Increased ventriculostomy infection rate with use of intraventricular tissue plasminogen activator: a single-center observation.

Objective: Intraventricular tissue plasminogen activator (alteplase) has been advocated for prevention of vasospasm in aneurysmal subarachnoid hemorrhage and treatment of traumatic or spontaneous intraventricular hemorrhage. External ventricular drain (EVD) insertion is often performed to manage increased intracranial pressure and hydrocephalus associated with these disease states. EVD-related ventriculitis is a serious infection with an up to 50% mortality rate.

Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy.

Objective: To report a series of four patients with uterine sarcoma, including one with müllerian adenosarcoma (MA) and three with low-grade endometrial stromal sarcoma (LGESS), who developed intracranial meningiomas while receiving the progesterone agonist megestrol acetate.

Methods: The hospital records, imaging studies, and pathology slides of four patients who were treated for uterine sarcomas and subsequently developed intracranial meningiomas were reviewed.

Results: All patients underwent surgery for their gynecologic cancers and received maintenance therapy with long-term hormonal suppression with megestrol acetate.

Endovascular treatment of a large aneurysm arising from a basilar trunk fenestration using the waffle-cone technique.

Objective: Endovascular treatment of large intracranial aneurysms arising from a fenestrated parent vessel may prove particularly difficult. We present a case of a large, broad-based aneurysm arising from a proximal basilar artery (BA) fenestration treated with the waffle-cone technique. Technical nuances and indications for this treatment option are reviewed.

Healthcare savings associated with reduced infection rates using antimicrobial suture wound closure for cerebrospinal fluid shunt procedures.

Background/aims/methods: This is a follow-up study from a recent randomized controlled trial conducted at the Women and Children's Hospital of Buffalo that investigated the use of antimicrobial sutures (AMS) for wound closure during cerebrospinal fluid shunting procedures. Our purpose was to determine the average cost of shunt infections at our institution and estimate the healthcare savings associated with reduced infection rates secondary to AMS use.

Result: We found that the treatment and management of a shunt infection resulted in a 5.

Pediatric neurosurgical practice patterns designed to prevent cerebrospinal fluid shunt infection.

Background/aims: Various factors have been associated with cerebrospinal fluid (CSF) shunt infection risk, leading to many recommendations intended to reduce that risk. We sought to assess current North American pediatric neurosurgical practice patterns in this regard via a web-based survey. Particular attention was paid to the use of antibiotic-impregnated materials and prophylactic perioperative antibiotics.

Transient ventriculomegaly in an adolescent presenting with shunted hydrocephalus, diabetic ketoacidosis, and hyperglycemia.

In this report, the authors describe a unique presentation of ventriculomegaly in the setting of diabetic ketoacidosis (DKA). A 15-year-old male, with a history of shunt placement for hydrocephalus and repair of a myelomeningocele, presented to the emergency room with DKA and was found to have ventriculomegaly. At the time of presentation, the patient had a 24- to 48-hour history of lethargy, nausea, vomiting, fever (102.

Thoracolumbar spine subdural hematoma as a result of nonaccidental trauma in a 4-month-old infant.

The authors describe the previously unreported occurrence of thoracolumbar subdural hematoma (SDH) resulting from nonaccidental trauma and emphasize the need for a complete and thorough neurological, physical, and radiological examination in all cases of suspected nonaccidental trauma. A 4-month-old male infant presented to the authors' Level 1 pediatric trauma center in respiratory arrest. According to the family, he had been previously healthy with a 1-day history of fussiness and irritability.