11/633. Fetal hydrocephalus secondary to intraventricular hemorrhage diagnosed by ultrasonography and in utero fast magnetic resonance imaging. A case report.Although fetal hydrocephalus is commonly detected by prenatal ultrasonographic examination, posthemorrhagic hydrocephalus has rarely been observed in the fetus. We report a case of hydrocephalus secondary to intraventricular hemorrhage (IVH) diagnosed by in utero magnetic resonance imaging (MRI) at 37 1 weeks of gestation. ultrasonography revealed enlargement of the bilateral ventricles and an irregular mass measuring 20 x 12 x 10 mm in the right lateral ventricle. T1-weighted images with two-dimensional fast low-angle shot (2D-FLASH) and T2-weighted images with half-Fourier single-shot turbo spin echo (HASTE) demonstrated that an old hemorrhagic clot existed in the right lateral ventricle of the fetus. hydrocephalus secondary to IVH was confirmed by postnatal MRI and ventriculoscopy. Fast MRI is especially useful for prenatal diagnosis of fetal brain abnormalities because it minimizes the artifact of fetal movement.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
12/633. Endoscopic-guided proximal catheter placement in treatment of posterior fossa cysts.PURPOSE: Treatment of posterior fossa cysts by cystoperitoneal shunting may be complicated by a malpositioned proximal catheter located within the brainstem or cerebellum causing acute shunt malfunction or neurological deficits. We propose that proximal catheter placement from a posterior fossa approach aided by a malleable endoscope may prevent malposition and its complications. methods: We present 4 procedures we performed on 3 patients with posterior fossa cysts using a posterior fossa approach. In each case, the proximal catheter was molded along with a malleable endoscope to place the catheter parallel to the long axis of the fourth ventricle. Direct visualization during catheter placement insured an intracavitary position. RESULTS: Ultimately, the procedure was successful in all 3 patients as judged by intracavitary catheter position and decrease in cyst size on postoperative imaging. In 1 patient, revision using the same technique was required based upon suboptimal catheter position within one of numerous cystic compartments within the posterior fossa. There were no complications related to direct or indirect brainstem injury. CONCLUSIONS: Many posterior fossa cysts can be treated effectively and safely via a posterior fossa approach with the aid of a malleable endoscope. Direct visualization facilitates intracavitary catheter placement and orientation of the catheter in the long axis of the cyst, thereby decreasing the risk of injury to surrounding structures.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
13/633. Globular glioma of the tectum.Brainstem gliomas are a heterogeneous group of tumors whose prognosis and treatment depend not only on the histologic features but also on the location within the brainstem. magnetic resonance imaging allows the recognition of a distinct type of brainstem glioma of the tectal region of the midbrain, leading to aqueductal compression and hydrocephalus. The radiologic appearance of these tumors is usually rather uniform, with a characteristic nonenhancing thickening of the tectal plate. Because of its protracted course, no further treatment is necessary beyond cerebrospinal fluid diversion and close clinicoradiologic follow-up. The authors report two children with tectal plate gliomas of unusual but strikingly similar appearance. They present a clinical picture suggestive of intracranial hypertension without localizing signs. Magnetic resonance images reveal hydrocephalus related to the presence of perfectly circular lesions, hypointense on T1 and hyperintense on T2, which could be mistaken for parasitic cysts or represent dilated rostral portions of the sylvian aqueduct. After the cerebrospinal fluid diversion procedures, no further treatment was given, with one of the patients being monitored for 10 years and the other for 8 months, without tumor progression. These patients demonstrate that tectal gliomas, despite sharing a good prognosis, may have various patterns of growth, leading to unusual radiologic appearances that may pose diagnostic difficulties.- - - - - - - - - - ranking = 3keywords = brain (Clic here for more details about this article) |
14/633. Bilateral sensorineural deafness, partial agenesis of the corpus callosum, and arachnoid cysts in two sisters.We describe two sisters (ages 10 and 3 years, respectively) with a normal development and a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, arachnoid cyst, and hydrocephalus. Neither girl has distinctive physical anomalies. In the oldest girl, there was a hearing loss of 80 dB bilaterally, and the most severe loss on audiogram was seen at 2,000-4,000 Hz. In the youngest girl, there was a hearing loss of 100 dB bilaterally. Above 2,000 Hz no neural reactions were seen. Cerebral magnetic resonance imaging in one girl and computed tomography in the other showed a partial agenesis of the corpus callosum and a cyst in the pineal region, causing an aqueduct stenosis by compression and consequent hydrocephalus. The parents have normal hearing, and brain magnetic resonance imaging showed no abnormalities. They are nonconsanguineous but from the same small village. This is the first report of a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, and an arachnoid cyst. The pattern of inheritance is probably autosomal recessive.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
15/633. cleidocranial dysplasia with neonatal death due to central nervous system injury in utero: case report and literature review.cleidocranial dysplasia (CCD), an uncommon disorder involving membranous bones, is rarely lethal in early life. The calvaria is defective and wormian bones are present. Abnormalities of the clavicles vary in severity from a minor unilateral defect to bilateral absence. This report concerns pre- and postmortem anatomical and radiological findings in a 15-day-old female neonate with CCD. Her postnatal course was characterized by seizures and recognition of hydrocephalus during the first day of life. The calvaria was hypoplastic with numerous wormian bones. A pseudofracture of the right clavicle was present. hydrocephalus was present in the brachycephalic brain which had a severely thinned cerebral cortex. hemosiderin in the ventricular lining and marked subependymal gliosis were interpreted as evidence of old intraventricular hemorrhage that had occurred in utero. A CCD-related condition, Yunis-Varon syndrome (YVS), is noted for early lethality and for developmental and secondary abnormalities of the central nervous system. The present case only partially matches the phenotype of YVS and might represent a part of a spectrum of phenotypic variants ranging from viable CCD to lethal YVS.- - - - - - - - - - ranking = 22.371963048853keywords = cerebral, brain (Clic here for more details about this article) |
16/633. Variants of congenital ocular motor apraxia: associations with hydrocephalus, pontocerebellar tumor, and a deficit of vertical saccades.BACKGROUND: Congenital ocular motor apraxia (coma) is characterized by the inability to generate volitional horizontal saccadic eye movements in the absence of other focal neurologic abnormalities. SUBJECTS: We report on two children (ages 5 months and 3 years) whose coma did not adhere to these classic criteria. The children were followed up clinically with serial ocular motor examinations and neuroimaging over a period of 3 years. RESULTS: In the first child horizontal coma was associated initially with neonatal communicating hydrocephalus. Two and one half years after the first signs of coma, a fourth ventricle medulloblastoma appeared. The second child, who recovered from a periventricular hemorrhage caused by perinatal asphyxia, manifested vertical coma and compensatory vertical head thrusts. CONCLUSIONS: coma may be associated with hydrocephalus, pontocerebellar tumor, and periventricular hemorrhage. These rare variants of coma emphasize that the eye movement deficits may arise from several locations, cerebral as well as pontocerebellar, in the neuronal pathways generating saccades.- - - - - - - - - - ranking = 21.371963048853keywords = cerebral (Clic here for more details about this article) |
17/633. Intracranial dislocation of a lumbo-peritoneal shunt-catheter: case report and review of the literature.We report on the dislocation of the tip of a lumbo-peritoneal shunting catheter into the cerebral parenchyma 10 months after insertion. The progressive migration towards the deep structures of the brain, once the catheter had left the peritoneal cavity, might have been caused by CSF-flow. Such hypothesis is supported by modern MRI technology visualizing CSF-flow in a spino-cerebral direction.- - - - - - - - - - ranking = 43.743926097706keywords = cerebral, brain (Clic here for more details about this article) |
18/633. External hydrocephalus in primary hypomagnesaemia: a new finding.This paper reports a new finding in two siblings with primary hypomagnesaemia as a result of renal magnesium wasting, namely, rapidly increasing head size. External hydrocephalus and brain shrinkage in primary hypomagnesaemia seen on computed tomography of the brain with reversibility after magnesium treatment has not been reported previously.- - - - - - - - - - ranking = 2keywords = brain (Clic here for more details about this article) |
19/633. dandy-walker syndrome successfully treated with cystoperitoneal shunting--case report.A neonate presented with dandy-walker syndrome manifesting as a large posterior cranial fossa cyst, aplasia of the lower cerebellar vermis, and elevation of the confluence of the sinuses but without hydrocephalus. A cystoperitoneal shunt was placed at one month after birth. The cyst diminished in size, and marked development of the cerebellar hemispheres and descent of the confluence of sinuses were observed, but not vermis development. The primary pathology of dandy-walker syndrome is posterior cranial fossa cyst formation due to passage obstruction in the fourth ventricle exit area and aplasia of the lower cerebellar vermis. The first choice of treatment in patients with dandy-walker syndrome in whom the cerebral aqueduct is open is cystoperitoneal shunt surgery, regardless of the presence or absence of hydrocephalus.- - - - - - - - - - ranking = 21.371963048853keywords = cerebral (Clic here for more details about this article) |
20/633. Severe factor v deficiency and neonatal intracranial haemorrhage: a case report.We report a case of severe factor V (FV) deficiency (<1%) associated with multiple episodes of intracranial bleeding which presented at birth. The clinical course was further complicated by the development of an inhibitor, episodes of sepsis and cardiac failure. The management using virally inactivated FFP and platelets is discussed.- - - - - - - - - - ranking = 205.19061512208keywords = haemorrhage (Clic here for more details about this article) |
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