Posthemorrhagic hydrocephalus and shunts: what are the predictors of multiple revision surgeries?

Object: Cerebrospinal fluid shunts in patients with posthemorrhagic hydrocephalus are prone to failure, with some patients at risk for multiple failures. The objective of this study was to identify factors leading to multiple failures.

Methods: The authors performed a retrospective analysis of cases of posthemorrhagic hydrocephalus requiring neurosurgical intervention between 1982 and 2010.

How bullet trajectory affects outcomes of civilian gunshot injury to the spine.

We analysed retrospectively the effect of missile trajectory on outcomes from civilian gunshot injury to the spine (GSIS) between 1994 and 2008. Most of the 98 patients were male (88.8%).

Cerebellar lesion.

Lhermitte-Duclos disease is a rare cerebellar lesion that poses many diagnostic, pathophysiologic and therapeutic conundrums. Here we present a case that highlights the most important imaging characteristics for diagnosis, the pathophysiology of the disease, and the current management recommendations.

Role of stereotactic radiosurgery as a primary treatment option in the management of newly diagnosed multiple (3-6) intracranial metastases.

Objective: The objective of this study was to assess the role of stereotactic radiosurgery in the management of newly diagnosed multiple intracranial metastases from known primary cancer locations.

Methods: Fifty (29 women and 21 men) patients received radiosurgery for newly diagnosed 3 or more metastatic brain tumors. Their mean age was 53 years.

Ventriculosubgaleal shunts for posthemorrhagic hydrocephalus in premature infants.

Objective: The early management of posthemorrhagic hydrocephalus in premature infants is challenging and controversial. These infants need a temporary cerebrospinal fluid (CSF) diversion procedure until they gain adequate weight, and the blood and protein levels in CSF are reasonably low before permanent shunt can be placed. Various options are available with their associated advantages and disadvantages.

Diffuse back pain and urological symptoms: recognizing tethered cord syndrome early.

Tethered cord syndrome (TCS) is a rare entity in adults, with only about 100 cases being reported in the literature. It is a syndrome in which patients have neurologic, urologic, and orthopedic signs and symptoms. We present a case of a 40-year-old man with back pain and urinary incontinence who was diagnosed with tethered cord syndrome.

Metastatic lesions involving the sella: report of three cases and review of the literature.

Metastatic cancer must be considered as a possibility for intrasellar masses. Newer treatment modalities, such as gamma knife radiosurgery needs to be explored for these lesions. Three cases of intrasellar metastatic lesions were retrospectively reviewed.

Survival trends in elderly patients with glioblastoma multiforme: resective surgery, radiation, and chemotherapy.

Background: It is appropriate to investigate and to determine survival trends following glioblastoma multiforme treatment using resective surgery, radiation therapy, and/or chemotherapy in patients aged 59 years and higher.

Methods: We retrospectively reviewed 30 elderly patients (> or =59 years old) who were treated for histopathologically confirmed glioblastoma multiforme at our tertiary care institution from 1990 through 2002. All patients were treated with steroids.

A case report of complete disappearance of essential tremor after Gamma Knife radiosurgery.

Pharmacological therapy for essential tremor (ET), the most common movement disorder, remains largely unsatisfactory. Surgical options such as radiofrequency or thermocoagulation are only suitable for a select group of patients, the young and those free of pre-existing medical conditions. Radiosurgery using the Leksell Gamma Knife has recently gained acceptance as a viable treatment option for tremor control in ET patients.

Gamma knife radiosurgery for trigeminal neuralgia: a study of predictors of success, efficacy, safety, and outcome at LSUHSC.

Background: Trigeminal neuralgia (TN) is a painful condition of controversial origin; however, vascular compression of the root entry zone of the trigeminal nerve is thought to be responsible in some cases. Recently, stereotactic radiosurgery has been established as an alternative treatment for medically intractable TN.

Methods: Forty patients with medically refractory TN underwent gamma knife surgery for pain control at our institution.

Gamma knife surgery in the management of brain metastases from lung carcinoma: a retrospective analysis of survival, local tumor control, and freedom from new brain metastasis.

Object: The objective of this retrospective study was to analyze the results of stereotactic radiosurgery performed using a gamma knife in the treatment of 44 consecutive patients with brain metastases from lung carcinoma.

Methods: Forty-four patients with lung carcinoma were treated for metastatic brain tumors by performing radiosurgery with a Leksell Gamma Knife. Twenty-one patients (47.

Management of epidural cauda equina disease of prostate cancer by radiotherapy.

Objective: Secondary prostate cancer affection of the cauda equina (SPCCE) can be an ultimate cause of morbidity and mortality. Since the results of management of this particular disease condition remain largely unknown, a retrospective case review was undertaken to determine the effects of treatment by radiation in SPCCE patients.

Methods: The records of 12 patients with SPCCE treated at the Division of Therapeutic Radiology during the period 1984 to 1998 were reviewed.

Gamma knife radiosurgery for brain metastases: do patients benefit from adjuvant external-beam radiotherapy? An 18-month comparative analysis.

Objective: To analyze 18 months of results of gamma knife stereotactic radiosurgery in the treatment of brain metastases and determine factors affecting outcome by examining the effectiveness of additional external-beam radiotherapy (XRT).

Materials And Methods: Between January 2000 and September 2001, 61 patients with 103 tumors diagnosed as cerebral metastases were treated with gamma knife. Mean patient age was 57 years (range = 36-81).

Management of carotid artery injuries: Louisiana State University Shreveport experience.

Background: Traumatic carotid artery injury is an infrequently encountered surgical entity. Carotid artery injuries in polytrauma patients can be easily missed in the absence of clinical findings and/or presence of confounding concurrent injuries.

Methods: Between 1991 and 1998, 23 patients were diagnosed with various carotid artery injuries at the trauma center of Louisiana State University Health Sciences Center, Shreveport, Louisiana.

Selective intraoperative angiography in intracranial aneurysm surgery: intraoperative factors associated with aneurysmal remnants and vessel occlusions.

Background: The objective of this study was to assess the role of selective intraoperative angiography and to analyze the factors associated with faulty clip application.

Methods: Two hundred thirty-eight patients undergoing surgery for intracranial aneurysms were studied consecutively for intraoperative angiography (IOA)-related events. The procedure was performed in 155 operations.

First 100 cases of gamma knife radiosurgery in Louisiana: analysis of demographics and early results.

Louisiana's first ever Leksell Gamma Knife was commissioned at Louisiana State University Health Sciences Center (LSUHSC) in Shreveport in January 2000. Between January 2000 and January 2001,113 patients with various indications were treated using the 201-source Co-60 Leksell model "B" Gamma Knife (Elekta Instruments, Atlanta, Georgia) at LSUHSC-Shreveport. Sixty-three patients were female and 50 were male.