Purpose: In the pediatric population urodynamic evaluation for nonneurological causes has been previously reported as a low yield endeavor when considering patients with a primary diagnosis of dysfunctional voiding. We evaluated the rate of clinically significant urodynamic findings that would drive therapeutic intervention for a spectrum of urological disorders in pediatric patients without neurological deficit in whom initial conventional management had failed.
Materials And Methods: We retrospectively reviewed the charts of patients who had undergone urodynamics in the last 7 years. Patients with known neurological deficits were excluded.
Results: A total of 805 pediatric urodynamic evaluations were performed from December 1997 to July 2004 at our institution, including 89 in patients with no known neurological diagnosis and charts available for review. Of the urodynamic studies 33 (37.1%) were reported as normal and 56 patients (62.9%) had clinically significant discoveries. Storage phase abnormalities were the predominant finding in 37 patients (66.1%), including uninhibited detrusor contractions in 31 (55.4%). Emptying phase abnormalities were less common (19 patients or 33.9%). There was no difference in the percent of patients with positive urodynamics findings depending on sex.
Conclusions: In our analysis evaluation of all recent urodynamics performed at a single institution revealed a high rate of pathological findings in patients with various nonneurological diagnoses.
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http://dx.doi.org/10.1016/j.juro.2006.03.125 | DOI Listing |
J Neurosurg Case Lessons
January 2025
The Trauma and Neuroscience Institutes, St. John's Hospital and Medical Center, Tulsa, Oklahoma.
Background: Direct carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and/or intraparenchymal hemorrhage.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida.
Background: Radiation-induced sarcoma (RIS) is an exceptionally rare occurrence following radiation therapy, and manifestation usually occurs after a several-year latency period. Herein, the authors report the development of a radiation-induced osteosarcoma of the frontoparietal calvaria following treatment for an oligodendroglioma in an 84-year-old woman.
Observations: The patient had been diagnosed with a grade III anaplastic oligodendroglioma when she was 78 years old.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany.
Background: Optic nerve schwannomas are an extremely rare pathology in neurosurgery. Their origin is rather debatable given the structure of the optic nerve, which does not typically have Schwann cells therein. However, a number of clinical cases of optic nerve tumors classified as schwannomas have been described in the literature.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, Department of Stroke, University Hospital Cleveland Medical Center, Case Western Reserve University, Cleveland, OH.
Background And Objectives: Although previous trials have established the efficacy and safety of endovascular thrombectomy (EVT) in large ischemic core strokes, most of them excluded patients with extracranial internal carotid artery (e-ICA) occlusion. We aimed to compare outcomes in patients with e-ICA occlusion and large ischemic core infarcts treated with EVT vs medical management (MM).
Methods: This was a secondary analysis of the SELECT2 trial, a randomized controlled trial conducted at 31 international sites.
Stroke
February 2025
Division of Interventional Neuroradiology, Department of Radiology (H.C., S.M., D.G.), University of Maryland Medical Center, Baltimore.
Background: Sex-specific differences in stroke risk factors, clinical presentation, and outcomes are well documented. However, little is known about real-world differences in transient ischemic attack (TIA) hospitalizations and outcomes between men and women.
Methods: This was a retrospective cohort study of the 2016 to 2021 Nationwide Readmissions Database in the United States.
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