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: Toma, Ahmed Kassem Abbass

مصطلحات موضوعية: 616.858843

الوصف: Objectives: Idiopathic normal pressure hydrocephalus (INPH) is a condition that affects the elderly population with clinical presentation of gait and balance impairment, cognitive impairment and urinary incontinence. Brain imaging shows -. ventriculomegaly in the absence of raised intracranial pressure. Shunt insertion is the standard method of treatment. However; there is a lack of good quality evidence of its effectiveness. As a result, many physicians and even few surgeons are sceptic about the existence of this condition as a separate entity. The aim of this thesis is to provide evidence supporting or refuting the role of surgical management in INPH, through a prospective randomized controlled double blinded study. Methods: Fourteen probable INPH patients who showed clinical improvement following extended lumbar drainage were randomized to have ventriculoperitoneal shunt insertion with an open or closed adjustable valve. Closed shunts were opened after three months. Primary endpoint was improvement in walking speed. Secondary endpoints were improvement in cognitive function, urinary symptoms and incidence of complications. Results: There was a statistically significant advantage of the open shunt in improving walking speed compared with the closed shunt at the study endpoint (43% vs. 0% p=0.02). In addition, the prospectively collected data has shown that both groups improved in terms of mobility one year following shunt insertion (47% and 46.7% respectively). There was a trend suggesting that delay in opening the shunt has delayed improvement beyond the 3 months hypothesized in study design. However; this delay was not statistically significant (p=0.08). 4 us.

الإتاحة: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.558383Test

المؤلفون: D’Antona, Linda, Jaime Merchan, Melida Andrea, Vassiliou, Anna, Watkins, Laurence Dale, Davagnanam, Indran, Toma, Ahmed Kassem, Matharu, Manjit Singh

المصدر: JAMA Neurology ; volume 78, issue 3, page 329 ; ISSN 2168-6149

الإتاحة: https://doi.org/10.1001/jamaneurol.2020.4799Test
https://jamanetwork.com/journals/jamaneurology/articlepdf/2774171/jamaneurology_dantona_2021_oi_200093_1614894413.54738.pdfTest

المؤلفون: D’Antona, Linda, Craven, Claudia Louise, Merchan, Melida Andrea Jaime, Thompson, Simon David, Bremner, Fion, Thorne, Lewis, Matharu, Manjit Singh, Watkins, Laurence Dale, Toma, Ahmed Kassem

المساهمون: University College London

المصدر: Acta Neurochirurgica ; volume 162, issue 10, page 2451-2458 ; ISSN 0001-6268 0942-0940

مصطلحات موضوعية: Neurology (clinical), Surgery

الوصف: Background The hydrodynamics of cerebrospinal fluid shunts have been described in vitro; however, knowledge on the response of intracranial pressure (ICP) to valve settings adjustments in vivo is limited. This study describes the effect of adjusting the shunt valve setting on ICP in a cohort of patients with complex symptom management. Method Single-centre retrospective observational study. Patients who underwent ICP-guided valve setting adjustments during 24-h continuous ICP monitoring, between 2014 and 2019, were included. Patients with suspected shunt malfunction were excluded. Median night ICP before and after the valve adjustments were compared (Δ night ICP). The responses of ICP to valve adjustment were divided into 3 different groups as follows: expected, paradoxical and no response. The frequency of the paradoxical response and its potential predicting factors were investigated. Results Fifty-one patients (37 females, 14 males, mean age 38 years) receiving 94 valve setting adjustments met the study inclusion criteria. Patients’ underlying conditions were most commonly hydrocephalus (47%) or idiopathic intracranial hypertension (43%). The response of ICP to valve setting adjustments was classified as ‘expected’ in 54 cases (57%), ‘paradoxical’ in 17 cases (18%) and ‘no effect’ (Δ night ICP < 1 mmHg) in 23 cases (24%). There was a significant correlation between the Δ night ICP and the magnitude of valve setting change in both the investigated valves (Miethke ProGAV, p = 0.01 and Medtronic Strata, p = 0.02). Conclusions Paradoxical ICP changes can occur after shunt valve setting adjustments. This observation should be taken into account when performing ICP-guided valve adjustments and is highly relevant for the future development of “smart” shunt systems.

الإتاحة: https://doi.org/10.1007/s00701-020-04462-yTest

المؤلفون: D’Antona, Linda, Thompson, Simon David, Thorne, Lewis, Watkins, Laurence Dale, Toma, Ahmed Kassem

المصدر: Neurosurgery ; volume 87, issue 6, page E707-E708 ; ISSN 0148-396X 1524-4040

الإتاحة: https://doi.org/10.1093/neuros/nyaa386Test
https://academic.oup.com/neurosurgery/article-pdf/87/6/E707/41162200/nyaa386.pdfTest

المؤلفون: D'Antona, Linda, Palasz, Joanna, Haq, Huzaifah, Usher, Inga, De-Saram, Sophia, Curtis, Carmel, Thorne, Lewis, Watkins, Laurence Dale, Toma, Ahmed Kassem

المساهمون: UCLH Biomedical Research Centre

المصدر: World Neurosurgery ; volume 140, page 486-488 ; ISSN 1878-8750

مصطلحات موضوعية: Neurology (clinical), Surgery

الإتاحة: https://doi.org/10.1016/j.wneu.2020.06.034Test
https://api.elsevier.com/content/article/PII:S1878875020312924?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1878875020312924?httpAccept=text/plainTest

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 ; volume 37, issue 1, page 112-115 ; ISSN 0268-8697 1360-046X

الإتاحة: https://doi.org/10.1080/02688697.2022.2066629Test

المؤلفون: D'Antona, Linda, Asif, Hasan, Craven, Claudia Louise, McHugh, James Alexander, Vassiliou, Anna, Thorne, Lewis, Matharu, Manjit Singh, Watkins, Laurence Dale, Bremner, Fion, Toma, Ahmed Kassem

المصدر: Neurology ; volume 96, issue 22 ; ISSN 0028-3878 1526-632X

الإتاحة: https://doi.org/10.1212/wnl.0000000000012023Test

المؤلفون: D’Antona, Linda, Craven, Claudia Louise, Bremner, Fion, Matharu, Manjit Singh, Thorne, Lewis, Watkins, Laurence Dale, Toma, Ahmed Kassem

المصدر: Journal of Neurosurgery; Jun2022, Vol. 136 Issue 6, p1781-1789, 9p

المؤلفون: Funnell, Jonathan Perry, D’Antona, Linda, Craven, Claudia Louise, Thorne, Lewis, Watkins, Laurence Dale, Toma, Ahmed Kassem

المصدر: Acta Neurochirurgica ; volume 162, issue 12, page 2967-2974 ; ISSN 0001-6268 0942-0940

مصطلحات موضوعية: Neurology (clinical), Surgery

الإتاحة: https://doi.org/10.1007/s00701-020-04596-zTest