The Experts below are selected from a list of 216 Experts worldwide ranked by ideXlab platform

Gianfranco Rossi - One of the best experts on this subject based on the ideXlab platform.

  • Cerebrospinal Fluid Shunting for Hydrocephalus in the Adult: Factors Related to Shunt Revision
    Neurosurgery, 1991
    Co-Authors: Alfredo Puca, Carmelo Anile, Giulio Maira, Gianfranco Rossi
    Abstract:

    Abstract Cerebrospinal Fluid Shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of Cerebrospinal Fluid. In spite of its popularity, this operation frequently requires surgical revision. A retrospective analysis of a series of 356 adults who underwent the insertion of a Cerebrospinal Fluid shunt between January 1970 and December 1988 was performed. The incidence of revision was analyzed, and an attempt was made to identify possible causal factors. The overall incidence of surgical revisions was 28.65%; the number of revisions in the same patient ranged between one and eight. The most frequent causes of revision were distal malposition, obstruction, and infection. A statistically significant difference (P < 0.05) was found in both the risk of revision in patients who had undergone previous operations and those who had not and in the incidence of revision before and after January 1985. Meticulous surgical technique as well as perioperative antibiotic prophylaxis appear responsible for the latter. The differences in the incidence of revision among patients treated with different types of shunts and valves, though remarkable, is not statistically significant.

  • Cerebrospinal Fluid Shunting for hydrocephalus in the adult: factors related to shunt revision.
    Neurosurgery, 1991
    Co-Authors: Alfredo Puca, Carmelo Anile, Giulio Maira, Gianfranco Rossi
    Abstract:

    Cerebrospinal Fluid Shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of Cerebrospinal Fluid. In spite of its popularity, this operation frequently requires surgical revision. A retrospective analysis of a series of 356 adults who underwent the insertion of a Cerebrospinal Fluid shunt between January 1970 and December 1988 was performed. The incidence of revision was analyzed, and an attempt was made to identify possible causal factors. The overall incidence of surgical revisions was 28.65%; the number of revisions in the same patient ranged between one and eight. The most frequent causes of revision were distal malposition, obstruction, and infection. A statistically significant difference (P less than 0.05) was found in both the risk of revision in patients who had undergone previous operations and those who had not and in the incidence of revision before and after January 1985. Meticulous surgical technique as well as perioperative antibiotic prophylaxis appear responsible for the latter. The differences in the incidence of revision among patients treated with different types of shunts and valves, though remarkable, is not statistically significant.

Kazushige Wakuda - One of the best experts on this subject based on the ideXlab platform.

  • palliative Cerebrospinal Fluid Shunting for leptomeningeal metastasis related hydrocephalus in patients with lung adenocarcinoma a single center retrospective study
    PLOS ONE, 2019
    Co-Authors: Koichi Mitsuya, Yoko Nakasu, Nakamasa Hayashi, Shoichi Deguchi, Toshiaki Takahashi, Haruyasu Murakami, Tateaki Naito, Hirotsugu Kenmotsu, Akira Ono, Kazushige Wakuda
    Abstract:

    Purpose Management of leptomeningeal metastasis-related hydrocephalus (LM-H) is particularly challenging regarding the control of severe headache, nausea, and vomiting due to intracranial hypertension. To investigate the improvements of performance status and outcome with Cerebrospinal Fluid (CSF) shunt surgery for LM-H in patients with lung adenocarcinoma. Methods Data on patients with leptomeningeal metastasis-related hydrocephalus from lung adenocarcinoma diagnosed by MR imaging and/or cytological examination were retrospectively analyzed. Between August 2008 and July 2017, the authors reviewed 31 patients requiring CSF shunt, who underwent ventriculo-peritoneal or lumbo-peritoneal shunt. Results The patients consisted of 11 men and 20 women with a median age of 59 years. Twenty-six patients received EGFR-tyrosine kinase inhibitors (TKIs). CSF shunt surgery yielded rapid improvement in the performance status of 90.3% of patients. Median overall survival from the diagnosis of LM in patients with ECOG performance status less than 2 was 7.7 months, and this was significantly longer than those in patients with PS 3 or 4 (4.4 or 1.5 months; p<0.001). Multivariate analysis by Cox regression revealed survival differences according to PS at diagnosis of LM [PS 1–3 vs. PS4, hazard ratio (HR) 0.201, p = 0.034], controlled extracranial disease (HR 0.248, p = 0.005), and post-shunt EGFR-TKI for LM treatment (HR 0.193, p = 0.008). Postoperative symptomatic peritoneal carcinomatosis was observed in one patient (3.2%). Conclusion CSF Shunting may be a safe and effective strategy in patients with LM-H from lung adenocarcinoma. A prospective study is needed to establish the effectiveness and safety of palliative CSF shunt for LM-H.

  • Palliative Cerebrospinal Fluid Shunting for leptomeningeal metastasis-related hydrocephalus in patients with lung adenocarcinoma: A single-center retrospective study
    2019
    Co-Authors: Koichi Mitsuya, Yoko Nakasu, Nakamasa Hayashi, Shoichi Deguchi, Toshiaki Takahashi, Haruyasu Murakami, Tateaki Naito, Hirotsugu Kenmotsu, Akira Ono, Kazushige Wakuda
    Abstract:

    PurposeManagement of leptomeningeal metastasis-related hydrocephalus (LM-H) is particularly challenging regarding the control of severe headache, nausea, and vomiting due to intracranial hypertension. To investigate the improvements of performance status and outcome with Cerebrospinal Fluid (CSF) shunt surgery for LM-H in patients with lung adenocarcinoma.MethodsData on patients with leptomeningeal metastasis-related hydrocephalus from lung adenocarcinoma diagnosed by MR imaging and/or cytological examination were retrospectively analyzed. Between August 2008 and July 2017, the authors reviewed 31 patients requiring CSF shunt, who underwent ventriculo-peritoneal or lumbo-peritoneal shunt.ResultsThe patients consisted of 11 men and 20 women with a median age of 59 years. Twenty-six patients received EGFR-tyrosine kinase inhibitors (TKIs). CSF shunt surgery yielded rapid improvement in the performance status of 90.3% of patients. Median overall survival from the diagnosis of LM in patients with ECOG performance status less than 2 was 7.7 months, and this was significantly longer than those in patients with PS 3 or 4 (4.4 or 1.5 months; p

Andreas Niedeggen - One of the best experts on this subject based on the ideXlab platform.

Joanne Kurtzberg - One of the best experts on this subject based on the ideXlab platform.

  • clinical outcome of Cerebrospinal Fluid Shunting for communicating hydrocephalus in mucopolysaccharidoses i ii and iii a retrospective analysis of 13 patients
    Neurosurgery, 2010
    Co-Authors: Hamidreza Aliabadi, Renee M Reynolds, Ciaran J Powers, Gerald A Grant, Herbert E Fuchs, Joanne Kurtzberg
    Abstract:

    BACKGROUND: Intracranial pathology is a well-documented feature of mucopoly-saccharidoses (MPSs), including communicating hydrocephalus (CH). Neither the success nor the complications of Cerebrospinal Fluid Shunting in MPS patients have been well documented. OBJECTIVE: To retrospectively analyze 13 children with communicating hydrocephalus and MPS at our institution between 1998 and 2006. METHODS: Thirteen patients diagnosed with MPS I, II, or III presenting for stem cell transplantation were retrospectively analyzed. Patients underwent a rigorous pre-transplantation workup, including magnetic resonance imaging of the brain. If imaging revealed ventriculomegaly, a lumbar puncture was performed. If intracranial pressure was > 20 cm H 2 0 or the patient demonstrated clinical signs of hydrocephalus or evidence of clinical decline with increasing ventricular size on imaging, a ventriculoperitoneal shunt (VPS) was placed. Clinical outcomes were analyzed after dividing the patients into 2 groups: patients who underwent VPS before (group A) and after (Group B) stem cell transplantation. RESULTS: There were 8 patients in group A and 5 in group B. Group B patients developed more severe complications, including 2 patients who required VPS early after transplantation, one who died secondary to intracerebral hemorrhage and another who developed a subdural empyema. Of the 8 patients in group A, 5 had complications, including 2 shunt infections, a punctate intracerebral hematoma, shunt tube migration, and 3 shunt failures. CONCLUSION: This is the largest review of MPS patients with communicating hydrocephalus. It demonstrates that VPS is an effective treatment. MPS patients need to be evaluated for hydrocephalus before stem cell transplantation because pre-transplantation Shunting appears to have the most favorable risk/benefit ratio.

Alfredo Puca - One of the best experts on this subject based on the ideXlab platform.

  • Cerebrospinal Fluid Shunting for Hydrocephalus in the Adult: Factors Related to Shunt Revision
    Neurosurgery, 1991
    Co-Authors: Alfredo Puca, Carmelo Anile, Giulio Maira, Gianfranco Rossi
    Abstract:

    Abstract Cerebrospinal Fluid Shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of Cerebrospinal Fluid. In spite of its popularity, this operation frequently requires surgical revision. A retrospective analysis of a series of 356 adults who underwent the insertion of a Cerebrospinal Fluid shunt between January 1970 and December 1988 was performed. The incidence of revision was analyzed, and an attempt was made to identify possible causal factors. The overall incidence of surgical revisions was 28.65%; the number of revisions in the same patient ranged between one and eight. The most frequent causes of revision were distal malposition, obstruction, and infection. A statistically significant difference (P &lt; 0.05) was found in both the risk of revision in patients who had undergone previous operations and those who had not and in the incidence of revision before and after January 1985. Meticulous surgical technique as well as perioperative antibiotic prophylaxis appear responsible for the latter. The differences in the incidence of revision among patients treated with different types of shunts and valves, though remarkable, is not statistically significant.

  • Cerebrospinal Fluid Shunting for hydrocephalus in the adult: factors related to shunt revision.
    Neurosurgery, 1991
    Co-Authors: Alfredo Puca, Carmelo Anile, Giulio Maira, Gianfranco Rossi
    Abstract:

    Cerebrospinal Fluid Shunting procedures are widely employed in the treatment of hydrocephalus and other disturbances of the dynamics of Cerebrospinal Fluid. In spite of its popularity, this operation frequently requires surgical revision. A retrospective analysis of a series of 356 adults who underwent the insertion of a Cerebrospinal Fluid shunt between January 1970 and December 1988 was performed. The incidence of revision was analyzed, and an attempt was made to identify possible causal factors. The overall incidence of surgical revisions was 28.65%; the number of revisions in the same patient ranged between one and eight. The most frequent causes of revision were distal malposition, obstruction, and infection. A statistically significant difference (P less than 0.05) was found in both the risk of revision in patients who had undergone previous operations and those who had not and in the incidence of revision before and after January 1985. Meticulous surgical technique as well as perioperative antibiotic prophylaxis appear responsible for the latter. The differences in the incidence of revision among patients treated with different types of shunts and valves, though remarkable, is not statistically significant.