The Role of Choroid Plexus in Hydrocephalus from the Perspective of Structure and Function: a Therapeutic Target.

Hydrocephalus is one of the most common neurological diseases, characterized by abnormal excessive accumulation of cerebrospinal fluid (CSF) in the ventricular system. Its pathophysiological mechanism is believed to be related to the imbalance of CSF circulation and homeostasis. As the main source of CSF secretion, the choroid plexus is closely related to hydrocephalus.

Preoperative imaging biomarkers combined with tap test for predicting shunt surgery outcome in idiopathic normal pressure hydrocephalus: a multicenter retrospective study.

Objectives: The study aims to investigate the predictive performance of preoperative imaging features combined with tap test for the outcomes of ventriculoperitoneal (VP) shunt in idiopathic normal pressure hydrocephalus (iNPH).

Methods: In this multicenter retrospective study, 166 iNPH patients who underwent VP shunt surgery between August 2019 and November 2023 were included. Preoperative clinical characteristics and imaging features were collected.

Novel Mutation in Two Siblings With Classic Bartter Syndrome.

Bartter syndrome is a rare genetic illness characterized by impairment in kidney function caused by different gene defects. The primary pathogenic mechanism of Bartter syndrome is defective salt reabsorption, predominantly in the thick ascending limb of the loop of Henle. Here, we present a case series between 2 siblings diagnosed with Bartter syndrome through clinical and genetic analyses.

Case Report: Ultralow-field portable MRI improves the diagnosis of congenital hydrocephalus.

Introduction: Congenital hydrocephalus is an increasing condition both in high as in low and middle income countries. Main causes include aqueductal stenosis, neonatal central nervous system infections, intracranial hemorrhage, malformations and tumors. Investigation of its etiology should include magnetic resonance imaging (MRI) to detect especially pathologies of the fossa cranii posterior.

Fetoscopic repair of open spina bifida between 26 0/7 and 27 6/7 gestational weeks and postnatal cerebrospinal fluid diversion.

Objective: To assess the rate and risk factors for cerebrospinal fluid (CSF) diversion among cases of prenatal repair of open spina bifida (OSB) performed from 26 0/7 to 27 6/7 gestational weeks, given a traditional cutoff of 25 6/7 weeks.

Methods: This is a descriptive study of patients who underwent fetoscopic OSB repair (2019-2023) from 26 0/7 to 27 6/7 gestational weeks. Data were collected prospectively and examined as predictors of CSF diversion (ventriculoperitoneal shunt or endoscopic third ventriculostomy) within the first 12 months of life.

Case of endocarditis triggering both ischemic and haemorrhagic stroke: A rare clinical presentation from eastern India.

We report a rare clinical presentation of a 54-year-old male diagnosed with infective endocarditis caused by , a nutritionally variant streptococcus (NVS) characterized by unique growth requirements and high pathogenic potential. The patient presented with prolonged fever and residual hemiparesis following an ischemic stroke. Blood culture confirmed , and imaging identified vegetations on a bicuspid aortic valve.

Severe status epilepticus induced by shunt malfunction: A case report.

Introduction: Focal impaired awareness seizures are a common neurological disorder characterized by abnormal electrical activity in a specific brain region, resulting in impaired consciousness and neurological symptoms. Treatment options for patients may include antiepileptic medications, lifestyle modifications, or, in some cases, surgical intervention aimed at resecting the area of the brain responsible for seizure generation. Shunt malfunction can lead to seizures in cases of hydrocephalus; however, seizures triggered by stimulation of a specific brain area by the shunt catheter post-placement have not been reported.

Case Report: A modified approach to converting ventriculoperitoneal shunt to ventriculoatrial shunt due to recurrent encapsulation of the peritoneal catheter.

Background: Hydrocephalus is a condition characterized by the accumulation of cerebrospinal fluid (CSF) in the ventricular system due to various causes, including excessive CSF production, impaired circulation, or absorption dysfunction. This condition is often accompanied by ventricular enlargement, compression of brain parenchyma, and increased intracranial pressure. Ventriculoperitoneal (VP) shunting is the first-line treatment for hydrocephalus; however, when the peritoneal catheter becomes obstructed due to encapsulation, the procedure may need to be converted to a ventriculoatrial (VA) shunt, which serves as a second-line treatment.

Most infants with prenatal osteogenesis imperfecta diagnosis and poor prognosis survive: experience of a quaternary care osteogenesis imperfecta center.

Osteogenesis imperfecta is a genetic condition with improperly or inadequately produced Type I collagen. Manifestations include bowing deformities, fractures, hydrocephalus, respiratory insufficiency, and feeding difficulty. Moderate or severe OI is often diagnosed prenatally based on ultrasound findings and genetic testing may be labeled as lethal.

Ventriculosagittal sinus shunt for treating hydrocephalus with elevated cerebrospinal fluid protein.

This study aimed to investigate the feasibility, acceptability, and preliminary efficacy of a ventriculosagittal sinus (VSS) shunt in the treatment of hydrocephalus with elevated cerebrospinal fluid (CSF) protein content. In this single-center retrospective analysis, we enrolled 80 patients with hydrocephalus and elevated CSF protein levels. Based on these procedures, primary cohort was divided into two groups using CSF protein (CSFP) for subsequent analysis to determine the relationship between the clinical effect and CSFP.

Treatments for obstructive hydrocephalus secondary to malignant midline intracranial tumors during the perioperative period - a retrospective study of 372 pediatric patients from a single institution.

Objective: Common treatments for obstructive hydrocephalus caused by malignant midline intracranial tumors during the perioperative period include ventriculoperitoneal shunt (VPS) placement, endoscopic third ventriculostomy (ETV), and direct tumor resection. The purpose of this study is to determine whether it is necessary to treat hydrocephalus before tumor resection and to clarify which treatment is most effective.

Methods: Data from 372 pediatric patients (under 18 years) with obstructive hydrocephalus due to malignant midline intracranial tumors, referred to the Department of Pediatric Neurosurgery at Beijing Tiantan Hospital between January 2018 and September 2019, were collected.

Peripapillary alterations in Idiopathic Normal Pressure Hydrocephalus.

Purpose: To evaluate the peripapillary area in eyes of patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) before and after shunt surgery.

Methods: Twenty iNPH patients were prospectively recruited. Enhance depth imaging-optical coherence tomography (EDI-OCT) was performed to image the peripapillary region.

Long-term gait improvement following a CSF tap test in idiopathic normal pressure hydrocephalus patients: an analysis of clinical outcomes.

Objectives: To evaluate the sustained effects of the cerebrospinal fluid (CSF) tap test (TT) on gait parameters over one month in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods: A retrospective study was conducted on 150 patients with iNPH from two university hospitals who underwent CSF TT and quantitative gait analysis. Gait parameters, including walking speed (WS) and stride length (SL), were measured before, within 24 h after, and one month after the CSF TT.

Primary Leptomeningeal Lymphoma Presenting As Rapidly Progressive Hydrocephalus: Diagnosis and Symptom Relief Through Endoscopic Ependymal Biopsy and Third Ventriculostomy.

Primary leptomeningeal lymphoma (PLML) is a rare variant of primary central nervous system lymphoma, distinguished by the absence of parenchymal lesions. We describe an exceptionally rare case of PLML in an 86-year-old woman presenting with hydrocephalus. Magnetic resonance imaging showed ventricular enlargement over a two-week period, accompanied by faint periventricular contrast enhancement.

A review of cerebrospinal fluid circulation with respect to Chiari-like malformation and syringomyelia in brachycephalic dogs.

Cerebrospinal fluid (CSF) plays a crucial role in maintaining brain homeostasis by facilitating the clearance of metabolic waste and regulating intracranial pressure. Dysregulation of CSF flow can lead to conditions like syringomyelia, and hydrocephalus. This review details the anatomy of CSF flow, examining its contribution to waste clearance within the brain and spinal cord.

Severe brainstem dysfunction in a neonate following intrauterine myelomeningocele repair: illustrative case.

Background: Caudal brainstem dysfunction associated with Chiari malformation type II (CM-II) is an important source of morbidity and mortality in neonates with myelomeningocele (MMC).

Observations: Prenatal MMC repair has been shown to improve or even completely reverse the extent of hindbrain herniation (HH) associated with CM-II as well as reduce the incidence of hydrocephalus requiring CSF diversion, possibly leading to a reduction in CM-II-related symptoms in these children. Urgent CSF diversion and potential CM-II decompression surgery are typically the preferred treatments for infants demonstrating caudal brainstem dysfunction, although contemporary reports have described a decreased need for both CSF diversionary surgery and CM-II decompression following prenatal MMC repair.

Diagnosis of shunt nephritis through cerebrospinal fluid culture: avoiding the need for kidney biopsy. Illustrative case.

Background: Shunt nephritis, although rare, should be high in the differential diagnoses for patients with gross or microscopic hematuria and a history of a ventriculoatrial/cystoatrial shunt.

Observations: The authors present the case of a 31-year-old female with a history of a resected posterior fossa hemangioblastoma and hydrocephalus, who presented to the nephrology clinic with night sweats and tea-colored urine for 3 months after being hospitalized for a saddle pulmonary embolism; kidney biopsy was contraindicated. The patient had hypocomplementemia, nephrotic-range proteinuria, positive proteinase 3-specific antineutrophil cytoplasmic antibody, and dysmorphic red blood cells in the urine sediment.

Minimally invasive interventions for intracranial pathologies using tubular retractors in the pediatric population: Safety, efficacy, technical aspects and outcomes.

Background: Minimally invasive surgeries for intracranial pathologies are gaining popularity, recognizing the intrinsic benefits, mostly related to recovery time, while minimizing injury to healthy parenchyma and adjacent functional areas, especially during the resection of deep and centrally located lesions. These procedures require technical familiarity and cultivated surgical experience, coupled with dedicated instruments, appropriate planning, and a stringent patient selection.

Objective: To describe our novel experience with minimally invasive trans-sulcal parafascicular surgery (MIPS) in a single-center pediatric population, emphasizing the interdependencies between surgical experience, best practices, preparation, and positive surgical outcomes.

Distinguishing Pathologic Gait in Older Adults Using Instrumented Insoles and Deep Neural Networks.

Gait abnormalities are common in the older population owing to aging- and disease-related changes in physical and neurological functions. Differentiating the causes of gait abnormalities is challenging because various abnormal gaits share a similar pattern in older patients. Herein, we propose a deep neural network (DNN) model to classify disease-specific gait patterns in older adults using commercialized instrumented insoles.

Hydrocephalus Renders Ventricular or Subarachnoid Drainage as an Efficacies Cure for Decompressive Craniectomy-Induced Subdural Effusion After Traumatic Brain Injury.

Objective: Traumatic brain injury (TBI) patients with decompressive craniectomy (DC) frequently accompany the complication of secondary subdural effusion (SDE). In cases where cranioplasty is contraindicated, there are no clear-cut guidelines on surgical approaches for managing subdural effusion resulting from DC. Therefore, the authors conducted this study to compare different surgical procedures for patients with SDE in the context of contraindications for cranioplasty.

Relationship Between CNS Infections, Stroke, and Neurological Complications: A Case Series.

Central nervous system infections and complications such as meningitis and stroke in immunocompromised patients can be caused by a wide spectrum of pathogens, including bacteria, viruses, parasites, or fungi. This case series first presents a case of a 24-year-old Latino male patient with HIV, cytomegalovirus (CMV) encephalitis, a positive CSF for antigen, and a stroke, who presented to the primary care office with a headache and double vision. With his symptoms now occurring for more than two months without improvement, the patient was sent to the ED for a repeat MRI, where an enlargement of his ventricles compatible with hydrocephalus was observed.

Effect of priority cranioplasty on post-traumatic hydrocephalus with severe collapse of brain tissue: A case report.

Trephine syndrome and post-traumatic hydrocephalus are frequent complications following decompressive craniectomy in patients with traumatic brain injury. The recommended treatments for trephine syndrome and post-traumatic hydrocephalus include cranioplasty and ventriculoperitoneal shunt placement. However, There is no consensus on the priority of these two procedures.

Chronic Traumatic Encephalopathy Neuropathologic Change is Infrequent Following Isolated Moderate-Severe Traumatic Brain Injury.

Chronic traumatic encephalopathy-neuropathologic change (CTE-NC) has been primarily studied in contact sport athletes with repetitive head impacts (RHI). An association with isolated traumatic brain injury (TBI) is less clear. We systematically reviewed the autopsied cohort of Late Effects of TBI (LETBI), characterized primarily by isolated TBI but also including RHI, for features of CTE-NC.

Childhood disabilities, household poverty, and inequality: A population-based case-control study in rural Bangladesh.

Aim: To explore the relationship between household poverty, inequality, and disability among children in rural Bangladesh.

Method: This was a matched case-control study in Shahjadpur, northern Sirajganj, Bangladesh. Children aged younger than 18 years with disabilities (i.

Reducing complications in duraplasty with autologous dural graft material: A meta-analysis.

Objective: This review aims to perform qualitative and quantitative analysis to determine which dural graft materials are preferable for neurosurgical patients.

Methods: A literature search using the PubMed database was conducted to collect relevant articles that compared complications associated with autologous and non-autologous dural grafts. The extracted data included graft type and related complications.