparisons were made between pre-angioplasty PbtO2 and post-angioplasty PbtO2 median values (4 h before angioplasty, 4 h after and 12 h after). RESULTS: There were immediate significant improvements in PbtO2 at the start of intervention in both groups. PbtO2 then increased by 13 mmHg in the CA group and 15 mmHg in the TBA plus CA group in the first 4 h post-intervention. This improvement in PbtO2 was sustained for the TBA plus CA group but not the CA group. CONCLUSION: Combined balloon plus chemical angioplasty results in more sustained improvement in brain tissue oxygenation compared with chemical angioplasty alone. Our findings suggest that PbtO2 is a useful tool for monitoring the response to angioplasty in vasospasm.

وصف الملف: application/pdf; text/xml

العلاقة: https://www.repository.cam.ac.uk/handle/1810/367275Test

الإتاحة: https://www.repository.cam.ac.uk/handle/1810/367275Test

المؤلفون: Moncur, Eleanor M.^1,2 (AUTHOR) eleanor.moncur@gmail.com, Craven, Claudia L.³ (AUTHOR), Al-Ahmad, Selma¹ (AUTHOR), Jones, Bethany¹ (AUTHOR), Robertson, Fergus⁴ (AUTHOR), Reddy, Ugan¹ (AUTHOR), Toma, Ahmed K.¹ (AUTHOR)

المصدر: Acta Neurochirurgica. 4/16/2024, Vol. 166 Issue 1, p1-7. 7p.

مصطلحات موضوعية: *TRANSLUMINAL angioplasty, *CEREBRAL ischemia, *ANGIOPLASTY, *CEREBRAL vasospasm, *MEDIAN (Mathematics), *SUBARACHNOID hemorrhage

مستخلص: Background: Delayed cerebral ischaemia (DCI) is a major cause of morbidity and mortality after aneurysmal subarachnoid haemorrhage (aSAH). Chemical angioplasty (CA) and transluminal balloon angioplasty (TBA) are used to treat patients with refractory vasospasm causing DCI. Multi-modal monitoring including brain tissue oxygenation (PbtO2) is routinely used at this centre for early detection and management of DCI following aSAH. In this single-centre pilot study, we are comparing these two treatment modalities and their effects on PbtO2. Methods: Retrospective case series of patients with DCI who had PbtO2 monitoring as part of their multimodality monitoring and underwent either CA or TBA combined with CA. PbtO2 values were recorded from intra-parenchymal Raumedic NEUROVENT-PTO® probes. Data were continuously collected and downloaded as second-by-second data. Comparisons were made between pre-angioplasty PbtO2 and post-angioplasty PbtO2 median values (4 h before angioplasty, 4 h after and 12 h after). Results: There were immediate significant improvements in PbtO2 at the start of intervention in both groups. PbtO2 then increased by 13 mmHg in the CA group and 15 mmHg in the TBA plus CA group in the first 4 h post-intervention. This improvement in PbtO2 was sustained for the TBA plus CA group but not the CA group. Conclusion: Combined balloon plus chemical angioplasty results in more sustained improvement in brain tissue oxygenation compared with chemical angioplasty alone. Our findings suggest that PbtO2 is a useful tool for monitoring the response to angioplasty in vasospasm. [ABSTRACT FROM AUTHOR]

المؤلفون: Moncur, Eleanor M., Murphy, Mary, Craven, Claudia L.

المصدر: Journal of Neurosciences in Rural Practice; Apr-Jun2024, Vol. 15 Issue 2, p357-360, 4p

مصطلحات موضوعية: FORAMEN magnum, ARNOLD-Chiari deformity, TEST validity, FEASIBILITY studies, PERCEIVED benefit

مستخلص: Foramen magnum decompression (FMD) is a standard neurosurgical procedure, typically utilized to treat Chiari malformation. The aim of this educational project was to develop and validate a low-cost FMD simulation training model. Mold-based methods were used to develop a prototype. Feasibility was tested during an FMD training session for 17 neurosurgery trainees. Face and content validity were assessed through a Likert Scale. The perceived training benefit was determined using the Physician Performance Diagnostic Inventory Scale (PPDIS). A total of 87.5% successfully removed the C1 arch, 81.3% successfully performed an FMD, and 68.8% avoided injury to the underlying structures. The model scored highly for visual and tactile realism. The median confidence rating on PPDIS significantly improved from early learner to competent. We demonstrate feasibility, content, and face validity. Furthermore, this is a low-cost, portable model that can be easily replicated and used for simulation training. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Neurosciences in Rural Practice is the property of Thieme Medical & Scientific Publishers Private Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Perera, Duranka¹ (AUTHOR), Craven, Claudia L.¹ (AUTHOR), Thompson, Dominic¹ (AUTHOR) Dominic.Thompson@gosh.nhs.uk

المصدر: Child's Nervous System. Mar2024, Vol. 40 Issue 3, p715-728. 14p.

مصطلحات موضوعية: *NEUROGENIC bladder, *LUMBOSACRAL region, *NATURAL history, *SYMPTOMS, *CONUS, *SURGICAL & topographical anatomy

مستخلص: Objective: Conus region lumbosacral lipomas (LSLs) are highly heterogeneous in their morphology, clinical presentation, and outcome, with an incompletely understood natural history and often treacherous surgical anatomy. This systematic review aims to critically evaluate and assess the strength of the current LSL evidence base to guide management strategies. Methods: According to a systematic review following PRISMA guidelines, a search was conducted using the key term "lumbosacral lipoma" across MEDLINE (OVID), Embase, Cochrane Library, and PubMed databases from January 1951 to April 2021. All studies containing ten or more paediatric conus lipomas were included. Data heterogeneity and bias were assessed. Results: A total of 13 studies were included, containing 913 LSLs (predominantly transitional type—58.5%). Two-thirds (67.5%) of all patients (treated and non-treated) remained clinically stable and 17.6% deteriorated. Neuropathic bladder was present in 8.6% at final follow-up. Of patients managed surgically, near-total resection vs. subtotal resection deterioration-free survival rates were 77.2–98.4% and 10–67% respectively. 4.5% (0.0–27.3%) required re-do untethering surgery. Outcomes varied according to lipoma type. Most publications contained heterogeneous populations and used variable terminology. There was a lack of consistency in reported outcomes. Conclusion: Amongst published series, there is wide variability in patient factors such as lipoma type, patient age, and methods of (particularly urological) assessment. Currently, there is insufficient evidence base upon which to make clear recommendations for the management of children with LSL. There is an imperative for neurosurgeons, neuroradiologists, and urologists to collaborate to better standardise the terminology, assessment tools, and surgical interventions for this challenging group of conditions. [ABSTRACT FROM AUTHOR]